| 1. |
- Lozano, Rafael, et al.
(author)
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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
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In: The Lancet. - : Elsevier. - 1474-547X .- 0140-6736. ; 392:10159, s. 2091-2138
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Journal article (peer-reviewed)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.
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| 2. |
- Murray, Christopher J. L., et al.
(author)
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Population and fertility by age and sex for 195 countries and territories, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017
- 2018
-
In: The Lancet. - 1474-547X .- 0140-6736. ; 392:10159, s. 1995-2051
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Journal article (peer-reviewed)abstract
- Background: Population estimates underpin demographic and epidemiological research and are used to track progress on numerous international indicators of health and development. To date, internationally available estimates of population and fertility, although useful, have not been produced with transparent and replicable methods and do not use standardised estimates of mortality. We present single-calendar year and single-year of age estimates of fertility and population by sex with standardised and replicable methods. Methods: We estimated population in 195 locations by single year of age and single calendar year from 1950 to 2017 with standardised and replicable methods. We based the estimates on the demographic balancing equation, with inputs of fertility, mortality, population, and migration data. Fertility data came from 7817 location-years of vital registration data, 429 surveys reporting complete birth histories, and 977 surveys and censuses reporting summary birth histories. We estimated age-specific fertility rates (ASFRs; the annual number of livebirths to women of a specified age group per 1000 women in that age group) by use of spatiotemporal Gaussian process regression and used the ASFRs to estimate total fertility rates (TFRs; the average number of children a woman would bear if she survived through the end of the reproductive age span [age 10–54 years] and experienced at each age a particular set of ASFRs observed in the year of interest). Because of sparse data, fertility at ages 10–14 years and 50–54 years was estimated from data on fertility in women aged 15–19 years and 45–49 years, through use of linear regression. Age-specific mortality data came from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 estimates. Data on population came from 1257 censuses and 761 population registry location-years and were adjusted for underenumeration and age misreporting with standard demographic methods. Migration was estimated with the GBD Bayesian demographic balancing model, after incorporating information about refugee migration into the model prior. Final population estimates used the cohort-component method of population projection, with inputs of fertility, mortality, and migration data. Population uncertainty was estimated by use of out-of-sample predictive validity testing. With these data, we estimated the trends in population by age and sex and in fertility by age between 1950 and 2017 in 195 countries and territories. Findings: From 1950 to 2017, TFRs decreased by 49·4% (95% uncertainty interval [UI] 46·4–52·0). The TFR decreased from 4·7 livebirths (4·5–4·9) to 2·4 livebirths (2·2–2·5), and the ASFR of mothers aged 10–19 years decreased from 37 livebirths (34–40) to 22 livebirths (19–24) per 1000 women. Despite reductions in the TFR, the global population has been increasing by an average of 83·8 million people per year since 1985. The global population increased by 197·2% (193·3–200·8) since 1950, from 2·6 billion (2·5–2·6) to 7·6 billion (7·4–7·9) people in 2017; much of this increase was in the proportion of the global population in south Asia and sub-Saharan Africa. The global annual rate of population growth increased between 1950 and 1964, when it peaked at 2·0%; this rate then remained nearly constant until 1970 and then decreased to 1·1% in 2017. Population growth rates in the southeast Asia, east Asia, and Oceania GBD super-region decreased from 2·5% in 1963 to 0·7% in 2017, whereas in sub-Saharan Africa, population growth rates were almost at the highest reported levels ever in 2017, when they were at 2·7%. The global average age increased from 26·6 years in 1950 to 32·1 years in 2017, and the proportion of the population that is of working age (age 15–64 years) increased from 59·9% to 65·3%. At the national level, the TFR decreased in all countries and territories between 1950 and 2017; in 2017, TFRs ranged from a low of 1·0 livebirths (95% UI 0·9–1·2) in Cyprus to a high of 7·1 livebirths (6·8–7·4) in Niger. The TFR under age 25 years (TFU25; number of livebirths expected by age 25 years for a hypothetical woman who survived the age group and was exposed to current ASFRs) in 2017 ranged from 0·08 livebirths (0·07–0·09) in South Korea to 2·4 livebirths (2·2–2·6) in Niger, and the TFR over age 30 years (TFO30; number of livebirths expected for a hypothetical woman ageing from 30 to 54 years who survived the age group and was exposed to current ASFRs) ranged from a low of 0·3 livebirths (0·3–0·4) in Puerto Rico to a high of 3·1 livebirths (3·0–3·2) in Niger. TFO30 was higher than TFU25 in 145 countries and territories in 2017. 33 countries had a negative population growth rate from 2010 to 2017, most of which were located in central, eastern, and western Europe, whereas population growth rates of more than 2·0% were seen in 33 of 46 countries in sub-Saharan Africa. In 2017, less than 65% of the national population was of working age in 12 of 34 high-income countries, and less than 50% of the national population was of working age in Mali, Chad, and Niger. Interpretation: Population trends create demographic dividends and headwinds (ie, economic benefits and detriments) that affect national economies and determine national planning needs. Although TFRs are decreasing, the global population continues to grow as mortality declines, with diverse patterns at the national level and across age groups. To our knowledge, this is the first study to provide transparent and replicable estimates of population and fertility, which can be used to inform decision making and to monitor progress. Funding: Bill & Melinda Gates Foundation.
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| 3. |
- Stanaway, Jeffrey D., et al.
(author)
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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
-
In: The Lancet. - 1474-547X .- 0140-6736. ; 392:10159, s. 1923-1994
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Journal article (peer-reviewed)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.
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| 4. |
- Abbafati, Cristiana, et al.
(author)
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- 2020
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Journal article (peer-reviewed)
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| 5. |
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| 6. |
- Djalalinia, Shirin, et al.
(author)
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Prevalence and Years Lived with Disability of 310 Diseases and Injuries in Iran and its Neighboring Countries, 1990-2015 : Findings from Global Burden of Disease Study 2015
- 2017
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In: Archives of Iranian Medicine. - 1029-2977 .- 1735-3947. ; 20:7, s. 392-402
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Journal article (peer-reviewed)abstract
- BACKGROUND: Due to significant achievements in reducing mortality and increasing life expectancy, the issue of disability from diseases and injuries, and their related interventions, has become one of the most important concerns of health-related research.METHODS: Using data obtained from the GBD 2015 study, the present report provides prevalence and years lived with disability (YLDs) of 310 diseases and injuries by sex and age in Iran and neighboring countries over the period 1990-2015. Age-standardized rates of all causes of YLDs are presented for both males and females in 16 countries for 1990 and 2015. We present the percentage of total YLDs for 21 categories of diseases and injuries, the percentage of YLDs for age groups, as well as the ranking of the most prevalent causes and YLDs from the top 50 diseases and injuries in Iran.RESULTS: In 2015, the burden of 310 diseases and injuries among the Iranian population was responsible for 8,357,878 loss of all-age total years, which is equal to 10.58% of total years lived per year. This differs from the neighboring countries, as it ranges from 9.05% in Turkmenistan to 13.36% in Russia. During the past 25 years, a remarkable decrease was observed in all-cause YLD rates in all 16 countries. Meanwhile, in all countries, the age-standardized rate of all causes of YLDs was higher in females than males.CONCLUSION: Based on our findings, one of the remarkable changes in NCDs observed among the studied age groups was increased rate of YLDs from mental disorders, which was replaced by musculoskeletal disorders in older age groups in 2015.
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| 7. |
- Feigin, Valery L., et al.
(author)
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Global, regional, and national burden of neurological disorders, 1990–2016 : a systematic analysis for the Global Burden of Disease Study 2016
- 2019
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In: Lancet Neurology. - : Elsevier. - 1474-4422 .- 1474-4465. ; 18:5, s. 459-480
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Journal article (peer-reviewed)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.
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| 8. |
- Micah, Angela E., et al.
(author)
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Tracking development assistance for health and for COVID-19 : a review of development assistance, government, out-of-pocket, and other private spending on health for 204 countries and territories, 1990-2050
- 2021
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In: The Lancet. - : Elsevier. - 0140-6736 .- 1474-547X. ; 398:10308, s. 1317-1343
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Research review (peer-reviewed)abstract
- Background The rapid spread of COVID-19 renewed the focus on how health systems across the globe are financed, especially during public health emergencies. Development assistance is an important source of health financing in many low-income countries, yet little is known about how much of this funding was disbursed for COVID-19. We aimed to put development assistance for health for COVID-19 in the context of broader trends in global health financing, and to estimate total health spending from 1995 to 2050 and development assistance for COVID-19 in 2020. Methods We estimated domestic health spending and development assistance for health to generate total health-sector spending estimates for 204 countries and territories. We leveraged data from the WHO Global Health Expenditure Database to produce estimates of domestic health spending. To generate estimates for development assistance for health, we relied on project-level disbursement data from the major international development agencies' online databases and annual financial statements and reports for information on income sources. To adjust our estimates for 2020 to include disbursements related to COVID-19, we extracted project data on commitments and disbursements from a broader set of databases (because not all of the data sources used to estimate the historical series extend to 2020), including the UN Office of Humanitarian Assistance Financial Tracking Service and the International Aid Transparency Initiative. We reported all the historic and future spending estimates in inflation-adjusted 2020 US$, 2020 US$ per capita, purchasing-power parity-adjusted US$ per capita, and as a proportion of gross domestic product. We used various models to generate future health spending to 2050. Findings In 2019, health spending globally reached $8. 8 trillion (95% uncertainty interval [UI] 8.7-8.8) or $1132 (1119-1143) per person. Spending on health varied within and across income groups and geographical regions. Of this total, $40.4 billion (0.5%, 95% UI 0.5-0.5) was development assistance for health provided to low-income and middle-income countries, which made up 24.6% (UI 24.0-25.1) of total spending in low-income countries. We estimate that $54.8 billion in development assistance for health was disbursed in 2020. Of this, $13.7 billion was targeted toward the COVID-19 health response. $12.3 billion was newly committed and $1.4 billion was repurposed from existing health projects. $3.1 billion (22.4%) of the funds focused on country-level coordination and $2.4 billion (17.9%) was for supply chain and logistics. Only $714.4 million (7.7%) of COVID-19 development assistance for health went to Latin America, despite this region reporting 34.3% of total recorded COVID-19 deaths in low-income or middle-income countries in 2020. Spending on health is expected to rise to $1519 (1448-1591) per person in 2050, although spending across countries is expected to remain varied. Interpretation Global health spending is expected to continue to grow, but remain unequally distributed between countries. We estimate that development organisations substantially increased the amount of development assistance for health provided in 2020. Continued efforts are needed to raise sufficient resources to mitigate the pandemic for the most vulnerable, and to help curtail the pandemic for all. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.
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| 9. |
- Mokdad, Ali H., et al.
(author)
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Adolescent health in the Eastern Mediterranean Region : findings from the global burden of disease 2015 study
- 2018
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In: International Journal of Public Health. - : SPRINGER BASEL AG. - 1661-8556 .- 1661-8564. ; 63, s. 79-96
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Journal article (peer-reviewed)abstract
- The 22 countries of the East Mediterranean Region (EMR) have large populations of adolescents aged 10-24 years. These adolescents are central to assuring the health, development, and peace of this region. We described their health needs. Using data from the Global Burden of Disease Study 2015 (GBD 2015), we report the leading causes of mortality and morbidity for adolescents in the EMR from 1990 to 2015. We also report the prevalence of key health risk behaviors and determinants. Communicable diseases and the health consequences of natural disasters reduced substantially between 1990 and 2015. However, these gains have largely been offset by the health impacts of war and the emergence of non-communicable diseases (including mental health disorders), unintentional injury, and self-harm. Tobacco smoking and high body mass were common health risks amongst adolescents. Additionally, many EMR countries had high rates of adolescent pregnancy and unmet need for contraception. Even with the return of peace and security, adolescents will have a persisting poor health profile that will pose a barrier to socioeconomic growth and development of the EMR.
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| 10. |
- Moradi-Lakeh, Maziar, et al.
(author)
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Trend of Socio-Demographic Index and Mortality Estimates in Iran and its Neighbors, 1990-2015 : Findings of the Global Burden of Diseases 2015 Study
- 2017
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In: Archives of Iranian Medicine. - 1029-2977 .- 1735-3947. ; 20:7, s. 419-428
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Journal article (peer-reviewed)abstract
- BACKGROUND: The Global burden of disease and injuries study (GBD 2015) reports expected measures for years of life lost (YLL) based on socio-demographic index (SDI) of countries, as well as the observed measures. In this extended GBD 2015 report, we reviewed total and cause-specific deaths and YLL for Iran and all its neighboring countries between 1990 and 2015.METHODS: We extracted data from the GBD 2015 database. Observed YLL measures were calculated by multiplying the number of deaths by standard life expectancy at each age. SDI was a composite index, calculated based on income per capita, average years of schooling, and total fertility rate. The GBD world population was used for age standardization.RESULTS: All-ages crude death rate in Iran reduced from 665.6 per 100,000 population (95% uncertainty interval: 599.3-731.6) in 1990 to 487.2 (414.9-566.1) in 2015. The ratio of observed to expected YLL (O/E ratio) for all-causes ranged between 0.54 (Turkey) and 1.95 (Russia) in 2015. For Iran, the all-causes O/E ratio was less than 1 in all years (1990-2015), except 2003. However, cause-specific O/E ratio was more than 1 for some causes, including the top leading causes of YLL (ischemic heart disease, road injuries, and cerebrovascular disorders). Ischemic heart disease was the first or second cause of YLL in all comparator countries except Afghanistan.CONCLUSION: The leading YLL causes with high O/E ratios should be prioritized in public health efforts. In addition to research evidence, countries with low O/E ratios should be scrutinized to find feasible innovative interventions.
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| 11. |
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| 12. |
- Sepanlou, Sadaf G., et al.
(author)
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Disability-Adjusted Life-Years (DALYs) for 315 Diseases and Injuries and Healthy Life Expectancy (HALE) in Iran and its Neighboring Countries, 1990-2015 : Findings from Global Burden of Disease Study 2015
- 2017
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In: Archives of Iranian Medicine. - 1029-2977 .- 1735-3947. ; 20:7, s. 403-418
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Journal article (peer-reviewed)abstract
- BACKGROUND: Summary measures of health are essential in making estimates of health status that are comparable across time and place. They can be used for assessing the performance of health systems, informing effective policy making, and monitoring the progress of nations toward achievement of sustainable development goals. The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015) provides disability-adjusted life-years (DALYs) and healthy life expectancy (HALE) as main summary measures of health. We assessed the trends of health status in Iran and 15 neighboring countries using these summary measures.METHODS: We used the results of GBD 2015 to present the levels and trends of DALYs, life expectancy (LE), and HALE in Iran and its 15 neighboring countries from 1990 to 2015. For each country, we assessed the ratio of observed levels of DALYs and HALE to those expected based on socio-demographic index (SDI), an indicator composed of measures of total fertility rate, income per capita, and average years of schooling.RESULTS: All-age numbers of DALYs reached over 19 million years in Iran in 2015. The all-age number of DALYs has remained stable during the past two decades in Iran, despite the decreasing trends in all-age and age-standardized rates. The all-cause DALY rates decreased from 47,200 in 1990 to 28,400 per 100,000 in 2015. The share of non-communicable diseases in DALYs increased in Iran (from 42% to 74%) and all of its neighbors between 1990 and 2015; the pattern of change is similar in almost all 16 countries. The DALY rates for NCDs and injuries in Iran were higher than global rates and the average rate in High Middle SDI countries, while those for communicable, maternal, neonatal, and nutritional disorders were much lower in Iran. Among men, cardiovascular diseases ranked first in all countries of the region except for Bahrain. Among women, they ranked first in 13 countries. Life expectancy and HALE show a consistent increase in all countries. Still, there are dissimilarities indicating a generally low LE and HALE in Afghanistan and Pakistan and high expectancy in Qatar, Kuwait, and Saudi Arabia. Iran ranked 11th in terms of LE at birth and 12th in terms of HALE at birth in 1990 which improved to 9th for both metrics in 2015. Turkey and Iran had the highest increase in LE and HALE from 1990 to 2015 while the lowest increase was observed in Armenia, Pakistan, Kuwait, Kazakhstan, Russia, and Iraq.CONCLUSIONS: The levels and trends in causes of DALYs, life expectancy, and HALE generally show similarities between the 16 countries, although differences exist. The differences observed between countries can be attributed to a myriad of determinants, including social, cultural, ethnic, religious, political, economic, and environmental factors as well as the performance of the health system. Investigating the differences between countries can inform more effective health policy and resource allocation. Concerted efforts at national and regional levels are required to tackle the emerging burden of non-communicable diseases and injuries in Iran and its neighbors.
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| 13. |
- Alehojat, Mobin, 1982-, et al.
(author)
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Electron beam-powder bed fusion of Alloy 718 : Effect of hot isostatic pressing and thermal spraying on microstructural characteristics and oxidation performance
- 2020
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In: Surface & Coatings Technology. - : Elsevier BV. - 0257-8972 .- 1879-3347. ; 404
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Journal article (peer-reviewed)abstract
- Alloy 718 manufactured via electron beam-powder bed fusion (EB-PBF) was coated with a thermally- sprayed NiCoCrAlY coating for enhanced oxidation protection. A high-velocity air fuel technique was used to deposit the coating. The specimens were then subjected to hot isostatic pressing (HIP). Oxidation of the specimens was undertaken in an ambient air environment at 650 and 800 °C for 168 h. The oxidation performance of EB-PBF-built Alloy 718 was improved after the deposition of the coating, particularly at 800 °C. In this temperature, a thick Cr-rich oxide scale was found on the uncoated Alloy 718 specimen, whereas a thin and stable Al-rich oxide scale was formed on the surface of the coated specimen. HIPing enhanced the oxidation resistance of uncoated Alloy 718; however, the oxidation behavior of coated Alloy 718 was negatively affected by HIPing. © 2020 The Authors
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| 14. |
- Ehrenberg, Måns, et al.
(author)
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tRNA-ribosome interactions
- 1995
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In: Biochemistry and Cell Biology. - 0829-8211 .- 1208-6002. ; 73:11-12, s. 1049-1054
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Research review (peer-reviewed)abstract
- Direct measurements of the rates of dissociation of dipeptidyl-tRNA from the ribosome show that hyperaccurate SmP and SmD ribosomes have unstable A-site binding of peptidyl-tRNA, while P-site binding is extremely stable in relation to the wild type. Error-prone Ram ribosomes, on the other hand, have stable A-site and unstable P-site binding of peptidyl-tRNA. At least for these mutant ribosomes, we conclude that stabilization of peptidyl-tRNA in one site destabilizes binding in the other. Elongation factor Tu (EF-Tu) undergoes a dramatic structural transition from its GDP-bound form to its active GTP-bound form, in which it binds aa-tRNA (aminoacyl-tRNA) in ternary complex. The effects of substitution mutations at three sites in domain I of EF-Tu, Gln124, Leu120, and Tyr160, all of which point into the domain I-domain III interface in both the GTP and GDP conformations of EF-Tu, were examined. Mutations at each position cause large reductions in aa-tRNA binding. An attractive possibility is that the mutations alter the domain I-domain III interface such that the switching of EF-Tu between different conformations is altered, decreasing the probability of aa-tRNA binding. We have previously found that two GTPs are hydrolyzed per peptide bond on EF-Tu, the implication being that two molecules of EF-Tu may interact on the ribosome to catalyze the binding of a single aa-tRNA to the A-site. More recently we found that ribosomes programmed with mRNA constructs other than poly(U), including the sequence AUGUUUACG, invariably use two GTPs per peptide bond in EF-Tu function. Other experiments measuring the protection of aa-tRNA from deacylation or from RNAse A attack show that protection requires two molecules of EF-Tu, suggesting an extended ternary complex. To remove remaining ambiguities in the interpretion of these experiments, we are making direct molecular weight determinations with neutron scattering and sedimentation-diffusion techniques.
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| 15. |
- Emamian, Sepehr, et al.
(author)
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Robust decentralized voltage control of an islanded microgrid under unbalanced and nonlinear load conditions
- 2013
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Conference paper (peer-reviewed)abstract
- This paper presents a new decentralized control strategy for the islanded operation of a microgrid under unknown load conditions. In the islanded mode of operation, the microgrid should provide the load with a set of regulated balanced three-phase voltages. The load which is parametrically and topologically uncertain can also be unbalanced and/or nonlinear. Thus, the use of conventional control strategies results in the poor performance and even instability of the microgrid system. The proposed method assumes that the load current is a measurable disturbance signal. The robust optimal controlapproaches are used to design a controller to overcome the disturbances resulting from the unknownloads dynamics. The optimization problem is converted to a convex problem and is solved using the linear matrix inequalities (LMIs). The performance of the designed controller is verified using time-domain simulations carried out in PSCAD/EMTDC software.
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| 16. |
- Gureya, David Daharewa, 1988-, et al.
(author)
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Bandwidth-Aware Page Placement in NUMA
- 2020
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In: 2020 IEEE International Parallel and Distributed Processing Symposium (IPDPS). - : Institute of Electrical and Electronics Engineers (IEEE). ; , s. 546-556
-
Conference paper (peer-reviewed)abstract
- Page placement is a critical problem for memory-intensive applications running on a shared-memory multiprocessor with a non-uniform memory access (NUMA) architecture. State-of-the-art page placement mechanisms interleave pages evenly across NUMA nodes. However, this approach fails to maximize memory throughput in modern NUMA systems, characterized by asymmetric bandwidths and latencies, and sensitive to memory contention and interconnect congestion phenomena.We propose BWAP, a novel page placement mechanism based on asymmetric weighted page interleaving. BWAP combines an analytical performance model of the target NUMA system with on-line iterative tuning of page distribution for a given memory-intensive application. Our experimental evaluation with representative memory-intensive workloads shows that BWAP performs up to 66% better than state-of-the-art techniques. These gains are particularly relevant when multiple co-located applications run in disjoint partitions of a large NUMA machine or when applications do not scale up to the total number of cores.
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| 17. |
- Islam, Abu Reza Md Towfiqul, et al.
(author)
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Machine learning algorithm-based risk assessment of riparian wetlands in Padma River Basin of Northwest Bangladesh
- 2021
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In: Environmental Science and Pollution Research. - : Springer Science and Business Media LLC. - 0944-1344 .- 1614-7499. ; 28, s. 34450-34471
-
Journal article (peer-reviewed)abstract
- Wetland risk assessment is a global concern especially in developing countries like Bangladesh. The present study explored the spatiotemporal dynamics of wetlands, prediction of wetland risk assessment. The wetland risk assessment was predicted based on ten selected parameters, such as fragmentation probability, distance to road, and settlement. We used M5P, random forest (RF), reduced error pruning tree (REPTree), and support vector machine (SVM) machine learning techniques for wetland risk assessment. The results showed that wetland areas at present are declining less than one-third of those in 1988 due to the construction of the dam at Farakka, which is situated at the upstream of the Padma River. The distance to the river and built-up area are the two most contributing drivers influencing the wetland risk assessment based on information gain ratio (InGR). The prediction results of machine learning models showed 64.48% of area by M5P, 61.75% of area by RF, 62.18% of area by REPTree, and 55.74% of area by SVM have been predicted as the high and very high-risk zones. The results of accuracy assessment showed that the RF outperformed than other models (area under curve: 0.83), followed by the SVM, M5P, and REPTree. Degradation of wetlands explored in this study demonstrated the negative effects on biodiversity. Therefore, to conserve and protect the wetlands, continuous monitoring of wetlands using high resolution satellite images, feeding with the ecological flow, confining built up area and agricultural expansion towards wetlands, and new wetland creation is essential for wetland management. Graphical abstract: [Figure not available: see fulltext.]
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| 18. |
- Jain, Vishal, et al.
(author)
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InP/InAsP Nanowire-Based Spatially Separate Absorption and Multiplication Avalanche Photodetectors
- 2017
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In: ACS Photonics. - Washington : American Chemical Society (ACS). - 2330-4022. ; 4:11, s. 2693-2698
-
Journal article (peer-reviewed)abstract
- Avalanche photodetectors (APDs) are key components in optical communication systems due to their increased photocurrent gain and short response time as compared to conventional photodetectors. A detector design where the multiplication region is implemented in a large band gap material is desired to avoid detrimental Zener tunneling leakage currents, a concern otherwise in smaller band gap materials required for absorption at 1.3/1.55 μm. Self-assembled III-V semiconductor nanowires offer key advantages such as enhanced absorption due to optical resonance effects, strain-relaxed heterostructures, and compatibility with mainstream silicon technology. Here, we present electrical and optical characteristics of single InP and InP/InAsP nanowire APD structures. Temperature-dependent breakdown characteristics of p+-n-n+ InP nanowire devices were investigated first. A clear trap-induced shift in breakdown voltage was inferred from I-V measurements. An improved contact formation to the p+-InP segment was observed upon annealing, and its effect on breakdown characteristics was investigated. The band gap in the absorption region was subsequently varied from pure InP to InAsP to realize spatially separate absorption and multiplication APDs in heterostructure nanowires. In contrast to the homojunction APDs, no trap-induced shifts were observed for the heterostructure APDs. A gain of 12 was demonstrated for selective optical excitation of the InAsP segment. Additional electron-beam-induced current measurements were carried out to investigate the effect of local excitation along the nanowire on the I-V characteristics. Simulated band profiles and electric field distributions support our interpretation of the experiments. Our results provide important insight for optimization of avalanche photodetector devices based on III-V nanowires.
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| 19. |
- Karimi, Armin, 1993-, et al.
(author)
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A Silicon-Micromachined Beam Shape Switchable and Beam-steering Frontend for Sub-THz Radar
-
Other publication (other academic/artistic)abstract
- This paper presents the design, fabrication, and characterization of a compact silicon-micromachined beam steering frontend circuit featuring beam shape switching and frequency beam steering. The designed beam steering frontend includes a switching circuit consisting of a crossover switch and a magic-tee for beam shape switching, as well as a delay line network connected to a corporate-fed dual-line antenna array for frequency beam steering. All components are co-designed and integrated to minimize the insertion loss. The signal chain is implemented on four layers of silicon-on-insulator chips with a total footprint of 20mm×1.4mm×1.2mm. The designed frontend operates properly in the 220-260 GHz frequency band with a measured return loss of better than 15 dB and a beam steering range of 238-248 GHz with a measured return loss of better than 20 dB. The frontend has two standard WR-3.4 waveguide input ports, and each port can create two different radiation patterns, a broad and a notched beam, in which both can be steered from 238 to 248 GHz in the E-plane of the antenna array. The sidelobe level of the broad beam is reduced by amplitude tapering and remains better than 18 dB in the H-plane of the antenna array across the scanning range. Moreover, the depth of the notched beam remains better than 17 dB in the entire scanning range, making the presented beam steering frontend well-suited for tracking, surveillance, imaging, and radar applications.
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| 20. |
- Karimi, Alireza, et al.
(author)
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Developing an experimental-computational workflow to study the biomechanics of the human conventional aqueous outflow pathway
- 2023
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In: Acta Biomaterialia. - 1742-7061. ; 164, s. 346-362
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Journal article (peer-reviewed)abstract
- The aqueous humor actively interacts with the trabecular meshwork (TM), juxtacanalicular tissue (JCT), and Schlemm's canal (SC) through a dynamic fluid-structure interaction (FSI) coupling. Despite the fact that intraocular pressure (IOP) undergoes significant fluctuations, our understanding of the hyperviscoelastic biomechanical properties of the aqueous outflow tissues is limited. In this study, a quadrant of the anterior segment from a normal human donor eye was dynamically pressurized in the SC lumen, and imaged using a customized optical coherence tomography (OCT). The TM/JCT/SC complex finite element (FE) with embedded collagen fibrils was reconstructed based on the segmented boundary nodes in the OCT images. The hyperviscoelastic mechanical properties of the outflow tissues’ extracellular matrix with embedded viscoelastic collagen fibrils were calculated using an inverse FE-optimization method. Thereafter, the 3D microstructural FE model of the TM, with adjacent JCT and SC inner wall, from the same donor eye was constructed using optical coherence microscopy and subjected to a flow load-boundary from the SC lumen. The resultant deformation/strain in the outflow tissues was calculated using the FSI method, and compared to the digital volume correlation (DVC) data. TM showed larger shear modulus (0.92 MPa) compared to the JCT (0.47 MPa) and SC inner wall (0.85 MPa). Shear modulus (viscoelastic) was larger in the SC inner wall (97.65 MPa) compared to the TM (84.38 MPa) and JCT (56.30 MPa). The conventional aqueous outflow pathway is subjected to a rate-dependent IOP load-boundary with large fluctuations. This necessitates addressing the biomechanics of the outflow tissues using hyperviscoelastic material-model. Statement of significance: While the human conventional aqueous outflow pathway is subjected to a large-deformation and time-dependent IOP load-boundary, we are not aware of any studies that have calculated the hyperviscoelastic mechanical properties of the outflow tissues with embedded viscoelastic collagen fibrils. A quadrant of the anterior segment of a normal humor donor eye was dynamically pressurized from the SC lumen with relatively large fluctuations. The TM/JCT/SC complex were OCT imaged and the mechanical properties of the tissues with embedded collagen fibrils were calculated using the inverse FE-optimization algorithm. The resultant displacement/strain in the FSI outflow model was validated versus the DVC data. The proposed experimental-computational workflow may significantly contribute to understanding of the effects of different drugs on the biomechanics of the conventional aqueous outflow pathway.
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| 21. |
- Karimi Bakhshandi, Reza, et al.
(author)
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Failure analysis of two cylindrical impact pistons subjected to high velocity impacts in drilling applications
- 2022
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In: Engineering Failure Analysis. - : Elsevier. - 1350-6307 .- 1873-1961. ; 140
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Journal article (peer-reviewed)abstract
- Top hammer drilling is a common method to drill holes in rock formations in mining and civil engineering applications. Failure of drilling machine components has a significant impact on the cost and period of the operation. Internal components of percussive hammers experience extreme loading conditions during their service life. The focus of the present case study is to characterize failure mechanisms of two cylindrical impact pistons subjected to impact loading. The investi-gated components were manufactured from two different steel grades, a surface hardened low alloyed high strength steel and a through hardened cold work tool steel.Failure of both pistons started with degradation of the impact surfaces in term of cavitation erosion and localized surface fatigue phenomena. Subsequently, chipping and removal of material from impact surfaces resulted in formation of semi-spherical holes and craters on both surfaces.Radial and hoop cracks started to develop from cavities on the impact surface. The radial cracks then propagated parallel to the impacting surface in the longitudinal direction of the piston. Once the cracks formed at the impact surface, the damage was controlled by impact fa-tigue. Fatigue beach marks were identified on the fracture surface of failed component.
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| 22. |
- Karimi, H. Reza, et al.
(author)
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Switched Multi-Radio Transmission Diversity for Non-Collocated Radio Accesses
- 2006
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In: 2006 IEEE 63RD VEHICULAR TECHNOLOGY CONFERENCE, VOLS 1-6. - 9780780393912 ; , s. 167-171
-
Conference paper (peer-reviewed)abstract
- We evaluate the spectral efficiency gains observed through multi-radio transmission diversity (MRTD), whereby packets of data are jointly scheduled for downlink transmission over multiple independent radio accesses. We specifically address downlink switched MRTD employed across macro- and pico-cellular radio accesses with non-collocated base stations in a hierarchical cell structure. It is shown that while significant gains can be achieved via MRTD among collocated macro-cell (or pico-cell) base stations, tight cooperation across non-collocated macro- and pico-cell base stations is only beneficial for a small subset of possible geometries. The impact of CQI reporting delays is also investigated.
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| 23. |
- Karimi Neghlani, Paria, 1986-, et al.
(author)
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Columnar-to-equiaxed grain transition in powder bed fusion via mimicking casting solidification and promoting in situ recrystallization
- 2021
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In: Additive Manufacturing. - : ELSEVIER. - 2214-8604 .- 2214-7810. ; 46
-
Journal article (peer-reviewed)abstract
- Columnar grain structure typically formed along the build direction in the electron beam-powder bed fusion (EBPBF) technique leads to anisotropic physical and mechanical properties. In this study, casting solidification condition was mimicked, and in situ recrystallization was promoted in EB-PBF to facilitate columnar-to-equiaxed grain structure transition in Alloy 718. This is achieved via a unique linear melting strategy coupled with a specific selection of process parameters in EB-PBF. It was found that site-specific melting using line order number (LON) function affected the cooling rate and temperature gradient, which controlled grain morphology and texture. A high LON resulted in a large equiaxed grain zone with a random texture, whereas a fixed LON with a high areal energy density led to a strong texture. The main driving force in the formation of cracks and shrinkage defects during the transition was investigated. A high LON at a fixed areal energy density reduced the average total shrinkage defects and crack length. The hardness was decreased through the transition, which was linked to the reduction in the size of the gamma ‘’ precipitates.
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| 24. |
- Karimi, Reza
(author)
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Determinants of peptidyl-tRNA drop-off from E. coli Ribosomes : Effects of antibiotics, mutations and translation factors
- 1998
-
Doctoral thesis (other academic/artistic)abstract
- During protein synthesis, some peptidyl-tRNA molecules dissociate from the ribosomes and become hydrolysed by peptidyl-tRNA hydrolase (Pth). Two different in vitro systems, poly(U) and natural mRNA programmed ribosomes, have been used in order to determine dissociation (drop-off) rates of deacylated- and peptidyl-tRNAs from different sites on ribosomes.A direct measurement of the rates of dissociation of dipeptidyl-tRNAs from the A- and P-site of poly(U) programmed wild-type (wt), hyper-accurate (SmD and SmP, altered in ribosomal protein S12) and error-prone (ram, altered in ribosomal protein S4 or S5) ribosomes has been performed. Dipeptidyl-tRNA dissociates faster from the A-site of wt than from ram ribosomes and it dissociates faster from SmD and SmP than from wt ribosomes. The dissociation of dipeptidyl-tRNA from the P-site has an opposite behaviour compared to the A-site. Dipeptidyl-tRNA dissociates faster from the P-site of ram than from wt ribosomes and faster from wt than SmD and SmP ribosomes. Aminoglycoside antibiotics [streptomycin (Sm)and neomycin (Nm)] reduce the dissociation rate of dipeptidyl-tRNA from the A-site and increase it from the P-site for all these ribosomal variants. Remarkably, when the binding of dipeptidyl-tRNA to the A-site is weak, the affinity for the P-site is strong, and vice versa. In the absence of Sm non-cognate dipeptidyl-tRNA dissociates 150 times faster from the A-site of ram ribosomes than cognate. In the presence of Sm the rate difference is only eight fold. This suggests that Sm may distort the 16S rRNA conformation and, consequently, the codon-anticodon structure.Using a new in vitro system with heteropolymeric mRNAs has revealed that i) Initiation factors IF1 and IF2 synergistically remove short peptidyl-tRNAs from the P-site of ribosomes in a way that depends both on the length and sequence of the nascent peptide. ii) Ribosome recycling factor (RFF), elongation factor G (EF-G) and release factor 3 (RF3) stimulate dissociation of short peptidyl-tRNAs from the P-site in almost the same manner as IF1/IF2. iii) RRF, EF-G, GTP and initiation factor 3 (IF3), after termination, split the 70S ribosomes and remove deacylated tRNA from the P-site of ribosomes in a mechanism that is strictly dependent on GTP hydrolysis. In vivo experiments, showing that overexpression of RRF or simultaneous overexpression of IF1/IF2 impairs growth rate in thermosensitive pth mutant strains, are consistent with the in vitro results.
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| 25. |
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