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1.	Lozano, Rafael, et al. (author) 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 In: The Lancet. - : Elsevier. - 1474-547X .- 0140-6736. ; 392:10159, s. 2091-2138 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.
2.	Stanaway, Jeffrey D., et al. (author) 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 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.
3.	Fullman, Nancy, et al. (author) Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: A systematic analysis from the Global Burden of Disease Study 2016 2018 In: The Lancet. - : Lancet Publishing Group. - 1474-547X .- 0140-6736. ; 391:10136, s. 2236-2271 Journal article (peer-reviewed)
4.	Murray, Christopher J. L., et al. (author) 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 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.
5.	Abbafati, Cristiana, et al. (author) 2020 Journal article (peer-reviewed)
6.	Feigin, Valery L., et al. (author) Global, regional, and national burden of neurological disorders, 1990–2016 : a systematic analysis for the Global Burden of Disease Study 2016 2019 In: Lancet Neurology. - : Elsevier. - 1474-4422 .- 1474-4465. ; 18:5, s. 459-480 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.
7.	Griswold, Max G., et al. (author) Alcohol use and burden for 195 countries and territories, 1990-2016 : a systematic analysis for the Global Burden of Disease Study 2016 2018 In: The Lancet. - : Elsevier. - 0140-6736 .- 1474-547X. ; 392:10152, s. 1015-1035 Journal article (peer-reviewed)abstract Background: Alcohol use is a leading risk factor for death and disability, but its overall association with health remains complex given the possible protective effects of moderate alcohol consumption on some conditions. With our comprehensive approach to health accounting within the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we generated improved estimates of alcohol use and alcohol-attributable deaths and disability-adjusted life-years (DALYs) for 195 locations from 1990 to 2016, for both sexes and for 5-year age groups between the ages of 15 years and 95 years and older.Methods: Using 694 data sources of individual and population-level alcohol consumption, along with 592 prospective and retrospective studies on the risk of alcohol use, we produced estimates of the prevalence of current drinking, abstention, the distribution of alcohol consumption among current drinkers in standard drinks daily (defined as 10 g of pure ethyl alcohol), and alcohol-attributable deaths and DALYs. We made several methodological improvements compared with previous estimates: first, we adjusted alcohol sales estimates to take into account tourist and unrecorded consumption; second, we did a new meta-analysis of relative risks for 23 health outcomes associated with alcohol use; and third, we developed a new method to quantify the level of alcohol consumption that minimises the overall risk to individual health.Findings: Globally, alcohol use was the seventh leading risk factor for both deaths and DALYs in 2016, accounting for 2.2% (95% uncertainty interval [UI] 1.5-3.0) of age-standardised female deaths and 6.8% (5.8-8.0) of age-standardised male deaths. Among the population aged 15-49 years, alcohol use was the leading risk factor globally in 2016, with 3.8% (95% UI 3.2-4-3) of female deaths and 12.2% (10.8-13-6) of male deaths attributable to alcohol use. For the population aged 15-49 years, female attributable DALYs were 2.3% (95% UI 2.0-2.6) and male attributable DALYs were 8.9% (7.8-9.9). The three leading causes of attributable deaths in this age group were tuberculosis (1.4% [95% UI 1. 0-1. 7] of total deaths), road injuries (1.2% [0.7-1.9]), and self-harm (1.1% [0.6-1.5]). For populations aged 50 years and older, cancers accounted for a large proportion of total alcohol-attributable deaths in 2016, constituting 27.1% (95% UI 21.2-33.3) of total alcohol-attributable female deaths and 18.9% (15.3-22.6) of male deaths. The level of alcohol consumption that minimised harm across health outcomes was zero (95% UI 0.0-0.8) standard drinks per week.Interpretation: Alcohol use is a leading risk factor for global disease burden and causes substantial health loss. We found that the risk of all-cause mortality, and of cancers specifically, rises with increasing levels of consumption, and the level of consumption that minimises health loss is zero. These results suggest that alcohol control policies might need to be revised worldwide, refocusing on efforts to lower overall population-level consumption.
8.	Kim, Min Seo, et al. (author) Global burden of peripheral artery disease and its risk factors, 1990-2019 : a systematic analysis for the Global Burden of Disease Study 2019 2023 In: The Lancet Global Health. - : Elsevier. - 2214-109X. ; 11:10, s. E1553-E1565 Journal article (peer-reviewed)abstract Background: Peripheral artery disease is a growing public health problem. We aimed to estimate the global disease burden of peripheral artery disease, its risk factors, and temporospatial trends to inform policy and public measures.Methods: Data on peripheral artery disease were modelled using the Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2019 database. Prevalence, disability-adjusted life years (DALYs), and mortality estimates of peripheral artery disease were extracted from GBD 2019. Total DALYs and age-standardised DALY rate of peripheral artery disease attributed to modifiable risk factors were also assessed.Findings: In 2019, the number of people aged 40 years and older with peripheral artery disease was 113 million (95% uncertainty interval [UI] 99 center dot 2-128 center dot 4), with a global prevalence of 1 center dot 52% (95% UI 1 center dot 33-1 center dot 72), of which 42 center dot 6% was in countries with low to middle Socio-demographic Index (SDI). The global prevalence of peripheral artery disease was higher in older people, (14 center dot 91% [12 center dot 41-17 center dot 87] in those aged 80-84 years), and was generally higher in females than in males. Globally, the total number of DALYs attributable to modifiable risk factors in 2019 accounted for 69 center dot 4% (64 center dot 2-74 center dot 3) of total peripheral artery disease DALYs. The prevalence of peripheral artery disease was highest in countries with high SDI and lowest in countries with low SDI, whereas DALY and mortality rates showed U-shaped curves, with the highest burden in the high and low SDI quintiles.Interpretation: The total number of people with peripheral artery disease has increased globally from 1990 to 2019. Despite the lower prevalence of peripheral artery disease in males and low-income countries, these groups showed similar DALY rates to females and higher-income countries, highlighting disproportionate burden in these groups. Modifiable risk factors were responsible for around 70% of the global peripheral artery disease burden. Public measures could mitigate the burden of peripheral artery disease by modifying risk factors.
9.	Micah, Angela E., et al. (author) 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 In: The Lancet. - : Elsevier. - 0140-6736 .- 1474-547X. ; 398:10308, s. 1317-1343 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.
10.	Mousavi, Seyed Mohsen, et al. (author) Optimal Landfill Site Selection for Solid Waste of Three Municipalities Based on Boolean and Fuzzy Methods: A Case Study in Kermanshah Province, Iran 2022 In: Land. - : MDPI AG. - 2073-445X. ; 11:10 Journal article (peer-reviewed)abstract In recent decades, population increase and urban development have led to catastrophic environmental consequences. One of the principal objectives to achieve “sustainable development” is to find suitable landfills. Due to their physical characteristics, which have led to a lack of landfill sites and closeness to water bodies, agricultural fields, and residential areas, the cities of Javanrood, Paveh, and Ravansar were chosen as the necessary research regions. On the other hand, these landfills are unable to accommodate the growing urban population. Therefore, this study attempts to develop a framework for spotting the most suitable sites for landfill construction with these three cities as case studies. For this, 10 important driving factors (9 factors and 1 constraint) in landfill site selection were generated. Second, for the fuzzy membership function, the analytic hierarchy process (AHP) method was employed for the standardization of criteria and determining the weight of the driving factors. Then, the Boolean, weighted linear combination (WLC) and ordered weighted average (OWA) methods were utilized to spot optimal sites for landfills. Finally, two suitable sites were found for landfills: site (a) was obtained from the WLC, and site (b) was obtained from OWA-low risk some trade-off (LRST) methods. Our results proved the high efficiency of multi-criteria decision-making methodology for landfill site selection.
11.	Ebrahimipour, Seyed Milad, et al. (author) Aadam : A Fast, Accurate, and Versatile Aging-Aware Cell Library Delay Model using Feed-Forward Neural Network 2020 In: IEEE ACM Int. Conf. Comput. Des. Dig. Tech. Pap. ICCAD. - New York, NY, USA : Institute of Electrical and Electronics Engineers Inc.. Conference paper (peer-reviewed)abstract With the CMOS technology scaling, transistor aging has become one major issue affecting circuit reliability and lifetime. There are two major classes of existing studies that model the aging effects in the circuit delay. One is at transistor-level, which is highly accurate but very slow. The other is at gate-level, which is faster but less accurate. Moreover, most prior studies only consider a limited subset or limited value ranges of aging factors. In this paper, we propose Aadam, a fast, accurate, and versatile aging-aware delay model for generic cell libraries. In Aadam, we first use transistor-level SPICE simulations to accurately characterize the delay degradation of each library cell under a versatile set of aging factors, including both physical parameters (i.e., initial threshold voltage and transistor width/length ratio) and operating conditions (i.e., working temperature, signal probability, input signal slew range, output load capacitance range, and projected lifetime). For each library cell, we then train a feed-forward neural network (FFNN) to learn the relation between the input aging factors and output cell delay degradation. Therefore, for a given input circuit and a given combination of aging factors, we can use the trained FFNNs to quickly and accurately infer the delay degradation for each gate in the circuit. Finally, to effectively estimate the aging-aware lifetime delay of large-scale circuits, we also integrate Aadam into a state-of-the-art static timing analysis tool called OpenTimer. Experimental results demonstrate that Aadam achieves fast estimation of the aging-induced delay with high accuracy close to transistor-level simulation.
12.	Hemminki, Kari, et al. (author) Breast Cancer Histology in Immigrants to Sweden: Do Ethnic Differences Exist? 2012 In: The Breast Journal. - : Hindawi Limited. - 1075-122X. ; 18:4, s. 392-393 Journal article (peer-reviewed)
13.	Hemminki, Kari, et al. (author) Cancer in immigrants as a pointer to the causes of cancer. 2014 In: European Journal of Public Health. - : Oxford University Press (OUP). - 1101-1262 .- 1464-360X. ; 24 Suppl 1, s. 64-71 Journal article (peer-reviewed)abstract The early cancer studies on immigrants, which started to appear some 50 years ago, showed that the incidence in cancers changes to the level of the new host country in one or two generations. These findings were fundamental to the understanding of the environmental etiology of human cancer. Many immigrant groups originate from countries with no cancer registration, and, hence, the immigrant studies may provide estimates on the indigenous cancer rates. The Swedish Family-Cancer Database has been an important source of data for immigrant studies on various diseases. The Database covers the Swedish population of the past 100 years, and it records the country of birth for each subject. A total of 1.79 million individuals were foreign born, Finns and other Scandinavians being the largest immigrant groups. Over the course of years, some 30 publications have appeared relating to cancer in immigrants. In the present article, we will review more recent immigrant studies, mainly among Swedish immigrants, on all cancers and emphasize the differences between ethnic groups. In the second part, we discuss the problem of reliable registration of cancer and compare cancer incidence among non-European immigrants with cancer incidence in countries of origin, as these have now active cancer registries. We discuss the experiences in cancer registration in Morocco and Egypt. We show the usefulness and limitations in predicting cancer incidence in the countries of origin.
14.	Hemminki, Kari, et al. (author) Disease Etiology And Prevention: Old And New Lessons From Immigrant Studies 2010 In: Epidemiologia & Prevenzione. - 1120-9763. ; 34:5-6, s. 78-78 Conference paper (peer-reviewed)
15.	Hemminki, Kari, et al. (author) Does the Breast Cancer Age at Diagnosis Differ by Ethnicity? A Study on Immigrants to Sweden 2011 In: The Oncologist. - : Oxford University Press (OUP). - 1083-7159 .- 1549-490X. ; 16:2, s. 146-154 Journal article (peer-reviewed)abstract Background. Age-specific incidence rates for breast cancer in low-risk and high-risk ethnic populations differ by age at which the incidence maximum is reached: around 50 years in low-risk populations and over 60 years in high-risk populations. The interpretation of these differences remains unsettled, one line primarily referring to biological differences, the second one to cohort effects of rapidly increasing rates in young populations, and the third one to incomplete registration of cancer in the elderly. Methods. The nationwide Family-Cancer Database was used to analyze standardized incidence ratios (SIRs) and age at diagnosis of breast cancer in female immigrants to Sweden by their region of origin compared with women native to Sweden matched on birth year and other relevant factors. Results. We showed first that the SIRs for breast cancer were lower in many immigrant groups compared with natives of Sweden; women from Turkey had the lowest SIR of 0.45, followed by those from Chile (0.54) and Southeast Asia (0.57). Women from nine regions showed an earlier mean age at diagnosis than their matched Swedish controls, the largest differences being 5.5 years for women from Turkey, 5.1 years for those from Asian Arab and "Other African" countries, 4.3 years for those from Iran, and 4.0 years for those from Iraq. Conclusions. The results show that in many immigrant groups, the diagnostic age is earlier (< 50 years) than in natives of Sweden (> 50 years), suggesting that true biological factors underlie the differences. These factors may explain much of the international variation in breast cancer incidence. Identifying these factors should advance understanding of breast cancer etiology and prevention. The Oncologist 2011; 16: 146-154
16.	Hemminki, Kari, et al. (author) Histology-specific risks in testicular cancer in immigrants to Sweden 2010 In: Endocrine-Related Cancer. - 1479-6821. ; 17:2, s. 329-334 Journal article (peer-reviewed)abstract The changes of cancer incidence upon immigration have been used as an estimator of environmental influence on cancer risk. The previous immigrant studies have indicated that the origins of testicular cancer are at an early age in life, probably in the intrauterine period. We wanted to reexamine the critical periods on histology-specific testicular cancer in sons of immigrants to Sweden. We used the nationwide Swedish Family-Cancer Database to calculate standardized incidence ratios (SIRs) for testicular cancer in sons of parents immigrating to Sweden from low-and high-risk countries compared with the native Swedes. Among the large immigrant groups, the SIRs for sons of two Finnish and Asian parents were decreased if the sons were born outside Sweden. The sons of a Danish immigrant couple showed an increased risk of testicular cancer. The changes in SIR were most systematic for seminoma. The present patterns of testicular cancer risk among sons of immigrants point to the early environmental risk factors, which influence the risk probably after the intrauterine period. These factors appear to influence seminoma risk in a more enduring way than they influence non-seminoma. Endocrine-Related Cancer (2010) 17 329-334
17.	Hemminki, Kari, et al. (author) Liver and gallbladder cancer in immigrants to Sweden. 2010 In: European Journal of Cancer. - : Elsevier BV. - 1879-0852 .- 0959-8049. ; 46, s. 926-931 Journal article (peer-reviewed)abstract BACKGROUND: The changes of cancer incidence upon immigration can be used as an estimator of environmental influence on cancer risk. We studied site-specific liver and biliary cancers in first-generation immigrants to Sweden with an aim to search for aetiological clues and to find evidence for indigenous incidence rates. MATERIAL AND METHODS: We used the nation-wide Swedish Family-Cancer Database to calculate standardised incidence ratios (SIRs) in immigrants compared to native Swedes. RESULTS: A total of 1428 cancers were identified in immigrants whose median ages (years) at immigration were 27 for men and 26 for women and whose median diagnostic ages were 64 and 66, respectively. The highest SIRs of 6.7 for primary liver cancer were observed for men from East Asia and sub-Saharan Africa. Increased SIRs were recorded for male immigrants from previous Yugoslavia (1.78), Southern Europe (2.91), Turkey (2.15) and Asian Arab countries (2.89). For gallbladder cancer, only women from the Indian subcontinent (3.84) and Chile (2.34) had increased risk while some Northern European immigrants showed decreased risks. CONCLUSIONS: Primary liver cancer was increased in immigrants from endemic regions of hepatitis B virus infection but also from large regions lacking cancer incidence data, North Africa, Asian Arab countries, Turkey and previous Yugoslavia; these are probably intermediary risk regions for this infection. The consideration of these regions as risk areas would justify active diagnostic and vaccination programs. The increase in gallbladder cancer in Chileans and Indians suggests that some persistent damage was inflicted before emigration, characterisation of which will be a challenge for aetiological studies.
18.	Hemminki, Kari, et al. (author) Preventable breast cancer is postmenopausal 2011 In: Breast Cancer Research and Treatment. - : Springer Science and Business Media LLC. - 1573-7217 .- 0167-6806. ; 125:1, s. 163-167 Journal article (peer-reviewed)abstract Breast cancer incidence has markedly increased in Western countries for reasons that are not entirely understood. We characterized periodic and age-specific incidence trends of breast cancer in immigrants who migrated from low incidence areas to Sweden. The incidence in immigrants was compared to that in native Swedes and standardized incidence ratios (SIRs) were calculated, based on the Swedish Family-Cancer Database. Age-specific incidence data for low and high incidence populations were obtained from Cancer Incidence in Five Continents IX and NORDCAN. For immigrants from the seven lowest countries/regions 535 breast cancers were identified; the SIRs ranging from 0.45 for Turkish to 0.70 for Greek women. The SIR increased somewhat with the length of stay in Sweden, from 0.55 for stay between 0 and 10 years to 0.59 for a stay of 20+ years. The age-specific incidence curves for these immigrants were superimposable upon the earliest Swedish (year 1960) or Danish (1943) rates. These rates differed from the current Swedish rates by a much lower postmenopausal component. Large incidence differences were also observed between white Californians and immigrants from China and Korea. Our results show that the main difference between high and low incidence areas is in postmenopausal cancer which has increased preferentially during the past century. Immigrants from low risk areas to Sweden show age-specific incidence patterns of Swedes half a century ago. These differences offer opportunities for the identification of factors underlying breast cancer etiology and tools for prevention.
19.	Hemminki, Kari, et al. (author) Prostate cancer incidence and survival in immigrants to Sweden 2013 In: World Journal of Urology. - : Springer Science and Business Media LLC. - 1433-8726 .- 0724-4983. ; 31:6, s. 1483-1488 Journal article (peer-reviewed)abstract The large international variation in the incidence of prostate cancer (PC) is well known but the underlying reasons are not understood. We want to compare PC incidence and survival among immigrants to Sweden in order to explain the international differences. Cancer data were obtained from the Swedish Cancer Registry. Standardized incidence ratios (SIRs) were calculated for PC in first-degree immigrants by country of birth. The immigrants were classified into four groups by SIR and area of origin. Survival in PC was assessed by hazard ratio (HR) in the four groups. In some analyses, clinical stage of PC was assessed by the tumor, node, and metastasis classification. The SIR was 0.47 (95 % confidence interval 0.43-0.51) for immigrants with the lowest risk, constituting men from Turkey, Middle East, Asia, and Chile. The HR was 0.60 (0.45-0.81) for these men and it was 0.49 if they had stayed 20+ years in Sweden. The SIR in screening detected PC, T1c, was 0.55. Among these men, screening detected PC constituted 34.5 % of all PC, compared to 29.0 % among Swedes (p = 0.10). The results showed that the non-European immigrants, of mainly Middle East, Asian, and Chilean origin, with the lowest risk of PC, also had the most favorable survival in PC. As the available clinical features of PC at diagnosis or the distribution of known risk factors could not explain the differences, a likely biological mechanism through a favorable androgenic hormonal host environment is suggested as an explanation of the observed effects.
20.	Hemminki, Kari, et al. (author) Testicular and prostate cancers: genetic and environmental factors 2010 In: International Journal of Andrology. - 0105-6263. ; 33, s. 31-32 Conference paper (peer-reviewed)
21.	Hemminki, Karl, et al. (author) The Swedish Family-Cancer Database 2009: prospects for histology-specific and immigrant studies 2010 In: International Journal of Cancer. - : Wiley. - 0020-7136 .- 1097-0215. ; 126:10, s. 2259-2267 Journal article (peer-reviewed)abstract The Swedish Family-Cancer Database comprises a total of 11.8 million individuals covering the Swedish population of the past 100 years. Version VIII of the Database is described in the present article. Cancer cases were retrieved from the Swedish Cancer Registry for the period 1958-2006, including more than 1 million first primary cancers. The number of familial cancers in offspring is 14,000 when a parent was diagnosed with a concordant (same) cancer and the number of concordant siblings was 6,000. From the year 1993 onwards histopathological data according to the SNOMED classification were used, which entails advantages for certain cancers, such as breast cancer. Even though the specific morphological classification only covers a limited number of years, it does cover most familial cancers in the offspring generation. The Database records the country of birth for each subject. A total of 1.79 million individuals were foreign born, Finns and other Scandinavians being the largest immigrant groups. The cancer incidence in the first-generation immigrants was compared to that in native Swedes using standardised incidence ratios (SIRs) to measure relative risk. The SIRs ranged widely between the immigrant groups, from 1.9-fold for myeloma to 25-fold for melanoma. The differences in SIRs were smaller in the second-generation immigrants. The usefulness and the possible applications of the Family-Cancer Database have increased with increasing numbers of cases, and the numerous applications have been described in some 300 publications. Familial cancer studies are in the stimulating interphase of the flourishing disciplines of genetics and epidemiology.
22.	Momeni Dolatabadi, Amir, et al. (author) Last stage stator blade profile improvement for a steam turbine under a non-equilibrium condensation condition : A CFD and cost-saving approach 2023 In: Alexandria Engineering Journal. - : Elsevier BV. - 1110-0168 .- 2090-2670. ; 73, s. 27-46 Journal article (peer-reviewed)abstract Non-equilibrium phenomena and related damages have always been one of the great concerns among researchers, designers, and industry managers. In power plants, the overhaul of turbines during a pre-planned schedule includes checking, repairing, and replacing damaged parts, which always challenge industry investors with variable costs. In this study, a modified profile for the stationary cascade blades of a 200 MW steam turbine is predicted by help of the Computational Fluid Dynamics (CFD) according to a cost-saving approach for a power plant. Wet steam model is used to investigate the flow behavior between the turbine blades, due to the sonication and non-equilibrium phenomena. The numerical model based on the Eulerian-Eulerian approach accounts the turbulence caused by the presence of droplets, condensation shocks and aerodynamics. At first, such model has been carefully validated against the available experimental data. Then, the entrance edge of the blade is designed considering different shapes and sizes. The flow behavior at the entrance edge region has been fully investigated. Finally, according to the criteria for measuring the non-equilibrium flow phenomena (erosion rate, Mach number, entropy, exergy destruction and transfer of mass and heat between flow phases), a modified model for the steam turbine blade considering the economic aspects has been presented. The modified blade model exhibits 88%, 0.13% and 7% reduction in the erosion rate, entropy generation and exergy destruction, respectively. Furthermore, the application of this modified blade profile save 456$ of the total monthly maintenance costs.
23.	Mousavi, Seyed Mohsen, et al. (author) Age- and time-dependent changes in cancer incidence among immigrants to Sweden: colorectal, lung, breast and prostate cancers 2012 In: International Journal of Cancer. - : Wiley. - 0020-7136. ; 131:2, s. 122-128 Journal article (peer-reviewed)abstract To examine the role of gender, age at immigration and length of stay on incidence trends of common cancers, we studied risk of colorectal, lung, breast and prostate cancers in immigrants to Sweden from 1958 to 2008. The nationwide Swedish Family-Cancer Database was used to calculate standardized incidence ratios for common cancers among immigrants compared to Swedes. Immigrants were classified into high-risk countries when their risk was increased, into low-risk when their risk was decreased and into other when their risk was nonsignificant. Among those who immigrated at younger age (<30 years), we found an increasing trend for colorectal cancer risk in low-risk men and high-risk women. Among those who immigrated at older age (=30 years), a decreasing lung cancer risk in high-risk men and an increasing breast cancer risk in low-risk women were observed. The increasing trend of prostate cancer risk was independent of age at immigration. The risk trends for other immigrants were between the risks of low- and high-risk countries. The gender-specific shifts in cancer risks in immigrants toward the risk in natives indicate a major role of sex, age at immigration and environmental exposures in colorectal and lung cancers risks. In contrast, the unchanged trend of breast cancer among those who immigrated at younger ages and an increasing trend for those who migrated at older ages may suggest a limited effect for environmental exposures, especially at younger age. Our study points out a role of age at immigration on the risk trend of cancer.
24.	Mousavi, Seyed Mohsen, et al. (author) Cancer incidence among Iranian immigrants in Sweden and Iranian residents compared to the native Swedish population 2010 In: European Journal of Cancer. - : Elsevier BV. - 1879-0852 .- 0959-8049. ; 46:3, s. 599-605 Journal article (peer-reviewed)abstract Background and goals: Comparing cancer incidence by migrant studies is one of the main approaches to generate hypotheses on the aetiology of cancer. Immigrant studies are most informative when cancer incidence data are available from both the Source and the host country. Methods: The age standardised incidence rate (ASR) and standardised incidence ratio (SIR) of cancers among the Iranian immigrants were compared to the native Swedish population as the standard population by using the Swedish Family-Cancer Database (FCD) from 1958 to 2006. We also compared SIRs between Iranian immigrants and Iranian residents for whom the data were derived from the Iranian national cancer registry report of 2006. Results: Among the 65,501 Iranian immigrants, the median age at immigration was 26 years and the median length of stay was 16 years. Their all-cancer ASR was 175.3 and 153.1 per 100,000 person years for males and females, respectively, during the period from 1996 to 2006, higher than for the Iranian residents. The ASRs increased among the male Iranian immigrants during the past two decades but were stable among females. The risk for all-cancers among Iranian immigrants was lower than that for the native Swedish population. The Iranian immigrants had a significantly increased risk for male urinary bladder (SIR = 1.40) and thyroid cancers (2.64) compared to the Swedes. Conclusion: The reasons for the decreased risk for all-cancers among the Iranian immigrants remain to be established. The ASR difference between the Iranian immigrants and the Iranian residents may be due to the differences between the registry systems, selected immigrant groups and environmental exposures. (C) 2009 Elsevier Ltd. All rights reserved.
25.	Mousavi, Seyed Mohsen, et al. (author) Cancer incidence among Turkish, Chilean, and North African first-generation immigrants in Sweden compared with residents in the countries of origin and native Swedes. 2012 In: European Journal of Cancer Prevention. - 1473-5709. Journal article (peer-reviewed)abstract We compared the incidence of cancer among Turkish, Chilean, and North African (NA) first-generation immigrants with residents in their countries of origin and native Swedes. The Swedish Family-Cancer Database was used to calculate age-standardized incidence rates. We compared the age-standardized incidence rates for immigrants with those in the Cancer Incidence in Five Continents report. All-cancer rates were decreased in Turks (men) and Chileans and increased in NAs compared with the residents in their countries of origin. The rates of stomach cancer in Chileans and lung cancer in Turkish men were decreased, whereas Turkish women had an increased rate of lung cancer. Furthermore, the rate of prostate cancer in Turks and NAs and nervous system tumors in NA men and Turkish women were increased. Chileans had higher rates of stomach and testicular cancers and lower rates of colon cancer, nervous system tumors, and non-Hodgkin's lymphoma compared with Swedes. Higher rates of male lung cancer and female thyroid cancer, and lower rates of male rectal and kidney cancers and nervous system tumors, and female stomach and colon cancers were observed among Turks compared with Swedes. The differences observed in all-cancer rates among immigrants were mostly attributable to decreased rates of stomach and lung cancers or an increased rate of prostate cancer after migration. We observed increased rates of colon, breast, and nervous system cancers after migration, whereas the rates of testicular, kidney and thyroid cancers, and non-Hodgkin's lymphoma remained unchanged.
26.	Mousavi, Seyed Mohsen, et al. (author) Cancer incidence, trends, and survival among immigrants to Sweden: a population-based study. 2015 In: European Journal of Cancer Prevention. - 1473-5709. Journal article (peer-reviewed)abstract This review aimed at covering cancer risk trends by site and histology in first-generation and second-generation immigrants in Sweden compared with natives. In addition, we reviewed data on cancer survival in immigrants to explore factors explaining cancer survival in the entire population. The Swedish Family-Cancer Database was used to calculate standardized incidence ratios and hazard ratios (HRs) of death from cancer in 77 360 and 993 824 cases among first-generation, and 4356 and 263 485 cases among second-generation immigrants and Swedes, respectively. Ordinal logistic regression analyses were used to calculate odds ratio. To obtain the maximum number of cases, we classified the immigrants according to geographical setting, population, and/or cancer risk. Compared with native Swedes, the highest risk of cancer was observed for nasopharyngeal carcinoma in Southeast Asian men (standardized incidence ratio=35.6) and women (24.6), for hypopharyngeal carcinoma in Indian men (5.4), for squamous-cell carcinoma of the esophagus in Iranian women (3.8), for cardia of the stomach in East Asian women (4.2), for signet-ring cell carcinoma of the stomach in Southeast Asian women (6.7), for the liver in East Asian men (6.8), for the gall bladder in Indian women (3.8), for the pancreas in North African men (2.2), for large cell carcinoma of the lung in former Yugoslavian men (4.2), for pleural mesothelioma in Turkish women (23.8), for the cervix in Danes (1.6), for seminoma in Chileans (2.1), for transitional-cell carcinoma of the bladder in Asian Arab men (2.3), for meningioma in former Yugoslavians (1.3), and for papillary carcinoma of the thyroid in East and Southeast Asian men (3.6). No immigrant groups had an increased risk of breast, uterus, ovary, and prostate cancers or nervous system tumors. The HRs for all breast cancers were between 1.0 in low-risk Europeans and 1.2 in lowest-risk non-Europeans. Low-risk non-Europeans had an HR of 2.9 for lobular carcinoma. Low-risk non-Europeans were diagnosed in a higher T-class (odds ratio=1.9) than Swedes. The HRs for prostate cancer were 0.6 in Turks, Middle Easterners, Asians, and Chileans. In conclusion, environmental and behavioral factors, early-childhood exposures, and infections may play a major role in the risk of esophageal, stomach, liver, nasopharyngeal and hypopharyngeal cancers, malignant pleural mesothelioma, breast, gynecological, testicular, urinary bladder, and thyroid cancers. Pancreatic cancer and nervous system tumors may have a major genetic component in the etiology. The ethnic differences in the risk of breast cancer by histology had no major influence on survival. Middle Easterners, Asians, and Chileans, with the lowest risk of prostate cancer, also had the most favorable survival, suggesting a biological mechanism for this finding.
27.	Mousavi, Seyed Mohsen, et al. (author) Do Reproductive Factors Influence T, N, and M Classes of Ductal and Lobular Breast Cancers? A Nation-Wide Follow-Up Study 2013 In: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 8:5 Journal article (peer-reviewed)abstract Backgrounds: The clinical tumor-node-metastasis (T, N and M) classes of breast cancers provide important prognostic information. However, the possible association of TNM classes with reproductive factors has remained largely unexplored. Because every woman has a reproductive history, implications to outcome prediction are potentially significant. Methods: During the study period from 2002 through 2008, 5,614 pre- and 27,310 postmenopausal patients were identified in the Swedish Family-Cancer Database. Ordinal logistic regression analysis was used to estimate odds ratios (ORs) for TNM classes of breast cancers by histology. The reproductive variables were parity, age at first and last childbirth and time interval between first and last childbirth. Results: Among postmenopausal patients, the ORs for high-T class (T2-T4) (tumor size >= 2 cm) and metastasis were decreased by parity. A late age at first and last childbirth associated with high-T class and the effects were higher for lobular (OR for late age at first childbirth = 2.85) than ductal carcinoma. Overall, long time interval between first and last childbirth was related to high-T class and metastasis. However, a short time interval between first and last childbirth in patients with late age at first or last childbirth increased the risk of metastasis. Late age at last childbirth was associated with increased occurrence of lobular carcinoma in situ. Among premenopausal ductal carcinoma patients, nulliparity and early age at first childbirth were associated with high-T class. Conclusions: Increasing parity was protective against high-T class and metastasis; late ages at first and last childbirth were risk factors for high-T class in postmenopausal breast cancers. The current decline in parity and delayed age at first childbirth in many countries may negatively influence prognosis of breast cancer.
28.	Mousavi, Seyed Mohsen, et al. (author) Does immigration play a role in the risk of gastric cancer by site and by histological type? A study of first-generation immigrants in Sweden 2011 In: Gastric Cancer. - : Springer Science and Business Media LLC. - 1436-3291 .- 1436-3305. ; 14:3, s. 285-289 Journal article (peer-reviewed)abstract The observed increased risks of gastric cancer among first-generation immigrants compared to those in Swedes suggest the role of childhood environmental exposure in the risk of this disease.
29.	Mousavi, Seyed Mohsen, et al. (author) Does Immigration Play a Role in the Risk of Pancreatic Cancer? A Study on Immigrants to Sweden 2010 In: Pancreas. - 0885-3177 .- 1536-4828. ; 39:7, s. 1118-1120 Journal article (other academic/artistic)
30.	Mousavi, Seyed Mohsen, et al. (author) Does the risk of stomach cancer remain among second-generation immigrants in Sweden? 2012 In: Gastric Cancer. - : Springer Science and Business Media LLC. - 1436-3291 .- 1436-3305. ; 15:2, s. 213-215 Journal article (peer-reviewed)abstract The observed increased risks of noncardia stomach cancer among foreign-born second-generation immigrants compared to the Swedes suggest that these immigrants were infected by Helicobacter pylori before immigration.
31.	Mousavi, Seyed Mohsen, et al. (author) Esophageal cancer risk among immigrants in Sweden. 2011 In: European Journal of Cancer Prevention. - 1473-5709. ; 20, s. 71-76 Journal article (peer-reviewed)abstract Esophageal squamous cell carcinoma is linked to alcohol drinking, whereas esophageal adenocarcinoma risk is increased by overweight and obesity. Both histologies are directly related to tobacco smoking. We wanted to define the risk of esophageal cancer by histology and length of stay among immigrants in Sweden. The nationwide Swedish Family Cancer database (2010 version: data on cancers originate from the nationwide Swedish Cancer Registry) was used to calculate standardized incidence ratios (SIRs) for esophageal cancer among immigrants compared with the native Swedes. SIRs for lung cancer were also calculated as a proxy for smoking prevalence. The patient series covered 5930 male and 1998 female Swedes, and 410 and 198 immigrants. The risk of esophageal cancer was increased in female Finns (SIR=1.66), Britons (3.73), and Southeast Africans (5.26), whereas male Baltic (0.44), former Yugoslavian (0.47), other Europeans (0.58), and other Asians (0.52) showed a decreased risk. The risk of squamous cell carcinoma was increased among Finns (men=1.32, women=1.90) and Iranian women (3.80), whereas Danish men (1.66) had an increased risk of adenocarcinoma. No trend was observed for the risks in immigrants according to the length of stay. We found no covariation between the birth region-specific SIRs for squamous cell carcinoma and lung cancer. Early childhood exposures or preservation of original habits might be the main environmental exposures influencing squamous cell carcinoma risks in some immigrants. The increased risk of adenocarcinoma among Danish men may confirm the role of obesity in adenocarcinoma risk.
32.	Mousavi, Seyed Mohsen, et al. (author) Ethnic differences in breast cancer risk and survival: A study on immigrants in Sweden 2013 In: Acta Oncologica. - 1651-226X. ; 52:8, s. 1637-1642 Journal article (peer-reviewed)abstract Background. There are large geographic differences in breast cancer risk but whether survival differs between low- and high-risk groups is less well-established. As the survival of cancer depends on the level of healthcare and awareness of disease risks, subtle differences in cancer biology cannot be revealed in international comparisons. Instead, comparison of diverse immigrant groups in a country of uniformly accessible healthcare system should enable conclusions to be made about ethnic determinants of cancer risk and survival. Material and methods. The Swedish Family-Cancer Database was used to calculate standardized incidence (SIRs) and hazard ratios (HRs) of death from female breast cancer in 12 505 and 137 547 patients diagnosed with breast cancer among immigrants and Swedes, respectively. The ratios were adjusted for age, period, region, parity, and age at first childbirth. Ordinal logistic regression analysis was used to estimate odds ratios (ORs) for the clinical TNM classes. The analyses were stratified by menopausal status and histology. Results. Turks, Southeast Asians, and Chileans had the lowest breast cancer risk (SIR = 0.44; 95% CI 0.37-0.51) and Iraqis the highest risk (1.19; 1.05-1.35), mainly due to premenopausal cancer (1.51; 1.27-1.78). The HRs for all breast cancers were between 0.98 (0.81-1.18) (low-risk Europeans) and 1.24 (0.94-1.63) (lowest-risk non-Europeans), but were not significant. No differences in survival of ductal carcinoma between immigrants and Swedes were found, while low-risk non-Europeans had a HR of 2.88 (1.37-6.08) for lobular carcinoma. Low-risk non-Europeans were diagnosed in a higher T-class (OR = 1.87; 1.21-2.87) than Swedes. Conclusion. We did not find any evidence that ethnic differences in breast cancer risk substantially affect the survival. The observed poor survival of some low-risk immigrants in lobular carcinoma may be related to treatment. The tendency of low-risk immigrants to present with higher T-class compared to Swedes may depend on their lower participation in the mammography screening program.
33.	Mousavi, Seyed Mohsen, et al. (author) Examining the Role of the Main Terrestrial Factors Won the Seasonal Distribution of Atmospheric Carbon Dioxide Concentration over Iran 2023 In: Journal of the Indian Society of Remote Sensing. - : Springer Science and Business Media LLC. - 0255-660X .- 0974-3006. ; 51:4, s. 865-875 Journal article (peer-reviewed)abstract Global warming is one of the most important environmental issues from the last few decades and is causing climate change due to carbon dioxide (CO2) emissions and other greenhouse gases (GHG) emissions. Therefore, examination of atmospheric CO2 concentration (XCO2) variations on the local and global scale is critical. The purpose of this research was to analyze the role of environmental variables in the seasonal distribution of XCO2 from 2015 to 2021 across Iran. Initially, by using XCO2 data acquired from the OCO-2 satellite, yearly and seasonal Spatio-temporal XCO2 distribution maps were developed. Subsequently, to understand the role of environmental variables on the Spatio-temporal variations of XCO2, the correlation of XCO2 with vegetation cover, precipitation and temperature were examined in different seasons. The annual increase of XCO2 can be observed, the concentrations in each year in all the areas were higher than those in the previous year. There was a different pattern of the spatial distribution of XCO2 in different seasons. In the growing seasons (spring and summer), the critical role of environmental variables in the north and west of Iran caused reaching XCO2 to the minimum amount. While in the cold seasons (autumn and winter) due to the decrease of vegetation cover, the XCO2 did not decrease in these areas. Furthermore, finding the correlation of XCO2 with environmental variables revealed that XCO2 had a significant correlation with these variables in the growing seasons. These correlations showed that the region with low vegetation coverage and precipitation and high temperature, which is situated in the south and east of Iran had the maximum amount of XCO2. Our results suggested the potential of satellite data for producing Spatio-temporal distribution maps that will help us to a better understanding of the carbon cycle at a regional scale.
34.	Mousavi, Seyed Mohsen, et al. (author) Is risk of pleural mesothelioma an environmental risk outside Turkey? A study on immigrants to Sweden 2010 In: Lung Cancer. - : Elsevier BV. - 1872-8332 .- 0169-5002. ; 68:1, s. 125-126 Journal article (other academic/artistic)
35.	Mousavi, Seyed Mohsen, et al. (author) Morbidity and mortality in gynecological cancers among first- and second-generation immigrants in Sweden 2012 In: International Journal of Cancer. - : Wiley. - 0020-7136. ; 131:2, s. 497-504 Journal article (peer-reviewed)abstract We studied the effect of new environment on the risk in and mortality of gynecological cancers in first- and second-generation immigrants in Sweden. We used the nationwide Swedish Family-Cancer Database to calculate standardized incidence/mortality ratios (SIRs/SMRs) of cervical, endometrial and ovarian cancers among immigrants in comparison to the native Swedes. Risk of cervical cancer increased among first-generation immigrants with Danish (SIR = 1.64), Norwegian (1.33), former Yugoslavian (1.21) and East European (1.35) origins, whereas this risk decreased among Finns (0.88) and Asians (SIRs varies from 0.11 in Iranians to 0.54 in East Asians). Risk of endometrial (SIRs varies from 0.28 in Africans to 0.86 in Finns) and ovarian (SIRs varies from 0.23 in Chileans to 0.82 in Finns) cancers decreased in first-generation immigrants. The overall gynecological cancer risk for the second-generation immigrants, independent of the birth region, was almost similar to that obtained for the first generations. The birth region-specific SMRs of gynecological cancers in first- and second-generation immigrants co-varied with the SIRs. Risk of gynecological cancers among the first-generation immigrants is similar to that in their original countries, except for cervical cancer among Africans and endometrial cancer among North Americans and East Europeans. Our findings show that risk and mortality of gynecological cancers observed in the first-generation immigrants remain in the second generation. We conclude that the risk and protective factors of gynecological cancers are preserved upon immigration and through generations, suggesting a role for behavioral factors or familial aggregation in the etiology of these diseases.
36.	Mousavi, Seyed Mohsen, et al. (author) Nasopharyngeal and hypopharyngeal carcinoma risk among immigrants in Sweden 2010 In: International Journal of Cancer. - : Wiley. - 0020-7136 .- 1097-0215. ; 127:12, s. 2888-2892 Journal article (peer-reviewed)abstract Environmental exposures, particularly infection with Epstein-Barr virus (EBV) and tobacco, are known risk factors for oral cancer. Studies in migrants may provide valuable insight into the environmental and genetic etiology of cancer. We wanted to define nasopharyngeal and hypopharyngeal carcinoma among immigrants in Sweden. The nationwide Swedish Family-Cancer Database (FCD) was used to calculate standardized incidence ratios (SIRs) for nasopharyngeal and hypopharyngeal carcinomas among the first-generation immigrants compared to the native Swedes. The FCD included 1969 and 691 cases of nasopharyngeal and hypopharyngeal carcinoma in the male and female Swedes and 178 and 65 cases in immigrants, respectively. The median age at diagnosis (years) was 63 among Swedes and 55 among immigrants. The risk of nasopharyngeal carcinoma was significantly higher in male (SIR = 35.6) and female (24.6) Southeast Asians, male (12.4) and female (34.7) North Africans, male (4.9) and female (10.9) Asian Arabs and some other male Asians immigrants (6.2 to 6.7). Among immigrants from European countries, only the men from former Yugoslavian showed an elevated risk (2.7). Hypopharyngeal carcinoma risk was only increased among the male immigrants from the Indian Subcontinent (5.4). Early life infection with EBV in countries of origin and probably a minor contribution by tobacco smoking may be the main environmental exposures influencing nasopharyngeal carcinoma risks among immigrants to Sweden. The high rates of hypopharyngeal carcinoma among Indian immigrants may point to a continued using of smokeless tobacco.
37.	Mousavi, Seyed Mohsen, et al. (author) Nervous system tumors in adult immigrants to Sweden by subsite and histology. 2011 In: European Journal of Neurology. - : Wiley. - 1351-5101. ; 18, s. 766-771 Journal article (peer-reviewed)abstract Background: The coding of histology of nervous system (NS) tumors with various degrees of malignancies differs between cancer registries, whereby the comparison of incidence rates from one registry to another seems difficult. No study has systematically defined whether the change in the risk of NS tumors upon immigration in adulthood varies by subsite or histology. Therefore, we aimed to address this issue amongst the first-generation immigrants to Sweden based on a large uniform cancer registry data (1958-2006). Methods: The nationwide Swedish Family-Cancer Database (2008 version; >11.8 million individuals; 1.8 million immigrants; histology code in force since 1958) was used to calculate standardized incidence ratios (SIRs). We analyzed 28 981 adult cases of NS tumors amongst Swedes and 2519 amongst immigrants (age ≥30). Results: Significantly decreased risks for brain glioma were amongst German (SIR = 0.64), Eastern European (0.62), some Asian (0.71), Chilean (0.34), and African immigrants (0.52). We found an increased risk for brain meningioma amongst Finns (1.15) and former Yugoslavians (1.33), whilst only Norwegians (0.71) and Latin Americans (0.21) had a decreased risk. The risk for spinal ependymoma and astrocytoma was increased in Germans (3.66) and former Yugoslavians (8.89). We found no significant difference for peripheral nerve tumors between immigrants and the native Swedes. Conclusion: Significant differences between risk of NS tumors amongst immigrants and the native Swedes may suggest different risk factor profiles for glioma compared to meningioma indicating a higher etiological role of genetic background or childhood environmental risk factors rather than exposures after immigration.
38.	Mousavi, Seyed Mohsen, et al. (author) Risk of Kaposi Sarcoma Among Immigrants to Sweden 2014 In: Acta Dermato-Venereologica. - : Medical Journals Sweden AB. - 1651-2057 .- 0001-5555. ; 94:4, s. 476-477 Journal article (peer-reviewed)abstract Kaposi sarcoma (KS) is a locally aggressive endothelial tumour that is classified into 4 clinico-epidemiological forms: classic KS affecting lower limbs in elderly Mediterranean or East European men; endemic KS occurring in extremities among Equatorial African middle-aged men and children; iatrogenic KS involving lower limbs in immunosuppressive patients; and AIDS-associated (epidemic) KS observed among homo- and bisexual HIV-1-infected young men (1, 2). The world-wide epidemiology of KS has changed by spreading of HIV infection (1). For example, KS represented 7% of all cancers in Sub-Saharan African men in the 1960s, whereas in the 1980s the rate increased to 50%. Furthermore, the age distribution of KS has changed from elderly (in classic form) to the late thirties (in epidemic form). KS is a rare tumour in Nordic countries; the incidence is 0.1-0.2/100,000 according to the Cancer Incidence in Five Continents (CI5) report (3). According to this source, the rate in many Asian countries is <0.5/100,000, whereas African American men have a rate of 6.2/100,000. The highest rate is in men from Zimbabwe (52.2/100,000) (3). Human herpesvirus 8 (HHV-8) is the recognised cause of all forms of KS (2). There is discrepancy between the prevalence of HHV-8 and KS incidence in some populations suggesting underreporting of KS or the existance of some unknown protective factors for KS (1). Migrant studies provide data on international differences in cancer rates (4). Furthermore, studies on immigrants may provide supplementary and confirmatory data on the incidence of cancer in countries without local cancer registries. A few available studies on immigrants have focused only on classic KS (5, 6). In the present study, we report mean age at diagnosis and KS rates by site in first-generation immigrants to Sweden.
39.	Mousavi, Seyed Mohsen, et al. (author) Risk of lung cancer by histology among immigrants to Sweden 2012 In: Lung Cancer. - : Elsevier BV. - 1872-8332 .- 0169-5002. ; 76:2, s. 159-164 Journal article (peer-reviewed)abstract Background: We wanted to define lung cancer incidence rates by histological subtype among immigrants in Sweden to explore the effect of new environments on the incidence of lung cancer by histological subtype in different ethnic populations. Methods: The nationwide Swedish Family-Cancer Database w used to calculate age-standardized incidence rates (ASR) (per 100,000) and standardized incidence ratios (SIRs). The patient series covered 19,255 male and 14,601 female Swedes, and 3236 male and 1751 female immigrants. Results: By time since immigration, Former Yugoslavian (ASR = 46.4) and Asian Arab (38.8) men, and Danish (23.3), Norwegian (19.5) and Finnish (14.5) women had the highest rates for lung cancer, while the lowest rate was seen among Asian Arab women (5.8). The highest adenocarcinoma rates were seen among South European men (11.5), and Danish (7.4) and Norwegian (6.9) women, while squamous cell (SCC) and small cell carcinomas rates were the highest among former Yugoslavian (16.0) and Baltic (8.8) men, respectively. Former Yugoslavian men (2.6) had the highest rate for large cell carcinoma. Compared to Swedes, former Yugoslavian men had the highest significant risk for SCC (SIR = 3.62), small cell (3.14) and large cell (4.21) carcinomas, whereas the highest adenocarcinoma risk was seen among Asian Arabs (2.35). Danish women had the highest risks for SCC (1.91) and small cell carcinoma (2.56). Conclusion: The ethnic-specific lung cancer rates by histology followed the rates in the countries of origin. Our findings may suggest that preservation of smoking habits in the host country is linked to the ethnic diversity of lung cancer incidence by histology. (C) 2011 Elsevier Ireland Ltd. All rights reserved.
40.	Mousavi, Seyed Mohsen, et al. (author) Risk of transitional-cell carcinoma of the bladder in first- and second-generation immigrants to Sweden 2010 In: European Journal of Cancer Prevention. - 1473-5709. ; 19:4, s. 275-279 Journal article (peer-reviewed)abstract Environmental risk factors, particularly tobacco smoking, are important for transitional-cell carcinoma of the bladder. Studies in migrants may provide valuable insight into the environmental and genetic etiology of cancer. The nationwide Swedish Family-Cancer Database was used to calculate standardized incidence ratios (SIRs) for transitional-cell carcinoma among the immigrants compared with native Swedes. SIRs for lung cancer were also calculated as a proxy for smoking prevalence. Significantly decreased risks of bladder cancer were observed for male (SIR=0.89) and female (0.71) Finns and male East Asian (0.39) first-generation immigrants. Male immigrants from many countries showed increased risks, ranging from 1.18 to 2.29. Only female immigrants from Denmark (1.40) and Norway (1.27) had increased risks. The risks for bladder and lung cancers correlated, except for Finnish and Iranian men. The sons of immigrants born in high-risk countries had an increased SIR (1.51) whereas the daughters of immigrants born in low-risk countries had a decreased risk (0.32). The risk in the second-generation immigrants born in Sweden was equal to that of natives. In conclusion, the observed bladder cancer risks in the first-generation immigrants, the changes in risks in the second-generation immigrants, and the covariation of the risk patterns of bladder and lung cancers suggested a main contribution by tobacco smoking. The exceptional patterns among the Finns and Iranians may point to the existence of modifying factors. The changes in incidence in second-generation immigrants, yet based on small case numbers, lend little support to the involvement of genetic factors. European Journal of Cancer Prevention 19:275-279 (C) 2010 Wolters Kluwer Health \| Lippincott Williams & Wilkins.
41.	Mousavi, Seyed Mohsen, et al. (author) Risks of papillary and follicular thyroid cancer among immigrants to Sweden 2011 In: International Journal of Cancer. - : Wiley. - 0020-7136. ; 129:9, s. 2248-2255 Journal article (peer-reviewed)abstract Previous studies have indicated that ionizing radiation, particularly during childhood, is the main established risk factor for thyroid cancer. History of benign nodules/adenoma, goiter, iodine deficiency or high-iodine intake might be other associated factors. We wanted to define the histology-specific thyroid cancer risk in the first-generation immigrants to Sweden. We used the 2010 update of the nation-wide Swedish Family-Cancer Database (>12 million individuals; 1.8 million immigrants; histology code in force since 1958) to calculate standardized incidence ratios (SIRs) for histology-specific thyroid cancer among immigrants compared to the native Swedes. The patient series covered 2,604 male and 6,406 female Swedes, and 247 and 863 immigrants. The median age at immigration was 29 years, and the median age at thyroid cancer diagnosis was 46 years. Increased risks for female papillary carcinoma were observed for Finns (SIR = 1.63), former Yugoslavians (2.36), Russians (2.34), other East Europeans (2.14), Turks (3.16), Iranians (2.68), Iraqis (2.77), East and Southeast Asians (2.92), other Asians (1.69) and South Americans (2.23). Male Iranians (2.85), East and Southeast Asians (3.57) and other Asians (2.26) had an increased risk for papillary carcinoma. Only male East and Southeast Asians (2.93) had an increased risk for follicular carcinoma. The data might suggest that immigrant populations in Sweden from areas of low or high-iodine intake are at risk of papillary carcinoma, implicating iodine imbalance as a contributing factor to our findings. The increased risk of thyroid cancer among Asian immigrants may confirm the role of childhood-ionizing radiation on thyroid cancer risk.
42.	Mousavi, Seyed Mohsen, et al. (author) Unveiling the drivers of atmospheric methane variability in Iran : A 20-year exploration using spatiotemporal modeling and machine learning 2024 In: Environmental Challenges. - 2667-0100. ; 15 Journal article (peer-reviewed)abstract Understanding the factors controlling spatial and temporal variability of atmospheric methane concentration (XCH4) is crucial for mitigating its impacts and implementing emission reduction strategies. This study comprehensively investigates XCH4 and its driving factors (environmental, meteorological, and anthropogenic activity) across Iran over 20 years, from 2003 to 2022. It combines multi-source satellite observations, advanced spatiotemporal modeling techniques, correlation analysis, and machine learning algorithms. The spatiotemporal analysis showed notable spatial variation, with high XCH4 levels in central, southern, and eastern Iran and lower levels in the northwest and north. Moreover, distinct seasonal cycles emerged, with maximum XCH4 occurring during summer (August-September) and minimum levels in spring (April-May). Correlation analysis and variable importance assessment were developed to elucidate the key drivers governing XCH4 dynamics. Correlation analysis revealed that vegetation cover, precipitation, and soil moisture were negatively correlated with XCH4, while temperature indices showed a positive correlation, exhibiting the highest correlation in time dispersion and quantity among the studied variables. The Permutation Importance technique, used with a Random Forest classifier, a machine learning-based approach that considers the role of all variables together, showed that land surface temperature, wind speed, soil moisture, and vegetation cover are the dominant controls, with their importance ranked respectively. Surprisingly, anthropogenic emissions played a relatively minor role in shaping XCH4 distributions at the regional scale. These findings highlight the significant influence of meteorological variables and ecosystem processes on XCH4 modulation, revealing intricate Earth system feedbacks that inform targeted mitigation strategies and predictive models for curbing greenhouse gas emissions and mitigating climate change impacts.

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