| 1. |
- Forouzanfar, Mohammad H, et al.
(författare)
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Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013 : a systematic analysis for the Global Burden of Disease Study 2013.
- 2015
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Ingår i: The Lancet. - 0140-6736 .- 1474-547X. ; 386:10010, s. 2287-2323
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The Global Burden of Disease, Injuries, and Risk Factor study 2013 (GBD 2013) is the first of a series of annual updates of the GBD. Risk factor quantification, particularly of modifiable risk factors, can help to identify emerging threats to population health and opportunities for prevention. The GBD 2013 provides a timely opportunity to update the comparative risk assessment with new data for exposure, relative risks, and evidence on the appropriate counterfactual risk distribution.METHODS: Attributable deaths, years of life lost, years lived with disability, and disability-adjusted life-years (DALYs) have been estimated for 79 risks or clusters of risks using the GBD 2010 methods. Risk-outcome pairs meeting explicit evidence criteria were assessed for 188 countries for the period 1990-2013 by age and sex using three inputs: risk exposure, relative risks, and the theoretical minimum risk exposure level (TMREL). Risks are organised into a hierarchy with blocks of behavioural, environmental and occupational, and metabolic risks at the first level of the hierarchy. The next level in the hierarchy includes nine clusters of related risks and two individual risks, with more detail provided at levels 3 and 4 of the hierarchy. Compared with GBD 2010, six new risk factors have been added: handwashing practices, occupational exposure to trichloroethylene, childhood wasting, childhood stunting, unsafe sex, and low glomerular filtration rate. For most risks, data for exposure were synthesised with a Bayesian meta-regression method, DisMod-MR 2.0, or spatial-temporal Gaussian process regression. Relative risks were based on meta-regressions of published cohort and intervention studies. Attributable burden for clusters of risks and all risks combined took into account evidence on the mediation of some risks such as high body-mass index (BMI) through other risks such as high systolic blood pressure and high cholesterol.FINDINGS: All risks combined account for 57·2% (95% uncertainty interval [UI] 55·8-58·5) of deaths and 41·6% (40·1-43·0) of DALYs. Risks quantified account for 87·9% (86·5-89·3) of cardiovascular disease DALYs, ranging to a low of 0% for neonatal disorders and neglected tropical diseases and malaria. In terms of global DALYs in 2013, six risks or clusters of risks each caused more than 5% of DALYs: dietary risks accounting for 11·3 million deaths and 241·4 million DALYs, high systolic blood pressure for 10·4 million deaths and 208·1 million DALYs, child and maternal malnutrition for 1·7 million deaths and 176·9 million DALYs, tobacco smoke for 6·1 million deaths and 143·5 million DALYs, air pollution for 5·5 million deaths and 141·5 million DALYs, and high BMI for 4·4 million deaths and 134·0 million DALYs. Risk factor patterns vary across regions and countries and with time. In sub-Saharan Africa, the leading risk factors are child and maternal malnutrition, unsafe sex, and unsafe water, sanitation, and handwashing. In women, in nearly all countries in the Americas, north Africa, and the Middle East, and in many other high-income countries, high BMI is the leading risk factor, with high systolic blood pressure as the leading risk in most of Central and Eastern Europe and south and east Asia. For men, high systolic blood pressure or tobacco use are the leading risks in nearly all high-income countries, in north Africa and the Middle East, Europe, and Asia. For men and women, unsafe sex is the leading risk in a corridor from Kenya to South Africa.INTERPRETATION: Behavioural, environmental and occupational, and metabolic risks can explain half of global mortality and more than one-third of global DALYs providing many opportunities for prevention. Of the larger risks, the attributable burden of high BMI has increased in the past 23 years. In view of the prominence of behavioural risk factors, behavioural and social science research on interventions for these risks should be strengthened. Many prevention and primary care policy options are available now to act on key risks.FUNDING: Bill & Melinda Gates Foundation.
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| 2. |
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| 3. |
- Devries, K., et al.
(författare)
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Who perpetrates violence against children? A systematic analysis of age-specific and sex-specific data
- 2018
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Ingår i: BMJ Paediatr Open. - : BMJ. - 2399-9772. ; 2:1
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The epidemiology of violence against children is likely to differ substantially by sex and age of the victim and the perpetrator. Thus far, investment in effective prevention strategies has been hindered by lack of clarity in the burden of childhood violence across these dimensions. We produced the first age-specific and sex-specific prevalence estimates by perpetrator type for physical, sexual and emotional violence against children globally. Design: We used random effects meta-regression to estimate prevalence. Estimates were adjusted for relevant quality covariates, variation in definitions of violence and weighted by region-specific, age-specific and sex-specific population data to ensure estimates reflect country population structures. Data sources: Secondary data from 600 population or school-based representative datasets and 43 publications obtained via systematic literature review, representing 13 830 estimates from 171 countries. Eligibility criteria for selecting studies: Estimates for recent violence against children aged 0-19 were included. Results: The most common perpetrators of physical and emotional violence for both boys and girls across a range of ages are household members, with prevalence often surpassing 50%, followed by student peers. Children reported experiencing more emotional than physical violence from both household members and students. The most common perpetrators of sexual violence against girls aged 15-19 years are intimate partners; however, few data on other perpetrators of sexual violence against children are systematically collected internationally. Few age-specific and sex-specific data are available on violence perpetration by schoolteachers; however, existing data indicate high prevalence of physical violence from teachers towards students. Data from other authority figures, strangers, siblings and other adults are limited, as are data on neglect of children. Conclusions: Without further investment in data generation on violence exposure from multiple perpetrators for boys and girls of all ages, progress towards Sustainable Development Goals 4, 5 and 16 may be slow. Despite data gaps, evidence shows violence from household members, peers in school and for girls, from intimate partners, should be prioritised for prevention. Trial registration number: PROSPERO 2015: CRD42015024315.
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| 4. |
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| 5. |
- Cuni-Sanchez, Aida, et al.
(författare)
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High aboveground carbon stock of African tropical montane forests
- 2021
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Ingår i: Nature. - : Springer Science and Business Media LLC. - 0028-0836 .- 1476-4687. ; 596:7873, s. 536-542
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Tidskriftsartikel (refereegranskat)abstract
- Tropical forests store 40–50per cent of terrestrial vegetation carbon. However, spatial variations in aboveground live tree biomass carbon (AGC) stocks remain poorly understood, in particular in tropical montane forests. Owing to climatic and soil changes with increasing elevation, AGC stocks are lower in tropical montane forests compared with lowland forests. Here we assemble and analyse a dataset of structurally intact old-growth forests (AfriMont) spanning 44 montane sites in 12 African countries. We find that montane sites in the AfriMont plot network have a mean AGC stock of 149.4megagrams of carbon per hectare (95% confidence interval 137.1–164.2), which is comparable to lowland forests in the African Tropical Rainforest Observation Network4 and about 70per cent and 32per cent higher than averages from plot networks in montane and lowland forests in the Neotropics, respectively. Notably, our results are two-thirds higher than the Intergovernmental Panel on Climate Change default values for these forests in Africa8. We find that the low stem density and high abundance of large trees of African lowland forests is mirrored in the montane forests sampled. This carbon store is endangered: we estimate that 0.8 million hectares of old-growth African montane forest have been lost since 2000. We provide country-specific montane forest AGC stock estimates modelled from our plot network to helpto guide forest conservation and reforestation interventions. Our findings highlight the need for conserving these biodiverse and carbon-rich ecosystems.
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| 6. |
- Litaudon, X., et al.
(författare)
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Development of steady-state scenarios compatible with ITER-like wall conditions
- 2007
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Ingår i: Plasma Physics and Controlled Fusion. - 0741-3335 .- 1361-6587. ; 49:12B, s. B529-B550
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Tidskriftsartikel (refereegranskat)abstract
- A key issue for steady-state tokamak operation is to determine the edge conditions that are compatible both with good core confinement and with the power handling and plasma exhaust capabilities of the plasma facing components (PFCs) and divertor systems. A quantitative response to this open question will provide a robust scientific basis for reliable extrapolation of present regimes to an ITER compatible steady-state scenario. In this context, the JET programme addressing steady-state operation is focused on the development of non-inductive, high confinement plasmas with the constraints imposed by the PFCs. A new beryllium main chamber wall and tungsten divertor together with an upgrade of the heating/fuelling capability are currently in preparation at JET. Operation at higher power with this ITER-like wall will impose new constraints on non-inductive scenarios. Recent experiments have focused on the preparation for this new phase of JET operation. In this paper, progress in the development of advanced tokamak (AT) scenarios at JET is reviewed keeping this long-term objective in mind. The approach has consisted of addressing various critical issues separately during the 2006-2007 campaigns with a view to full scenario integration when the JET upgrades are complete. Regimes with internal transport barriers (ITBs) have been developed at q(95) similar to 5 and high triangularity, 3 (relevant to the ITER steady-state demonstration) by applying more than 30 MW of additional heating power reaching beta(N) similar to 2 at B(o) similar to 3.1 T. Operating at higher 6 has allowed the edge pedestal and core densities to be increased pushing the ion temperature closer to that of the electrons. Although not yet fully integrated into a performance enhancing ITB scenario, Neon seeding has been successfully explored to increase the radiated power fraction (up to 60%), providing significant reduction of target tile power fluxes (and hence temperatures) and mitigation of edge localized mode (ELM) activity. At reduced toroidal magnetic field strength, high beta(N) regimes have been achieved and q-profile optimization investigated for use in steady-state scenarios. Values of beta(N) above the 'no-wall magnetohydrodynamic limit' (beta(N) similar to 3.0) have been sustained for a resistive current diffusion time in high-delta configurations (at 1.2 MA/1.8 T). In this scenario, ELM activity has been mitigated by applying magnetic perturbations using error field correction coils to provide ergodization of the magnetic field at the plasma edge. In a highly shaped, quasi-double null X-point configuration, ITBs have been generated on the ion heat transport channel and combined with 'grassy' ELMs with similar to 30 MW of applied heating power (at 1.2 MA/2.7 T, q(95) similar to 7). Advanced algorithms and system identification procedures have been developed with a view to developing simultaneously temperature and q-profile control in real-time. These techniques have so far been applied to the control of the q-profile evolution in JET AT scenarios.
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| 7. |
- Sediva, A, et al.
(författare)
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Europe Immunoglobulin Map
- 2014
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Ingår i: JOURNAL OF CLINICAL IMMUNOLOGY. - : Oxford University Press (OUP). - 0271-9142. ; 178178 Suppl 1, s. 141-143
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)
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| 8. |
- Abrahams, N., et al.
(författare)
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Worldwide prevalence of non-partner sexual violence: a systematic review
- 2014
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Ingår i: The Lancet. - 0140-6736. ; 383:9929, s. 1648-1654
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Tidskriftsartikel (refereegranskat)abstract
- Background: Several highly publicised rapes and murders of young women in India and South Africa have focused international attention on sexual violence. These cases are extremes of the wider phenomenon of sexual violence against women, but the true extent is poorly quantified. We did a systematic review to estimate prevalence. Methods: We searched for articles published from Jan 1, 1998, to Dec 31, 2011, and manually search reference lists and contacted experts to identify population-based data on the prevalence of women's reported experiences of sexual violence from age 15 years onwards, by anyone except intimate partners. We used random effects meta-regression to calculate adjusted and unadjusted prevalence for regions, which we weighted by population size to calculate the worldwide estimate. Findings: We identified 7231 studies from which we obtained 412 estimates covering 56 countries. In 2010 7·2% (95% CI 5·2-9·1) of women worldwide had ever experienced non-partner sexual violence. The highest estimates were in sub-Saharan Africa, central (21%, 95%CI 4·5-37·5) and sub-Saharan Africa, southern (17·4%, 11·4-23·3). The lowest prevalence was for Asia, south (3·3%, 0-8·3). Limited data were available from sub-Saharan Africa, central, North Africa/Middle East, Europe, eastern, and Asia Pacific, high income. Interpretation: Sexual violence against women is common worldwide, with endemic levels seen in some areas, although large variations between settings need to be interpreted with caution because of differences in data availability and levels of disclosure. Nevertheless, our findings indicate a pressing health and human rights concern. Funding: South African Medical Research Council, Sigrid Rausing Trust, WHO. © 2014 World Health Organization. Published by Elsevier Ltd/Inc/BV. All rights reserved.
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| 9. |
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| 10. |
- Devries, K. M., et al.
(författare)
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Intimate Partner Violence and Incident Depressive Symptoms and Suicide Attempts: A Systematic Review of Longitudinal Studies
- 2013
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Ingår i: Plos Medicine. - : Public Library of Science (PLoS). - 1549-1676. ; 10:5
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Forskningsöversikt (refereegranskat)abstract
- Background: Depression and suicide are responsible for a substantial burden of disease globally. Evidence suggests that intimate partner violence (IPV) experience is associated with increased risk of depression, but also that people with mental disorders are at increased risk of violence. We aimed to investigate the extent to which IPV experience is associated with incident depression and suicide attempts, and vice versa, in both women and men. Methods and Findings: We conducted a systematic review and meta-analysis of longitudinal studies published before February 1, 2013. More than 22,000 records from 20 databases were searched for studies examining physical and/or sexual intimate partner or dating violence and symptoms of depression, diagnosed major depressive disorder, dysthymia, mild depression, or suicide attempts. Random effects meta-analyses were used to generate pooled odds ratios (ORs). Sixteen studies with 36,163 participants met our inclusion criteria. All studies included female participants; four studies also included male participants. Few controlled for key potential confounders other than demographics. All but one depression study measured only depressive symptoms. For women, there was clear evidence of an association between IPV and incident depressive symptoms, with 12 of 13 studies showing a positive direction of association and 11 reaching statistical significance; pooled OR from six studies = 1.97 (95% CI 1.56-2.48, I-2 = 50.4%, p(heterogeneity) = 0.073). There was also evidence of an association in the reverse direction between depressive symptoms and incident IPV (pooled OR from four studies = 1.93, 95% CI 1.51-2.48, I-2 = 0%, p = 0.481). IPV was also associated with incident suicide attempts. For men, evidence suggested that IPV was associated with incident depressive symptoms, but there was no clear evidence of an association between IPV and suicide attempts or depression and incident IPV. Conclusions: In women, IPV was associated with incident depressive symptoms, and depressive symptoms with incident IPV. IPV was associated with incident suicide attempts. In men, few studies were conducted, but evidence suggested IPV was associated with incident depressive symptoms. There was no clear evidence of association with suicide attempts.
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| 11. |
- Evans, M., et al.
(författare)
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Use of fast-acting insulin aspart in insulin pump therapy in clinical practice
- 2019
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Ingår i: Diabetes, Obesity and Metabolism. - : Wiley. - 1462-8902 .- 1463-1326. ; 21:9, s. 2039-2047
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Tidskriftsartikel (refereegranskat)abstract
- Fast-acting insulin aspart (faster aspart) is a novel formulation of insulin aspart (IAsp) containing the additional excipients niacinamide and L-arginine. The improved pharmacological profile and greater early glucose-lowering action of faster aspart compared with IAsp suggests that faster aspart may be advantageous for people with diabetes using continuous subcutaneous insulin infusion (CSII). The recent onset 5 trial was the first to evaluate the efficacy and safety of an ultra-fast-acting insulin in CSII therapy in a large number of participants with type 1 diabetes (T1D). Non-inferiority of faster aspart to IAsp in terms of change from baseline in HbA1c was confirmed, with an estimated treatment difference (ETD) of 0.09% (95% CI, 0.01; 0.17; P < 0.001 for non-inferiority [0.4% margin]). Faster aspart was superior to IAsp in terms of change from baseline in 1-hour post-prandial glucose (PPG) increment after a meal test (ETD [95% CI], −0.91 mmol/L [−1.43; −0.39]; P = 0.001), with statistically significant improvements also at 30 minutes and 2 hours. The overall rate of severe or blood glucose-confirmed hypoglycaemia was not statistically significantly different between treatments, with an estimated rate ratio of 1.00 (95% CI, 0.85; 1.16). A numerical imbalance in severe hypoglycaemic episodes between faster aspart and IAsp was seen in the treatment (21 vs 7) and the 4-week run-in periods (4 vs 0). Experience from clinical practice indicates that all pump settings should be reviewed when initiating faster aspart with CSII, and that the use of continuous glucose monitoring or flash glucose monitoring, along with a good understanding of meal content and bolus type, may also facilitate optimal use. This review summarizes the available clinical evidence for faster aspart administered via CSII and highlights practical considerations based on clinical experience that may help healthcare providers and individuals with T1D successfully initiate and adjust faster aspart with CSII. © 2019 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.
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| 12. |
- Fabbri, C., et al.
(författare)
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Modelling the effect of the COVID-19 pandemic on violent discipline against children
- 2021
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Ingår i: Child Abuse and Neglect. - : Elsevier BV. - 0145-2134. ; 116:Pt 2
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Tidskriftsartikel (refereegranskat)abstract
- Background: The COVID-19 pandemic could increase violence against children at home. However, collecting empirical data on violence is challenging due to ethical, safety, and data quality concerns. Objective: This study estimated the anticipated effect of COVID-19 on violent discipline at home using multivariable predictive regression models. Participants: Children aged 1–14 years and household members from the Multiple Indicator Cluster Surveys (MICS) conducted in Nigeria, Mongolia, and Suriname before the COVID-19 pandemic were included. Methods: A conceptual model of how the COVID-19 pandemic could affect risk factors for violent discipline was developed. Country specific multivariable linear models were used to estimate the association between selected variables from MICS and a violent discipline score which captured the average combination of violent disciplinary methods used in the home. A review of the literature informed the development of quantitative assumptions about how COVID-19 would impact the selected variables under a “high restrictions” pandemic scenario, approximating conditions expected during a period of intense response measures, and a “lower restrictions” scenario with easing of COVID-19 restrictions but with sustained economic impacts. These assumptions were used to estimate changes in violent discipline scores. Results: Under a “high restrictions” scenario there would be a 35%–46% increase in violent discipline scores in Nigeria, Mongolia and Suriname, and under a “lower restrictions” scenario there would be between a 4%–6% increase in violent discipline scores in these countries. Conclusion: Policy makers need to plan for increases in violent discipline during successive waves of lockdowns. © 2020 Elsevier Ltd
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| 13. |
- Hermanides, J, et al.
(författare)
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Sensor-augmented pump therapy lowers HbA(1c) in suboptimally controlled Type 1 diabetes; a randomized controlled trial.
- 2011
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Ingår i: Diabetic Medicine: A journal of the British Diabetic Association. - : Wiley. - 1464-5491. ; 28, s. 1158-1167
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Tidskriftsartikel (refereegranskat)abstract
- Aims To investigate the efficacy of sensor-augmented pump therapy vs. multiple daily injection therapy in patients with suboptimally controlled Type 1 diabetes. Methods In this investigator-initiated multi-centre trial (the Eurythmics Trial) in eight outpatient centres in Europe, we randomized 83 patients with Type 1 diabetes (40 women) currently treated with multiple daily injections, age 18-65 years and HbA(1c) ≥ 8.2% (≥ 66 mmol/mol) to 26 weeks of treatment with either a sensor-augmented insulin pump (n = 44) (Paradigm(®) REAL-Time) or continued with multiple daily injections (n = 39). Change in HbA(1c) between baseline and 26 weeks, sensor-derived endpoints and patient-reported outcomes were assessed. Results The trial was completed by 43/44 (98%) patients in the sensor-augmented insulin pump group and 35/39 (90%) patients in the multiple daily injections group. Mean HbA(1c) at baseline and at 26 weeks changed from 8.46% (sd 0.95) (69 mmol/mol) to 7.23% (sd 0.65) (56 mmol/mol) in the sensor-augmented insulin pump group and from 8.59% (sd 0.82) (70 mmol/mol) to 8.46% (sd 1.04) (69 mmol/mol) in the multiple daily injections group. Mean difference in change in HbA(1c) after 26 weeks was -1.21% (95% confidence interval -1.52 to -0.90, P < 0.001) in favour of the sensor-augmented insulin pump group. This was achieved without an increase in percentage of time spent in hypoglycaemia: between-group difference 0.0% (95% confidence interval -1.6 to 1.7, P = 0.96). There were four episodes of severe hypoglycaemia in the sensor-augmented insulin pump group and one episode in the multiple daily injections group (P = 0.21). Problem Areas in Diabetes and Diabetes Treatment Satisfaction Questionnaire scores improved in the sensor-augmented insulin pump group. Conclusions Sensor augmented pump therapy effectively lowers HbA(1c) in patients with Type 1 diabetes suboptimally controlled with multiple daily injections.
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| 14. |
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| 15. |
- Popescu, A., et al.
(författare)
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Increasing transparency and privacy for online social network users – USEMP value model, scoring framework and legal
- 2016
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Ingår i: Privacy Technologies and Policy. - Cham : Encyclopedia of Global Archaeology/Springer Verlag. - 9783319314556 - 9783319314563 ; , s. 38-59
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Konferensbidrag (refereegranskat)abstract
- In this paper we present research results from the multi-disciplinary EU research project USEMP (USEMP is a project funded from EU research framework, additional information about project scope and deliverables are available at project’s public website at: http://www.usemp-project.eu/). In particular, we look at the legal aspects of personal data licensing and profile transparency, the development of a personal data value model in Online Social Networks (OSNs) and the development of disclosure scoring and personal data value frameworks. In the first part of the paper we show how personal data usage licensing and profile transparency for OSN activities provides for Data Protection by Design (DPbD). We also present an overview of the existing personal data monetization ecosystem in OSNs and its possible evolutions for increasing privacy and transparency for consumers about their OSN presence. In the last part of the paper, we describe the USEMP scoring framework for personal information disclosure and data value that can assist users to better perceive how their privacy is affected by their OSN presence and what the value of their OSN activities is.
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| 16. |
- Santala, M. I. K., et al.
(författare)
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Proton-triton nuclear reaction in ICRF heated plasmas in JET
- 2006
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Ingår i: Plasma Physics and Controlled Fusion. - : IOP Publishing. - 0741-3335 .- 1361-6587. ; 48:8, s. 1233-1253
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Tidskriftsartikel (refereegranskat)abstract
- Fast protons can react with tritons in an endothermic nuclear reaction which can act as a source of neutrons in magnetically confined fusion plasmas. We have performed an experiment to systematically study this reaction in low tritium concentration (approximate to 1%) plasmas in the Joint European Torus. A linear dependence is found between excess neutron rate and tritium concentration when the DT fusion rate is low. We discuss the properties of the neutron emission, including anisotropy, from the proton-triton reaction in a fusion reactor environment and derive simple models for the calculation of the neutron yield from this reaction in terms of tritium density, fast ion temperature and fast ion energy content.
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| 17. |
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