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1. Recent expansions of novel strategies towards the drug targeting into the brain

Author

Alexander A, Agrawal M, Uddin A, Siddique S, Shehata AM, Shaker MA, Ata Ur Rahman S, and Abdul MIM

Subjects
Medicine (General), R5-920, intranasal drug delivery, liposome, Brain, nanocarrier, drug targeting, BBB
Abstract

Amit Alexander,1 Mukta Agrawal,1 Ajaz Uddin,1 Sabahuddin Siddique,2 Ahmed M Shehata,3,4 Mahmoud A Shaker,5,6 Syed Ata Ur Rahman,7 Mohi Iqbal M Abdul,3 Mohamed A Shaker6,71Department of Pharmaceutics, Rungta College of Pharmaceutical Sciences and Research, Bhilai, Chhattisgarh, India; 2Patel College of Pharmacy, Madhyanchal Professional University, Bhopal, Madhya Pradesh, India; 3Department of Pharmacology and Toxicology, College of Pharmacy, Taibah University, Al-Madinah Al-Munawarah, Kingdom of Saudi Arabia; 4Department of Pharmacology and Toxicology, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt; 5Department of Pharmaceutics, College of Pharmacy, King Khalid University, Abha, Kingdom of Saudi Arabia; 6Pharmaceutics Department, Faculty of Pharmacy, Helwan University, Cairo, Egypt; 7Pharmaceutics and Pharmaceutical Technology Department, College of Pharmacy, Taibah University, Al-Madinah Al-Munawarah, Kingdom of Saudi ArabiaAbstract: The treatment of central nervous system (CNS) disorders always remains a challenge for the researchers. The presence of various physiological barriers, primarily the blood–brain barrier (BBB) limits the accessibility of the brain and hinders the efficacy of various drug therapies. Hence, drug targeting to the brain, particularly to the diseased cells by circumventing the physiological barriers is essential to develop a promising therapy for the treatment of brain disorders. Presently, the investigations emphasize the role of different nanocarrier systems or surface modified target specific novel carrier system to improve the efficiency and reduce the side effects of the brain therapeutics. Such approaches supposed to circumvent the BBB or have the ability to cross the barrier function and thus increases the drug concentration in the brain. Although the efficacy of novel carrier system depends upon various physiological factors like active efflux transport, protein corona of the brain, stability, and toxicity of the nanocarrier, physicochemical properties, patient-related factors and many more. Hence, to develop a promising carrier system, it is essential to understand the physiology of the brain and BBB and also the other associated factors. Along with this, some alternative route like direct nose-to-brain drug delivery can also offer a better means to access the brain without exposure of the BBB. In this review, we have discussed the role of various physiological barriers including the BBB and blood-cerebrospinal fluid barrier (BCSFB) on the drug therapy and the mechanism of drug transport across the BBB. Further, we discussed different novel strategies for brain targeting of drug including, polymeric nanoparticles, lipidic nanoparticles, inorganic nanoparticles, liposomes, nanogels, nanoemulsions, dendrimers, quantum dots, etc. along with the intranasal drug delivery to the brain. We have also illustrated various factors affecting the drug targeting efficiency of the developed novel carrier system.Keywords: brain, drug targeting, nanocarrier, BBB, liposome, intranasal drug delivery

Published
2019

2. High incidence of multidrug-resistant Escherichia coli coharboring mcr-1 and blaCTX-M-15 recovered from pigs

Author

Shafiq M, Huang J, Ur Rahman S, Shah JM, Chen L, Gao Y, Wang M, and Wang L

Subjects
ESBL, E. coli, co-existence, lcsh:RC109-216, colistin, mcr-1, lcsh:Infectious and parasitic diseases
Abstract

Muhammad Shafiq,1 Jinhu Huang,1 Sadeeq Ur Rahman,2 Jan Mohammad Shah,1 Li Chen,1 Yi Gao,1 Mengli Wang,1 Liping Wang11Moe Joint International Research Laboratory of Animal Health and Food Safety, Laboratory of Veterinary Pharmacology and Toxicology, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, 210095, People’s Republic of China; 2College of Veterinary Sciences and Animal Husbandry, Section Microbiology, Abdul Wali Khan University, Mardan, KP, PakistanPurpose: The coexistence of mobile colistin (COL)-resistant gene mcr-1 with extended-spectrum beta-lactamase (ESBL) gene in Escherichia coli has become a serious threat globally. The aim of this study was to investigate the increasing resistance to COL and in particular its coexistence with ESBL-producing E. coli recovered from pig farms in China.Materials and methods: E. coli were isolated from 14 pig farms in Jiangsu China. Susceptibility testing was identified by micro-dilution method. PCR assay and nucleotide sequencing were used to detect COL-resistant genes, mcr-1 to −5, as well as ESBL genes, blaCTX-M, blaSHV and blaTEM. Conjugation experiment, plasmid replicon typing of the multidrug resistance (MDR), S1-PFGE and DNA southern hybridization were performed to study the transferability of these genes.Results: Overall, 275 E. coli isolates were recovered from a total of 432 cloacal and nasal swabs. More than 90% of the isolates were MDR, of which 70.18% were resistant to COL. Of these 275 isolates, mcr-1 was identified as the most predominant gene carried by 71.63% (197/275) of isolates, 39.59% (78/197) of the isolates were harboring both mcr-1 and ESBL genes (blaCTX-M, blaSHV and blaTEM). ESBL genotyping showed that blaCTX-M was the most predominant ESBL (68.49%) followed by blaSHV (16.4%) and blaTEM (15%). Sequencing revealed that the most common variants of blaCTX-M identified were, blaCTX-M-15 (69%), blaCTX-M-55 (29%) and blaCTX-M-1 (1.8%). IncHI2, IncFIB, IncFIC, IncN and IncX4 were found to be the most common Inc-types found both in donors and in transconjugants and were associated with the transfer of the mcr-1 and ESBL encoding genes. Six strains carried a total of five different plasmids: approximately 97-, 130-, 160-, 227- and 242-kb plasmids.Conclusion: The coexistence of the mcr-1- and blaCTX-M-15-carrying isolates displaying high MDR, recovered from E. coli of pig origin, is a major concern for both humans and veterinary medicine.Keywords: E. coli, colistin, mcr-1, ESBL, coexistence

Published
2019

3. Class attendance and cardiology examination performance: a study in problem-based medical curriculum

Author

Bamuhair SS, Al Farhan AI, Althubaiti A, ur Rahman S, and Al-Kadri HM

Subjects
lcsh:R5-920, education, academic performance, problem-based learning, lcsh:Medicine (General), Class attendance
Abstract

Samira S Bamuhair,1 Ali I Al Farhan,1,2 Alaa Althubaiti,1 Saeed ur Rahman,1,2 Hanan M Al-Kadri1,3 1College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, 2Department of Family Medicine and Primary Health Care, 3Department of Obstetrics and Gynecology, King Abdulaziz Medical City, Riyadh, Saudi Arabia Background and aims: Information on the effect of students' class attendance on examination performance in a problem-based learning medical curriculum is limited. This study investigates the impact of different educational activities on students' academic performance in a problem-based learning curriculum. Methods: This is a retrospective cohort study conducted on the cardiology block at the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. All students who undertook the cardiology block during the academic year 2011–2012 were included. The students' attendance was measured using their overall attendance percentage. This percentage is a product of their attendance of many activities throughout the block. The students' performance was assessed by the final mark obtained, which is a product of many assessment elements. Statistical correlation between students' attendance and performance was established. Results: A total of 127 students were included. The average lecture attendance rate for the medical students in this study was found to be 86%. A significant positive correlation was noted between the overall attendance and the accumulated students' block mark (r=0.52; P

Published
2016

4. Global, regional, and national age-sex-specific mortality and life expectancy, 1950-2017: A systematic analysis for the Global Burden of Disease Study 2017

Author

Dicker, D. Nguyen, G. Abate, D. Abate, K.H. Abay, S.M. Abbafati, C. Abbasi, N. Abbastabar, H. Abd-Allah, F. Abdela, J. Abdelalim, A. Abdel-Rahman, O. Abdi, A. Abdollahpour, I. Abdulkader, R.S. Abdurahman, A.A. Abebe, H.T. Abebe, M. Abebe, Z. Abebo, T.A. Aboyans, V. Abraha, H.N. Abrham, A.R. Abu-Raddad, L.J. Abu-Rmeileh, N.M.E. Accrombessi, M.M.K. Acharya, P. Adebayo, O.M. Adedeji, I.A. Adedoyin, R.A. Adekanmbi, V. Adetokunboh, O.O. Adhena, B.M. Adhikari, T.B. Adib, M.G. Adou, A.K. Adsuar, J.C. Afarideh, M. Afshin, A. Agarwal, G. Aggarwal, R. Aghayan, S.A. Agrawal, S. Agrawal, A. Ahmadi, M. Ahmadi, A. Ahmadieh, H. Ahmed, M.L.C.B. Ahmed, S. Ahmed, M.B. Aichour, A.N. Aichour, I. Aichour, M.T.E. Akanda, A.S. Akbari, M.E. Akibu, M. Akinyemi, R.O. Akinyemiju, T. Akseer, N. Alahdab, F. Al-Aly, Z. Alam, K. Alebel, A. Aleman, A.V. Alene, K.A. Al-Eyadhy, A. Ali, R. Alijanzadeh, M. Alizadeh-Navaei, R. Aljunid, S.M. Alkerwi, A. Alla, F. Allebeck, P. Allen, C.A. Alonso, J. Al-Raddadi, R.M. Alsharif, U. Altirkawi, K. Alvis-Guzman, N. Amare, A.T. Amini, E. Ammar, W. Amoako, Y.A. Anber, N.H. Andrei, C.L. Androudi, S. Animut, M.D. Anjomshoa, M. Anlay, D.Z. Ansari, H. Ansariadi, A. Ansha, M.G. Antonio, C.A.T. Appiah, S.C.Y. Aremu, O. Areri, H.A. Ärnlöv, J. Arora, M. Artaman, A. Aryal, K.K. Asadi-Lari, M. Asayesh, H. Asfaw, E.T. Asgedom, S.W. Assadi, R. Ataro, Z. Atey, T.M.M. Athari, S.S. Atique, S. Atre, S.R. Atteraya, M.S. Attia, E.F. Ausloos, M. Avila-Burgos, L. Avokpaho, E.F.G.A. Awasthi, A. Awuah, B. Ayala Quintanilla, B.P. Ayele, H.T. Ayele, Y. Ayer, R. Ayuk, T.B. Azzopardi, P.S. Azzopardi-Muscat, N. Badali, H. Badawi, A. Balakrishnan, K. Bali, A.G. Banach, M. Banstola, A. Barac, A. Barboza, M.A. Barquera, S. Barrero, L.H. Basaleem, H. Bassat, Q. Basu, A. Basu, S. Baune, B.T. Bazargan-Hejazi, S. Bedi, N. Beghi, E. Behzadifar, M. Behzadifar, M. Béjot, Y. Bekele, B.B. Belachew, A.B. Belay, A.G. Belay, E. Belay, S.A. Belay, Y.A. Bell, M.L. Bello, A.K. Bennett, D.A. Bensenor, I.M. Berhane, A. Berman, A.E. Bernabe, E. Bernstein, R.S. Bertolacci, G.J. Beuran, M. Beyranvand, T. Bhala, N. Bhatia, E. Bhatt, S. Bhattarai, S. Bhaumik, S. Bhutta, Z.A. Biadgo, B. Bijani, A. Bikbov, B. Bililign, N. Bin Sayeed, M.S. Birlik, S.M. Birungi, C. Bisanzio, D. Biswas, T. Bjørge, T. Bleyer, A. Bora Basara, B. Bose, D. Bosetti, C. Boufous, S. Bourne, R. Brady, O.J. Bragazzi, N.L. Brant, L.C. Brazinova, A. Breitborde, N.J.K. Brenner, H. Britton, G. Brugha, T. Burke, K.E. Busse, R. Butt, Z.A. Cahuana-Hurtado, L. Callender, C.S.K.H. Campos-Nonato, I.R. Campuzano Rincon, J.C. Cano, J. Car, M. Cárdenas, R. Carreras, G. Carrero, J.J. Carter, A. Carvalho, F. Castañeda-Orjuela, C.A. Castillo Rivas, J. Castro, F. Catalá-López, F. Çavlin, A. Cerin, E. Chaiah, Y. Champs, A.P. Chang, H.-Y. Chang, J.-C. Chattopadhyay, A. Chaturvedi, P. Chen, W. Chiang, P.P.-C. Chimed-Ochir, O. Chin, K.L. Chisumpa, V.H. Chitheer, A. Choi, J.-Y.J. Christensen, H. Christopher, D.J. Chung, S.-C. Cicuttini, F.M. Ciobanu, L.G. Cirillo, M. Claro, R.M. Cohen, A.J. Collado-Mateo, D. Constantin, M.-M. Conti, S. Cooper, C. Cooper, L.T. Cortesi, P.A. Cortinovis, M. Cousin, E. Criqui, M.H. Cromwell, E.A. Crowe, C.S. Crump, J.A. Cucu, A. Cunningham, M. Daba, A.K. Dachew, B.A. Dadi, A.F. Dandona, L. Dandona, R. Dang, A.K. Dargan, P.I. Daryani, A. Das, S.K. Das Gupta, R. Das Neves, J. Dasa, T.T. Dash, A.P. Davis Weaver, N. Davitoiu, D.V. Davletov, K. Dayama, A. de Courten, B. De la Hoz, F.P. De leo, D. De Neve, J.-W. Degefa, M.G. Degenhardt, L. Degfie, T.T. Deiparine, S. Dellavalle, R.P. Demoz, G.T. Demtsu, B.B. Denova-Gutiérrez, E. Deribe, K. Dervenis, N. Des Jarlais, D.C. Dessie, G.A. Dey, S. Dharmaratne, S.D. Dhimal, M. Ding, E.L. Djalalinia, S. Doku, D.T. Dolan, K.A. Donnelly, C.A. Dorsey, E.R. Douwes-Schultz, D. Doyle, K.E. Drake, T.M. Driscoll, T.R. Dubey, M. Dubljanin, E. Duken, E.E. Duncan, B.B. Duraes, A.R. Ebrahimi, H. Ebrahimpour, S. Edessa, D. Edvardsson, D. Eggen, A.E. El Bcheraoui, C. El Sayed Zaki, M. Elfaramawi, M. El-Khatib, Z. Ellingsen, C.L. Elyazar, I.R.F. Enayati, A. Endries, A.Y.Y. Er, B. Ermakov, S.P. Eshrati, B. Eskandarieh, S. Esmaeili, R. Esteghamati, A. Esteghamati, S. Fakhar, M. Fakhim, H. Farag, T. Faramarzi, M. Fareed, M. Farhadi, F. Farid, T.A. E Sá Farinha, C.S. Farioli, A. Faro, A. Farvid, M.S. Farzadfar, F. Farzaei, M.H. Fazeli, M.S. Feigin, V.L. Feigl, A.B. Feizy, F. Fentahun, N. Fereshtehnejad, S.-M. Fernandes, E. Fernandes, J.C. Feyissa, G.T. Fijabi, D.O. Filip, I. Finegold, S. Fischer, F. Flor, L.S. Foigt, N.A. Ford, J.A. Foreman, K.J. Fornari, C. Frank, T.D. Franklin, R.C. Fukumoto, T. Fuller, J.E. Fullman, N. Fürst, T. Furtado, J.M. Futran, N.D. Galan, A. Gallus, S. Gambashidze, K. Gamkrelidze, A. Gankpe, F.G. Garcia-Basteiro, A.L. Garcia-Gordillo, M.A. Gebre, T. Gebre, A.K. Gebregergs, G.B. Gebrehiwot, T.T. Gebremedhin, A.T. Gelano, T.F. Gelaw, Y.A. Geleijnse, J.M. Genova-Maleras, R. Gessner, B.D. Getachew, S. Gething, P.W. Gezae, K.E. Ghadami, M.R. Ghadimi, R. Ghasemi Falavarjani, K. Ghasemi-Kasman, M. Ghiasvand, H. Ghimire, M. Ghoshal, A.G. Gill, P.S. Gill, T.K. Gillum, R.F. Giussani, G. Goenka, S. Goli, S. Gomez, R.S. Gomez-Cabrera, M.C. Gómez-Dantés, H. Gona, P.N. Goodridge, A. Gopalani, S.V. Goto, A. Goulart, A.C. Goulart, B.N.G. Grada, A. Grosso, G. Gugnani, H.C. Guimaraes, A.L.S. Guo, Y. Gupta, P.C. Gupta, R. Gupta, R. Gupta, T. Gyawali, B. Haagsma, J.A. Hachinski, V. Hafezi-Nejad, N. Hagos, T.B. Hailegiyorgis, T.T. Hailu, G.B. Haj-Mirzaian, A. Haj-Mirzaian, A. Hamadeh, R.R. Hamidi, S. Handal, A.J. Hankey, G.J. Harb, H.L. Harikrishnan, S. Haririan, H. Haro, J.M. Hasan, M. Hassankhani, H. Hassen, H.Y. Havmoeller, R. Hay, R.J. Hay, S.I. He, Y. Hedayatizadeh-Omran, A. Hegazy, M.I. Heibati, B. Heidari, M. Hendrie, D. Henok, A. Henry, N.J. Heredia-Pi, I. Herteliu, C. Heydarpour, F. Heydarpour, P. Heydarpour, S. Hibstu, D.T. Hoek, H.W. Hole, M.K. Homaie Rad, E. Hoogar, P. Horino, M. Hosgood, H.D. Hosseini, S.M. Hosseinzadeh, M. Hostiuc, S. Hostiuc, M. Hotez, P.J. Hoy, D.G. Hsairi, M. Htet, A.S. Hu, G. Huang, J.J. Husseini, A. Hussen, M.M. Hutfless, S. Iburg, K.M. Igumbor, E.U. Ikeda, C.T. Ilesanmi, O.S. Iqbal, U. Irvani, S.S.N. Isehunwa, O.O. Islam, S.M.S. Islami, F. Jahangiry, L. Jahanmehr, N. Jain, R. Jain, S.K. Jakovljevic, M. James, S.L. Javanbakht, M. Jayaraman, S. Jayatilleke, A.U. Jee, S.H. Jeemon, P. Jha, R.P. Jha, V. Ji, J.S. Johnson, S.C. Jonas, J.B. Joshi, A. Jozwiak, J.J. Jungari, S.B. Jürisson, M. Madhanraj, K. Kabir, Z. Kadel, R. Kahsay, A. Kahssay, M. Kalani, R. Kapil, U. Karami, M. Karami Matin, B. Karch, A. Karema, C. Karimi, N. Karimi, S.M. Karimi-Sari, H. Kasaeian, A. Kassa, G.M. Kassa, T.D. Kassa, Z.Y. Kassebaum, N.J. Katibeh, M. Katikireddi, S.V. Kaul, A. Kawakami, N. Kazemeini, H. Kazemi, Z. Kazemi Karyani, A. Prakash, K.C. Kebede, S. Keiyoro, P.N. Kemp, G.R. Kengne, A.P. Keren, A. Kereselidze, M. Khader, Y.S. Khafaie, M.A. Khajavi, A. Khalid, N. Khalil, I.A. Khan, E.A. Khan, G. Khan, M.S. Khan, M.A. Khang, Y.-H. Khanna, T. Khater, M.M. Khatony, A. Khazaie, H. Khoja, A.T. Khosravi, A. Khosravi, M.H. Khubchandani, J. Kiadaliri, A.A. Kibret, G.D.D. Kim, C.-I. Kim, D. Kim, J.Y. Kim, Y.-E. Kimokoti, R.W. Kinfu, Y. Kinra, S. Kisa, A. Kissimova-Skarbek, K. Kissoon, N. Kivimäki, M. Kleber, M.E. Knibbs, L.D. Knudsen, A.K.S. Kochhar, S. Kokubo, Y. Kolola, T. Kopec, J.A. Kosek, M.N. Kosen, S. Koul, P.A. Koyanagi, A. Kravchenko, M.A. Krishan, K. Krishnaswami, S. Kuate Defo, B. Kucuk Bicer, B. Kudom, A.A. Kuipers, E.J. Kulikoff, X.R. Kumar, G.A. Kumar, M. Kumar, P. Kumsa, F.A. Kutz, M.J. Lad, S.D. Lafranconi, A. Lal, D.K. Lalloo, R. Lam, H. Lami, F.H. Lan, Q. Langan, S.M. Lansingh, V.C. Lansky, S. Larson, H.J. Laryea, D.O. Lassi, Z.S. Latifi, A. Lavados, P.M. Laxmaiah, A. Lazarus, J.V. Lebedev, G. Lee, P.H. Leigh, J. Leshargie, C.T. Leta, S. Levi, M. Li, S. Li, Y. Li, X. Liang, J. Liang, X. Liben, M.L. Lim, L.-L. Lim, S.S. Limenih, M.A. Linn, S. Liu, S. Liu, Y. Lodha, R. Logroscino, G. Lonsdale, C. Lorch, S.A. Lorkowski, S. Lotufo, P.A. Lozano, R. Lucas, T.C.D. Lunevicius, R. Lyons, R.A. Ma, S. Mabika, C. Macarayan, E.R.K. Mackay, M.T. Maddison, E.R. Maddison, R. Madotto, F. Magdy Abd El Razek, H. Magdy Abd El Razek, M. Maghavani, D.P. Majdan, M. Majdzadeh, R. Majeed, A. Malekzadeh, R. Malik, M.A. Malta, D.C. Mamun, A.A. Manamo, W.A. Manda, A.-L. Mansournia, M.A. Mantovani, L.G. Mapoma, C.C. Marami, D. Maravilla, J.C. Marcenes, W. Marina, S. Martinez-Raga, J. Martins, S.C.O. Martins-Melo, F.R. März, W. Marzan, M.B. Mashamba-Thompson, T.P. Masiye, F. Massenburg, B.B. Maulik, P.K. Mazidi, M. McGrath, J.J. McKee, M. Mehata, S. Mehendale, S.M. Mehndiratta, M.M. Mehrotra, R. Mehta, K.M. Mehta, V. Mekonen, T. Mekonnen, T.C. Meles, H.G. Meles, K.G. Melese, A. Melku, M. Memiah, P.T.N. Memish, Z.A. Mendoza, W. Mengistu, D.T. Mengistu, G. Mensah, G.A. Mereta, S.T. Meretoja, A. Meretoja, T.J. Mestrovic, T. Mezgebe, H.B. Miangotar, Y. Miazgowski, B. Miazgowski, T. Miller, T.R. Mini, G.K. Mirica, A. Mirrakhimov, E.M. Misganaw, A.T. Moazen, B. Moges, N.A. Mohammad, K.A. Mohammadi, M. Mohammadifard, N. Mohammadi-Khanaposhtani, M. Mohammadnia-Afrouzi, M. Mohammed, S. Mohammed, M.A. Mohan, V. Mokdad, A.H. Molokhia, M. Monasta, L. Moradi, G. Moradi, M. Moradi-Lakeh, M. Moradinazar, M. Moraga, P. Morawska, L. Moreno Velásquez, I. Morgado-Da-costa, J. Morrison, S.D. Mosapour, A. Moschos, M.M. Mousavi, S.M. Muche, A.A. Muchie, K.F. Mueller, U.O. Mukhopadhyay, S. Mullany, E.C. Muller, K. Murhekar, M. Murphy, T.B. Murthy, G.V.S. Murthy, S. Musa, J. Musa, K.I. Mustafa, G. Muthupandian, S. Nachega, J.B. Nagel, G. Naghavi, M. Naheed, A. Nahvijou, A. Naik, G. Nair, S. Najafi, F. Nangia, V. Nansseu, J.R. Nascimento, B.R. Nawaz, H. Ncama, B.P. Neamati, N. Negoi, I. Negoi, R.I. Neupane, S. Newton, C.R.J. Ngalesoni, F.N. Ngunjiri, J.W. Nguyen, H.T. Nguyen, H.T. Nguyen, L.H. Nguyen, M. Nguyen, T.H. Ningrum, D.N.A. Nirayo, Y.L. Nisar, M.I. Nixon, M.R. Nolutshungu, N. Nomura, S. Norheim, O.F. Noroozi, M. Norrving, B. Noubiap, J.J. Nouri, H.R. Nourollahpour Shiadeh, M. Nowroozi, M.R. Nsoesie, E.O. Nyasulu, P.S. Ofori-Asenso, R. Ogah, O.S. Ogbo, F.A. Oh, I.-H. Okoro, A. Oladimeji, O. Olagunju, A.T. Olagunju, T.O. Olivares, P.R. Olusanya, B.O. Olusanya, J.O. Ong, S.K. Opio, J.N. Oren, E. Ortiz, J.R. Ortiz, A. Ota, E. Otstavnov, S.S. Øverland, S. Owolabi, M.O. Oyekale, A.S. Mahesh, P.A. Pacella, R. Pakhale, S. Pakhare, A.P. Pana, A. Panda, B.K. Panda-Jonas, S. Pandey, A.R. Pandian, J.D. Parisi, A. Park, E.-K. Parry, C.D.H. Parsian, H. Patel, S. Patle, A. Patten, S.B. Patton, G.C. Paudel, D. Pearce, N. Peprah, E.K. Pereira, A. Pereira, D.M. Perez, K.M. Perico, N. Pervaiz, A. Pesudovs, K. Petri, W.A. Petzold, M. Phillips, M.R. Pigott, D.M. Pillay, J.D. Pirsaheb, M. Pishgar, F. Plass, D. Polinder, S. Pond, C.D. Popova, S. Postma, M.J. Pourmalek, F. Pourshams, A. Poustchi, H. 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Salz, I. Sambala, E.Z. Samy, A.M. Sanabria, J. Sanchez-Niño, M.D. Santos, I.S. Santos, J.V. Santric Milicevic, M.M. Sao Jose, B.P. Sardana, M. Sarker, A.R. Sarrafzadegan, N. Sartorius, B. Sarvi, S. Sathian, B. Satpathy, M. Savic, M. Sawant, A.R. Sawhney, M. Saxena, S. Sayyah, M. Scaria, V. Schaeffner, E. Schelonka, K. Schmidt, M.I. Schneider, I.J.C. Schöttker, B. Schutte, A.E. Schwebel, D.C. Schwendicke, F. Scott, J.G. Sekerija, M. Sepanlou, S.G. Serván-Mori, E. Shabaninejad, H. Shackelford, K.A. Shafieesabet, A. Shaheen, A.A. Shaikh, M.A. Shakir, R.A. Shams-Beyranvand, M. Shamsi, M. Shamsizadeh, M. Sharafi, H. Sharafi, K. Sharif, M. Sharif-Alhoseini, M. Sharma, M. Sharma, J. Sharma, R. She, J. Sheikh, A. Sheth, K.N. Shi, P. Shibuya, K. Shifa, G.T. Shiferaw, M.S. Shigematsu, M. Shiri, R. Shirkoohi, R. Shiue, I. Shokraneh, F. Shrime, M.G. Shukla, S.R. Si, S. Siabani, S. Siddiqi, T.J. Sigfusdottir, I.D. Sigurvinsdottir, R. Silpakit, N. Silva, D.A.S. Silva, J.P. Silveira, D.G.A. Singam, N.S.V. Singh, J.A. Singh, V. Sinha, A.P. Sinha, D.N. Sitas, F. Skirbekk, V. Sliwa, K. Soares Filho, A.M. Sobaih, B.H. Sobhani, S. Soofi, M. Soriano, J.B. Soyiri, I.N. Sposato, L.A. Sreeramareddy, C.T. Srinivasan, V. Srivastava, R.K. Starodubov, V.I. Stathopoulou, V. Steel, N. Stein, D.J. Steiner, C. Stewart, L.G. Stokes, M.A. Sudaryanto, A. Sufiyan, M.B. Sulo, G. Sunguya, B.F. Sur, P.J. Sutradhar, I. Sykes, B.L. Sylaja, P.N. Sylte, D.O. Szoeke, C.E.I. Tabarés-Seisdedos, R. Tabuchi, T. Tadakamadla, S.K. Takahashi, K. Tandon, N. Tassew, A.A. Tassew, S.G. Tavakkoli, M. Taveira, N. Tawye, N.Y. Tehrani-Banihashemi, A. Tekalign, T.G. Tekle, M.G. Temesgen, H. Temsah, M.-H. Temsah, O. Terkawi, A.S. Teshale, M.Y. Tessema, B. Teweldemedhin, M. Thakur, J.S. Thankappan, K.R. Thirunavukkarasu, S. Thomas, L.A. Thomas, N. Thrift, A.G. Tilahun, B. To, Q.G. Tobe-Gai, R. Tonelli, M. Topor-Madry, R. Topouzis, F. Torre, A.E. Tortajada-Girbés, M. Tovani-Palone, M.R. Towbin, J.A. Tran, B.X. Tran, K.B. Tripathi, S. Tripathy, S.P. Truelsen, T.C. Truong, N.T. Tsadik, A.G. Tsilimparis, N. Tudor Car, L. Tuzcu, E.M. Tyrovolas, S. Ukwaja, K.N. Ullah, I. Usman, M.S. Uthman, O.A. Uzun, S.B. Vaduganathan, M. Vaezi, A. Vaidya, G. Valdez, P.R. Varavikova, E. Varughese, S. Vasankari, T.J. Vasconcelos, A.M.N. Venketasubramanian, N. Vidavalur, R. Villafaina, S. Violante, F.S. Vladimirov, S.K. Vlassov, V. Vollset, S.E. Vos, T. Vosoughi, K. Vujcic, I.S. Wagner, G.R. Wagnew, F.W.S. Waheed, Y. Wang, Y. Wang, Y.-P. Wassie, M.M. Weiderpass, E. Weintraub, R.G. Weiss, D.J. Weiss, J. Weldegebreal, F. Weldegwergs, K.G. Werdecker, A. Westerman, R. Whiteford, H.A. Widecka, J. Widecka, K. Wijeratne, T. Winkler, A.S. Wiysonge, C.S. Wolfe, C.D.A. Wondemagegn, S.A. Wu, S. Wyper, G.M.A. Xu, G. Yadav, R. Yakob, B. Yamada, T. Yan, L.L. Yano, Y. Yaseri, M. Yasin, Y.J. Ye, P. Yearwood, J.A. Yentür, G.K. Yeshaneh, A. Yimer, E.M. Yip, P. Yisma, E. Yonemoto, N. Yoon, S.-J. York, H.W. Yotebieng, M. Younis, M.Z. Yousefifard, M. Yu, C. Zachariah, G. Zadnik, V. Zafar, S. Zaidi, Z. Zaman, S.B. Zamani, M. Zare, Z. Zeeb, H. Zeleke, M.M. Zenebe, Z.M. Zerfu, T.A. Zhang, K. Zhang, X. Zhou, M. Zhu, J. Zodpey, S. Zucker, I. Zuhlke, L.J.J. Lopez, A.D. Gakidou, E. Murray, C.J.L. GBD 2017 Mortality Collaborators

Abstract

Background: Assessments of age-specifc mortality and life expectancy have been done by the UN Population Division, Department of Economics and Social Afairs (UNPOP), the United States Census Bureau, WHO, and as part of previous iterations of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD). Previous iterations of the GBD used population estimates from UNPOP, which were not derived in a way that was internally consistent with the estimates of the numbers of deaths in the GBD. The present iteration of the GBD, GBD 2017, improves on previous assessments and provides timely estimates of the mortality experience of populations globally. Methods: The GBD uses all available data to produce estimates of mortality rates between 1950 and 2017 for 23 age groups, both sexes, and 918 locations, including 195 countries and territories and subnational locations for 16 countries. Data used include vital registration systems, sample registration systems, household surveys (complete birth histories, summary birth histories, sibling histories), censuses (summary birth histories, household deaths), and Demographic Surveillance Sites. In total, this analysis used 8259 data sources. Estimates of the probability of death between birth and the age of 5 years and between ages 15 and 60 years are generated and then input into a model life table system to produce complete life tables for all locations and years. Fatal discontinuities and mortality due to HIV/AIDS are analysed separately and then incorporated into the estimation. We analyse the relationship between age-specifc mortality and development status using the Socio-demographic Index, a composite measure based on fertility under the age of 25 years, education, and income. There are four main methodological improvements in GBD 2017 compared with GBD 2016: 622 additional data sources have been incorporated; new estimates of population, generated by the GBD study, are used; statistical methods used in diferent components of the analysis have been further standardised and improved; and the analysis has been extended backwards in time by two decades to start in 1950. Findings: Globally, 18·7% (95% uncertainty interval 18·4-19·0) of deaths were registered in 1950 and that proportion has been steadily increasing since, with 58·8% (58·2-59·3) of all deaths being registered in 2015. At the global level, between 1950 and 2017, life expectancy increased from 48·1 years (46·5-49·6) to 70·5 years (70·1-70·8) for men and from 52·9 years (51·7-54·0) to 75·6 years (75·3-75·9) for women. Despite this overall progress, there remains substantial variation in life expectancy at birth in 2017, which ranges from 49·1 years (46·5-51·7) for men in the Central African Republic to 87·6 years (86·9-88·1) among women in Singapore. The greatest progress across age groups was for children younger than 5 years; under-5 mortality dropped from 216·0 deaths (196·3-238·1) per 1000 livebirths in 1950 to 38·9 deaths (35·6-42·83) per 1000 livebirths in 2017, with huge reductions across countries. Nevertheless, there were still 5·4 million (5·2-5·6) deaths among children younger than 5 years in the world in 2017. Progress has been less pronounced and more variable for adults, especially for adult males, who had stagnant or increasing mortality rates in several countries. The gap between male and female life expectancy between 1950 and 2017, while relatively stable at the global level, shows distinctive patterns across super-regions and has consistently been the largest in central Europe, eastern Europe, and central Asia, and smallest in south Asia. Performance was also variable across countries and time in observed mortality rates compared with those expected on the basis of development. Interpretation: This analysis of age-sex-specifc mortality shows that there are remarkably complex patterns in population mortality across countries. The fndings of this study highlight global successes, such as the large decline in under-5 mortality, which refects signifcant local, national, and global commitment and investment over several decades. However, they also bring attention to mortality patterns that are a cause for concern, particularly among adult men and, to a lesser extent, women, whose mortality rates have stagnated in many countries over the time period of this study, and in some cases are increasing. © 2018 The Author(s).

Published
2018

5. 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

Author

Murray, C.J.L. Callender, C.S.K.H. Kulikoff, X.R. Srinivasan, V. Abate, D. Abate, K.H. Abay, S.M. Abbasi, N. Abbastabar, H. Abdela, J. Abdelalim, A. Abdel-Rahman, O. Abdi, A. Abdoli, N. Abdollahpour, I. Abdulkader, R.S. Abebe, H.T. Abebe, M. Abebe, Z. Abebo, T.A. Abejie, A.N. Aboyans, V. Abraha, H.N. Abreu, D.M.X. Abrham, A.R. Abu-Raddad, L.J. Abu-Rmeileh, N.M.E. Accrombessi, M.M.K. Acharya, P. Adamu, A.A. Adebayo, O.M. Adedeji, I.A. Adekanmbi, V. Adetokunboh, O.O. Adhena, B.M. Adhikari, T.B. Adib, M.G. Adou, A.K. Adsuar, J.C. Afarideh, M. Afshin, A. Agarwal, G. Agesa, K.M. Aghayan, S.A. Agrawal, S. Ahmadi, A. Ahmadi, M. Ahmed, M.B. Ahmed, S. Aichour, A.N. Aichour, I. Aichour, M.T.E. Akanda, A.S. Akbari, M.E. Akibu, M. Akinyemi, R.O. Akinyemiju, T. Akseer, N. Alahdab, F. Al-Aly, Z. Alam, K. Alebel, A. Aleman, A.V. Alene, K.A. Al-Eyadhy, A. Ali, R. Alijanzadeh, M. Alizadeh-Navaei, R. Aljunid, S.M. Alkerwi, A. Alla, F. Allebeck, P. Almasi, A. Alonso, J. Al-Raddadi, R.M. Alsharif, U. Altirkawi, K. Alvis-Guzman, N. Amare, A.T. Ammar, W. Anber, N.H. Andrei, C.L. Androudi, S. Animut, M.D. Ansari, H. Ansha, M.G. Antonio, C.A.T. Appiah, S.C.Y. Aremu, O. Areri, H.A. Arian, N. Ärnlöv, J. Artaman, A. Aryal, K.K. Asayesh, H. Asfaw, E.T. Asgedom, S.W. Assadi, R. Atey, T.M.M. Atique, S. Atteraya, M.S. Ausloos, M. Avokpaho, E.F.G.A. Awasthi, A. Ayala Quintanilla, B.P. Ayele, Y. Ayer, R. Ayuk, T.B. Azzopardi, P.S. Babalola, T.K. Babazadeh, A. Badali, H. Badawi, A. Bali, A.G. Banach, M. Barker-Collo, S.L. Bärnighausen, T.W. Barrero, L.H. Basaleem, H. Bassat, Q. Basu, A. Baune, B.T. Baynes, H.W. Beghi, E. Behzadifar, M. Behzadifar, M. Bekele, B.B. Belachew, A.B. Belay, A.G. Belay, E. Belay, S.A. Belay, Y.A. Bell, M.L. Bello, A.K. Bennett, D.A. Bensenor, I.M. Bergeron, G. Berhane, A. Berman, A.E. Bernabe, E. Bernstein, R.S. Bertolacci, G.J. Beuran, M. Bhattarai, S. Bhaumik, S. Bhutta, Z.A. Biadgo, B. Bijani, A. Bikbov, B. Bililign, N. Bin Sayeed, M.S. Birlik, S.M. Birungi, C. 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Ganji, M. Gankpe, F.G. Garcia, G.M. Garcia-Gordillo, M.Á. Gebre, A.K. Gebre, T. Gebregergs, G.B. Gebrehiwot, T.T. Gebremedhin, A.T. Gelano, T.F. Gelaw, Y.A. Geleijnse, J.M. Genova-Maleras, R. Gething, P. Gezae, K.E. Ghadami, M.R. Ghadimi, R. Ghadiri, K. Falavarjani, K.G. Ghasemi-Kasman, M. Ghiasvand, H. Ghimire, M. Ghoshal, A.G. Gill, P.S. Gill, T.K. Giussani, G. Gnedovskaya, E.V. Goli, S. Gomez, R.S. Gómez-Dantés, H. Gona, P.N. Goodridge, A. Gopalani, S.V. Goulart, A.C. Goulart, B.N.G. Grada, A. Grosso, G. Gugnani, H.C.C. Guo, J. Guo, Y. Gupta, P.C. Gupta, R. Gupta, R. Gupta, T. Haagsma, J.A. Hachinski, V. Hafezi-Nejad, N. Hagos, T.B. Hailegiyorgis, T.T. Hailu, G.B. Haj-Mirzaian, A. Haj-Mirzaian, A. Hamadeh, R.R. Hamidi, S. Handal, A.J. Hankey, G.J. Hao, Y. Harb, H.L. Haririan, H. Haro, J.M. Hasan, M. Hassankhani, H. Hassen, H.Y. Havmoeller, R. Hay, S.I. He, Y. Hedayatizadeh-Omran, A. Hegazy, M.I. Heibati, B. Heidari, B. Hendrie, D. Henok, A. Henry, N.J. Herteliu, C. Heydarpour, F. Hibstu, D.T. Hole, M.K. Rad, E.H. Hoogar, P. Hosgood, H.D. Hosseini, S.M. Hosseini Chavoshi, M.M. Hosseinzadeh, M. Hostiuc, M. Hostiuc, S. Hsairi, M. Hsiao, T. Hu, G. Huang, J.J. Iburg, K.M. Igumbor, E.U. Ikeda, C.T. Ilesanmi, O.S. Iqbal, U. Irenso, A.A. Irvani, S.S.N. Isehunwa, O.O. Islam, S.M.S. Jahangiry, L. Jahanmehr, N. Jain, S.K. Jakovljevic, M. Jalu, M.T. James, S.L. Jassal, S.K. Javanbakht, M. Jayatilleke, A.U. Jeemon, P. Jha, R.P. Jha, V. Ji, J.S. Jonas, J.B. Jozwiak, J.J. Jungari, S.B. Jürisson, M. Kabir, Z. Kadel, R. Kahsay, A. Kalani, R. Kapil, U. Karami, M. Karami Matin, B. Karch, A. Karema, C. Karimi, S.M. Kasaeian, A. Kassa, D.H. Kassa, G.M. Kassa, T.D. Kassa, Z.Y. Kassebaum, N.J. Kastor, A. Katikireddi, S.V. Kaul, A. Kawakami, N. Kazemi Karyani, A. Kebede, S. Keiyoro, P.N. Kemp, G.R. Kengne, A.P. Keren, A. Kereselidze, M. Khader, Y.S. Khafaie, M.A. Khajavi, A. Khalid, N. Khalil, I.A. Khan, E.A. Khan, M.S. Khang, Y.-H. Khanna, T. Khater, M.M. Khatony, A. Khazaeipour, Z. Khazaie, H. Khoja, A.T. Khosravi, A. Khosravi, M.H. Kibret, G.D. Kidanemariam, Z.T. Kiirithio, D.N. Kilgore, P.E. Kim, D. Kim, J.Y. Kim, Y.-E. Kim, Y.J. Kimokoti, R.W. Kinfu, Y. Kinra, S. Kisa, A. Kivimäki, M. Kochhar, S. Kokubo, Y. Kolola, T. Kopec, J.A. Kosek, M.N. Kosen, S. Koul, P.A. Koyanagi, A. Krishan, K. Krishnaswami, S. Krohn, K.J. Defo, B.K. Bicer, B.K. Kumar, G.A. Kumar, M. Kumar, P. Kumsa, F.A. Kutz, M.J. Lad, S.D. Lafranconi, A. Lal, D.K. Lalloo, R. Lam, H. Lami, F.H. Lang, J.J. Lansky, S. Lansingh, V.C. Laryea, D.O. Lassi, Z.S. Latifi, A. Laxmaiah, A. Lazarus, J.V. Lee, J.B. Lee, P.H. Leigh, J. Leshargie, C.T. Leta, S. Levi, M. Li, S. Li, X. Li, Y. Liang, J. Liang, X. Liben, M.L. Lim, L.-L. Limenih, M.A. Linn, S. Liu, S. Lorkowski, S. Lotufo, P.A. Lozano, R. Lunevicius, R. Mabika, C.M. Macarayan, E.R.K. Mackay, M.T. Madotto, F. Mahmood, T.A.E. Mahotra, N.B. Majdan, M. Majdzadeh, R. Majeed, A. Malekzadeh, R. Malik, M.A. Mamun, A.A. Manamo, W.A. Manda, A.-L. Mangalam, S. Mansournia, M.A. Mantovani, L.G. Mapoma, C.C. Marami, D. Maravilla, J.C. Marcenes, W. Marina, S. Martins-Melo, F.R. März, W. Marzan, M.B. Mashamba-Thompson, T.P. Masiye, F. Mason-Jones, A.J. Massenburg, B.B. Mathur, M.R. Maulik, P.K. Mazidi, M. McGrath, J.J. Mehata, S. Mehendale, S.M. Mehndiratta, M.M. Mehrotra, R. Mehrzadi, S. Mehta, K.M. Mehta, V. Mekonnen, T.C. Meles, H.G. Meles, K.G. Melese, A. Melku, M. Memiah, P.T.N. Memish, Z.A. Mendoza, W. Mengesha, M.M. Mengistu, D.T. Mengistu, G. Mensah, G.A. Mereta, S.T. Meretoja, A. Meretoja, T.J. Mestrovic, T. Mezgebe, H.B. Miangotar, Y. Miazgowski, B. Miazgowski, T. Miller, T.R. Miller-Petrie, M.K. Mini, G.K. Mirabi, P. Mirica, A. Mirrakhimov, E.M. Misganaw, A.T. Moazen, B. Mohammad, K.A. Mohammadi, M. Mohammadifard, N. Mohammadi-Khanaposhtani, M. Mohammed, M.A. Mohammed, S. Mokdad, A.H. Mola, G.D. Molokhia, M. Monasta, L. Montañez, J.C. Moradi, G. Moradi, M. Moradi-Lakeh, M. Moradinazar, M. Moraga, P. Morgado-Da-Costa, J. Mori, R. Morrison, S.D. Mosapour, A. Moschos, M.M. Mousavi, S.M. Muche, A.A. Muchie, K.F. Mueller, U.O. Mukhopadhyay, S. Murphy, T.B. Muller, K. Murthy, G.V.S. Musa, J. Musa, K.I. Mustafa, G. Muthupandian, S. Nachega, J.B. Nagel, G. Naghavi, M. Naheed, A. Nahvijou, A. Naik, G. Naik, P. Najafi, F. Naldi, L. Nangia, V. Nansseu, J.R. Nascimento, B.R. Nawaz, H. Ncama, B.P. Neamati, N. Negoi, I. Negoi, R.I. Neupane, S. Newton, C.R.J. Ngalesoni, F.N. Ngunjiri, J.W. Nguyen, G. Nguyen, L.H. Nguyen, T.H. Ningrum, D.N.A. Nirayo, Y.L. Nisar, M.I. Nixon, M.R. Nomura, S. Noroozi, M. Noubiap, J.J. Nouri, H.R. Nourollahpour Shiadeh, M. Nowroozi, M.R. Nyandwi, A. Nyasulu, P.S. Odell, C.M. Ofori-Asenso, R. Ogah, O.S. Ogbo, F.A. Oh, I.-H. Okoro, A. Oladimeji, O. Olagunju, A.T. Olagunju, T.O. Olivares, P.R. Olusanya, B.O. Olusanya, J.O. Ong, S.K. Ortiz, A. Osgood-Zimmerman, A. Ota, E. Otieno, B.A. Otstavnov, S.S. Owolabi, M.O. Oyekale, A.S. Mahesh, P.A. Pakhale, S. Pakhare, A.P. Pana, A. Panda, B.K. Panda-Jonas, S. Pandey, A.R. Park, E.-K. Parsian, H. Patel, S. Patil, S.T. Patle, A. Patton, G.C. Paturi, V.R. Paudel, D. Pedroso, M.M. Peprah, E.K. Pereira, D.M. Perico, N. Pesudovs, K. Petri, W.A. Petzold, M. Pierce, M. Pigott, D.M. Pillay, J.D. Pirsaheb, M. Polanczyk, G.V. Postma, M.J. Pourmalek, F. Pourshams, A. Poustchi, H. Prakash, S. Prasad, N. Purcell, C.A. Purwar, M.B. Qorbani, M. Quansah, R. Radfar, A. Rafay, A. Rafiei, A. Rahim, F. Rahimi-Movaghar, A. Rahimi-Movaghar, V. Rahman, M. Rahman, M.S. Ur Rahman, M.H. Rahman, M.A. Ur Rahman, S. Rai, R.K. Rajati, F. Rajsic, S. Ram, U. Ranabhat, C.L. Ranjan, P. Rawaf, D.L. Rawaf, S. Ray, S.E. Razo-García, C. Reiner, R.C. Reis, C. Remuzzi, G. Renzaho, A.M.N. Resnikoff, S. Rezaei, S. Rezaeian, S. Rezai, M.S. Riahi, S.M. Rios-Blancas, M.J. Roba, K.T. Roberts, N.L.S. Roever, L. Ronfani, L. Roshandel, G. Rostami, A. Rubagotti, E. Ruhago, G.M. Sabde, Y.D. Sachdev, P.S. Saddik, B. Moghaddam, S.S. Safari, H. Safari, Y. Safari-Faramani, R. Safdarian, M. Safi, S. Safiri, S. Sagar, R. Sahebkar, A. Sahraian, M.A. Sajadi, H.S. Salahshoor, M. Salam, N. Salama, J.S. Salamati, P. Saldanha, R.D.F. Saleem, Z. Salimi, Y. Salimzadeh, H. Salomon, J.A. Salvi, S.S. Salz, I. Sambala, E.Z. Samy, A.M. Sanabria, J. Sanchez-Niño, M.D. Santos, I.S. Santric Milicevic, M.M. Sao Jose, B.P. Sardana, M. Sarker, A.R. Sarmiento-Suárez, R. Saroshe, S. Sarrafzadegan, N. Sartorius, B. Sarvi, S. Sathian, B. Satpathy, M. Sawant, A.R. Sawhney, M. Saxena, S. Schaeffner, E. Schelonka, K. Schneider, I.J.C. Schwebel, D.C. Schwendicke, F. Seedat, S. Sekerija, M. Sepanlou, S.G. Serván-Mori, E. Shabaninejad, H. Shackelford, K.A. Shafieesabet, A. Shaheen, A.A. Shaikh, M.A. Shakir, R.A. Shams-Beyranvand, M. Shamsi, M. Shamsizadeh, M. Sharafi, H. Sharafi, K. Sharif, M. Sharif-Alhoseini, M. Sharma, J. Sharma, R. She, J. Sheikh, A. Shi, P. Shibuya, K. Shigematsu, M. Shiri, R. Shirkoohi, R. Shiue, I. Shokraneh, F. Shukla, S.R. Si, S. Siabani, S. Sibai, A.M. Siddiqi, T.J. Sigfusdottir, I.D. Sigurvinsdottir, R. Silpakit, N. Silva, D.A.S. Silva, J.P. Silveira, D.G.A. Singam, N.S.V. Singh, J.A. Singh, N.P. Singh, V. Sinha, D.N. Sliwa, K. Soares Filho, A.M. Sobaih, B.H. Sobhani, S. Soofi, M. Soriano, J.B. Soyiri, I.N. Sreeramareddy, C.T. Starodubov, V.I. Steiner, C. Stewart, L.G. Stokes, M.A. Strong, M. Subart, M.L. Sufiyan, M.B. Sulo, G. Sunguya, B.F. Sur, P.J. Sutradhar, I. Sykes, B.L. Sylaja, P.N. Sylte, D.O. Szoeke, C.E.I. Tabarés-Seisdedos, R. Tabb, K.M. Tadakamadla, S.K. Tandon, N. Tassew, A.A. Tassew, S.G. Taveira, N. Tawye, N.Y. Tehrani-Banihashemi, A. Tekalign, T.G. Tekle, M.G. Temsah, M.-H. Terkawi, A.S. Teshale, M.Y. Tessema, B. Teweldemedhin, M. Thakur, J.S. Thankappan, K.R. Thirunavukkarasu, S. Thomas, N. Thomson, A.J. Tilahun, B. To, Q.G. Tonelli, M. Topor-Madry, R. Torre, A.E. Tortajada-Girbés, M. Tovani-Palone, M.R. Toyoshima, H. Tran, B.X. Tran, K.B. Tripathy, S.P. Truelsen, T.C. Truong, N.T. Tsadik, A.G. Tsegay, A. Tsilimparis, N. Car, L.T. Ukwaja, K.N. Ullah, I. Usman, M.S. Uthman, O.A. Uzun, S.B. Vaduganathan, M. Vaezi, A. Vaidya, G. Valdez, P.R. Varavikova, E. Varughese, S. Vasankari, T.J. Vasconcelos, A.M.N. Venketasubramanian, N. Villafaina, S. Violante, F.S. Vladimirov, S.K. Vlassov, V. Vollset, S.E. Vos, T. Vosoughi, K. Vujcic, I.S. Wagnew, F.S. Waheed, Y. Walson, J.L. Wang, Y. Wang, Y.-P. Weiderpass, E. Weintraub, R.G. Weldegwergs, K.G. Werdecker, A. Westerman, R. Whiteford, H. Widecka, J. Widecka, K. Wijeratne, T. Winkler, A.S. Wiysonge, C.S. Wolfe, C.D.A. Wu, S. Wyper, G.M.A. Xu, G. Yamada, T. Yano, Y. Yaseri, M. Yasin, Y.J. Ye, P. Yentür, G.K. Yeshaneh, A. Yimer, E.M. Yip, P. Yisma, E. Yonemoto, N. Yoon, S.-J. Yotebieng, M. Younis, M.Z. Yousefifard, M. Yu, C. Zadnik, V. Zaidi, Z. Zaman, S.B. Zamani, M. Zare, Z. Zeleke, M.M. Zenebe, Z.M. Zerfu, T.A. Zhang, X. Zhao, X.-J. Zhou, M. Zhu, J. Zimsen, S.R.M. Zodpey, S. Zoeckler, L. Lopez, A.D. Lim, S.S. GBD 2017 Population Fertility Collaborators

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. © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license

Published
2018

6. Direct wavefront sensing in adaptive microscopy

Author

Azmeen-ur-Rahman, S and Booth, M

Subjects
Medical Sciences, Optics,electromagnetic theory (mathematics), Sensors, Electrical engineering, Optoelectronics, Electronics, Biomedical engineering
Abstract

Specimen-induced aberrations are frequently encountered in high resolution microscopy, particularly when high numerical aperture lenses are used to image deep into biological specimens. These aberrations distort the focal spot causing reduction in resolution, signal level and contrast. Aberrations arise due to refractive index variations in the specimen. Adaptive optics has been used in microscopes to correct for these effects and restore optimum imaging performance. An adaptive element, such as a deformable mirror, is used to compensate for aberrations by introducing equal but opposite phase distortions to that introduced by the specimen. Most adaptive optics systems in microscopy have employed indirect optimisation schemes that require several exposures of the specimen before the correction phase can be determined. This could lead to photo-toxicity and is sometimes unsuitable for real-time imaging. Direct wavefront sensing can significantly decrease the time required for aberration measurements by using dedicated sensors, but has limitations, particularly when backscattered light is used from thick specimens. While similar research has been undertaken in ophthalmology where the imaged retina is approximately two-dimensional, this report extends that work to three-dimensional specimens in microscopes. Aberration correction has already been demonstrated in single-pass systems for scattering specimens, but have employed either indirect wavefront sensing techniques or fluorescent beads as guide stars. The use of a Shack-Hartmann wavefront sensor for direct wavefront sensing using backscattered light in a dual-pass system is investigated here. Out-of-focus rejection using an axial selectivity pinhole is studied, along with the phase smoothing effect that is dependant on the pinhole size. The effectiveness of using asymmetric illumination and detection paths, and polarisation filtering in the retrieval of phase information are also demonstrated. It is shown that whilst direct quantitative measurements are not possible for scattering specimens, the measurements could be used in closed-loop adaptive optics systems to correct aberrations.

Published
2016

7. Treatment of Missing Values in Data Mining

Author

Imran Mj, Waqas I, Rehan A, and Syed Saeed-Ur Rahman S

Subjects
business.industry, Computer science, Human error, Information technology, computer.software_genre, Missing data, Set (abstract data type), Data set, Pure Data, Path (graph theory), Data mining, business, Value (mathematics), computer, computer.programming_language
Abstract

Data mining has pushed the realm of information technology beyond predictable limits. Data mining has left its permanent marks on decision making in just in few years of its inception. Missing value is one of the major factor, which can render the obtain result beyond use attained from specific data set by applying data mining technique. There could be numerous reasons for missing values in a data set such as human error, hardware malfunction etc. It is imperative to tackle the labyrinth of missing values before applying any technique of data mining; otherwise, the information extracted from data set containing missing values will lead to the path of wrong decision making. There are several techniques available to control the issue of missing values such as replacing the missing value with: (a) closest value, (b) mean value and (c) median value etc. Some algorithms are also used to deal with the problem of missing values such as k-nearest neighbour. Paper reviewed certain techniques and algorithms to deal with the puzzle of missing values whereby achieving pure data set (i.e., data set without missing value) which in-turn will lead to path of correct and accurate decision making.

Published
2015

8. Global, regional, and national levels and causes of maternal mortality during 1990-2013: A systematic analysis for the Global Burden of Disease Study 2013

Author

Carl Abelardo T. Antonio, Rob E. Dorrington, Belinda K Lloyd, Elisabete Weiderpass, Kovin Naidoo, Leslie T. Cooper, Sandra Nolte, Eduardo A. Undurraga, Mohammad A. AlMazroa, R. Kumar, Xiaofeng Liang, Amanda J. Mason-Jones, Kazem Rahimi, Sanjay Basu, Vasiliy Victorovich Vlassov, André Karch, Dipan Bose, Vivekanand Jha, Adansi A. Amankwaa, Kaire Innos, Ione Jayce Ceola Schneider, Itamar S. Santos, Anwar Rafay, Bolajoko O. Olusanya, Tommi Vasankari, Nana Kwaku Mainoo, Saleem M Rana, Wagner Marcenes, Fortuné Gbètoho Gankpé, Rana J. Asghar, Lela Sturua, Nicholas J K Breitborde, Corine Karema, Charles R. Newton, Uche S. Uchendu, Jongmin Lee, Inga Dora Sigfusdottir, Harish Chander Gugnani, Kaushalendra Kumar, Reza Assadi, Ibrahim Abubakar, Konstantinos Stroumpoulis, Megan Coggeshall, Timothy M. Wolock, Ronny Westerman, Samath D Dharmaratne, Katya Anne Shackelford, Anders Larsson, Jeffrey A. Towbin, Jixiang Ma, Lynne Gaffikin, Konstantin Kazanjan, Mohammad Ali Sahraian, Mohammad H. Forouzanfar, Yichong Li, Felix Sayinzoga, Daniel Dicker, Philimon Gona, Maurice Giroud, Maysaa El Sayed Zaki, Shiwei Liu, Lorenzo Monasta, Chantal Huynh, Abdullatif Husseini, Ted R. Miller, Solomon Meseret Woldeyohannes, D. Alex Quistberg, Justin Beardsley, Majed Asad, Uʇur Dilmen, Alaa Badawi, Hsien-Ho Lin, Haidong Kan, Vinod K. Paul, Mitsuru Mukaigawara, James Leigh, Xiao Nong Zou, Sajjad Ur Rahman, Valentina Arsić Arsenijević, Gokalp Kadri Yentur, Man Mohan Mehndiratta, Murugesan Raju, Stephanie J. London, Kingsley N. Ukwaja, Young-Ho Khang, Knud Juel, Mohsen Naghavi, Rasmus Havmoeller, Gelin Xu, Semaw Ferede Abera, Devina Nand, Norito Kawakami, Neil Pearce, Elisabeth Barboza França, Ferrán Catalá-López, Ketevan Goginashvili, Vegard Skirbekk, Neeraj Bedi, Barthelemy Kuate Defo, Andrew H. Kemp, H. Dean Hosgood, Vafa Rahimi-Movaghar, Konrad Pesudovs, Linhong Wang, Xiao Rong Wang, Alan D. Lopez, Ademola Lukman Adelekan, Joshua A. Salomon, Walter Mendoza, Aref A. Bin Abdulhak, Ivy Shiue, G Anil Kumar, Yuichiro Yano, Luke D. Knibbs, Jung-Chen Chang, Yousef Khader, Caitlyn Steiner, Selen Begüm Uzun, Luciano A. Sposato, Gabrielle deVeber, Raghib Ali, Andre Pascal Kengne, Chakib Nejjari, Rafael Alfonso-Cristancho, Tania Georgina Sánchez Pimienta, Roberto Tchio Talongwa, Hilda L Harb, Ali H. Mokdad, Edward J Mills, Angel J Paternina Caicedo, Xiaohong Li, Luke Nyakarahuka, Diego De Leo, Rashmi Gupta, Robert G. Weintraub, Tim Driscoll, Sun Ha Jee, Carolina Maria Teixeira, Ole Frithjof Norheim, Zulfiqar A Bhutta, Hwashin Hyun Shin, Palwasha Anwari, Daniel Pope, Hassan Amini, Jae-Hyun Park, Saad B. Omer, Eric L. Ding, Narayanaswamy Venketasubramanian, Juan Liang, Tara Templin, Arindam Basu, Farshad Farzadfar, Yang Yang, Xuan Che, Scott Weichenthal, Jeyaraj D Pandian, David L. Tirschwell, Adrian Davis, Hilton Lam, Feng Tan, Stephen S Lim, Soewarta Kosen, Atsushi Goto, Ratilal Lalloo, Yanping Wang, Glen Mola, Paulo A. Lotufo, Dhruv S. Kazi, Jose C. Adsuar, Amany H Refaat, Ruben Castro, Gene F. Kwan, Johanna M. Geleijnse, Emerito Jose A. Faraon, Costas A. Christophi, Theo Vos, Sara Sheikhbahaei, Guilherme V. Polanczyk, Jed D. Blore, Azmeraw T. Amare, Kyle R. Heuton, Walid Ammar, Louisa Degenhardt, Andrew Vallely, Guohong Jiang, Ricky Leung, Jasvinder A. Singh, Zewdie Aderaw Alemu, A Artaman, Steven E. Lipshultz, Carlos A Castañeda-Orjuela, Seyed-Mohammad Fereshtehnejad, Sadaf G. Sepanlou, Mark J. Nieuwenhuijsen, John Q. Wong, Manami Inoue, Coen H. Van Gool, James D. Wilkinson, Ejaz Ahmad Khan, Yoshihiro Kokubo, Manuela Mendonca Felicio, Farshad Pourmalek, Boris I. Pavlin, Karen Sliwa, Robert G. Nelson, Tom Achoki, Edmond K. Kabagambe, Orish Ebere Orisakwe, Christopher J L Murray, In-Hwan Oh, Uchechukwu K.A. Sampson, Ulrich O Mueller, Austin E Schumacher, Edson Serván-Mori, Berrak Bora Basara, Simon I. Hay, Anil Kaul, Foad Abd-Allah, Takayoshi Ohkubo, Kim Yun Jin, Abdullah Sulieman Terkawi, Mall Leinsalu, Sergei Petrovich Ermakov, Marek Majdan, Ileana B. Heredia Pi, Christina Papachristou, Scott B. Patten, Rajeev Gupta, Kalpana Balakrishnan, Mustafa Z. Younis, Kenji Shibuya, Graça Maria Ferreira De Lima, Andrea P. Silva, Maziar Moradi-Lakeh, Anand Dayama, Eiman Jahangir, Stefan Ma, Karen M. Tabb, Nicholas J Kassebaum, Shams Eldin Ali Hassan Khalifa, Mazin J. Al Kahbouri, Nadim E. Karam, Jun Zhu, Chandrashekhar T Sreeramareddy, Dinorah González-Castell, Diego Gonzalez-Medina, Aliya Naheed, Ryan M Barber, Salvador Villalpando, Yang Liu, Chanda Kulkarni, Vinay Nangia, Haidong Wang, Yongmei Li, Rosario Cárdenas, Randah R. Hamadeh, Suzanne Polinder, Van C. Lansingh, François Alla, Max Petzold, Bryan L. Sykes, Ubai Alsharif, Chuanhua Yu, Francesco Saverio Violante, Monika Sawhney, Ayse Abbasoglu Ozgoren, Graeme J. Hankey, Mouhanad Hammami, Iuri da Costa Leite, Dickens Akena, Rintaro Mori, Alanur Çavlin, Maia Kereselidze, Jonathan de la Cruz Monis, Deena Alasfoor, Taavi Lai, Eric Y. Tenkorang, Cyrus Cooper, Sudan Prasad Neupane, Dan Poenaru, Veena S. Kulkarni, Naohiro Yonemoto, Elizabeth Glaser, Sergey Soshnikov, Ziad A. Memish, Paul N. Jensen, Fabiola Mejía-Rodríguez, Ana C. Garcia, Rakhi Dandona, Emilie Agardh, Katherine B Gibney, Vasco Manuel Pedro Machado, Michelle L. Bell, David M. Pereira, Muluemebet Abera Wordofa, Samantha M. Colquhoun, Elena Alvarez, Stephen G. Waller, Ketevan Gambashidze, Eduardo Bernabé, Rafael Lozano, Damian G Hoy, Miltiadis K. Tsilimbaris, Hebe N. Gouda, Muhammad Imran Nisar, Zanfina Ademi, Andrew L. Thorne-Lyman, Denis Nash, Dima M. Qato, Luca Ronfani, Nobhojit Roy, Donald H. Silberberg, Monica S. Vavilala, Lydia S. Atkins, Hans W. Hoek, Muluken Dessalegn, David C. Schwebel, Christopher C. Mapoma, Jost B. Jonas, Tolesa Bekele, Lalit Dandona, Borja del Pozo-Cruz, Sumeet S. Chugh, Johan Ärnlöv, Tariku Jibat Beyene, Melvin Barrientos Marzan, Ami R. Moore, Marie Ng, Maigeng Zhou, Samia Alhabib, Massimo Cirillo, Soraya Seedat, Paul S. F. Yip, Nima Hafezi-Nejad, Amelia Bertozzi-Villa, Kebede Deribe, John Nelson Opio, Peter J. Allen, Marina Shakh-Nazarova, Bach Xuan Tran, Arsène Kouablan Adou, Yingfeng Zheng, Julio Cesar Montañez Hernandez, Yong Zhao, Nelson Alvis-Guzman, Bulat Idrisov, Alireza Esteghamati, Seok Jun Yoon, Kathryn H. Jacobsen, Kassebaum, Nicholas J., Bertozzi-Villa, Amelia, Coggeshall, Megan S., Shackelford, Katya A., Steiner, Caitlyn, Heuton, Kyle R., Gonzalez-Medina, Diego, Barber, Ryan, Huynh, Chantal, Dicker, Daniel, Templin, Tara, Wolock, Timothy M., Ozgoren, Ayse Abbasoglu, Abd-Allah, Foad, Abera, Semaw Ferede, Abubakar, Ibrahim, Achoki, Tom, Adelekan, Ademola, Ademi, Zanfina, Adou, Arsène Kouablan, Adsuar, José C., Agardh, Emilie E., Akena, Dicken, Alasfoor, Deena, Alemu, Zewdie Aderaw, Alfonso-Cristancho, Rafael, Alhabib, Samia, Ali, Raghib, Al Kahbouri, Mazin J., Alla, Françoi, Allen, Peter J., Almazroa, Mohammad A., Alsharif, Ubai, Alvarez, Elena, Alvis-Guzmán, Nelson, Amankwaa, Adansi A., Amare, Azmeraw T., Amini, Hassan, Ammar, Walid, Antonio, Carl A.T., Anwari, Palwasha, Ärnlöv, Johan, Arsenijevic, Valentina S. Arsic, Artaman, Ali, Asad, Majed Masoud, Asghar, Rana J., Assadi, Reza, Atkins, Lydia S., Badawi, Alaa, Balakrishnan, Kalpana, Basu, Arindam, Basu, Sanjay, Beardsley, Justin, Bedi, Neeraj, Bekele, Tolesa, Bell, Michelle L., Bernabe, Eduardo, Beyene, Tariku J., Bhutta, Zulfiqar, Abdulhak, Aref Bin, Blore, Jed D., Basara, Berrak Bora, Bose, Dipan, Breitborde, Nichola, Cárdenas, Rosario, Castañeda-Orjuela, Carlos A., Castro, Ruben Estanislao, Catalá-López, Ferrán, Cavlin, Alanur, Chang, Jung-Chen, Che, Xuan, Christophi, Costas A., Chugh, Sumeet S., Cirillo, Massimo, Colquhoun, Samantha M., Cooper, Leslie Trumbull, Cooper, Cyru, Da Costa Leite, Iuri, Dandona, Lalit, Dandona, Rakhi, Davis, Adrian, Dayama, Anand, Degenhardt, Louisa, De Leo, Diego, Del Pozo-Cruz, Borja, Deribe, Kebede, Dessalegn, Muluken, Deveber, Gabrielle A., Dharmaratne, Samath D., Dilmen, Uʇur, Ding, Eric L., Dorrington, Rob E., Driscoll, Tim R., Ermakov, Sergei Petrovich, Esteghamati, Alireza, Faraon, Emerito Jose A., Farzadfar, Farshad, Felicio, Manuela Mendonca, Fereshtehnejad, Seyed-Mohammad, De Lima, Graça Maria Ferreira, Forouzanfar, Mohammad H., França, Elisabeth B., Gaffikin, Lynne, Gambashidze, Ketevan, Gankpé, Fortuné Gbètoho, Garcia, Ana C., Geleijnse, Johanna M., Gibney, Katherine B., Giroud, Maurice, Glaser, Elizabeth L., Goginashvili, Ketevan, Gona, Philimon, González-Castell, Dinorah, Goto, Atsushi, Gouda, Hebe N., Gugnani, Harish Chander, Gupta, Rahul, Gupta, Rajeev, Hafezi-Nejad, Nima, Hamadeh, Randah Ribhi, Hammami, Mouhanad, Hankey, Graeme J., Harb, Hilda L., Havmoeller, Rasmu, Hay, Simon I., Pi, Ileana B. Heredia, Hoek, Hans W., Hosgood, H Dean, Hoy, Damian G., Husseini, Abdullatif, Idrisov, Bulat T., Innos, Kaire, Inoue, Manami, Jacobsen, Kathryn H., Jahangir, Eiman, Jee, Sun Ha, Jensen, Paul N., Jha, Vivekanand, Jiang, Guohong, Jonas, Jost B., Juel, Knud, Kabagambe, Edmond Kato, Kan, Haidong, Karam, Nadim E., Karch, André, Karema, Corine Kakizi, Kaul, Anil, Kawakami, Norito, Kazanjan, Konstantin, Kazi, Dhruv S., Kemp, Andrew H., Kengne, Andre Pascal, Kereselidze, Maia, Khader, Yousef Saleh, Khalifa, Shams Eldin Ali Hassan, Khan, Ejaz Ahmed, Khang, Young-Ho, Knibbs, Luke, Kokubo, Yoshihiro, Kosen, Soewarta, Defo, Barthelemy Kuate, Kulkarni, Chanda, Kulkarni, Veena S., Kumar, G. Anil, Kumar, Kaushalendra, Kumar, Ravi B., Kwan, Gene, Lai, Taavi, Lalloo, Ratilal, Lam, Hilton, Lansingh, Van C., Larsson, Ander, Lee, Jong-Tae, Leigh, Jame, Leinsalu, Mall, Leung, Ricky, Li, Xiaohong, Li, Yichong, Li, Yongmei, Liang, Juan, Liang, Xiaofeng, Lim, Stephen S., Lin, Hsien-Ho, Lipshultz, Steven E., Liu, Shiwei, Liu, Yang, Lloyd, Belinda K., London, Stephanie J., Lotufo, Paulo A., Ma, Jixiang, Ma, Stefan, Machado, Vasco Manuel Pedro, Mainoo, Nana Kwaku, Majdan, Marek, Mapoma, Christopher Chabila, Marcenes, Wagner, Marzan, Melvin Barriento, Mason-Jones, Amanda J., Mehndiratta, Man Mohan, Mejia-Rodriguez, Fabiola, Memish, Ziad A., Mendoza, Walter, Miller, Ted R., Mills, Edward J., Mokdad, Ali H., Mola, Glen Liddell, Monasta, Lorenzo, De La Cruz Monis, Jonathan, Hernandez, Julio Cesar Montañez, Moore, Ami R., Moradi-Lakeh, Maziar, Mori, Rintaro, Mueller, Ulrich O., Mukaigawara, Mitsuru, Naheed, Aliya, Naidoo, Kovin S., Nand, Devina, Nangia, Vinay, Nash, Deni, Nejjari, Chakib, Nelson, Robert G., Neupane, Sudan Prasad, Newton, Charles R., Ng, Marie, Nieuwenhuijsen, Mark J., Nisar, Muhammad Imran, Nolte, Sandra, Norheim, Ole F., Nyakarahuka, Luke, Oh, In-Hwan, Ohkubo, Takayoshi, Olusanya, Bolajoko O., Omer, Saad B., Opio, John Nelson, Orisakwe, Orish Ebere, Pandian, Jeyaraj D., Papachristou, Christina, Park, Jae-Hyun, Paternina Caicedo, Angel J., Patten, Scott B., Paul, Vinod K., Pavlin, Boris Igor, Pearce, Neil, Pereira, David M., Pesudovs, Konrad, Petzold, Max, Poenaru, Dan, Polanczyk, Guilherme V., Polinder, Suzanne, Pope, Dan, Pourmalek, Farshad, Qato, Dima, Quistberg, D. Alex, Rafay, Anwar, Rahimi, Kazem, Rahimi-Movaghar, Vafa, Ur Rahman, Sajjad, Raju, Murugesan, Rana, Saleem M., Refaat, Amany, Ronfani, Luca, Roy, Nobhojit, Pimienta, Tania Georgina Sánchez, Sahraian, Mohammad Ali, Salomon, Joshua A., Sampson, Uchechukwu, Santos, Itamar S., Sawhney, Monika, Sayinzoga, Felix, Schneider, Ione J.C., Schumacher, Austin, Schwebel, David C., Seedat, Soraya, Sepanlou, Sadaf G., Servan-Mori, Edson E., Shakh-Nazarova, Marina, Sheikhbahaei, Sara, Shibuya, Kenji, Shin, Hwashin Hyun, Shiue, Ivy, Sigfusdottir, Inga Dora, Silberberg, Donald H., Silva, Andrea P., Singh, Jasvinder A., Skirbekk, Vegard, Sliwa, Karen, Soshnikov, Sergey S., Sposato, Luciano A., Sreeramareddy, Chandrashekhar T., Stroumpoulis, Konstantino, Sturua, Lela, Sykes, Bryan L., Tabb, Karen M., Talongwa, Roberto Tchio, Tan, Feng, Teixeira, Carolina Maria, Tenkorang, Eric Yeboah, Terkawi, Abdullah Sulieman, Thorne-Lyman, Andrew L., Tirschwell, David L., Towbin, Jeffrey A., Tran, Bach X., Tsilimbaris, Miltiadi, Uchendu, Uche S., Ukwaja, Kingsley N., Undurraga, Eduardo A., Uzun, Selen Begüm, Vallely, Andrew J., Van Gool, Coen H., Vasankari, Tommi J., Vavilala, Monica S., Venketasubramanian, N., Villalpando, Salvador, Violante, Francesco S., Vlassov, Vasiliy Victorovich, Vos, Theo, Waller, Stephen, Wang, Haidong, Wang, Linhong, Wang, Xiao Rong, Wang, Yanping, Weichenthal, Scott, Weiderpass, Elisabete, Weintraub, Robert G., Westerman, Ronny, Wilkinson, James D., Woldeyohannes, Solomon Meseret, Wong, John Q., Wordofa, Muluemebet Abera, Xu, Gelin, Yang, Yang C., Yano, Yuichiro, Yentur, Gokalp Kadri, Yip, Paul, Yonemoto, Naohiro, Yoon, Seok-Jun, Younis, Mustafa Z., Yu, Chuanhua, Jin, Kim Yun, El Sayed Zaki, Maysaa, Zhao, Yong, Zheng, Yingfeng, Zhou, Maigeng, Zhu, Jun, Zou, Xiao Nong, Lopez, Alan D., Naghavi, Mohsen, Murray, Christopher J.L., Lozano, Rafael, Kassebaum, Nj, Bertozzi-Villa, A, Coggeshall, M, Shackelford, Ka, Steiner, C, Heuton, Kr, Gonzalez-Medina, D, Barber, R, Huynh, C, Dicker, D, Templin, T, Wolock, Tm, Ozgoren, Aa, Abd-Allah, F, Abera, Sf, Achoki, T, Adelekan, A, Ademi, Z, Adou, Ak, Adsuar, Jc, Agardh, Ee, Akena, D, Alasfoor, D, Alemu, Za, Alfonso-Cristancho, R, Alhabib, S, Ali, R, Al Kahbouri, Mj, Alla, F, Allen, Pj, Almazroa, Ma, Alsharif, U, Alvarez, E, Alvis-Guzmán, N, Amankwaa, Aa, Amare, At, Amini, H, Ammar, W, Antonio, Ca, Anwari, P, Arnlöv, J, Arsenijevic, V, Artaman, A, Asad, Mm, Asghar, Rj, Assadi, R, Atkins, L, Badawi, A, Balakrishnan, K, Basu, A, Basu, S, Beardsley, J, Bedi, N, Bekele, T, Bell, Ml, Bernabe, E, Beyene, Tj, Bhutta, Z, Bin Abdulhak, A, Blore, J, Basara, Bb, Bose, D, Breitborde, N, Cárdenas, R, Castañeda-Orjuela, Ca, Castro, Re, Catalá-López, F, Cavlin, A, Chang, Jc, Che, X, Christophi, Ca, Chugh, S, Cirillo, M, Colquhoun, Sm, Cooper, Lt, Cooper, C, da Costa Leite, I, Dandona, L, Dandona, R, Davis, A, Dayama, A, Degenhardt, L, De Leo, D, Del Pozo-Cruz, B, Deribe, K, Dessalegn, M, Deveber, Ga, Dharmaratne, Sd, Dilmen, U, Ding, El, Dorrington, Re, Driscoll, Tr, Ermakov, Sp, Esteghamati, A, Faraon, Ej, Farzadfar, F, Felicio, Mm, Fereshtehnejad, Sm, de Lima, Gm, Forouzanfar, Mh, França, Eb, Gaffikin, L, Gambashidze, K, Gankpé, Fg, Garcia, Ac, Geleijnse, Jm, Gibney, Kb, Giroud, M, Glaser, El, Goginashvili, K, Gona, P, González-Castell, D, Goto, A, Gouda, Hn, Gugnani, Hc, Gupta, R, Hafezi-Nejad, N, Hamadeh, Rr, Hammami, M, Hankey, Gj, Harb, Hl, Havmoeller, R, Hay, S, Pi, Ib, Hoek, Hw, Hosgood, Hd, Hoy, Dg, Husseini, A, Idrisov, Bt, Innos, K, Inoue, M, Jacobsen, Kh, Jahangir, E, Jee, Sh, Jensen, Pn, Jha, V, Jiang, G, Juel, K, Kabagambe, Ek, Kan, H, Karam, Ne, Karch, A, Karema, Ck, Kaul, A, Kawakami, N, Kazanjan, K, Kazi, D, Kemp, Ag, Kengne, Ap, Kereselidze, M, Khader, Y, Khalifa, Se, Khan, Ea, Khang, Yh, Knibbs, L, Kokubo, Y, Kosen, S, Defo, Bk, Kulkarni, C, Kulkarni, V, Kumar, Ga, Kumar, K, Kumar, Rb, Kwan, G, Lai, T, Lalloo, R, Lam, H, Lansingh, Vc, Larsson, A, Lee, Jt, Leigh, J, Leinsalu, M, Leung, R, Li, X, Li, Y, Liang, J, Liang, X, Lim, S, Lin, Hh, Lipshultz, Se, Liu, S, Liu, Y, Lloyd, Bk, London, Sj, Lotufo, Pa, Ma, J, Ma, S, Machado, Vm, Mainoo, Nk, Majdan, M, Mapoma, Cc, Marcenes, W, Marzan, Mb, Mason-Jones, Aj, Mehndiratta, Mm, Mejia-Rodriguez, F, Memish, Za, Mendoza, W, Miller, Tr, Mills, Ej, Mokdad, Ah, Mola, Gl, Monasta, L, de la Cruz Monis, J, Hernandez, Jc, Moore, Ar, Mori, R, Mueller, Uo, Mukaigawara, M, Naheed, A, Naidoo, K, Nand, D, Nangia, V, Nash, D, Nejjari, C, Nelson, Rg, Neupane, Sp, Newton, Cr, Ng, M, Nieuwenhuijsen, Mj, Nisar, Mi, Nolte, S, Norheim, Of, Nyakarahuka, L, Oh, Ih, Ohkubo, T, Olusanya, Bo, Omer, Sb, Opio, Jn, Orisakwe, Oe, Pandian, Jd, Papachristou, C, Park, Jh, Caicedo, Aj, Patten, Sb, Paul, Vk, Pavlin, Bi, Pearce, N, Pereira, Dm, Pesudovs, K, Petzold, M, Poenaru, D, Polanczyk, Gv, Polinder, S, Pope, D, Pourmalek, F, Qato, D, Quistberg, Da, Rafay, A, Rahimi, K, Rahimi-Movaghar, V, Ur Rahman, S, Raju, M, Rana, Sm, Refaat, A, Ronfani, L, Roy, N, Pimienta, Tg, Sahraian, Ma, Salomon, J, Sampson, U, Santos, I, Sawhney, M, Sayinzoga, F, Schneider, Ij, Schumacher, A, Schwebel, Dc, Seedat, S, Sepanlou, Sg, Servan-Mori, Ee, Shakh-Nazarova, M, Sheikhbahaei, S, Shibuya, K, Shin, Hh, Shiue, I, Sigfusdottir, Id, Silberberg, Dh, Silva, Ap, Singh, Ja, Skirbekk, V, Sliwa, K, Soshnikov, S, Sposato, La, Sreeramareddy, Ct, Stroumpoulis, K, Sturua, L, Sykes, Bl, Tabb, Km, Talongwa, Rt, Tan, F, Teixeira, Cm, Tenkorang, Ey, Terkawi, A, Thorne-Lyman, Al, Tirschwell, Dl, Towbin, Ja, Tran, Bx, Tsilimbaris, M, Uchendu, U, Ukwaja, Kn, Undurraga, Ea, Uzun, Sb, Vallely, Aj, van Gool, Ch, Vasankari, Tj, Vavilala, M, Venketasubramanian, N, Villalpando, S, Violante, F, Vlassov, Vv, Vos, T, Waller, S, Wang, H, Wang, L, Wang, Sx, Wang, Y, Weichenthal, S, Weiderpass, E, Weintraub, Rg, Westerman, R, Wilkinson, Jd, Woldeyohannes, Sm, Wong, Jq, Wordofa, Ma, Xu, G, Yang, Yc, Yano, Y, Yentur, Gk, Yip, P, Yonemoto, N, Yoon, Sj, Younis, Mz, Yu, C, Jin, Ky, El Sayed Zaki, M, Zhao, Y, Zheng, Y, Zhou, M, Zhu, J, Zou, Xn, Lopez, Ad, Naghavi, M, Murray, Cj, Lozano, R, Cell biology, Epidemiology, Public Health, Erasmus MC other, Cardiothoracic Surgery, and Pathology

Subjects
Pediatrics, Time Factors, Nutrition and Disease, hiv-infection, immunodeficiency virus-1 infection, peripartum cardiomyopathy, Poison control, HIV Infections, IMMUNODEFICIENCY VIRUS-1 INFECTION, Socioeconomic Factor, Global Health, 0302 clinical medicine, PERIPARTUM CARDIOMYOPATHY, pregnancy-related mortality, Risk Factors, Pregnancy, Voeding en Ziekte, Cause of Death, Global health, HIV Infection, 030212 general & internal medicine, Pregnancy Complications, Infectious, 10. No inequality, Cause of death, 030219 obstetrics & reproductive medicine, south-africa, Medicine (all), 1. No poverty, WOMEN, PREGNANCY-RELATED MORTALITY, health initiatives, General Medicine, SOUTH-AFRICA, 3. Good health, Maternal Mortality, World Health, CHILD SURVIVAL, Female, Maternal death, women, Human, medicine.medical_specialty, Time Factor, DEATHS, child survival, Article, adult mortality, 03 medical and health sciences, Age Distribution, HEALTH INITIATIVES, SDG 3 - Good Health and Well-being, HIV-INFECTION, ADULT MORTALITY, Injury prevention, medicine, Organizational Objectives, Organizational Objective, Humans, VLAG, Models, Statistical, business.industry, Risk Factor, medicine.disease, deaths, Standardized mortality ratio, Socioeconomic Factors, Relative risk, Pregnancy Complications, Infectiou, business, Demography
Abstract

BACKGROUND: The fifth Millennium Development Goal (MDG 5) established the goal of a 75% reduction in the maternal mortality ratio (MMR; number of maternal deaths per 100,000 livebirths) between 1990 and 2015. We aimed to measure levels and track trends in maternal mortality, the key causes contributing to maternal death, and timing of maternal death with respect to delivery.METHODS: We used robust statistical methods including the Cause of Death Ensemble model (CODEm) to analyse a database of data for 7065 site-years and estimate the number of maternal deaths from all causes in 188 countries between 1990 and 2013. We estimated the number of pregnancy-related deaths caused by HIV on the basis of a systematic review of the relative risk of dying during pregnancy for HIV-positive women compared with HIV-negative women. We also estimated the fraction of these deaths aggravated by pregnancy on the basis of a systematic review. To estimate the numbers of maternal deaths due to nine different causes, we identified 61 sources from a systematic review and 943 site-years of vital registration data. We also did a systematic review of reports about the timing of maternal death, identifying 142 sources to use in our analysis. We developed estimates for each country for 1990-2013 using Bayesian meta-regression. We estimated 95% uncertainty intervals (UIs) for all values.FINDINGS: 292,982 (95% UI 261,017-327,792) maternal deaths occurred in 2013, compared with 376,034 (343,483-407,574) in 1990. The global annual rate of change in the MMR was -0·3% (-1·1 to 0·6) from 1990 to 2003, and -2·7% (-3·9 to -1·5) from 2003 to 2013, with evidence of continued acceleration. MMRs reduced consistently in south, east, and southeast Asia between 1990 and 2013, but maternal deaths increased in much of sub-Saharan Africa during the 1990s. 2070 (1290-2866) maternal deaths were related to HIV in 2013, 0·4% (0·2-0·6) of the global total. MMR was highest in the oldest age groups in both 1990 and 2013. In 2013, most deaths occurred intrapartum or postpartum. Causes varied by region and between 1990 and 2013. We recorded substantial variation in the MMR by country in 2013, from 956·8 (685·1-1262·8) in South Sudan to 2·4 (1·6-3·6) in Iceland.INTERPRETATION: Global rates of change suggest that only 16 countries will achieve the MDG 5 target by 2015. Accelerated reductions since the Millennium Declaration in 2000 coincide with increased development assistance for maternal, newborn, and child health. Setting of targets and associated interventions for after 2015 will need careful consideration of regions that are making slow progress, such as west and central Africa.FUNDING: Bill & Melinda Gates Foundation.

Published
2016

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