| 1. |
|
|
| 2. |
- Lozano, Rafael, et al.
(författare)
-
Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017
- 2018
-
Ingår i: The Lancet. - : Elsevier. - 1474-547X .- 0140-6736. ; 392:10159, s. 2091-2138
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Efforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of “leaving no one behind”, it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health-related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990–2017, projected indicators to 2030, and analysed global attainment. Methods: We measured progress on 41 health-related SDG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the health-related SDG index, we transformed the value for each indicator on a scale of 0–100, with 0 as the 2·5th percentile and 100 as the 97·5th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the probability of attainment in 2030 calculated from 1000 draws. We also did a global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends. Using 2015 global averages of indicators with defined SDG targets, we calculated the global annualised rates of change required from 2015 to 2030 to meet these targets, and then identified in what percentiles the required global annualised rates of change fell in the distribution of country-level rates of change from 1990 to 2015. We took the mean of these global percentile values across indicators and applied the past rate of change at this mean global percentile to all health-related SDG indicators, irrespective of target definition, to estimate the equivalent 2030 global average value and percentage change from 2015 to 2030 for each indicator. Findings: The global median health-related SDG index in 2017 was 59·4 (IQR 35·4–67·3), ranging from a low of 11·6 (95% uncertainty interval 9·6–14·0) to a high of 84·9 (83·1–86·7). SDG index values in countries assessed at the subnational level varied substantially, particularly in China and India, although scores in Japan and the UK were more homogeneous. Indicators also varied by SDI quintile and sex, with males having worse outcomes than females for non-communicable disease (NCD) mortality, alcohol use, and smoking, among others. Most countries were projected to have a higher health-related SDG index in 2030 than in 2017, while country-level probabilities of attainment by 2030 varied widely by indicator. Under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria indicators had the most countries with at least 95% probability of target attainment. Other indicators, including NCD mortality and suicide mortality, had no countries projected to meet corresponding SDG targets on the basis of projected mean values for 2030 but showed some probability of attainment by 2030. For some indicators, including child malnutrition, several infectious diseases, and most violence measures, the annualised rates of change required to meet SDG targets far exceeded the pace of progress achieved by any country in the recent past. We found that applying the mean global annualised rate of change to indicators without defined targets would equate to about 19% and 22% reductions in global smoking and alcohol consumption, respectively; a 47% decline in adolescent birth rates; and a more than 85% increase in health worker density per 1000 population by 2030. Interpretation: The GBD study offers a unique, robust platform for monitoring the health-related SDGs across demographic and geographic dimensions. Our findings underscore the importance of increased collection and analysis of disaggregated data and highlight where more deliberate design or targeting of interventions could accelerate progress in attaining the SDGs. Current projections show that many health-related SDG indicators, NCDs, NCD-related risks, and violence-related indicators will require a concerted shift away from what might have driven past gains—curative interventions in the case of NCDs—towards multisectoral, prevention-oriented policy action and investments to achieve SDG aims. Notably, several targets, if they are to be met by 2030, demand a pace of progress that no country has achieved in the recent past. The future is fundamentally uncertain, and no model can fully predict what breakthroughs or events might alter the course of the SDGs. What is clear is that our actions—or inaction—today will ultimately dictate how close the world, collectively, can get to leaving no one behind by 2030.
|
|
| 3. |
- Stanaway, Jeffrey D., et al.
(författare)
-
Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017
- 2018
-
Ingår i: The Lancet. - 1474-547X .- 0140-6736. ; 392:10159, s. 1923-1994
-
Tidskriftsartikel (refereegranskat)abstract
- Background The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk-outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk-outcome pairs, and new data on risk exposure levels and risk- outcome associations. Methods We used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs by decomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risks; and (6) changes due to all other factors, approximated as the risk-deleted death and DALY rates, where the risk-deleted rate is the rate that would be observed had we reduced the exposure levels to the TMREL for all risk factors included in GBD 2017.
|
|
| 4. |
- Yamaga, Takumi, et al.
(författare)
-
Study of the elementary (K -, n) reactions to search for the K NN bound state via the 3He (K -, n) reaction at J-PARC
- 2016
-
Ingår i: XVIth International Conference on Hadron Spectroscopy, Hadron 2015. - : Author(s). - 9780735413894 ; 1735
-
Konferensbidrag (refereegranskat)abstract
- We have searched for the simplest kaonic nuclear state, K̄NN, using the in-flight 3He (K-, n) reaction at the J-PARC hadron experimental facility. In the semi-inclusive neutron missing-mass spectrum at θnlab=0°, an excess of yield was observed just below the K- pp mass-threshold, which cannot be explained by any elementary reactions [PTEP 2015, 061D01]. To understand the missing-mass spectrum of 3He (K-, n) X, we investigated the elementary (K-, n) reactions using hydrogen and deuterium targets. The p (K-, n) X missing-mass spectrum was well described by the charge-exchange reaction. However, in the d (K-, n) X spectrum, we observed an excess of yield just below the K- p mass-threshold, which was similar to that in the 3He (K-, n) X spectrum.
|
|
| 5. |
- Asano, H., et al.
(författare)
-
Spectroscopic study of the Λ(1405) resonance via the d (K-, n) reaction at J-PARC
- 2019
-
Ingår i: 13th International Conference on Hypernuclear and Strange Particle Physics, HYP 2018. - : AIP Publishing. - 9780735418721 ; 2130
-
Konferensbidrag (refereegranskat)abstract
- The structure of the Λ(1405) hyperon is an important and long-standing issue related to the K̄-nucleus interaction. The J-PARC E31 experiment has been performed to investigate the Λ(1405) spectrum shape. Because it is hard to form the Λ(1405) directly by a K̄N scattering in free space, E31 uses the d(K-, n) reaction with an incident kaon momentum of 1 GeV/c. We will identify three final states - ς-π+, ς+π-, ς0π0-so that the isospin structure of hyperon resonance states produced can be decomposed. The first physics run of the E31 experiment was performed in 2016. To enhance the statistics of the data set, we have performed the second physics run in the beginning of 2018. During the second run of E31, around 3.9×1010 kaons impacted on the deuteron target.
|
|
| 6. |
- Sada, Y., et al.
(författare)
-
Structure near the K- + p + p threshold in the in-flight 3He(K-, Λp)n reaction
- 2016
-
Ingår i: Progress of Theoretical and Experimental Physics. - : Oxford University Press (OUP). - 2050-3911. ; 2016:5
-
Tidskriftsartikel (refereegranskat)abstract
- To search for an S = -1 di-baryonic state which decays toΛp, the 3He(K-,Λp)nmissing reaction was studied at 1.0 GeV/c. Unobserved neutrons were kinematically identified from the missing mass MX of the 3He (K-,Λp) X reaction in order to have a large acceptance for the Λpn final state. The observed Λpn events, distributed widely over the kinematically allowed region of the Dalitz plot, establish that the major component comes from a three-nucleon absorption process. A concentration of events at a specific neutron kinetic energy was observed in a region of low momentum transfer to the Λp. To account for the observed peak structure, the simplest S-wave polewas assumed to exist in the reaction channel, having a Breit-Wigner formin energy and with a Gaussian form factor. A minimum X2 method was applied to deduce its mass, MX = 2355+6 -8 (stat.) ±12 (syst.)MeV/c2, and decay width, γX = 110+19 -17 (stat.) ±27 (syst.)MeV/c2, respectively. The form factor parameter QX ∼ 400MeV/c implies that the range of the interaction is about 0.5 fm.
|
|
| 7. |
- Feigin, Valery L., et al.
(författare)
-
Global, regional, and national burden of neurological disorders, 1990–2016 : a systematic analysis for the Global Burden of Disease Study 2016
- 2019
-
Ingår i: Lancet Neurology. - : Elsevier. - 1474-4422 .- 1474-4465. ; 18:5, s. 459-480
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Neurological disorders are increasingly recognised as major causes of death and disability worldwide. The aim of this analysis from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 is to provide the most comprehensive and up-to-date estimates of the global, regional, and national burden from neurological disorders.Methods: We estimated prevalence, incidence, deaths, and disability-adjusted life-years (DALYs; the sum of years of life lost [YLLs] and years lived with disability [YLDs]) by age and sex for 15 neurological disorder categories (tetanus, meningitis, encephalitis, stroke, brain and other CNS cancers, traumatic brain injury, spinal cord injury, Alzheimer's disease and other dementias, Parkinson's disease, multiple sclerosis, motor neuron diseases, idiopathic epilepsy, migraine, tension-type headache, and a residual category for other less common neurological disorders) in 195 countries from 1990 to 2016. DisMod-MR 2.1, a Bayesian meta-regression tool, was the main method of estimation of prevalence and incidence, and the Cause of Death Ensemble model (CODEm) was used for mortality estimation. We quantified the contribution of 84 risks and combinations of risk to the disease estimates for the 15 neurological disorder categories using the GBD comparative risk assessment approach.Findings: Globally, in 2016, neurological disorders were the leading cause of DALYs (276 million [95% UI 247–308]) and second leading cause of deaths (9·0 million [8·8–9·4]). The absolute number of deaths and DALYs from all neurological disorders combined increased (deaths by 39% [34–44] and DALYs by 15% [9–21]) whereas their age-standardised rates decreased (deaths by 28% [26–30] and DALYs by 27% [24–31]) between 1990 and 2016. The only neurological disorders that had a decrease in rates and absolute numbers of deaths and DALYs were tetanus, meningitis, and encephalitis. The four largest contributors of neurological DALYs were stroke (42·2% [38·6–46·1]), migraine (16·3% [11·7–20·8]), Alzheimer's and other dementias (10·4% [9·0–12·1]), and meningitis (7·9% [6·6–10·4]). For the combined neurological disorders, age-standardised DALY rates were significantly higher in males than in females (male-to-female ratio 1·12 [1·05–1·20]), but migraine, multiple sclerosis, and tension-type headache were more common and caused more burden in females, with male-to-female ratios of less than 0·7. The 84 risks quantified in GBD explain less than 10% of neurological disorder DALY burdens, except stroke, for which 88·8% (86·5–90·9) of DALYs are attributable to risk factors, and to a lesser extent Alzheimer's disease and other dementias (22·3% [11·8–35·1] of DALYs are risk attributable) and idiopathic epilepsy (14·1% [10·8–17·5] of DALYs are risk attributable).Interpretation: Globally, the burden of neurological disorders, as measured by the absolute number of DALYs, continues to increase. As populations are growing and ageing, and the prevalence of major disabling neurological disorders steeply increases with age, governments will face increasing demand for treatment, rehabilitation, and support services for neurological disorders. The scarcity of established modifiable risks for most of the neurological burden demonstrates that new knowledge is required to develop effective prevention and treatment strategies.Funding: Bill & Melinda Gates Foundation.
|
|
| 8. |
|
|
| 9. |
- Ackermann, M., et al.
(författare)
-
CONSTRAINTS ON THE COSMIC-RAY DENSITY GRADIENT BEYOND THE SOLAR CIRCLE FROM FERMI gamma-RAY OBSERVATIONS OF THE THIRD GALACTIC QUADRANT
- 2011
-
Ingår i: Astrophysical Journal. - 0004-637X .- 1538-4357. ; 726:2, s. 81-
-
Tidskriftsartikel (refereegranskat)abstract
- We report an analysis of the interstellar gamma-ray emission in the third Galactic quadrant measured by the Fermi Large Area Telescope. The window encompassing the Galactic plane from longitude 210 degrees to 250 degrees has kinematically well-defined segments of the Local and the Perseus arms, suitable to study the cosmic-ray (CR) densities across the outer Galaxy. We measure no large gradient with Galactocentric distance of the gamma-ray emissivities per interstellar H atom over the regions sampled in this study. The gradient depends, however, on the optical depth correction applied to derive the H I column densities. No significant variations are found in the interstellar spectra in the outer Galaxy, indicating similar shapes of the CR spectrum up to the Perseus arm for particles with GeV to tens of GeV energies. The emissivity as a function of Galactocentric radius does not show a large enhancement in the spiral arms with respect to the interarm region. The measured emissivity gradient is flatter than expectations based on a CR propagation model using the radial distribution of supernova remnants and uniform diffusion properties. In this context, observations require a larger halo size and/or a flatter CR source distribution than usually assumed. The molecular mass calibrating ratio, X(CO) = N(H(2))/W(CO), is found to be (2.08 +/- 0.11) x 10(20) cm(-2)(K km s(-1))(-1) in the Local arm clouds and is not significantly sensitive to the choice of Hi spin temperature. No significant variations are found for clouds in the interarm region.
|
|
| 10. |
- Ackermann, M., et al.
(författare)
-
FERMI LARGE AREA TELESCOPE STUDY OF COSMIC RAYS AND THE INTERSTELLAR MEDIUM IN NEARBY MOLECULAR CLOUDS
- 2012
-
Ingår i: Astrophysical Journal. - 0004-637X .- 1538-4357. ; 755:1
-
Tidskriftsartikel (refereegranskat)abstract
- We report an analysis of the interstellar gamma-ray emission from the Chamaeleon, R Coronae Australis (R CrA), and Cepheus and Polaris flare regions with the Fermi Large Area Telescope. They are among the nearest molecular cloud complexes, within similar to 300 pc from the solar system. The gamma-ray emission produced by interactions of cosmic rays (CRs) and interstellar gas in those molecular clouds is useful to study the CR densities and distributions of molecular gas close to the solar system. The obtained gamma-ray emissivities above 250 MeV are (5.9 +/- 0.1(stat-1.0sys)(+0.9)) x 10(-27) photons s(-1) sr(-1) H-atom(-1), (10.2 +/- 0.4(stat-1.7sys)(+1.2)) x 10(-27) photons s(-1) sr(-1) H-atom(-1), and (9.1 +/- 0.3(stat-0.6sys)(+1.5)) x 10(-27) photons s(-1) sr(-1) H-atom(-1) for the Chamaeleon, R CrA, and Cepheus and Polaris flare regions, respectively. Whereas the energy dependences of the emissivities agree well with that predicted from direct CR observations at the Earth, the measured emissivities from 250 MeV to 10 GeV indicate a variation of the CR density by similar to 20% in the neighborhood of the solar system, even if we consider systematic uncertainties. The molecular mass calibrating ratio, X-CO = N(H-2)/W-CO, is found to be (0.96 +/- 0.06(stat-0.12sys)(+0.15)) x 10(20) H-2-molecule cm(-2) (K km s(-1))(-1), (0.99 +/- 0.08(stat-0.10sys)(+0.18)) x 10(20) H-2-molecule cm(-2) (K km s(-1))(-1), and (0.63 +/- 0.02(stat-0.07sys)(+0.09)) x 10(20) H-2-molecule cm(-2) (K km s(-1))(-1) for the Chamaeleon, R CrA, and Cepheus and Polaris flare regions, respectively, suggesting a variation of X-CO in the vicinity of the solar system. From the obtained values of X-CO, the masses of molecular gas traced by W-CO in the Chamaeleon, R CrA, and Cepheus and Polaris flare regions are estimated to be similar to 5 x 10(3)M(circle dot), similar to 10(3)M(circle dot), and similar to 3.3 x 10(4)M(circle dot), respectively. A comparable amount of gas not traced well by standard Hi and CO surveys is found in the regions investigated.
|
|
