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1. Unraveling reproductive and maternal health challenges of women living with HIV/AIDS in Vietnam: a qualitative study

Author

Nguyen, Lynn T, Minh Giang, Le, Nguyen, Diep B, Nguyen, Trang T, and Lin, Chunqing

Subjects
Biomedical and Clinical Sciences, Midwifery, Public Health, Health Sciences, Reproductive Medicine, Clinical Research, Behavioral and Social Science, HIV/AIDS, Contraception/Reproduction, Pediatric, Health Services, 8.1 Organisation and delivery of services, Health and social care services research, Reproductive health and childbirth, Infection, Good Health and Well Being, Pregnancy, Humans, Female, Infant, Newborn, Acquired Immunodeficiency Syndrome, HIV, Maternal Health, Vietnam, HIV Infections, Qualitative Research, Women, Stigma, Maternal care, Reproductive health, Paediatrics and Reproductive Medicine, Obstetrics & Reproductive Medicine, Reproductive medicine, Public health
Abstract

BackgroundHuman Immunodeficiency Virus (HIV) remains a significant public health concern worldwide. Women living with HIV/AIDS (WLHA) have the additional and unique need to seek sexual and reproductive health services. WLHA's maternal health journeys can be shaped by the cultural norms and resources that exist in their society. This study sought to understand if and how WLHA's family planning, pregnancy, and motherhood experiences could be influenced by the patriarchal culture, gender roles, and HIV stigma in Vietnam, specifically.MethodsBetween December 2021 and March 2022, 30 WLHA with diverse socioeconomic backgrounds and childbirth experiences were interviewed in Hanoi, Vietnam. These semi-structured interviews covered topics including HIV stigma, gender norms, pregnancy experiences, and child-rearing challenges. Interviews were audio recorded, transcribed, and analysed using ATLAS.ti.ResultsQualitative analyses of participant quotes revealed how limited information on one's health prospects and reproductive options posed a significant challenge to family planning. Societal and familial expectations as well as economic circumstances also influenced reproductive decision-making. WLHA often encountered substandard healthcare during pregnancy, labor, and delivery. Stigma and lack of provider attentiveness resulted in cases where women were denied pain relief and other medical services. Communication breakdowns resulted in failure to administer antiretroviral therapy for newborns. Motherhood for WLHA was shadowed by concerns for not only their own health, but also the wellbeing of their children, as HIV stigma affected their children at school and in society as well. Many WLHA highlighted the constructive or destructive role that family members could play in their childbirth decision-making and care-giving experiences.ConclusionsOverall, this study underscores the complex ways that cultural expectations, family support, and stigma in healthcare impact WLHA. Efforts to educate and engage families and healthcare providers are warranted to better understand and address the needs of WLHA, ultimately improving their reproductive and maternal health.

Published
2024

2. Stimulation of ectopically expressed muscarinic receptors induces IFN-γ but suppresses IL-2 production by inhibiting activation of pAKT pathways in primary T cells

Author

Nguyen, Trang TT, Lu, Wen, Zhu, Wandi S, Ansel, K Mark, Liang, Hong-Erh, and Weiss, Arthur

Subjects
Biochemistry and Cell Biology, Biomedical and Clinical Sciences, Biological Sciences, Immunology, Medical Physiology, Pharmacology and Pharmaceutical Sciences, Rare Diseases, Underpinning research, 1.1 Normal biological development and functioning, Aetiology, 2.1 Biological and endogenous factors, Humans, Animals, Mice, Interleukin-2, Clozapine, Receptors, Muscarinic, Interferon-gamma, GTP-Binding Proteins, Tyrosine, muscarinic receptor, GPCR, T cells, signaling
Abstract

T cell antigen receptor stimulation induces tyrosine phosphorylation of downstream signaling molecules and the phosphatidylinositol, Ras, MAPK, and PI3 kinase pathways, leading to T cell activation. Previously, we reported that the G-protein-coupled human muscarinic receptor could bypass tyrosine kinases to activate the phosphatidylinositol pathway and induce interleukin-2 production in Jurkat leukemic T cells. Here, we demonstrate that stimulating G-protein-coupled muscarinic receptors (M1 and synthetic hM3Dq) can activate primary mouse T cells if PLCβ1 is coexpressed. Resting peripheral hM3Dq+PLCβ1 (hM3Dq/β1) T cells did not respond to clozapine, an hM3Dq agonist, unless they were preactivated by TCR and CD28 stimulation which increased hM3Dq and PLCβ1 expression. This permitted large calcium and phosphorylated ERK responses to clozapine. Clozapine treatment induced high IFN-γ, CD69, and CD25 expression, but surprisingly did not induce substantial IL-2 in hM3Dq/β1 T cells. Importantly, costimulation of both muscarinic receptors plus the TCR even led to reduced IL-2 expression, suggesting a selective inhibitory effect of muscarinic receptor costimulation. Stimulation of muscarinic receptors induced strong nuclear translocation of NFAT and NFκB and activated AP-1. However, stimulation of hM3Dq led to reduced IL-2 mRNA stability which correlated with an effect on the IL-2 3'UTR activity. Interestingly, stimulation of hM3Dq resulted in reduced pAKT and its downstream pathway. This may explain the inhibitory impact on IL-2 production in hM3Dq/β1T cells. Moreover, an inhibitor of PI3K reduced IL-2 production in TCR-stimulated hM3Dq/β1 CD4 T cells, suggesting that activating the pAKT pathway is critical for IL-2 production in T cells.

Published
2023

3. Challenges of methadone maintenance treatment decentralisation from Vietnamese primary care providers' perspectives

Author

Nguyen, Diep Bich, Nguyen, Trang Thu, Lin, Chunqing, Dinh, Thuy Thi Thanh, Le, Giang Minh, and Li, Li

Subjects
Health Services and Systems, Health Sciences, Clinical Research, HIV/AIDS, Health Services, Health and social care services research, 8.1 Organisation and delivery of services, Good Health and Well Being, Humans, Methadone, Opiate Substitution Treatment, Politics, Primary Health Care, Vietnam, decentralisation, methadone maintenance treatment, opioid use disorder, primary care providers, Medical and Health Sciences, Studies in Human Society, Psychology and Cognitive Sciences, Substance Abuse, Health sciences, Human society, Psychology
Abstract

IntroductionDecentralising methadone maintenance treatment to primary care improves patients' access to care and their drug and HIV treatment outcomes. However, primary care providers (PCP), especially those working in limited-resource settings, are facing great challenges to provide quality methadone treatment. This study explores the challenges perceived by PCP providing methadone treatment at commune health centres in a mountainous region in Vietnam.MethodWe conducted in-depth interviews with 26 PCP who worked as program managers, physicians, counsellors, pharmacists and medication dispensing staff at the methadone programs of eight commune health centres in Dien Bien, Vietnam, in November and December 2019. We used the health-care system framework in developing the interview guides and in summarising data themes.ResultsParticipants identified major challenges in providing methadone treatment in commune health centres at the individual, clinic and environmental levels. Individual-level challenges included a lack of confidence and motivation in providing methadone treatment. Clinic-level factors included inadequate human resources, lack of institutional support, insufficient technical support, lack of referral resources and additional support for patients. Environment-level factors comprised a lack of reasonable policies on financial support for providers at commune health centres for providing methadone treatment, lack of regulations and mechanisms to ensure providers' safety in case of potential violence by patients and to share responsibility for overdose during treatment.Discussion and conclusionPCP in Vietnam faced multi-level challenges in providing quality methadone treatment. Supportive policies and additional resources are needed to ensure the effectiveness of the decentralisation program.

Published
2023

4. The Type 2 Diabetes Knowledge Portal: An open access genetic resource dedicated to type 2 diabetes and related traits

Author

Costanzo, Maria C, von Grotthuss, Marcin, Massung, Jeffrey, Jang, Dongkeun, Caulkins, Lizz, Koesterer, Ryan, Gilbert, Clint, Welch, Ryan P, Kudtarkar, Parul, Hoang, Quy, Boughton, Andrew P, Singh, Preeti, Sun, Ying, Duby, Marc, Moriondo, Annie, Nguyen, Trang, Smadbeck, Patrick, Alexander, Benjamin R, Brandes, MacKenzie, Carmichael, Mary, Dornbos, Peter, Green, Todd, Huellas-Bruskiewicz, Kenneth C, Ji, Yue, Kluge, Alexandria, McMahon, Aoife C, Mercader, Josep M, Ruebenacker, Oliver, Sengupta, Sebanti, Spalding, Dylan, Taliun, Daniel, Consortium, AMP-T2D, Abecasis, Gonçalo, Akolkar, Beena, Allred, Nicholette D, Altshuler, David, Below, Jennifer E, Bergman, Richard, Beulens, Joline WJ, Blangero, John, Boehnke, Michael, Bokvist, Krister, Bottinger, Erwin, Bowden, Donald, Brosnan, M Julia, Brown, Christopher, Bruskiewicz, Kenneth, Burtt, Noël P, Cebola, Inês, Chambers, John, Chen, Yii-Der Ida, Cherkas, Andriy, Chu, Audrey Y, Clark, Christopher, Claussnitzer, Melina, Cox, Nancy J, Hoed, Marcel den, Dong, Duc, Duggirala, Ravindranath, Dupuis, Josée, Elders, Petra JM, Engreitz, Jesse M, Fauman, Eric, Ferrer, Jorge, Flannick, Jason, Flicek, Paul, Flickinger, Matthew, Florez, Jose C, Fox, Caroline S, Frayling, Timothy M, Frazer, Kelly A, Gaulton, Kyle J, Gloyn, Anna L, Hanis, Craig L, Hanson, Robert, Hattersley, Andrew T, Im, Hae Kyung, Iqbal, Sidra, Jacobs, Suzanne BR, Jang, Dong-Keun, Jordan, Tad, Kamphaus, Tania, Karpe, Fredrik, Keane, Thomas M, Kim, Seung K, Lage, Kasper, Lange, Leslie A, and Lazar, Mitchell

Subjects
Genetics, Diabetes, Human Genome, Metabolic and endocrine, Good Health and Well Being, Humans, Diabetes Mellitus, Type 2, Access to Information, Prospective Studies, Genomics, Phenotype, AMP-T2D Consortium, CMDKP, GWAS, T2DKP, data sharing, diabetes, effector genes, genetic associations, genetic support, genomics, portal, Biochemistry and Cell Biology, Medical Biochemistry and Metabolomics, Endocrinology & Metabolism
Abstract

Associations between human genetic variation and clinical phenotypes have become a foundation of biomedical research. Most repositories of these data seek to be disease-agnostic and therefore lack disease-focused views. The Type 2 Diabetes Knowledge Portal (T2DKP) is a public resource of genetic datasets and genomic annotations dedicated to type 2 diabetes (T2D) and related traits. Here, we seek to make the T2DKP more accessible to prospective users and more useful to existing users. First, we evaluate the T2DKP's comprehensiveness by comparing its datasets with those of other repositories. Second, we describe how researchers unfamiliar with human genetic data can begin using and correctly interpreting them via the T2DKP. Third, we describe how existing users can extend their current workflows to use the full suite of tools offered by the T2DKP. We finally discuss the lessons offered by the T2DKP toward the goal of democratizing access to complex disease genetic results.

Published
2023

5. A combined polygenic score of 21,293 rare and 22 common variants improves diabetes diagnosis based on hemoglobin A1C levels

Author

Dornbos, Peter, Koesterer, Ryan, Ruttenburg, Andrew, Nguyen, Trang, Cole, Joanne B, Leong, Aaron, Meigs, James B, Florez, Jose C, Rotter, Jerome I, Udler, Miriam S, and Flannick, Jason

Subjects
Biological Sciences, Genetics, Precision Medicine, Diabetes, 2.1 Biological and endogenous factors, Metabolic and endocrine, Good Health and Well Being, Humans, Multifactorial Inheritance, Glycated Hemoglobin, Diabetes Mellitus, Type 2, Genome-Wide Association Study, AMP-T2D-GENES Consortium, Medical and Health Sciences, Developmental Biology, Agricultural biotechnology, Bioinformatics and computational biology
Abstract

Polygenic scores (PGSs) combine the effects of common genetic variants1,2 to predict risk or treatment strategies for complex diseases3-7. Adding rare variation to PGSs has largely unknown benefits and is methodically challenging. Here, we developed a method for constructing rare variant PGSs and applied it to calculate genetically modified hemoglobin A1C thresholds for type 2 diabetes (T2D) diagnosis7-10. The resultant rare variant PGS is highly polygenic (21,293 variants across 154 genes), depends on ultra-rare variants (72.7% observed in fewer than three people) and identifies significantly more undiagnosed T2D cases than expected by chance (odds ratio = 2.71; P = 1.51 × 10-6). A PGS combining common and rare variants is expected to identify 4.9 million misdiagnosed T2D cases in the United States-nearly 1.5-fold more than the common variant PGS alone. These results provide a method for constructing complex trait PGSs from rare variants and suggest that rare variants will augment common variants in precision medicine approaches for common disease.

Published
2022

6. Contact-Tracing Outcomes Among Household Contacts of Fully Vaccinated Coronavirus Disease 2019 (COVID-19) Patients: San Francisco, California, 29 January–2 July 2021

Author

Sachdev, Darpun D, Ng, Rilene Chew, Sankaran, Madeline, Ernst, Alexandra, Hernandez, Katherine T, Servellita, Venice, Sotomayor-Gonzalez, Alicia, Stoltey, Juliet, Cohen, Stephanie E, Nguyen, Trang Quyen, Chiu, Charles Y, and Philip, Susan

Subjects
Infectious Diseases, Emerging Infectious Diseases, Prevention, Clinical Research, Biodefense, Vaccine Related, Good Health and Well Being, COVID-19, Contact Tracing, Family Characteristics, Humans, SARS-CoV-2, San Francisco, contact tracing, household transmission, breakthrough, vaccination, Biological Sciences, Medical and Health Sciences, Microbiology
Abstract

BackgroundThe extent to which vaccinated persons diagnosed with coronavirus disease 2019 (COVID-19) can transmit to other vaccinated and unvaccinated persons is unclear.MethodsUsing data from the San Francisco Department of Public Health, this report describes outcomes of household contact tracing during 29 January-2 July 2021, where fully vaccinated patients with COVID-19 were the index case in the household.ResultsAmong 248 fully vaccinated patients with breakthrough infections, 203 (82%) were symptomatic and 105 were identified as the index patient within their household. Among 179 named household contacts, 71 (40%) contacts tested, over half (56%) were fully vaccinated and the secondary attack rate was 28%. Overall transmission from a symptomatic fully vaccinated patient with breakthrough infection to household contacts was suspected in 14 of 105 (13%) of households. Viral genomic sequencing of samples from 44% of fully vaccinated patients showed that 82% of those sequenced were infected by a variant of concern or interest and 77% by a variant carrying mutation(s) associated with resistance to neutralizing antibodies.ConclusionsTransmission from fully vaccinated symptomatic index patients to vaccinated and unvaccinated household contacts can occur. Indoor face masking and timely testing of all household contacts should be considered when a household member receives a positive test result in order to identify and interrupt transmission chains.

Published
2022

7. Dissecting the treatment-naive ecosystem of human melanoma brain metastasis

Author

Biermann, Jana, Melms, Johannes C, Amin, Amit Dipak, Wang, Yiping, Caprio, Lindsay A, Karz, Alcida, Tagore, Somnath, Barrera, Irving, Ibarra-Arellano, Miguel A, Andreatta, Massimo, Fullerton, Benjamin T, Gretarsson, Kristjan H, Sahu, Varun, Mangipudy, Vaibhav S, Nguyen, Trang TT, Nair, Ajay, Rogava, Meri, Ho, Patricia, Koch, Peter D, Banu, Matei, Humala, Nelson, Mahajan, Aayushi, Walsh, Zachary H, Shah, Shivem B, Vaccaro, Daniel H, Caldwell, Blake, Mu, Michael, Wünnemann, Florian, Chazotte, Margot, Berhe, Simon, Luoma, Adrienne M, Driver, Joseph, Ingham, Matthew, Khan, Shaheer A, Rapisuwon, Suthee, Slingluff, Craig L, Eigentler, Thomas, Röcken, Martin, Carvajal, Richard, Atkins, Michael B, Davies, Michael A, Agustinus, Albert, Bakhoum, Samuel F, Azizi, Elham, Siegelin, Markus, Lu, Chao, Carmona, Santiago J, Hibshoosh, Hanina, Ribas, Antoni, Canoll, Peter, Bruce, Jeffrey N, Bi, Wenya Linda, Agrawal, Praveen, Schapiro, Denis, Hernando, Eva, Macosko, Evan Z, Chen, Fei, Schwartz, Gary K, and Izar, Benjamin

Subjects
Cancer, Biotechnology, Neurosciences, Aetiology, 2.1 Biological and endogenous factors, Brain Neoplasms, CD8-Positive T-Lymphocytes, Ecosystem, Humans, Melanoma, RNA-Seq, brain metastasis, chromosomal instability, melanoma, neuronal-like cell state, single-cell genomics, spatial transcriptomics, tumor-microenvironment, Biological Sciences, Medical and Health Sciences, Developmental Biology
Abstract

Melanoma brain metastasis (MBM) frequently occurs in patients with advanced melanoma; yet, our understanding of the underlying salient biology is rudimentary. Here, we performed single-cell/nucleus RNA-seq in 22 treatment-naive MBMs and 10 extracranial melanoma metastases (ECMs) and matched spatial single-cell transcriptomics and T cell receptor (TCR)-seq. Cancer cells from MBM were more chromosomally unstable, adopted a neuronal-like cell state, and enriched for spatially variably expressed metabolic pathways. Key observations were validated in independent patient cohorts, patient-derived MBM/ECM xenograft models, RNA/ATAC-seq, proteomics, and multiplexed imaging. Integrated spatial analyses revealed distinct geography of putative cancer immune evasion and evidence for more abundant intra-tumoral B to plasma cell differentiation in lymphoid aggregates in MBM. MBM harbored larger fractions of monocyte-derived macrophages and dysfunctional TOX+CD8+ T cells with distinct expression of immune checkpoints. This work provides comprehensive insights into MBM biology and serves as a foundational resource for further discovery and therapeutic exploration.

Published
2022

8. Comparison of infection control strategies to reduce COVID-19 outbreaks in homeless shelters in the United States: a simulation study

Author

Chapman, Lloyd AC, Kushel, Margot, Cox, Sarah N, Scarborough, Ashley, Cawley, Caroline, Nguyen, Trang Q, Rodriguez-Barraquer, Isabel, Greenhouse, Bryan, Imbert, Elizabeth, and Lo, Nathan C

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Homelessness, Prevention, Infectious Diseases, Emerging Infectious Diseases, 4.1 Discovery and preclinical testing of markers and technologies, Detection, screening and diagnosis, Infection, Good Health and Well Being, COVID-19, COVID-19 Nucleic Acid Testing, Cities, Computer Simulation, Cross-Sectional Studies, Disease Outbreaks, Ill-Housed Persons, Housing, Humans, Infection Control, Mass Screening, United States, SARS-CoV-2, Shelters, Infection control, Outbreaks, Symptom-based screening, PCR testing, Universal masking, Medical and Health Sciences, General & Internal Medicine, Biomedical and clinical sciences, Health sciences
Abstract

BackgroundCOVID-19 outbreaks have occurred in homeless shelters across the US, highlighting an urgent need to identify the most effective infection control strategy to prevent future outbreaks.MethodsWe developed a microsimulation model of SARS-CoV-2 transmission in a homeless shelter and calibrated it to data from cross-sectional polymerase chain reaction (PCR) surveys conducted during COVID-19 outbreaks in five homeless shelters in three US cities from March 28 to April 10, 2020. We estimated the probability of averting a COVID-19 outbreak when an exposed individual is introduced into a representative homeless shelter of 250 residents and 50 staff over 30 days under different infection control strategies, including daily symptom-based screening, twice-weekly PCR testing, and universal mask wearing.ResultsThe proportion of PCR-positive residents and staff at the shelters with observed outbreaks ranged from 2.6 to 51.6%, which translated to the basic reproduction number (R0) estimates of 2.9-6.2. With moderate community incidence (~ 30 confirmed cases/1,000,000 people/day), the estimated probabilities of averting an outbreak in a low-risk (R0 = 1.5), moderate-risk (R0 = 2.9), and high-risk (R0 = 6.2) shelter were respectively 0.35, 0.13, and 0.04 for daily symptom-based screening; 0.53, 0.20, and 0.09 for twice-weekly PCR testing; 0.62, 0.27, and 0.08 for universal masking; and 0.74, 0.42, and 0.19 for these strategies in combination. The probability of averting an outbreak diminished with higher transmissibility (R0) within the simulated shelter and increasing incidence in the local community.ConclusionsIn high-risk homeless shelter environments and locations with high community incidence of COVID-19, even intensive infection control strategies (incorporating daily symptom screening, frequent PCR testing, and universal mask wearing) are unlikely to prevent outbreaks, suggesting a need for non-congregate housing arrangements for people experiencing homelessness. In lower-risk environments, combined interventions should be employed to reduce outbreak risk.

Published
2021

9. Probiotics for periodontal health—Current molecular findings

Author

Nguyen, Trang, Brody, Hanna, Radaic, Alan, and Kapila, Yvonne

Subjects
Biomedical and Clinical Sciences, Dentistry, Dental/Oral and Craniofacial Disease, Infectious Diseases, Nutrition, Complementary and Integrative Health, Biotechnology, Aetiology, 2.1 Biological and endogenous factors, Infection, Oral and gastrointestinal, Good Health and Well Being, Dysbiosis, Humans, Microbiota, Periodontal Diseases, Probiotics, in vitro, in vivo, periodontal, probiotics, in vitro, in vivo
Abstract

Dysbiosis of the oral microbiome is associated with a variety of oral and systemic diseases, including periodontal disease. Oral dysbiosis in periodontal disease leads to an exacerbated host immune response that induces progressive periodontal tissue destruction and ultimately tooth loss. To counter the disease-associated dysbiosis of the oral cavity, strategies have been proposed to reestablish a "healthy" microbiome via the use of probiotics. This study reviews the literature on the use of probiotics for modifying the oral microbial composition toward a beneficial state that might alleviate disease progression. Four in vitro and 10 preclinical studies were included in the analysis, and these studies explored the effects of probiotics on cultured biofilm growth and bacterial gene expressions, as well as modulation of the host response to inflammation. The current molecular findings on probiotics provide fundamental evidence for further clinical research for the use of probiotics in periodontal therapy. They also point out an important caveat: Changing the biofilm composition might alter the normal oral flora that is beneficial and/or critical for oral health.

Published
2021

10. The SARS-CoV-2 pandemic: the race to trace: contact tracing scale-up in San Francisco—early lessons learned

Author

Reid, Michael, Enanoria, Wayne, Stoltey, Juliet, Philip, Susan, Fuchs, Jonathan, Lockwood, Amy, Krueger, Elizabeth, White, Karen, Celentano, Jessica, Rutherford, George, Scheer, Susan, Nguyen, Trang, and Sachdev, Darpun

Subjects
Emerging Infectious Diseases, Prevention, Biodefense, Infectious Diseases, Vaccine Related, Good Health and Well Being, COVID-19, COVID-19 Testing, Contact Tracing, Data Management, Efficiency, Organizational, Humans, Pandemics, Public Health Administration, Quarantine, SARS-CoV-2, San Francisco, Social Work, Contact tracing, Epidemiology, Containment, Policy and Administration, Public Health
Abstract

In order to effectively control spread of coronavirus 2019 (COVID-19), it is essential that jurisdictions have the capacity to rapidly trace close contacts of each and every case. Best practice guidance on how to implement such programs is urgently needed. We describe the early experience in the City and County of San Francisco (CCSF), where the City's Department of Health expanded contact tracing capability in anticipation of changes in San Francisco's 'shelter in place' order between April and June 2020. Important prerequisites to successful scale-up included a rapid expansion of the COVID-19 response workforce, expansion of testing capability, and other containment resources. San Francisco's scale-up offers a model for how other jurisdictions can rapidly mobilize a workforce. We underscore the importance of an efficient digital case management system, effective training, and expansion of supportive service programs for those in quarantine or isolation, and metrics to ensure continuous performance improvement.

Published
2021

11. Reversible phosphorylation of cyclin T1 promotes assembly and stability of P-TEFb

Author

Huang, Fang, Nguyen, Trang TT, Echeverria, Ignacia, Ramachandran, Rakesh, Cary, Daniele C, Paculova, Hana, Sali, Andrej, Weiss, Arthur, Peterlin, Boris Matija, and Fujinaga, Koh

Subjects
Biomedical and Clinical Sciences, Immunology, HIV/AIDS, Infectious Diseases, Sexually Transmitted Infections, 2.1 Biological and endogenous factors, 1.1 Normal biological development and functioning, Generic health relevance, Cyclin T, Cyclin-Dependent Kinase 9, HEK293 Cells, Humans, Jurkat Cells, Phosphorylation, Positive Transcriptional Elongation Factor B, T-Lymphocytes, P-TEFb, PKC, PP1, phosphorylation, transcription, anergy, exhaustion, Human, Mouse, biochemistry, chemical biology, chromosomes, gene expression, human, mouse, Biochemistry and Cell Biology, Biological sciences, Biomedical and clinical sciences, Health sciences
Abstract

The positive transcription elongation factor b (P-TEFb) is a critical coactivator for transcription of most cellular and viral genes, including those of HIV. While P-TEFb is regulated by 7SK snRNA in proliferating cells, P-TEFb is absent due to diminished levels of CycT1 in quiescent and terminally differentiated cells, which has remained unexplored. In these cells, we found that CycT1 not bound to CDK9 is rapidly degraded. Moreover, productive CycT1:CDK9 interactions are increased by PKC-mediated phosphorylation of CycT1 in human cells. Conversely, dephosphorylation of CycT1 by PP1 reverses this process. Thus, PKC inhibitors or removal of PKC by chronic activation results in P-TEFb disassembly and CycT1 degradation. This finding not only recapitulates P-TEFb depletion in resting CD4+ T cells but also in anergic T cells. Importantly, our studies reveal mechanisms of P-TEFb inactivation underlying T cell quiescence, anergy, and exhaustion as well as proviral latency and terminally differentiated cells.

Published
2021

12. “It’s extremely hard but it’s not a burden”: A qualitative study of family caregiving for people living with dementia in Vietnam

Author

Nguyen, Huong, Nguyen, Trang, Tran, Duyen, and Hinton, Ladson

Subjects
Health Services and Systems, Nursing, Health Sciences, Human Society, Alzheimer's Disease including Alzheimer's Disease Related Dementias (AD/ADRD), Behavioral and Social Science, Alzheimer's Disease, Dementia, Aging, Acquired Cognitive Impairment, Clinical Research, Neurodegenerative, Brain Disorders, 7.1 Individual care needs, Management of diseases and conditions, Good Health and Well Being, Caregivers, Humans, Qualitative Research, Vietnam, General Science & Technology
Abstract

BackgroundVietnam is one of the fastest-aging countries in the world with a rising number of people with Alzheimer's disease and related dementias (ADRD). Families in Vietnam provide most of the care for persons living with dementia, yet our understanding of their experiences and needs is limited. This study examined the family caregiving experience in a semi-rural region outside of central Hanoi from the perspectives of family caregivers and other key informants.MaterialsSemi-structured interviews were conducted with 21 key stakeholders (12 family caregivers and 9 healthcare providers and community leaders). A descriptive, thematic analysis was conducted.ResultsQualitative data analysis revealed four themes related to the family caregiving experience: 1) perceptions of dementia symptoms as a normal part of aging rather than a disease, 2) caregiving as a moral and expected familial obligation, 3) patterns of caregiving that are heavily influenced by both gender and sibling order, and 4) multiple challenges or hardships, including time constraints, loss of income, increased social isolation, a toll on their perceived physical health, and emotional distress. Caregivers rejected the notion that caregiving was a "burden" and expressed their distress through terms such as frustration, sadness, and exhaustion.ConclusionsIn this low-resource setting, the stress of family caregiving may be amplified by lack of community resources, cultural stigma discouraging outside help-seeking, and economic impact of care provision. The study highlights the vulnerability and predicament of Vietnamese women who often face multiple challenges in their caregiving role as well as the urgent need for the development of community-based programs and supports.

Published
2021

13. Unnamed Partners From Syphilis Partner Services Interviews, 7 Jurisdictions.

Author

Cope, Anna Barry, Bernstein, Kyle, Matthias, James, Rahman, Mohammad, Diesel, Jill, Pugsley, River A, Schillinger, Julia A, Ng, Rilene A Chew, Sachdev, Darpun, Shaw, Rebecca, Nguyen, Trang Quyen, Klingler, Ellen J, Mobley, Victoria L, Samoff, Erika, and Peterman, Thomas A

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Health Sciences, Clinical Research, Contact Tracing, Female, Heterosexuality, Homosexuality, Male, Humans, Interviews as Topic, Male, Sexual Behavior, Sexual Partners, Syphilis, United States, Biological Sciences, Medical and Health Sciences, Public Health, Clinical sciences, Epidemiology, Public health
Abstract

BackgroundReducing transmission depends on the percentage of infected partners treated; if many are missed, impact on transmission will be low. Traditional partner services metrics evaluate the number of partners found and treated. We estimated the proportion of partners of syphilis patients not locatable for intervention.MethodsWe reviewed records of early syphilis cases (primary, secondary, early latent) reported in 2015 to 2017 in 7 jurisdictions (Florida, Louisiana, Michigan, North Carolina, Virginia, New York City, and San Francisco). Among interviewed syphilis patients, we determined the proportion who reported named partners (with locating information), reported unnamed partners (no locating information), and did not report partners. For patients with no reported partners, we estimated their range of unreported partners to be between one and the average number of partners for patients who reported partners.ResultsAmong 29,719 syphilis patients, 23,613 (80%) were interviewed and 18,581 (63%) reported 84,224 sex partners (average, 4.5; 20,853 [25%] named and 63,371 [75%] unnamed). An estimated 11,138 to 54,521 partners were unreported. Thus, 74,509 to 117,892 (of 95,362-138,745) partners were not reached by partner services (78%-85%). Among interviewed patients, 71% reported ≥1 unnamed partner or reported no partners; this proportion was higher for men who reported sex with men (75%) compared with men who reported sex with women only (65%) and women (44%).ConclusionsApproximately 80% of sex partners were either unnamed or unreported. Partner services may be less successful at interrupting transmission in networks for men who reported sex with men where a higher proportion of partners are unnamed or unreported.

Published
2020

14. Host‐microbe interactions: Profiles in the transcriptome, the proteome, and the metabolome

Author

Nguyen, Trang, Sedghi, Lea, Ganther, Sean, Malone, Erin, Kamarajan, Pachiyappan, and Kapila, Yvonne L

Subjects
Medical Biochemistry and Metabolomics, Biomedical and Clinical Sciences, Dentistry, Infectious Diseases, Genetics, Prevention, Biotechnology, Dental/Oral and Craniofacial Disease, Oral and gastrointestinal, Good Health and Well Being, Humans, Metabolome, Metabolomics, Proteome, Proteomics, Transcriptome
Abstract

Periodontal studies using transcriptomics, proteomics, and metabolomics encompass the collection of mRNA transcripts, proteins, and small-molecule chemicals in the context of periodontal health and disease. The number of studies using these approaches has significantly increased in the last decade and they have provided new insight into the pathogenesis and host-microbe interactions that define periodontal diseases. This review provides an overview of current molecular findings using -omic approaches that underlie periodontal disease, including modulation of the host immune response, tissue homeostasis, and complex metabolic processes of the host and the oral microbiome. Integration of these -omic approaches will broaden our perspective of the molecular mechanisms involved in periodontal disease, advancing and improving the diagnosis and treatment of various stages and forms of periodontal disease.

Published
2020

15. Natural IgM and the Development of B Cell-Mediated Autoimmune Diseases

Author

Nguyen, Trang TT and Baumgarth, Nicole

Subjects
Biomedical and Clinical Sciences, Immunology, Biodefense, Autoimmune Disease, Vaccine Related, Prevention, 2.1 Biological and endogenous factors, 1.1 Normal biological development and functioning, Aetiology, Underpinning research, Inflammatory and immune system, Animals, Autoimmune Diseases, B-Lymphocytes, Humans, Immunoglobulin M, IgM-deficiency, B-1 cells, B-cell development, tolerance induction
Abstract

Most serum immunoglobulin M (IgM) is "natural IgM", which is produced apparently spontaneously by a distinct subset of B cells requiring no exogenous antigenic or microbial stimuli. Natural IgM is an evolutionarily conserved molecule and reacts with a variety of epitopes expressed on both self- and non-self antigens. It has long been understood that secreted (s) IgM contributes to the removal of altered self-antigens, such as apoptotic and dying cells. As we outline in this review, it is thought that this sIgM housekeeping function removes potential triggers of autoresponse induction. However, we recently demonstrated an unexpected and distinct role for sIgM in the control of autoreactive B cells: the regulation of bone marrow B cell development. The absence of sIgM blocked pro- to pre- B-cell transition and greatly altered the BCR repertoire of the developing B cells and the peripheral B-cell pools in genetically engineered mice. This finding strongly suggests that IgM is critical for B-cell central tolerance induction. Given that treatment of sIgM-deficient mice with polyclonal IgM corrected these developmental defects, therapeutic application of IgM could be of clinical relevance in the treatment of some B-cell-mediated autoimmune diseases.

Published
2016

16. How has the COVID-19 epidemic affected the risk behaviors of people who inject drugs in a city with high harm reduction service coverage in Vietnam? A qualitative investigation

Author

Le, Sao, Duong, Thi, Khuat, Thi, Pham, Minh, Vallo, Roselyne, Rapoud, Delphine, Quillet, Catherine, Nguyen, Quang, Nham, Thi Tuyet T., Hoang, Thi, Feelemyer, Jonathan, Vu, Hai, Moles, Jean‐pierre, Doan, Hong, Laureillard, Didier, Des Jarlais, Don, Nagot, Nicolas, Michel, Laurent, Nguyen, Trang Thu, Hoang, Giang Thi, Nguyen, Duc Quang, Nguyen, Anh Huu, Luong, Ngoc Anh, Duong, Huong Thi, Nham, Thanh Thi Tuyet, Khuat, Oanh Thi Hai, Pham, Khue Minh, Le, Mai Sao, Le, Giang Minh, Centre for Research and Training on Substance Abuse – HIV, Hanoi Medical University, Viet Nam, Supporting Community Development Initiatives [Hanoï, Vietnam], Hai Phong University of Medicine and Pharmacy [Hai Phong, Vietnam], Pathogenesis and Control of Chronic and Emerging Infections (PCCEI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université des Antilles (UA)-Etablissement français du don du sang [Montpellier]-Université de Montpellier (UM), Institut National de la Santé et de la Recherche Médicale (INSERM), EFS, Université de Montpellier (UM), Hai Phong University of Medicine and Pharmacy, Haiphong, Vietnam., New York University College of Global Public Health, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, PARIS SACLAY UNIVERSITY, PIERRE NICOLE CENTER, and BONIZEC, Sandrine

Subjects
Harm reduction, Sex Workers, SARS-CoV-2, Research, [SDV]Life Sciences [q-bio], Public Health, Environmental and Occupational Health, Medicine (miscellaneous), COVID-19, Risk behaviors, Drug Users, [SDV] Life Sciences [q-bio], Psychiatry and Mental health, Risk-Taking, Vietnam, Communicable Disease Control, Humans, Female, Public aspects of medicine, RA1-1270, Substance Abuse, Intravenous, Pandemics, People who inject drugs
Abstract

Introduction The COVID-19 outbreak disproportionally affects vulnerable populations including people who inject drugs (PWID). Social distancing and stay-at-home orders might result in a lack of access to medical and social services, poorer mental health, and financial precariousness, and thus, increases in HIV and HCV risk behaviors. This article explores how the HIV/HCV risk behaviors of PWID in Haiphong, a city with high harm reduction service coverage in Vietnam, changed during the early phase of the COVID-19 pandemic, and what shaped such changes, using the risk environment framework. Method We conducted three focus group discussions with peer outreach workers in May 2020 at the very end of the first lockdown, and 30 in-depth interviews with PWID between September and October 2020, after the second wave of infection in Vietnam. Discussions and interviews centered on the impact of the COVID-19 pandemic on their lives, and how their drug use and sexual behaviors changed as a result of the pandemic. Results The national shutdown of nonessential businesses due to the COVID-19 epidemic caused substantial economic challenges to participants, who mostly were in a precarious financial situation before the start of the epidemic. Unsafe injection is no longer an issue among our sample of PWID in Haiphong thanks to a combination of different factors, including high awareness of injection-related HIV/HCV risk and the availability of methadone treatment. However, group methamphetamine use as a means to cope with the boredom and stress related to COVID-19 was common during the lockdown. Sharing of smoking equipment was a standard practice. Female sex workers, especially those who were active heroin users, suffered most from COVID-related financial pressure and may have engaged in unsafe sex. Conclusion While unsafe drug injection might no longer be an issue, group methamphetamine use and unsafe sex were the two most worrisome HIV/HCV risk behaviors of PWID in Haiphong during the social distancing and lockdown periods. These elevated risks could continue beyond the enforced lockdown periods, given PWID in general, and PWID who are also sex workers in particular, have been disproportionately affected during the global crisis.

Published
2022

18. Sweet or not : Using information and cognitive dissonance to nudge children toward healthier food choices

Author

Nguyen, Trang, de Brauw, Alan, and van den Berg, Marrit

Subjects
Child health, Lab-in-field experiment, Economics, Econometrics and Finance (miscellaneous), WASS, Cognitive dissonance, Choice Behavior, Ontwikkelingseconomie, Beverages, Food Preferences, Development Economics, Health information, Behavioral economics, Humans, International Policy, Child, Sugars, Internationaal Beleid
Abstract

In the interest of public health, it is important to nudge children toward healthier food choices (e.g., beverages with less added sugar). We conducted a field experiment in a peri-urban region in Vietnam to evaluate the effects of information and cognitive dissonance on the food choices of children. Our sample consisted of more than 1200 primary school children, randomly assigned into three groups: control, health information, and health information plus hypocrisy inducement. The third group was intended to raise cognitive dissonance by illustrating the gap between what people know they should do (socially desired behaviors) and what they actually do (transgressions). The results indicate that health information increased the likelihood of selecting milk with less sugar by around 30 %, as compared to the control group. Hypocrisy inducement did not make any additional contribution to healthier food choices. The treatment effects declined when there was a delay between the treatment and the behavioral choice. We discuss the practical implications of our findings for short-term intervention field studies.

Published
2022

19. Contact tracing outcomes among household contacts of fully vaccinated COVID-19 patients — San Francisco, California, January 29-July 2, 2021

Author

Sachdev, Darpun D, Chew Ng, Rilene, Sankaran, Madeline, Ernst, Alexandra, Hernandez, Katherine T, Servellita, Venice, Sotomayor-Gonzalez, Alicia, Stoltey, Juliet, Cohen, Stephanie E, Nguyen, Trang Quyen, Chiu, Charles, and Philip, Susan

Subjects
Family Characteristics, AcademicSubjects/MED00290, SARS-CoV-2, household transmission, Major Article, COVID-19, Humans, breakthrough, San Francisco, Contact Tracing, vaccination
Abstract

Background The extent to which vaccinated persons diagnosed with COVID-19 can transmit to other vaccinated and unvaccinated persons is unclear. Methods Using data from the San Francisco Department of Public Health (SFDPH), this report describes outcomes of household contact tracing during January 29–July 2, 2021, where fully vaccinated COVID-19 patients were the index case in the household. Results Among 248 fully vaccinated patients with breakthrough infections, 203 (82%) were symptomatic and 105 were identified as the index patient within their household. Among 179 named household contacts, 71 (40%) contacts tested, over half (56%) were fully vaccinated and the secondary attack rate was 28%. Overall transmission from a symptomatic fully vaccinated patient with breakthrough infection to household contacts was suspected in 14 of 105 (13%) of households. Viral genomic sequencing of samples from 44% of fully vaccinated patients showed that 82% of those sequenced were infected by a variant of concern or interest, and 77% by a variant carrying mutation(s) associated with resistance to neutralizing antibodies. Conclusions Transmission from fully vaccinated symptomatic index patients to vaccinated and unvaccinated household contacts can occur. Indoor face masking and timely testing of all household contacts should be considered when a household member receives a positive test result in order to identify and interrupt transmission chains.

Published
2021

20. The Influence of VE-Cadherin on Adhesion and Incorporation of Breast Cancer Cells into Vascular Endothelium

Author

Brock, Thomas, Boudriot, Elisabeth, Klawitter, Anke, Großer, Marianne, Nguyen, Trang T. P., Giebe, Sindy, Klapproth, Erik, Temme, Achim, El-Armouche, Ali, and Breier, Georg

Subjects
transendothelial migration, QH301-705.5, Breast Neoplasms, Cadherins, Article, Coculture Techniques, Molecular Imaging, Gene Expression Regulation, Neoplastic, Chemistry, VE-cadherin, breast cancer, Antigens, CD, Cell Movement, Cell Line, Tumor, Cell Adhesion, Human Umbilical Vein Endothelial Cells, Humans, metastasis, Female, Endothelium, Vascular, Neoplasm Metastasis, Biology (General), QD1-999
Abstract

During metastasis, cancer cells that originate from the primary tumor circulate in the bloodstream, extravasate, and form micrometastases at distant locations. Several lines of evidence suggest that specific interactions between cancer cells and endothelial cells, in particular tumor cell adhesion to the endothelium and transendothelial migration, play a crucial role in extravasation. Here we have studied the role of vascular endothelial (VE)-cadherin which is expressed aberrantly by breast cancer cells and might promote such interactions. By comparing different human breast cancer cell lines, we observed that the number of cancer cells that adhered to endothelium correlated with VE-cadherin expression levels. VE-cadherin silencing experiments confirmed that VE-cadherin enhances cancer cell adhesion to endothelial cells. However, in contrast, the number of cancer cells that incorporated into the endothelium was not dependent on VE-cadherin. Thus, it appears that cancer cell adhesion and incorporation are distinct processes that are governed by different molecular mechanisms. When cancer cells incorporated into the endothelial monolayer, they formed VE-cadherin positive contacts with endothelial cells. On the other hand, we also observed tumor cells that had displaced endothelial cells, reflecting either different modes of incorporation, or a temporal sequence where cancer cells first form contact with endothelial cells and then displace them to facilitate transmigration. Taken together, these results show that VE-cadherin promotes the adhesion of breast cancer cells to the endothelium and is involved in the initial phase of incorporation, but not their transmigration. Thus, VE-cadherin might be of relevance for therapeutic strategies aiming at preventing the metastatic spread of breast cancer cells.

Published
2021
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21. Predicting the sorption efficiency of heavy metal based on the biochar characteristics, metal sources, and environmental conditions using various novel hybrid machine learning models

Author

Hossein Moayedi, Hoang Nguyen, Xuan-Nam Bui, Romulus Costache, Bo Ke, Yosoon Choi, Jian Zhou, Thao Nguyen-Trang, and Hoang-Bac Bui

Subjects
Environmental Engineering, Health, Toxicology and Mutagenesis, 0208 environmental biotechnology, 02 engineering and technology, 010501 environmental sciences, 01 natural sciences, Machine Learning, Artificial Intelligence, Metals, Heavy, Biochar, Environmental Chemistry, Humans, Water pollution, Process engineering, 0105 earth and related environmental sciences, Soft computing, Ensemble forecasting, Artificial neural network, business.industry, Public Health, Environmental and Occupational Health, Reproducibility of Results, Sorption, General Medicine, General Chemistry, Pollution, 020801 environmental engineering, Support vector machine, Wastewater, Charcoal, Environmental science, business
Abstract

Heavy metals in water and wastewater are taken into account as one of the most hazardous environmental issues that significantly impact human health. The use of biochar systems with different materials helped significantly remove heavy metals in the water, especially wastewater treatment systems. Nevertheless, heavy metal's sorption efficiency on the biochar systems is highly dependent on the biochar characteristics, metal sources, and environmental conditions. Therefore, this study implicates the feasibility of biochar systems in the heavy metal sorption in water/wastewater and the use of artificial intelligence (AI) models in investigating efficiency sorption of heavy metal on biochar. Accordingly, this work investigated and proposed 20 artificial intelligent models for forecasting the sorption efficiency of heavy metal onto biochar based on five machine learning algorithms and bagging technique (BA). Accordingly, support vector machine (SVM), random forest (RF), artificial neural network (ANN), M5Tree, and Gaussian process (GP) algorithms were used as the key algorithms for the aim of this study. Subsequently, the individual models were bagged with each other to generate new ensemble models. Finally, 20 intelligent models were developed and evaluated, including SVM, RF, M5Tree, GP, ANN, BA-SVM, BA-RF, BA-M5Tree, BA-GP, BA-ANN, SVM-RF, SVM-M5Tree, SVM-GP, SVM-ANN, RF-M5Tree, RF-GP, RF-ANN, M5Tree-GP, M5Tree-ANN, GP-ANN. Of those, the hybrid models (i.e., BA-SVM, BA-RF, BA-M5Tree, BA-GP, BA-ANN, SVM-RF, SVM-M5Tree, SVM-GP, SVM-ANN, RF-M5Tree, RF-GP, RF-ANN, M5Tree-GP, M5Tree-ANN, GP-ANN) are introduced as the novelty of this study for estimating the heavy metal's sorption efficiency on the biochar systems. Also, the biochar characteristics, metal sources, and environmental conditions were comprehensively assessed and used, and they are considered as a novelty of the study as well. For this aim, a dataset of sorption efficiency of heavy metal was collected and processed with 353 experimental tests. Various performance indexes were applied to evaluate the models, such as RMSE, R2, MAE, color intensity, Taylor diagram, box and whiskers plots. This study's findings revealed that AI models could predict heavy metal's sorption efficiency onto biochar with high reliability, and the efficiency of the ensemble models is higher than those of individual models. The results also reported that the SVM-ANN ensemble model is the most superior model among 20 developed models. The predictive model proposed that heavy metal's efficiency sorption on biochar can be accurately forecasted and early warning for the water pollution by heavy metal.

Published
2020

22. Ancient and conserved functional interplay between Bcl-2 family proteins in the mitochondrial pathway of apoptosis

Author

Popgeorgiev, Nikolay, Sa, Jaison D, Jabbour, Lea, Banjara, Suresh, Nguyen, Trang Thi Minh, Akhavan-E-Sabet, Aida, Gadet, Rudy, Ralchev, Nikola, Manon, Stéphen, Hinds, Mark G., Osigus, Hans-Jürgen, Schierwater, Bernd, Humbert, Patrick O., Rimokh, Ruth, Gillet, Germain, Kvansakul, Marc, manon, stéphen, Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre National de la Recherche Scientifique (CNRS), and Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Mammals, Evolutionary Biology, SciAdv r-articles, Apoptosis, [SDV.BC.BC]Life Sciences [q-bio]/Cellular Biology/Subcellular Processes [q-bio.SC], Mitochondria, bcl-2 Homologous Antagonist-Killer Protein, Structural Biology, Mitochondrial Membranes, [SDV.BC.BC] Life Sciences [q-bio]/Cellular Biology/Subcellular Processes [q-bio.SC], Animals, Humans, biological phenomena, cell phenomena, and immunity, [SDV.BBM.BC]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Biochemistry [q-bio.BM], [SDV.BBM.BC] Life Sciences [q-bio]/Biochemistry, Molecular Biology/Biochemistry [q-bio.BM], Research Articles, Research Article
Abstract

Bcl-2 proteins are molecular gatekeepers of the mitochondrial pathway of apoptosis that emerged early during metazoan evolution., In metazoans, Bcl-2 family proteins are major regulators of mitochondrially mediated apoptosis; however, their evolution remains poorly understood. Here, we describe the molecular characterization of the four members of the Bcl-2 family in the most primitive metazoan, Trichoplax adhaerens. All four trBcl-2 homologs are multimotif Bcl-2 group, with trBcl-2L1 and trBcl-2L2 being highly divergent antiapoptotic Bcl-2 members, whereas trBcl-2L3 and trBcl-2L4 are homologs of proapoptotic Bax and Bak, respectively. trBax expression permeabilizes the mitochondrial outer membrane, while trBak operates as a BH3-only sensitizer repressing antiapoptotic activities of trBcl-2L1 and trBcl-2L2. The crystal structure of a trBcl-2L2:trBak BH3 complex reveals that trBcl-2L2 uses the canonical Bcl-2 ligand binding groove to sequester trBak BH3, indicating that the structural basis for apoptosis control is conserved from T. adhaerens to mammals. Finally, we demonstrate that both trBax and trBak BH3 peptides bind selectively to human Bcl-2 homologs to sensitize cancer cells to chemotherapy treatment.

Published
2020

23. The global, regional, and national burden of cirrhosis by cause in 195 countries and territories, 1990-2017 : a systematic analysis for the Global Burden of Disease Study 2017

Author

Sepanlou, Sadaf G., Safiri, Saeid, Bisignano, Catherine, Ikuta, Kevin S., Merat, Shahin, Saberifiroozi, Mehdi, Poustchi, Hossein, Tsoi, Derrick, Colombara, Danny V., Abdoli, Amir, Adedoyin, Rufus Adesoji, Afarideh, Mohsen, Agrawal, Sutapa, Ahmad, Sohail, Ahmadian, Elham, Ahmadpour, Ehsan, Akinyemiju, Tomi, Akunna, Chisom Joyqueenet, Alipour, Vahid, Almasi-Hashiani, Amir, Almulhim, Abdulaziz M., Al-Raddadi, Rajaa M., Alvis-Guzman, Nelson, Anber, Nahla Hamed, Angus, Colin, Anoushiravani, Amir, Arabloo, Jalal, Araya, Ephrem Mebrahtu, Asmelash, Daniel, Ataeinia, Bahar, Ataro, Zerihun, Atout, Maha Moh'd Wahbi, Ausloos, Floriane, Awasthi, Ashish, Badawi, Alaa, Banach, Maciej, Bejarano Ramirez, Diana Fernanda, Bhagavathula, Akshaya Srikanth, Bhala, Neeraj, Bhattacharyya, Krittika, Biondi, Antonio, Bolla, Srinivasa Rao, Boloor, Archith, Borzì, Antonio M., Butt, Zahid A., Cámera, Luis LA Alberto, Campos-Nonato, Ismael R., Carvalho, Félix, Chu, Dinh-Toi, Chung, Sheng-Chia, Cortesi, Paolo Angelo, Costa, Vera M., Cowie, Benjamin C, Daryani, Ahmad, de Courten, Barbora, Demoz, Gebre Teklemariam, Desai, Rupak, Dharmaratne, Samath Dhamminda, Djalalinia, Shirin, Do, Hoa Thi, Dorostkar, Fariba, Drake, Thomas M., Dubey, Manisha, Duncan, Bruce B., Effiong, Andem, Eftekhari, Aziz, Elsharkawy, Aisha, Etemadi, Arash, Farahmand, Mohammad, Farzadfar, Farshad, Fernandes, Eduarda, Filip, Irina, Fischer, Florian, Gebremedhin, Ketema Bizuwork Bizuwork, Geta, Birhanu, Gilani, Syed Amir, Gill, Paramjit, Gutirrez, Reyna Alma, Haile, Michael Tamene, Haj-Mirzaian, Arvin, Hamid, Saeed S., Hasankhani, Milad, Hasanzadeh, Amir, Hashemian, Maryam, Hassen, Hamid Yimam, Hay, Simon I., Hayat, Khezar, Heidari, Behnam, Henok, Andualem, Hoang, Chi Linh, Hostiuc, Mihaela, Hostiuc, Sorin, Hsieh, Vivian Chia-rong, Igumbor, Ehimario U., Ilesanmi, Olayinka Stephen, Irvani, Seyed Sina Naghibi, Jafari Balalami, Nader, James, Spencer L., Jeemon, Panniyammakal, Jha, Ravi Prakash, Jonas, Jost B., Jozwiak, Jacek Jerzy, Kabir, Ali, Kasaeian, Amir, Kassaye, Hagazi Gebremedhin, Kefale, Adane Teshome, Khalilov, Rovshan, Khan, Muhammad Ali, Khan, Ejaz Ahmad, Khater, Amir, Kim, Yun Jin, Koyanagi, Ai, La Vecchia, Carlo, Lim, Lee-Ling, Lopez, Alan D., Lorkowski, Stefan, Lotufo, Paulo A., Lozano, Rafael, Magdy Abd El Razek, Muhammed, Mai, Hue Thi, Manafi, Navid, Manafi, Amir, Mansournia, Mohammad Ali, Mantovani, Lorenzo Giovanni, Mazzaglia, Giampiero, Mehta, Dhruv, Mendoza, Walter, Menezes, Ritesh G., Mengesha, Melkamu Merid, Meretoja, Tuomo J., Mestrovic, Tomislav, Miazgowski, Bartosz, Miller, Ted R., Mirrakhimov, Erkin M., Mithra, Prasanna, Moazen, Babak, Moghadaszadeh, Masoud, Mohammadian-Hafshejani, Abdollah, Mohammed, Shafiu, Mokdad, Ali H., Montero-Zamora, Pablo A., Moradi, Ghobad, Naimzada, Mukhammad David, Nayak, Vinod, Negoi, Ionut, Nguyen, Trang Huyen, Ofori-Asenso, Richard, Oh, In-Hwan, Olagunju, Tinuke O., Padubidri, Jagadish Rao, Pakshir, Keyvan, Pana, Adrian, Pathak, Mona, Pourshams, Akram, Rabiee, Navid, Radfar, Amir, Rafiei, Alireza, Ramezanzadeh, Kiana, Rana, Saleem Muhammad M., Rawaf, Salman, Rawaf, David Laith, Reiner, Robert C., Roever, Leonardo, Room, Robin, Roshandel, Gholamreza, Safari, Saeed, Samy, Abdallah M., Sanabria, Juan, Sartorius, Benn, Schmidt, Maria Inês, Senthilkumaran, Subramanian, Shaikh, Masood Ali, Sharif, Mehdi, Sharifi, Amrollah, Shigematsu, Mika, Singh, Jasvinder A., Soheili, Amin, Suleria, Hafiz Ansar Rasul, Teklehaimanot, Berhane Fseha, Tesfay, Berhe Etsay, Vacante, Marco, Vahedian-Azimi, Amir, Valdez, Pascual R., Vasankari, Tommi Juhani, Vu, Giang Thu, Waheed, Yasir, Weldegwergs, Kidu Gidey, Werdecker, Andrea, Westerman, Ronny, Wondafrash, Dawit Zewdu, Wondmieneh, Adam Belay, Yeshitila, Yordanos Gizachew, Yonemoto, Naohiro, Yu, Chuanhua, Zaidi, Zoubida, Zarghi, Afshin, Zelber-Sagi, Shira, Zewdie, Kaleab Alemayehu, Zhang, Zhi-Jiang, Zhao, Xiu-Ju, Naghavi, Mohsen, Malekzadeh, Reza, HASH(0x5651c9b09eb8), Institute for Molecular Medicine Finland, HUS Comprehensive Cancer Center, Clinicum, University of Helsinki, Sepanlou, S, Safiri, S, Bisignano, C, Ikuta, K, Merat, S, Saberifiroozi, M, Poustchi, H, Tsoi, D, Colombara, D, Abdoli, A, Adedoyin, R, Afarideh, M, Agrawal, S, Ahmad, S, Ahmadian, E, Ahmadpour, E, Akinyemiju, T, Akunna, C, Alipour, V, Almasi-Hashiani, A, Almulhim, A, Al-Raddadi, R, Alvis-Guzman, N, Anber, N, Angus, C, Anoushiravani, A, Arabloo, J, Araya, E, Asmelash, D, Ataeinia, B, Ataro, Z, Atout, M, Ausloos, F, Awasthi, A, Badawi, A, Banach, M, Bejarano Ramirez, D, Bhagavathula, A, Bhala, N, Bhattacharyya, K, Biondi, A, Bolla, S, Boloor, A, Borzì, A, Butt, Z, Cámera, L, Campos-Nonato, I, Carvalho, F, Chu, D, Chung, S, Cortesi, P, Costa, V, Cowie, B, Daryani, A, de Courten, B, Demoz, G, Desai, R, Dharmaratne, S, Djalalinia, S, Do, H, Dorostkar, F, Drake, T, Dubey, M, Duncan, B, Effiong, A, Eftekhari, A, Elsharkawy, A, Etemadi, A, Farahmand, M, Farzadfar, F, Fernandes, E, Filip, I, Fischer, F, Gebremedhin, K, Geta, B, Gilani, S, Gill, P, Gutirrez, R, Haile, M, Haj-Mirzaian, A, Hamid, S, Hasankhani, M, Hasanzadeh, A, Hashemian, M, Hassen, H, Hay, S, Hayat, K, Heidari, B, Henok, A, Hoang, C, Hostiuc, M, Hostiuc, S, Hsieh, V, Igumbor, E, Ilesanmi, O, Irvani, S, Jafari Balalami, N, James, S, Jeemon, P, Jha, R, Jonas, J, Jozwiak, J, Kabir, A, Kasaeian, A, Kassaye, H, Kefale, A, Khalilov, R, Khan, M, Khan, E, Khater, A, Kim, Y, Koyanagi, A, La Vecchia, C, Lim, L, Lopez, A, Lorkowski, S, Lotufo, P, Lozano, R, Magdy Abd El Razek, M, Mai, H, Manafi, N, Manafi, A, Mansournia, M, Mantovani, L, Mazzaglia, G, Mehta, D, Mendoza, W, Menezes, R, Mengesha, M, Meretoja, T, Mestrovic, T, Miazgowski, B, Miller, T, Mirrakhimov, E, Mithra, P, Moazen, B, Moghadaszadeh, M, Mohammadian-Hafshejani, A, Mohammed, S, Mokdad, A, Montero-Zamora, P, Moradi, G, Naimzada, M, Nayak, V, Negoi, I, Nguyen, T, Ofori-Asenso, R, Oh, I, Olagunju, T, Padubidri, J, Pakshir, K, Pana, A, Pathak, M, Pourshams, A, Rabiee, N, Radfar, A, Rafiei, A, Ramezanzadeh, K, Rana, S, Rawaf, S, Rawaf, D, Reiner RC, J, Roever, L, Room, R, Roshandel, G, Safari, S, Samy, A, Sanabria, J, Sartorius, B, Schmidt, M, Senthilkumaran, S, Shaikh, M, Sharif, M, Sharifi, A, Shigematsu, M, Singh, J, Soheili, A, Suleria, H, Teklehaimanot, B, Tesfay, B, Vacante, M, Vahedian-Azimi, A, Valdez, P, Vasankari, T, Vu, G, Waheed, Y, Weldegwergs, K, Werdecker, A, Westerman, R, Wondafrash, D, Wondmieneh, A, Yeshitila, Y, Yonemoto, N, Yu, C, Zaidi, Z, Zarghi, A, Zelber-Sagi, S, Zewdie, K, Zhang, Z, Zhao, X, Naghavi, M, and Malekzadeh, R

Subjects
Liver Cirrhosis, Male, Cirrhosis, Cost-Benefit Analysis, HEPATITIS-B, Global Burden of Disease, Liver disease, Disability Evaluation, 0302 clinical medicine, Burden, Global, Mortality, Cirrhosis, Non-alcoholic Fatty Liver Disease, Risk Factors, FIBROSIS, Europe, Eastern, POPULATION, Aged, 80 and over, education.field_of_study, Singapore, Mortality rate, 1. No poverty, Gastroenterology, Hepatitis C, Hepatitis B, Middle Aged, 3. Good health, PREVALENCE, 030220 oncology & carcinogenesis, Asia, Central, 030211 gastroenterology & hepatology, Egypt, Female, Quality-Adjusted Life Years, Viral hepatitis, Life Sciences & Biomedicine, Adult, EUROPE, Population, GBD 2017 Cirrhosis Collaborators, Article, 03 medical and health sciences, LIVER-DISEASE, medicine, Humans, education, Liver Diseases, Alcoholic, Africa South of the Sahara, Aged, Science & Technology, Hepatology, Gastroenterology & Hepatology, business.industry, MORTALITY, DISABILITY, DECOMPENSATION, medicine.disease, Years of potential life lost, Early Diagnosis, Socioeconomic Factors, 3121 General medicine, internal medicine and other clinical medicine, INJURIES, Human medicine, business, Demography, RC
Abstract

Background\ud \ud Cirrhosis and other chronic liver diseases (collectively referred to as cirrhosis in this paper) are a major cause of morbidity and mortality globally, although the burden and underlying causes differ across locations and demographic groups. We report on results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 on the burden of cirrhosis and its trends since 1990, by cause, sex, and age, for 195 countries and territories.\ud \ud \ud \ud Methods\ud \ud We used data from vital registrations, vital registration samples, and verbal autopsies to estimate mortality. We modelled prevalence of total, compensated, and decompensated cirrhosis on the basis of hospital and claims data. Disability-adjusted life-years (DALYs) were calculated as the sum of years of life lost due to premature death and years lived with disability. Estimates are presented as numbers and age-standardised or age-specific rates per 100 000 population, with 95% uncertainty intervals (UIs). All estimates are presented for five causes of cirrhosis: hepatitis B, hepatitis C, alcohol-related liver disease, non-alcoholic steatohepatitis (NASH), and other causes. We compared mortality, prevalence, and DALY estimates with those expected according to the Socio-demographic Index (SDI) as a proxy for the development status of regions and countries.\ud \ud \ud \ud Findings\ud \ud In 2017, cirrhosis caused more than 1·32 million (95% UI 1·27–1·45) deaths (440 000 [416 000–518 000; 33·3%] in females and 883 000 [838 000–967 000; 66·7%] in males) globally, compared with less than 899 000 (829 000–948 000) deaths in 1990. Deaths due to cirrhosis constituted 2·4% (2·3–2·6) of total deaths globally in 2017 compared with 1·9% (1·8–2·0) in 1990. Despite an increase in the number of deaths, the age-standardised death rate decreased from 21·0 (19·2–22·3) per 100 000 population in 1990 to 16·5 (15·8–18·1) per 100 000 population in 2017. Sub-Saharan Africa had the highest age-standardised death rate among GBD super-regions for all years of the study period (32·2 [25·8–38·6] deaths per 100 000 population in 2017), and the high-income super-region had the lowest (10·1 [9·8–10·5] deaths per 100 000 population in 2017). The age-standardised death rate decreased or remained constant from 1990 to 2017 in all GBD regions except eastern Europe and central Asia, where the age-standardised death rate increased, primarily due to increases in alcohol-related liver disease prevalence. At the national level, the age-standardised death rate of cirrhosis was lowest in Singapore in 2017 (3·7 [3·3–4·0] per 100 000 in 2017) and highest in Egypt in all years since 1990 (103·3 [64·4–133·4] per 100 000 in 2017). There were 10·6 million (10·3–10·9) prevalent cases of decompensated cirrhosis and 112 million (107–119) prevalent cases of compensated cirrhosis globally in 2017. There was a significant increase in age-standardised prevalence rate of decompensated cirrhosis between 1990 and 2017. Cirrhosis caused by NASH had a steady age-standardised death rate throughout the study period, whereas the other four causes showed declines in age-standardised death rate. The age-standardised prevalence of compensated and decompensated cirrhosis due to NASH increased more than for any other cause of cirrhosis (by 33·2% for compensated cirrhosis and 54·8% for decompensated cirrhosis) over the study period. From 1990 to 2017, the number of prevalent cases more than doubled for compensated cirrhosis due to NASH and more than tripled for decompensated cirrhosis due to NASH. In 2017, age-standardised death and DALY rates were lower among countries and territories with higher SDI.\ud \ud \ud \ud Interpretation\ud \ud Cirrhosis imposes a substantial health burden on many countries and this burden has increased at the global level since 1990, partly due to population growth and ageing. Although the age-standardised death and DALY rates of cirrhosis decreased from 1990 to 2017, numbers of deaths and DALYs and the proportion of all global deaths due to cirrhosis increased. Despite the availability of effective interventions for the prevention and treatment of hepatitis B and C, they were still the main causes of cirrhosis burden worldwide, particularly in low-income countries. The impact of hepatitis B and C is expected to be attenuated and overtaken by that of NASH in the near future. Cost-effective interventions are required to continue the prevention and treatment of viral hepatitis, and to achieve early diagnosis and prevention of cirrhosis due to alcohol-related liver disease and NASH.\ud \ud \ud \ud Funding\ud \ud Bill & Melinda Gates Foundation.

Published
2020

24. Global, regional, and national deaths, prevalence, disability-adjusted life years, and years lived with disability for chronic obstructive pulmonary disease and asthma, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015

Author

Soriano, Joan B., Abajobir, Amanuel Alemu, Abate, Kalkidan Hassen, Abera, Semaw Ferede, Agrawal, Anurag, Ahmed, Muktar Beshir, Aichour, Amani Nidhal, Aichour, Ibtihel, Aichour, Miloud Taki Eddine, Alam, Khurshid, Alam, Noore, Alkaabi, Juma M., Al-Maskari, Fatma, Alvis-Guzman, Nelson, Amberbir, Alemayehu, Amoako, Yaw Ampem, Ansha, Mustafa Geleto, Anto, Josep M., Asayesh, Hamid, Atey, Tesfay Mehari, Avokpaho, Euripide Frinel G. Arthur, Barac, Aleksandra, Basu, Sanjay, Bedi, Neeraj, Bensenor, Isabela M., Berhane, Adugnaw, Beyene, Addisu Shunu, Bhutta, Zulfiqar A., Biryukov, Stan, Boneya, Dube Jara, Brauer, Michael, Carpenter, David O., Casey, Daniel, Christopher, Devasahayam Jesudas, Dandona, Lalit, Dandona, Rakhi, Dharmaratne, Samath D., Huyen Phuc Do, Huyen Phuc Do, Fischer, Florian, Geleto, Ayele, Ghoshal, Aloke Gopal, Gillum, Richard F., Ginawi, Ibrahim Abdelmageem Mohamed, Gupta, Vipin, Hay, Simon I., Hedayati, Mohammad T., Horita, Nobuyuki, Hosgood, H. Dean, Jakovljevic, Mihajlo (Michael) B., James, Spencer Lewis, Jonas, Jost B., Kasaeian, Amir, Khader, Yousef Saleh, Khalil, Ibrahim A., Khan, Ejaz Ahmad, Khang, Young-Ho, Khubchandani, Jagdish, Knibbs, Luke D., Kosen, Soewarta, Koul, Parvaiz A., Kumar, G. Anil, Leshargie, Cheru Tesema, Liang, Xiaofeng, Abd El Razek, Hassan Magdy, Majeed, Azeem, Malta, Deborah Carvalho, Manhertz, Treh, Marquez, Neal, Mehari, Alem, Mensah, George A., Miller, Ted R., Mohammad, Karzan Abdulmuhsin, Mohammed, Kedir Endris, Mohammed, Shafiu, Mokdad, Ali H., Naghavi, Mohsen, Cuong Tat Nguyen, Cuong Tat Nguyen, Nguyen, Grant, Quyen Le Nguyen, Quyen Le Nguyen, Trang Huyen Nguyen, Trang Huyen Nguyen, Ningrum, Dina Nur Anggraini, Vuong Minh Nong, Vuong Minh Nong, Obi, Jennifer Ifeoma, Odeyemi, Yewande E., Ogbo, Felix Akpojene, Oren, Eyal, Mahesh, P. A., Park, Eun-Kee, Patton, George C., Paulson, Katherine, Qorbani, Mostafa, Quansah, Reginald, Rafay, Anwar, Rahman, Mohammad Hifz Ur, Rai, Rajesh Kumar, Rawaf, Salman, Reinig, Nik, Safiri, Saeid, Sarmiento-Suarez, Rodrigo, Sartorius, Benn, Savic, Miloje, Sawhney, Monika, Shigematsu, Mika, Smith, Mari, Tadese, Fentaw, Thurston, George D., Topor-Madry, Roman, Tran, Bach Xuan, Ukwaja, Kingsley Nnanna, van Boven, Job F. M., Vlassov, Vasiliy Victorovich, Vollset, Stein Emil, Wan, Xia, Werdecker, Andrea, Hanson, Sarah Wulf, Yano, Yuichiro, Yimam, Hassen Hamid, Yonemoto, Naohiro, Yu, Chuanhua, Zaidi, Zoubida, Zaki, Maysaa El Sayed, Murray, Christopher J. L., and Vos, Theo

Subjects
Adult, Aged, 80 and over, Male, Incidence, Bayes Theorem, Articles, Middle Aged, Global Health, Asthma, Article, Global Burden of Disease, respiratory tract diseases, Pulmonary Disease, Chronic Obstructive, Risk Factors, Cause of Death, Prevalence, Humans, Regression Analysis, Female, Quality-Adjusted Life Years, Aged
Abstract

Background Chronic obstructive pulmonary disease (COPD) and asthma are common diseases with a heterogeneous distribution worldwide. Here, we present methods and disease and risk estimates for COPD and asthma from the Global Burden of Diseases, Injuries, and Risk Factors (GBD) 2015 study. The GBD study provides annual updates on estimates of deaths, prevalence, and disability-adjusted life years (DALYs), a summary measure of fatal and non-fatal disease outcomes, for over 300 diseases and injuries, for 188 countries from 1990 to the most recent year. Methods We estimated numbers of deaths due to COPD and asthma using the GBD Cause of Death Ensemble modelling (CODEm) tool. First, we analysed data from vital registration and verbal autopsy for the aggregate category of all chronic respiratory diseases. Subsequently, models were run for asthma and COPD relying on covariates to predict rates in countries that have incomplete or no vital registration data. Disease estimates for COPD and asthma were based on systematic reviews of published papers, unpublished reports, surveys, and health service encounter data from the USA. We used the Global Initiative of Chronic Obstructive Lung Disease spirometry-based definition as the reference for COPD and a reported diagnosis of asthma with current wheeze as the definition of asthma. We used a Bayesian meta-regression tool, DisMod-MR 2.1, to derive estimates of prevalence and incidence. We estimated population-attributable fractions for risk factors for COPD and asthma from exposure data, relative risks, and a theoretical minimum exposure level. Results were stratified by Socio-demographic Index (SDI), a composite measure of income per capita, mean years of education over the age of 15 years, and total fertility rate. Findings In 2015, 3.2 million people (95% uncertainty interval [UI] 3.1 million to 3.3 million) died from COPD worldwide, an increase of 11.6% (95% UI 5.3 to 19.8) compared with 1990. There was a decrease in age-standardised death rate of 41.9% (37.7 to 45.1) but this was counteracted by population growth and ageing of the global population. From 1990 to 2015, the prevalence of COPD increased by 44.2% (41.7 to 46.6), whereas age-standardised prevalence decreased by 14.7% (13.5 to 15.9). In 2015, 0.40 million people (0.36 million to 0.44 million) died from asthma, a decrease of 26.7% (-7.2 to 43.7) from 1990, and the age-standardised death rate decreased by 58.8% (39.0 to 69.0). The prevalence of asthma increased by 12.6% (9.0 to 16.4), whereas the age-standardised prevalence decreased by 17.7% (15.1 to 19.9). Age-standardised DALY rates due to COPD increased until the middle range of the SDI before reducing sharply. Age-standardised DALY rates due to asthma in both sexes decreased monotonically with rising SDI. The relation between with SDI and DALY rates due to asthma was attributed to variation in years of life lost (YLLs), whereas DALY rates due to COPD varied similarly for YLLs and years lived with disability across the SDI continuum. Smoking and ambient particulate matter were the main risk factors for COPD followed by household air pollution, occupational particulates, ozone, and secondhand smoke. Together, these risks explained 73.3% (95% UI 65.8 to 80.1) of DALYs due to COPD. Smoking and occupational asthmagens were the only risks quantified for asthma in GBD, accounting for 16.5% (14.6 to 18.7) of DALYs due to asthma. Interpretation Asthma was the most prevalent chronic respiratory disease worldwide in 2015, with twice the number of cases of COPD. Deaths from COPD were eight times more common than deaths from asthma. In 2015, COPD caused 2.6% of global DALYs and asthma 1.1% of global DALYs. Although there are laudable international collaborative efforts to make surveys of asthma and COPD more comparable, no consensus exists on case definitions and how to measure disease severity for population health measurements like GBD. Comparisons between countries and over time are important, as much of the chronic respiratory burden is either preventable or treatable with affordable interventions. Copyright (C) The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.

Published
2017

25. Spending on health and HIV/AIDS: domestic health spending and development assistance in 188 countries, 1995-2015

Author

Dieleman, Joseph L., Haakenstad, Annie, Micah, Angela, Moses, Mark, Abbafati, Cristiana, Acharya, Pawan, Adhikari, Tara Ballav, Adou, Arsene Kouablan, Kiadaliri, Aliasghar Ahmad, Alam, Khurshid, Alizadeh-Navaei, Reza, Alkerwi, Ala'a, Ammar, Walid, Antonio, Carl Abelardo T., Aremu, Olatunde, Asgedom, Solomon Weldegebreal, Atey, Tesfay Mehari, Avila-Burgos, Leticia, Awasthi, Ashish, Ayer, Rakesh, Badali, Hamid, Banach, Maciej, Banstola, Amrit, Barac, Aleksandra, Belachew, Abate Bekele, Birungi, Charles, Bragazzi, Nicola L., Breitborde, Nicholas J. K., Cahuana-Hurtado, Lucero, Car, Josip, Catala-Lopez, Ferran, Chapin, Abigail, Dandona, Lalit, Dandona, Rakhi, Daryani, Ahmad, Dharmaratne, Samath D., Dubey, Manisha, Edessa, Dumessa, Eldrenkamp, Erika, Eshrati, Babak, Faro, Andre, Feigl, Andrea B., Fenny, Ama P., Fischer, Florian, Foigt, Nataliya, Foreman, Kyle J., Fullman, Nancy, Ghimire, Mamata, Goli, Srinivas, Hailu, Alemayehu Desalegne, Hamidi, Samer, Harb, Hilda L., Hay, Simon I., Hendrie, Delia, Ikilezi, Gloria, Javanbakht, Mehdi, John, Denny, Jonas, Jost B., Kaldjian, Alexander, Kasaeian, Amir, Kates, Jennifer, Khalil, Ibrahim A., Khang, Young-Ho, Khubchandani, Jagdish, Kim, Yun Jin, Kinge, Jonas M., Kosen, Soewarta, Krohn, Kristopher J., Kumar, G. Anil, Lam, Hilton, Listl, Stefan, Abd El Razek, Hassan Magdy, Abd El Razek, Mohammed Magdy, Majeed, Azeem, Malekzadeh, Reza, Malta, Deborah Carvalho, Mensah, George A., Meretoja, Atte, Miller, Ted R., Mirrakhimov, Erkin M., Mlashu, Fitsum Weldegebreal, Mohammed, Ebrahim, Mohammed, Shafiu, Naghavi, Mohsen, Nangia, Vinay, Ngalesoni, Frida Namnyak, Cuong Tat Nguyen, Cuong Tat Nguyen, Trang Huyen Nguyen, Trang Huyen Nguyen, Niriayo, Yirga, Noroozi, Mehdi, Owolabi, Mayowa O., Pereira, David M., Qorbani, Mostafa, Rafay, Anwar, Rafiei, Alireza, Rahimi-Movaghar, Vafa, Rai, Rajesh Kumar, Ram, Usha, Ranabhat, Chhabi Lal, Ray, Sarah E., Reiner, Robert C., Sadat, Nafis, Sajadi, Haniye Sadat, Santos, Joao Vasco, Sarker, Abdur Razzaque, Sartorius, Benn, Satpathy, Maheswar, Savic, Miloje, Schneider, Matthew, Sepanlou, Sadaf G., Shaikh, Masood Ali, Sharif, Mehdi, She, Jun, Sheikh, Aziz, Sisay, Mekonnen, Soneji, Samir, Soofi, Moslem, Tadesse, Andualem Henok, Tao, Tianchan, Templin, Tara, Tesema, Azeb Gebresilassie, Thapa, Subash, Thomson, Alan J., Tobe-Gai, Ruoyan, Topor-Madry, Roman, Bach Xuan Tran, Bach Xuan Tran, Khanh Bao Tran, Khanh Bao Tran, Tung Thanh Tran, Tung Thanh Tran, Undurraga, Eduardo A., Vasankari, Tommi, Violante, Francesco S., Wijeratne, Tissa, Xu, Gelin, Yonemoto, Naohiro, Younis, Mustafa Z., Yu, Chuanhua, Zaki, Maysaa El Sayed, Zhou, Lei, Zlavog, Bianca, Murray, Christopher J. L., Dieleman, Joseph L, Haakenstad, Annie, Micah, Angela, Moses, Mark, Abbafati, Cristiana, Acharya, Pawan, Adhikari, Tara Ballav, Adou, Arsène Kouablan, Ahmad Kiadaliri, Aliasghar, Alam, Khurshid, Alizadeh-Navaei, Reza, Alkerwi, Ala'a, Ammar, Walid, Antonio, Carl Abelardo T, Aremu, Olatunde, Asgedom, Solomon Weldegebreal, Atey, Tesfay Mehari, Avila-Burgos, Leticia, Awasthi, Ashish, Ayer, Rakesh, Badali, Hamid, Banach, Maciej, Banstola, Amrit, Barac, Aleksandra, Belachew, Abate Bekele, Birungi, Charle, Bragazzi, Nicola L, Breitborde, Nicholas J K, Cahuana-Hurtado, Lucero, Car, Josip, Catalá-López, Ferrán, Chapin, Abigail, Dandona, Lalit, Dandona, Rakhi, Daryani, Ahmad, Dharmaratne, Samath D, Dubey, Manisha, Edessa, Dumessa, Eldrenkamp, Erika, Eshrati, Babak, Faro, André, Feigl, Andrea B, Fenny, Ama P, Fischer, Florian, Foigt, Nataliya, Foreman, Kyle J, Fullman, Nancy, Ghimire, Mamata, Goli, Sriniva, Hailu, Alemayehu Desalegne, Hamidi, Samer, Harb, Hilda L, Hay, Simon I, Hendrie, Delia, Ikilezi, Gloria, Javanbakht, Mehdi, John, Denny, Jonas, Jost B, Kaldjian, Alexander, Kasaeian, Amir, Kates, Jennifer, Khalil, Ibrahim A, Khang, Young-Ho, Khubchandani, Jagdish, Kim, Yun Jin, Kinge, Jonas M, Kosen, Soewarta, Krohn, Kristopher J, Kumar, G Anil, Lam, Hilton, Listl, Stefan, Magdy Abd El Razek, Hassan, Magdy Abd El Razek, Mohammed, Majeed, Azeem, Malekzadeh, Reza, Malta, Deborah Carvalho, Mensah, George A, Meretoja, Atte, Miller, Ted R, Mirrakhimov, Erkin M, Mlashu, Fitsum Weldegebreal, Mohammed, Ebrahim, Mohammed, Shafiu, Naghavi, Mohsen, Nangia, Vinay, Ngalesoni, Frida Namnyak, Nguyen, Cuong Tat, Nguyen, Trang Huyen, Niriayo, Yirga, Noroozi, Mehdi, Owolabi, Mayowa O, Pereira, David M, Qorbani, Mostafa, Rafay, Anwar, Rafiei, Alireza, Rahimi-Movaghar, Vafa, Rai, Rajesh Kumar, Ram, Usha, Ranabhat, Chhabi Lal, Ray, Sarah E, Reiner, Robert C, Sadat, Nafi, Sajadi, Haniye Sadat, Santos, João Vasco, Sarker, Abdur Razzaque, Sartorius, Benn, Satpathy, Maheswar, Savic, Miloje, Schneider, Matthew, Sepanlou, Sadaf G, Shaikh, Masood Ali, Sharif, Mehdi, She, Jun, Sheikh, Aziz, Sisay, Mekonnen, Soneji, Samir, Soofi, Moslem, Tadesse, Henok, Tao, Tianchan, Templin, Tara, Tesema, Azeb Gebresilassie, Thapa, Subash, Thomson, Alan J, Tobe-Gai, Ruoyan, Topor-Madry, Roman, Tran, Bach Xuan, Tran, Khanh Bao, Tran, Tung Thanh, Undurraga, Eduardo A, Vasankari, Tommi, Violante, Francesco S, Wijeratne, Tissa, Xu, Gelin, Yonemoto, Naohiro, Younis, Mustafa Z, Yu, Chuanhua, Zaki, Maysaa El Sayed, Zhou, Lei, Zlavog, Bianca, and Murray, Christopher J L

Subjects
Financing, Government, Medicine (all), HIV, International Agencies, HIV Infections, Infections, Global Health, Article, spending across disease, health spending by source, spatiotemporal Gaussian regression, Animals, Domestic, Animals, Health Resources, Humans, Economic Development, Health Expenditures, Developing Countries
Abstract

Background Comparable estimates of health spending are crucial for the assessment of health systems and to optimally deploy health resources. The methods used to track health spending continue to evolve, but little is known about the distribution of spending across diseases. We developed improved estimates of health spending by source, including development assistance for health, and, for the first time, estimated HIV/AIDS spending on prevention and treatment and by source of funding, for 188 countries. Methods We collected published data on domestic health spending, from 1995 to 2015, from a diverse set of international agencies. We tracked development assistance for health from 1990 to 2017. We also extracted 5385 datapoints about HIV/AIDS spending, between 2000 and 2015, from online databases, country reports, and proposals submitted to multilateral organisations. We used spatiotemporal Gaussian process regression to generate complete and comparable estimates for health and HIV/AIDS spending. We report most estimates in 2017 purchasing-power parity-adjusted dollars and adjust all estimates for the effect of inflation. Findings Between 1995 and 2015, global health spending per capita grew at an annualised rate of 3.1% (95% uncertainty interval [UI] 3.1 to 3.2), with growth being largest in upper-middle-income countries (5.4% per capita [UI 5.3-5.5]) and lower-middle-income countries (4.2% per capita [4.2-4.3]). In 2015, $9.7 trillion (9.7 trillion to 9.8 trillion) was spent on health worldwide. High-income countries spent $6.5 trillion (6.4 trillion to 6.5 trillion) or 66.3% (66.0 to 66.5) of the total in 2015, whereas low-income countries spent $70.3 billion (69.3 billion to 71.3 billion) or 0.7% (0.7 to 0.7). Between 1990 and 2017, development assistance for health increased by 394.7% ($29.9 billion), with an estimated $37.4 billion of development assistance being disbursed for health in 2017, of which $9.1 billion (24.2%) targeted HIV/AIDS. Between 2000 and 2015, $562.6 billion (531.1 billion to 621.9 billion) was spent on HIV/AIDS worldwide. Governments financed 57.6% (52.0 to 60.8) of that total. Global HIV/AIDS spending peaked at 49.7 billion (46.2-54.7) in 2013, decreasing to $48.9 billion (45.2 billion to 54.2 billion) in 2015. That year, low-income and lower-middle-income countries represented 74.6% of all HIV/AIDS disability-adjusted life-years, but just 36.6% (34.4 to 38.7) of total HIV/AIDS spending. In 2015, $9.3 billion (8.5 billion to 10.4 billion) or 19.0% (17.6 to 20.6) of HIV/AIDS financing was spent on prevention, and $27.3 billion (24.5 billion to 31.1 billion) or 55.8% (53.3 to 57.9) was dedicated to care and treatment. Interpretation From 1995 to 2015, total health spending increased worldwide, with the fastest per capita growth in middle-income countries. While these national disparities are relatively well known, low-income countries spent less per person on health and HIV/AIDS than did high-income and middle-income countries. Furthermore, declines in development assistance for health continue, including for HIV/AIDS. Additional cuts to development assistance could hasten this decline, and risk slowing progress towards global and national goals. Copyright (c) 2018 The Author(s). Published by Elsevier Ltd.

Published
2017

26. The global, regional, and national burden of colorectal cancer and its attributable risk factors in 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

Author

Safiri, Saeid, Sepanlou, Sadaf G., Ikuta, Kevin S., Bisignano, Catherine, Salimzadeh, Hamideh, Delavari, Alireza, Ansari, Reza, Roshandel, Gholamreza, Merat, Shahin, Fitzmaurice, Christina, Force, Lisa M., Nixon, Molly R., Abbastabar, Hedayat, Abegaz, Kedir Hussein, Afarideh, Mohsen, Ahmadi, Ayat, Ahmed, Muktar Beshir, Akinyemiju, Tomi, Alahdab, Fares, Ali, Raghib, Alikhani, Mahtab, Alipour, Vahid, Aljunid, Syed Mohamed, Almadi, Majid Abdulrahman Hamad, Almasi-Hashiani, Amir, Al-Raddadi, Rajaa M., Alvis-Guzman, Nelson, Amini, Saeed, Anber, Nahla Hamed, Ansari-Moghaddam, Alireza, Arabloo, Jalal, Arefi, Zohreh, Jafarabadi, Mohammad Asghari, Azadmehr, Abbas, Badawi, Alaa, Baheiraei, Nafiseh, Barnighausen, Till Winfried, Basaleem, Huda, Behzadifar, Masoud, Behzadifar, Meysam, Belayneh, Yaschilal Muche, Berhe, Kidanemaryam, Bhattacharyya, Krittika, Biadgo, Belete, Bijani, Ali, Biondi, Antonio, Bjorge, Tone, Borzi, Antonio M., Bosetti, Cristina, Bou-Orm, Ibrahim R., Brenner, Hermann, Briko, Andrey Nikolaevich, Briko, Nikolay Ivanovich, Carreras, Giulia, Carvalho, Felix, Castaneda-Orjuela, Carlos A., Cerin, Ester, Chiang, Peggy Pei-Chia, Chido-Amajuoyi, Onyema Greg, Daryani, Ahmad, Davitoiu, Dragos Virgil, Demoz, Gebre Teklemariam, Desai, Rupak, Nasab, Mostafa Dianati, Eftekhari, Aziz, El Sayed, Iman, Elbarazi, Iffat, Emamian, Mohammad Hassan, Endries, Aman Yesuf, Esmaeilzadeh, Firooz, Esteghamati, Alireza, Etemadi, Arash, Farzadfar, Farshad, Fernandes, Eduarda, Fernandes, Joao C., Filip, Irina, Fischer, Florian, Foroutan, Masoud, Gad, Mohamed M., Gallus, Silvano, Ghaseni-Kebria, Fatemeh, Ghashghaee, Ahmad, Gorini, Giuseppe, Hafezi-Nejad, Nima, Haj-Mirzaian, Arvin, Haj-Mirzaian, Arya, Hasanpour-Heidari, Susan, Hasanzadeh, Amir, Hassanipour, Soheil, Hay, Simon, I, Hoang, Chi Linh, Hostiuc, Mihaela, Househ, Mowafa, Ilesanmi, Olayinka Stephen, Ilic, Milena D., Innos, Kaire, Irvani, Seyed Sina Naghibi, Islami, Farhad, Jaca, Anelisa, Balalami, Nader Jafari, Delouei, Nastaran Jafari, Jafarinia, Morteza, Jahani, Mohammad Ali, Jakovljevic, Mihajlo, James, Spencer L., Javanbakht, Mehdi, Jenabi, Ensiyeh, Jha, Ravi Prakash, Joukar, Farahnaz, Kasaeian, Amir, Kassa, Tesfaye Dessale, Kassaw, Mesfin Wudu, Kengne, Andre Pascal, Khader, Yousef Saleh, Khaksarian, Mojtaba, Khalilov, Rovshan, Khan, Ejaz Ahmad, Khayamzadeh, Maryam, Khazaee-Pool, Maryam, Khazaei, Salman, Shadmani, Fatemeh Khosravi, Khubchandani, Jagdish, Kim, Daniel, Kisa, Adnan, Kisa, Sezer, Kocarnik, Jonathan M., Komaki, Hamidreza, Kopec, Jacek A., Koyanagi, Ai, Kuipers, Ernst J., Kumar, Vivek, La Vecchia, Carlo, Lami, Faris Hasan, Lopez, Alan D., Lopukhov, Platon D., Lunevicius, Raimundas, Majeed, Azeem, Majidinia, Maryam, Manafi, Amir, Manafi, Navid, Manda, Ana-Laura, Mansour-Ghanaei, Fariborz, Mantovani, Lorenzo Giovanni, Mehta, Dhruv, Meier, Toni, Meles, Hagazi Gebre, Mendoza, Walter, Mestrovic, Tomislav, Miazgowski, Bartosz, Miazgowski, Tomasz, Mir, Seyed Mostafa, Mirzaei, Hamed, Mohammad, Karzan Abdulmuhsin, Mezerji, Naser Mohammad Gholi, Mohammadian-Hafshejani, Abdollah, Mohammadoo-Khorasani, Milad, Mohammed, Shafiu, Mohebi, Farnam, Mokdad, Ali H., Monasta, Lorenzo, Moossavi, Maryam, Moradi, Ghobad, Moradpour, Farhad, Moradzadeh, Rahmatollah, Nahvijou, Azin, Naik, Gurudatta, Najafi, Farid, Nazari, Javad, Negoi, Ionut, Negru, Serban, Cuong Tat Nguyen, Cuong Tat Nguyen, Trang Huyen Nguyen, Trang Huyen Nguyen, Ningrum, Dina Nur Anggraini, Ogbo, Felix Akpojene, Olagunju, Andrew T., Olagunju, Tinuke O., Pana, Adrian, Pereira, David M., Pirestani, Majid, Pourshams, Akram, Poustchi, Hossein, Qorbani, Mostafa, Rabiee, Mohammad, Rabiee, Navid, Radfar, Amir, Rahmati, Marveh, Rajati, Fatemeh, Raoofi, Samira, Rawaf, David Laith, Rawaf, Salman, Reiner, Robert C., Jr., Renzaho, Andre M. N., Rezaei, Nima, Rezapour, Aziz, Saad, Anas M., Saadatagah, Seyedmohammad, Saddik, Basema, Salehi, Farkhonde, Zahabi, Saleh Salehi, Salz, Inbal, Samy, Abdallah M., Sanabria, Juan, Milicevic, Milena M. Santric, Sarveazad, Arash, Satpathy, Maheswar, Schneider, Ione J. C., Sekerija, Mario, Shaahmadi, Faramarz, Shabaninejad, Hosein, Shamsizadeh, Morteza, Sharafi, Zeinab, Sharif, Mehdi, Sharifi, Amrollah, Sheikhbahaei, Sara, Shirkoohi, Reza, Malleshappa, Sudeep K. Siddappa, Silva, Diego Augusto Santos, Sisay, Mekonnen, Smarandache, Catalin-Gabriel, Soofi, Moslem, Soreide, Kjetil, Soshnikov, Sergey, Starodubov, Vladimir, I, Tabares-Seisdedos, Rafael, Sullman, Mark, Taherkhani, Amir, Tesfay, Berhe Etsay, Topor-Madry, Roman, Traini, Eugenio, Bach Xuan Tran, Bach Xuan Tran, Khanh Bao Tran, Khanh Bao Tran, Ullah, Irfan, Uthman, Olalekan A., Vacante, Marco, Vahedian-Azimi, Amir, Valli, Alessandro, Varavikova, Elena, Vujcic, Isidora S., Westerman, Ronny, Yazdi-Feyzabadi, Vahid, Yisma, Engida, Yu, Chuanhua, Zadnik, Vesna, Moghadam, Telma Zahirian, Zaki, Leila, Zandian, Hamed, Zhang, Zhi-Jiang, Murray, Christopher J. L., Naghavi, Mohsen, Malekzadeh, Reza, Veritati - Repositório Institucional da Universidade Católica Portuguesa, Safiri, S, Sepanlou, S, Ikuta, K, Bisignano, C, Salimzadeh, H, Delavari, A, Ansari, R, Roshandel, G, Merat, S, Fitzmaurice, C, Force, L, Nixon, M, Abbastabar, H, Abegaz, K, Afarideh, M, Ahmadi, A, Ahmed, M, Akinyemiju, T, Alahdab, F, Ali, R, Alikhani, M, Alipour, V, Aljunid, S, Almadi, M, Almasi-Hashiani, A, Al-Raddadi, R, Alvis-Guzman, N, Amini, S, Anber, N, Ansari-Moghaddam, A, Arabloo, J, Arefi, Z, Asghari Jafarabadi, M, Azadmehr, A, Badawi, A, Baheiraei, N, Barnighausen, T, Basaleem, H, Behzadifar, M, Belayneh, Y, Berhe, K, Bhattacharyya, K, Biadgo, B, Bijani, A, Biondi, A, Bjorge, T, Borzi, A, Bosetti, C, Bou-Orm, I, Brenner, H, Briko, A, Briko, N, Carreras, G, Carvalho, F, Castaneda-Orjuela, C, Cerin, E, Chiang, P, Chido-Amajuoyi, O, Daryani, A, Davitoiu, D, Demoz, G, Desai, R, Dianati Nasab, M, Eftekhari, A, El Sayed, I, Elbarazi, I, Emamian, M, Endries, A, Esmaeilzadeh, F, Esteghamati, A, Etemadi, A, Farzadfar, F, Fernandes, E, Fernandes, J, Filip, I, Fischer, F, Foroutan, M, Gad, M, Gallus, S, Ghaseni-Kebria, F, Ghashghaee, A, Gorini, G, Hafezi-Nejad, N, Haj-Mirzaian, A, Hasanpour-Heidari, S, Hasanzadeh, A, Hassanipour, S, Hay, S, Hoang, C, Hostiuc, M, Househ, M, Ilesanmi, O, Ilic, M, Innos, K, Irvani, S, Islami, F, Jaca, A, Jafari Balalami, N, Jafari Delouei, N, Jafarinia, M, Jahani, M, Jakovljevic, M, James, S, Javanbakht, M, Jenabi, E, Jha, R, Joukar, F, Kasaeian, A, Kassa, T, Kassaw, M, Kengne, A, Khader, Y, Khaksarian, M, Khalilov, R, Khan, E, Khayamzadeh, M, Khazaee-Pool, M, Khazaei, S, Khosravi Shadmani, F, Khubchandani, J, Kim, D, Kisa, A, Kisa, S, Kocarnik, J, Komaki, H, Kopec, J, Koyanagi, A, Kuipers, E, Kumar, V, La Vecchia, C, Lami, F, Lopez, A, Lopukhov, P, Lunevicius, R, Majeed, A, Majidinia, M, Manafi, A, Manafi, N, Manda, A, Mansour-Ghanaei, F, Mantovani, L, Mehta, D, Meier, T, Meles, H, Mendoza, W, Mestrovic, T, Miazgowski, B, Miazgowski, T, Mir, S, Mirzaei, H, Mohammad, K, Mohammad Gholi Mezerji, N, Mohammadian-Hafshejani, A, Mohammadoo-Khorasani, M, Mohammed, S, Mohebi, F, Mokdad, A, Monasta, L, Moossavi, M, Moradi, G, Moradpour, F, Moradzadeh, R, Nahvijou, A, Naik, G, Najafi, F, Nazari, J, Negoi, I, Negru, S, Nguyen, C, Nguyen, T, Ningrum, D, Ogbo, F, Olagunju, A, Olagunju, T, Pana, A, Pereira, D, Pirestani, M, Pourshams, A, Poustchi, H, Qorbani, M, Rabiee, M, Rabiee, N, Radfar, A, Rahmati, M, Rajati, F, Raoofi, S, Rawaf, D, Rawaf, S, Reiner, R, Renzaho, A, Rezaei, N, Rezapour, A, Saad, A, Saadatagah, S, Saddik, B, Salehi, F, Zahabi, S, Salz, I, Samy, A, Sanabria, J, Santric Milicevic, M, Sarveazad, A, Satpathy, M, Schneider, I, Sekerija, M, Shaahmadi, F, Shabaninejad, H, Shamsizadeh, M, Sharafi, Z, Sharif, M, Sharifi, A, Sheikhbahaei, S, Shirkoohi, R, Siddappa Malleshappa, S, Silva, D, Sisay, M, Smarandache, C, Soofi, M, Soreide, K, Soshnikov, S, Starodubov, V, Tabares-Seisdedos, R, Sullman, M, Taherkhani, A, Tesfay, B, Topor-Madry, R, Traini, E, Tran, B, Tran, K, Ullah, I, Uthman, O, Vacante, M, Vahedian-Azimi, A, Valli, A, Varavikova, E, Vujcic, I, Westerman, R, Yazdi-Feyzabadi, V, Yisma, E, Yu, C, Zadnik, V, Zahirian Moghadam, T, Zaki, L, Zandian, H, Zhang, Z, Murray, C, Naghavi, M, Malekzadeh, R, Safiri, Saeid, Sepanlou, Sadaf G, Ikuta, Kevin S, Bisignano, C., Yisma, Engida, Malekzadeh, Reza, GBD 2017 Colorectal Cancer Collaborators, and Gastroenterology & Hepatology

Subjects
Hepatology, Gastroenterology, global health, colorectal neoplasms, Global Health, Corrections, Article, Global Burden of Disease, SDG 3 - Good Health and Well-being, Risk Factors, Humans, global disease burden, Colorectal Neoplasms, GBD 2017 Colorectal Cancer Collaborators, medicine (all), colorectal tumor
Abstract

Background Data about the global, regional, and country-specific variations in the levels and trends of colorectal cancer are required to understand the impact of this disease and the trends in its burden to help policy makers allocate resources. Here we provide a status report on the incidence, mortality, and disability caused by colorectal cancer in 195 countries and territories between 1990 and 2017. Methods Vital registration, sample vital registration, verbal autopsy, and cancer registry data were used to generate incidence, death, and disability-adjusted life-year (DALY) estimates of colorectal cancer at the global, regional, and national levels. We also determined the association between development levels and colorectal cancer age-standardised DALY rates, and calculated DALYs attributable to risk factors that had evidence of causation with colorectal cancer. All of the estimates are reported as counts and age-standardised rates per 100 000 person-years, with some estimates also presented by sex and 5-year age groups. Findings In 2017, there were 1.8 million (95% UI 1.8-1.9) incident cases of colorectal cancer globally, with an age-standardised incidence rate of 23.2 (22.7-23.7) per 100 000 person-years that increased by 9.5% (4.5-13.5) between 1990 and 2017. Globally, colorectal cancer accounted for 896 000 (876 300-915 700) deaths in 2017, with an age-standardised death rate of 11.5 (11.3-11.8) per 100 000 person-years, which decreased between 1990 and 2017 (-13.5% [-18.4 to -10.0]). Colorectal cancer was also responsible for 19.0 million (18.5-19.5) DALYs globally in 2017, with an age-standardised rate of 235.7 (229.7-242.0) DALYs per 100 000 person-years, which decreased between 1990 and 2017 (-14.5% [-20.4 to -10.3]). Slovakia, the Netherlands, and New Zealand had the highest age-standardised incidence rates in 2017. Greenland, Hungary, and Slovakia had the highest age-standardised death rates in 2017. Numbers of incident cases and deaths were higher among males than females up to the ages of 80-84 years, with the highest rates observed in the oldest age group (>= 95 years) for both sexes in 2017. There was a non-linear association between the Socio-demographic Index and the Healthcare Access and Quality Index and age-standardised DALY rates. In 2017, the three largest contributors to DALYs at the global level, for both sexes, were diet low in calcium (20.5% [12.9-28.9]), alcohol use (15.2% [12.1-18.3]), and diet low in milk (14.3% [5.1-24.8]). Interpretation There is substantial global variation in the burden of colorectal cancer. Although the overall colorectal cancer age-standardised death rate has been decreasing at the global level, the increasing age-standardised incidence rate in most countries poses a major public health challenge across the world. The results of this study could be useful for policy makers to carry out cost-effective interventions and to reduce exposure to modifiable risk factors, particularly in countries with high incidence or increasing burden. Copyright (C) 2019 The Author(s). Published by Elsevier Ltd.

Published
2019

27. Global, Regional, and Country-Specific Lifetime Risks of Stroke, 1990 and 2016

Author

GBD 2016 Lifetime Risk of Stroke Collaborators, Feigin, Valery L, Nguyen, Grant, Cercy, Kelly, Johnson, Catherine O, Alam, Tahiya, Parmar, Priyakumari G, Abajobir, Amanuel A, Abate, Kalkidan H, Abd-Allah, Foad, Abejie, Ayenew N, Abyu, Gebre Y, Ademi, Zanfina, Agarwal, Gina, Ahmed, Muktar B, Akinyemi, Rufus O, Al-Raddadi, Rajaa, Aminde, Leopold N, Amlie-Lefond, Catherine, Ansari, Hossein, Asayesh, Hamid, Asgedom, Solomon W, Atey, Tesfay M, Ayele, Henok T, Banach, Maciej, Banerjee, Amitava, Barac, Aleksandra, Barker-Collo, Suzanne L, Bärnighausen, Till, Barregard, Lars, Basu, Sanjay, Bedi, Neeraj, Behzadifar, Masoud, Béjot, Yannick, Bennett, Derrick A, Bensenor, Isabela M, Berhe, Derbew F, Boneya, Dube J, Brainin, Michael, Campos-Nonato, Ismael R, Caso, Valeria, Castañeda-Orjuela, Carlos A, Rivas, Jacquelin C, Catalá-López, Ferrán, Christensen, Hanne, Criqui, Michael H, Damasceno, Albertino, Dandona, Lalit, Dandona, Rakhi, Davletov, Kairat, de Courten, Barbora, deVeber, Gabrielle, Dokova, Klara, Edessa, Dumessa, Endres, Matthias, Faraon, Emerito JA, Farvid, Maryam S, Fischer, Florian, Foreman, Kyle, Forouzanfar, Mohammad H, Gall, Seana L, Gebrehiwot, Tsegaye T, Geleijnse, Johanna M, Gillum, Richard F, Giroud, Maurice, Goulart, Alessandra C, Gupta, Rahul, Gupta, Rajeev, Hachinski, Vladimir, Hamadeh, Randah R, Hankey, Graeme J, Hareri, Habtamu A, Havmoeller, Rasmus, Hay, Simon I, Hegazy, Mohamed I, Hibstu, Desalegn T, James, Spencer L, Jeemon, Panniyammakal, John, Denny, Jonas, Jost B, Jóźwiak, Jacek, Kalani, Rizwan, Kandel, Amit, Kasaeian, Amir, Kengne, Andre P, Khader, Yousef S, Khan, Abdur R, Khang, Young-Ho, Khubchandani, Jagdish, Kim, Daniel, Kim, Yun J, Kivimaki, Mika, Kokubo, Yoshihiro, Kolte, Dhaval, Kopec, Jacek A, Kosen, Soewarta, Kravchenko, Michael, Krishnamurthi, Rita, Kumar, G Anil, Lafranconi, Alessandra, Lavados, Pablo M, Legesse, Yirga, Li, Yongmei, Liang, Xiaofeng, Lo, Warren D, Lorkowski, Stefan, Lotufo, Paulo A, Loy, Clement T, Mackay, Mark T, Abd El Razek, Hassan Magdy, Mahdavi, Mahdi, Majeed, Azeem, Malekzadeh, Reza, Malta, Deborah C, Mamun, Abdullah A, Mantovani, Lorenzo G, Martins, Sheila CO, Mate, Kedar K, Mazidi, Mohsen, Mehata, Suresh, Meier, Toni, Melaku, Yohannes A, Mendoza, Walter, Mensah, George A, Meretoja, Atte, Mezgebe, Haftay B, Miazgowski, Tomasz, Miller, Ted R, Ibrahim, Norlinah M, Mohammed, Shafiu, Mokdad, Ali H, Moosazadeh, Mahmood, Moran, Andrew E, Musa, Kamarul I, Negoi, Ruxandra I, Nguyen, Minh, Nguyen, Quyen L, Nguyen, Trang H, Tran, Tung T, Nguyen, Thanh T, Anggraini Ningrum, Dina Nur, Norrving, Bo, Noubiap, Jean J, O’Donnell, Martin J, Olagunju, Andrew T, Onuma, Oyere K, Owolabi, Mayowa O, Parsaeian, Mahboubeh, Patton, George C, Piradov, Michael, Pletcher, Martin A, Pourmalek, Farshad, Prakash, V, Qorbani, Mostafa, Rahman, Mahfuzar, Rahman, Muhammad A, Rai, Rajesh K, Ranta, Annemarei, Rawaf, David, Rawaf, Salman, Renzaho, Andre MN, Robinson, Stephen R, Sahathevan, Ramesh, Sahebkar, Amirhossein, Salomon, Joshua A, Santalucia, Paola, Santos, Itamar S, Sartorius, Benn, Schutte, Aletta E, Sepanlou, Sadaf G, Shafieesabet, Azadeh, Shaikh, Masood A, Shamsizadeh, Morteza, Sheth, Kevin N, Sisay, Mekonnen, Shin, Min-Jeong, Shiue, Ivy, Silva, Diego AS, Sobngwi, Eugene, Soljak, Michael, Sorensen, Reed JD, Sposato, Luciano A, Stranges, Saverio, Suliankatchi, Rizwan A, Tabarés-Seisdedos, Rafael, Tanne, David, Nguyen, Cuong Tat, Thakur, JS, Thrift, Amanda G, Tirschwell, David L, Topor-Madry, Roman, Tran, Bach X, Nguyen, Luong T, Truelsen, Thomas, Tsilimparis, Nikolaos, Tyrovolas, Stefanos, Ukwaja, Kingsley N, Uthman, Olalekan A, Varakin, Yuri, Vasankari, Tommi, Venketasubramanian, Narayanaswamy, Vlassov, Vasiliy V, Wang, Wenzhi, Werdecker, Andrea, Wolfe, Charles DA, Xu, Gelin, Yano, Yuichiro, Yonemoto, Naohiro, Yu, Chuanhua, Zaidi, Zoubida, El Sayed Zaki, Maysaa, Zhou, Maigeng, Ziaeian, Boback, Zipkin, Ben, Vos, Theo, Naghavi, Mohsen, Murray, Christopher JL, and Roth, Gregory A

Subjects
Risk, Adult, Aged, 80 and over, Male, Medical And Health Sciences, Incidence, Middle Aged, Global Health, Global Burden of Disease, Stroke, Age Distribution, GBD 2016 Lifetime Risk of Stroke Collaborators, Socioeconomic Factors, Cause of Death, General & Internal Medicine, Humans, Female, Sex Distribution, Aged
Abstract

BACKGROUND:The lifetime risk of stroke has been calculated in a limited number of selected populations. We sought to estimate the lifetime risk of stroke at the regional, country, and global level using data from a comprehensive study of the prevalence of major diseases. METHODS:We used the Global Burden of Disease (GBD) Study 2016 estimates of stroke incidence and the competing risks of death from any cause other than stroke to calculate the cumulative lifetime risks of first stroke, ischemic stroke, or hemorrhagic stroke among adults 25 years of age or older. Estimates of the lifetime risks in the years 1990 and 2016 were compared. Countries were categorized into quintiles of the sociodemographic index (SDI) used in the GBD Study, and the risks were compared across quintiles. Comparisons were made with the use of point estimates and uncertainty intervals representing the 2.5th and 97.5th percentiles around the estimate. RESULTS:The estimated global lifetime risk of stroke from the age of 25 years onward was 24.9% (95% uncertainty interval, 23.5 to 26.2); the risk among men was 24.7% (95% uncertainty interval, 23.3 to 26.0), and the risk among women was 25.1% (95% uncertainty interval, 23.7 to 26.5). The risk of ischemic stroke was 18.3%, and the risk of hemorrhagic stroke was 8.2%. In high-SDI, high-middle-SDI, and low-SDI countries, the estimated lifetime risk of stroke was 23.5%, 31.1% (highest risk), and 13.2% (lowest risk), respectively; the 95% uncertainty intervals did not overlap between these categories. The highest estimated lifetime risks of stroke according to GBD region were in East Asia (38.8%), Central Europe (31.7%), and Eastern Europe (31.6%), and the lowest risk was in eastern sub-Saharan Africa (11.8%). The mean global lifetime risk of stroke increased from 22.8% in 1990 to 24.9% in 2016, a relative increase of 8.9% (95% uncertainty interval, 6.2 to 11.5); the competing risk of death from any cause other than stroke was considered in this calculation. CONCLUSIONS:In 2016, the global lifetime risk of stroke from the age of 25 years onward was approximately 25% among both men and women. There was geographic variation in the lifetime risk of stroke, with the highest risks in East Asia, Central Europe, and Eastern Europe. (Funded by the Bill and Melinda Gates Foundation.).

Published
2018

28. Global, regional, and national burden of motor neuron diseases 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

Author

Logroscino, Giancarlo, Piccininni, Marco, Marin, Benoît, Nichols, Emma, Abd-Allah, Foad, Abdelalim, Ahmed, Alahdab, Fares, Asgedom, Solomon Weldegebreal, Awasthi, Ashish, Chaiah, Yazan, Daryani, Ahmad, Do, Huyen Phuc, Dubey, Manisha, Elbaz, Alexis, Eskandarieh, Sharareh, Farhadi, Farzaneh, Farzadfar, Farshad, Fereshtehnejad, Seyed-Mohammad, Fernandes, Eduarda, Filip, Irina, Foreman, Kyle J., Gebre, Abadi Kahsu, Gnedovskaya, Elena V., Hamidi, Samer, Hay, Simon I., Irvani, Seyed Sina Naghibi, Ji, John S., Kasaeian, Amir, Kim, Yun Jin, Mantovani, Lorenzo Giovanni, Mashamba-Thompson, Tivani Phosa, Mehndiratta, Man Mohan, Mokdad, Ali H., Nagel, Gabriele, Nguyen, Trang Huyen, Nixon, Molly R, Olagunju, Andrew T, Owolabi, Mayowa Ojo, Piradov, Michael A, Qorbani, Mostafa, Radfar, Amir, Reiner, Robert C, Sahraian, Mohammad Ali, Sarvi, Shahabeddin, Sharif, Mehdi, Temsah, Omar, Tran, Bach Xuan, Truong, Nu Thi, Venketasubramanian, Narayanaswamy, Winkler, Andrea Sylvia, Yimer, Ebrahim M, Feigin, Valery L., Vos, Theo, Murray, Christopher J L, Università degli studi di Bari, Neuroépidémiologie Tropicale (NET), CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Service de l'Information Médicale et de l'Évaluation [CHU Limoges] (SIME), CHU Limoges, Laboratoire de Biostatistique et d'Informatique Médicale, Université de Limoges (UNILIM), Institute for Health Metrics and Evaluation [University of Washington], University of Washington [Seattle], Department of Neurology [Egypte], Cairo University - Faculty of Medicine, Mayo Clinic [Rochester], Public Health Directorate, Saudi Ministry of Health, WHO Collaborating Center for Mass Gathering Medicine, Riyadh, Saudi Arabia, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia., Neuroépidémiologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université, Spatial Ecology and Epidemiology Group, Department of Zoology, Ludwig-Maximilians-University of Munich-Grosshadern, Department of Neurology, Università degli studi di Bari Aldo Moro (UNIBA), Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM)-CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM), Département santé travail (DST-InVS), Institut de Veille Sanitaire (INVS), Institute of Epidemiology, Universität Ulm - Ulm University [Ulm, Allemagne], University of Tehran, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [APHP], Logroscino, G, Piccininni, M, Marin, B, Nichols, E, Abd-Allah, F, Abdelalim, A, Alahdab, F, Asgedom, S, Awasthi, A, Chaiah, Y, Daryani, A, Do, H, Dubey, M, Elbaz, A, Eskandarieh, S, Farhadi, F, Farzadfar, F, Fereshtehnejad, S, Fernandes, E, Filip, I, Foreman, K, Gebre, A, Gnedovskaya, E, Hamidi, S, Hay, S, Irvani, S, Ji, J, Kasaeian, A, Kim, Y, Mantovani, L, Mashamba-Thompson, T, Mehndiratta, M, Mokdad, A, Nagel, G, Nguyen, T, Nixon, M, Olagunju, A, Owolabi, M, Piradov, M, Qorbani, M, Radfar, A, Reiner, R, Sahraian, M, Sarvi, S, Sharif, M, Temsah, O, Tran, B, Truong, N, Venketasubramanian, N, Winkler, A, Yimer, E, Feigin, V, Vos, T, and Murray, C

Subjects
Aged, 80 and over, Male, Incidence, Amyotrophic Lateral Sclerosis, Bayes Theorem, Middle Aged, Article, Global Burden of Disease, Age Distribution, Life Expectancy, Cause of Death, Prevalence, Humans, Disabled Persons, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Neurology (clinical), Motor Neuron Disease, Aged
Abstract

Summary Background Understanding how prevalence, incidence, and mortality of motor neuron diseases change over time and by location is crucial for understanding the causes of these disorders and for health-care planning. Our aim was to produce estimates of incidence, prevalence, and disability-adjusted life-years (DALYs) for motor neuron diseases for 195 countries and territories from 1990 to 2016 as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016. Methods The motor neuron diseases included in this study were amyotrophic lateral sclerosis, spinal muscular atrophy, hereditary spastic paraplegia, primary lateral sclerosis, progressive muscular atrophy, and pseudobulbar palsy. Incidence, prevalence, and DALYs were estimated using a Bayesian meta-regression model. We analysed 14 165 site-years of vital registration cause of death data using the GBD 2016 cause of death ensemble model. The 84 risk factors quantified in GBD 2016 were tested for an association with incidence or death from motor neuron diseases. We also explored the relationship between Socio-demographic Index (SDI; a compound measure of income per capita, education, and fertility) and age-standardised DALYs of motor neuron diseases. Findings In 2016, globally, 330 918 (95% uncertainty interval [UI] 299 522–367 254) individuals had a motor neuron disease. Motor neuron diseases have caused 926 090 (881 566–961 758) DALYs and 34 325 (33 051–35 364) deaths in 2016. The worldwide all-age prevalence was 4·5 (4·1–5·0) per 100 000 people, with an increase in age-standardised prevalence of 4·5% (3·4–5·7) over the study period. The all-age incidence was 0·78 (95% UI 0·71–0·86) per 100 000 person-years. No risk factor analysed in GBD showed an association with motor neuron disease incidence. The largest age-standardised prevalence was in high SDI regions: high-income North America (16·8, 95% UI 15·8–16·9), Australasia (14·7, 13·5–16·1), and western Europe (12·9, 11·7–14·1). However, the prevalence and incidence were lower than expected based on SDI in high-income Asia Pacific. Interpretation Motor neuron diseases have low prevalence and incidence, but cause severe disability with a high fatality rate. Incidence of motor neuron diseases has geographical heterogeneity, which is not explained by any risk factors quantified in GBD, suggesting other unmeasured risk factors might have a role. Between 1990 and 2016, the burden of motor neuron diseases has increased substantially. The estimates presented here, as well as future estimates based on data from a greater number of countries, will be important in the planning of services for people with motor neuron diseases worldwide. Funding Bill & Melinda Gates Foundation.

Published
2018

29. Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

Author

Abajobir, Amanuel Alemu, Abate, Kalkidan Hassen, Abbafati, Cristiana, Abbas, Kaja M, Abd-Allah, Foad, Abdulkader, Rizwan Suliankatchi, Abdulle, Abdishakur M, Abebo, Teshome Abuka, Abera, Semaw Ferede, Aboyans, Victor, Abu-Raddad, Laith J, Ackerman, Ilana N, Adedeji, Isaac A, Adetokunboh, Olatunji, Afshin, Ashkan, Aggarwal, Rakesh, Agrawal, Sutapa, Agrawal, Anurag, Ahmed, Muktar Beshir, Aichour, Miloud Taki Eddine, Aichour, Amani Nidhal, Aichour, Ibtihel, Aiyar, Sneha, Akinyemiju, Tomi F, Akseer, Nadia, Al Lami, Faris Hasan, Alahdab, Fares, Al-Aly, Ziyad, Alam, Khurshid, Alam, Noore, Alam, Tahiya, Alasfoor, Deena, Alene, Kefyalew Addis, Ali, Raghib, Alizadeh-Navaei, Reza, Alkaabi, Juma M, Alkerwi, Ala'a, Alla, François, Allebeck, Peter, Allen, Christine, Al-Maskari, Fatma, AlMazroa, Mohammad AbdulAziz, Al-Raddadi, Rajaa, Alsharif, Ubai, Alsowaidi, Shirina, Althouse, Benjamin M, Altirkawi, Khalid A, Alvis-Guzman, Nelson, Amare, Azmeraw T, Amini, Erfan, Ammar, Walid, Amoako, Yaw Ampem, Ansha, Mustafa Geleto, Antonio, Carl Abelardo T, Anwari, Palwasha, Ärnlöv, Johan, Arora, Megha, Artaman, Al, Aryal, Krishna Kumar, Asgedom, Solomon W, Atey, Tesfay Mehari, Atnafu, Niguse Tadele, Avila-Burgos, Leticia, Avokpaho, Euripide Frinel G Arthur, Awasthi, Ashish, Awasthi, Shally, Azarpazhooh, Mahmoud Reza, Azzopardi, Peter, Babalola, Tesleem Kayode, Bacha, Umar, Badawi, Alaa, Balakrishnan, Kalpana, Bannick, Marlena S, Barac, Aleksandra, Barker-Collo, Suzanne L, Bärnighausen, Till, Barquera, Simon, Barrero, Lope H, Basu, Sanjay, Battista, Robert, Battle, Katherine E, Baune, Bernhard T, Bazargan-Hejazi, Shahrzad, Beardsley, Justin, Bedi, Neeraj, Béjot, Yannick, Bekele, Bayu Begashaw, Bell, Michelle L, Bennett, Derrick A, Bennett, James R, Bensenor, Isabela M, Benson, Jennifer, Berhane, Adugnaw, Berhe, Derbew Fikadu, Bernabé, Eduardo, Betsu, Balem Demtsu, Beuran, Mircea, Beyene, Addisu Shunu, Bhansali, Anil, Bhatt, Samir, Bhutta, Zulfiqar A, Biadgilign, Sibhatu, Bicer, Burcu Kucuk, Bienhoff, Kelly, Bikbov, Boris, Birungi, Charles, Biryukov, Stan, Bisanzio, Donal, Bizuayehu, Habtamu Mellie, Blyth, Fiona M, Boneya, Dube Jara, Bose, Dipan, Bou-Orm, Ibrahim R, Bourne, Rupert R A, Brainin, Michael, Brayne, Carol, Brazinova, Alexandra, Breitborde, Nicholas J K, Briant, Paul S, Britton, Gabrielle, Brugha, Traolach S, Buchbinder, Rachelle, Bulto, Lemma Negesa Bulto, Bumgarner, Blair R, Butt, Zahid A, Cahuana-Hurtado, Lucero, Cameron, Ewan, Campos-Nonato, Ismael Ricardo, Carabin, Hélène, Cárdenas, Rosario, Carpenter, David O, Carrero, Juan Jesus, Carter, Austin, Carvalho, Felix, Casey, Daniel, Castañeda-Orjuela, Carlos A, Castle, Chris D, Catalá-López, Ferrán, Chang, Jung-Chen, Charlson, Fiona J, Chaturvedi, Pankaj, Chen, Honglei, Chibalabala, Mirriam, Chibueze, Chioma Ezinne, Chisumpa, Vesper Hichilombwe, Chitheer, Abdulaal A, Chowdhury, Rajiv, Christopher, Devasahayam Jesudas, Ciobanu, Liliana G, Cirillo, Massimo, Colombara, Danny, Cooper, Leslie Trumbull, Cooper, 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Undurraga, Eduardo A, Uneke, Chigozie Jesse, Updike, Rachel, Uthman, Olalekan A, Uzochukwu, Benjamin S Chudi, van Boven, Job F M, Varughese, Santosh, Vasankari, Tommi, Veerman, Lennert J, Venkatesh, S., Venketasubramanian, Narayanaswamy, Vidavalur, Ramesh, Vijayakumar, Lakshmi, Violante, Francesco S, Vishnu, Abhishek, Vladimirov, Sergey K, Vlassov, Vasiliy Victorovich, Vollset, Stein Emil, Vos, Theo, Wadilo, Fiseha, Wakayo, Tolassa, Wallin, Mitchell T, Wang, Yuan-Pang, Weichenthal, Scott, Weiderpass, Elisabete, Weintraub, Robert G, Weiss, Daniel J, Werdecker, Andrea, Westerman, Ronny, Whiteford, Harvey A, Wijeratne, Tissa, Williams, Hywel C, Wiysonge, Charles Shey, Woldeyes, Belete Getahun, Wolfe, Charles D A, Woodbrook, Rachel, Woolf, Anthony D, Workicho, Abdulhalik, Xavier, Deni, Xu, Gelin, Yadgir, Simon, Yaghoubi, Mohsen, Yakob, Bereket, Yan, Lijing L, Yano, Yuichiro, Ye, Pengpeng, Yihdego, Mahari Gidey, Yimam, Hassen Hamid, Yip, Paul, Yonemoto, Naohiro, Yoon, Seok-Jun, Yotebieng, 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Johnson, C, Johnson, S, Jonas, J, Jürisson, M, Kabir, Z, Kadel, R, Kahsay, A, Kamal, R, Kar, C, Karam, N, Karch, A, Karema, C, Karimi, S, Karimkhani, C, Kasaeian, A, Kassa, G, Kassaw, N, Kassebaum, N, Kastor, A, Katikireddi, S, Kaul, A, Kawakami, N, Keiyoro, P, Kemmer, L, Kengne, A, Keren, A, Kesavachandran, C, Khader, Y, Khalil, I, Khan, E, Khang, Y, Khoja, A, Khosravi, A, Khubchandani, J, Kiadaliri, A, Kieling, C, Kim, Y, Kim, D, Kimokoti, R, Kinfu, Y, Kisa, A, Kissimova-Skarbek, K, Kissoon, N, Kivimaki, M, Knudsen, A, Kokubo, Y, Kolte, D, Kopec, J, Kosen, S, Kotsakis, G, Koul, P, Koyanagi, A, Kravchenko, M, Krohn, K, Kumar, G, Kumar, P, Kyu, H, Lager, A, Lal, D, Lalloo, R, Lallukka, T, Lambert, N, Lan, Q, Lansingh, V, Larsson, A, Leasher, J, Lee, P, Leigh, J, Leshargie, C, Leung, J, Leung, R, Levi, M, Li, Y, Liang, X, Liben, M, Lim, S, Linn, S, Liu, P, Liu, A, Liu, S, Liu, Y, Lodha, R, Logroscino, G, Looker, K, Lopez, A, Lorkowski, S, Lotufo, P, Lozano, R, Lucas, T, Lunevicius, R, Lyons, R, Macarayan, E, Maddison, E, Magdy Abd El Razek, H, Magdy Abd El Razek, M, Magis-Rodriguez, C, Mahdavi, M, Majdan, M, Majdzadeh, R, Majeed, A, Malekzadeh, R, Malhotra, R, Malta, D, Mamun, A, Manguerra, H, Manhertz, T, Mantovani, L, Mapoma, C, March, L, Marczak, L, Martinez-Raga, J, Martins, P, Martins-Melo, F, Martopullo, I, März, W, Mathur, M, Mazidi, M, Mcalinden, C, Mcgaughey, M, Mcgrath, J, Mckee, M, Mehata, S, Meier, T, Meles, K, Memiah, P, Memish, Z, Mendoza, W, Mengesha, M, Mengistie, M, Mengistu, D, Mensah, G, Meretoja, T, Meretoja, A, Mezgebe, H, Micha, R, Millear, A, Miller, T, Minnig, S, Mirarefin, M, Mirrakhimov, E, Misganaw, A, Mishra, S, Mitchell, P, Mohammad, K, Mohammadi, A, Mohammed, M, Mohammed, K, Mohammed, S, Mohan, M, Mokdad, A, Mollenkopf, S, Monasta, L, Montañez Hernandez, J, Montico, M, Moradi-Lakeh, M, Moraga, P, Morawska, L, Mori, R, Morrison, S, Moses, M, Mountjoy-Venning, C, Mruts, K, Mueller, U, Muller, K, Murdoch, M, Murray, C, Murthy, G, Murthy, S, Musa, K, Nachega, J, Nagel, G, Naghavi, M, Naheed, A, Naidoo, K, Nangia, V, Nasher, J, Natarajan, G, Negasa, D, Negoi, R, Negoi, I, Newton, C, Ngunjiri, J, Nguyen, C, Nguyen, Q, Nguyen, T, Nguyen, G, Nguyen, M, Nichols, E, Ningrum, D, Nong, V, Norheim, O, Norrving, B, Noubiap, J, Nyandwi, A, Obermeyer, C, O'Donnell, M, Ogbo, F, Oh, I, Okoro, A, Oladimeji, O, Olagunju, A, Olagunju, T, Olsen, H, Olusanya, B, Olusanya, J, Ong, K, Opio, J, Oren, E, Ortiz, A, Osborne, R, Osgood-Zimmerman, A, Osman, M, Ota, E, Owolabi, M, Pa, M, Pacella, R, Panda, B, Pandian, J, Papachristou, C, Park, E, Parry, C, Parsaeian, M, Patil, S, Patten, S, Patton, G, Paudel, D, Paulson, K, Pearce, N, Pereira, D, Perez, K, Perico, N, Pesudovs, K, Peterson, C, Petri, W, Petzold, M, Phillips, M, Phipps, G, Pigott, D, Pillay, J, Pinho, C, Piradov, M, Plass, D, Pletcher, M, Popova, S, Poulton, R, Pourmalek, F, Prabhakaran, D, Prasad, N, Purcell, C, Purwar, M, Qorbani, M, Quintanilla, B, Rabiee, R, Radfar, A, Rafay, A, Rahimi, K, Rahimi-Movaghar, A, Rahimi-Movaghar, V, Rahman, M, Rai, R, Rajsic, S, Ram, U, Ranabhat, C, Rangaswamy, T, Rankin, Z, Rao, P, Rawaf, S, Ray, S, Reiner, R, Reinig, N, Reitsma, M, Remuzzi, G, Renzaho, A, Resnikoff, S, Rezaei, S, Ribeiro, A, Rivas, J, Roba, H, Robinson, S, Rojas-Rueda, D, Rokni, M, Ronfani, L, Roshandel, G, Roth, G, Rothenbacher, D, Roy, A, Rubagotti, E, Ruhago, G, Saadat, S, Safdarian, M, Safiri, S, Sagar, R, Sahathevan, R, Sahraian, M, Salama, J, Saleh, M, Salomon, J, Salvi, S, Samy, A, Sanabria, J, Sanchez-Niño, M, Santomauro, D, Santos, J, Santos, I, Santric Milicevic, M, Sartorius, B, Satpathy, M, Sawhney, M, Saxena, S, Schelonka, K, Schmidt, M, Schneider, I, Schöttker, B, Schutte, A, Schwebel, D, Schwendicke, F, Seedat, S, Sepanlou, S, Servan-Mori, E, Shaheen, A, Shaikh, M, Shamsipour, M, Sharma, R, Sharma, J, She, J, Shi, P, Shibuya, K, Shields, C, Shifa, G, Shiferaw, M, Shigematsu, M, Shiri, R, Shirkoohi, R, Shirude, S, Shishani, K, Shoman, H, Siabani, S, Sibai, A, Sigfusdottir, I, Silberberg, D, Silva, D, Silva, J, Silveira, D, Singh, J, Singh, O, Singh, N, Singh, V, Sinha, D, Skiadaresi, E, Slepak, E, Smith, D, Smith, M, Sobaih, B, Sobngwi, E, Soljak, M, Sorensen, R, Sousa, T, Sposato, L, Sreeramareddy, C, Srinivasan, V, Stanaway, J, Stathopoulou, V, Steel, N, Stein, D, Steiner, C, Steinke, S, Stokes, M, Stovner, L, Strub, B, Subart, M, Sufiyan, M, Sunguya, B, Sur, P, Swaminathan, S, Sykes, B, Sylte, D, Szoeke, C, Tabarés-Seisdedos, R, Tadakamadla, S, Taffere, G, Takala, J, Tandon, N, Tanne, D, Tarekegn, Y, Tavakkoli, M, Taveira, N, Taylor, H, Tegegne, T, Tehrani-Banihashemi, A, Tekelab, T, Terkawi, A, Tesfaye, D, Tesssema, B, Thakur, J, Thamsuwan, O, Theadom, A, Theis, A, Thomas, K, Thomas, N, Thompson, R, Thrift, A, Tobe-Gai, R, Tobollik, M, Tonelli, M, Topor-Madry, R, Tortajada, M, Touvier, M, Traebert, J, Tran, B, Troeger, C, Truelsen, T, Tsoi, D, Tuzcu, E, Tymeson, H, Tyrovolas, S, Ukwaja, K, Undurraga, E, Uneke, C, Updike, R, Uthman, O, Uzochukwu, B, van Boven, J, Varughese, S, Vasankari, T, Veerman, L, Venkatesh, S, Venketasubramanian, N, Vidavalur, R, Vijayakumar, L, Violante, F, Vishnu, A, Vladimirov, S, Vlassov, V, Vollset, S, Vos, T, Wadilo, F, Wakayo, T, Wallin, M, Wang, Y, Weichenthal, S, Weiderpass, E, Weintraub, R, Weiss, D, Werdecker, A, Westerman, R, Whiteford, H, Wijeratne, T, Williams, H, Wiysonge, C, Woldeyes, B, Wolfe, C, Woodbrook, R, Woolf, A, Workicho, A, Xavier, D, Xu, G, Yadgir, S, Yaghoubi, M, Yakob, B, Yan, L, Yano, Y, Ye, P, Yihdego, M, Yimam, H, Yip, P, Yonemoto, N, Yoon, S, Yotebieng, M, Younis, M, Yu, C, Zaidi, Z, Zaki, M, Zegeye, E, Zenebe, Z, Zhang, X, Zheng, Y, Zhou, M, Zipkin, B, Zodpey, S, Zoeckler, L, Zuhlke, L, Brayne, Carol [0000-0001-5307-663X], Chowdhury, Rajiv [0000-0003-4881-5690], and Apollo - University of Cambridge Repository

Subjects
Male, Dánarmein, AUSTRALIA, GBD, disability-adjusted life-years (DALYs), Heilsufar, Lífslíkur, Epidemiology, Life expectancy, Diseases, Global Health, THERAPY, Global Burden of Disease, Residence Characteristics, Fullorðnir, Cause of Death, Medicine and Health Sciences, Psychology, Konur, Aged, 80 and over, Tölfræði, PLASMODIUM-FALCIPARUM, Aldraðir, Sjúkdómar, Medicine (all), Fatlaðir, Men, Þjóðir, 11 Medical And Health Sciences, ASSOCIATION, Middle Aged, Health policy, PREVALENCE, Sálfræði, disability-adjusted life-years (DALYs), Female, Lýðheilsa, Quality-Adjusted Life Years, Life Sciences & Biomedicine, Global Health Metrics, Adult, AFRICA, Quality of life, People with disabilities, GBD, WEIGHTS, Social ecology, Lífsgæði, Communicable Diseases, World health/statistics, Age Distribution, Life Expectancy, Medicine, General & Internal, SDG 3 - Good Health and Well-being, General & Internal Medicine, Heilbrigðisstefna, Humans, Adults, Disabled Persons, Women, Sex Distribution, Mortality, Noncommunicable Diseases, Aged, Science & Technology, Faraldsfræði, MORTALITY, Wounds and injuries, EPIDEMIOLOGIC TRANSITION, HIV, Áverkar, Karlar, Wounds and Injuries, Félagshagfræði, Older people
Abstract

Correction in: LANCET Volume: 390 Issue: 10106 Pages: E38-E38 Published: OCT 28 2017, Background Measurement of changes in health across locations is useful to compare and contrast changing epidemiological patterns against health system performance and identify specific needs for resource allocation in research, policy development, and programme decision making. Using the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we drew from two widely used summary measures to monitor such changes in population health: disability-adjusted life-years (DALYs) and healthy life expectancy (HALE). We used these measures to track trends and benchmark progress compared with expected trends on the basis of the Socio-demographic Index (SDI). Methods We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 for all-cause mortality, cause-specific mortality, and non-fatal disease burden to derive HALE and DALYs by sex for 195 countries and territories from 1990 to 2016. We calculated DALYs by summing years of life lost and years of life lived with disability for each location, age group, sex, and year. We estimated HALE using age-specific death rates and years of life lived with disability per capita. We explored how DALYs and HALE differed from expected trends when compared with the SDI: the geometric mean of income per person, educational attainment in the population older than age 15 years, and total fertility rate. Findings The highest globally observed HALE at birth for both women and men was in Singapore, at 75.2 years (95% uncertainty interval 71.9-78.6) for females and 72.0 years (68.8-75.1) for males. The lowest for females was in the Central African Republic (45.6 years [42.0-49.5]) and for males was in Lesotho (41.5 years [39.0-44.0]). From 1990 to 2016, global HALE increased by an average of 6.24 years (5.97-6.48) for both sexes combined. Global HALE increased by 6.04 years (5.74-6.27) for males and 6.49 years (6.08-6.77) for females, whereas HALE at age 65 years increased by 1.78 years (1.61-1.93) for males and 1.96 years (1.69-2.13) for females. Total global DALYs remained largely unchanged from 1990 to 2016 (-2.3% [-5.9 to 0.9]), with decreases in communicable, maternal, neonatal, and nutritional (CMNN) disease DALYs offset by increased DALYs due to non-communicable diseases (NCDs). The exemplars, calculated as the five lowest ratios of observed to expected age-standardised DALY rates in 2016, were Nicaragua, Costa Rica, the Maldives, Peru, and Israel. The leading three causes of DALYs globally were ischaemic heart disease, cerebrovascular disease, and lower respiratory infections, comprising 16.1% of all DALYs. Total DALYs and age-standardised DALY rates due to most CMNN causes decreased from 1990 to 2016. Conversely, the total DALY burden rose for most NCDs; however, age-standardised DALY rates due to NCDs declined globally. Interpretation At a global level, DALYs and HALE continue to show improvements. At the same time, we observe that many populations are facing growing functional health loss. Rising SDI was associated with increases in cumulative years of life lived with disability and decreases in CMNN DALYs offset by increased NCD DALYs. Relative compression of morbidity highlights the importance of continued health interventions, which has changed in most locations in pace with the gross domestic product per person, education, and family planning. The analysis of DALYs and HALE and their relationship to SDI represents a robust framework with which to benchmark location-specific health performance. Country-specific drivers of disease burden, particularly for causes with higher-than-expected DALYs, should inform health policies, health system improvement initiatives, targeted prevention efforts, and development assistance for health, including financial and research investments for all countries, regardless of their level of sociodemographic development. The presence of countries that substantially outperform others suggests the need for increased scrutiny for proven examples of best practices, which can help to extend gains, whereas the presence of underperforming countries suggests the need for devotion of extra attention to health systems that need more robust support., Bill & Melinda Gates Foundation

Published
2017

30. Methylation Profiles of BRCA1, RASSF1A and GSTP1 in Vietnamese Women with Breast Cancer

Author

Vu, Trang Lan, Nguyen, Trang Thu, Doan, Van Thi Hong, Vo, Lan Thi Thuong, Laboratoire des biomolécules (LBM UMR 7203), Centre National de la Recherche Scientifique (CNRS)-Sorbonne Université (SU)-Département de Chimie - ENS Paris, École normale supérieure - Paris (ENS Paris), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-École normale supérieure - Paris (ENS Paris), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Chimie Moléculaire de Paris Centre (FR 2769), Institut de Chimie du CNRS (INC)-École normale supérieure - Paris (ENS Paris), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Centre National de la Recherche Scientifique (CNRS)-Ecole Nationale Supérieure de Chimie de Paris - Chimie ParisTech-PSL (ENSCP), Université Paris sciences et lettres (PSL)-Ecole Superieure de Physique et de Chimie Industrielles de la Ville de Paris (ESPCI Paris), Université Paris sciences et lettres (PSL)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Ecole Nationale Supérieure de Chimie de Paris - Chimie ParisTech-PSL (ENSCP), Université Paris sciences et lettres (PSL)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Sorbonne Université - Faculté de Médecine (SU FM), Sorbonne Université (SU), and Vietnam National University [Hanoï] (VNU)

Subjects
Methylation Specific Polymerase chain reaction (MSP), BRCA1 Protein, Tumor Suppressor Proteins, [SDV.CAN]Life Sciences [q-bio]/Cancer, Breast Neoplasms, DNA Methylation, Middle Aged, Breast cancer 1 (BRCA1), Prognosis, Asian People, Glutathione S-Transferase pi, Vietnam, [SDV.BBM.GTP]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Genomics [q-bio.GN], Case-Control Studies, Biomarkers, Tumor, Glutation S-transferase P1 (GSTP1), Humans, Female, skin and connective tissue diseases, Promoter Regions, Genetic, RAS-association domain family member 1 (RASSF1A), Follow-Up Studies, Research Article
Abstract

International audience; Objective: This study investigated the DNA promoter methylation profiles of BRCA1, RASSF1A and GSTP1 genes, both individually and in an integrative manner in order to clarify their correlation with clinicopathological parameters of breast cancer from Vietnamese patients, and establish new potential integrative methylation biomarkers for breast cancer detection. Material and methods: The methylation frequencies of BRCA1, RASSF1A and GSTP1 were analyzed by methylation specific polymerase chain reaction (MSP) in 70 specimens of breast carcinomas and 79 pairs of tumor and matched adjacent normal tissues from breast cancer patients.Results: All the three analyzed genes showed a concordance concerning their promoter methylation in tumor and adjacent normal tissue. The methylation of BRCA1, RASSF1A and GSTP1 was found in 58.23 %, 74.68 % and 59.49 % of tumor tissues and 51.90 %, 63.29 % and 35.44 % of corresponding adjacent tissues, respectively. When each gene was assessed individually, only the methylation of GSTP1 was significantly associated with tumor tissues (p=0.003). However, the methylation frequency of at least one of the three genes and the methylation frequency of all the three genes both showed significant association with tumor (p=0.008 and p=0.04, respectively). The methylation of BRCA1 was found to be significantly associated with tumor grade (p=0.01).Conclusion: This study emphasized that the panel of the three genes BRCA1, RASSF1A and GSTP1 can be further developed as potential biomarkers in diagnosis and classification of breast cancer in Vietnamese women.

Published
2018

31. Global, regional, and national burden of Alzheimer's disease and other dementias, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016

Author

Nichols, Emma, Szoeke, Cassandra E I, Vollset, Stein Emil, Abbasi, Nooshin, Abd-Allah, Foad, Abdela, Jemal, Aichour, Miloud Taki Eddine, Akinyemi, Rufus O, Alahdab, Fares, Asgedom, Solomon W, Awasthi, Ashish, Barker-Collo, Suzanne L, Baune, Bernhard T, Béjot, Yannick, Belachew, Abate B, Bennett, Derrick A., Biadgo, Belete, Bijani, Ali, Bin Sayeed, Muhammad Shahdaat, Brayne, Carol, Carpenter, David O, Carvalho, Félix, Catalá-López, Ferrán, Cerin, Ester, Choi, Jee-Young J, Dang, Anh Kim, Degefa, Meaza G, Djalalinia, Shirin, Dubey, Manisha, Duken, Eyasu Ejeta, Edvardsson, David, Endres, Matthias, Eskandarieh, Sharareh, Faro, Andre, Farzadfar, Farshad, Fereshtehnejad, Seyed-Mohammad, Fernandes, Eduarda, Filip, Irina, Fischer, Florian, Gebre, Abadi K, Geremew, Demeke, Ghasemi-Kasman, Maryam, Gnedovskaya, Elena V., Gupta, Rajeev, Hachinski, Vladimir, Hagos, Tekleberhan B, Hamidi, Samer, Hankey, Graeme J., Haro, Josep M, Hay, Simon I, Irvani, Seyed Sina N, Jha, Ravi P, Jonas, Jost B., Kalani, Rizwan, Karch, André, Kasaeian, Amir, Khader, Yousef Saleh, Khalil, Ibrahim A, Khan, Ejaz Ahmad, Khanna, Tripti, Khoja, Tawfik A M, Khubchandani, Jagdish, Kisa, Adnan, Kissimova-Skarbek, Katarzyna, Kivimäki, Mika, Koyanagi, Ai, Krohn, Kristopher J, Logroscino, Giancarlo, Lorkowski, Stefan, Majdan, Marek, Malekzadeh, Reza, März, Winfried, Massano, João, Mengistu, Getnet, Meretoja, Atte, Mohammadi, Moslem, Mohammadi-Khanaposhtani, Maryam, Mokdad, Ali H, Mondello, Stefania, Moradi, Ghobad, Nagel, Gabriele, Naghavi, Mohsen, Naik, Gurudatta, Nguyen, Long H, Nguyen, Trang H, Nirayo, Yirga L, Nixon, Molly R, Ofori-Asenso, Richard, Ogbo, Felix A, Olagunju, Andrew T, Owolabi, Mayowa O, Panda-Jonas, Songhomitra, Passos, Valéria M de Azeredo, Pereira, David M., Pinilla-Monsalve, Gabriel D, Piradov, Michael A, Pond, Constance D, Poustchi, Hossein, Qorbani, Mostafa, Radfar, Amir, Reiner, Robert C, Robinson, Stephen R, Roshandel, Gholamreza, Rostami, Ali, Russ, Tom C, Sachdev, Perminder S, Safari, Hosein, Safiri, Saeid, Sahathevan, Ramesh, Salimi, Yahya, Satpathy, Maheswar, Sawhney, Monika, Saylan, Mete, Sepanlou, Sadaf G., Shafieesabet, Azadeh, Shaikh, Masood A, Sahraian, Mohammad Ali, Shigematsu, Mika, Shiri, Rahman, Shiue, Ivy, Silva, João P, Smith, Mari, Sobhani, Soheila, Stein, Dan J, Tabarés-Seisdedos, Rafael, Tovani-Palone, Marcos R, Tran, Bach X, Tran, Tung Thanh, Tsegay, Amanuel T, Ullah, Irfan, Venketasubramanian, Narayanaswamy, Vlassov, Vasily, Wang, Yuan-Pang, Weiss, Jordan, Westerman, Ronny, Wijeratne, Tissa, Wyper, Grant M. A., Yano, Yuichiro, Yimer, Ebrahim M, Yonemoto, Naohiro, Yousefifard, Mahmoud, Zaidi, Zoubida, Zare, Zohreh, Vos, Theo, Feigin, Valery L., Murray, Christopher J L, European Regional Development Fund (ERDF/FEDER), Generalitat Valenciana, and Bill & Melinda Gates Foundation

Subjects
Adult, Male, Article, Global Burden of Disease, Age Distribution, Life Expectancy, Sex Factors, RISK-FACTOR, Alzheimer Disease, Risk Factors, Prevalence, Humans, METAANALYSIS, Aged, Aged, 80 and over, DECLINE, Incidence, Age Factors, Public Health, Global Health, Social Medicine and Epidemiology, COGNITIVE IMPAIRMENT, PREVALENCE, TRENDS, Middle Aged, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Caregivers, Dementia, Female, Quality-Adjusted Life Years
Abstract

BACKGROUND: The number of individuals living with dementia is increasing, negatively affecting families, communities, and health-care systems around the world. A successful response to these challenges requires an accurate understanding of the dementia disease burden. We aimed to present the first detailed analysis of the global prevalence, mortality, and overall burden of dementia as captured by the Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study 2016, and highlight the most important messages for clinicians and neurologists. METHODS: GBD 2016 obtained data on dementia from vital registration systems, published scientific literature and surveys, and data from health-service encounters on deaths, excess mortality, prevalence, and incidence from 195 countries and territories from 1990 to 2016, through systematic review and additional data-seeking efforts. To correct for differences in cause of death coding across time and locations, we modelled mortality due to dementia using prevalence data and estimates of excess mortality derived from countries that were most likely to code deaths to dementia relative to prevalence. Data were analysed by standardised methods to estimate deaths, prevalence, years of life lost (YLLs), years of life lived with disability (YLDs), and disability-adjusted life-years (DALYs; computed as the sum of YLLs and YLDs), and the fractions of these metrics that were attributable to four risk factors that met GBD criteria for assessment (high body-mass index [BMI], high fasting plasma glucose, smoking, and a diet high in sugar-sweetened beverages). FINDINGS: In 2016, the global number of individuals who lived with dementia was 43·8 million (95% uncertainty interval [UI] 37·8-51·0), increased from 20.2 million (17·4-23·5) in 1990. This increase of 117% (95% UI 114-121) contrasted with a minor increase in age-standardised prevalence of 1·7% (1·0-2·4), from 701 cases (95% UI 602-815) per 100 000 population in 1990 to 712 cases (614-828) per 100 000 population in 2016. More women than men had dementia in 2016 (27·0 million, 95% UI 23·3-31·4, vs 16.8 million, 14.4-19.6), and dementia was the fifth leading cause of death globally, accounting for 2·4 million (95% UI 2·1-2·8) deaths. Overall, 28·8 million (95% UI 24·5-34·0) DALYs were attributed to dementia; 6·4 million (95% UI 3·4-10·5) of these could be attributed to the modifiable GBD risk factors of high BMI, high fasting plasma glucose, smoking, and a high intake of sugar-sweetened beverages. INTERPRETATION: The global number of people living with dementia more than doubled from 1990 to 2016, mainly due to increases in population ageing and growth. Although differences in coding for causes of death and the heterogeneity in case-ascertainment methods constitute major challenges to the estimation of the burden of dementia, future analyses should improve on the methods for the correction of these biases. Until breakthroughs are made in prevention or curative treatment, dementia will constitute an increasing challenge to health-care systems worldwide. FUNDING: Bill & Melinda Gates Foundation. AA received financial support from the Department of Science and Technology, Government of India, (New Delhi, India) through the INSPIRE Faculty program. MSBS received Australian Government Research and Training Program funding for post-graduates to study at the Australian National University (Canberra, ACT, Australia). FC acknowledges support from the European Union (FEDER funds POCI/01/0145/FEDER/007728 and POCI/01/0145/FEDER/007265) and National Funds (FCT/MEC, Fundação para a Ciência e a Tecnologia and Ministério da Educação e Ciência) under the Partnership Agreements PT2020 UID/MULTI/04378/2013 and PT2020 UID/QUI/50006/2013. EC is supported by an Australian Research Council Future fellowship (FT3 140100085). AK was supported by the Miguel Servet contract financed by the CP13/00150 and PI15/00862 projects, integrated into the National R + D + I and funded by the ISCIII (General Branch Evaluation and Promotion of Health Research) and the European Regional Development fund (ISCIII-FEDER). MOO is supported by grant U54HG007479 from the National Institutes of Health. TCR is a member of the Alzheimer Scotland Dementia Research Centre (University of Edinburgh, Edinburgh, UK) and is supported by Alzheimer Scotland. RT-S was partly supported by grant number PROMETEOII/2015/021 from Generalitat Valenciana and the national grant PI17/00719 from ISCIII-FEDER. TW acknowledges academic support from University of Rajarata (Mihintale, Sri Lanka). Sí

Published
2018

32. Burden of cancer in the Eastern Mediterranean Region, 2005-2015: findings from the Global Burden of Disease 2015 Study

Author

Fitzmaurice, Christina, Alsharif, Ubai, El Bcheraoui, Charbel, Khalil, Ibrahim, Charara, Raghid, Moradi-Lakeh, Maziar, Afshin, Ashkan, Collison, Michael, Chew, Adrienne, Krohn, Kristopher J, Daoud, Farah, Dicker, Daniel, Foreman, Kyle J, Frostad, Joseph, Kassebaum, Nicholas J, Kutz, Michael, Wang, Haidong, Abyu, Gebre Yitayih, Adedeji, Isaac Akinkunmi, Kiadaliri, Aliasghar Ahmad, Ahmed, Muktar Beshir, Al-Eyadhy, Ayman, Alam, Khurshid, Alasfoor, Deena, Ali, Raghib, Alizadeh-Navaei, Reza, Al-Raddadi, Rajaa, Altirkawi, Khalid A, Alvis-Guzman, Nelson, Amini, Erfan, Anber, Nahla, Anwari, Palwasha, Artaman, Al, Asgedom, Solomon Weldegebreal, Atey, Tesfay Mehari, Awasthi, Ashish, Saleem, Huda Omer Ba, Bacha, Umar, Barac, Aleksandra, Bedi, Neeraj, Bhutta, Zulfiqar A, Butt, Zahid A, Castaneda-Orjuela, Carlos A, Chitheer, Abdulaal A, Danawi, Hadi, das Neves, Jose, Davitoiu, Dragos V, Dey, Subhojit, Dharmaratne, Samath D, Djalalinia, Shirin, Do, Huyen Phuc, Dubey, Manisha, Ebrahimi, Hedyeh, Ekwueme, Donatus U, Endries, Aman Yesuf, Eshrati, Babak, Esteghamati, Alireza, Farvid, Maryam S, Fereshtehnejad, Seyed-Mohammad, Fischer, Florian, Gebrehiwot, Tsegaye Tewelde, Gopalani, Sameer Vali, Hafezi-Nejad, Nima, Hamadeh, Randah Ribhi, Hamidi, Samer, Hareri, Habtamu Abera, Hay, Roderick J, Horita, Nobuyuki, Hsairi, Mohamed, Jakovljevic, Mihajlo B, Jonas, Jost B, Kasaeian, Amir, Kassaw, Nigussie Assefa, Khader, Yousef Saleh, Khan, Ejaz Ahmad, Khan, Gulfaraz, Kim, Daniel, Kinfu, Yohannes, Larson, Heidi J, Latif, Asma Abdul, Linn, Shai, Lunevicius, Raimundas, Abd El Razek, Hassan Magdy, Abd El Razek, Mohammed Magdy, Majeed, Azeem, Malekzadeh, Reza, Malta, Deborah Carvalho, Markos, Desalegn, Memiah, Peter, Memish, Ziad A, Mendoza, Walter, Meretoja, Tuomo J, Miller, Ted R, Mohammed, Shafiu, Nangia, Vinay, Nguyen, Quyen Le, Nguyen, Trang Huyen, Ogbo, Felix Akpojene, Mahesh, PA, Park, Eun-Kee, Patel, Tejas, Pereira, David M, Pishgar, Farhad, Pourmalek, Farshad, Qorbani, Mostafa, Radfar, Amir, Rafay, Anwar, Rahimi-Movaghar, Vafa, Rai, Rajesh Kumar, Rana, Saleem M, Rawaf, Salman, Renzaho, Andre MN, Rezaei, Satar, Roba, Kedir Teji, Roshandel, Gholamreza, Safdarian, Mahdi, Safi, Sare, Safiri, Saeid, Salamati, Payman, Samy, Abdallah M, Sanabria, Juan Ramon, Milicevic, Milena M Santric, Sartorius, Benn, Sepanlou, Sadaf G, Shaikh, Masood Ali, Shrime, Mark G, Stathopoulou, Vasiliki, Sufiyan, Muawiyyah Babale, Abdulkader, Rizwan Suliankatchi, Tabares-Seisdedos, Rafael, Tehrani-Banihashemi, Arash, Tekelab, Tesfalidet, Temsah, Mohamad-Hani, Tran, Bach Xuan, Ukwaja, Kingsley Nnanna, Uthman, Olalekan A, Vlassov, Vasiliy Victorovich, Vollset, Stein Emil, Wakayo, Tolassa, Weiderpass, Elisabete, Werdecker, Andrea, Yaghoubi, Mohsen, Yaseri, Mehdi, Yimam, Hassen Hamid, Yonemoto, Naohiro, Zaki, Maysaa El Sayed, Zein, Bassel, Jumaan, Aisha O, Vos, Theo, Hay, Simon I, Naghavi, Mohsen, Murray, Christopher JL, Mokdad, Ali H, Reg, GBD 2015 Eastern Mediterranean, Instituto de Investigação e Inovação em Saúde, Alsharif, U, El Bcheraoui, C, Khalil, I, Charara, R, Ahmed, MB, Fitzmaurice, C, Department of Surgery, University of Helsinki, II kirurgian klinikka, Clinicum, Department of Oncology, and HUS Comprehensive Cancer Center

Subjects
Health (social science), Palliative care, Global Health, Mediterranean Region / epidemiology, Eastern Mediterranean Region, Disability-adjusted life years, Global Burden of Disease, Middle East, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, Neoplasms / economics, Neoplasms, MIDDLE-INCOME COUNTRIES, Environmental health, medicine, cancer, Humans, 030212 general & internal medicine, Mortality, Lung cancer, Disease burden, Global Burden of Disease / statistics & numerical data, Cancer, Cancer prevention, Mediterranean Region, business.industry, Incidence (epidemiology), Incidence, DEATH, Public Health, Environmental and Occupational Health, CARE, medicine.disease, mortality, 3142 Public health care science, environmental and occupational health, Neoplasms / mortality, 3. Good health, Cancer registry, 1117 Public Health And Health Services, 030220 oncology & carcinogenesis, Original Article, Public Health, Neoplasms / epidemiology, Quality-Adjusted Life Years, business, Middle East / epidemiology
Abstract

Objectives: To estimate incidence, mortality, and disability-adjusted life years (DALYs) caused by cancer in the Eastern Mediterranean Region (EMR) between 2005 and 2015. Methods: Vital registration system and cancer registry data from the EMR region were analyzed for 29 cancer groups in 22 EMR countries using the Global Burden of Disease Study 2015 methodology. Results: In 2015, cancer was responsible for 9.4% of all deaths and 5.1% of all DALYs. It accounted for 722,646 new cases, 379,093 deaths, and 11.7 million DALYs. Between 2005 and 2015, incident cases increased by 46%, deaths by 33%, and DALYs by 31%. The increase in cancer incidence was largely driven by population growth and population aging. Breast cancer, lung cancer, and leukemia were the most common cancers, while lung, breast, and stomach cancers caused most cancer deaths. Conclusions: Cancer is responsible for a substantial disease burden in the EMR, which is increasing. There is an urgent need to expand cancer prevention, screening, and awareness programs in EMR countries as well as to improve diagnosis, treatment, and palliative care services. The funding source played no role in the design of thestudy, the analysis and interpretation of data, and the writing of thepaper. GBD 2015 is funded by Bill & Melinda Gates Foundation.

Published
2018

33. Amphetamine-Type-Stimulants (ATS) Use and Homosexuality-Related Enacted Stigma Are Associated With Depression Among Men Who Have Sex With Men (MSM) in Two Major Cities in Vietnam in 2014

Author

Vu, Nga Thi Thu, Holt, Martin, Phan, Huong Thi Thu, La, Lan Thi, Tran, Gioi Minh, Doan, Tung Thanh, Nguyen, Trang Nhu Nguyen, de Wit, John, Public Health, Leerstoel de Wit, Public Health, and Leerstoel de Wit

Subjects
Adult, Male, medicine.medical_specialty, Health (social science), Social stigma, Adolescent, Cross-sectional study, media_common.quotation_subject, Sexual Behavior, Amphetamine-Related Disorders, Social Stigma, Medicine (miscellaneous), men who have sex with men, Men who have sex with men, Suicidal Ideation, 03 medical and health sciences, Young Adult, 0302 clinical medicine, medicine, Prevalence, Humans, 030212 general & internal medicine, Homosexuality, Young adult, Cities, Homosexuality, Male, homosexuality-related stigma and dicrimination, Psychiatry, Suicidal ideation, media_common, Depressive Disorder, 030505 public health, Public Health, Environmental and Occupational Health, Age Factors, virus diseases, Middle Aged, Mental health, Health Surveys, amphetamine-type-stimulants, Patient Health Questionnaire, Psychiatry and Mental health, Cross-Sectional Studies, Mental Health, Vietnam, depression, medicine.symptom, 0305 other medical science, Psychology
Abstract

Background: Men who have sex with men (MSM) are disproportionately affected by mental health concerns, including depression. Amphetamine-type-stimulants (ATS) use and homosexuality-related stigma and discrimination have been found associated with depression among MSM. Objectives: To assess the prevalence of depression and its associations with ATS use and homosexuality-related stigma and discrimination among MSM in Vietnam. Methods: 622 MSM were conveniently recruited in Hanoi and Ho Chi Minh city, Vietnam, from September to December 2014. We collected information on demographic characteristics, ATS, alcohol and other drug use, sexual behaviors, homosexuality-related and discrimination stigma, and sexual sensation-seeking. Depression and suicidal thoughts were assessed by the Patient Health Questionnaire (PHQ-9). We assessed associations of depression with ATS use and homosexuality-related stigma and discrimination using logistic regression. Results: Of 622 sampled MSM, 11.3% were classified as having major depression, 9.8% reported any suicidal thoughts in the last two weeks, 30.4% ever had used any ATS, 88.8% ever ad drank alcohol and 21.5% had ever used any other drugs. In multivariate analysis, depression was significantly associated with ATS use (Adjusted Odds Ratio [AOR: 2.20; (95% Confidence Interval (CI): 1.32–3.67], younger age of sexual debut with another man (AOR: 0.09; 95% CI: 0.02–0.50), and greater enacted homosexuality-related stigma (AOR: 1.97; 95% CI: 1.19–3.26). Conclusions: We found a moderate prevalence of depression among sampled MSM, which was associated with ATS use and enacted homosexuality-related stigma. We recommend integrating assessment and interventions regarding depression and methamphetamine use into gay-friendly, culturally adapted holistic HIV prevention for MSM in Vietnam.

Published
2017

34. Amphetamine-type stimulant use among men who have sex with men (MSM) in Vietnam: Results from a socio-ecological, community-based study

Author

Vu, Nga Thi Thu, Holt, Martin, Phan, Huong Thi Thu, Le, Huong Thi, La, Lan Thi, Tran, Gioi Minh, Doan, Tung Thanh, Nguyen, Trang Nhu Nguyen, de Wit, John, Leerstoel de Wit, and Public Health

Subjects
Adult, Male, Adolescent, Sexual Behavior, Research Support, Non-U.S. Gov't, Amphetamine-Related Disorders, Amphetamines, Social Stigma, Street Drugs, HIV Infections, Middle Aged, Methamphetamine, Young Adult, Cross-Sectional Studies, Risk-Taking, Socioeconomic Factors, Vietnam, Residence Characteristics, Journal Article, Humans, Central Nervous System Stimulants, Homosexuality, Male
Abstract

INTRODUCTION: Amphetamine-type-stimulants (ATS) use is associated with HIV-related sexual risk behaviours and is an emergent problem among men who have sex with men (MSM) in Vietnam. The purpose of this study is to describe ATS use patterns and understand the correlates of recent methamphetamine use from a socio-ecological perspective. METHODS: From September through December, 2014, 622 MSM were recruited in Hanoi and Ho Chi Minh City, Vietnam. We collected information on demographic characteristics, HIV testing behaviours, use of ATS and other recreational drugs (ever and recently), sexual sensation seeking, depressive mood, experienced and internalized stigma related to homosexuality, social involvement with other MSM, and perceptions of ATS use in MSM networks. We performed descriptive statistics to describe ATS use patterns and multivariate logistic regression to establish independent correlates of recent methamphetamine use. RESULTS: Nearly one-third (30.4%) had ever used ATS, including 23.6% who had used methamphetamine, 4.3% who had used amphetamine ('speed') and 20.9% who had used ecstasy. 20.1% and 11.9% had ever used methamphetamine and ecstasy, respectively, during sex. Eighteen percent of methamphetamine users were classified as engaged in high-risk use. Recent methamphetamine use (in the last 3 months) was associated with participants perceiving more methamphetamine use in their MSM network, recent sex work, and higher sexual sensation seeking scores. CONCLUSIONS: ATS use is relatively prevalent among MSM sampled in Vietnam's main cities. Interventions to address methamphetamine are warranted for MSM in Vietnam. Methamphetamine treatments are needed for high-risk users.

Published
2016

35. Is anybody out there? Integrating HIV services in rural regions

Author

Nguyen, Trang Quyen and Whetten, Kathryn

Subjects
Social Work, Delivery of Health Care, Integrated, Financing, Organized, Public Health, Environmental and Occupational Health, HIV Infections, Community Health Centers, Continuity of Patient Care, Community Health Planning, Health Services Accessibility, North Carolina, Humans, Rural Health Services, Cooperative Behavior, Case Management, Public Health Administration, Research Article
Abstract

As the HIV epidemic has changed nationally, the parallel change in the Southern states has been a disproportionate increase in HIV infection among people of color and among women. Due to the limited and disjointed health care and social service resources in rural Southern regions, already marginalized groups have difficulty in accessing appropriate care and services to address their HIV infection seamlessly and with continuity. To ameliorate the limitations in the health care infrastructure, the North Carolina Services Integration Project collaborated with North Carolina medical and social service providers and state agencies to create a sustainable and replicable model of integrated care for HIV-positive, geographically dispersed residents.

Published
2003

36. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980–2016: a systematic analysis for the Global Burden of Disease Study 2016

Author

Naghavi, Mohsen, Abajobir, Amanuel Alemu, Abbafati, Cristiana, Abbas, Kaja M., Abd-Allah, Foad, Abera, Semaw Ferede, Aboyans, Victor, Adetokunboh, Olatunji, Arnlov, Johan, Afshin, Ashkan, Agrawal, Anurag, Kiadaliri, Aliasghar Ahmad, Ahmadi, Alireza, Ahmed, Muktar Beshir, Aichour, Amani Nidhal, Aichour, Ibtihel, Aichour, Miloud Taki Eddine, Aiyar, Sneha, Al-Eyadhy, Ayman, Alahdab, Fares, Al-Aly, Ziyad, Alam, Khurshid, Alam, Noore, Alam, Tahiya, Alene, Kefyalew Addis, Ali, Syed Danish, Alizadeh-Navaei, Reza, Alkaabi, Juma M., Alkerwi, Ala'a, Alla, Francois, Allebeck, Peter, Allen, Christine, Al-Raddadi, Rajaa, Alsharif, Ubai, Altirkawi, Khalid A., Alvis-Guzman, Nelson, Amare, Azmeraw T., Amini, Erfan, Ammar, Walid, Amoako, Yaw Ampem, Anber, Nahla, Andersen, Hjalte H., Andrei, Catalina Liliana, Androudi, Sofia, Ansari, Hossein, Antonio, Carl Abelardo T., Anwari, Palwasha, Arora, Megha, Artaman, Al, Aryal, Krishna Kumar, Asayesh, Hamid, Asgedom, Solomon W., Atey, Tesfay Mehari, Avila-Burgos, Leticia, Avokpaho, Euripide Frinel G. Arthur, Awasthi, Ashish, Paulina, Beatriz, Quintanilla, Ayala, Bejot, Yannick, Babalola, Tesleem Kayode, Bacha, Umar, Balakrishnan, Kalpana, Barac, Aleksandra, Barboza, Miguel A., Barker-Collo, Suzanne L., Barquera, Simon, Barregard, Lars, Barrero, Lope H., Baune, Bernhard T., Bedi, Neeraj, Beghi, Ettore, Bekele, Bayu Begashaw, Bell, Michelle L., Bennett, James R., Bensenor, Isabela M., Berhane, Adugnaw, Bernabe, Eduardo, Betsu, Balem Demtsu, Beuran, Mircea, Bhatt, Samir, Biadgilign, Sibhatu, Bienhoff, Kelly, Bikbov, Boris, Bisanzio, Donal, Bourne, Rupert R. A., Breitborde, Nicholas J. K., Negesa, Lemma, Bulto, Bulto, Bumgarner, Blair R., Butt, Zahid A., Cardenas, Rosario, Cahuana-Hurtado, Lucero, Cameron, Ewan, Cesar Campuzano, Julio, Car, Josip, Jesus Carrero, Juan, Carter, Austin, Casey, Daniel C., Castaneda-Orjuela, Carlos A., Catala-Lopez, Ferran, Charlson, Fiona J., Chibueze, Chioma Ezinne, Chimed-Ochir, Odgerel, Chisumpa, Vesper Hichilombwe, Chitheer, Abdulaal A., Christopher, Devasahayam Jesudas, Ciobanu, Liliana G., Cirillo, Massimo, Cohen, Aaron J., Colombara, Danny, Cooper, Cyrus, Cowie, Benjamin C., Criqui, Michael H., Dandona, Lalit, Dandona, Rakhi, Dargan, Paul I., das Neves, Jose, Davitoiu, Dragos V., Davletov, Kairat, de Courten, Barbora, Degenhardt, Louisa, Deiparine, Selina, Deribe, Kebede, Deribew, Amare, Dey, Subhojit, Dicker, Daniel, Ding, Eric L., Djalalinia, Shirin, Huyen Phuc Do, Huyen Phuc Do, Doku, David Teye, Douwes-Schultz, Dirk, Driscoll, Tim R., Dubey, Manisha, Duncan, Bruce Bartholow, Echko, Michelle, El-Khatib, Ziad Ziad, Ellingsen, Christian Lycke, Enayati, Ahmadali, Erskine, Holly E., Eskandarieh, Sharareh, Esteghamati, Alireza, Ermakov, Sergey P., Estep, Kara, E Sa Farinha, Carla Sofia, Faro, Andre, Farzadfar, Farshad, Feigin, Valery L., Fereshtehnejad, Seyed-Mohammad, Fernandes, Joao C., Ferrari, Alize J., Feyissa, Tesfaye Regassa, Filip, Irina, Finegold, Samuel, Fischer, Florian, Fitzmaurice, Christina, Flaxman, Abraham D., Foigt, Nataliya, Frank, Tahvi, Fraser, Maya, Fullman, Nancy, Furst, Thomas, Furtado, Joao M., Gakidou, Emmanuela, Garcia-Basteiro, Alberto L., Gebre, Teshome, Gebregergs, Gebremedhin Berhe, Gebrehiwot, Tsegaye Tewelde, Gebremichael, Delelegn Yilma, Geleijnse, Johanna M., Genova-Maleras, Ricard, Gesesew, Hailay Abrha, Gething, Peter W., Gillum, Richard F., Ginawi, Ibrahim Abdelmageem Mohamed, Giref, Ababi Zergaw, Giroud, Maurice, Giussani, Giorgia, Godwin, William W., Gold, Audra L., Goldberg, Ellen M., Gona, Philimon N., Gopalani, Sameer Vali, Gouda, Hebe N., Goulart, Alessandra Carvalho, Griswold, Max, Gupta, Prakash C., Gupta, Rajeev, Gupta, Tanush, Gupta, Vipin, Haagsma, Juanita A., Hafezi-Nejad, Nima, Hailu, Alemayehu Desalegne, Hailu, Gessessew Bugssa, Hamadeh, Randah Ribhi, Hambisa, Mitiku Teshome, Hamidi, Samer, Hammami, Mouhanad, Hancock, Jamie, Handal, Alexis J., Hankey, Graeme J., Hao, Yuantao, Harb, Hilda L., Hareri, Habtamu Abera, Hassanvand, Mohammad Sadegh, Havmoeller, Rasmus, Hay, Simon I., He, Fei, Hedayati, Mohammad T., Henry, Nathaniel J., Beatriz Heredia-Pi, Ileana, Herteliu, Claudiu, Hoek, Hans W., Horino, Masako, Horita, Nobuyuki, Hosgood, H. Dean, Hostiuc, Sorin, Hotez, Peter J., Hoy, Damian G., Huynh, Chantal, Iburg, Kim Moesgaard, Ikeda, Chad, Ileanu, Bogdan Vasile, Irenso, Asnake Ararsa, Irvine, Caleb Mackay Salpeter, Jurisson, Mikk, Jacobsen, Kathryn H., Jahanmehr, Nader, Jakovljevic, Mihajlo B., Javanbakht, Mehdi, Jayaraman, Sudha P., Jeemon, Panniyammakal, Jha, Vivekanand, John, Denny, Johnson, Catherine O., Johnson, Sarah Charlotte, Jonas, Jost B., Kabir, Zubair, Kadel, Rajendra, Kahsay, Amaha, Kamal, Ritul, Karch, Andre, Karimi, Seyed M., Karimkhani, Chante, Kasaeian, Amir, Kassaw, Nigussie Assefa, Kassebaum, Nicholas J., Katikireddi, Srinivasa Vittal, Kawakami, Norito, Keiyoro, Peter Njenga, Kemmer, Laura, Kesavachandran, Chandrasekharan Nair, Khader, Yousef Saleh, Khan, Ejaz Ahmad, Khang, Young-Ho, Khoja, Abdullah Tawfih Abdullah, Khosravi, Ardeshir, Khosravi, Mohammad Hossein, Khubchandani, Jagdish, Kieling, Christian, Kievlan, Daniel, Kim, Daniel, Kim, Yun Jin, Kimokoti, Ruth W., Kinfu, Yohannes, Kissoon, Niranjan, Kivimaki, Mika, Knudsen, Ann Kristin, Kopec, Jacek A., Kosen, Soewarta, Koul, Parvaiz A., Koyanagi, Ai, Defo, Barthelemy Kuate, Kulikoff, Xie Rachel, Kumar, G. Anil, Kumar, Pushpendra, Kutz, Michael, Kyu, Hmwe H., Lal, Dharmesh Kumar, Lalloo, Ratilal, Lallukka, Tea, Lambert, Nkurunziza, Lan, Qing, Lansingh, Van C., Larsson, Anders, Lee, Paul H., Leigh, James, Leung, Janni, Levi, Miriam, Li, Yongmei, Kappe, Darya Li, Liang, Xiaofeng, Liben, Misgan Legesse, Lim, Stephen S., Liu, Angela, Liu, Patrick Y., Liu, Yang, Lodha, Rakesh, Logroscino, Giancarlo, Lorkowski, Stefan, Lotufo, Paulo A., Lozano, Rafael, Lucas, Timothy C. D., Ma, Stefan, Macarayan, Erlyn Rachelle King, Maddison, Emilie R., Abd el Razek, Mohammed Magdy, Majdan, Marek, Majdzadeh, Reza, Majeed, Azeem, Malekzadeh, Reza, Malhotra, Rajesh, Malta, Deborah Carvalho, Manguerra, Helena, Manyazewal, Tsegahun, Mapoma, Chabila C., Marczak, Laurie B., Markos, Desalegn, Martinez-Raga, Jose, Martins-Melo, Francisco Rogerlandio, Martopullo, Ira, McAlinden, Colm, McGaughey, Madeline, McGrath, John J., Mehata, Suresh, Meier, Toni, Meles, Kidanu Gebremariam, Memiah, Peter, Memish, Ziad A., Mengesha, Melkamu Merid, Mengistu, Desalegn Tadese, Menota, Bereket Gebremichael, Mensah, George A., Meretoja, Atte, Meretoja, Tuomo J., Millear, Anoushka, Miller, Ted R., Minnig, Shawn, Mirarefin, Mojde, Mirrakhimov, Erkin M., Misganaw, Awoke, Mishra, Shiva Raj, Mohammad, Karzan Abdulmuhsin, Mohammadi, Alireza, Mohammed, Shafiu, Mokdad, Ali H., Mola, Glen Liddell D., Mollenkopf, Sarah K., Molokhia, Mariam, Monasta, Lorenzo, Montanez Hernandez, Julio C., Montico, Marcella, Mooney, Meghan D., Moradi-Lakeh, Maziar, Moraga, Paula, Morawska, Lidia, Morrison, Shane D., Morozoff, Chloe, Mountjoy-Venning, Cliff, Mruts, Kalayu Birhane, Muller, Kate, Murthy, Gudlavalleti Venkata Satyanarayana, Musa, Kamarul Imran, Nachega, Jean B., Naheed, Aliya, Naldi, Luigi, Nangia, Vinay, Nascimento, Bruno Ramos, Nasher, Jamal T., Natarajan, Gopalakrishnan, Negoi, Ionut, Ngunjiri, Josephine Wanjiku, Cuong Tat Nguyen, Cuong Tat Nguyen, Grant Nguyen, Grant Nguyen, Minh Nguyen, Minh Nguyen, Quyen Le Nguyen, Quyen Le Nguyen, Trang Huyen Nguyen, Trang Huyen Nguyen, Nichols, Emma, Ningrum, Dina Nur Anggraini, Vuong Minh Nong, Vuong Minh Nong, Noubiap, Jean Jacques N., Ogbo, Felix Akpojene, Oh, In-Hwan, Okoro, Anselm, Olagunju, Andrew Toyin, Olsen, Helen E., Olusanya, Bolajoko Olubukunola, Olusanya, Jacob Olusegun, Ong, Kanyin, Opio, John Nelson, Oren, Eyal, Ortiz, Alberto, Osman, Majdi, Ota, Erika, Pa, Mahesh, Pacella, Rosana E., Pakhale, Smita, Pana, Adrian, Panda, Basant Kumar, Panda-Jonas, Songhomitra, Papachristou, Christina, Park, Eun-Kee, Patten, Scott B., Patton, George C., Paudel, Deepak, Paulson, Katherine, Pereira, David M., Perez-Ruiz, Fernando, Perico, Norberto, Pervaiz, Aslam, Petzold, Max, Phillips, Michael Robert, Pigott, David M., Pinho, Christine, Plass, Dietrich, Pletcher, Martin A., Polinder, Suzanne, Postma, Maarten J., Pourmalek, Farshad, Purcell, Caroline, Qorbani, Mostafa, Radfar, Amir, Rafay, Anwar, Rahimi-Movaghar, Vafa, Rahman, Mahfuzar, Rahman, Mohammad Hifz Ur, Rai, Rajesh Kumar, Ranabhat, Chhabi Lal, Rankin, Zane, Rao, Puja C., Rath, Goura Kishor, Rawaf, Salman, Ray, Sarah E., Rehm, Jurgen, Reiner, Robert C., Reitsma, Marissa B., Remuzzi, Giuseppe, Rezaei, Satar, Rezai, Mohammad Sadegh, Rokni, Mohammad Bagher, Ronfani, Luca, Roshandel, Gholamreza, Roth, Gregory A., Rothenbacher, Dietrich, Ruhago, George Mugambage, Saadat, Rizwan S. A. Soheil, Sachdev, Perminder S., Sadat, Nafis, Safdarian, Mahdi, Safi, Sare, Safiri, Saeid, Sagar, Rajesh, Sahathevan, Ramesh, Salama, Joseph, Salamati, Payman, Salomon, Joshua A., Samy, Abdallah M., Sanabria, Juan Ramon, Dolores Sanchez-Nino, Maria, Santomauro, Damian, Santos, Itamar S., Milicevic, Milena M. Santric, Sartorius, Benn, Satpathy, Maheswar, Shahraz, Saeid, Schmidt, Maria Ines, Schneider, Ione J. C., Schulhofer-Wohl, Sam, Schutte, Aletta E., Schwebel, David C., Schwendicke, Falk, Sepanlou, Sadaf G., Servan-Mori, Edson E., Shackelford, Katya Anne, Shaikh, Masood Ali, Shamsipour, Mansour, Shamsizadeh, Morteza, Islam, Sheikh Mohammed Shariful, Sharma, Jayendra, Sharma, Rajesh, She, Jun, Sheikhbahaei, Sara, Shey, Muki, Shi, Peilin, Shields, Chloe, Shigematsu, Mika, Shiri, Rahman, Shirude, Shreya, Shiue, Ivy, Shoman, Haitham, Shrime, Mark G., Sigfusdottir, Inga Dora, Silpakit, Naris, Silva, Joao Pedro, Singh, Abhishek, Singh, Jasvinder A., Skiadaresi, Eirini, Sligar, Amber, Smith, Alison, Smith, David L., Smith, Mari, Sobaih, Badr H. A., Soneji, Samir, Sorensen, Reed J. D., Soriano, Joan B., Sreeramareddy, Chandrashekhar T., Srinivasan, Vinay, Stanaway, Jeffrey D., Stathopoulou, Vasiliki, Steel, Nicholas, Stein, Dan J., Steiner, Caitlyn, Steinke, Sabine, Stokes, Mark Andrew, Strong, Mark, Strub, Bryan, Subart, Michelle, Sufiyan, Muawiyyah Babale, Sunguya, Bruno F., Sur, Patrick J., Swaminathan, Soumya, Sykes, Bryan L., Tabares-Seisdedos, Rafael, Tadakamadla, Santosh Kumar, Takahashi, Ken, Takala, Jukka S., Talongwa, Roberto Tchio, Tarawneh, Mohammed Rasoul, Tavakkoli, Mohammad, Taveira, Nuno, Tegegne, Teketo Kassaw, Tehrani-Banihashemi, Arash, Temsah, Mohamad-Hani, Terkawi, Abdullah Sulieman, Thakur, J. S., Thamsuwan, Ornwipa, Thankappan, Kavumpurathu Raman, Thomas, Katie E., Thompson, Alex H., Thomson, Alan J., Thrift, Amanda G., Tobe-Gai, Ruoyan, Topor-Madry, Roman, Torre, Anna, Tortajada, Miguel, Towbin, Jeffrey Allen, Bach Xuan Tran, Bach Xuan Tran, Troeger, Christopher, Truelsen, Thomas, Tsoi, Derrick, Tuzcu, Emin Murat, Tyrovolas, Stefanos, Ukwaja, Kingsley N., Undurraga, Eduardo A., Updike, Rachel, Uthman, Olalekan A., Uzochukwu, Benjamin S. Chudi, van Boven, Job F. M., Vasankari, Tommi, Venketasubramanian, Narayanaswamy, Violante, Francesco S., Vlassov, Vasiliy Victorovich, Vollset, Stein Emil, Vos, Theo, Wakayo, Tolassa, Wallin, Mitchell T., Wang, Yuan-Pang, Weiderpass, Elisabete, Weintraub, Robert G., Weiss, Daniel J., Werdecker, Andrea, Westerman, Ronny, Whetter, Brian, Whiteford, Harvey A., Wijeratne, Tissa, Wiysonge, Charles Shey, Woldeyes, Belete Getahun, Wolfe, Charles D. A., Woodbrook, Rachel, Workicho, Abdulhalik, Xavier, Denis, Xiao, Qingyang, Xu, Gelin, Yaghoubi, Mohsen, Yakob, Bereket, Yano, Yuichiro, Yaseri, Mehdi, Yimam, Hassen Hamid, Yonemoto, Naohiro, Yoon, Seok-Jun, Yotebieng, Marcel, Younis, Mustafa Z., Zaidi, Zoubida, Zaki, Maysaa El Sayed, Zegeye, Elias Asfaw, Zenebe, Zerihun Menlkalew, Zerfu, Taddese Alemu, Zhang, Anthony Lin, Zhang, Xueying, Zipkin, Ben, Zodpey, Sanjay, Lopez, Alan D., Murray, Christopher J. L., Abajobir, Amanuel Alemu, Abbafati, Cristiana, Abbas, Kaja M, Abd-Allah, Foad, Abera, Semaw Ferede, Aboyans, Victor, Adetokunboh, Olatunji, Afshin, Ashkan, Agrawal, Anurag, Ahmadi, Alireza, Ahmed, Muktar Beshir, Aichour, Amani Nidhal, Aichour, Miloud Taki Eddine, Aichour, Ibtihel, Aiyar, Sneha, Alahdab, Fare, Al-Aly, Ziyad, Alam, Khurshid, Alam, Noore, Alam, Tahiya, Alene, Kefyalew Addi, Al-Eyadhy, Ayman, Ali, Syed Danish, Alizadeh-Navaei, Reza, Alkaabi, Juma M, Alkerwi, Ala'a, Alla, Françoi, Allebeck, Peter, Allen, Christine, Al-Raddadi, Rajaa, Alsharif, Ubai, Altirkawi, Khalid A, Alvis-Guzman, Nelson, Amare, Azmeraw T, Amini, Erfan, Ammar, Walid, Amoako, Yaw Ampem, Anber, Nahla, Andersen, Hjalte H, Andrei, Catalina Liliana, Androudi, Sofia, Ansari, Hossein, Antonio, Carl Abelardo T, Anwari, Palwasha, Ärnlöv, Johan, Arora, Megha, Artaman, Al, Aryal, Krishna Kumar, Asayesh, Hamid, Asgedom, Solomon W, Atey, Tesfay Mehari, Avila-Burgos, Leticia, Avokpaho, Euripide Frinel G, Awasthi, Ashish, Babalola, Tesleem Kayode, Bacha, Umar, Balakrishnan, Kalpana, Barac, Aleksandra, Barboza, Miguel A, Barker-Collo, Suzanne L, Barquera, Simon, Barregard, Lar, Barrero, Lope H, Baune, Bernhard T, Bedi, Neeraj, Beghi, Ettore, Béjot, Yannick, Bekele, Bayu Begashaw, Bell, Michelle L, Bennett, James R, Bensenor, Isabela M, Berhane, Adugnaw, Bernabé, Eduardo, Betsu, Balem Demtsu, Beuran, Mircea, Bhatt, Samir, Biadgilign, Sibhatu, Bienhoff, Kelly, Bikbov, Bori, Bisanzio, Donal, Bourne, Rupert R A, Breitborde, Nicholas J K, Bulto, Lemma Negesa Bulto, Bumgarner, Blair R, Butt, Zahid A, Cahuana-Hurtado, Lucero, Cameron, Ewan, Campuzano, Julio Cesar, Car, Josip, Cárdenas, Rosario, Carrero, Juan Jesu, Carter, Austin, Casey, Daniel C, Castañeda-Orjuela, Carlos A, Catalá-López, Ferrán, Charlson, Fiona J, Chibueze, Chioma Ezinne, Chimed-Ochir, Odgerel, Chisumpa, Vesper Hichilombwe, Chitheer, Abdulaal A, Christopher, Devasahayam Jesuda, Ciobanu, Liliana G, Cirillo, Massimo, Cohen, Aaron J, Colombara, Danny, Cooper, Cyru, Cowie, Benjamin C, Criqui, Michael H, Dandona, Lalit, Dandona, Rakhi, Dargan, Paul I, das Neves, José, Davitoiu, Dragos V, Davletov, Kairat, de Courten, Barbora, Defo, Barthelemy Kuate, Degenhardt, Louisa, Deiparine, Selina, Deribe, Kebede, Deribew, Amare, Dey, Subhojit, Dicker, Daniel, Ding, Eric L, Djalalinia, Shirin, Do, Huyen Phuc, Doku, David Teye, Douwes-Schultz, Dirk, Driscoll, Tim R, Dubey, Manisha, Duncan, Bruce Bartholow, Echko, Michelle, El-Khatib, Ziad Ziad, Ellingsen, Christian Lycke, Enayati, Ahmadali, Erskine, Holly E, Eskandarieh, Sharareh, Esteghamati, Alireza, Estep, Kara, Farinha, Carla Sofia e Sa, Faro, André, Farzadfar, Farshad, Feigin, Valery L, Fereshtehnejad, Seyed-Mohammad, Fernandes, João C, Ferrari, Alize J, Feyissa, Tesfaye Regassa, Filip, Irina, Finegold, Samuel, Fischer, Florian, Fitzmaurice, Christina, Flaxman, Abraham D, Foigt, Nataliya, Frank, Tahvi, Fraser, Maya, Fullman, Nancy, Fürst, Thoma, Furtado, Joao M, Gakidou, Emmanuela, Garcia-Basteiro, Alberto L, Gebre, Teshome, Gebregergs, Gebremedhin Berhe, Gebrehiwot, Tsegaye Tewelde, Gebremichael, Delelegn Yilma, Geleijnse, Johanna M, Genova-Maleras, Ricard, Gesesew, Hailay Abrha, Gething, Peter W, Gillum, Richard F, Giroud, Maurice, Giussani, Giorgia, Godwin, William W, Gold, Audra L, Goldberg, Ellen M, Gona, Philimon N, Gopalani, Sameer Vali, Gouda, Hebe N, Goulart, Alessandra Carvalho, Griswold, Max, Gupta, Rajeev, Gupta, Tanush, Gupta, Vipin, Haagsma, Juanita A, Hafezi-Nejad, Nima, Hailu, Alemayehu Desalegne, Hailu, Gessessew Bugssa, Hamadeh, Randah Ribhi, Hambisa, Mitiku Teshome, Hamidi, Samer, Hammami, Mouhanad, Hancock, Jamie, Handal, Alexis J, Hankey, Graeme J, Hao, Yuantao, Harb, Hilda L, Hareri, Habtamu Abera, Hassanvand, Mohammad Sadegh, Havmoeller, Rasmu, Hay, Simon I, He, Fei, Hedayati, Mohammad T, Henry, Nathaniel J, Heredia-Pi, Ileana Beatriz, Herteliu, Claudiu, Hoek, Hans W, Horino, Masako, Horita, Nobuyuki, Hosgood, H Dean, Hostiuc, Sorin, Hotez, Peter J, Hoy, Damian G, Huynh, Chantal, Iburg, Kim Moesgaard, Ikeda, Chad, Ileanu, Bogdan Vasile, Irenso, Asnake Ararsa, Irvine, Caleb Mackay Salpeter, Islam, Sheikh Mohammed Shariful, Jacobsen, Kathryn H, Jahanmehr, Nader, Jakovljevic, Mihajlo B, Javanbakht, Mehdi, Jayaraman, Sudha P, Jeemon, Panniyammakal, Jha, Vivekanand, John, Denny, Johnson, Catherine O, Johnson, Sarah Charlotte, Jonas, Jost B, Jürisson, Mikk, Kabir, Zubair, Kadel, Rajendra, Kahsay, Amaha, Kamal, Ritul, Karch, André, Karimi, Seyed M, Karimkhani, Chante, Kasaeian, Amir, Kassaw, Nigussie Assefa, Kassebaum, Nicholas J, Katikireddi, Srinivasa Vittal, Kawakami, Norito, Keiyoro, Peter Njenga, Kemmer, Laura, Kesavachandran, Chandrasekharan Nair, Khader, Yousef Saleh, Khan, Ejaz Ahmad, Khang, Young-Ho, Khoja, Abdullah Tawfih Abdullah, Khosravi, Mohammad Hossein, Khosravi, Ardeshir, Khubchandani, Jagdish, Kiadaliri, Aliasghar Ahmad, Kieling, Christian, Kievlan, Daniel, Kim, Yun Jin, Kim, Daniel, Kimokoti, Ruth W, Kinfu, Yohanne, Kissoon, Niranjan, Kivimaki, Mika, Knudsen, Ann Kristin, Kopec, Jacek A, Kosen, Soewarta, Koul, Parvaiz A, Koyanagi, Ai, Kulikoff, Xie Rachel, Kumar, G Anil, Kumar, Pushpendra, Kutz, Michael, Kyu, Hmwe H, Lal, Dharmesh Kumar, Lalloo, Ratilal, Lambert, Tea Lallukka Nkurunziza, Lan, Qing, Lansingh, Van C, Larsson, Ander, Lee, Paul H, Leigh, Jame, Leung, Janni, Levi, Miriam, Li, Yongmei, Li Kappe, Darya, Liang, Xiaofeng, Liben, Misgan Legesse, Lim, Stephen S, Liu, Patrick Y, Liu, Angela, Liu, Yang, Lodha, Rakesh, Logroscino, Giancarlo, Lopez, Alan D, Lorkowski, Stefan, Lotufo, Paulo A, Lozano, Rafael, Lucas, Timothy C D, Ma, Stefan, Macarayan, Erlyn Rachelle King, Maddison, Emilie R, Magdy Abd El Razek, Mohammed, Majdan, Marek, Majdzadeh, Reza, Majeed, Azeem, Malekzadeh, Reza, Malhotra, Rajesh, Malta, Deborah Carvalho, Manguerra, Helena, Manyazewal, Tsegahun, Mapoma, Chabila C, Marczak, Laurie B, Markos, Desalegn, Martinez-Raga, Jose, Martins-Melo, Francisco Rogerlândio, Martopullo, Ira, McAlinden, Colm, McGaughey, Madeline, McGrath, John J, Mehata, Suresh, Meier, Toni, Meles, Kidanu Gebremariam, Memiah, Peter, Memish, Ziad A, Mengesha, Melkamu Merid, Mengistu, Desalegn Tadese, Menota, Bereket Gebremichael, Mensah, George A, Meretoja, Tuomo J, Meretoja, Atte, Millear, Anoushka, Miller, Ted R, Minnig, Shawn, Mirarefin, Mojde, Mirrakhimov, Erkin M, Misganaw, Awoke, Mishra, Shiva Raj, Mohamed, Ibrahim Abdelmageem, Mohammad, Karzan Abdulmuhsin, Mohammadi, Alireza, Mohammed, Shafiu, Mokdad, Ali H, Mola, Glen Liddell D, Mollenkopf, Sarah K, Molokhia, Mariam, Monasta, Lorenzo, Montañez, Julio C, Montico, Marcella, Mooney, Meghan D, Moradi-Lakeh, Maziar, Moraga, Paula, Morawska, Lidia, Morozoff, Chloe, Morrison, Shane D, Mountjoy-Venning, Cliff, Mruts, Kalayu Birhane, Muller, Kate, Murray, Christopher J L, Murthy, Gudlavalleti Venkata Satyanarayana, Musa, Kamarul Imran, Nachega, Jean B, Naghavi, Mohsen, Naheed, Aliya, Naldi, Luigi, Nangia, Vinay, Nascimento, Bruno Ramo, Nasher, Jamal T, Natarajan, Gopalakrishnan, Negoi, Ionut, Ngunjiri, Josephine Wanjiku, Nguyen, Cuong Tat, Nguyen, Quyen Le, Nguyen, Trang Huyen, Nguyen, Grant, Nguyen, Minh, Nichols, Emma, Ningrum, Dina Nur Anggraini, Nong, Vuong Minh, Noubiap, Jean Jacques N, Ogbo, Felix Akpojene, Oh, In-Hwan, Okoro, Anselm, Olagunju, Andrew Toyin, Olsen, Helen E, Olusanya, Bolajoko Olubukunola, Olusanya, Jacob Olusegun, Ong, Kanyin, Opio, John Nelson, Oren, Eyal, Ortiz, Alberto, Osman, Majdi, Ota, Erika, PA, Mahesh, Pacella, Rosana E, Pakhale, Smita, Pana, Adrian, Panda, Basant Kumar, Panda-Jonas, Songhomitra, Papachristou, Christina, Park, Eun-Kee, Patten, Scott B, Patton, George C, Paudel, Deepak, Paulson, Katherine, Pereira, David M, Perez-Ruiz, Fernando, Perico, Norberto, Pervaiz, Aslam, Petzold, Max, Phillips, Michael Robert, Pigott, David M, Pinho, Christine, Plass, Dietrich, Pletcher, Martin A, Polinder, Suzanne, Postma, Maarten J, Pourmalek, Farshad, Purcell, Caroline, Qorbani, Mostafa, Quintanilla, Beatriz Paulina Ayala, Radfar, Amir, Rahimi-Movaghar, Vafa, Rahman, Mohammad Hifz Ur, Rahman, Mahfuzar, Rai, Rajesh Kumar, Ranabhat, Chhabi Lal, Rankin, Zane, Rao, Puja C, Rath, Goura Kishor, Rawaf, Salman, Ray, Sarah E, Rehm, Jürgen, Reiner, Robert C, Reitsma, Marissa B, Remuzzi, Giuseppe, Rezaei, Satar, Rezai, Mohammad Sadegh, Rokni, Mohammad Bagher, Ronfani, Luca, Roshandel, Gholamreza, Roth, Gregory A, Rothenbacher, Dietrich, Ruhago, George Mugambage, SA, Rizwan, Saadat, Soheil, Sachdev, Perminder S, Sadat, Nafi, Safdarian, Mahdi, Safi, Sare, Safiri, Saeid, Sagar, Rajesh, Sahathevan, Ramesh, Salama, Joseph, Salamati, Payman, Salomon, Joshua A, Samy, Abdallah M, Sanabria, Juan Ramon, Sanchez-Niño, Maria Dolore, Santomauro, Damian, Santos, Itamar S, Santric Milicevic, Milena M, Sartorius, Benn, Satpathy, Maheswar, Schmidt, Maria Inê, Schneider, Ione J C, Schulhofer-Wohl, Sam, Schutte, Aletta E, Schwebel, David C, Schwendicke, Falk, Sepanlou, Sadaf G, Servan-Mori, Edson E, Shackelford, Katya Anne, Shahraz, Saeid, Shaikh, Masood Ali, Shamsipour, Mansour, Shamsizadeh, Morteza, Sharma, Jayendra, Sharma, Rajesh, She, Jun, Sheikhbahaei, Sara, Shey, Muki, Shields, Chloe, Shigematsu, Mika, Shiri, Rahman, Shirude, Shreya, Shiue, Ivy, Shoman, Haitham, Shrime, Mark G, Sigfusdottir, Inga Dora, Silpakit, Nari, Silva, João Pedro, Singh, Jasvinder A, Singh, Abhishek, Skiadaresi, Eirini, Sligar, Amber, Smith, David L, Smith, Alison, Smith, Mari, Sobaih, Badr H A, Soneji, Samir, Sorensen, Reed J D, Soriano, Joan B, Sreeramareddy, Chandrashekhar T, Srinivasan, Vinay, Stanaway, Jeffrey D, Stathopoulou, Vasiliki, Steel, Nichola, Stein, Dan J, Steiner, Caitlyn, Steinke, Sabine, Stokes, Mark Andrew, Strong, Mark, Strub, Bryan, Subart, Michelle, Sufiyan, Muawiyyah Babale, Sunguya, Bruno F, Sur, Patrick J, Swaminathan, Soumya, Sykes, Bryan L, Tabarés-Seisdedos, Rafael, Tadakamadla, Santosh Kumar, Takahashi, Ken, Takala, Jukka S, Talongwa, Roberto Tchio, Tarawneh, Mohammed Rasoul, Tavakkoli, Mohammad, Taveira, Nuno, Tegegne, Teketo Kassaw, Tehrani-Banihashemi, Arash, Temsah, Mohamad-Hani, Terkawi, Abdullah Sulieman, Thakur, J.S., Thamsuwan, Ornwipa, Thankappan, Kavumpurathu Raman, Thomas, Katie E, Thompson, Alex H, Thomson, Alan J, Thrift, Amanda G, Tobe-Gai, Ruoyan, Topor-Madry, Roman, Torre, Anna, Tortajada, Miguel, Towbin, Jeffrey Allen, Tran, Bach Xuan, Troeger, Christopher, Truelsen, Thoma, Tsoi, Derrick, Tyrovolas, Stefano, Ukwaja, Kingsley N, Undurraga, Eduardo A, Updike, Rachel, Uthman, Olalekan A, Uzochukwu, Benjamin S Chudi, van Boven, Job F M, Vasankari, Tommi, Venketasubramanian, Narayanaswamy, Violante, Francesco S, Vlassov, Vasiliy Victorovich, Vollset, Stein Emil, Vos, Theo, Wakayo, Tolassa, Wallin, Mitchell T, Wang, Yuan-Pang, Weiderpass, Elisabete, Weintraub, Robert G, Weiss, Daniel J, Werdecker, Andrea, Westerman, Ronny, Whetter, Brian, Whiteford, Harvey A, Wijeratne, Tissa, Wiysonge, Charles Shey, Woldeyes, Belete Getahun, Wolfe, Charles D A, Woodbrook, Rachel, Workicho, Abdulhalik, Xavier, Deni, Xiao, Qingyang, Xu, Gelin, Yaghoubi, Mohsen, Yakob, Bereket, Yano, Yuichiro, Yaseri, Mehdi, Yimam, Hassen Hamid, Yonemoto, Naohiro, Yoon, Seok-Jun, Yotebieng, Marcel, Younis, Mustafa Z, Zaidi, Zoubida, Zaki, Maysaa El Sayed, Zegeye, Elias Asfaw, Zenebe, Zerihun Menlkalew, Zerfu, Taddese Alemu, Zhang, Anthony Lin, Zhang, Xueying, Zipkin, Ben, Zodpey, Sanjay, Giref, Ababi Zergaw, Rafay, Anwar, Tuzcu, Emin Murat, Ermakov, Sergey Petrovich, Shi, Peilin, Gupta, Parkash C, Erasmus MC other, Public Health, Neurosciences, Viðskiptadeild (HR), School of Business (RU), Háskólinn í Reykjavík, Reykjavik University, Mohsen, Naghavi, Amanuel, Alemu, Abajobir, Cristiana, Abbafati, Kaja, M, Abbas, Foad, Abd Allah, Semaw, Ferede, Abera, Victor, Aboyan, Olatunji, Adetokunboh, Johan, Ärnlöv, Ashkan, Afshin, Anurag, Agrawal, Aliasghar, Ahmad, Kiadaliri, Alireza, Ahmadi, Muktar, Beshir, Ahmed, Amani, Nidhal, Aichour, Ibtihel, Aichour, Miloud, Taki, Eddine, Aichour, Sneha, Aiyar, Ayman, Al Eyadhy, Fares, Alahdab, Ziyad, Al Aly, Khurshid, Alam, Noore, Alam, Tahiya, Alam, Kefyalew, Addi, Alene, Syed, Danish, Ali, Reza, Alizadeh Navaei, Juma, M, Alkaabi, Ala’A, Alkerwi, François, Alla, Peter, Allebeck, Christine, Allen, Rajaa, Al Raddadi, Ubai, Alsharif, Khalid, A, Altirkawi, Nelson, Alvis Guzman, Azmeraw, T, Amare, Erfan, Amini, Walid, Ammar, Yaw, Ampem, Amoako, Nahla, Anber, Hjalte, H, Andersen, Catalina, Liliana, Andrei, Sofia, Androudi, Hossein, Ansari, Carl, Abelardo, T, Antonio, Palwasha, Anwari, Megha, Arora, Al, Artaman, Krishna, Kumar, Aryal, Hamid, Asayesh, Solomon, W, Asgedom, Tesfay, Mehari, Atey, Leticia, Avila Burgo, Euripide, Frinel, G, Arthur, Avokpaho, Ashish, Awasthi, Beatriz, Paulina, Ayala, Quintanilla, Yannick, Béjot, Tesleem, Kayode, Babalola, Umar, Bacha, Kalpana, Balakrishnan, Aleksandra, Barac, Miguel, A, Barboza, Suzanne, L, Barker, Collo, Simon, Barquera, Lars, Barregard, Lope, H, Barrero, Bernhard, T, Baune, Neeraj, Bedi, Ettore, Beghi, Bayu, Begashaw, Bekele, Michelle, L, Bell, James, R, Bennett, Isabela, M, Bensenor, Adugnaw, Berhane, Eduardo, Bernabé, Balem, Demtsu, Betsu, Mircea, Beuran, Samir, Bhatt, Sibhatu, Biadgilign, Kelly, Bienhoff, Boris, Bikbov, Donal, Bisanzio, Rupert, R, A, Bourne, Nicholas, J, K, Breitborde, Lemma, Negesa, Bulto, Bulto, Blair, R, Bumgarner, Zahid, A, Butt, Rosario, Cárdena, Lucero, Cahuana Hurtado, Ewan, Cameron, Julio, Cesar, Campuzano, Josip, Car, Juan, Jesu, Carrero, Austin, Carter, Daniel, C, Casey, Carlo, A, Castañeda, Orjuela, Ferrán, Catalá López, Fiona, J, Charlson, Chioma, Ezinne, Chibueze, Odgerel, Chimed Ochir, Vesper, Hichilombwe, Chisumpa, Abdulaal, A, Chitheer, Devasahayam, Jesuda, Christopher, Liliana, G, Ciobanu, Aaron, J, and Cohen

Subjects
Dánarmein, Male, Heilsufar, Dánartíðni, Newborn infants, Lífslíkur, Life expectancy, Communicable diseases, Global Health, Global Burden of Disease, Disasters, Pregnancy, Cause of Death, Psychology, Child, Konur, Aged, 80 and over, Ungbörn, CLIMATE-CHANGE, PLASMODIUM-FALCIPARUM, Kransæðasjúkdómar, Global burden of disease/statistics and numerical data, Medicine (all), Men, Þjóðir, Öndunarfærasjúkdómar, 11 Medical And Health Sciences, Middle Aged, Nutrition Disorders, PREVALENCE, Coronary heart disease, Smitsjúkdómar, Death, Suicide, Cardiovascular diseases, Sálfræði, World health, Child, Preschool, Nýburar, Female, GBD, mortality, Infants, Life Sciences & Biomedicine, Age distribution, Global Health Metrics, Adult, Diarrhea, AFRICA, HUMAN HEALTH, Adolescent, GBD, UNITED-STATES, Socioeconomic factors, Communicable Diseases, Young Adult, Age Distribution, Heilbrigðisvísindi, Medicine, General & Internal, General & Internal Medicine, Humans, QUALITY, Women, Nutrition disorders, INCOME COUNTRIES, Mortality, Noncommunicable Diseases, Aged, Science & Technology, Infant, Newborn, Infant, Respiratory infections, Næringarskortur, ALCOHOL POLICY, mortality, Malaria, Pregnancy Complications, Socioeconomic Factors, Áverkar, Karlar, Wounds and Injuries, Félagshagfræði, Accidental Falls, Cause of death/trends, RESISTANCE
Abstract

Correction: Group Author(s): GBD 2016 Causes Death LANCET Volume: 390 Issue: 10106 Pages: E38-E38 Published: OCT 28 2017 Group Author(s): GBD 2016 Dis Injury Incidence LANCET Volume: 390 Issue: 10106 Pages: E38-E38 Published: OCT 28 2017, Background Monitoring levels and trends in premature mortality is crucial to understanding how societies can address prominent sources of early death. The Global Burden of Disease 2016 Study (GBD 2016) provides a comprehensive assessment of cause-specific mortality for 264 causes in 195 locations from 1980 to 2016. This assessment includes evaluation of the expected epidemiological transition with changes in development and where local patterns deviate from these trends. Methods We estimated cause-specific deaths and years of life lost (YLLs) by age, sex, geography, and year. YLLs were calculated from the sum of each death multiplied by the standard life expectancy at each age. We used the GBD cause of death database composed of: vital registration (VR) data corrected for under-registration and garbage coding; national and subnational verbal autopsy (VA) studies corrected for garbage coding; and other sources including surveys and surveillance systems for specific causes such as maternal mortality. To facilitate assessment of quality, we reported on the fraction of deaths assigned to GBD Level 1 or Level 2 causes that cannot be underlying causes of death (major garbage codes) by location and year. Based on completeness, garbage coding, cause list detail, and time periods covered, we provided an overall data quality rating for each location with scores ranging from 0 stars (worst) to 5 stars (best). We used robust statistical methods including the Cause of Death Ensemble model (CODEm) to generate estimates for each location, year, age, and sex. We assessed observed and expected levels and trends of cause-specific deaths in relation to the Socio-demographic Index (SDI), a summary indicator derived from measures of average income per capita, educational attainment, and total fertility, with locations grouped into quintiles by SDI. Relative to GBD 2015, we expanded the GBD cause hierarchy by 18 causes of death for GBD 2016. Findings The quality of available data varied by location. Data quality in 25 countries rated in the highest category (5 stars), while 48, 30, 21, and 44 countries were rated at each of the succeeding data quality levels. Vital registration or verbal autopsy data were not available in 27 countries, resulting in the assignment of a zero value for data quality. Deaths from non-communicable diseases (NCDs) represented 72.3% (95% uncertainty interval [UI] 71.2-73.2) of deaths in 2016 with 19.3% (18.5-20.4) of deaths in that year occurring from communicable, maternal, neonatal, and nutritional (CMNN) diseases and a further 8.43% (8.00-8.67) from injuries. Although age-standardised rates of death from NCDs decreased globally between 2006 and 2016, total numbers of these deaths increased; both numbers and age-standardised rates of death from CMNN causes decreased in the decade 2006-16-age-standardised rates of deaths from injuries decreased but total numbers varied little. In 2016, the three leading global causes of death in children under-5 were lower respiratory infections, neonatal preterm birth complications, and neonatal encephalopathy due to birth asphyxia and trauma, combined resulting in 1.80 million deaths (95% UI 1.59 million to 1.89 million). Between 1990 and 2016, a profound shift toward deaths at older ages occurred with a 178% (95% UI 176-181) increase in deaths in ages 90-94 years and a 210% (208-212) increase in deaths older than age 95 years. The ten leading causes by rates of age-standardised YLL significantly decreased from 2006 to 2016 (median annualised rate of change was a decrease of 2.89%); the median annualised rate of change for all other causes was lower (a decrease of 1.59%) during the same interval. Globally, the five leading causes of total YLLs in 2016 were cardiovascular diseases; diarrhoea, lower respiratory infections, and other common infectious diseases; neoplasms; neonatal disorders; and HIV/AIDS and tuberculosis. At a finer level of disaggregation within cause groupings, the ten leading causes of total YLLs in 2016 were ischaemic heart disease, cerebrovascular disease, lower respiratory infections, diarrhoeal diseases, road injuries, malaria, neonatal preterm birth complications, HIV/AIDS, chronic obstructive pulmonary disease, and neonatal encephalopathy due to birth asphyxia and trauma. Ischaemic heart disease was the leading cause of total YLLs in 113 countries for men and 97 countries for women. Comparisons of observed levels of YLLs by countries, relative to the level of YLLs expected on the basis of SDI alone, highlighted distinct regional patterns including the greater than expected level of YLLs from malaria and from HIV/AIDS across sub-Saharan Africa; diabetes mellitus, especially in Oceania; interpersonal violence, notably within Latin America and the Caribbean; and cardiomyopathy and myocarditis, particularly in eastern and central Europe. The level of YLLs from ischaemic heart disease was less than expected in 117 of 195 locations. Other leading causes of YLLs for which YLLs were notably lower than expected included neonatal preterm birth complications in many locations in both south Asia and southeast Asia, and cerebrovascular disease in western Europe. Interpretation The past 37 years have featured declining rates of communicable, maternal, neonatal, and nutritional diseases across all quintiles of SDI, with faster than expected gains for many locations relative to their SDI. A global shift towards deaths at older ages suggests success in reducing many causes of early death. YLLs have increased globally for causes such as diabetes mellitus or some neoplasms, and in some locations for causes such as drug use disorders, and conflict and terrorism. Increasing levels of YLLs might reflect outcomes from conditions that required high levels of care but for which effective treatments remain elusive, potentially increasing costs to health systems., Bill & Melinda Gates Foundation.

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37. Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

Author

Hay, Simon I, Abajobir, Amanuel Alemu, Abate, Kalkidan Hassen, Abbafati, Cristiana, Abbas, Kaja M, Abd-Allah, Foad, Abdulle, Abdishakur M, Abebo, Teshome Abuka, Abera, Semaw Ferede, Aboyans, Victor, Abu-Raddad, Laith J, Ackerman, Ilana N, Adedeji, Isaac A, Adetokunboh, Olatunji, Afshin, Ashkan, Aggarwal, Rakesh, Agrawal, Sutapa, Agrawal, Anurag, Kiadaliri, Aliasghar Ahmad, Ahmed, Muktar Beshir, Aichour, Amani Nidhal, Aichour, Ibtihel, Aichour, Miloud Taki Eddine, Aiyar, Sneha, Akinyemiju, Tomi F, Akseer, Nadia, Al Lami, Faris Hasan, Alahdab, Fares, Al-Aly, Ziyad, Alam, Khurshid, Alam, Noore, Alam, Tahiya, Alasfoor, Deena, Alene, Kefyalew Addis, Ali, Raghib, Alizadeh-Navaei, Reza, Alkaabi, Juma M, Alkerwi, Ala'a, Alla, Francois, Allebeck, Peter, Allen, Christine, Al-Maskari, Fatma, AlMazroa, Mohammad AbdulAziz, Al-Raddadi, Rajaa, Alsharif, Ubai, Alsowaidi, Shirina, Althouse, Benjamin M, Altirkawi, Khalid A, Alvis-Guzman, Nelson, Amare, Azmeraw T, Amini, Erfan, Ammar, Walid, Ampem, Yaw Amoako, Ansha, Mustafa Geleto, Antonio, Carl Abelardo T, Anwari, Palwasha, Arnlov, Johan, Arora, Megha, Artaman, Al, Aryal, Krishna Kumar, Asgedom, Solomon W, Atey, Tesfay Mehari, Atnafu, Niguse Tadele, Avila-Burgos, Leticia, Avokpaho, Euripide Frinel G Arthur, Awasthi, Ashish, Awasthi, Shally, Quintanilla, Beatriz Paulina Ayala, Azarpazhooh, Mahmoud Reza, Azzopardi, Peter, Babalola, Tesleem Kayode, Bacha, Umar, Badawi, Alaa, Balakrishnan, Kalpana, Bannick, Marlena S, Barac, Aleksandra, Barker-Collo, Suzanne L, Barnighausen, Till, Barquera, Simon, Barrero, Lope H, Basu, Sanjay, Battista, Robert, Battle, Katherine E, Baune, Bernhard T, Bazargan-Hejazi, Shahrzad, Beardsley, Justin, Bedi, Neeraj, Bejot, Yannick, Bekele, Bayu Begashaw, Bell, Michelle L, Bennett, Derrick A, Bennett, James R, Bensenor, Isabela M, Benson, Jennifer, Berhane, Adugnaw, Berhe, Derbew Fikadu, Bernabe, Eduardo, Betsu, Balem Demtsu, Beuran, Mircea, Beyene, Addisu Shunu, Bhansali, Anil, Bhatt, Samir, Bhutta, Zulfiqar A, Biadgilign, Sibhatu, Bienhoff, Kelly, Bikbov, Boris, Birungi, Charles, Biryukov, Stan, Bisanzio, Donal, Bizuayehu, Habtamu Mellie, Blyth, Fiona M, Boneya, Dube Jara, Bose, Dipan, Bou-Orm, Ibrahim R, Bourne, Rupert RA, Brainin, Michael, Brayne, Carol EG, Brazinova, Alexandra, Breitborde, Nicholas JK, Briant, Paul S, Britton, Gabrielle, Brugha, Traolach S, Buchbinder, Rachelle, Bulto, Lemma Negesa Bulto, Bumgarner, Blair, Butt, Zahid A, Cahuana-Hurtado, Lucero, Cameron, Ewan, Ricardo Campos-Nonato, Ismael, Carabin, Helene, Cardenas, Rosario, Carpenter, David O, Carrero, Juan Jesus, Carter, Austin, Carvalho, Felix, Casey, Daniel, Castaneda-Orjuela, Carlos A, Rivas, Jacqueline Castillo, Castle, Chris D, Catala-Lopez, Ferran, Chang, Jung-Chen, Charlson, Fiona J, Chaturvedi, Pankaj, Chen, Honglei, Chibalabala, Mirriam, Chibueze, Chioma Ezinne, Chisumpa, Vesper Hichilombwe, Chitheer, Abdulaal A, Chowdhury, Rajiv, Christopher, Devasahayam Jesudas, Ciobanu, Liliana G, Cirillo, Massimo, Colombara, Danny, Cooper, Leslie Trumbull, Cooper, Cyrus, Cortesi, Paolo Angelo, Cortinovis, Monica, Criqui, Michael H, Cromwell, Elizabeth A, Cross, Marita, Crump, John A, Dadi, Abel Fekadu, Dalal, Koustuv, Damasceno, Albertino, Dandona, Lalit, Dandona, Rakhi, Das Neves, Jose, Davitoiu, Dragos V, Davletov, Kairat, De Courten, Barbora, De Leo, Diego, De Steur, Hans, Degenhardt, Louisa, Deiparine, Selina, Dellavalle, Robert P, Deribe, Kebede, Deribew, Amare, Des Jarlais, Don C, Dey, Subhojit, Dharmaratne, Samath D, Dhillon, Preet K, Dicker, Daniel, Djalalinia, Shirin, Do, Huyen Phuc, Dokova, Klara, Doku, David Teye, Dorsey, E Ray, Bender Dos Santos, Kadine Priscila, Driscoll, Tim R, Dubey, Manisha, Duncan, Bruce Bartholow, Ebel, Beth E, Echko, Michelle, El-Khatib, Ziad Ziad, Enayati, Ahmadali, Endries, Aman Yesuf, Ermakov, Sergey Petrovich, Erskine, Holly E, Eshetie, Setegn, Eshrati, Babak, Esteghamati, Alireza, Estep, Kara, Fanuel, Fanuel Belayneh Bekele, Farag, Tamer, Sofia, Carla, Farinha, Sa, Faro, Andre, Farzadfar, Farshad, Fazeli, Mir Sohail, Feigin, Valery L, Feigl, Andrea B, Fereshtehnejad, Seyed-Mohammad, Fernandes, Joao C, Ferrari, Alize J, Feyissa, Tesfaye Regassa, Filip, Irina, Fischer, Florian, Fitzmaurice, Christina, Flaxman, Abraham D, Foigt, Nataliya, Foreman, Kyle J, Franklin, Richard C, Frostad, Joseph J, Fullman, Nancy, Furst, Thomas, Furtado, Joao M, Futran, Neal D, Gakidou, Emmanuela, Garcia-Basteiro, Alberto L, Gebre, Teshome, Gebregergs, Gebremedhin Berhe, Gebrehiwot, Tsegaye Tewelde, Geleijnse, Johanna M, Geleto, Ayele, Gemechu, Bikila Lencha, Gesesew, Hailay Abrha, Gething, Peter W, Ghajar, Alireza, Gibney, Katherine B, Gillum, Richard F, Ginawi, Ibrahim Abdelmageem Mohamed, Gishu, Melkamu Dedefo, Giussani, Giorgia, Godwin, William W, Goel, Kashish, Goenka, Shifalika, Goldberg, Ellen M, Gona, Philimon N, Goodridge, Amador, Gopalani, Sameer Vali, Gosselin, Richard A, Gotay, Carolyn C, Goto, Atsushi, Goulart, Alessandra Carvalho, Graetz, 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Zoubida, Zaki, Maysaa El Sayed, Zegeye, Elias Asfaw, Zenebe, Zerihun Menlkalew, Zhang, Xueying, Zheng, Yingfeng, Zhou, Maigeng, Zipkin, Ben, Zodpey, Sanjay, Zoeckler, Leo, Zuhlke, Liesl Joanna, Murray, Christopher JL, and Collaborators, GBD DALYs HALE

Subjects
Adult, Aged, 80 and over, Male, 1. No poverty, Middle Aged, Global Health, Communicable Diseases, 3. Good health, Global Burden of Disease, Age Distribution, Life Expectancy, Residence Characteristics, Cause of Death, Humans, Wounds and Injuries, Disabled Persons, Female, sense organs, Quality-Adjusted Life Years, Sex Distribution, Noncommunicable Diseases, Aged
Abstract

Measurement of changes in health across locations is useful to compare and contrast changing epidemiological patterns against health system performance and identify specific needs for resource allocation in research, policy development, and programme decision making. Using the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we drew from two widely used summary measures to monitor such changes in population health: disability-adjusted life-years (DALYs) and healthy life expectancy (HALE). We used these measures to track trends and benchmark progress compared with expected trends on the basis of the Socio-demographic Index (SDI).

38. Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950–2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019

Author

Abbafati, C., Machado, D.B., Cislaghi, B., Salman, O.M., Karanikolos, M., McKee, M., Abbas, K.M., Brady, O.J., Larson, H.J., Trias-Llimós, S., Cummins, S., Langan, S.M., Sartorius, B., Hafiz, A., Jenabi, E., Mohammad Gholi Mezerji, N., Borzouei, S., Azarian, G., Khazaei, S., Abbasi, M., Asghari, B., Masoumi, S., Komaki, H., Taherkhani, A., Adabi, M., Abbasifard, M., Bazmandegan, G., Kamiab, Z., Vakilian, A., Anjomshoa, M., Mokari, A., Sabour, S., Shahbaz, M., Saeedi, R., Ahmadieh, H., Yousefinezhadi, T., Haj-Mirzaian, A., Nikbakhsh, R., Safi, S., Asgari, S., Irvani, S.N., Jahanmehr, N., Ramezanzadeh, K., Abbasi-Kangevari, M., Khayamzadeh, M., Abbastabar, H., Shirkoohi, R., Fazlzadeh, M., Janjani, H., Hosseini, M., Mansournia, M., Tohidinik, H., Bakhtiari, A., Fazaeli, A., Mousavi, S., Hasanzadeh, A., Nabavizadeh, B., Malekzadeh, R., Hashemian, M., Pourshams, A., Salimzadeh, H., Sepanlou, S.G., Afarideh, M., Esteghamati, A., Esteghamati, S., Ghajar, A., Heidari, B., Rezaei, N., 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Fariborz, Mansouri, Borhan, Mansournia, Mohammad Ali, Mapoma, Chabila Christopher, Martini, Santi, Martins-Melo, Francisco Rogerlândio, Masaka, Anthony, Mastrogiacomo, Claudia I, Mathur, Manu Raj, May, Erin A, Mcalinden, Colm, Mcgrath, John J, Mckee, Martin, Mehndiratta, Man Mohan, Mehri, Fereshteh, Mehta, Kala M, Meitei, Wahengbam Bigyananda, Memiah, Peter T N, Mendoza, Walter, Menezes, Ritesh G, Mengesha, Endalkachew Worku, Mensah, George A, Meretoja, Atte, Meretoja, Tuomo J, Mestrovic, Tomislav, Michalek, Irmina Maria, Mihretie, Kebadnew Mulatu, Miller, Ted R, Mills, Edward J, Milne, George J, Mirrakhimov, Erkin M, Mirzaei, Hamed, Mirzaei, Maryam, Mirzaei-Alavijeh, Mehdi, Misganaw, Awoke Temesgen, Moazen, Babak, Moghadaszadeh, Masoud, Mohamadi, Efat, Mohammad, Dara K, Mohammad, Yousef, Mohammad Gholi Mezerji, Naser, Mohammadbeigi, Abolfazl, Mohammadian-Hafshejani, Abdollah, Mohammadpourhodki, Reza, Mohammed, Hussen, Mohammed, Shafiu, Mohebi, Farnam, Mohseni Bandpei, Mohammad A, Mokari, Amin, Mokdad, Ali H, Momen, Natalie C, Monasta, Lorenzo, Mooney, Meghan D, Moradi, Ghobad, Moradi, Masoud, Moradi-Joo, Mohammad, Moradi-Lakeh, Maziar, Moradzadeh, Rahmatollah, Moraga, Paula, Moreno Velásquez, Ilai, Morgado-da-Costa, Joana, Morrison, Shane Dougla, Mosser, Jonathan F, Mouodi, Simin, Mousavi, Seyyed Meysam, Mousavi Khaneghah, Amin, Mueller, Ulrich Otto, Musa, Kamarul Imran, Muthupandian, Saravanan, Nabavizadeh, Behnam, Naderi, Mehdi, Nagarajan, Ahamarshan Jayaraman, Naghavi, Mohsen, Naghshtabrizi, Behshad, Naik, Gurudatta, Najafi, Farid, Nangia, Vinay, Nansseu, Jobert Richie, Ndwandwe, Duduzile Edith, Negoi, Ionut, Negoi, Ruxandra Irina, Ngunjiri, Josephine W, Nguyen, Huong Lan Thi, Nguyen, Trang Huyen, Nigatu, Yeshambel T, Nikbakhsh, Rajan, Nikpoor, Amin Reza, Nixon, Molly R, Nnaji, Chukwudi A, Nomura, Shuhei, Noubiap, Jean Jacque, Nouraei Motlagh, Soraya, Nowak, Christoph, Oţoiu, Adrian, Odell, Christopher M, Oh, In-Hwan, Oladnabi, Morteza, Olagunju, Andrew T, Olusanya, Bolajoko Olubukunola, Olusanya, Jacob Olusegun, Omar Bali, Ahmed, Ong, Kanyin L, Onwujekwe, Obinna E, Ortiz, Alberto, Otstavnov, Nikita, Otstavnov, Stanislav S, Øverland, Simon, Owolabi, Mayowa O, P A, Mahesh, Padubidri, Jagadish Rao, Pakshir, Keyvan, Palladino, Raffaele, Pana, Adrian, Panda-Jonas, Songhomitra, Park, Jame, Pasupula, Deepak Kumar, Patel, Jenil R, Patel, Sangram Kishor, Patton, George C, Paulson, Katherine R, Pazoki Toroudi, Hamidreza, Pease, Spencer A, Peden, Amy E, Pepito, Veincent Christian Filipino, Peprah, Emmanuel K, Pereira, Alexandre, Pereira, David M, Perico, Norberto, Pigott, David M, Pilgrim, Thoma, Pilz, Tessa M, Piradov, Michael A, Pirsaheb, Meghdad, Pokhrel, Khem Narayan, Postma, Maarten J, Pourjafar, Hadi, Pourmalek, Farshad, Pourshams, Akram, Poznańska, Anna, Prada, Sergio I, Prakash, Sanjay, Preotescu, Liliana, Quazi Syed, Zahiruddin, Rabiee, Mohammad, Rabiee, Navid, Radfar, Amir, Rafiei, Alireza, Raggi, Alberto, Rahman, Muhammad Aziz, Rajabpour-Sanati, Ali, Ram, Pradhum, Ranabhat, Chhabi Lal, Rao, Sowmya J, Rasella, Davide, Rashedi, Vahid, Rastogi, Prateek, Rathi, Priya, Rawal, Lal, Remuzzi, Giuseppe, Renjith, Vishnu, Renzaho, Andre M N, Resnikoff, Serge, Rezaei, Nima, Rezai, Mohammad sadegh, Rezapour, Aziz, Rickard, Jennifer, Roever, Leonardo, Ronfani, Luca, Roshandel, Gholamreza, Rostamian, Morteza, Rubagotti, Enrico, Rwegerera, Godfrey M, Sabour, Siamak, Saddik, Basema, Sadeghi, Ehsan, Sadeghi, Masoumeh, Saeedi Moghaddam, Sahar, Safari, Yahya, Safi, Sare, Safiri, Saeid, Sagar, Rajesh, Sahebkar, Amirhossein, Sahraian, Mohammad Ali, Sajadi, S Mohammad, Salahshoor, Mohammad Reza, Salama, Joseph S, Salamati, Payman, Salem, Marwa R Rashad, Salimi, Yahya, Salomon, Joshua A, Salz, Inbal, Samad, Zainab, Samy, Abdallah M, Sanabria, Juan, Santric-Milicevic, Milena M, Saraswathy, Sivan Yegnanarayana Iyer, Sartorius, Benn, Sarveazad, Arash, Sathian, Brijesh, Sathish, Thirunavukkarasu, Sattin, Davide, Saylan, Mete, Schaeffer, Lauren E, Schiavolin, Silvia, Schwebel, David C, Schwendicke, Falk, Sekerija, Mario, Senbeta, Anbissa Muleta, Senthilkumaran, Subramanian, Sepanlou, Sadaf G, Serván-Mori, Edson, Shabani, Mahsima, Shahabi, Saeed, Shahbaz, Mohammad, Shaheen, Amira A, Shaikh, Masood Ali, Shalash, Ali S, Shams-Beyranvand, Mehran, Shamsi, Mohammadbagher, Shamsizadeh, Morteza, Shannawaz, Mohammed, Sharafi, Kiomar, Sharafi, Zeinab, Sharara, Fablina, Sharma, Rajesh, Shaw, David H, Sheikh, Aziz, Shin, Jae Il, Shiri, Rahman, Shrime, Mark G, Shuval, Kerem, Siabani, Soraya, Sigfusdottir, Inga Dora, Sigurvinsdottir, Rannveig, Silva, Diego Augusto Santo, Simonetti, Biagio, Simpson, Kyle E, Singh, Jasvinder A, Skiadaresi, Eirini, Skryabin, Valentin Yurievich, Soheili, Amin, Sokhan, Anton, Sorensen, Reed J D, Soriano, Joan B, Sorrie, Muluken Bekele, Soyiri, Ireneous N, Spurlock, Emma Elizabeth, Sreeramareddy, Chandrashekhar T, Stockfelt, Leo, Stokes, Mark A, Stubbs, Jacob L, Sudaryanto, Agu, Sufiyan, Mu'awiyyah Babale, Suliankatchi Abdulkader, Rizwan, Sykes, Bryan L, Tabarés-Seisdedos, Rafael, Tabb, Karen M, Tadakamadla, Santosh Kumar, Taherkhani, Amir, Tang, Muming, Taveira, Nuno, Taylor, Heather Jean, Teagle, Whitney L, Tehrani-Banihashemi, Arash, Teklehaimanot, Berhane Fseha, Tessema, Zemenu Tadesse, Thankappan, Kavumpurathu Raman, Thomas, Nihal, Thrift, Amanda G, Titova, Mariya Vladimirovna, Tohidinik, Hamid Reza, Tonelli, Marcello, Topor-Madry, Roman, Topouzis, Foti, Tovani-Palone, Marcos Roberto Roberto, Traini, Eugenio, Tran, Bach Xuan, Travillian, Ravensara, Trias-Llimós, Sergi, Truelsen, Thomas Clement, Tudor Car, Lorainne, Unnikrishnan, Bhaskaran, Upadhyay, Era, Vacante, Marco, Vakilian, Alireza, Valdez, Pascual R, Valli, Alessandro, Vardavas, Constantine, Vasankari, Tommi Juhani, Vasconcelos, Ana Maria Nogale, Vasseghian, Yasser, Veisani, Yousef, Venketasubramanian, Narayanaswamy, Vidale, Simone, Violante, Francesco S, Vlassov, Vasily, Vollset, Stein Emil, Vos, Theo, Vujcic, Isidora S, Vukovic, Ana, Vukovic, Rade, Waheed, Yasir, Wallin, Mitchell Taylor, Walters, Magdalene K, Wang, Hongbo, Wang, Yuan-Pang, Watson, Stefanie, Wei, Jingkai, Weiss, Jordan, Weldesamuel, Girmay Teklay, Werdecker, Andrea, Westerman, Ronny, Whiteford, Harvey A, Wiangkham, Taweewat, Wiens, Kirsten E, Wijeratne, Tissa, Wiysonge, Charles Shey, Wojtyniak, Bogdan, Wolfe, Charles D A, Wondmieneh, Adam Belay, Wool, Eve E, Wu, Ai-Min, Wu, Junjie, Xu, Gelin, Yamada, Tomohide, Yamagishi, Kazumasa, Yano, Yuichiro, Yaya, Sanni, Yazdi-Feyzabadi, Vahid, Yearwood, Jamal A, Yeheyis, Tomas Y, Yilgwan, Christopher Sabo, Yip, Paul, Yonemoto, Naohiro, Yoon, Seok-Jun, Yoosefi Lebni, Javad, York, Hunter W, Younis, Mustafa Z, Younker, Theodore Patrick, Yousefi, Zabihollah, Yousefinezhadi, Taraneh, Yousuf, Abdilahi Yousuf, Yusefzadeh, Hasan, Zahirian Moghadam, Telma, Zakzuk, Josefina, Zaman, Sojib Bin, Zamani, Mohammad, Zamanian, Maryam, Zandian, Hamed, Zhang, Zhi-Jiang, Zheng, Peng, Zhou, Maigeng, Ziapour, Arash, Murray, Christopher J L, Collaborators, GBD 2019 Demographics, GBD 2019 Demographics Collaborator, Violante FS, Value, Affordability and Sustainability (VALUE), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Microbes in Health and Disease (MHD), Department of Earth Systems Analysis, Biomechanical Engineering, TechMed Centre, Biomolecular Nanotechnology, Research Methodology, Measurement and Data Analysis, Materials Science and Technology of Polymers, Inorganic Materials Science, MESA+ Institute, Biomedical and Environmental Sensorsystems, Mesoscale Chemical Systems, Faculty of Engineering Technology, Nonlinear Solid Mechanics, Digital Society Institute, Pervasive Systems, Nanobiophysics, Faculty of Geo-Information Science and Earth Observation, Multi Scale Mechanics, Engineering Fluid Dynamics, Physics of Complex Fluids, Developmental BioEngineering, Physics of Fluids, Elastomer Technology and Engineering, Medical Cell Biophysics, European Membrane Institute, Department of Earth Observation Science, Biomaterials Science and Technology, Sustainable Process Technology, Department of Urban and Regional Planning and Geo-Information Management, Department of Natural Resources, XUV Optics, Databases (Former), Department of Water Resources, Psychology, Health & Technology, Membrane Science & Technology, Department of Public Health, Clinicum, HUS Neurocenter, HUS Comprehensive Cancer Center, and Environmental Sciences

Subjects
Male, very elderly, Demographic transition, HALE, 030204 cardiovascular system & hematology, preschool child, Global Burden of Disease, Carga Global de Enfermedades, 0302 clinical medicine, newborn, Risk Factors, Surveys and Questionnaires, and Risk Factors Study, 80 and over, 030212 general & internal medicine, Birth Rate, Child, Migration, 11 Medical and Health Sciences, Aged, 80 and over, education.field_of_study, Injuries, Geography, Mortality rate, 1. No poverty, DEATH, Censuses, General Medicine, SDG 10 - Reduced Inequalities, Middle Aged, Demographic analysis, 3142 Public health care science, environmental and occupational health, 3. Good health, demographic analysis, Estilo de Vida Saludable, risk factor, Child, Preschool, Demography/statistics & numerical data, Global Burden of Diseases, Injuries, Risk Factors, Fertility, Mortality, Migration, Population, epidemiology, Female, A990 Medicine and Dentistry not elsewhere classified, CHILD-MORTALITY, Live Birth, Global Health Metrics, TRANSITION, demographics, GBD, fertility, mortality, hale, Adult, Adolescent, Total fertility rate, Population, Global Burden of Diseases, Injuries, and Risk Factors Study, Birth rate, 03 medical and health sciences, Young Adult, Life Expectancy, SDG 3 - Good Health and Well-being, General & Internal Medicine, SYSTEMATIC ANALYSIS, Demografía, Humans, Global Burden of Disease Study, human, Mortality, education, Preschool, Aged, Demography, Spatial Analysis, questionnaire, Infant, Newborn, Klinisk medicin, HIV, Infant, Global Burden of Diseases, sex-specific fertility, Live Birth/epidemiology, purl.org/pe-repo/ocde/ford#3.02.00 [https], MODEL, Fertilidad, Fertility, Demographic change, Life expectancy, NA, global disease burden, Clinical Medicine, population research
Abstract

Background Accurate and up-to-date assessment of demographic metrics is crucial for understanding a wide range of social, economic, and public health issues that affect populations worldwide. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 produced updated and comprehensive demographic assessments of the key indicators of fertility, mortality, migration, and population for 204 countries and territories and selected subnational locations from 1950 to 2019. Methods 8078 country-years of vital registration and sample registration data, 938 surveys, 349 censuses, and 238 other sources were identified and used to estimate age-specific fertility. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate age-specific fertility rates for 5-year age groups between ages 15 and 49 years. With extensions to age groups 10-14 and 50-54 years, the total fertility rate (TFR) was then aggregated using the estimated age-specific fertility between ages 10 and 54 years. 7417 sources were used for under-5 mortality estimation and 7355 for adult mortality. ST-GPR was used to synthesise data sources after correction for known biases. Adult mortality was measured as the probability of death between ages 15 and 60 years based on vital registration, sample registration, and sibling histories, and was also estimated using ST-GPR. HIV-free life tables were then estimated using estimates of under-5 and adult mortality rates using a relational model life table system created for GBD, which closely tracks observed age-specific mortality rates from complete vital registration when available. Independent estimates of HIV-specific mortality generated by an epidemiological analysis of HIV prevalence surveys and antenatal clinic serosurveillance and other sources were incorporated into the estimates in countries with large epidemics. Annual and single-year age estimates of net migration and population for each country and territory were generated using a Bayesian hierarchical cohort component model that analysed estimated age-specific fertility and mortality rates along with 1250 censuses and 747 population registry years. We classified location-years into seven categories on the basis of the natural rate of increase in population (calculated by subtracting the crude death rate from the crude birth rate) and the net migration rate. We computed healthy life expectancy (HALE) using years lived with disability (YLDs) per capita, life tables, and standard demographic methods. Uncertainty was propagated throughout the demographic estimation process, including fertility, mortality, and population, with 1000 draw-level estimates produced for each metric. Findings The global TFR decreased from 2.72 (95% uncertainty interval [UI] 2.66-2.79) in 2000 to 2.31 (2.17-2.46) in 2019. Global annual livebirths increased from 134.5 million (131.5-137.8) in 2000 to a peak of 139.6 million (133.0-146.9) in 2016. Global livebirths then declined to 135.3 million (127.2-144.1) in 2019. Of the 204 countries and territories included in this study, in 2019, 102 had a TFR lower than 2.1, which is considered a good approximation of replacement-level fertility. All countries in sub-Saharan Africa had TFRs above replacement level in 2019 and accounted for 27.1% (95% UI 26.4-27.8) of global livebirths. Global life expectancy at birth increased from 67.2 years (95% UI 66.8-67.6) in 2000 to 73.5 years (72.8-74.3) in 2019. The total number of deaths increased from 50.7 million (49.5-51.9) in 2000 to 56.5 million (53.7-59.2) in 2019. Under-5 deaths declined from 9.6 million (9.1-10.3) in 2000 to 5.0 million (4.3-6.0) in 2019. Global population increased by 25.7%, from 6.2 billion (6.0-6.3) in 2000 to 7.7 billion (7.5-8.0) in 2019. In 2019, 34 countries had negative natural rates of increase; in 17 of these, the population declined because immigration was not sufficient to counteract the negative rate of decline. Globally, HALE increased from 58.6 years (56.1-60.8) in 2000 to 63.5 years (60.8-66.1) in 2019. HALE increased in 202 of 204 countries and territories between 2000 and 2019. Interpretation Over the past 20 years, fertility rates have been dropping steadily and life expectancy has been increasing, with few exceptions. Much of this change follows historical patterns linking social and economic determinants, such as those captured by the GBD Socio-demographic Index, with demographic outcomes. More recently, several countries have experienced a combination of low fertility and stagnating improvement in mortality rates, pushing more populations into the late stages of the demographic transition. Tracking demographic change and the emergence of new patterns will be essential for global health monitoring. Copyright (C) 2020 The Author(s). Published by Elsevier Ltd.

Published
2020

39. Understanding the transmission dynamics of a large-scale measles outbreak in Southern Vietnam

Author

Thi Huyen Trang Nguyen, Thuong Vu Nguyen, Quang Chan Luong, Thang Vinh Ho, Christel Faes, Niel Hens, NGUYEN, Trang, Nguyen, Thuong Vu, Luong, Quang Chan, Ho, Thang Vinh, FAES, Christel, and HENS, Niel

Subjects
Microbiology (medical), Vaccine preventable disease, Likelihood Functions, Science & Technology, Vaccination Coverage, CITY, Measles Vaccine, Vaccination, General Medicine, Spatio-temporal analysis, FRAMEWORK, Disease Outbreaks, MODEL, Infectious Diseases, Vietnam, EPIDEMIC, VACCINATION COVERAGE, Humans, Human medicine, Life Sciences & Biomedicine, ELIMINATION, Measles
Abstract

Objectives: Southern Vietnam experienced a large measles outbreak of over 26,0 0 0 cases during 20182020. We aimed to understand and quantify the measles spread in space-time dependence and the transmissibility during the outbreak.Methods: Measles surveillance reported cases between January 2018 and June 2020, vaccination coverage, and population data at provinicial level were used. To illustrate the spatio-temporal pattern of disease spread, we employed the endemic-epidemic multivariate time series model decomposing measles risk additively into autoregressive, spatio-temporal, and endemic components. Likelihood-based estimation procedures were performed to determine the time-varying reproductive number R e of measles. Results: Our analysis showed that the incidence of measles was associated with vaccination coverage heterogeneity and spatial interaction between provincial units. The risk of infections was dominated by between-province transmission (36.1% to 78.8%), followed by local endogenous transmission (4.1% to 61.5%). In contrast, the endemic behavior had a relatively small contribution (2.4% to 33.4%) across provinces. In the exponential phase of the epidemic, R e was above the threshold with a maximum value of 2.34 (95% CI: 2.20-2.46).Conclusion: Local vaccination coverage and human mobility are important factors contributing to the measles dynamics in Southern Vietnam, and the high risk of inter-provincial transmission is of most concern. Strengthening the disease surveillance is recommended, and further research is essential to understand the relative contribution of population immunity and control measures in measles epidemics. (c) 2022 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ) This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. We would like to thank the VLIR-UOS for awarding T.H.T.N. a scholarship to study the Master of Epidemiology at the University of Antwerp, Belgium. We are pleased to acknowledge the Pasteur Institute in Ho Chi Minh City including the Board of Directors for supporting the research endeavor in terms of data use, colleagues of the Outbreak Control Unit (Pham Duy Quang, Nguyen Thi Phuong Thuy, Tran Cong Kha, Doan Ngoc Minh Quan, Nguyen Quoc Kien, Tran Anh Tuan, Phan Thi Ngoc Uyen, Nguyen Viet Thinh, Hoang Thi Lien, and Phan Cong Hung), and the EPI Unit (Hoang Anh Thang, Chau Van Luom, Truong Cong Hieu, Vo Ngoc Quang, Nguyen Dieu Thuy, Nguyen Thi Huyen, Phan Thi Quynh Tram, Vien Dang Khanh Linh, Nguyen Thi Thu Trang, Nguyen Van Hoang, Tran Quang Trung, Trinh Trung Truc, Tran Thanh Hai) for their huge efforts and enthusiasm in case monitoring, surveillance and contact tracing, outbreak investigation, and launching the supplementary immunization activities during the measles outbreak. We would also like to acknowledge the large contribution of 20 Provincial Centers for Disease Control and Prevention in two cities and 18 provinces in Southern Vietnam in the EPI National Project.

Published
2022

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