Author: "Azzopardi P" / Topic: medicine - Searchworks@Jio Institute Digital Library Search Results

Your search keyword '"Azzopardi P"' showing total 45 results

Start Over Author "Azzopardi P" Topic medicine

45 results on '"Azzopardi P"'

1. The genome sequence of the John Dory, Zeus faber Linnaeus, 1758 [version 2; peer review: 2 approved, 1 not approved]

Author: Patrick Adkins, Rachel Brittain, Joanna Harley, Kesella Scott-Somme, and Freja Azzopardi
Subjects: Zeus faber, John Dory, genome sequence, chromosomal, Zeiformes, eng, Medicine, Science
Abstract: We present a genome assembly from an individual Zeus faber (the John Dory; Chordata; Actinopteri; Zeiformes; Zeidae). The genome sequence is 804.7 megabases in span. Most of the assembly is scaffolded into 22 chromosomal pseudomolecules. The mitochondrial genome has also been assembled and is 16.72 kilobases in length.
Published: 2024
Full Text: View/download PDF

2. Cohort profile: Understanding the influence of early life environments and health and social service system contacts over time and across generations through the Western Australian Aboriginal Child Health Survey (WAACHS) Linked Data Study

Author: Alex Brown, Sarah E Johnson, Peter Richmond, Peter Azzopardi, Stephen R Zubrick, Melissa O'Donnell, Juli Coffin, Asha C Bowen, Jenny Downs, Elizabeth A Davis, Hayley M Passmore, Heather A D'Antoine, Helen Milroy, Glenn Pearson, Francis Mitrou, Sharynne L Hamilton, Christopher G Brennan-Jones, Stefanie Schurer, Katherine M Conigrave, Matthew M Cooper, Kathryn A Ramsey, Anna Ferrante, Leah Cave, Philip Vlaskovsky, Katrina D Hopkins, and Ted Wilkes
Subjects: Medicine
Abstract: Purpose Despite the volume of accumulating knowledge from prospective Aboriginal cohort studies, longitudinal data describing developmental trajectories in health and well-being is limited. The linkage of child and carer cohorts from a historical cross-sectional survey with longitudinal health-service and social-service administrative data has created a unique and powerful data resource that underpins the Western Australian Aboriginal Child Health Survey (WAACHS) linked data study. This study aims to provide evidence-based information to Aboriginal communities across Western Australia, governments and non-government agencies on the heterogeneous life trajectories of Aboriginal children and families.Participants This study comprises data from a historical cross-sectional household study of 5289 Aboriginal children from the WAACHS (2000–2002) alongside their primary (N=2113) and other (N=1040) carers, and other householders. WAACHS data were linked with Western Australia (WA) government administrative datasets up to 2020 including health, education, child protection, police and justice system contacts. The study also includes two non-Aboriginal cohorts from WA, linked with the same administrative data sources allowing comparisons of outcomes across cohorts in addition to between-group comparisons within the Aboriginal population.Findings to date Linked data coverage rates are presented for all WAACHS participants. Child health outcomes for the WAACHS children (Cohort 1) are described from birth into adulthood along with other outcomes including child protection and juvenile justice involvement.Future plans Analysis of data from both the child and carer cohorts will seek to understand the contribution of individual, family (intergenerational) and community-level influences on Aboriginal children’s developmental and health pathways, identify key developmental transitions or turning points where interventions may be most effective in improving outcomes, and compare service pathways for Aboriginal and non-Aboriginal children. All research is guided by Aboriginal governance processes and study outputs will be produced with Aboriginal leadership to guide culturally appropriate policy and practice for improving health, education and social outcomes.
Published: 2024
Full Text: View/download PDF

3. Control strategy for current limitation and maximum capacity utilization of grid connected PV inverter under unbalanced grid conditions

Author: Jyoti Joshi, Vibhu Jately, Peeyush Kala, Abhishek Sharma, Wei Hong Lim, and Brian Azzopardi
Subjects: Grid connected PV system, Active and reactive power control, Active power curtailment, Voltage stability, Inverter current limitation, Medicine, Science
Abstract: Abstract Under grid voltage sags, over current protection and exploiting the maximum capacity of the inverter are the two main goals of grid-connected PV inverters. To facilitate low-voltage ride-through (LVRT), it is imperative to ensure that inverter currents are sinusoidal and remain within permissible limits throughout the inverter operation. An improved LVRT control strategy for a two-stage three-phase grid-connected PV system is presented here to address these challenges. To provide over current limitation as well as to ensure maximum exploitation of the inverter capacity, a control strategy is proposed, and performance the strategy is evaluated based on the three generation scenarios on a 2-kW grid connected PV system. An active power curtailment (APC) loop is activated only in high power generation scenario to limit the current’s amplitude below the inverter’s rated current. The superior performance of the proposed strategy is established by comparison with two recent LVRT control strategies. The proposed method not only injects necessary active and reactive power but also minimizes overcurrent with increased exploitation of the inverter’s capacity under unbalanced grid voltage sag.
Published: 2024
Full Text: View/download PDF

4. The genome sequence of the ruby bryozoan, Bugula neritina (Linnaeus, 1758) [version 1; peer review: 1 approved, 2 approved with reservations]

Author: Patrick Adkins, John Bishop, Helen Jenkins, Christine Wood, Freja Azzopardi, and Rebekka Uhl
Subjects: Bugula neritina, ruby bryozoan, genome sequence, chromosomal, Cheilostomatida, eng, Medicine, Science
Abstract: We present a genome assembly from a specimen of Bugula neritina (the ruby bryozoan; Bryozoa; Gymnolaemata; Cheilostomatida; Bugulidae). The genome sequence has total length of 216.00 megabases. Most of the assembly is scaffolded into 9 chromosomal pseudomolecules. The mitochondrial genome has also been assembled and is 15.25 kilobases in length. Gene annotation of this assembly on Ensembl identified 20,264 protein-coding genes.
Published: 2024
Full Text: View/download PDF

5. Generating evidence to inform responsive and effective actions for Aboriginal and Torres Strait Islander adolescent health and well-being: a mix method protocol for evidence integration ‘the Roadmap Project’

Author: Alex Brown, Peter Azzopardi, Jaameeta Kurji, Karla Canuto, Rachel Reilly, Seth Westhead, Odette Pearson, Daniel McDonough, Salenna Elliott, India Shackleford, Brittney Andrews, Felicity Andrews, Sally Cooke, Mahlia Garay, Thomas Harrington, Corey Kennedy, Jaeda Lenoy, Monique Maclaine, Hannah McCleary, Lorraine Randall, Hamish Rose, Daniel Rosendale, Jakirah Telfer, Tina Brodie, and James Charles
Subjects: Medicine
Abstract: Background Australia does not have a national strategy for Aboriginal and Torres Strait Islander adolescent health and as a result, policy and programming actions are fragmented and may not be responsive to needs. Efforts to date have also rarely engaged Aboriginal and Torres Strait Islander people in co-designing solutions. The Roadmap Project aims to work in partnership with young people to define priority areas of health and well-being need and establish the corresponding developmentally appropriate, evidence-based actions.Methods and analysis All aspects of this project are governed by a group of Aboriginal and Torres Strait Islander young people. Needs, determinants and corresponding responses will be explored with Aboriginal and Torres Strait Islander adolescents (aged 10–24 years) across Australia through an online qualitative survey, interviews and focus group discussions. Parents, service providers and policy makers (stakeholders) will share their perspectives on needs and support required through interviews. Data generated will be co-analysed with the governance group and integrated with population health data, policy frameworks and evidence of effective programmes (established through reviews) to define responsive and effective actions for Aboriginal and Torres Strait Islander adolescent health and well-being.Ethics and dissemination Ethical approval for this study has been obtained from the Aboriginal Health Council of South Australia (Ref: 04-21-956), the Aboriginal Health and Medical Research Council of New South Wales (Ref: 1918/22), the Western Australian Aboriginal Health Ethics Committee (Ref: HREC1147), the Northern Territory Health and Menzies School of Health Research (Ref: 2022–4371), ACT Health Human Research Ethics Committee (Ref: 2022.ETH.00133), the St. Vincent’s Hospital, Victoria (Ref: HREC 129/22), University of Tasmania (Ref: 28020), Far North Queensland Human Research Ethics Committee (Ref: HREC/2023/QCH/89911) and Griffith University (Ref: 2023/135). Prospective adolescent participants will provide their own consent for the online survey (aged 13–24 years) and, interviews or focus group discussions (aged 15–24 years); with parental consent and adolescent assent required for younger adolescents (aged 10–14 years) participating in interviews.Study findings (priority needs and evidence-based responses) will be presented at a series of co-design workshops with adolescents and stakeholders from relevant sectors. We will also communicate findings through reports, multimedia clips and peer-reviewed publications as directed by the governance group.
Published: 2024
Full Text: View/download PDF

6. Menstrual Practice Needs Scale short form (MPNS-SF) and rapid (MPNS-R): development in Khulna, Bangladesh, and validation in cross-sectional surveys from Bangladesh and Uganda

Author: Md Tanvir Hasan, Julie Hennegan, Calum Smith, Adrita Kaiser, Peter S Azzopardi, Abdul Jabbar, Lillian Bagala, Tasfiyah Jalil, Sabina Akter, Afreen Zaman, Laura Dunstan, Alexandra Head, Erin C Hunter, Arifa Bente Mohosin, Nigar Sultana Zoha, and Muhammad Khairul Alam
Subjects: Medicine
Abstract: Objectives Develop and validate short and rapid forms of the 36-item Menstrual Practice Needs Scale (MPNS-36).Design Item reduction prioritised content validity and was informed by cognitive interviews with schoolgirls in Bangladesh, performance of scale items in past research and stakeholder feedback. The original MPNS-36 was revalidated, and short and rapid forms tested in a cross-sectional survey. This was followed by further tests of dimensionality, internal consistency and validity in multiple cross-sectional surveys.Setting and participants Short form (MPNS-SF) and rapid form (MPNS-R) measures were developed in a survey of 313 menstruating girls (mean age=13.51) in Khulna, Bangladesh. They were further tested in the baseline survey of the Adolescent Menstrual Experiences and Health Cohort, in Khulna, Bangladesh (891 menstruating girls, mean age=12.40); and the dataset from the MPNS-36 development in Soroti, Uganda (538 menstruating girls, mean age=14.49).Results The 18-item short form reflects the six original subscales, with the four core subscales demonstrating good fit in all three samples (Khulna pilot: root mean square error of approximation (RMSEA)=0.064, 90% CI 0.043 to 0.084, Comparative Fit Index (CFI)=0.94, Tucker-Lewis Index (TLI)=0.92. Cohort baseline: RMSEA=0.050, 90% CI 0.039 to 0.062, CFI=0.96, TLI=0.95. Uganda: RMSEA=0.039, 90% CI 0.028 to 0.050, CFI=0.95, TLI=0.94). The 9-item rapid form captures diverse needs. A two-factor structure was the most appropriate but fell short of adequate fit (Khulna pilot: RMSEA=0.092, 90% CI 0.000 to 0.158, CFI=0.93, TLI=0.89). Hypothesised associations between the MPNS scores and other constructs were comparable between the MPNS-36 and MPNS-SF in all populations, and replicated, with attenuation, in the MPNS-R. Internal consistency remained acceptable.Conclusions The MPNS-SF offers a reliable and valid measure of adolescent girls’ menstrual hygiene experience while reducing participant burden, to support implementation and improve measurement in menstrual health research. The MPNS-R provides a brief measure with poorer structural validity, suited to short surveys and including menstrual health within broader research topics.
Published: 2024
Full Text: View/download PDF

7. A DNA barcoding framework for taxonomic verification in the Darwin Tree of Life Project [version 1; peer review: 2 approved]

Author: Silvia Salatino, Rebekka Uhl, Peter O. Mulhair, Freja Azzopardi, Jordan Beasley, Alex D. Twyford, Lucia Campos-Dominguez, Michelle L. Hart, Olga Sivell, David Bell, Gavin Broad, Felix Shaw, Piotr Cuber, Darren Choonea, Peter M. Hollingsworth, Laura L. Forrest, Sahr Mian, Alexandra Dombrowski, Mara K.N. Lawniczak, Claire Griffin, Clementine Greeves, Peter W.H. Holland, Joanna Harley, Owen T. Lewis, Amanda Jones, Ben W. Price, Raju Misra, Estelle Kilias, Ian Barnes, Laura Sivess, Heather Allen, Alice Minotto, Inez Januszczak, Michael Cunliffe, Mark L. Blaxter, Liam Crowley, Lyndall Pereira da Conceicoa, Brian Douglas, Kieran Woof, Ester Gaya, and Paul Kersey
Subjects: DNA barcoding, species identification, taxonomy, Britain and Ireland, biodiversity, eng, Medicine, Science
Abstract: Biodiversity genomics research requires reliable organismal identification, which can be difficult based on morphology alone. DNA-based identification using DNA barcoding can provide confirmation of species identity and resolve taxonomic issues but is rarely used in studies generating reference genomes. Here, we describe the development and implementation of DNA barcoding for the Darwin Tree of Life Project (DToL), which aims to sequence and assemble high quality reference genomes for all eukaryotic species in Britain and Ireland. We present a standardised framework for DNA barcode sequencing and data interpretation that is then adapted for diverse organismal groups. DNA barcoding data from over 12,000 DToL specimens has identified up to 20% of samples requiring additional verification, with 2% of seed plants and 3.5% of animal specimens subsequently having their names changed. We also make recommendations for future developments using new sequencing approaches and streamlined bioinformatic approaches.
Published: 2024
Full Text: View/download PDF

8. Assessing the feasibility and acceptability of a diabetes-specific nurse-led multicomponent smoking cessation intervention in diabetes education: study protocol for an open-label pragmatic randomised controlled trial

Author: Ian Norman, Joseph Grech, Catherine Azzopardi, Moira Grixti, and Roberta Sammut
Subjects: Medicine
Abstract: Introduction Smoking cessation is an essential, but often overlooked aspect of diabetes management. Despite the need for tailored smoking cessation support for individuals with diabetes, evidence of effective interventions for this cohort is limited. Additionally, individuals with diabetes do not easily adopt such interventions, resulting in low uptake and abstinence rates. This protocol describes a study that aims to assess the feasibility and acceptability of a unique smoking cessation intervention, based on the best evidence, theory and the needs of individuals with diabetes, among patients and service providers, the diabetes nurse educators.Methods and analysis This is an open-label pragmatic randomised controlled trial. Between 80 and 100 individuals with type 1 or type 2 diabetes who smoke will be recruited from the diabetes outpatients at the main acute public hospital in Malta, starting in August 2023. Participants will be randomly assigned (1:1 ratio) to the intervention or control arm for 12 weeks. The experimental intervention will consist of three to four smoking cessation behavioural support sessions based on the 5As (Ask, Advise, Assess, Assist and Arrange) algorithm, and a 6-week supply of nicotine replacement therapy. The control intervention will consist of an active referral to the Maltese National Health Service’s one-to-one smoking cessation support service, which is based on motivational interviewing. The primary feasibility and acceptability outcomes include the recruitment and participation rates, resources used, problems identified by the nurses, the nurses’ perceived challenges and facilitators to implementation and the nurses’ and patients’ acceptability of the study intervention. Data analyses will be descriptive, with quantitative feasibility and acceptability outcomes reported with 95% confidence intervals.Ethics and dissemination Ethical clearance was obtained from the Faculty of Health Sciences Research Ethics Committee, University of Malta. The study results will be disseminated through conference presentations and a publication in a peer-reviewed journal.Trial registration number NCT05920096.
Published: 2024
Full Text: View/download PDF

9. Health and well-being needs of Indigenous adolescents: a protocol for a scoping review of qualitative studies

Author: Alex Brown, Sue Crengle, Matire Harwood, Jeff Reading, Siv Kvernmo, Peter Azzopardi, Brittany Bingham, Elizabeth Saewyc, Jaameeta Kurji, Rachel Reilly, Seth Westhead, Ngiare Brown, Odette Pearson, Jordan Tewhaiti-Smith, Andrew Sise, Daniel McDonough, Chenoa Cassidy-Matthews, Terryann C Clark, Salenna Elliott, Summer May Finlay, Ketil Lenert Hansen, Jonill Margrethe Fjellheim Knapp, Crystal Lee, Ricky-Lee Watts, Melanie Nadeau, Amalie Seljenes, Jon Petter A Stoor, and Paula Aubrey
Subjects: Medicine
Abstract: Introduction Improving the health of Indigenous adolescents is central to addressing the health inequities faced by Indigenous peoples. To achieve this, it is critical to understand what is needed from the perspectives of Indigenous adolescents themselves. There have been many qualitative studies that capture the perspectives of Indigenous young people, but synthesis of these has been limited to date.Methods and analysis This scoping review seeks to understand the specific health needs and priorities of Indigenous adolescents aged 10–24 years captured via qualitative studies conducted across Australia, Aotearoa New Zealand, Canada, the USA, Greenland and Sami populations (Norway and Sweden). A team of Indigenous and non-Indigenous researchers from these nations will systematically search PubMed (including the MEDLINE, PubMed Central and Bookshelf databases), CINAHL, Embase, Scopus, the Informit Indigenous and Health Collections, Google Scholar, Arctic Health, the Circumpolar Health Bibliographic Database, Native Health Database, iPortal and NZresearch.org, as well as specific websites and clearinghouses within each nation for qualitative studies. We will limit our search to articles published in any language during the preceding 5 years given that needs may have changed significantly over time. Two independent reviewers will identify relevant articles using a two-step process, with disagreements resolved by a third reviewer and the wider research group. Data will then be extracted from included articles using a standardised form, with descriptive synthesis focussing on key needs and priorities. This scoping review will be conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines.Ethics and dissemination Ethics approval was not required for this review. Findings will be disseminated via a peer-reviewed journal article and will inform a broader international collaboration for Indigenous adolescent health to develop evidence-based actions and solutions.
Published: 2024
Full Text: View/download PDF

10. Specific and off-target immune responses following COVID-19 vaccination with ChAdOx1-S and BNT162b2 vaccines—an exploratory sub-study of the BRACE trialResearch in context

Author: Nicole L. Messina, Susie Germano, Rebecca McElroy, Rhian Bonnici, Branka Grubor-Bauk, David J. Lynn, Ellie McDonald, Suellen Nicholson, Kirsten P. Perrett, Laure F. Pittet, Rajeev Rudraraju, Natalie E. Stevens, Kanta Subbarao, Nigel Curtis, Andrew Davidson, Kaya Gardiner, Amanda Gwee, Tenaya Jamieson, Nicole Messina, Thilanka Morawakage, Susan Perlen, Kirsten Perrett, Laure Pittet, Amber Sastry, Jia Wei Teo, Francesca Orsini, Katherine Lee, Cecilia Moore, Suzanna Vidmar, Rashida Ali, Ross Dunn, Peta Edler, Grace Gell, Casey Goodall, Richard Hall, Ann Krastev, Nathan La, Nick McPhate, Thao Nguyen, Jack Ren, Luke Stevens, Ahmed Alamrousi, Thanh Dang, Jenny Hua, Monica Razmovska, Scott Reddiex, Xiaofang Wang, Jeremy Anderson, Kristy Azzopardi, Vicki Bennett-Wood, Anna Czajko, Nadia Mazarakis, Conor McCafferty, Frances Oppedisano, Belinda Ortika, Casey Pell, Leena Spry, Ryan Toh, Sunitha Velagapudi, Amanda Vlahos, Ashleigh Wee-Hee, Pedro Ramos, Karina De La Cruz, Dinusha Gamage, Anushka Karunanayake, Isabella Mezzetti, Benjamin Ong, Ronita Singh, Enoshini Sooriyarachchi, Natalie Cain, Rianne Brizuela, Han Huang, Veronica Abruzzo, Morgan Bealing, Patricia Bimboese, Kirsty Bowes, Emma Burrell, Joyce Chan, Jac Cushnahan, Hannah Elborough, Olivia Elkington, Kieran Fahey, Monique Fernandez, Catherine Flynn, Sarah Fowler, Marie Gentile Andrit, Bojana Gladanac, Catherine Hammond, Norine Ma, Sam Macalister, Emmah Milojevic, Jesutofunmi Mojeed, Jill Nguyen, Liz O’Donnell, Nadia Olivier, Isabelle Ooi, Stephanie Reynolds, Lisa Shen, Barb Sherry, Judith Spotswood, Jamie Wedderburn, Angela Younes, Donna Legge, Jason Bell, Jo Cheah, Annie Cobbledick, Kee Lim, Sonja Elia, Lynne Addlem, Anna Bourke, Clare Brophy, Nadine Henare, Narelle Jenkins, Francesca Machingaifa, Skye Miller, Kirsten Mitchell, Sigrid Pitkin, Kate Wall, Paola Villanueva, Nigel Crawford, Wendy Norton, Niki Tan, Thilakavathi Chengodu, Diane Dawson, Victoria Gordon, Tony Korman, Jess O’Bryan, Sophie Agius, Samantha Bannister, Jess Bucholc, Alison Burns, Beatriz Camesella, John Carlin, Marianna Ciaverella, Maxwell Curtis, Stephanie Firth, Christina Guo, Matthew Hannan, Erin Hill, Sri Joshi, Katherine Lieschke, Megan Mathers, Sasha Odoi, Ashleigh Rak, Chris Richards, Leah Steve, Carolyn Stewart, Eva Sudbury, Helen Thomson, Emma Watts, Fiona Williams, Angela Young, Penny Glenn, Andrew Kaynes, Amandine Philippart De Floy, Sandy Buchanan, Thijs Sondag, Ivy Xie, Harriet Edmund, Bridie Byrne, Tom Keeble, Belle Ngien, Fran Noonan, Michelle Wearing-Smith, Alison Clarke, Pemma Davies, Oliver Eastwood, Alric Ellinghaus, Rachid Ghieh, Zahra Hilton, Emma Jennings, Athina Kakkos, Iris Liang, Katie Nicol, Sally O’Callaghan, Helen Osman, Gowri Rajaram, Sophia Ratcliffe, Victoria Rayner, Ashleigh Salmon, Angela Scheppokat, Aimee Stevens, Rebekah Street, Nicholas Toogood, Nicholas Wood, Twinkle Bahaduri, Therese Baulman, Jennifer Byrne, Candace Carter, Mary Corbett, Aiken Dao, Maria Desylva, Andrew Dunn, Evangeline Gardiner, Rosemary Joyce, Rama Kandasamy, Craig Munns, Lisa Pelayo, Ketaki Sharma, Katrina Sterling, Caitlin Uren, Clinton Colaco, Mark Douglas, Kate Hamilton, Adam Bartlett, Brendan McMullan, Pamela Palasanthiran, Phoebe Williams, Justin Beardsley, Nikki Bergant, Renier Lagunday, Kristen Overton, Jeffrey Post, Yasmeen Al-Hindawi, Sarah Barney, Anthony Byrne, Lee Mead, Marshall Plit, David Lynn, Saoirse Benson, Stephen Blake, Rochelle Botten, Tee Yee Chern, Georgina Eden, Liddy Griffith, Jane James, Miriam Lynn, Angela Markow, Domenic Sacca, Natalie Stevens, Steve Wesselingh, Catriona Doran, Simone Barry, Alice Sawka, Sue Evans, Louise Goodchild, Christine Heath, Meredith Krieg, Helen Marshall, Mark McMillan, Mary Walker, Peter Richmond, Nelly Amenyogbe, Christina Anthony, Annabelle Arnold, Beth Arrowsmith, Rym Ben-Othman, Sharon Clark, Jemma Dunnill, Nat Eiffler, Krist Ewe, Carolyn Finucane, Lorraine Flynn, Camille Gibson, Lucy Hartnell, Elysia Hollams, Heidi Hutton, Lance Jarvis, Jane Jones, Jan Jones, Karen Jones, Jennifer Kent, Tobias Kollmann, Debbie Lalich, Wenna Lee, Rachel Lim, Sonia McAlister, Fiona McDonald, Andrea Meehan, Asma Minhaj, Lisa Montgomery, Melissa O’Donnell, Jaslyn Ong, Joanne Ong, Kimberley Parkin, Glady Perez, Catherine Power, Shadie Rezazadeh, Holly Richmond, Sally Rogers, Nikki Schultz, Margaret Shave, Patrycja Skut, Lisa Stiglmayer, Alexandra Truelove, Ushma Wadia, Rachael Wallace, Justin Waring, Michelle England, Erin Latkovic, Laurens Manning, Susan Herrmann, Michaela Lucas, Marcus Lacerda, Paulo Henrique Andrade, Fabiane Bianca Barbosa, Dayanne Barros, Larissa Brasil, Ana Greyce Capella, Ramon Castro, Erlane Costa, Dilcimar de Souza, Maianne Dias, José Dias, Klenilson Ferreira, Paula Figueiredo, Thamires Freitas, Ana Carolina Furtado, Larissa Gama, Vanessa Godinho, Cintia Gouy, Daniele Hinojosa, Bruno Jardim, Tyane Jardim, Joel Junior, Augustto Lima, Bernardo Maia, Adriana Marins, Kelry Mazurega, Tercilene Medeiros, Rosangela Melo, Marinete Moraes, Elizandra Nascimento, Juliana Neves, Maria Gabriela Oliveira, Thais Oliveira, Ingrid Oliveira, Arthur Otsuka, Rayssa Paes, Handerson Pereira, Gabrielle Pereira, Christiane Prado, Evelyn Queiroz, Laleyska Rodrigues, Bebeto Rodrigues, Vanderson Sampaio, Anna Gabriela Santos, Daniel Santos, Tilza Santos, Evelyn Santos, Ariandra Sartim, Ana Beatriz Silva, Juliana Silva, Emanuelle Silva, Mariana Simão, Caroline Soares, Antonny Sousa, Alexandre Trindade, Fernando Val, Adria Vasconcelos, Heline Vasconcelos, Julio Croda, Carolinne Abreu, Katya Martinez Almeida, Camila Bitencourt de Andrade, Jhenyfer Thalyta Campos Angelo, Ghislaine Gonçalvez de Araújo Arcanjo, Bianca Maria Silva Menezes Arruda, Wellyngthon Espindola Ayala, Adelita Agripina Refosco Barbosa, Felipe Zampieri Vieira Batista, Fabiani de Morais Batista, Miriam de Jesus Costa, Mariana Garcia Croda, Lais Alves da Cruz, Roberta Carolina Pereira Diogo, Rodrigo Cezar Dutra Escobar, Iara Rodrigues Fernandes, Leticia Ramires Figueiredo, Leandro Galdino Cavalcanti Gonçalves, Sarita Lahdo, Joyce dos Santos Lencina, Guilherme Teodoro de Lima, Larissa Santos Matos, Bruna Tayara Leopoldina Meireles, Debora Quadros Moreira, Lilian Batista Silva Muranaka, Adriely de Oliveira, Karla Regina Warszawski de Oliveira, Matheus Vieira de Oliveira, Roberto Dias de Oliveira, Andrea Antonia Souza de Almeida dos Reis Pereira, Marco Puga, Caroliny Veron Ramos, Thaynara Haynara Souza da Rosa, Karla Lopes dos Santos, Claudinalva Ribeiro dos Santos, Dyenyffer Stéffany Leopoldina dos Santos, Karina Marques Santos, Paulo César Pereira da Silva, Paulo Victor Rocha da Silva, Débora dos Santos Silva, Patricia Vieira da Silva, Bruno Freitas da Rosa Soares, Mariana Gazzoni Sperotto, Mariana Mayumi Tadokoro, Daniel Tsuha, Hugo Miguel Ramos Vieira, Margareth Maria Pretti Dalcolmo, Cíntia Maria Lopes Alves da Paixão, Gabriela Corrêa E Castro, Simone Silva Collopy, Renato da Costa Silva, Samyra Almeida da Silveira, Alda Maria Da-Cruz, Alessandra Maria da Silva Passos de Carvalho, Rita de Cássia Batista, Maria Luciana Silva De Freitas, Aline Gerhardt de Oliveira Ferreira, Ana Paula Conceição de Souza, Paola Cerbino Doblas, Ayla Alcoforado da Silva dos Santos, Vanessa Cristine de Moraes dos Santos, Dayane Alves dos Santos Gomes, Anderson Lage Fortunato, Adriano Gomes-Silva, Monique Pinto Gonçalves, Paulo Leandro Garcia Meireless Junior, Estela Martins da Costa Carvalho, Fernando do Couto Motta, Ligia Maria Olivo de Mendonça, Girlene dos Santos Pandine, Rosa Maria Plácido Pereira, Ivan Ramos Maia, Jorge Luiz da Rocha, João Victor Paiva Romano, Glauce dos Santos, Erica Fernandes da Silva, Marilda Agudo Mendonça Teixeira de Siqueira, Ágatha Cristinne Prudêncio Soares, Marc Bonten, Sandra Franch Arroyo, Henny Ophorst-den Besten, Anna Boon, Karin M. Brakke, Axel Janssen, Marijke A.H. Koopmans, Toos Lemmens, Titia Leurink, Cristina Prat-Aymerich, Engelien Septer-Bijleveld, Kimberly Stadhouders, Darren Troeman, Marije van der Waal, Marjoleine van Opdorp, Nicolette van Sluis, Beatrijs Wolters, Jan Kluytmans, Jannie Romme, Wouter van den Bijllaardt, Linda van Mook, M.M.L (Miranda) van Rijen, Margreet Filius, Jet Gisolf, Frances Greven, Danique Huijbens, Robert Jan Hassing, Roos Pon, Lieke Preijers, Joke van Leusen, Harald Verheij, Wim Boersma, Evelien Brans, Paul Kloeg, Kitty Molenaar-Groot, Nhat Khanh Nguyen, Nienke Paternotte, Anke Rol, Lida Stooper, Helga Dijkstra, Esther Eggenhuizen, Lucas Huijs, Simone Moorlag, Mihai Netea, Eva Pranger, Esther Taks, Jaap ten Oever, Rob ter Heine, Kitty Blauwendraat, Bob Meek, Isil Erkaya, Houda Harbech, Nienke Roescher, Rifka Peeters, Menno te Riele, Carmen Zhou, Esther Calbo, Cristina Badia Marti, Emma Triviño Palomares, Tomás Perez Porcuna, Anabel Barriocanal, Ana Maria Barriocanal, Irma Casas, Jose Dominguez, Maria Esteve, Alicia Lacoma, Irene Latorre, Gemma Molina, Barbara Molina, Antoni Rosell, Sandra Vidal, Lydia Barrera, Natalia Bustos, Ines Portillo Calderón, David Gutierrez Campos, Jose Manuel Carretero, Angel Dominguez Castellano, Renato Compagnone, Encarnacion Ramirez de Arellano, Almudena de la Serna, Maria Dolores del Toro Lopez, Marie-Alix Clement Espindola, Ana Belen Martin Gutierrez, Alvaro Pascual Hernandez, Virginia Palomo Jiménez, Elisa Moreno, Nicolas Navarrete, Teresa Rodriguez Paño, Jesús Rodríguez-Baño, Enriqueta Tristán, Maria Jose Rios Villegas, Atsegiñe Canga Garces, Erika Castro Amo, Raquel Coya Guerrero, Josune Goikoetxea, Leticia Jorge, Cristina Perez, María Carmen Fariñas Álvarez, Manuel Gutierrez Cuadra, Francisco Arnaiz de las Revillas Almajano, Pilar Bohedo Garcia, Teresa Giménez Poderos, Claudia González Rico, Blanca Sanchez, Olga Valero, Noelia Vega, John Campbell, Anna Barnes, Helen Catterick, Tim Cranston, Phoebe Dawe, Emily Fletcher, Liam Fouracre, Alison Gifford, John Kirkwood, Christopher Martin, Amy McAnew, Marcus Mitchell, Georgina Newman, Abby O’Connell, Jakob Onysk, Lynne Quinn, Shelley Rhodes, Samuel Stone, Lorrie Symons, Harry Tripp, Adilia Warris, Darcy Watkins, Bethany Whale, Alex Harding, Gemma Lockhart, Kate Sidaway-Lee, Sam Hilton, Sarah Manton, Daniel Webber-Rookes, Rachel Winder, James Moore, Freya Bateman, Michael Gibbons, Bridget Knight, Julie Moss, Sarah Statton, Josephine Studham, Lydia Hall, Will Moyle, and Tamsin Venton
Subjects: Vaccine, Off-target, Immunoregulation, Cytokine, SARS-CoV-2, Heterologous immunity, Medicine, Medicine (General), R5-920
Abstract: Summary: Background: The COVID-19 pandemic led to the rapid development and deployment of several highly effective vaccines against SARS-CoV-2. Recent studies suggest that these vaccines may also have off-target effects on the immune system. We sought to determine and compare the off-target effects of the adenovirus vector ChAdOx1-S (Oxford-AstraZeneca) and modified mRNA BNT162b2 (Pfizer-BioNTech) vaccines on immune responses to unrelated pathogens. Methods: Prospective sub-study within the BRACE trial. Blood samples were collected from 284 healthcare workers before and 28 days after ChAdOx1-S or BNT162b2 vaccination. SARS-CoV-2-specific antibodies were measured using ELISA, and whole blood cytokine responses to specific (SARS-CoV-2) and unrelated pathogen stimulation were measured by multiplex bead array. Findings: Both vaccines induced robust SARS-CoV-2 specific antibody and cytokine responses. ChAdOx1-S vaccination increased cytokine responses to heat-killed (HK) Candida albicans and HK Staphylococcus aureus and decreased cytokine responses to HK Escherichia coli and BCG. BNT162b2 vaccination decreased cytokine response to HK E. coli and had variable effects on cytokine responses to BCG and resiquimod (R848). After the second vaccine dose, BNT162b2 recipients had greater specific and off-target cytokine responses than ChAdOx1-S recipients. Interpretation: ChAdOx1-S and BNT162b2 vaccines alter cytokine responses to unrelated pathogens, indicative of potential off-target effects. The specific and off-target effects of these vaccines differ in their magnitude and breadth. The clinical relevance of these findings is uncertain and needs further study. Funding: Bill & Melinda Gates Foundation, National Health and Medical Research Council, Swiss National Science Foundation and the Melbourne Children’s. BRACE trial funding is detailed in acknowledgements.
Published: 2024
Full Text: View/download PDF

11. Protocol for the Adolescent Menstrual Experiences and Health Cohort (AMEHC) Study in Khulna, Bangladesh: A Prospective cohort to quantify the influence of menstrual health on adolescent girls’ health and education outcomes.

Author: Peter Azzopardi, Sabina Faiz Rashid, Helen Anne Weiss, Md Tanvir Hasan, Julie Hennegan, G J Melendez-Torres, Adrita Kaiser, Kyu Kyu Than, Nick Scott, Sonia Grover, Abdul Jabbar, Mahfuj-ur Rahman, Thin Mar Win, Tasfiyah Jalil, Elissa Kennedy, Erin Hunter, Sabina Akter, Afreen Zaman, Laura Dunstan, Alexandra Head, Chad L Hughes, and Mahadi Hasan
Subjects: Medicine
Abstract: Background Menstrual health is essential for gender equity and the well-being of women and girls. Qualitative research has described the burden of poor menstrual health on health and education; however, these impacts have not been quantified, curtailing investment. The Adolescent Menstrual Experiences and Health Cohort (AMEHC) Study aims to describe menstrual health and its trajectories across adolescence, and quantify the relationships between menstrual health and girls’ health and education in Khulna, Bangladesh.Methods and analysis AMEHC is a prospective longitudinal cohort of 2016 adolescent girls recruited at the commencement of class 6 (secondary school, mean age=12) across 101 schools selected through a proportional random sampling approach. Each year, the cohort will be asked to complete a survey capturing (1) girls’ menstrual health and experiences, (2) support for menstrual health, and (3) health and education outcomes. Survey questions were refined through qualitative research, cognitive interviews and pilot survey in the year preceding the cohort. Girls’ guardians will be surveyed at baseline and wave 2 to capture their perspectives and household demographics. Annual assessments will capture schools’ water, sanitation and hygiene, and support for menstruation and collect data on participants’ education, including school attendance and performance (in maths, literacy). Cohort enrolment and baseline survey commenced in February 2023. Follow-up waves are scheduled for 2024, 2025 and 2026, with plans for extension. A nested subcohort will follow 406 post-menarche girls at 2-month intervals throughout 2023 (May, August, October) to describe changes across menstrual periods. This protocol outlines a priori hypotheses regarding the impacts of menstrual health to be tested through the cohort.Ethics and dissemination AMEHC has ethical approval from the Alfred Hospital Ethics Committee (369/22) and BRAC James P Grant School of Public Health Institutional Review Board (IRB-06 July 22-024). Study materials and outputs will be available open access through peer-reviewed publication and study web pages.
Published: 2024
Full Text: View/download PDF

12. Performance investigation of state-of-the-art metaheuristic techniques for parameter extraction of solar cells/module

Author: Abhishek Sharma, Abhinav Sharma, Moshe Averbukh, Vibhu Jately, Shailendra Rajput, Brian Azzopardi, and Wei Hong Lim
Subjects: Medicine, Science
Abstract: Abstract One of the greatest challenges for widespread utilization of solar energy is the low conversion efficiency, motivating the needs of developing more innovative approaches to improve the design of solar energy conversion equipment. Solar cell is the fundamental component of a photovoltaic (PV) system. Solar cell’s precise modelling and estimation of its parameters are of paramount importance for the simulation, design, and control of PV system to achieve optimal performances. It is nontrivial to estimate the unknown parameters of solar cell due to the nonlinearity and multimodality of search space. Conventional optimization methods tend to suffer from numerous drawbacks such as a tendency to be trapped in some local optima when solving this challenging problem. This paper aims to investigate the performance of eight state-of-the-art metaheuristic algorithms (MAs) to solve the solar cell parameter estimation problem on four case studies constituting of four different types of PV systems: R.T.C. France solar cell, LSM20 PV module, Solarex MSX-60 PV module, and SS2018P PV module. These four cell/modules are built using different technologies. The simulation results clearly indicate that the Coot-Bird Optimization technique obtains the minimum RMSE values of 1.0264E-05 and 1.8694E−03 for the R.T.C. France solar cell and the LSM20 PV module, respectively, while the wild horse optimizer outperforms in the case of the Solarex MSX-60 and SS2018 PV modules and gives the lowest value of RMSE as 2.6961E−03 and 4.7571E−05, respectively. Furthermore, the performances of all eight selected MAs are assessed by employing two non-parametric tests known as Friedman ranking and Wilcoxon rank-sum test. A full description is also provided, enabling the readers to understand the capability of each selected MA in improving the solar cell modelling that can enhance its energy conversion efficiency. Referring to the results obtained, some thoughts and suggestions for further improvements are provided in the conclusion section.
Published: 2023
Full Text: View/download PDF

13. The genome sequence of the John Dory, Zeus faber Linnaeus, 1758 [version 1; peer review: 2 approved]

Author: Patrick Adkins, Rachel Brittain, Joanna Harley, Kesella Scott-Somme, and Freja Azzopardi
Subjects: Zeus faber, John Dory, genome sequence, chromosomal, Zeiformes, eng, Medicine, Science
Abstract: We present a genome assembly from an individual Zeus faber (the John Dory; Chordata; Actinopteri; Zeiformes; Zeidae). The genome sequence is 804.7 megabases in span. Most of the assembly is scaffolded into 22 chromosomal pseudomolecules. The mitochondrial genome has also been assembled and is 16.72 kilobases in length.
Published: 2024
Full Text: View/download PDF

14. Codesigning enhanced models of care for Northern Australian Aboriginal and Torres Strait Islander youth with type 2 diabetes: study protocol

Author: Louise Maple-Brown, Alex Brown, Peter Azzopardi, Natasha Freeman, Jonathan E Shaw, Vicki O'Donnell, Christine Connors, Elizabeth Davis, Angela Titmuss, Renae Kirkham, John Boffa, Elna Ellis, Sian Graham, Stefanie Puszka, Emma Weaver, Jade Morris, Shiree Mack, James Dowler, Sumaria Corpus, Lydia Scott, Ashim K Sinha, and Brandy Wicklow
Subjects: Medicine
Abstract: Introduction Premature onset of type 2 diabetes and excess mortality are critical issues internationally, particularly in Indigenous populations. There is an urgent need for developmentally appropriate and culturally safe models of care. We describe the methods for the codesign, implementation and evaluation of enhanced models of care with Aboriginal and Torres Strait Islander youth living with type 2 diabetes across Northern Australia.Methods and analysis Our mixed-methods approach is informed by the principles of codesign. Across eight sites in four regions, the project brings together the lived experience of Aboriginal and Torres Strait Islander young people (aged 10–25) with type 2 diabetes, their families and communities, and health professionals providing diabetes care through a structured yet flexible codesign process. Participants will help identify and collaborate in the development of a range of multifaceted improvements to current models of care. These may include addressing needs identified in our formative work such as the development of screening and management guidelines, referral pathways, peer support networks, diabetes information resources and training for health professionals in youth type 2 diabetes management. The codesign process will adopt a range of methods including qualitative interviews, focus group discussions, art-based methods and healthcare systems assessments. A developmental evaluation approach will be used to create and refine the components and principles of enhanced models of care. We anticipate that this codesign study will produce new theoretical insights and practice frameworks, resources and approaches for age-appropriate, culturally safe models of care.Ethics and dissemination The study design was developed in collaboration with Aboriginal and Torres Strait Islander and non-Indigenous researchers, health professionals and health service managers and has received ethical approval across all sites. A range of outputs will be produced to disseminate findings to participants, other stakeholders and the scholarly community using creative and traditional formats.
Published: 2024
Full Text: View/download PDF

15. Editorial: Innovations in quality of care

Author: João Breda, Ara Darzi, Hutan Ashrafian, Francisco Goiana-da-Silva, and Natasha Azzopardi-Muscat
Subjects: sustainable development, World Health Organization, quality of care, SARS-CoV-2 pandemic, medical and surgical innovation, Institute Of Global Health Innovation, Medicine
Published: 2024
Full Text: View/download PDF

16. Association between culture and the preference for, and perceptions of, 11 routes of medicine administration: A survey in 21 countries and regions

Author: Sudaxshina Murdan, Li Wei, Diana A. van Riet-Nales, Abyot Endale Gurmu, Stella Folajole Usifoh, Adriana-Elena Tăerel, Ayca Yıldız-Peköz, Dušanka Krajnović, Lilian M. Azzopardi, Tina Brock, Ana I. Fernandes, André Luis Souza dos Santos, Berko Panyin Anto, Thibault Vallet, Eunkyung Euni Lee, Kyeong Hye Jeong, Marwan Akel, Eliza Tam, Daisy Volmer, Tawfik Douss, Sharvari Shukla, Shigeo Yamamura, Xiaoe Lou, Bauke H.G. van Riet, Cyril O. Usifoh, Mahama Duwiejua, Fabrice Ruiz, and Adrian Furnham
Subjects: Medicine, Route of administration, Culture, Perception, Preference, Association, Pharmacy and materia medica, RS1-441
Abstract: Medicines can be taken by various routes of administration. These can impact the effects and perceptions of medicines. The literature about individuals' preferences for and perceptions of the different routes of administration is sparse, but indicates a potential influence of culture. Our aim was to determine: (i) any association between one's culture and one's preferred route of medicine administration and (ii) individual perceptions of pain, efficacy, speed of action and acceptability when medicines are swallowed or placed in the mouth, under the tongue, in the nose, eye, ear, lungs, rectum, vagina, on the skin, or areinjected.A cross-sectional, questionnaire-based survey of adults was conducted in 21 countries and regions of the world, namely, Tunisia, Ghana, Nigeria, Turkey, Ethiopia, Lebanon, Malta, Brazil, Great Britain, United States, India, Serbia, Romania, Portugal, France, Netherlands, Japan, South Korea, Hong Kong, mainland China and Estonia, using the Inglehart–Welzel cultural map to ensure coverage across all cultures. Participants scored the pain/discomfort, efficacy, speed of onset and acceptability of the different routes of medicine administration and stated their preferred route. Demographic information was collected.A total of 4435 participants took part in the survey. Overall, the oral route was the most preferred route, followed by injection, while the rectal route was the least preferred. While the oral route was the most preferred in all cultures, the percentage of participants selecting this route varied, from 98% in Protestant Europe to 50% in the African-Islamic culture. A multinomial logistic regression model revealed a number of predictors for the preferred route. Injections were favoured in the Baltic, South Asia, Latin America and African-Islamic cultures while dermal administration was favoured in Catholic Europe, Baltic and Latin America cultures. A marked association was found between culture and the preference for, and perceptions of the different routes by which medicines are taken. This applied to even the least favoured routes (vaginal and rectal). Only women were asked about the vaginal route, and our data shows that the vaginal route was slightly more popular than the rectal one.
Published: 2023
Full Text: View/download PDF

17. Aortoiliac graft‐enteric fistula presenting as gastrointestinal hemorrhage: A report on a complex case management

Author: Michael Azzopardi, Tom Wallace, and Yazan S. Khaled
Subjects: artery‐enteric fistula, gastrointestinal hemorrhage, graft explant, sigmoid cancer, Medicine, Medicine (General), R5-920
Abstract: Key Clinical Message Iliac artery‐enteric fistula is a rare cause of lower GI bleeding and can cause life‐threatening consequences. A high degree of clinical suspicion is needed in patients with previous aortic surgery to allow early multidisciplinary intervention. Abstract This case study discusses the staged management of a 78‐year‐old patient presenting with life‐threatening lower gastrointestinal (GI) bleeding secondary to an aortoiliac graft‐enteric fistula (GEF) into the sigmoid colon on the background of an adenocarcinoma and diverticular disease. The patient had an aorto bi‐iliac synthetic dacron graft repair of an abdominal aortic aneurysm (AAA) some 20 years ago. Here, we present a case of successful endovascular treatment of massive hemorrhage as a bridge to definitive second‐stage dacron graft explant and autologous vein reconstruction with a simultaneous anterior resection.
Published: 2023
Full Text: View/download PDF

18. A randomised study to assess the nicotine pharmacokinetics of an oral nicotine pouch and two nicotine replacement therapy products

Author: David Azzopardi, James Ebajemito, Michael McEwan, Oscar M. Camacho, Jesse Thissen, George Hardie, Richard Voisine, Gavin Mullard, Zvi Cohen, and James Murphy
Subjects: Medicine, Science
Abstract: Abstract Nicotine replacement therapies (NRTs) are intended for short-term use to help cigarette smokers to quit. Some smokers find NRTs ineffective or seek a more satisfactory source of nicotine. Tobacco-free oral nicotine pouch (NP) products have emerged as a potential reduced risk product compared with cigarettes and other tobacco products. In a randomised crossover clinical study, thirty-four healthy adult smokers were enrolled and their nicotine Cmax and AUC0-T determined for three 4 mg nicotine products (NP, gum, lozenge) under fasting conditions. The NP, lozenge and gum mean Cmax values were 8.5, 8.3 and 4.4 ng/mL, AUC0-T values were 30.6, 31.5 and 14.3 ng*h/mL, respectively. The NP showed similar nicotine bioavailability to the lozenge (p = 0.6526 (Cmax), p = 1.0000 (AUC0-T)), and superior bioavailability to the gum (p
Published: 2022
Full Text: View/download PDF

19. Trends in cost and consumption of essential medicines for non-communicable diseases in Azerbaijan, Georgia, and Uzbekistan, from 2019 to 2021.

Author: Ninell Kadyrova, Dzintars Gotham, Stanislav Kniazkov, Elsever Aghayev, Polad Hajibalayev, Zohid Ermatov, and Natasha Azzopardi Muscat
Subjects: Medicine, Science
Abstract: BackgroundAccess to medicines is a global priority. Azerbaijan, Georgia, and Uzbekistan have different approaches to pricing policies for pharmaceuticals. The aim of this study was to analyze recent trends in the consumption and prices of non-communicable disease (NCD) medicines in Azerbaijan, Georgia, and Uzbekistan, in the outpatient setting.MethodsWe included medicines for asthma and COPD, cancer, cardiovascular disease, diabetes, epilepsy, and mental disorders. Sales data for pharmaceutical products in community pharmacies were extracted from a commercial database. Changes in consumption and prices were analyzed across all included NCD medicines, by disease category and pharmacological group.ResultsConsumption of NCD medicines was highest in Georgia, at twice the levels in Azerbaijan, and four times levels in Uzbekistan. Average prices of NCD medicines, weighted by consumption, increased by 26% in Georgia, but decreased by 3% in Azerbaijan and by 0.1% in Uzbekistan. Prices increased for all disease groups in Georgia (from +13% for epilepsy medicines to +86% for cancer), varied by group in Uzbekistan (from -22% for epilepsy medicines to +47% for cancer), while changes in Azerbaijan were smaller in magnitude (from -4% for medicines for cardiovascular disease to +11% for cancer). Cancer medicines had markedly higher prices in Uzbekistan, and asthma and COPD medicines had markedly higher prices in Azerbaijan and Uzbekistan.ConclusionsGeorgia showed the highest outpatient consumption of NCD medicines, suggesting the broadest access to treatment. However, Georgia also saw marked price increases, greater than in the other countries. In Georgia, where there was no price regulation, widespread price increases and increases in consumption both contribute to increasing pharmaceutical expenditures. In Azerbaijan and Uzbekistan, increases in outpatient pharmaceutical expenditures were primarily driven by increases in consumption, rather than increases in price. Comparing trends in consumption and pricing can identify gaps in access and inform future policy approaches.
Published: 2023
Full Text: View/download PDF

20. Biomarkers of Exposure and Potential Harm in Exclusive Users of Nicotine Pouches and Current, Former, and Never Smokers: Protocol for a Cross-sectional Clinical Study

Author: David Azzopardi, Linsey Ellen Haswell, Justin Frosina, Michael McEwan, Nathan Gale, Jesse Thissen, Filimon Meichanetzidis, and George Hardie
Subjects: Medicine, Computer applications to medicine. Medical informatics, R858-859.7
Abstract: BackgroundTobacco harm reduction (THR) aims to reduce the health burden of cigarettes by encouraging smokers to switch to using alternative tobacco or nicotine products. Nicotine pouches (NPs) are smokeless, tobacco-free, oral products that may be beneficial as part of a THR strategy. ObjectiveThis 2-center, cross-sectional confinement study conducted in Denmark and Sweden aimed to determine whether biomarkers of exposure (BoEs) to tobacco toxicants and biomarkers of potential harm (BoPHs) in exclusive users of NPs show favorable differences compared with current smokers. MethodsParticipants were healthy NP users (target n=100) and current, former, or never smokers (target n=40 each), as confirmed by urinary cotinine and exhaled carbon monoxide concentrations. During a 24-hour confinement period, participants were asked to use their usual product (NP or cigarette) as normal, and BoEs and BoPHs were measured in blood and 24-hour urine samples, with compliance determined using anabasine, anatabine, and N-(2-cyanoethyl)valine. BoEs and BoPHs were compared between NP users and current, former, and never smokers. Urinary total 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (BoE to nicotine-derived nitrosamine ketone) and urinary 8-epi-prostaglandin F2α type III, exhaled nitric oxide, blood carboxyhemoglobin, white blood cell count, soluble intercellular adhesion molecule-1, and high-density lipoprotein cholesterol (BoPHs) were evaluated as primary outcomes. Other measures included urinary 11-dehydrothromboxane B2, forced expiratory volume, carotid intima-media thickness, self-reported quality of life, and oral health. ResultsThe results of this study were received in mid-2022 and will be published in late 2022 to early 2023. ConclusionsThe results of this study will provide information on toxicant exposure and biomarkers associated with the development of smoking-related diseases among users of NPs compared with smokers, as well as on the potential role of NPs in THR. Trial RegistrationInternational Standard Randomised Controlled Trial Number (ISRCTN) ISRCTN16988167; https://www.isrctn.com/ISRCTN16988167 International Registered Report Identifier (IRRID)DERR1-10.2196/39785
Published: 2022
Full Text: View/download PDF

21. Strengthening assessment and response to mental health needs for Aboriginal and Torres Strait Islander children and adolescents in primary care settings: study protocol for the Ngalaiya Boorai Gabara Budbut implementation project

Author: Alex Brown, Jane Fisher, George Patton, Rachel Reilly, Peter S Azzopardi, Ngiare Brown, Odette Pearson, Debra J Rickwood, and Choong-Siew Yong
Subjects: Medicine
Abstract: Introduction Opportunities for improved mental health and wellbeing of Aboriginal and Torres Strait Islander children and young people lie in improving the capability of primary healthcare services to identify mental healthcare needs and respond in timely and appropriate ways. The development of culturally appropriate mental health assessment tools and clinical pathways have been identified as opportunities for strengthening workforce capacity in this area. The Ngalaiya Boorai Gabara Budbut implementation project seeks to pursue these opportunities by developing and validating a psychosocial assessment tool, understanding what services need to better care for your people and developing resources that address those needs.Methods and analysis The project will be governed by a research governance group comprising Aboriginal service providers, young people, and researchers. It will be implemented in an urban health service in Canberra, and regional services in Moree, Wollongong, and the Illawarra regions of New South Wales Australia. The validation study will follow an argument-based approach, assessing cultural appropriateness and ease of use; test–retest validity; internal consistency, construct validity and the quality of decisions made based on the assessment. Following piloting with a small group of young people and their caregivers (n=10), participants (n=200) will be young people and/or their caregivers, attending one of the partner services. The needs assessment will involve an in-depth exploration of service via an online survey (n=60) and in-depth interviews with service providers (n=16) and young people (n=16). These activities will run concurrently. Service providers, researchers and the governance group will codesign resources that respond to the needs identified and pilot them through the participating services.Ethics and dissemination The Aboriginal Health and Medical Research Council of NSW Human Research Ethics committee (#1769/21) has approved this project. Informed consent will be obtained from all participants and/or their caregivers (with assent from those aged
Published: 2022
Full Text: View/download PDF

22. SARS-CoV-2 aerosol transmission in schools: the effectiveness of different interventions

Author: Jennifer Villers, Andre Henriques, Serafina Calarco, Markus Rognlien, Nicolas Mounet, James Devine, Gabriella Azzopardi, Philip Elson, Marco Andreini, Nicola Tarocco, Claudia Vassella, and Olivia Keiser
Subjects: Medicine
Abstract: BACKGROUND: Indoor aerosol transmission of SARS-CoV-2 has been widely recognised, especially in schools where children remain in closed indoor spaces and largely unvaccinated. Measures such as strategic natural ventilation and high efficiency particulate air (HEPA) filtration remain poorly implemented and mask mandates are often progressively lifted as vaccination rollout is enhanced. METHODS: We adapted a previously developed aerosol transmission model to study the effect of interventions (natural ventilation, face masks, HEPA filtration and their combinations) on the concentration of virus particles in a classroom of 160 m3 containing one infectious individual. The cumulative dose of viruses absorbed by exposed occupants was calculated. RESULTS: In the absence of interventions, the cumulative dose absorbed was 1.5 times higher in winter than in spring/summer, increasing chances of indoor airborne transmission in winter. However, natural ventilation was more effective in winter, leading to up to a 20-fold decrease in cumulative dose when six windows were fully open at all times. In winter, partly opening two windows all day or fully opening six windows at the end of each class was effective as well (2.7- to 3-fold decrease). In summer, good ventilation levels could be achieved through the opening of windows all day long (2- to 7-fold decrease depending on the number of windows open). Opening windows only during yard and lunch breaks had minimal effect (≤1.5-fold decrease). One HEPA filter was as effective as two windows partly open all day in winter (3-fold decrease) whereas two filters were more effective (5-fold decrease). Surgical face masks were very effective independently of the season (8-fold decrease). Combined interventions (i.e., natural ventilation, masks, and HEPA filtration) were the most effective (≥25-fold decrease) and remained highly effective in the presence of a super-spreader. INTERPRETATION: Natural ventilation, face masks, and HEPA filtration are effective interventions to reduce SARS-CoV-2 aerosol transmission. These measures should be combined and complemented by additional interventions (e.g., physical distancing, hygiene, testing, contact tracing and vaccination) to maximise benefit.
Published: 2022
Full Text: View/download PDF

23. Predictors of response to TNF inhibitors in rheumatoid arthritis: an individual patient data pooled analysis of randomised controlled trials

Author: Philippe Goupille, Denis Mulleman, Jacqueline Detert, Theodora Bejan-Angoulvant, Johan Law-Wan, Marc-Antoine Sparfel, Sophie Derolez, and Nicolas Azzopardi
Subjects: Medicine
Published: 2021
Full Text: View/download PDF

24. BCG vaccination to reduce the impact of COVID-19 in healthcare workers: Protocol for a randomised controlled trial (BRACE trial)

Author: Donna Legge, Katherine J Lee, Rachel Dixon, Amanda Gwee, Nigel Curtis, Helen Marshall, Fiona McDonald, Nick Evans, Adam Finn, Mark McMillan, Peter Richmond, Joyce Chan, John Carlin, Anthony Byrne, Helen Thomson, Richard Hall, Jesús Rodríguez-Baño, Robert Harrison, Kirsten P Perrett, Michaela Lucas, Sue Evans, Melissa O’Donnell, Justin Waring, Andrew Davidson, Heidi Hutton, Laure F Pittet, Jan Kluytmans, Ana Maria Barriocanal, Emily Fletcher, James Moore, John Campbell, Kate Sidaway-Lee, Alex Harding, Katherine Lee, David Paterson, Juliana Silva, Michael Gibbons, Denise Faustman, Nicole L Messina, Kaya Gardiner, Frank Shann, Veronica Abruzzo, Susie Germano, Laurens Manning, Justin Beardsley, Jason Bell, Francesca Orsini, Jeremy Anderson, Kim Mulholland, Andrew Dunn, Jeffrey Post, Catherine Flynn, Clare Seamark, Andrew Steer, Sigrid Pitkin, Emma Watts, Carlos Garcia, Kristen Overton, Daniel Santos, Christina Guo, Antoni Rosell, Sarah Fowler, Richard Malley, Nicholas J Wood, Wim Boersma, Kanta Subbarao, Karen Jones, Chris Richards, Nigel Crawford, Adilia Warris, Mary Corbett, Pamela Palasanthiran, Cristina Pérez, Esther Calbo, Shelley Rhodes, Brendan McMullan, Jane Jones, Wendy Norton, Luke Stevens, Craig F Munns, Louise Goodchild, Mary Walker, Bridget Knight, Thilanka Morawakage, Josune Goikoetxea, Teresa Rodrigues, Nienke Roescher, David Seamark, Jorge Rocha, Stephanie Reynolds, Lynne Quinn, Harry Tripp, Tobias R Kollmann, Marc Bonten, Steve Wesselingh, Irene Latorre, Maria Esteve, Kate Hamilton, Angela Young, Cristina Prat-Aymerich, NICK WOOD, RAMÓN CASTRO, Ruth Warren, Christopher Martin, Diane Dawson, Lorrie Symons, Ann Krastev, Ellie McDonald, Claudia González Rico, Ester Valls, Julio Croda, Tobias Kollmann, Victoria Gordon, Marcus Vinícius Guimarães Lacerda, Jennifer Kent, Samantha Bannister, Margareth Dalcolmo, Sonja Elia, Casey Goodall, Tenaya Jamieson, Bruno Jardim, David J Lynn, Cristina Prat Aymerich, Eva Sudbury, Paola Villanueva, Katherine Lieschke, Carolinne Abreu, Lynne Addlem, Sophie Agius, Adelita Agripina Barbosa, Ahmed Alamrousi, Ayla Alcoforado Santos, Yasmeen Al-Hindawi, Samyra Almeida Da Silveira, Lais Alves Cruz, Christina Anthony, Andrea Antonia Pereira, Francisco Arnaiz Almajano, Annabelle Arnold, Beth Arrowsmith, Kristy Azzopardi, Cristina Badia Marti, Twinkle Bahaduri, Sarah Barney, Lydia Barrera, Anabel Barriocanal, Dayanne Barros, Adam Bartlett, Lilian Muranaka, Therese Baulman, Morgan Bealing, Ana Belen Gutierrez, Vicki Bennett-Wood, Nikki Bergant, Fabiane Bianca Barbosa, Wouter Bijllaardt, Patricia Bimboese, Camila Bitencourt Andrade, Kitty Blauwendraat, Pilar Bohedo Garcia, Rhian Bonnici, Anne Boon, Anna Bourke, Kirsty Bowes, Larissa Brasil, Clare Brophy, Sandy Buchanan, Jess Bucholc, Alison Burns, Emma Burrell, Natalia Bustos, Bridie Byrne, Jorge Calvo Montes, Beatriz Camesella, Atsegiñe Cangas, Maria Carmen Roque, Roberta Carolina Diogo, Estela Carvalho, Irma Casas, Erika Castro, Helen Catterick, Rodrigo Cezar Escobar, Jo Cheah, Thilakavathi Chengodu, Marianna Ciaverella, Sharon Clark, Marie-Alix Clement Espindola, Annie Cobbledick, Clinton Colaco, Simone Collopy, Patricia Comella, Gabriela Correa Castro, Erlane Costa, Raquel Coya, Alda Cruz, Jac Cushnahan, Anna Czajko, Renato da Silva, Bouchra Daitiri, Karen Dalton, Aiken Dao, Phoebe Dawe, Miriam Jesus Costa, Karina De La Cruz, Almudena de Serna, Fabiani de Morais Batista, Adriely de Oliveira, Rocio del Rey Morillo, Maria Desylva, Helga Dijkstra, Maria Dolores Lopez, Jose Dominguez, Angel Dominguez Castellano, Glauce Dos Santos, Joyce Santos Lencina, Débora Santos Silva, Mark Douglas, Ross Dunn, Jemma Dunnill, Harriet Edmund, Nat Eiffler, Hannah Elborough, Olivia Elkington, Michelle England, Wellyngthon Espindola Ayala, Krist Ewe, María Carmen Álvarez, Kieran Fahey, Jill Fairweather, Erica Fernandes Silva, Monique Fernandez, Galina Fidler, P.M.G. Filius, Carolyn Finucane, Stephanie Firth, Lorraine Flynn, Liam Fouracre, Thamires Freitas, Ana Carolina Furtado, Maria Gabriela Oliveira, Anna Gabriela Santos, Leandro Galdino Gonçalves, Laura Galletta, Larissa Gama, Dinusha Gamage, Radhika Ganpat, Mariana Garcia Croda, Evangeline Gardiner, Grace Gell, Aline Gerhardt Oliveira, Camille Gibson, Alison Gifford, Teresa Giménez Poderos, Ann Ginsberg, Jet Gisolf, Bojana Gladanac, Penny Glenn, Vanessa Godinho, Mayara Góes Santos, Telma Goldenberg, Adriano Gomes, Susana Gonzalez Marcos, Frances Greven, Ana Greyce Capella, David Gutierrez Campos, Manuel Gutierrez Cuadra, Lydia Hall, Matthew Hannan, Houda Harbech, Neil Haker, Robert Jan Hassing, Thaynara Haynara Rosa, Zaheerah Haywood, Nadine Henare, Paulo Henrique Andrade, Susan Herrmann, Erin Hill, Sam Hilton, Danique Huijbens, Axel Janssen, Tyane Jardim, Lance Jarvis, Narelle Jenkins, Jan Jones, Leticia Jorge, Maria Jose Vilegas, Sri Joshi, Rosemary Joyce, Joel Junior, Rama Kandasamy, Anushka Karunanayake, Hana Karuppasamy, Tom Keeble, Paul Kloeg, Tony Korman, Nathan La, Marcus Lacerda, Alicia Lacoma, Renier Lagunday, Debbie Lalich, Erin Latkovic, Paulo Leandro Junior, Toos Lemmers, Titia Leurink, Kee Lim, Gemma Lockhart, Cíntia Lopes Bogéa, Karla Lopes Santos, Reyes Lopez Marques, Maria Luciana Freitas, Norine Ma, Sam Macalister, Cristiane Machado, Matheus Machado Ramos, Francesca Machingaifa, Ivan Maia, Bernardo Maia, Sarah Manton, Jose Manuel Carrerero, Cíntia Maria Alves, Rosa Maria Pereira, Bianca Maria Arruda, Adriana Marins, Katya Martinez Almeida, Wayne Mather, Megan Mathers, Fábio Mauricio Gomes, Mariana Mayumi Tadokoro, Nadia Mazarakis, Kelry Mazurega, Sonia McAlister, Amy McAndrews, Rebecca McElroy, Nick McPhate, Lee Mead, Andrea Meehan, Bob Meek, Rosangela Melo, Guillermo Mena, Daniella Mesquita, Nicole Messina, Isabella Mezzetti, Hugo Miguel Vieira, Skye Miller, Kirsten Mitchell, Marcus Mitchell, Jesutofunmi Mojeed, Kitty Molenaar, Gemma Molina, Barbara Molina, Lisa Montgomery, Cecilia Moore, Simone Moorlag, Julie Moss, Will Moyle, Craig Munns, Elizandra Nascimento, Nicolas Navarrette, Mihai Netea, Juliana Neves, Georgina Newman, Belle Ngien, Jill Nguyen, Khanh Nguyen, Fran Noonan, Jess O’Bryan, Abby O’Connell, Sasha Odoi, Liz O’Donnell, Roberto Oliveira, Marilena Oliveira, Thais Oliveira, Ingrid Oliveira, Nadia Olivier, Ligia Olivio, Benjamin Ong, Jaslyn Ong, Joanne Ong, Jakob Onysk, Isabelle Ooi, Frances Oppedisano, Belinda Ortika, Orygen Group, Arthur Otsuka, Rosie Owens, Rayssa Paes, Virginia Palomo Jiménez, Girlene Pandine, Kimberley Parkin, Alvaro Pascual Hernandez, Nienke Paternotte, Ana Paula Souza, Lisa Pelayo, Casey Pell, Sille Pelser, Handerson Pereira, Gabrielle Pereira, Glady Perez, Tomás Perez Porcuna, Susan Perlen, Kirsten Perrett, Amandine Philippart Floy, Laure Pittet, R.C. Pon, Ines Portillo Calderón, Catherine Power, Christiane Prado, Endriaen Prajitno, Lieke Preijers, Marco Puga, Evelyn Queiroz, Ashleigh Rak, Leticia Ramires Figueiredo, Encarnacion Ramirez de Arellano, Pedro Ramos, Karla Regina Oliveira, Jack Ren, Claudinalva Ribeiro Santos, Holly Richmond, Ana Rita Souza, Laleyska Rodrigues, Bebeto Rodrigues, Iara Rodrigues Fernandes, Sally Rogers, Anke Rol, Jannie Romme, Maria Roser Font, Sonia Sallent, Vanderson Sampaio, Nuria Sanchez, Blanca Sanchez, Tilza Santos, Ariandra Sartim, Amber Sastry, Alice Sawka, Nikki Schultz, Engelien Septer-Bijleveld, Raquel Serrano, Ketaki Sharma, Margaret Shave, Lisa Shen, Adrian Siles Baena, Rafaela Silva, Emanuelle Silva, Mariana Simão, Ronita Singh, Marilda Siqueira, Marciléia Soares Chaves, Thijs Sondag, Enoshini Sooriyarachchi, Antonny Sousa, Leena Spry, Sarah Statton, Dyenyffer Stéffany Santos, Katrina Sterling, Leah Steve, Carolyn Stewart, Lisa Stiglmayer, Lida Stooper, Josephine Studham, Astrid Suiker, Esther Taks, Niki Tan, Bruna Tayara Meireles, Menno te Riele, Jaap ten Oever, Guilherme Teodoro Lima, Jhenyfer Thalyta Angelo, Ryan Toh, Alexandre Trindade, Enriqueta Tristán, Darren Troeman, Alexandra Truelove, Daniel Tsuha, Marlot Uffing, Fernando Val, Olga Valero, Chantal van Ven, Leo Van Heuvel, Sigrid van Veen, Marije van Waal, J.H. van Leusen, Linda van Mook, H. van Onzenoort, Marjoleine van Opdorp, Miranda van Rijen, Nicolette van Sluis, Adria Vasconcelos, Noelia Vega, Sunitha Velagapudi, Louise Vennells, Tamsin Venton, Harald Verheij, P.M. Verhoeven, Caroliny Veron Ramos, Paulo Victor Silva, Sandra Vidal, Patricia Vieira, Matheus Vieira Oliveira, Rosario Vigo Ortega, Raquel Villar, Amanda Vlahos, Ushma Wadia, Kate Wall, Rachael Wallace, Michelle Wearing-Smith, Daniel Webber-Rookes, Jamie Wedderburn, Ashleigh Wee-Hee, Jia Wei Teo, Bethany Whale, Phoebe Williams, Beatrijs Wolters, Ivy Xie, Angela Younes, Felipe Zampieri Batista, Carmen Zhou, Vivian Zwart, Simone Barry, Saoirse Benson, Stephen Blake, Rochelle Botten, Tee Yee Chern, Catriona Doran, Georgina Eden, Liddy Griffith, Christine Heath, Jane James, Meredith Krieg, David Lynn, Miriam Lynn, Angela Markow, Domenic Sacca, Natalie Stevens, and Rob ter Heine
Subjects: Medicine
Abstract: Introduction BCG vaccination modulates immune responses to unrelated pathogens. This off-target effect could reduce the impact of emerging pathogens. As a readily available, inexpensive intervention that has a well-established safety profile, BCG is a good candidate for protecting healthcare workers (HCWs) and other vulnerable groups against COVID-19.Methods and analysis This international multicentre phase III randomised controlled trial aims to determine if BCG vaccination reduces the incidence of symptomatic and severe COVID-19 at 6 months (co-primary outcomes) compared with no BCG vaccination. We plan to randomise 10 078 HCWs from Australia, The Netherlands, Spain, the UK and Brazil in a 1:1 ratio to BCG vaccination or no BCG (control group). The participants will be followed for 1 year with questionnaires and collection of blood samples. For any episode of illness, clinical details will be collected daily, and the participant will be tested for SARS-CoV-2 infection. The secondary objectives are to determine if BCG vaccination reduces the rate, incidence, and severity of any febrile or respiratory illness (including SARS-CoV-2), as well as work absenteeism. The safety of BCG vaccination in HCWs will also be evaluated. Immunological analyses will assess changes in the immune system following vaccination, and identify factors associated with susceptibility to or protection against SARS-CoV-2 and other infections.Ethics and dissemination Ethical and governance approval will be obtained from participating sites. Results will be published in peer-reviewed open-access journals. The final cleaned and locked database will be deposited in a data sharing repository archiving system.Trial registration ClinicalTrials.gov NCT04327206
Published: 2021
Full Text: View/download PDF

25. Data and Digital Solutions to Support Surveillance Strategies in the Context of the COVID-19 Pandemic

Author: Patty Kostkova, Francesc Saigí-Rubió, Hans Eguia, Damian Borbolla, Marieke Verschuuren, Clayton Hamilton, Natasha Azzopardi-Muscat, and David Novillo-Ortiz
Subjects: digital surveillance, digital epidemiology, data sources, outbreak, COVID-19, Medicine, Public aspects of medicine, RA1-1270, Electronic computers. Computer science, QA75.5-76.95
Abstract: Background: In order to prevent spread and improve control of infectious diseases, public health experts need to closely monitor human and animal populations. Infectious disease surveillance is an established, routine data collection process essential for early warning, rapid response, and disease control. The quantity of data potentially useful for early warning and surveillance has increased exponentially due to social media and other big data streams. Digital epidemiology is a novel discipline that includes harvesting, analysing, and interpreting data that were not initially collected for healthcare needs to enhance traditional surveillance. During the current COVID-19 pandemic, the importance of digital epidemiology complementing traditional public health approaches has been highlighted.Objective: The aim of this paper is to provide a comprehensive overview for the application of data and digital solutions to support surveillance strategies and draw implications for surveillance in the context of the COVID-19 pandemic and beyond.Methods: A search was conducted in PubMed databases. Articles published between January 2005 and May 2020 on the use of digital solutions to support surveillance strategies in pandemic settings and health emergencies were evaluated.Results: In this paper, we provide a comprehensive overview of digital epidemiology, available data sources, and components of 21st-century digital surveillance, early warning and response, outbreak management and control, and digital interventions.Conclusions: Our main purpose was to highlight the plausible use of new surveillance strategies, with implications for the COVID-19 pandemic strategies and then to identify opportunities and challenges for the successful development and implementation of digital solutions during non-emergency times of routine surveillance, with readiness for early-warning and response for future pandemics. The enhancement of traditional surveillance systems with novel digital surveillance methods opens a direction for the most effective framework for preparedness and response to future pandemics.
Published: 2021
Full Text: View/download PDF

26. Enablers and barriers to primary healthcare for Aboriginal and Torres Strait Islander adolescents: study protocol for participatory mixed-methods research that builds on WHO global standards

Author: Alex Brown, Yvonne Cadet-James, Julie Hennegan, Mark Wenitong, Peter S Azzopardi, Tirritpa Ritchie, Tara Purcell, Seth Westhead, Renae Kirkham, Johanna Neville, Clara Saleh, Ngiare Brown, Elissa C Kennedy, and Odette Pearson
Subjects: Medicine
Abstract: Introduction One-third of Australia’s Aboriginal and Torres Strait Islander population are adolescents. Recent data highlight their health needs are substantial and poorly met by existing services. To design effective models of primary healthcare, we need to understand the enablers and barriers to care for Aboriginal and Torres Strait Islander adolescents, the focus of this study.Methods and analysis This protocol was codesigned with Apunipima Cape York Health Council that supports the delivery of primary healthcare for 11 communities in Far North Queensland. We framed our study around the WHO global standards for high-quality health services for adolescents, adding an additional standard around culturally safe care. The study is participatory and mixed methods in design and builds on the recommended WHO assessment tools. Formative qualitative research with young people and their communities (exploring concepts in the WHO recommended quantitative surveys) seeks to understand demand-side enablers and barriers to care, as well as preferences for an enhanced response. Supply-side enablers and barriers will be explored through: a retrospective audit of clinic data (to identify current reasons for access and what can be strengthened); an objective assessment of the adolescent friendliness of clinical spaces; anonymous feedback from adolescent clients around quality of care received and what can be improved; and surveys and qualitative interviews with health providers to understand their perspectives and needs to provide enhanced care. This codesigned project has been approved by Apunipima Cape York Health Council and Far North Queensland Human Research Ethics Committee.Dissemination and implications The findings from this project will inform a codesigned accessible and responsive model of primary healthcare for Aboriginal and Torres Strait Islander adolescents.
Published: 2021
Full Text: View/download PDF

27. Correction: The first wave of COVID-19 in Malta; a national cross-sectional study.

Author: Sarah Micallef, Tonio V Piscopo, Ramon Casha, Denise Borg, Chantal Vella, Maria-Alessandra Zammit, Janice Borg, Daniela Mallia, James Farrugia, Sarah Marie Vella, Thelma Xerri, Anette Portelli, Manuel Fenech, Claudia Fsadni, and Charles Mallia Azzopardi
Subjects: Medicine, Science
Abstract: [This corrects the article DOI: 10.1371/journal.pone.0239389.].
Published: 2021
Full Text: View/download PDF

28. Detection of six soil-transmitted helminths in human stool by qPCR- a systematic workflow.

Author: Kristy I Azzopardi, Myra Hardy, Ciara Baker, Rhian Bonnici, Stacey Llewellyn, James S McCarthy, Rebecca J Traub, and Andrew C Steer
Subjects: Medicine, Science
Abstract: Soil-transmitted helminths (STH) infect up to one-quarter of the global population, with a significant associated disease burden. The main human STH are: Ancylostoma spp. and Necator americanus (hookworms); Ascaris lumbricoides, Trichuris trichiura, and Strongyloides stercoralis. The aim of this study was to establish a scalable system for stool STH multiplex quantitative real-time polymerase chain reactions (qPCR). Stool samples collected in Fiji and preserved in potassium dichromate were transferred to Melbourne at ambient temperature. Samples were washed to remove potassium dichromate and DNA was extracted with the Mini-Beadbeater-24 and a column-based kit. A SYBR green qPCR to detect the vertebrate mitochondrial gene was used as a DNA extraction control. Samples were tested using a probe-based multiplex qPCR targeting A. lumbricoides, T. trichiura and S. stercoralis, and in a second multiplex reaction to detect hookworms to the species level (A. duodenale, A. ceylanicum, N. americanus). An internal amplification control in both multiplex assays was included to prevent false-negative results due to PCR inhibitors. Samples were homogenised for a single cycle of 40 seconds to release STH DNA and washed stool was stored for up to 15 weeks at -30°C without compromising DNA. Our multiplex qPCR detected multiple species of STH without reduced sensitivity compared to singleplex. qPCR data from 40 stools was validated against STH-positive stools determined by microscopy. We have developed and validated an efficient and staged system for detecting six clinically important STH affecting humans that could be easily implemented without advanced automation in any qPCR-capable laboratory.
Published: 2021
Full Text: View/download PDF

29. Correction: Lifelong aerobic exercise protects against inflammaging and cancer.

Author: Mats I Nilsson, Jacqueline M Bourgeois, Joshua P Nederveen, Marlon R Leite, Bart P Hettinga, Adam L Bujak, Linda May, Ethan Lin, Michael Crozier, Daniel R Rusiecki, Chris Moffatt, Paul Azzopardi, Jacob Young, Yifan Yang, Jenny Nguyen, Ethan Adler, Lucy Lan, and Mark A Tarnopolsky
Subjects: Medicine, Science
Abstract: [This corrects the article DOI: 10.1371/journal.pone.0210863.].
Published: 2020
Full Text: View/download PDF

30. The first wave of COVID-19 in Malta; a national cross-sectional study.

Author: Sarah Micallef, Tonio V Piscopo, Ramon Casha, Denise Borg, Chantal Vella, Maria-Alessandra Zammit, Janice Borg, Daniela Mallia, James Farrugia, Sarah Marie Vella, Thelma Xerri, Anette Portelli, Manuel Fenech, Claudia Fsadni, and Charles Mallia Azzopardi
Subjects: Medicine, Science
Abstract: IntroductionThe COVID-19 pandemic has posed major challenges to all aspects of healthcare. Malta's population density, large proportion of elderly and high prevalence of diabetes and obesity put the country at risk of uncontrolled viral transmission and high mortality. Despite this, Malta achieved low mortality rates compared to figures overseas. The aim of this paper is to identify key factors that contributed to these favorable outcomes.MethodsThis is a retrospective, observational, nationwide study which evaluates outcomes of patients during the first wave of the pandemic in Malta, from the 7th of March to the 24th of April 2020. Data was collected on demographics and mode of transmission. Hospitalization rates to Malta's main general hospital, Mater Dei Hospital, length of in-hospital stay, intensive care unit admissions and 30-day mortality were also analyzed.ResultsThere were 447 confirmed cases in total; 19.5% imported, 74.2% related to community transmission and 6.3% nosocomially transmitted. Ninety-three patients (20.8%) were hospitalized, of which 4 were children. Patients with moderate-severe disease received hydroxychloroquine and azithromycin, in line with evidence available at the time. A total of 4 deaths were recorded, resulting in an all-cause mortality of 0.89%. Importantly, all admitted patients with moderate-severe disease survived to 30-day follow up.ConclusionEffective public health interventions, widespread testing, remote surveillance of patients in the community and a low threshold for admission are likely to have contributed to these favorable outcomes. Hospital infection control measures were key in preventing significant nosocomial spread. These concepts can potentially be applied to stem future outbreaks of viral diseases. Patients with moderate-severe disease had excellent outcomes with no deaths reported at 30-day follow up.
Published: 2020
Full Text: View/download PDF

31. Lifelong aerobic exercise protects against inflammaging and cancer.

Author: Mats I Nilsson, Jacqueline M Bourgeois, Joshua P Nederveen, Marlon R Leite, Bart P Hettinga, Adam L Bujak, Linda May, Ethan Lin, Michael Crozier, Daniel R Rusiecki, Chris Moffatt, Paul Azzopardi, Jacob Young, Yifan Yang, Jenny Nguyen, Ethan Adler, Lucy Lan, and Mark A Tarnopolsky
Subjects: Medicine, Science
Abstract: Biological aging is associated with progressive damage accumulation, loss of organ reserves, and systemic inflammation ('inflammaging'), which predispose for a wide spectrum of chronic diseases, including several types of cancer. In contrast, aerobic exercise training (AET) reduces inflammation, lowers all-cause mortality, and enhances both health and lifespan. In this study, we examined the benefits of early-onset, lifelong AET on predictors of health, inflammation, and cancer incidence in a naturally aging mouse model (C57BL/J6). Lifelong, voluntary wheel-running (O-AET; 26-month-old) prevented age-related declines in aerobic fitness and motor coordination vs. age-matched, sedentary controls (O-SED). AET also provided partial protection against sarcopenia, dynapenia, testicular atrophy, and overall organ pathology, hence augmenting the 'physiologic reserve' of lifelong runners. Systemic inflammation, as evidenced by a chronic elevation in 17 of 18 pro- and anti-inflammatory cytokines and chemokines (P < 0.05 O-SED vs. 2-month-old Y-CON), was potently mitigated by lifelong AET (P < 0.05 O-AET vs. O-SED), including master regulators of the cytokine cascade and cancer progression (IL-1β, TNF-α, and IL-6). In addition, circulating SPARC, previously known to be upregulated in metabolic disease, was elevated in old, sedentary mice, but was normalized to young control levels in lifelong runners. Remarkably, malignant tumours were also completely absent in the O-AET group, whereas they were present in the brain (pituitary), liver, spleen, and intestines of sedentary mice. Collectively, our results indicate that early-onset, lifelong running dampens inflammaging, protects against multiple cancer types, and extends healthspan of naturally-aged mice.
Published: 2019
Full Text: View/download PDF

32. Translation into modern standard Arabic, cross-cultural adaptation and psychometric properties' evaluation of the Lower Extremity Functional Scale (LEFS) in Arabic-speaking athletes with Anterior Cruciate Ligament (ACL) injury.

Author: Vasileios Korakakis, Michael Saretsky, Rodney Whiteley, Matthew C Azzopardi, Jasenko Klauznicer, Abdallah Itani, Omar Al Sayrafi, Giannis Giakas, and Nikolaos Malliaropoulos
Subjects: Medicine, Science
Abstract: BackgroundThe Lower Extremity Functional Scale evaluates the functional status of patients that have lower extremity conditions of musculoskeletal origin. Regional Arabic dialects often create barriers to clear communication and comparative research. We aimed to cross-culturally adapt the Lower Extremity Functional Scale in modern standard Arabic that is widely used and understood in the Middle East and North Africa region, and assess its psychometric properties.MethodsCross-cultural adaptation followed a combination of recommended guidelines. For psychometric evaluation 150 patients with anterior cruciate ligament injury and 65 asymptomatic individuals were recruited. All measurement properties as indicated by the Consensus-based Standards for the selection of health status Measurement Instruments recommendations were evaluated, including content-relevance analysis, structural validity, longitudinal reproducibility, anchor- and distribution-based methods of responsiveness, as well as the longitudinal pattern of change of Lower Extremity Functional Scale in anterior cruciate ligament injured patients' functional status.ResultsThe questionnaire presented excellent internal consistency (α = 0.96), reliability (0.80-0.98), and good convergent validity (ρ = 0.85). For reproducibility testing: minimal detectable change was 9.26 points; for responsiveness assessment: minimal clinically important difference was 9 points and presented moderate effect sizes (Glass'Δ = 0.71, Cohen's d = 0.81). Its unidimensionality was not confirmed and an exploratory factor analysis indicated a 2-factor solution explaining 78.1% of the variance.ConclusionThe Arabic Lower Extremity Functional Scale presented acceptable psychometric properties comparable to the original version. The Arabic version of Lower Extremity Functional Scale can be used in research and clinical practice to assess the functional status of Arabic-patients suffering an anterior cruciate ligament injury.
Published: 2019
Full Text: View/download PDF

33. Gram negative wound infection in hospitalised adult burn patients--systematic review and metanalysis-.

Author: Ernest A Azzopardi, Elayne Azzopardi, Liberato Camilleri, Jorge Villapalos, Dean E Boyce, Peter Dziewulski, William A Dickson, and Iain S Whitaker
Subjects: Medicine, Science
Abstract: BACKGROUND: Gram negative infection is a major determinant of morbidity and survival. Traditional teaching suggests that burn wound infections in different centres are caused by differing sets of causative organisms. This study established whether Gram-negative burn wound isolates associated to clinical wound infection differ between burn centres. METHODS: Studies investigating adult hospitalised patients (2000-2010) were critically appraised and qualified to a levels of evidence hierarchy. The contribution of bacterial pathogen type, and burn centre to the variance in standardised incidence of Gram-negative burn wound infection was analysed using two-way analysis of variance. PRIMARY FINDINGS: Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumanni, Enterobacter spp., Proteus spp. and Escherichia coli emerged as the commonest Gram-negative burn wound pathogens. Individual pathogens' incidence did not differ significantly between burn centres (F (4, 20) = 1.1, p = 0.3797; r2 = 9.84). INTERPRETATION: Gram-negative infections predominate in burn surgery. This study is the first to establish that burn wound infections do not differ significantly between burn centres. It is the first study to report the pathogens responsible for the majority of Gram-negative infections in these patients. Whilst burn wound infection is not exclusive to these bacteria, it is hoped that reporting the presence of this group of common Gram-negative "target organisms" facilitate clinical practice and target research towards a defined clinical demand.
Published: 2014
Full Text: View/download PDF

34. Mice with deficient BK channel function show impaired prepulse inhibition and spatial learning, but normal working and spatial reference memory.

Author: Marei Typlt, Magdalena Mirkowski, Erin Azzopardi, Lukas Ruettiger, Peter Ruth, and Susanne Schmid
Subjects: Medicine, Science
Abstract: Genetic variations in the large-conductance, voltage- and calcium activated potassium channels (BK channels) have been recently implicated in mental retardation, autism and schizophrenia which all come along with severe cognitive impairments. In the present study we investigate the effects of functional BK channel deletion on cognition using a genetic mouse model with a knock-out of the gene for the pore forming α-subunit of the channel. We tested the F1 generation of a hybrid SV129/C57BL6 mouse line in which the slo1 gene was deleted in both parent strains. We first evaluated hearing and motor function to establish the suitability of this model for cognitive testing. Auditory brain stem responses to click stimuli showed no threshold differences between knockout mice and their wild-type littermates. Despite of muscular tremor, reduced grip force, and impaired gait, knockout mice exhibited normal locomotion. These findings allowed for testing of sensorimotor gating using the acoustic startle reflex, as well as of working memory, spatial learning and memory in the Y-maze and the Morris water maze, respectively. Prepulse inhibition on the first day of testing was normal, but the knockout mice did not improve over the days of testing as their wild-type littermates did. Spontaneous alternation in the y-maze was normal as well, suggesting that the BK channel knock-out does not impair working memory. In the Morris water maze knock-out mice showed significantly slower acquisition of the task, but normal memory once the task was learned. Thus, we propose a crucial role of the BK channels in learning, but not in memory storage or recollection.
Published: 2013
Full Text: View/download PDF

35. Global, regional, and national mortality among young people aged 10–24 years, 1950–2019: a systematic analysis for the Global Burden of Disease Study 2019

Author: Collaborators, GAM, Ward, JL, Azzopardi, PS, Francis, KL, Santelli, JS, Skirbekk, V, Sawyer, SM, Kassebaum, NJ, Mokdad, AH, Hay, SI, Abd-Allah, F, Abdoli, A, Abdollahi, M, Abedi, A, Abolhassani, H, Abreu, LG, Abrigo, MRM, Abu-Gharbieh, E, Abushouk, AI, Adebayo, OM, Adekanmbi, V, Adham, D, Advani, SM, Afshari, K, Agrawal, A, Ahmad, T, Ahmadi, K, Ahmed, AE, Aji, B, Akombi-Inyang, B, Alahdab, F, Al-Aly, Z, Alam, K, Alanezi, FM, Alanzi, TM, Alcalde-Rabanal, JE, Alemu, BW, Al-Hajj, S, Alhassan, RK, Ali, S, Alicandro, G, Alijanzadeh, M, Aljunid, SM, Almasi-Hashiani, A, Almasri, NA, Al-Mekhlafi, HM, Alonso, J, Al-Raddadi, RM, Altirkawi, KA, Alvis-Guzman, N, Amare, AT, Amini, S, Aminorroaya, A, Amit, AML, Amugsi, DA, Ancuceanu, R, Anderlini, D, Andrei, CL, Androudi, S, Ansari, F, Ansari, I, Antonio, CAT, Anvari, D, Anwer, R, Appiah, SCY, Arabloo, J, Arab-Zozani, M, Ärnlöv, J, Asaad, M, Asadi-Aliabadi, M, Asadi-Pooya, AA, Atout, MMW, Ausloos, M, Avenyo, EK, Avila-Burgos, L, Quintanilla, BPA, Ayano, G, Aynalem, YA, Azari, S, Azene, ZN, Bakhshaei, MH, Bakkannavar, SM, Banach, M, Banik, PC, Barboza, MA, Barker-Collo, SL, Bärnighausen, TW, Basu, S, Baune, BT, Bayati, M, Bedi, N, Beghi, E, Bekuma, TT, Bell, AW, Bell, ML, Benjet, C, Bensenor, IM, Berhe, AK, Berhe, K, Berman, AE, Bhagavathula, AS, Bhardwaj, N, Bhardwaj, P, Bhattacharyya, K, Bhattarai, S, Bhutta, ZA, Bijani, A, Bikbov, B, Biondi, A, Birhanu, TTM, Biswas, RK, Bohlouli, S, Bolla, SR, Boloor, A, Borschmann, R, Boufous, S, Bragazzi, NL, Braithwaite, D, Breitborde, NJK, Brenner, H, Britton, GB, Burns, RA, Nagaraja, SB, Butt, ZA, dos Santos, FLC, Cámera, LA, Campos-Nonato, IR, Rincon, JCC, Cárdenas, R, Carreras, G, Carrero, JJ, Carvalho, F, Castaldelli-Maia, JM, Castañeda-Orjuela, CA, Castelpietra, G, Catalá-López, F, Cerin, E, Chandan, JS, Chang, H-Y, Chang, J-C, Charan, J, Chattu, VK, Chaturvedi, S, Choi, J-YJ, Chowdhury, MAK, Christopher, DJ, Chu, D-T, Chung, MT, Chung, S-C, Cicuttini, FM, Constantin, TV, Costa, VM, Dahlawi, SMA, Dai, H, Dai, X, Damiani, G, Dandona, L, Dandona, R, Daneshpajouhnejad, P, Darwesh, AM, Dávila-Cervantes, CA, Davletov, K, De la Hoz, FP, De Leo, D, Dervenis, N, Desai, R, Desalew, A, Deuba, K, Dharmaratne, SD, Dhungana, GP, Dianatinasab, M, da Silva, DD, Diaz, D, Didarloo, A, Djalalinia, S, Dorostkar, F, Doshi, CP, Doshmangir, L, Doyle, KE, Duraes, AR, Kalan, ME, Ebtehaj, S, Edvardsson, D, Tantawi, ME, Elgendy, IY, El-Jaafary, SI, Elsharkawy, A, Eshrati, B, Eskandarieh, S, Esmaeilnejad, S, Esmaeilzadeh, F, Esteghamati, S, Faro, A, Farzadfar, F, Fattahi, N, Feigin, VL, Ferede, TY, Fereshtehnejad, S-M, Fernandes, E, Ferrara, P, Filip, I, Fischer, F, Fisher, JL, Foigt, NA, Folayan, MO, Fomenkov, AA, Foroutan, M, Fukumoto, T, Gad, MM, Gaidhane, AM, Gallus, S, Gebre, T, Gebremedhin, KB, Gebremeskel, GG, Gebremeskel, L, Gebreslassie, AA, Gesesew, HA, Ghadiri, K, Ghafourifard, M, Ghamari, F, Ghashghaee, A, Gilani, SA, Gnedovskaya, EV, Godinho, MA, Golechha, M, Goli, S, Gona, PN, Gopalani, SV, Gorini, G, Grivna, M, Gubari, MIM, Gugnani, HC, Guimarães, RA, Guo, Y, Gupta, R, Haagsma, JA, Hafezi-Nejad, N, Haile, TG, Haj-Mirzaian, A, Hall, BJ, Hamadeh, RR, Abdullah, KH, Hamidi, S, Handiso, DW, Hanif, A, Hankey, GJ, Haririan, H, Haro, JM, Hasaballah, AI, Hashi, A, Hassan, A, Hassanipour, S, Hassankhani, H, Hayat, K, Heidari-Soureshjani, R, Herteliu, C, Heydarpour, F, Ho, HC, Hole, MK, Holla, R, Hoogar, P, Hosseini, M, Hosseinzadeh, M, Hostiuc, M, Hostiuc, S, Househ, M, Hsairi, M, Huda, TM, Humayun, A, Hussain, R, Hwang, B-F, Iavicoli, I, Ibitoye, SE, Ilesanmi, OS, Ilic, IM, Ilic, MD, Inbaraj, LR, Intarut, N, Iqbal, U, Irvani, SSN, Islam, MM, Islam, MS, Iso, H, Ivers, RQ, Jahani, MA, Jakovljevic, M, Jalali, A, Janodia, MD, Javaheri, T, Jeemon, P, Jenabi, E, Jha, RP, Jha, V, Ji, JS, Jonas, JB, Jones, KM, Joukar, F, Jozwiak, JJ, Juliusson, PB, Jürisson, M, Kabir, A, Kabir, Z, Kalankesh, LR, Kalhor, R, Kamyari, N, Kanchan, T, Karch, A, Karimi, SE, Kaur, S, Kayode, GA, Keiyoro, PN, Khalid, N, Khammarnia, M, Khan, M, Khan, N, Khatab, K, Khater, MM, Khatib, MN, Khayamzadeh, M, Khazaie, H, Khoja, AT, Kieling, C, Kim, Y-E, Kim, YJ, Kimokoti, RW, Kisa, A, Kisa, S, Kivimäki, M, Koolivand, A, Kosen, S, Koyanagi, A, Krishan, K, Kugbey, N, Kumar, GA, Kumar, M, Kumar, N, Kurmi, OP, Kusuma, D, La Vecchia, C, Lacey, B, Lal, DK, Lalloo, R, Lan, Q, Landires, I, Van Charles Lansingh, Larsson, AO, Lasrado, S, Lassi, ZS, Lauriola, P, Lee, PH, Lee, SWH, Leigh, J, Leonardi, M, Leung, J, Levi, M, Lewycka, S, Li, B, Li, M-C, Li, S, Lim, L-L, Lim, SS, Liu, X, Lorkowski, S, Lotufo, PA, Lunevicius, R, Maddison, R, Mahasha, PW, Mahdavi, MM, Mahmoudi, M, Majeed, A, Maleki, A, Malekzadeh, R, Malta, DC, Mamun, AA, Mansouri, B, Mansournia, MA, Martinez, G, Martinez-Raga, J, Martins-Melo, FR, Mason-Jones, AJ, Masoumi, SZ, Mathur, MR, Maulik, PK, McGrath, JJ, Mehndiratta, MM, Mehri, F, Memiah, PTN, Mendoza, W, Menezes, RG, Mengesha, EW, Meretoja, A, Meretoja, TJ, Mestrovic, T, Miazgowski, B, Miazgowski, T, Michalek, IM, Miller, TR, Mini, G, Mirica, A, Mirrakhimov, EM, Mirzaei, H, Mirzaei, M, Moazen, B, Mohammad, DK, Mohammadi, S, Mohammadian-Hafshejani, A, Mohammadifard, N, Mohammadpourhodki, R, Mohammed, S, Monasta, L, Moradi, G, Moradi-Lakeh, M, Moradzadeh, R, Moraga, P, Morrison, SD, Mosapour, A, Khaneghah, AM, Mueller, UO, Muriithi, MK, Murray, CJL, Muthupandian, S, Naderi, M, Nagarajan, AJ, Naghavi, M, Naimzada, MD, Nangia, V, Nayak, VC, Nazari, J, Ndejjo, R, Negoi, I, Negoi, RI, Netsere, HB, Nguefack-Tsague, G, Nguyen, DN, Nguyen, HLT, Nie, J, Ningrum, DNA, Nnaji, CA, Nomura, S, Noubiap, JJ, Nowak, C, Nuñez-Samudio, V, Ogbo, FA, Oghenetega, OB, Oh, I-H, Oladnabi, M, Olagunju, AT, Olusanya, BO, Olusanya, JO, Bali, AO, Omer, MO, Onwujekwe, OE, Ortiz, A, Otoiu, A, Otstavnov, N, Otstavnov, SS, Øverland, S, Owolabi, MO, Mahesh, PA, Padubidri, JR, Pakshir, K, Palladino, R, Pana, A, Panda-Jonas, S, Pandey, A, Panelo, CIA, Park, E-K, Patten, SB, Peden, AE, Pepito, VCF, Peprah, EK, Pereira, J, Pesudovs, K, Pham, HQ, Phillips, MR, Piradov, MA, Pirsaheb, M, Postma, MJ, Pottoo, FH, Pourjafar, H, Pourshams, A, Prada, SI, Pupillo, E, Syed, ZQ, Rabiee, MH, Rabiee, N, Radfar, A, Rafiee, A, Raggi, A, Rahim, F, Rahimi-Movaghar, V, Rahman, MHU, Rahman, MA, Ramezanzadeh, K, Ranabhat, CL, Rao, SJ, Rashedi, V, Rastogi, P, Rathi, P, Rawaf, DL, Rawaf, S, Rawal, L, Rawassizadeh, R, Renzaho, AMN, Rezaei, N, Rezai, MS, Riahi, SM, Rickard, J, Roever, L, Ronfani, L, Roth, GA, Rubagotti, E, Rumisha, SF, Rwegerera, GM, Sabour, S, Sachdev, PS, Saddik, B, Sadeghi, E, Moghaddam, SS, Sagar, R, Sahebkar, A, Sahraian, MA, Sajadi, SM, Salem, MR, Salimzadeh, H, Samy, AM, Sanabria, J, Santric-Milicevic, MM, Saraswathy, SYI, Sarrafzadegan, N, Sarveazad, A, Sathish, T, Sattin, D, Saxena, D, Saxena, S, Schiavolin, S, Schwebel, DC, Schwendicke, F, Senthilkumaran, S, Sepanlou, SG, Sha, F, Shafaat, O, Shahabi, S, Shaheen, AA, Shaikh, MA, Shakiba, S, Shamsi, M, Shannawaz, M, Sharafi, K, Sheikh, A, Sheikhbahaei, S, Shetty, BSK, Shi, P, Shigematsu, M, Shin, JI, Shiri, R, Shuval, K, Siabani, S, Sigfusdottir, ID, Sigurvinsdottir, R, Silva, DAS, Silva, JP, Simonetti, B, Singh, JA, Singh, V, Sinke, AH, Skryabin, VY, Slater, H, Smith, EUR, Sobhiyeh, MR, Sobngwi, E, Soheili, A, Somefun, OD, Sorrie, MB, Soyiri, IN, Sreeramareddy, CT, Stein, DJ, Stokes, MA, Sudaryanto, A, Sultan, I, Tabarés-Seisdedos, R, Tabuchi, T, Tadakamadla, SK, Taherkhani, A, Tamiru, AT, Tareque, I, Thankappan, KR, Thapar, R, Thomas, N, Titova, MV, Tonelli, M, Tovani-Palone, MR, Tran, BX, Travillian, RS, Tsai, AC, Tsatsakis, A, Car, LT, Uddin, R, Unim, B, Unnikrishnan, B, Upadhyay, E, Vacante, M, Tahbaz, SV, Valdez, PR, Varughese, S, Vasankari, TJ, Venketasubramanian, N, Villeneuve, PJ, Violante, FS, Vlassov, V, Vos, T, Vu, GT, Waheed, Y, Wamai, RG, Wang, Y, Wang, Y-P, Westerman, R, Wickramasinghe, ND, Wu, A-M, Wu, C, Jabbari, SHY, Yamagishi, K, Yano, Y, Yaya, S, Yazdi-Feyzabadi, V, Yeshitila, YG, Yip, P, Yonemoto, N, Yoon, S-J, Younis, MZ, Yousefinezhadi, T, Yu, C, Yu, Y, Yuce, D, Zaidi, SS, Bin Zaman, S, Zamani, M, Zamanian, M, Zarafshan, H, Zarei, A, Zastrozhin, MS, Zhang, Y, Zhang, Z-J, Zhao, X-JG, Zhu, C, Patton, GC, Viner, RM, Collaborators, GBD 2019 Adolescent Mortality, Ward, J. L., Azzopardi, P. S., Francis, K. L., Santelli, J. S., Skirbekk, V., Sawyer, S. M., Kassebaum, N. J., Mokdad, A. H., Hay, S. I., Abd-Allah, F., Abdoli, A., Abdollahi, M., Abedi, A., Abolhassani, H., Abreu, L. G., Abrigo, M. R. M., Abu-Gharbieh, E., Abushouk, A. I., Adebayo, O. M., Adekanmbi, V., Adham, D., Advani, S. M., Afshari, K., Agrawal, A., Ahmad, T., Ahmadi, K., Ahmed, A. E., Aji, B., Akombi-Inyang, B., Alahdab, F., Al-Aly, Z., Alam, K., Alanezi, F. M., Alanzi, T. M., Alcalde-Rabanal, J. E., Alemu, B. W., Al-Hajj, S., Alhassan, R. K., Ali, S., Alicandro, G., Alijanzadeh, M., Aljunid, S. M., Almasi-Hashiani, A., Almasri, N. A., Al-Mekhlafi, H. M., Alonso, J., Al-Raddadi, R. M., Altirkawi, K. A., Alvis-Guzman, N., Amare, A. T., Amini, S., Aminorroaya, A., Amit, A. M. L., Amugsi, D. A., Ancuceanu, R., Anderlini, D., Andrei, C. L., Androudi, S., Ansari, F., Ansari, I., Antonio, C. A. T., Anvari, D., Anwer, R., Appiah, S. C. Y., Arabloo, J., Arab-Zozani, M., Arnlov, J., Asaad, M., Asadi-Aliabadi, M., Asadi-Pooya, A. A., Atout, M. M. W., Ausloos, M., Avenyo, E. K., Avila-Burgos, L., Ayala Quintanilla, B. P., Ayano, G., Aynalem, Y. A., Azari, S., Azene, Z. N., Bakhshaei, M. H., Bakkannavar, S. M., Banach, M., Banik, P. C., Barboza, M. A., Barker-Collo, S. L., Barnighausen, T. W., Basu, S., Baune, B. T., Bayati, M., Bedi, N., Beghi, E., Bekuma, T. T., Bell, A. W., Bell, M. L., Benjet, C., Bensenor, I. M., Berhe, A. K., Berhe, K., Berman, A. E., Bhagavathula, A. S., Bhardwaj, N., Bhardwaj, P., Bhattacharyya, K., Bhattarai, S., Bhutta, Z. A., Bijani, A., Bikbov, B., Biondi, A., Birhanu, T. T. M., Biswas, R. K., Bohlouli, S., Bolla, S. R., Boloor, A., Borschmann, R., Boufous, S., Bragazzi, N. L., Braithwaite, D., Breitborde, N. J. K., Brenner, H., Britton, G. B., Burns, R. A., Burugina Nagaraja, S., Butt, Z. A., Caetano dos Santos, F. L., Camera, L. A., Campos-Nonato, I. R., Campuzano Rincon, J. C., Cardenas, R., Carreras, G., Carrero, J. J., Carvalho, F., Castaldelli-Maia, J. M., Castaneda-Orjuela, C. A., Castelpietra, G., Catala-Lopez, F., Cerin, E., Chandan, J. S., Chang, H. -Y., Chang, J. -C., Charan, J., Chattu, V. K., Chaturvedi, S., Choi, J. -Y. J., Chowdhury, M. A. K., Christopher, D. J., Chu, D. -T., Chung, M. T., Chung, S. -C., Cicuttini, F. M., Constantin, T. V., Costa, V. M., Dahlawi, S. M. A., Dai, H., Dai, X., Damiani, G., Dandona, L., Dandona, R., Daneshpajouhnejad, P., Darwesh, A. M., Davila-Cervantes, C. A., Davletov, K., De la Hoz, F. P., De Leo, D., Dervenis, N., Desai, R., Desalew, A., Deuba, K., Dharmaratne, S. D., Dhungana, G. P., Dianatinasab, M., Dias da Silva, D., Diaz, D., Didarloo, A., Djalalinia, S., Dorostkar, F., Doshi, C. P., Doshmangir, L., Doyle, K. E., Duraes, A. R., Ebrahimi Kalan, M., Ebtehaj, S., Edvardsson, D., El Tantawi, M., Elgendy, I. Y., El-Jaafary, S. I., Elsharkawy, A., Eshrati, B., Eskandarieh, S., Esmaeilnejad, S., Esmaeilzadeh, F., Esteghamati, S., Faro, A., Farzadfar, F., Fattahi, N., Feigin, V. L., Ferede, T. Y., Fereshtehnejad, S. -M., Fernandes, E., Ferrara, P., Filip, I., Fischer, F., Fisher, J. L., Foigt, N. A., Folayan, M. O., Fomenkov, A. A., Foroutan, M., Fukumoto, T., Gad, M. M., Gaidhane, A. M., Gallus, S., Gebre, T., Gebremedhin, K. B., Gebremeskel, G. G., Gebremeskel, L., Gebreslassie, A. A., Gesesew, H. A., Ghadiri, K., Ghafourifard, M., Ghamari, F., Ghashghaee, A., Gilani, S. A., Gnedovskaya, E. V., Godinho, M. A., Golechha, M., Goli, S., Gona, P. N., Gopalani, S. V., Gorini, G., Grivna, M., Gubari, M. I. M., Gugnani, H. C., Guimaraes, R. A., Guo, Y., Gupta, R., Haagsma, J. A., Hafezi-Nejad, N., Haile, T. G., Haj-Mirzaian, A., Hall, B. J., Hamadeh, R. R., Hamagharib Abdullah, K., Hamidi, S., Handiso, D. W., Hanif, A., Hankey, G. J., Haririan, H., Haro, J. M., Hasaballah, A. I., Hashi, A., Hassan, A., Hassanipour, S., Hassankhani, H., Hayat, K., Heidari-Soureshjani, R., Herteliu, C., Heydarpour, F., Ho, H. C., Hole, M. K., Holla, R., Hoogar, P., Hosseini, M., Hosseinzadeh, M., Hostiuc, M., Hostiuc, S., Househ, M., Hsairi, M., Huda, T. M., Humayun, A., Hussain, R., Hwang, B. -F., Iavicoli, I., Ibitoye, S. E., Ilesanmi, O. S., Ilic, I. M., Ilic, M. D., Inbaraj, L. R., Intarut, N., Iqbal, U., Irvani, S. S. N., Islam, M. M., Islam, S. M. S., Iso, H., Ivers, R. Q., Jahani, M. A., Jakovljevic, M., Jalali, A., Janodia, M. D., Javaheri, T., Jeemon, P., Jenabi, E., Jha, R. P., Jha, V., Ji, J. S., Jonas, J. B., Jones, K. M., Joukar, F., Jozwiak, J. J., Juliusson, P. B., Jurisson, M., Kabir, A., Kabir, Z., Kalankesh, L. R., Kalhor, R., Kamyari, N., Kanchan, T., Karch, A., Karimi, S. E., Kaur, S., Kayode, G. A., Keiyoro, P. N., Khalid, N., Khammarnia, M., Khan, M., Khan, M. N., Khatab, K., Khater, M. M., Khatib, M. N., Khayamzadeh, M., Khazaie, H., Khoja, A. T., Kieling, C., Kim, Y. -E., Kim, Y. J., Kimokoti, R. W., Kisa, A., Kisa, S., Kivimaki, M., Koolivand, A., Kosen, S., Koyanagi, A., Krishan, K., Kugbey, N., Kumar, G. A., Kumar, M., Kumar, N., Kurmi, O. P., Kusuma, D., La Vecchia, C., Lacey, B., Lal, D. K., Lalloo, R., Lan, Q., Landires, I., Lansingh, V. C., Larsson, A. O., Lasrado, S., Lassi, Z. S., Lauriola, P., Lee, P. H., Lee, S. W. H., Leigh, J., Leonardi, M., Leung, J., Levi, M., Lewycka, S., Li, B., Li, M. -C., Li, S., Lim, L. -L., Lim, S. S., Liu, X., Lorkowski, S., Lotufo, P. A., Lunevicius, R., Maddison, R., Mahasha, P. W., Mahdavi, M. M., Mahmoudi, M., Majeed, A., Maleki, A., Malekzadeh, R., Malta, D. C., Mamun, A. A., Mansouri, B., Mansournia, M. A., Martinez, G., Martinez-Raga, J., Martins-Melo, F. R., Mason-Jones, A. J., Masoumi, S. Z., Mathur, M. R., Maulik, P. K., Mcgrath, J. J., Mehndiratta, M. M., Mehri, F., Memiah, P. T. N., Mendoza, W., Menezes, R. G., Mengesha, E. W., Meretoja, A., Meretoja, T. J., Mestrovic, T., Miazgowski, B., Miazgowski, T., Michalek, I. M., Miller, T. R., Mini, G. K., Mirica, A., Mirrakhimov, E. M., Mirzaei, H., Mirzaei, M., Moazen, B., Mohammad, D. K., Mohammadi, S., Mohammadian-Hafshejani, A., Mohammadifard, N., Mohammadpourhodki, R., Mohammed, S., Monasta, L., Moradi, G., Moradi-Lakeh, M., Moradzadeh, R., Moraga, P., Morrison, S. D., Mosapour, A., Mousavi Khaneghah, A., Mueller, U. O., Muriithi, M. K., Murray, C. J. L., Muthupandian, S., Naderi, M., Nagarajan, A. J., Naghavi, M., Naimzada, M. D., Nangia, V., Nayak, V. C., Nazari, J., Ndejjo, R., Negoi, I., Negoi, R. I., Netsere, H. B., Nguefack-Tsague, G., Nguyen, D. N., Nguyen, H. L. T., Nie, J., Ningrum, D. N. A., Nnaji, C. A., Nomura, S., Noubiap, J. J., Nowak, C., Nunez-Samudio, V., Ogbo, F. A., Oghenetega, O. B., Oh, I. -H., Oladnabi, M., Olagunju, A. T., Olusanya, B. O., Olusanya, J. O., Omar Bali, A., Omer, M. O., Onwujekwe, O. E., Ortiz, A., Otoiu, A., Otstavnov, N., Otstavnov, S. S., Overland, S., Owolabi, M. O., P A, M., Padubidri, J. R., Pakshir, K., Palladino, R., Pana, A., Panda-Jonas, S., Pandey, A., Panelo, C. I. A., Park, E. -K., Patten, S. B., Peden, A. E., Pepito, V. C. F., Peprah, E. K., Pereira, J., Pesudovs, K., Pham, H. Q., Phillips, M. R., Piradov, M. A., Pirsaheb, M., Postma, M. J., Pottoo, F. H., Pourjafar, H., Pourshams, A., Prada, S. I., Pupillo, E., Quazi Syed, Z., Rabiee, M. H., Rabiee, N., Radfar, A., Rafiee, A., Raggi, A., Rahim, F., Rahimi-Movaghar, V., Rahman, M. H. U., Rahman, M. A., Ramezanzadeh, K., Ranabhat, C. L., Rao, S. J., Rashedi, V., Rastogi, P., Rathi, P., Rawaf, D. L., Rawaf, S., Rawal, L., Rawassizadeh, R., Renzaho, A. M. N., Rezaei, N., Rezai, M. S., Riahi, S. M., Rickard, J., Roever, L., Ronfani, L., Roth, G. A., Rubagotti, E., Rumisha, S. F., Rwegerera, G. M., Sabour, S., Sachdev, P. S., Saddik, B., Sadeghi, E., Saeedi Moghaddam, S., Sagar, R., Sahebkar, A., Sahraian, M. A., Sajadi, S. M., Salem, M. R., Salimzadeh, H., Samy, A. M., Sanabria, J., Santric-Milicevic, M. M., Saraswathy, S. Y. I., Sarrafzadegan, N., Sarveazad, A., Sathish, T., Sattin, D., Saxena, D., Saxena, S., Schiavolin, S., Schwebel, D. C., Schwendicke, F., Senthilkumaran, S., Sepanlou, S. G., Sha, F., Shafaat, O., Shahabi, S., Shaheen, A. A., Shaikh, M. A., Shakiba, S., Shamsi, M., Shannawaz, M., Sharafi, K., Sheikh, A., Sheikhbahaei, S., Shetty, B. S. K., Shi, P., Shigematsu, M., Shin, J. I., Shiri, R., Shuval, K., Siabani, S., Sigfusdottir, I. D., Sigurvinsdottir, R., Silva, D. A. S., Silva, J. P., Simonetti, B., Singh, J. A., Singh, V., Sinke, A. H., Skryabin, V. Y., Slater, H., Smith, E. U. R., Sobhiyeh, M. R., Sobngwi, E., Soheili, A., Somefun, O. D., Sorrie, M. B., Soyiri, I. N., Sreeramareddy, C. T., Stein, D. J., Stokes, M. A., Sudaryanto, A., Sultan, I., Tabares-Seisdedos, R., Tabuchi, T., Tadakamadla, S. K., Taherkhani, A., Tamiru, A. T., Tareque, M. I., Thankappan, K. R., Thapar, R., Thomas, N., Titova, M. V., Tonelli, M., Tovani-Palone, M. R., Tran, B. X., Travillian, R. S., Tsai, A. C., Tsatsakis, A., Tudor Car, L., Uddin, R., Unim, B., Unnikrishnan, B., Upadhyay, E., Vacante, M., Valadan Tahbaz, S., Valdez, P. R., Varughese, S., Vasankari, T. J., Venketasubramanian, N., Villeneuve, P. J., Violante, F. S., Vlassov, V., Vos, T., Vu, G. T., Waheed, Y., Wamai, R. G., Wang, Y., Wang, Y. -P., Westerman, R., Wickramasinghe, N. D., Wu, A. -M., Wu, C., Yahyazadeh Jabbari, S. H., Yamagishi, K., Yano, Y., Yaya, S., Yazdi-Feyzabadi, V., Yeshitila, Y. G., Yip, P., Yonemoto, N., Yoon, S. -J., Younis, M. Z., Yousefinezhadi, T., Yu, C., Yu, Y., Yuce, D., Zaidi, S. S., Zaman, S. B., Zamani, M., Zamanian, M., Zarafshan, H., Zarei, A., Zastrozhin, M. S., Zhang, Y., Zhang, Z. -J., Zhao, X. -J. G., Zhu, C., Patton, G. C., Viner, R. M., Value, Affordability and Sustainability (VALUE), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Microbes in Health and Disease (MHD), Bill & Melinda Gates Foundation, Ward J.L., Azzopardi P.S., Francis K.L., Santelli J.S., Skirbekk V., Sawyer S.M., Kassebaum N.J., Mokdad A.H., Hay S.I., Abd-Allah F., Abdoli A., Abdollahi M., Abedi A., Abolhassani H., Abreu L.G., Abrigo M.R.M., Abu-Gharbieh E., Abushouk A.I., Adebayo O.M., Adekanmbi V., Adham D., Advani S.M., Afshari K., Agrawal A., Ahmad T., Ahmadi K., Ahmed A.E., Aji B., Akombi-Inyang B., Alahdab F., Al-Aly Z., Alam K., Alanezi F.M., Alanzi T.M., Alcalde-Rabanal J.E., Alemu B.W., Al-Hajj S., Alhassan R.K., Ali S., Alicandro G., Alijanzadeh M., Aljunid S.M., Almasi-Hashiani A., Almasri N.A., Al-Mekhlafi H.M., Alonso J., Al-Raddadi R.M., Altirkawi K.A., Alvis-Guzman N., Amare A.T., Amini S., Aminorroaya A., Amit A.M.L., Amugsi D.A., Ancuceanu R., Anderlini D., Andrei C.L., Androudi S., Ansari F., Ansari I., Antonio C.A.T., Anvari D., Anwer R., Appiah S.C.Y., Arabloo J., Arab-Zozani M., Arnlov J., Asaad M., Asadi-Aliabadi M., Asadi-Pooya A.A., Atout M.M.W., Ausloos M., Avenyo E.K., Avila-Burgos L., Ayala Quintanilla B.P., Ayano G., Aynalem Y.A., Azari S., Azene Z.N., Bakhshaei M.H., Bakkannavar S.M., Banach M., Banik P.C., Barboza M.A., Barker-Collo S.L., Barnighausen T.W., Basu S., Baune B.T., Bayati M., Bedi N., Beghi E., Bekuma T.T., Bell A.W., Bell M.L., Benjet C., Bensenor I.M., Berhe A.K., Berhe K., Berman A.E., Bhagavathula A.S., Bhardwaj N., Bhardwaj P., Bhattacharyya K., Bhattarai S., Bhutta Z.A., Bijani A., Bikbov B., Biondi A., Birhanu T.T.M., Biswas R.K., Bohlouli S., Bolla S.R., Boloor A., Borschmann R., Boufous S., Bragazzi N.L., Braithwaite D., Breitborde N.J.K., Brenner H., Britton G.B., Burns R.A., Burugina Nagaraja S., Butt Z.A., Caetano dos Santos F.L., Camera L.A., Campos-Nonato I.R., Campuzano Rincon J.C., Cardenas R., Carreras G., Carrero J.J., Carvalho F., Castaldelli-Maia J.M., Castaneda-Orjuela C.A., Castelpietra G., Catala-Lopez F., Cerin E., Chandan J.S., Chang H.-Y., Chang J.-C., Charan J., Chattu V.K., Chaturvedi S., Choi J.-Y.J., Chowdhury M.A.K., Christopher D.J., Chu D.-T., Chung M.T., Chung S.-C., Cicuttini F.M., Constantin T.V., Costa V.M., Dahlawi S.M.A., Dai H., Dai X., Damiani G., Dandona L., Dandona R., Daneshpajouhnejad P., Darwesh A.M., Davila-Cervantes C.A., Davletov K., De la Hoz F.P., De Leo D., Dervenis N., Desai R., Desalew A., Deuba K., Dharmaratne S.D., Dhungana G.P., Dianatinasab M., Dias da Silva D., Diaz D., Didarloo A., Djalalinia S., Dorostkar F., Doshi C.P., Doshmangir L., Doyle K.E., Duraes A.R., Ebrahimi Kalan M., Ebtehaj S., Edvardsson D., El Tantawi M., Elgendy I.Y., El-Jaafary S.I., Elsharkawy A., Eshrati B., Eskandarieh S., Esmaeilnejad S., Esmaeilzadeh F., Esteghamati S., Faro A., Farzadfar F., Fattahi N., Feigin V.L., Ferede T.Y., Fereshtehnejad S.-M., Fernandes E., Ferrara P., Filip I., Fischer F., Fisher J.L., Foigt N.A., Folayan M.O., Fomenkov A.A., Foroutan M., Fukumoto T., Gad M.M., Gaidhane A.M., Gallus S., Gebre T., Gebremedhin K.B., Gebremeskel G.G., Gebremeskel L., Gebreslassie A.A., Gesesew H.A., Ghadiri K., Ghafourifard M., Ghamari F., Ghashghaee A., Gilani S.A., Gnedovskaya E.V., Godinho M.A., Golechha M., Goli S., Gona P.N., Gopalani S.V., Gorini G., Grivna M., Gubari M.I.M., Gugnani H.C., Guimaraes R.A., Guo Y., Gupta R., Haagsma J.A., Hafezi-Nejad N., Haile T.G., Haj-Mirzaian A., Hall B.J., Hamadeh R.R., Hamagharib Abdullah K., Hamidi S., Handiso D.W., Hanif A., Hankey G.J., Haririan H., Haro J.M., Hasaballah A.I., Hashi A., Hassan A., Hassanipour S., Hassankhani H., Hayat K., Heidari-Soureshjani R., Herteliu C., Heydarpour F., Ho H.C., Hole M.K., Holla R., Hoogar P., Hosseini M., Hosseinzadeh M., Hostiuc M., Hostiuc S., Househ M., Hsairi M., Huda T.M., Humayun A., Hussain R., Hwang B.-F., Iavicoli I., Ibitoye S.E., Ilesanmi O.S., Ilic I.M., Ilic M.D., Inbaraj L.R., Intarut N., Iqbal U., Irvani S.S.N., Islam M.M., Islam S.M.S., Iso H., Ivers R.Q., Jahani M.A., Jakovljevic M., Jalali A., Janodia M.D., Javaheri T., Jeemon P., Jenabi E., Jha R.P., Jha V., Ji J.S., Jonas J.B., Jones K.M., Joukar F., Jozwiak J.J., Juliusson P.B., Jurisson M., Kabir A., Kabir Z., Kalankesh L.R., Kalhor R., Kamyari N., Kanchan T., Karch A., Karimi S.E., Kaur S., Kayode G.A., Keiyoro P.N., Khalid N., Khammarnia M., Khan M., Khan M.N., Khatab K., Khater M.M., Khatib M.N., Khayamzadeh M., Khazaie H., Khoja A.T., Kieling C., Kim Y.-E., Kim Y.J., Kimokoti R.W., Kisa A., Kisa S., Kivimaki M., Koolivand A., Kosen S., Koyanagi A., Krishan K., Kugbey N., Kumar G.A., Kumar M., Kumar N., Kurmi O.P., Kusuma D., La Vecchia C., Lacey B., Lal D.K., Lalloo R., Lan Q., Landires I., Lansingh V.C., Larsson A.O., Lasrado S., Lassi Z.S., Lauriola P., Lee P.H., Lee S.W.H., Leigh J., Leonardi M., Leung J., Levi M., Lewycka S., Li B., Li M.-C., Li S., Lim L.-L., Lim S.S., Liu X., Lorkowski S., Lotufo P.A., Lunevicius R., Maddison R., Mahasha P.W., Mahdavi M.M., Mahmoudi M., Majeed A., Maleki A., Malekzadeh R., Malta D.C., Mamun A.A., Mansouri B., Mansournia M.A., Martinez G., Martinez-Raga J., Martins-Melo F.R., Mason-Jones A.J., Masoumi S.Z., Mathur M.R., Maulik P.K., McGrath J.J., Mehndiratta M.M., Mehri F., Memiah P.T.N., Mendoza W., Menezes R.G., Mengesha E.W., Meretoja A., Meretoja T.J., Mestrovic T., Miazgowski B., Miazgowski T., Michalek I.M., Miller T.R., Mini G.K., Mirica A., Mirrakhimov E.M., Mirzaei H., Mirzaei M., Moazen B., Mohammad D.K., Mohammadi S., Mohammadian-Hafshejani A., Mohammadifard N., Mohammadpourhodki R., Mohammed S., Monasta L., Moradi G., Moradi-Lakeh M., Moradzadeh R., Moraga P., Morrison S.D., Mosapour A., Mousavi Khaneghah A., Mueller U.O., Muriithi M.K., Murray C.J.L., Muthupandian S., Naderi M., Nagarajan A.J., Naghavi M., Naimzada M.D., Nangia V., Nayak V.C., Nazari J., Ndejjo R., Negoi I., Negoi R.I., Netsere H.B., Nguefack-Tsague G., Nguyen D.N., Nguyen H.L.T., Nie J., Ningrum D.N.A., Nnaji C.A., Nomura S., Noubiap J.J., Nowak C., Nunez-Samudio V., Ogbo F.A., Oghenetega O.B., Oh I.-H., Oladnabi M., Olagunju A.T., Olusanya B.O., Olusanya J.O., Omar Bali A., Omer M.O., Onwujekwe O.E., Ortiz A., Otoiu A., Otstavnov N., Otstavnov S.S., Overland S., Owolabi M.O., P A M., Padubidri J.R., Pakshir K., Palladino R., Pana A., Panda-Jonas S., Pandey A., Panelo C.I.A., Park E.-K., Patten S.B., Peden A.E., Pepito V.C.F., Peprah E.K., Pereira J., Pesudovs K., Pham H.Q., Phillips M.R., Piradov M.A., Pirsaheb M., Postma M.J., Pottoo F.H., Pourjafar H., Pourshams A., Prada S.I., Pupillo E., Quazi Syed Z., Rabiee M.H., Rabiee N., Radfar A., Rafiee A., Raggi A., Rahim F., Rahimi-Movaghar V., Rahman M.H.U., Rahman M.A., Ramezanzadeh K., Ranabhat C.L., Rao S.J., Rashedi V., Rastogi P., Rathi P., Rawaf D.L., Rawaf S., Rawal L., Rawassizadeh R., Renzaho A.M.N., Rezaei N., Rezai M.S., Riahi S.M., Rickard J., Roever L., Ronfani L., Roth G.A., Rubagotti E., Rumisha S.F., Rwegerera G.M., Sabour S., Sachdev P.S., Saddik B., Sadeghi E., Saeedi Moghaddam S., Sagar R., Sahebkar A., Sahraian M.A., Sajadi S.M., Salem M.R., Salimzadeh H., Samy A.M., Sanabria J., Santric-Milicevic M.M., Saraswathy S.Y.I., Sarrafzadegan N., Sarveazad A., Sathish T., Sattin D., Saxena D., Saxena S., Schiavolin S., Schwebel D.C., Schwendicke F., Senthilkumaran S., Sepanlou S.G., Sha F., Shafaat O., Shahabi S., Shaheen A.A., Shaikh M.A., Shakiba S., Shamsi M., Shannawaz M., Sharafi K., Sheikh A., Sheikhbahaei S., Shetty B.S.K., Shi P., Shigematsu M., Shin J.I., Shiri R., Shuval K., Siabani S., Sigfusdottir I.D., Sigurvinsdottir R., Silva D.A.S., Silva J.P., Simonetti B., Singh J.A., Singh V., Sinke A.H., Skryabin V.Y., Slater H., Smith E.U.R., Sobhiyeh M.R., Sobngwi E., Soheili A., Somefun O.D., Sorrie M.B., Soyiri I.N., Sreeramareddy C.T., Stein D.J., Stokes M.A., Sudaryanto A., Sultan I., Tabares-Seisdedos R., Tabuchi T., Tadakamadla S.K., Taherkhani A., Tamiru A.T., Tareque M.I., Thankappan K.R., Thapar R., Thomas N., Titova M.V., Tonelli M., Tovani-Palone M.R., Tran B.X., Travillian R.S., Tsai A.C., Tsatsakis A., Tudor Car L., Uddin R., Unim B., Unnikrishnan B., Upadhyay E., Vacante M., Valadan Tahbaz S., Valdez P.R., Varughese S., Vasankari T.J., Venketasubramanian N., Villeneuve P.J., Violante F.S., Vlassov V., Vos T., Vu G.T., Waheed Y., Wamai R.G., Wang Y., Wang Y.-P., Westerman R., Wickramasinghe N.D., Wu A.-M., Wu C., Yahyazadeh Jabbari S.H., Yamagishi K., Yano Y., Yaya S., Yazdi-Feyzabadi V., Yeshitila Y.G., Yip P., Yonemoto N., Yoon S.-J., Younis M.Z., Yousefinezhadi T., Yu C., Yu Y., Yuce D., Zaidi S.S., Zaman S.B., Zamani M., Zamanian M., Zarafshan H., Zarei A., Zastrozhin M.S., Zhang Y., Zhang Z.-J., Zhao X.-J.G., Zhu C., Patton G.C., Viner R.M., Lee Kong Chian School of Medicine (LKCMedicine), Ward, J, Azzopardi, P, Francis, K, Santelli, J, Skirbekk, V, Sawyer, S, Kassebaum, N, Mokdad, A, Hay, S, Abd-Allah, F, Abdoli, A, Abdollahi, M, Abedi, A, Abolhassani, H, Abreu, L, Abrigo, M, Abu-Gharbieh, E, Abushouk, A, Adebayo, O, Adekanmbi, V, Adham, D, Advani, S, Afshari, K, Agrawal, A, Ahmad, T, Ahmadi, K, Ahmed, A, Aji, B, Akombi-Inyang, B, Alahdab, F, Al-Aly, Z, Alam, K, Alanezi, F, Alanzi, T, Alcalde-Rabanal, J, Alemu, B, Al-Hajj, S, Alhassan, R, Ali, S, Alicandro, G, Alijanzadeh, M, Aljunid, S, Almasi-Hashiani, A, Almasri, N, Al-Mekhlafi, H, Alonso, J, Al-Raddadi, R, Altirkawi, K, Alvis-Guzman, N, Amare, A, Amini, S, Aminorroaya, A, Amit, A, Amugsi, D, Ancuceanu, R, Anderlini, D, Andrei, C, Androudi, S, Ansari, F, Ansari, I, Antonio, C, Anvari, D, Anwer, R, Appiah, S, Arabloo, J, Arab-Zozani, M, Arnlov, J, Asaad, M, Asadi-Aliabadi, M, Asadi-Pooya, A, Atout, M, Ausloos, M, Avenyo, E, Avila-Burgos, L, Ayala Quintanilla, B, Ayano, G, Aynalem, Y, Azari, S, Azene, Z, Bakhshaei, M, Bakkannavar, S, Banach, M, Banik, P, Barboza, M, Barker-Collo, S, Barnighausen, T, Basu, S, Baune, B, Bayati, M, Bedi, N, Beghi, E, Bekuma, T, Bell, A, Bell, M, Benjet, C, Bensenor, I, Berhe, A, Berhe, K, Berman, A, Bhagavathula, A, Bhardwaj, N, Bhardwaj, P, Bhattacharyya, K, Bhattarai, S, Bhutta, Z, Bijani, A, Bikbov, B, Biondi, A, Birhanu, T, Biswas, R, Bohlouli, S, Bolla, S, Boloor, A, Borschmann, R, Boufous, S, Bragazzi, N, Braithwaite, D, Breitborde, N, Brenner, H, Britton, G, Burns, R, Burugina Nagaraja, S, Butt, Z, Caetano dos Santos, F, Camera, L, Campos-Nonato, I, Campuzano Rincon, J, Cardenas, R, Carreras, G, Carrero, J, Carvalho, F, Castaldelli-Maia, J, Castaneda-Orjuela, C, Castelpietra, G, Catala-Lopez, F, Cerin, E, Chandan, J, Chang, H, Chang, J, Charan, J, Chattu, V, Chaturvedi, S, Choi, J, Chowdhury, M, Christopher, D, Chu, D, Chung, M, Chung, S, Cicuttini, F, Constantin, T, Costa, V, Dahlawi, S, Dai, H, Dai, X, Damiani, G, Dandona, L, Dandona, R, Daneshpajouhnejad, P, Darwesh, A, Davila-Cervantes, C, Davletov, K, De la Hoz, F, De Leo, D, Dervenis, N, Desai, R, Desalew, A, Deuba, K, Dharmaratne, S, Dhungana, G, Dianatinasab, M, Dias da Silva, D, Diaz, D, Didarloo, A, Djalalinia, S, Dorostkar, F, Doshi, C, Doshmangir, L, Doyle, K, Duraes, A, Ebrahimi Kalan, M, Ebtehaj, S, Edvardsson, D, El Tantawi, M, Elgendy, I, El-Jaafary, S, Elsharkawy, A, Eshrati, B, Eskandarieh, S, Esmaeilnejad, S, Esmaeilzadeh, F, Esteghamati, S, Faro, A, Farzadfar, F, Fattahi, N, Feigin, V, Ferede, T, Fereshtehnejad, S, Fernandes, E, Ferrara, P, Filip, I, Fischer, F, Fisher, J, Foigt, N, Folayan, M, Fomenkov, A, Foroutan, M, Fukumoto, T, Gad, M, Gaidhane, A, Gallus, S, Gebre, T, Gebremedhin, K, Gebremeskel, G, Gebremeskel, L, Gebreslassie, A, Gesesew, H, Ghadiri, K, Ghafourifard, M, Ghamari, F, Ghashghaee, A, Gilani, S, Gnedovskaya, E, Godinho, M, Golechha, M, Goli, S, Gona, P, Gopalani, S, Gorini, G, Grivna, M, Gubari, M, Gugnani, H, Guimaraes, R, Guo, Y, Gupta, R, Haagsma, J, Hafezi-Nejad, N, Haile, T, Haj-Mirzaian, A, Hall, B, Hamadeh, R, Hamagharib Abdullah, K, Hamidi, S, Handiso, D, Hanif, A, Hankey, G, Haririan, H, Haro, J, Hasaballah, A, Hashi, A, Hassan, A, Hassanipour, S, Hassankhani, H, Hayat, K, Heidari-Soureshjani, R, Herteliu, C, Heydarpour, F, Ho, H, Hole, M, Holla, R, Hoogar, P, Hosseini, M, Hosseinzadeh, M, Hostiuc, M, Hostiuc, S, Househ, M, Hsairi, M, Huda, T, Humayun, A, Hussain, R, Hwang, B, Iavicoli, I, Ibitoye, S, Ilesanmi, O, Ilic, I, Ilic, M, Inbaraj, L, Intarut, N, Iqbal, U, Irvani, S, Islam, M, Islam, S, Iso, H, Ivers, R, Jahani, M, Jakovljevic, M, Jalali, A, Janodia, M, Javaheri, T, Jeemon, P, Jenabi, E, Jha, R, Jha, V, Ji, J, Jonas, J, Jones, K, Joukar, F, Jozwiak, J, Juliusson, P, Jurisson, M, Kabir, A, Kabir, Z, Kalankesh, L, Kalhor, R, Kamyari, N, Kanchan, T, Karch, A, Karimi, S, Kaur, S, Kayode, G, Keiyoro, P, Khalid, N, Khammarnia, M, Khan, M, Khatab, K, Khater, M, Khatib, M, Khayamzadeh, M, Khazaie, H, Khoja, A, Kieling, C, Kim, Y, Kimokoti, R, Kisa, A, Kisa, S, Kivimaki, M, Koolivand, A, Kosen, S, Koyanagi, A, Krishan, K, Kugbey, N, Kumar, G, Kumar, M, Kumar, N, Kurmi, O, Kusuma, D, La Vecchia, C, Lacey, B, Lal, D, Lalloo, R, Lan, Q, Landires, I, Lansingh, V, Larsson, A, Lasrado, S, Lassi, Z, Lauriola, P, Lee, P, Lee, S, Leigh, J, Leonardi, M, Leung, J, Levi, M, Lewycka, S, Li, B, Li, M, Li, S, Lim, L, Lim, S, Liu, X, Lorkowski, S, Lotufo, P, Lunevicius, R, Maddison, R, Mahasha, P, Mahdavi, M, Mahmoudi, M, Majeed, A, Maleki, A, Malekzadeh, R, Malta, D, Mamun, A, Mansouri, B, Mansournia, M, Martinez, G, Martinez-Raga, J, Martins-Melo, F, Mason-Jones, A, Masoumi, S, Mathur, M, Maulik, P, Mcgrath, J, Mehndiratta, M, Mehri, F, Memiah, P, Mendoza, W, Menezes, R, Mengesha, E, Meretoja, A, Meretoja, T, Mestrovic, T, Miazgowski, B, Miazgowski, T, Michalek, I, Miller, T, Mini, G, Mirica, A, Mirrakhimov, E, Mirzaei, H, Mirzaei, M, Moazen, B, Mohammad, D, Mohammadi, S, Mohammadian-Hafshejani, A, Mohammadifard, N, Mohammadpourhodki, R, Mohammed, S, Monasta, L, Moradi, G, Moradi-Lakeh, M, Moradzadeh, R, Moraga, P, Morrison, S, Mosapour, A, Mousavi Khaneghah, A, Mueller, U, Muriithi, M, Murray, C, Muthupandian, S, Naderi, M, Nagarajan, A, Naghavi, M, Naimzada, M, Nangia, V, Nayak, V, Nazari, J, Ndejjo, R, Negoi, I, Negoi, R, Netsere, H, Nguefack-Tsague, G, Nguyen, D, Nguyen, H, Nie, J, Ningrum, D, Nnaji, C, Nomura, S, Noubiap, J, Nowak, C, Nunez-Samudio, V, Ogbo, F, Oghenetega, O, Oh, I, Oladnabi, M, Olagunju, A, Olusanya, B, Olusanya, J, Omar Bali, A, Omer, M, Onwujekwe, O, Ortiz, A, Otoiu, A, Otstavnov, N, Otstavnov, S, Overland, S, Owolabi, M, P A, M, Padubidri, J, Pakshir, K, Palladino, R, Pana, A, Panda-Jonas, S, Pandey, A, Panelo, C, Park, E, Patten, S, Peden, A, Pepito, V, Peprah, E, Pereira, J, Pesudovs, K, Pham, H, Phillips, M, Piradov, M, Pirsaheb, M, Postma, M, Pottoo, F, Pourjafar, H, Pourshams, A, Prada, S, Pupillo, E, Quazi Syed, Z, Rabiee, M, Rabiee, N, Radfar, A, Rafiee, A, Raggi, A, Rahim, F, Rahimi-Movaghar, V, Rahman, M, Ramezanzadeh, K, Ranabhat, C, Rao, S, Rashedi, V, Rastogi, P, Rathi, P, Rawaf, D, Rawaf, S, Rawal, L, Rawassizadeh, R, Renzaho, A, Rezaei, N, Rezai, M, Riahi, S, Rickard, J, Roever, L, Ronfani, L, Roth, G, Rubagotti, E, Rumisha, S, Rwegerera, G, Sabour, S, Sachdev, P, Saddik, B, Sadeghi, E, Saeedi Moghaddam, S, Sagar, R, Sahebkar, A, Sahraian, M, Sajadi, S, Salem, M, Salimzadeh, H, Samy, A, Sanabria, J, Santric-Milicevic, M, Saraswathy, S, Sarrafzadegan, N, Sarveazad, A, Sathish, T, Sattin, D, Saxena, D, Saxena, S, Schiavolin, S, Schwebel, D, Schwendicke, F, Senthilkumaran, S, Sepanlou, S, Sha, F, Shafaat, O, Shahabi, S, Shaheen, A, Shaikh, M, Shakiba, S, Shamsi, M, Shannawaz, M, Sharafi, K, Sheikh, A, Sheikhbahaei, S, Shetty, B, Shi, P, Shigematsu, M, Shin, J, Shiri, R, Shuval, K, Siabani, S, Sigfusdottir, I, Sigurvinsdottir, R, Silva, D, Silva, J, Simonetti, B, Singh, J, Singh, V, Sinke, A, Skryabin, V, Slater, H, Smith, E, Sobhiyeh, M, Sobngwi, E, Soheili, A, Somefun, O, Sorrie, M, Soyiri, I, Sreeramareddy, C, Stein, D, Stokes, M, Sudaryanto, A, Sultan, I, Tabares-Seisdedos, R, Tabuchi, T, Tadakamadla, S, Taherkhani, A, Tamiru, A, Tareque, M, Thankappan, K, Thapar, R, Thomas, N, Titova, M, Tonelli, M, Tovani-Palone, M, Tran, B, Travillian, R, Tsai, A, Tsatsakis, A, Tudor Car, L, Uddin, R, Unim, B, Unnikrishnan, B, Upadhyay, E, Vacante, M, Valadan Tahbaz, S, Valdez, P, Varughese, S, Vasankari, T, Venketasubramanian, N, Villeneuve, P, Violante, F, Vlassov, V, Vos, T, Vu, G, Waheed, Y, Wamai, R, Wang, Y, Westerman, R, Wickramasinghe, N, Wu, A, Wu, C, Yahyazadeh Jabbari, S, Yamagishi, K, Yano, Y, Yaya, S, Yazdi-Feyzabadi, V, Yeshitila, Y, Yip, P, Yonemoto, N, Yoon, S, Younis, M, Yousefinezhadi, T, Yu, C, Yu, Y, Yuce, D, Zaidi, S, Zaman, S, Zamani, M, Zamanian, M, Zarafshan, H, Zarei, A, Zastrozhin, M, Zhang, Y, Zhang, Z, Zhao, X, Zhu, C, Patton, G, and Viner, R
Subjects: Male, Joves -- Mortalitat, ADOLESCENT HEALTH, CHILDREN, Socioeconomic Factor, Global Burden of Disease, RA0421, Cause of Death, Medicine, Young adult, Child, 11 Medical and Health Sciences, Cause of death, education.field_of_study, Adolescent, Age Distribution, Female, Humans, Mortality, Sex Distribution, Socioeconomic Factors, Young Adult, Mortality rate, Public Health, Global Health, Social Medicine and Epidemiology, General Medicine, Articles, Hälsovetenskaper, MIDDLE-INCOME, MENTAL-HEALTH, Adolescent health, INTERVENTIONS, Human, SUICIDE, Total fertility rate, Population, Adolescent Health, Adolescents -- Mortalitat, General & Internal Medicine, Health Sciences, QUALITY, Medicine [Science], Social determinants of health, INCOME COUNTRIES, education, business.industry, TRENDS, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Years of potential life lost, INJURIES, business, Demography
Abstract: Background Documentation of patterns and long-term trends in mortality in young people, which reflect huge changes in demographic and social determinants of adolescent health, enables identification of global investment priorities for this age group. We aimed to analyse data on the number of deaths, years of life lost, and mortality rates by sex and age group in people aged 10–24 years in 204 countries and territories from 1950 to 2019 by use of estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. Methods We report trends in estimated total numbers of deaths and mortality rate per 100 000 population in young people aged 10–24 years by age group (10–14 years, 15–19 years, and 20–24 years) and sex in 204 countries and territories between 1950 and 2019 for all causes, and between 1980 and 2019 by cause of death. We analyse variation in outcomes by region, age group, and sex, and compare annual rate of change in mortality in young people aged 10–24 years with that in children aged 0–9 years from 1990 to 2019. We then analyse the association between mortality in people aged 10–24 years and socioeconomic development using the GBD Socio-demographic Index (SDI), a composite measure based on average national educational attainment in people older than 15 years, total fertility rate in people younger than 25 years, and income per capita. We assess the association between SDI and all-cause mortality in 2019, and analyse the ratio of observed to expected mortality by SDI using the most recent available data release (2017). Findings In 2019 there were 1·49 million deaths (95% uncertainty interval 1·39–1·59) worldwide in people aged 10–24 years, of which 61% occurred in males. 32·7% of all adolescent deaths were due to transport injuries, unintentional injuries, or interpersonal violence and conflict; 32·1% were due to communicable, nutritional, or maternal causes; 27·0% were due to non-communicable diseases; and 8·2% were due to self-harm. Since 1950, deaths in this age group decreased by 30·0% in females and 15·3% in males, and sex-based differences in mortality rate have widened in most regions of the world. Geographical variation has also increased, particularly in people aged 10–14 years. Since 1980, communicable and maternal causes of death have decreased sharply as a proportion of total deaths in most GBD super-regions, but remain some of the most common causes in sub-Saharan Africa and south Asia, where more than half of all adolescent deaths occur. Annual percentage decrease in all-cause mortality rate since 1990 in adolescents aged 15–19 years was 1·3% in males and 1·6% in females, almost half that of males aged 1–4 years (2·4%), and around a third less than in females aged 1–4 years (2·5%). The proportion of global deaths in people aged 0–24 years that occurred in people aged 10–24 years more than doubled between 1950 and 2019, from 9·5% to 21·6%. Interpretation Variation in adolescent mortality between countries and by sex is widening, driven by poor progress in reducing deaths in males and older adolescents. Improving global adolescent mortality will require action to address the specific vulnerabilities of this age group, which are being overlooked. Furthermore, indirect effects of the COVID-19 pandemic are likely to jeopardise efforts to improve health outcomes including mortality in young people aged 10–24 years. There is an urgent need to respond to the changing global burden of adolescent mortality, address inequities where they occur, and improve the availability and quality of primary mortality data in this age group. Funding Bill & Melinda Gates Foundation.
Published: 2021

36. Measuring universal health coverage based on an index of effective coverage of health services in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019

Author: William M. Gardner, Rawlance Ndejjo, Govinda Prasad Dhungana, Fereshteh Ansari, Kathleen Pillsbury Hopf, João Pedro Silva, M. Mofizul Islam, Cong Zhu, Abdul Hafiz, Irmina Maria Michalek, Syed Mohamed Aljunid, Leonardo Roever, Mustefa Glagn, Davood Anvari, Tessa M. Pilz, Sameer Vali Gopalani, Joel M. Francis, Man Mohan Mehndiratta, Rakhi Dandona, Abbas Sheikhtaheri, Mansour Ghafourifard, Simon Øverland, David Laith Rawaf, Jaykaran Charan, Akram Pourshams, Mostafa Dianatinasab, Morteza Mahmoudi, Alton Lu, Alyssa N. Sbarra, Lorainne Tudor Car, Franz Castro, Hafiz Ansar Rasul Suleria, Luca Ronfani, Marina Pinheiro, Mehran Asadi-Aliabadi, Maziar Moradi-Lakeh, Hoa Thi Do, Whitney L. Teagle, Sofia Androudi, Carl Abelardo T. Antonio, Myron Anthony Godinho, Bhaskaran Unnikrishnan, Oluchi Ezekannagha, Getinet Ayano, Seyyed Shamsadin Athari, Dimas Ria Angga Pribadi, Kyle E. Simpson, Muluken Bekele Sorrie, Vivekanand Jha, Chukwuma David Umeokonkwo, Akshaya Srikanth Bhagavathula, Cuong Tat Nguyen, Amr Hassan, Akine Eshete Abosetugn, Hailay Abrha Gesesew, Anna V. Korotkova, Brijesh Sathian, Marcello Tonelli, Olatunde Aremu, Mohammad Reza Salahshoor, Juan Jesus Carrero, Cameron J. Kneib, Ravi Prakash Jha, David H. Shaw, Hossein Samadi Kafil, Tanuj Kanchan, Khezar Hayat, Hamid Sharifi, Morteza Shamsizadeh, Muktar Omer Omer, Fatemeh Amiri, Hamidreza Pazoki Toroudi, David Edvardsson, Xiu Ju George Zhao, Hannah Han, Leticia Avila-Burgos, Adam E. Berman, Jemal Abdu Mohammed, Thomas Pilgrim, Leila Doshmangir, Mu'awiyyah Babale Sufiyan, David M. Pigott, Hadi Hassankhani, Beatriz Paulina Ayala Quintanilla, Teklemariam Gultie, Arash Ziapour, Seyed Sina Naghibi Irvani, Ilse N. Dippenaar, Jean Jacques Noubiap, Emmanuela Gakidou, Abiyu Mekonnen Gebrehiwot, Maha El Tantawi, Xuefeng Liu, Zulfiqar A. Bhutta, Keyghobad Ghadiri, João Mauricio Castaldelli-Maia, Behzad Karami Matin, Yunquan Zhang, Vera Marisa Costa, Iyad Sultan, Mostafa Hosseini, Abdulaziz Khalid Abu Haimed, Haidong Wang, Kaleab Alemayehu Zewdie, Celine M. Barthelemy, Hosna Janjani, Bartosz Miazgowski, Jobert Richie Nansseu, Arianna Maever L. Amit, John S. Ji, Ata Rafiee, Maria Inês Schmidt, Alireza Rafiei, Somayeh Bohlouli, Joana Morgado-da-Costa, Huong Lan Thi Nguyen, Pradyumna Agasthi, Tiffany K. Gill, Martin McKee, Khaled Khatab, Jae Il Shin, Animut Tagele Tamiru, Giancarlo Logroscino, Hassan Abolhassani, Syed Saoud Zaidi, Sivan Yegnanarayana Iyer Saraswathy, Garumma Tolu Feyissa, Ahmad Daryani, Ziyad Al-Aly, Gebreamlak Gebremedhn Gebremeskel, Michael T. Chung, Amirhossein Sahebkar, Mehedi Hasan, Saeed Shahabi, Diep Ngoc Nguyen, Yohannes Kinfu, Nicholas L S Roberts, Jagadish Rao Padubidri, Mika Shigematsu, Lucero Cahuana-Hurtado, Deepa Jahagirdar, Islam Y. Elgendy, Erkin M. Mirrakhimov, Tanvir M. Huda, Fakher Rahim, Dara K. Mohammad, Yingxi Zhao, Ruxandra Irina Negoi, Vinod C. Nayak, Reinhard Busse, Andrew T. Leever, Muhammad Aziz Rahman, Kathryn Mei Ming Lau, Stefania Mondello, Vivian Chia-Rong Hsieh, Kris J. Krohn, Reza Rawassizadeh, Vishnu Renjith, Jianing Ma, Moses K. Muriithi, Mark G. Shrime, Mayowa O. Owolabi, Nobuyuki Horita, Seyed Hossein Yahyazadeh Jabbari, Daniel Y. Cho, Miloje Savic, Moslem Soofi, Iqbal R. F. Elyazar, Freweini Gebrearegay G. Tela, Jonathan F. Mosser, Palash Chandra Banik, Andre Rodrigues Duraes, Yuan-Pang Wang, Natalie C. Galles, Rashid Abdi Guled, Abdallah M. Samy, Hadi Pourjafar, Roman Topor-Madry, Ayesha Humayun, Leila Zaki, Nuworza Kugbey, Maryam Khayamzadeh, Naznin Hossain, Jiregna Darega Gela, Jordi Alonso, Ruth W Kimokoti, A. A. Fomenkov, Jalal Arabloo, Aletta E. Schutte, Biruk Wogayehu Taddele, Teklehaimanot Gereziher Haile, Diego Augusto Santos Silva, Seyed Mohammad Kazem Aghamir, Maciej Banach, Deanna Anderlini, Moses J. Bockarie, Saleem Muhammad Rana, Randah R. Hamadeh, Farhad Islami, Olalekan A. Uthman, S. Mohammad Sajadi, Francisco Rogerlândio Martins-Melo, Shankar M Bakkannavar, Kairat Davletov, Soraya Seedat, Alan D. Lopez, Masoud Behzadifar, Benjamin B. Massenburg, Santosh Varughese, Ingan Ukur Tarigan, Amin Soheili, Félix Carvalho, Yun Jin Kim, Catalina Liliana Andrei, Caleb Mackay Salpeter Irvine, Mojgan Gitimoghaddam, G Anil Kumar, Rasmus J. Havmoeller, Hiroyasu Iso, Atte Meretoja, Yasir Waheed, João M. Furtado, Christian Razo, Neeti Kapoor, Mowafa Househ, Rajaa Al-Raddadi, Mohammad Khammarnia, Santi Martini, Feng Sha, Marco Vacante, Jacek A. Kopec, Hunduma Amensisa Bojia, Jacob Olusegun Olusanya, Kate E. LeGrand, Nikolay Ivanovich Briko, Robert S. Bernstein, Arun Balachandran, Davoud Adham, Ahad Bakhtiari, Shafiu Mohammed, Leake G. Gebremeskel, Smita Pakhale, Ejaz Ahmad Khan, Daniel Cury Ribeiro, Yousef Mohammad, Bernhard T. Baune, Azeem Majeed, Luis Camera, Mohammad Ali Jahani, Hasan Yusefzadeh, Rahman Shiri, Massimo Cirillo, Nikita Otstavnov, Vahid Yazdi-Feyzabadi, Paolo Lauriola, Irfan Ullah, Aruna M Kamath, Maryam Mirzaei, Zabihollah Yousefi, Iman El Sayed, Mohammad Farahmand, Yetunde O. John-Akinola, Khem Narayan Pokhrel, Felix Akpojene Ogbo, Megan Knight, Nelson J. Alvis-Zakzuk, Teferi Mekonnen, Iván Landires, Robert G. Weintraub, Chukwudi A Nnaji, Lauren E. Schaeffer, Paulo A. Lotufo, Mehdi Naderi, Tomislav Mestrovic, André Faro, Mohsen Bayati, Raffaele Palladino, Shahin Soltani, Vladimir Andreevich Korshunov, Birhanu Geta Meharie, Mihajlo Jakovljevic, Abdiwahab Hashi, Olatunji O. Adetokunboh, Dejana Braithwaite, Sergio I. Prada, Bárbara Niegia Garcia de Goulart, Reza Pourmirza Kalhori, Jee-Young Jasmine Choi, Ernoiz Antriyandarti, Ronny Westerman, Meghdad Pirsaheb, Paul S. F. Yip, Mehdi Mirzaei-Alavijeh, Gebremariam Woldu, Rashmi Gupta, Onome Bright Oghenetega, Shane D. Morrison, Inga Dora Sigfusdottir, Marcel Ausloos, Mehdi Hosseinzadeh, Marcos Roberto Tovani-Palone, K M Shivakumar, Alireza Ansari-Moghaddam, Archith Boloor, Aidin Abedi, Binyam Minuye Birihane, Mohammad Ali Mansournia, Nihad A. Almasri, Simachew Animen Bante, Carlo Eduardo Medina-Solís, Leeberk Raja Inbaraj, Edgar Denova-Gutiérrez, Antonio Biondi, Valentin Yurievich Skryabin, Srinivasa Vittal Katikireddi, Sarika Chaturvedi, Francesco Saverio Violante, Abhay Gaidhane, George A. Mensah, Naohiro Yonemoto, Ahmad Ghashghaee, Ebrahim Babaee, Saman Esmaeilnejad, Sharath Burugina Nagaraja, Avina Vongpradith, Javad Nazari, Amir Khater, Michael K. Hole, Ben Lacey, Razique Anwer, Łukasz Szumowski, Ai Koyanagi, Rajesh Sagar, Ali Rajabpour-Sanati, Seyed M Karimi, Yordanos Gizachew Yeshitila, Mona Pathak, Nithin Kumar, Masoud Foroutan, Mehdi Fazlzadeh, Anusha Ganapati Bhat, Abbas Mosapour, Kebede Deribe, Nermin Ghith, Vaman Kulkarni, Sanjay Zodpey, Asadollah Gholamian, Mohammed Shannawaz, Nancy Fullman, Benn Sartorius, Giulio Castelpietra, Ghulam Mustafa, Silvia Schiavolin, Nelson Alvis-Guzman, Jeffrey D. Stanaway, Rafael Lozano, Christopher J L Murray, Guoqing Hu, Andrew M. Briggs, Ashish Badiye, Yousef Khader, Masoud Moghadaszadeh, Rahmatollah Moradzadeh, Valery L. Feigin, Claudia I. Mastrogiacomo, Emma Smith, Yasser Vasseghian, Saeed Amini, Asif Hanif, Achala Upendra Jayatilleke, Maryam Adabi, Sarah Wulf Hanson, Bhaskar Thakur, Ravi Mehrotra, Virginia Núñez-Samudio, Lalit Dandona, Segun Emmanuel Ibitoye, Simon I. Hay, Kiirithio N. Ngari, Obinna Onwujekwe, Deborah Carvalho Malta, Lorenzo Monasta, Neda Kianipour, Khurshid Alam, Luisa Sorio Flor, Priya Rathi, Ali Bijani, Khalid A Altirkawi, Jaimie Adelson, Hamed Zandian, Frank Tanser, Dharmesh Kumar Lal, John Everett Mumford, Morteza Oladnabi, Telma Zahirian Moghadam, Rodrigo Sarmiento-Suárez, Masoud Moradi, Maseer Khan, Mohammad Ali Sahraian, Amy E. Peden, Dhirendra N Sinha, Shanshan Li, Shailesh Advani, Behshad Naghshtabrizi, Matilde Leonardi, Lope H Barrero, Nicholas Steel, Dinh-Toi Chu, Claudio Alberto Dávila-Cervantes, Pushpendra Singh, Adrian Otoiu, Fabrizio Tediosi, Yonas Getaye Tefera, Pawan Faris, George C. Patton, Christopher Troeger, Mohammed Madadin, Jeffrey V. Lazarus, Paul H. Lee, Mohammad Amin Bahrami, Wondimeneh Shibabaw Shiferaw, Emmanuel Wandera Okunga, Biniyam Sahiledengle Geberemariyam, Samer Hamidi, Young-Ho Khang, Rufus Akinyemi, Farhad Jadidi-Niaragh, Godfrey Mutashambara Rwegerera, Naser Mohammad Gholi Mezerji, Rupak Desai, Eduardo Bernabé, Jamal A. Yearwood, Nima Rezaei, Emerito Jose A. Faraon, Vasily Vlassov, Stanislav S. Otstavnov, Reed J D Sorensen, Elena V. Gnedovskaya, Johan Ärnlöv, Mukhammad David Naimzada, Tahereh Javaheri, Tamer H. Farag, Paolo Cortesi, Gbenga A. Kayode, Lucas Guimarães Abreu, Manu Raj Mathur, Getie Lake Aynalem, Narayanaswamy Venketasubramanian, Doris V.V. Ortega-Altamirano, Giorgia Giussani, Liliana G Ciobanu, Suraj Bhattarai, Basema Saddik, Mustafa Z. Younis, Ensiyeh Jenabi, Ira Martopullo, Mohamed M. Gad, Kanyin L. Ong, Addisu Melese, Fotis Topouzis, Hanne Christensen, In-Hwan Oh, Arash Sarveazad, Shuhei Nomura, Peter Memiah, Sergej M. Ostojic, Santosh Kumar Tadakamadla, Dinesh Bhandari, Ahmed Omar Bali, Farahnaz Joukar, Arielle Wilder Eagan, Emma Elizabeth Spurlock, Ferrán Catalá-López, Caroline Stein, Jonathan M. Kocarnik, Stephen S Lim, Siamak Sabour, Kelly Compton, Shoaib Hassan, Rannveig Sigurvinsdottir, Claudiu Herteliu, Aso Mohammad Darwesh, Muluken Altaye Ayza, Angela Y. Chang, Leila R Kalankesh, Rafael Alves Guimarães, Abdollah Mohammadian-Hafshejani, Lal B. Rawal, Soewarta Kosen, Degena Bahrey Tadesse, Theo Vos, Paula Moraga, Soheil Hassanipour, Abdelrahman Ibrahim Abushouk, Oladimeji Adebayo, Mikk Jürisson, Tuomo J. Meretoja, Ireneous N. Soyiri, Carlo La Vecchia, Khalil Eskandari, Aziz Sheikh, Jagdish Khubchandani, James Leigh, Morteza Arab-Zozani, Sheikh Mohammed Shariful Islam, Stefan Kohler, Olayinka Stephen Ilesanmi, Kazumasa Yamagishi, Michele Romoli, Jasvinder A. Singh, Neeraj Bedi, Ivo Iavicoli, Alyssa Pennini, Subas Neupane, Emmanuel Peprah, Sojib Bin Zaman, Marwa Rashad Salem, Mohammed Ibrahim Mohialdeen Gubari, Ramesh Holla, Bayisa Abdissa Baye, Robert Ancuceanu, Eduarda Fernandes, Chandrashekhar T Sreeramareddy, Ettore Beghi, Quique Bassat, B Reshmi, Masood Ali Shaikh, Ionut Negoi, Peter Azzopardi, Florian Fischer, Kerem Shuval, Sorin Hostiuc, Hmwe H Kyu, Ver Bilano, Siddhesh Zadey, Davide Rasella, Vahid Alipour, Sowmya J. Rao, Radoslaw Sierpinski, Irina Filip, Michelle L. Bell, Malke Asaad, Ravensara S. Travillian, Christopher R. Cederroth, Rafael Tabarés-Seisdedos, Ashkan Afshin, Saqib Ali, Mahalaqua Nazli Khatib, Saad M.A. Dahlawi, Hedayat Abbastabar, Zahid A Butt, Sagun Paudel, Vahid Rashedi, B. Suresh Kumar Shetty, Thomas R. Hird, Shokofeh Maleki, Atif Amin Baig, Reza Heidari-Soureshjani, Shaun Wen Huey Lee, Jorge R. Ledesma, Ai-Min Wu, Fablina Sharara, Zemenu Tadesse Tessema, Ratilal Lalloo, Rohollah Kalhor, Rosario Cárdenas, Amir Radfar, Salime Goharinezhad, Fereshteh Mehri, Katarzyna Kissimova-Skarbek, Spencer A. Pease, Diana Silva, Amir Hossein Goudarzian, Samath D Dharmaratne, Darshan B B, Mariya Vladimirovna Titova, Dickson A. Amugsi, Lee Ling Lim, Agegnehu Bante, Charles D.A. Wolfe, Majid A Almadi, Seyed Mohammad Riahi, Nader Jahanmehr, Yuming Guo, Tauseef Ahmad, Platon D. Lopukhov, Takahiro Tabuchi, Nicholas J Kassebaum, Jacek Jerzy Jozwiak, Ritesh G. Menezes, Giovanni Damiani, Delia Hendrie, Mostafa Amini-Rarani, Sanjay Basu, Mohammad Hossein Bakhshaei, Gholamreza Roshandel, Borhan Mansouri, Enrico Rubagotti, Anurag Agrawal, Alireza Esteghamati, Paramjit Gill, Graeme J. Hankey, Mikhail Sergeevich Zastrozhin, Nima Hafezi-Nejad, Bruce Bartholow Duncan, Silvano Gallus, Jeevan Pereira, Ahamarshan Jayaraman Nagarajan, Giulia Carreras, Fariba Dorostkar, Pietro Ferrara, Andrea Farioli, Christoph Nowak, Ahmed I. Hasaballah, Vijay Kumar Chattu, Bolajoko O. Olusanya, Perminder S. Sachdev, Era Upadhyay, Tommi Vasankari, Susan M Sawyer, Adnan Kisa, Farshad Pourmalek, Kiomars Sharafi, Golnaz Heidari, Mohammad Abdollahi, Georges Nguefack-Tsague, Sajid Hameed, Sanni Yaya, Bach Xuan Tran, Ole Frithjof Norheim, Robert Kaba Alhassan, Morenike Oluwatoyin Folayan, Ismail Tareque, Phetole Walter Mahasha, Kewal Krishan, Soraya Siabani, Aleksandr Y. Aravkin, Helena Ullyartha Pangaribuan, Maryam Zamanian, Joshua A. Salomon, Bianca S. Zlavog, Vinay Nangia, Falk Schwendicke, Takeshi Fukumoto, Hung Chak Ho, Jordan Weiss, Maha Atout, Tariku Tesfaye Bekuma, Efat Mohamadi, Nikolaos Dervenis, Joan B. Soriano, Syed Amir Gilani, Victor Adekanmbi, Marina Karanikolos, Alberto Raggi, Michael R.M. Abrigo, Weijia Fu, Reza Shirkoohi, Aditya Prasad Dash, Peng Jia, Masoumeh Sadeghi, Ashraf Nabhan, Isabela M. Benseñor, Morteza Jafarinia, Joht Singh Chandan, Usman Iqbal, Amira Shaheen, Deepak Saxena, Lauren B. Wilner, Nataliya A. Foigt, Jeadran N. Malagón-Rojas, David C. Schwebel, Gail Davey, Milena Ilic, Josep Maria Haro, Peter Njenga Keiyoro, Stein Emil Vollset, Andrea Werdecker, Zahiruddin Quazi Syed, Yared Asmare Aynalem, Entezar Mehrabi Nasab, Yihun Mulugeta Alemu, Muhammad Ali, Mona M. Khater, Ehsan Sadeghi, Thirunavukkarasu Sathish, Pascual R. Valdez, Jennifer Rickard, Mark A. Stokes, Davide Sattin, Ewerton Cousin, Oliver J. Brady, Krittika Bhattacharyya, Mika Kivimäki, Andrew T Olagunju, Jost B. Jonas, Dian Kusuma, Goura Kishor Rath, Alberto Ortiz, Samad Azari, Nayu Ikeda, James L. Fisher, Peng Zheng, Elisabetta Pupillo, Pankaj Bhardwaj, Suzanne Lyn Barker-Collo, Riaz Uddin, Ester Cerin, Amir Taherkhani, Martin Amogre Ayanore, Richard G. Wamai, Anders Larsson, Josephine W. Ngunjiri, Hosni Salem, Hesham M. Al-Mekhlafi, Sharareh Eskandarieh, Taraneh Yousefinezhadi, Srikanta Banerjee, Yang Xie, Yuichiro Yano, Songhomitra Panda-Jonas, Themba G. Ginindza, Manasi Kumar, Babak Moazen, Bing-Fang Hwang, Cristiana Abbafati, Florentino Luciano Caetano dos Santos, Juan Sanabria, Milena Santric-Milicevic, Carla Sofia e.Sá Farinha, Samuel B. Albertson, Chieh Han, Parvaiz A Koul, Foad Abd-Allah, Mojisola Oluwasanu, Mihaela Hostiuc, Chinwe Juliana Iwu, Colm McAlinden, Mohsen Naghavi, Maarten J. Postma, Chhabi Lal Ranabhat, Jalil Jaafari, Walter Mendoza, Abdulaziz M. Almulhim, Magdalene K. Walters, Ali H. Mokdad, Andre M. N. Renzaho, Catherine M. Antony, Ken Lee Chin, Ali A. Asadi-Pooya, Daniel Diaz, Adrian Pana, Salman Rawaf, Gina Agarwal, Demelash Woldeyohannes Handiso, Savita Lasrado, Amir Almasi-Hashiani, Praveen Hoogar, Srinivasa Rao Bolla, Fares Alahdab, Om P Kurmi, Sonali Kochhar, Van C. Lansingh, François Alla, Ali Almasi, Till Bärnighausen, Michael A. Piradov, Zubair Kabir, Boris Bikbov, Philip B. Mitchell, Amin Mousavi Khaneghah, Yahya Safari, Anirudh Kotlo, Jan-Walter De Neve, Biagio Simonetti, Carlos A Castañeda-Orjuela, Kenji Shibuya, GBD 2019 Universal Health Coverage Collaborator, Violante FS, Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), Microbes in Health and Disease (MHD), Department of Public Health, University of Helsinki, Clinicum, Neurologian yksikkö, HUS Neurocenter, HUS Comprehensive Cancer Center, Helsinki University Hospital Area, GBD 2019 Universal Health Coverage Collaborators, Lozano, Rafael, Fullman, Nancy, Mumford, John Everett, Knight, Megan, Barthelemy, Celine M, Abbafati, Cristiana, Abbastabar, Hedayat, Abd-Allah, Foad, Abdollahi, Mohammad, Abedi, Aidin, Abolhassani, Hassan, Abosetugn, Akine Eshete, Abreu, Lucas Guimarãe, Abrigo, Michael R M, Abu Haimed, Abdulaziz Khalid, Abushouk, Abdelrahman I, Adabi, Maryam, Adebayo, Oladimeji M, Adekanmbi, Victor, Adelson, Jaimie, Adetokunboh, Olatunji O, Adham, Davoud, Advani, Shailesh M, Afshin, Ashkan, Agarwal, Gina, Agasthi, Pradyumna, Aghamir, Seyed Mohammad Kazem, Agrawal, Anurag, Ahmad, Tauseef, Akinyemi, Rufus Olusola, Alahdab, Fare, Al-Aly, Ziyad, Alam, Khurshid, Albertson, Samuel B, Alemu, Yihun Mulugeta, Alhassan, Robert Kaba, Ali, Muhammad, Ali, Saqib, Alipour, Vahid, Aljunid, Syed Mohamed, Alla, Françoi, Almadi, Majid Abdulrahman Hamad, Almasi, Ali, Almasi-Hashiani, Amir, Almasri, Nihad A, Al-Mekhlafi, Hesham M, Almulhim, Abdulaziz M, Alonso, Jordi, Al-Raddadi, Rajaa M, Altirkawi, Khalid A, Alvis-Guzman, Nelson, Alvis-Zakzuk, Nelson J, Amini, Saeed, Amini-Rarani, Mostafa, Amiri, Fatemeh, Amit, Arianna Maever L, Amugsi, Dickson A, Ancuceanu, Robert, Anderlini, Deanna, Andrei, Catalina Liliana, Androudi, Sofia, Ansari, Fereshteh, Ansari-Moghaddam, Alireza, Antonio, Carl Abelardo T, Antony, Catherine M, Antriyandarti, Ernoiz, Anvari, Davood, Anwer, Razique, Arabloo, Jalal, Arab-Zozani, Morteza, Aravkin, Aleksandr Y, Aremu, Olatunde, Ärnlöv, Johan, Asaad, Malke, Asadi-Aliabadi, Mehran, Asadi-Pooya, Ali A, Ashbaugh, Charlie, Athari, Seyyed Shamsadin, Atout, Maha Moh'd Wahbi, Ausloos, Marcel, Avila-Burgos, Leticia, Ayala Quintanilla, Beatriz Paulina, Ayano, Getinet, Ayanore, Martin Amogre, Aynalem, Yared Asmare, Aynalem, Getie Lake, Ayza, Muluken Altaye, Azari, Samad, Azzopardi, Peter S, B, Darshan B, Babaee, Ebrahim, Badiye, Ashish D, Bahrami, Mohammad Amin, Baig, Atif Amin, Bakhshaei, Mohammad Hossein, Bakhtiari, Ahad, Bakkannavar, Shankar M, Balachandran, Arun, Balassyano, Shelly, Banach, Maciej, Banerjee, Srikanta K, Banik, Palash Chandra, Bante, Agegnehu Bante, Bante, Simachew Animen, Barker-Collo, Suzanne Lyn, Bärnighausen, Till Winfried, Barrero, Lope H, Bassat, Quique, Basu, Sanjay, Baune, Bernhard T, Bayati, Mohsen, Baye, Bayisa Abdissa, Bedi, Neeraj, Beghi, Ettore, Behzadifar, Masoud, Bekuma, Tariku Tesfaye Tesfaye, Bell, Michelle L, Bensenor, Isabela M, Berman, Adam E, Bernabe, Eduardo, Bernstein, Robert S, Bhagavathula, Akshaya Srikanth, Bhandari, Dinesh, Bhardwaj, Pankaj, Bhat, Anusha Ganapati, Bhattacharyya, Krittika, Bhattarai, Suraj, Bhutta, Zulfiqar A, Bijani, Ali, Bikbov, Bori, Bilano, Ver, Biondi, Antonio, Birihane, Binyam Minuye, Bockarie, Moses John, Bohlouli, Somayeh, Bojia, Hunduma Amensisa, Bolla, Srinivasa Rao Rao, Boloor, Archith, Brady, Oliver J, Braithwaite, Dejana, Briant, Paul Svitil, Briggs, Andrew M, Briko, Nikolay Ivanovich, Burugina Nagaraja, Sharath, Busse, Reinhard, Butt, Zahid A, Caetano dos Santos, Florentino Luciano, Cahuana-Hurtado, Lucero, Cámera, Luis Alberto, Cárdenas, Rosario, Carreras, Giulia, Carrero, Juan J, Carvalho, Felix, Castaldelli-Maia, Joao Mauricio, Castañeda-Orjuela, Carlos A, Castelpietra, Giulio, Castro, Franz, Catalá-López, Ferrán, Causey, Kate, Cederroth, Christopher R, Cercy, Kelly M, Cerin, Ester, Chandan, Joht Singh, Chang, Angela Y, Charan, Jaykaran, Chattu, Vijay Kumar, Chaturvedi, Sarika, Chin, Ken Lee, Cho, Daniel Youngwhan, Choi, Jee-Young Jasmine, Christensen, Hanne, Chu, Dinh-Toi, Chung, Michael T, Ciobanu, Liliana G, Cirillo, Massimo, Comfort, Haley, Compton, Kelly, Cortesi, Paolo Angelo, Costa, Vera Marisa, Cousin, Ewerton, Dahlawi, Saad M A, Damiani, Giovanni, Dandona, Lalit, Dandona, Rakhi, Darega Gela, Jiregna, Darwesh, Aso Mohammad, Daryani, Ahmad, Dash, Aditya Prasad, Davey, Gail, Dávila-Cervantes, Claudio Alberto, Davletov, Kairat, De Neve, Jan-Walter, Denova-Gutiérrez, Edgar, Deribe, Kebede, Dervenis, Nikolao, Desai, Rupak, Dharmaratne, Samath Dhamminda, Dhungana, Govinda Prasad, Dianatinasab, Mostafa, Dias da Silva, Diana, Diaz, Daniel, Dippenaar, Ilse N, Do, Hoa Thi, Dorostkar, Fariba, Doshmangir, Leila, Duncan, Bruce B, Duraes, Andre Rodrigue, Eagan, Arielle Wilder, Edvardsson, David, El Sayed, Iman, El Tantawi, Maha, Elgendy, Islam Y, Elyazar, Iqbal RF, Eskandari, Khalil, Eskandarieh, Sharareh, Esmaeilnejad, Saman, Esteghamati, Alireza, Ezekannagha, Oluchi, Farag, Tamer, Farahmand, Mohammad, Faraon, Emerito Jose A, Farinha, Carla Sofia e Sá, Farioli, Andrea, Faris, Pawan Sirwan, Faro, Andre, Fazlzadeh, Mehdi, Feigin, Valery L, Fernandes, Eduarda, Ferrara, Pietro, Feyissa, Garumma Tolu, Filip, Irina, Fischer, Florian, Fisher, James L, Flor, Luisa Sorio, Foigt, Nataliya A, Folayan, Morenike Oluwatoyin, Fomenkov, Artem Alekseevich, Foroutan, Masoud, Francis, Joel Msafiri, Fu, Weijia, Fukumoto, Takeshi, Furtado, João M, Gad, Mohamed M, Gaidhane, Abhay Motiramji, Gakidou, Emmanuela, Galles, Natalie C, Gallus, Silvano, Gardner, William M, Geberemariyam, Biniyam Sahiledengle, Gebrehiwot, Abiyu Mekonnen, Gebremeskel, Leake G, Gebremeskel, Gebreamlak Gebremedhn, Gesesew, Hailay Abrha, Ghadiri, Keyghobad, Ghafourifard, Mansour, Ghashghaee, Ahmad, Ghith, Nermin, Gholamian, Asadollah, Gilani, Syed Amir, Gill, Paramjit Singh, Gill, Tiffany K, Ginindza, Themba G, Gitimoghaddam, Mojgan, Giussani, Giorgia, Glagn, Mustefa, Gnedovskaya, Elena V, Godinho, Myron Anthony, Goharinezhad, Salime, Gopalani, Sameer Vali, Goudarzian, Amir Hossein, Goulart, Bárbara Niegia Garcia, Gubari, Mohammed Ibrahim Mohialdeen, Guimarães, Rafael Alve, Guled, Rashid Abdi, Gultie, Teklemariam, Guo, Yuming, Gupta, Rajeev, Gupta, Rahul, Hafezi-Nejad, Nima, Hafiz, Abdul, Haile, Teklehaimanot Gereziher, Hamadeh, Randah R, Hameed, Sajid, Hamidi, Samer, Han, Chieh, Han, Hannah, Handiso, Demelash Woldeyohanne, Hanif, Asif, Hankey, Graeme J, Haro, Josep Maria, Hasaballah, Ahmed I, Hasan, Md Mehedi, Hashi, Abdiwahab, Hassan, Shoaib, Hassan, Amr, Hassanipour, Soheil, Hassankhani, Hadi, Havmoeller, Rasmus J, Hay, Simon I, Hayat, Khezar, Heidari, Golnaz, Heidari-Soureshjani, Reza, Hendrie, Delia, Herteliu, Claudiu, Hird, Thomas R, Ho, Hung Chak, Hole, Michael K, Holla, Ramesh, Hollingsworth, Bruce, Hoogar, Praveen, Hopf, Kathleen Pillsbury, Horita, Nobuyuki, Hossain, Naznin, Hosseini, Mostafa, Hosseinzadeh, Mehdi, Hostiuc, Mihaela, Hostiuc, Sorin, Househ, Mowafa, Hsieh, Vivian Chia-rong, Hu, Guoqing, Huda, Tanvir M, Humayun, Ayesha, Hwang, Bing-Fang, Iavicoli, Ivo, Ibitoye, Segun Emmanuel, Ikeda, Nayu, Ilesanmi, Olayinka Stephen, Ilic, Irena M, Ilic, Milena D, Inbaraj, Leeberk Raja, Iqbal, Usman, Irvani, Seyed Sina Naghibi, Irvine, Caleb Mackay Salpeter, Islam, M Mofizul, Islam, Sheikh Mohammed Shariful, Islami, Farhad, Iso, Hiroyasu, Iwu, Chinwe Juliana, Iwu, Chidozie C D, Jaafari, Jalil, Jadidi-Niaragh, Farhad, Jafarinia, Morteza, Jahagirdar, Deepa, Jahani, Mohammad Ali, Jahanmehr, Nader, Jakovljevic, Mihajlo, Janjani, Hosna, Javaheri, Tahereh, Jayatilleke, Achala Upendra, Jenabi, Ensiyeh, Jha, Ravi Prakash, Jha, Vivekanand, Ji, John S, Jia, Peng, John-Akinola, Yetunde O, Jonas, Jost B, Joukar, Farahnaz, Jozwiak, Jacek Jerzy, Jürisson, Mikk, Kabir, Zubair, Kalankesh, Leila R, Kalhor, Rohollah, Kamath, Aruna M, Kanchan, Tanuj, Kapoor, Neeti, Karami Matin, Behzad, Karanikolos, Marina, Karimi, Seyed M, Kassebaum, Nicholas J, Katikireddi, Srinivasa Vittal, Kayode, Gbenga A, Keiyoro, Peter Njenga, Khader, Yousef Saleh, Khammarnia, Mohammad, Khan, Maseer, Khan, Ejaz Ahmad, Khang, Young-Ho, Khatab, Khaled, Khater, Amir M, Khater, Mona M, Khatib, Mahalaqua Nazli, Khayamzadeh, Maryam, Khubchandani, Jagdish, Kianipour, Neda, Kim, Young-Eun, Kim, Yun Jin, Kimokoti, Ruth W, Kinfu, Yohanne, Kisa, Adnan, Kissimova-Skarbek, Katarzyna, Kivimäki, Mika, Kneib, Cameron J, Kocarnik, Jonathan M, Kochhar, Sonali, Kohler, Stefan, Kopec, Jacek A, Korotkova, Anna V, Korshunov, Vladimir Andreevich, Kosen, Soewarta, Kotlo, Anirudh, Koul, Parvaiz A, Koyanagi, Ai, Krishan, Kewal, Krohn, Kris J, Kugbey, Nuworza, Kulkarni, Vaman, Kumar, G Anil, Kumar, Nithin, Kumar, Manasi, Kurmi, Om P, Kusuma, Dian, Kyu, Hmwe Hmwe, La Vecchia, Carlo, Lacey, Ben, Lal, Dharmesh Kumar, Lalloo, Ratilal, Landires, Iván, Lansingh, Van Charle, Larsson, Anders O, Lasrado, Savita, Lau, Kathryn Mei-Ming, Lauriola, Paolo, Lazarus, Jeffrey V, Ledesma, Jorge R, Lee, Paul H, Lee, Shaun Wen Huey, Leever, Andrew T, Legrand, Kate E, Leigh, Jame, Leonardi, Matilde, Li, Shanshan, Lim, Stephen S, Lim, Lee-Ling, Liu, Xuefeng, Logroscino, Giancarlo, Lopez, Alan D, Lopukhov, Platon D, Lotufo, Paulo A, Lu, Alton, Ma, Jianing, Madadin, Mohammed, Mahasha, Phetole Walter, Mahmoudi, Morteza, Majeed, Azeem, Malagón-Rojas, Jeadran N, Maleki, Shokofeh, Malta, Deborah Carvalho, Mansouri, Borhan, Mansournia, Mohammad Ali, Martini, Santi, Martins-Melo, Francisco Rogerlândio, Martopullo, Ira, Massenburg, Benjamin Ballard, Mastrogiacomo, Claudia I, Mathur, Manu Raj, Mcalinden, Colm, Mckee, Martin, Medina-Solís, Carlo Eduardo, Meharie, Birhanu Geta, Mehndiratta, Man Mohan, Mehrabi Nasab, Entezar, Mehri, Fereshteh, Mehrotra, Ravi, Mekonnen, Teferi, Melese, Addisu, Memiah, Peter T N, Mendoza, Walter, Menezes, Ritesh G, Mensah, George A, Meretoja, Tuomo J, Meretoja, Atte, Mestrovic, Tomislav, Miazgowski, Bartosz, Michalek, Irmina Maria, Mirrakhimov, Erkin M, Mirzaei, Maryam, Mirzaei-Alavijeh, Mehdi, Mitchell, Philip B, Moazen, Babak, Moghadaszadeh, Masoud, Mohamadi, Efat, Mohammad, Yousef, Mohammad, Dara K, Mohammad Gholi Mezerji, Naser, Mohammadian-Hafshejani, Abdollah, Mohammed, Shafiu, Mohammed, Jemal Abdu, Mokdad, Ali H, Monasta, Lorenzo, Mondello, Stefania, Moradi, Masoud, Moradi-Lakeh, Maziar, Moradzadeh, Rahmatollah, Moraga, Paula, Morgado-da-Costa, Joana, Morrison, Shane Dougla, Mosapour, Abba, Mosser, Jonathan F, Mousavi Khaneghah, Amin, Muriithi, Moses K, Mustafa, Ghulam, Nabhan, Ashraf F, Naderi, Mehdi, Nagarajan, Ahamarshan Jayaraman, Naghavi, Mohsen, Naghshtabrizi, Behshad, Naimzada, Mukhammad David, Nangia, Vinay, Nansseu, Jobert Richie, Nayak, Vinod C, Nazari, Javad, Ndejjo, Rawlance, Negoi, Ionut, Negoi, Ruxandra Irina, Neupane, Suba, Ngari, Kiirithio N, Nguefack-Tsague, George, Ngunjiri, Josephine W, Nguyen, Cuong Tat, Nguyen, Diep Ngoc, Nguyen, Huong Lan Thi, Nnaji, Chukwudi A, Nomura, Shuhei, Norheim, Ole F, Noubiap, Jean Jacque, Nowak, Christoph, Nunez-Samudio, Virginia, Otoiu, Adrian, Ogbo, Felix Akpojene, Oghenetega, Onome Bright, Oh, In-Hwan, Okunga, Emmanuel Wandera, Oladnabi, Morteza, Olagunju, Andrew T, Olusanya, Jacob Olusegun, Olusanya, Bolajoko Olubukunola, Oluwasanu, Mojisola Morenike, Omar Bali, Ahmed, Omer, Muktar Omer, Ong, Kanyin L, Onwujekwe, Obinna E, Ortega-Altamirano, Doris V V, Ortiz, Alberto, Ostojic, Sergej M, Otstavnov, Nikita, Otstavnov, Stanislav S, Øverland, Simon, Owolabi, Mayowa O, Padubidri, Jagadish Rao., Pakhale, Smita, Palladino, Raffaele, Pana, Adrian, Panda-Jonas, Songhomitra, Pangaribuan, Helena Ullyartha, Pathak, Mona, Patton, George C, Paudel, Sagun, Pazoki Toroudi, Hamidreza, Pease, Spencer A, Peden, Amy E, Pennini, Alyssa, Peprah, Emmanuel K, Pereira, Jeevan, Pigott, David M, Pilgrim, Thoma, Pilz, Tessa M, Pinheiro, Marina, Piradov, Michael A, Pirsaheb, Meghdad, Pokhrel, Khem Narayan, Postma, Maarten J, Pourjafar, Hadi, Pourmalek, Farshad, Pourmirza Kalhori, Reza, Pourshams, Akram, Prada, Sergio I, Pribadi, Dimas Ria Angga, Pupillo, Elisabetta, Quazi Syed, Zahiruddin, Radfar, Amir, Rafiee, Ata, Rafiei, Alireza, Raggi, Alberto, Rahim, Fakher, Rahman, Muhammad Aziz, Rajabpour-Sanati, Ali, Rana, Saleem Muhammad, Ranabhat, Chhabi Lal, Rao, Sowmya J, Rasella, Davide, Rashedi, Vahid, Rath, Goura Kishor, Rathi, Priya, Rawaf, Salman, Rawaf, David Laith, Rawal, Lal, Rawassizadeh, Reza, Razo, Christian, Renjith, Vishnu, Renzaho, Andre M N, Reshmi, Bhageerathy, Rezaei, Nima, Riahi, Seyed Mohammad, Ribeiro, Daniel Cury, Rickard, Jennifer, Roberts, Nicholas L S, Roever, Leonardo, Romoli, Michele, Ronfani, Luca, Roshandel, Gholamreza, Rubagotti, Enrico, Rwegerera, Godfrey M, Sabour, Siamak, Sachdev, Perminder S, Saddik, Basema, Sadeghi, Masoumeh, Sadeghi, Ehsan, Safari, Yahya, Sagar, Rajesh, Sahebkar, Amirhossein, Sahraian, Mohammad Ali, Sajadi, S. Mohammad, Salahshoor, Mohammad Reza, Salem, Marwa R Rashad, Salem, Hosni, Salomon, Joshua, Samadi Kafil, Hossein, Samy, Abdallah M, Sanabria, Juan, Santric-Milicevic, Milena M, Saraswathy, Sivan Yegnanarayana Iyer, Sarmiento-Suárez, Rodrigo, Sartorius, Benn, Sarveazad, Arash, Sathian, Brijesh, Sathish, Thirunavukkarasu, Sattin, Davide, Savic, Miloje, Sawyer, Susan M, Saxena, Deepak, Sbarra, Alyssa N, Schaeffer, Lauren E, Schiavolin, Silvia, Schmidt, Maria Inê, Schutte, Aletta Elisabeth, Schwebel, David C, Schwendicke, Falk, Seedat, Soraya, Sha, Feng, Shahabi, Saeed, Shaheen, Amira A, Shaikh, Masood Ali, Shamsizadeh, Morteza, Shannawaz, Mohammed, Sharafi, Kiomar, Sharara, Fablina, Sharifi, Hamid, Shaw, David H, Sheikh, Aziz, Sheikhtaheri, Abba, Shetty, B Suresh Kumar, Shibuya, Kenji, Shiferaw, Wondimeneh Shibabaw, Shigematsu, Mika, Shin, Jae Il, Shiri, Rahman, Shirkoohi, Reza, Shivakumar, K M, Shrime, Mark G, Shuval, Kerem, Siabani, Soraya, Sierpinski, Radoslaw, Sigfusdottir, Inga Dora, Sigurvinsdottir, Rannveig, Silva, Diego Augusto Santo, Silva, João Pedro, Simonetti, Biagio, Simpson, Kyle E, Singh, Jasvinder A, Singh, Pushpendra, Sinha, Dhirendra Narain, Skryabin, Valentin Yurievich, Smith, Emma U R, Soheili, Amin, Soltani, Shahin, Soofi, Moslem, Sorensen, Reed J. D., Soriano, Joan B, Sorrie, Muluken Bekele, Soyiri, Ireneous N, Spurlock, Emma Elizabeth, Sreeramareddy, Chandrashekhar T, Stanaway, Jeffrey D, Steel, Nichola, Stein, Caroline, Stokes, Mark A, Sufiyan, Mu'awiyyah Babale, Suleria, Hafiz Ansar Rasul, Sultan, Iyad, Szumowski, Łukasz, Tabarés-Seisdedos, Rafael, Tabuchi, Takahiro, Tadakamadla, Santosh Kumar, Taddele, Biruk Wogayehu, Tadesse, Degena Bahrey, Taherkhani, Amir, Tamiru, Animut Tagele, Tanser, Frank C, Tareque, Md Ismail, Tarigan, Ingan Ukur, Teagle, Whitney L, Tediosi, Fabrizio, Tefera, Yonas Getaye Getaye, Tela, Freweini Gebrearegay, Tessema, Zemenu Tadesse, Thakur, Bhaskar, Titova, Mariya Vladimirovna, Tonelli, Marcello, Topor-Madry, Roman, Topouzis, Foti, Tovani-Palone, Marcos Roberto Roberto, Tran, Bach Xuan, Travillian, Ravensara, Troeger, Christopher E, Tudor Car, Lorainne, Uddin, Riaz, Ullah, Irfan, Umeokonkwo, Chukwuma David, Unnikrishnan, Bhaskaran, Upadhyay, Era, Uthman, Olalekan A, Vacante, Marco, Valdez, Pascual R, Varughese, Santosh, Vasankari, Tommi Juhani, Vasseghian, Yasser, Venketasubramanian, Narayanaswamy, Violante, Francesco S, Vlassov, Vasily, Vollset, Stein Emil, Vongpradith, Avina, Vos, Theo, Waheed, Yasir, Walters, Magdalene K, Wamai, Richard G, Wang, Haidong, Wang, Yuan-Pang, Weintraub, Robert G, Weiss, Jordan, Werdecker, Andrea, Westerman, Ronny, Wilner, Lauren B, Woldu, Gebremariam, Wolfe, Charles D A, Wu, Ai-Min, Wulf Hanson, Sarah, Xie, Yang, Xu, Rixing, Yahyazadeh Jabbari, Seyed Hossein, Yamagishi, Kazumasa, Yano, Yuichiro, Yaya, Sanni, Yazdi-Feyzabadi, Vahid, Yearwood, Jamal A, Yeshitila, Yordanos Gizachew, Yip, Paul, Yonemoto, Naohiro, Younis, Mustafa Z, Yousefi, Zabihollah, Yousefinezhadi, Taraneh, Yusefzadeh, Hasan, Zadey, Siddhesh, Zahirian Moghadam, Telma, Zaidi, Syed Saoud, Zaki, Leila, Zaman, Sojib Bin, Zamani, Mohammad, Zamanian, Maryam, Zandian, Hamed, Zastrozhin, Mikhail Sergeevich, Zewdie, Kaleab Alemayehu, Zhang, Yunquan, Zhao, Xiu-Ju George, Zhao, Yingxi, Zheng, Peng, Zhu, Cong, Ziapour, Arash, Zlavog, Bianca S, Zodpey, Sanjay, Murray, Christopher J L, Lacey, B, Sartorius, B, Sálfræðideild (HR), Department of Psychology (RU), Samfélagssvið (HR), School of Social Sciences (RU), Háskólinn í Reykjavík, Reykjavik University, Lozano, R, Fullman, N, Mumford, J, Knight, M, Barthelemy, C, Abbafati, C, Abbastabar, H, Abd-Allah, F, Abdollahi, M, Abedi, A, Abolhassani, H, Abosetugn, A, Abreu, L, Abrigo, M, Abu Haimed, A, Abushouk, A, Adabi, M, Adebayo, O, Adekanmbi, V, Adelson, J, Adetokunboh, O, Adham, D, Advani, S, Afshin, A, Agarwal, G, Agasthi, P, Aghamir, S, Agrawal, A, Ahmad, T, Akinyemi, R, Alahdab, F, Al-Aly, Z, Alam, K, Albertson, S, Alemu, Y, Alhassan, R, Ali, M, Ali, S, Alipour, V, Aljunid, S, Alla, F, Almadi, M, Almasi, A, Almasi-Hashiani, A, Almasri, N, Al-Mekhlafi, H, Almulhim, A, Alonso, J, Al-Raddadi, R, Altirkawi, K, Alvis-Guzman, N, Alvis-Zakzuk, N, Amini, S, Amini-Rarani, M, Amiri, F, Amit, A, Amugsi, D, Ancuceanu, R, Anderlini, D, Andrei, C, Androudi, S, Ansari, F, Ansari-Moghaddam, A, Antonio, C, Antony, C, Antriyandarti, E, Anvari, D, Anwer, R, Arabloo, J, Arab-Zozani, M, Aravkin, A, Aremu, O, Ärnlöv, J, Asaad, M, Asadi-Aliabadi, M, Asadi-Pooya, A, Ashbaugh, C, Athari, S, Atout, M, Ausloos, M, Avila-Burgos, L, Ayala Quintanilla, B, Ayano, G, Ayanore, M, Aynalem, Y, Aynalem, G, Ayza, M, Azari, S, Azzopardi, P, B, D, Babaee, E, Badiye, A, Bahrami, M, Baig, A, Bakhshaei, M, Bakhtiari, A, Bakkannavar, S, Balachandran, A, Balassyano, S, Banach, M, Banerjee, S, Banik, P, Bante, A, Bante, S, Barker-Collo, S, Bärnighausen, T, Barrero, L, Bassat, Q, Basu, S, Baune, B, Bayati, M, Baye, B, Bedi, N, Beghi, E, Behzadifar, M, Bekuma, T, Bell, M, Bensenor, I, Berman, A, Bernabe, E, Bernstein, R, Bhagavathula, A, Bhandari, D, Bhardwaj, P, Bhat, A, Bhattacharyya, K, Bhattarai, S, Bhutta, Z, Bijani, A, Bikbov, B, Bilano, V, Biondi, A, Birihane, B, Bockarie, M, Bohlouli, S, Bojia, H, Bolla, S, Boloor, A, Brady, O, Braithwaite, D, Briant, P, Briggs, A, Briko, N, Burugina Nagaraja, S, Busse, R, Butt, Z, Caetano dos Santos, F, Cahuana-Hurtado, L, Cámera, L, Cárdenas, R, Carreras, G, Carrero, J, Carvalho, F, Castaldelli-Maia, J, Castañeda-Orjuela, C, Castelpietra, G, Castro, F, Catalá-López, F, Causey, K, Cederroth, C, Cercy, K, Cerin, E, Chandan, J, Chang, A, Charan, J, Chattu, V, Chaturvedi, S, Chin, K, Cho, D, Choi, J, Christensen, H, Chu, D, Chung, M, Ciobanu, L, Cirillo, M, Comfort, H, Compton, K, Cortesi, P, Costa, V, Cousin, E, Dahlawi, S, Damiani, G, Dandona, L, Dandona, R, Darega Gela, J, Darwesh, A, Daryani, A, Dash, A, Davey, G, Dávila-Cervantes, C, Davletov, K, De Neve, J, Denova-Gutiérrez, E, Deribe, K, Dervenis, N, Desai, R, Dharmaratne, S, Dhungana, G, Dianatinasab, M, Dias da Silva, D, Diaz, D, Dippenaar, I, Do, H, Dorostkar, F, Doshmangir, L, Duncan, B, Duraes, A, Eagan, A, Edvardsson, D, El Sayed, I, El Tantawi, M, Elgendy, I, Elyazar, I, Eskandari, K, Eskandarieh, S, Esmaeilnejad, S, Esteghamati, A, Ezekannagha, O, Farag, T, Farahmand, M, Faraon, E, Farinha, C, Farioli, A, Faris, P, Faro, A, Fazlzadeh, M, Feigin, V, Fernandes, E, Ferrara, P, Feyissa, G, Filip, I, Fischer, F, Fisher, J, Flor, L, Foigt, N, Folayan, M, Fomenkov, A, Foroutan, M, Francis, J, Fu, W, Fukumoto, T, Furtado, J, Gad, M, Gaidhane, A, Gakidou, E, Galles, N, Gallus, S, Gardner, W, Geberemariyam, B, Gebrehiwot, A, Gebremeskel, L, Gebremeskel, G, Gesesew, H, Ghadiri, K, Ghafourifard, M, Ghashghaee, A, Ghith, N, Gholamian, A, Gilani, S, Gill, P, Gill, T, Ginindza, T, Gitimoghaddam, M, Giussani, G, Glagn, M, Gnedovskaya, E, Godinho, M, Goharinezhad, S, Gopalani, S, Goudarzian, A, Goulart, B, Gubari, M, Guimarães, R, Guled, R, Gultie, T, Guo, Y, Gupta, R, Hafezi-Nejad, N, Hafiz, A, Haile, T, Hamadeh, R, Hameed, S, Hamidi, S, Han, C, Han, H, Handiso, D, Hanif, A, Hankey, G, Haro, J, Hasaballah, A, Hasan, M, Hashi, A, Hassan, S, Hassan, A, Hassanipour, S, Hassankhani, H, Havmoeller, R, Hay, S, Hayat, K, Heidari, G, Heidari-Soureshjani, R, Hendrie, D, Herteliu, C, Hird, T, Ho, H, Hole, M, Holla, R, Hollingsworth, B, Hoogar, P, Hopf, K, Horita, N, Hossain, N, Hosseini, M, Hosseinzadeh, M, Hostiuc, M, Hostiuc, S, Househ, M, Hsieh, V, Hu, G, Huda, T, Humayun, A, Hwang, B, Iavicoli, I, Ibitoye, S, Ikeda, N, Ilesanmi, O, Ilic, I, Ilic, M, Inbaraj, L, Iqbal, U, Irvani, S, Irvine, C, Islam, M, Islam, S, Islami, F, Iso, H, Iwu, C, Jaafari, J, Jadidi-Niaragh, F, Jafarinia, M, Jahagirdar, D, Jahani, M, Jahanmehr, N, Jakovljevic, M, Janjani, H, Javaheri, T, Jayatilleke, A, Jenabi, E, Jha, R, Jha, V, Ji, J, Jia, P, John-Akinola, Y, Jonas, J, Joukar, F, Jozwiak, J, Jürisson, M, Kabir, Z, Kalankesh, L, Kalhor, R, Kamath, A, Kanchan, T, Kapoor, N, Karami Matin, B, Karanikolos, M, Karimi, S, Kassebaum, N, Katikireddi, S, Kayode, G, Keiyoro, P, Khader, Y, Khammarnia, M, Khan, M, Khan, E, Khang, Y, Khatab, K, Khater, A, Khater, M, Khatib, M, Khayamzadeh, M, Khubchandani, J, Kianipour, N, Kim, Y, Kimokoti, R, Kinfu, Y, Kisa, A, Kissimova-Skarbek, K, Kivimäki, M, Kneib, C, Kocarnik, J, Kochhar, S, Kohler, S, Kopec, J, Korotkova, A, Korshunov, V, Kosen, S, Kotlo, A, Koul, P, Koyanagi, A, Krishan, K, Krohn, K, Kugbey, N, Kulkarni, V, Kumar, G, Kumar, N, Kumar, M, Kurmi, O, Kusuma, D, Kyu, H, La Vecchia, C, Lal, D, Lalloo, R, Landires, I, Lansingh, V, Larsson, A, Lasrado, S, Lau, K, Lauriola, P, Lazarus, J, Ledesma, J, Lee, P, Lee, S, Leever, A, Legrand, K, Leigh, J, Leonardi, M, Li, S, Lim, S, Lim, L, Liu, X, Logroscino, G, Lopez, A, Lopukhov, P, Lotufo, P, Lu, A, Ma, J, Madadin, M, Mahasha, P, Mahmoudi, M, Majeed, A, Malagón-Rojas, J, Maleki, S, Malta, D, Mansouri, B, Mansournia, M, Martini, S, Martins-Melo, F, Martopullo, I, Massenburg, B, Mastrogiacomo, C, Mathur, M, Mcalinden, C, Mckee, M, Medina-Solís, C, Meharie, B, Mehndiratta, M, Mehrabi Nasab, E, Mehri, F, Mehrotra, R, Mekonnen, T, Melese, A, Memiah, P, Mendoza, W, Menezes, R, Mensah, G, Meretoja, T, Meretoja, A, Mestrovic, T, Miazgowski, B, Michalek, I, Mirrakhimov, E, Mirzaei, M, Mirzaei-Alavijeh, M, Mitchell, P, Moazen, B, Moghadaszadeh, M, Mohamadi, E, Mohammad, Y, Mohammad, D, Mohammad Gholi Mezerji, N, Mohammadian-Hafshejani, A, Mohammed, S, Mohammed, J, Mokdad, A, Monasta, L, Mondello, S, Moradi, M, Moradi-Lakeh, M, Moradzadeh, R, Moraga, P, Morgado-da-Costa, J, Morrison, S, Mosapour, A, Mosser, J, Mousavi Khaneghah, A, Muriithi, M, Mustafa, G, Nabhan, A, Naderi, M, Nagarajan, A, Naghavi, M, Naghshtabrizi, B, Naimzada, M, Nangia, V, Nansseu, J, Nayak, V, Nazari, J, Ndejjo, R, Negoi, I, Negoi, R, Neupane, S, Ngari, K, Nguefack-Tsague, G, Ngunjiri, J, Nguyen, C, Nguyen, D, Nguyen, H, Nnaji, C, Nomura, S, Norheim, O, Noubiap, J, Nowak, C, Nunez-Samudio, V, Otoiu, A, Ogbo, F, Oghenetega, O, Oh, I, Okunga, E, Oladnabi, M, Olagunju, A, Olusanya, J, Olusanya, B, Oluwasanu, M, Omar Bali, A, Omer, M, Ong, K, Onwujekwe, O, Ortega-Altamirano, D, Ortiz, A, Ostojic, S, Otstavnov, N, Otstavnov, S, Øverland, S, Owolabi, M, Padubidri, J, Pakhale, S, Palladino, R, Pana, A, Panda-Jonas, S, Pangaribuan, H, Pathak, M, Patton, G, Paudel, S, Pazoki Toroudi, H, Pease, S, Peden, A, Pennini, A, Peprah, E, Pereira, J, Pigott, D, Pilgrim, T, Pilz, T, Pinheiro, M, Piradov, M, Pirsaheb, M, Pokhrel, K, Postma, M, Pourjafar, H, Pourmalek, F, Pourmirza Kalhori, R, Pourshams, A, Prada, S, Pribadi, D, Pupillo, E, Quazi Syed, Z, Radfar, A, Rafiee, A, Rafiei, A, Raggi, A, Rahim, F, Rahman, M, Rajabpour-Sanati, A, Rana, S, Ranabhat, C, Rao, S, Rasella, D, Rashedi, V, Rath, G, Rathi, P, Rawaf, S, Rawaf, D, Rawal, L, Rawassizadeh, R, Razo, C, Renjith, V, Renzaho, A, Reshmi, B, Rezaei, N, Riahi, S, Ribeiro, D, Rickard, J, Roberts, N, Roever, L, Romoli, M, Ronfani, L, Roshandel, G, Rubagotti, E, Rwegerera, G, Sabour, S, Sachdev, P, Saddik, B, Sadeghi, M, Sadeghi, E, Safari, Y, Sagar, R, Sahebkar, A, Sahraian, M, Sajadi, S, Salahshoor, M, Salem, M, Salem, H, Salomon, J, Samadi Kafil, H, Samy, A, Sanabria, J, Santric-Milicevic, M, Saraswathy, S, Sarmiento-Suárez, R, Sarveazad, A, Sathian, B, Sathish, T, Sattin, D, Savic, M, Sawyer, S, Saxena, D, Sbarra, A, Schaeffer, L, Schiavolin, S, Schmidt, M, Schutte, A, Schwebel, D, Schwendicke, F, Seedat, S, Sha, F, Shahabi, S, Shaheen, A, Shaikh, M, Shamsizadeh, M, Shannawaz, M, Sharafi, K, Sharara, F, Sharifi, H, Shaw, D, Sheikh, A, Sheikhtaheri, A, Shetty, B, Shibuya, K, Shiferaw, W, Shigematsu, M, Shin, J, Shiri, R, Shirkoohi, R, Shivakumar, K, Shrime, M, Shuval, K, Siabani, S, Sierpinski, R, Sigfusdottir, I, Sigurvinsdottir, R, Silva, D, Silva, J, Simonetti, B, Simpson, K, Singh, J, Singh, P, Sinha, D, Skryabin, V, Smith, E, Soheili, A, Soltani, S, Soofi, M, Sorensen, R, Soriano, J, Sorrie, M, Soyiri, I, Spurlock, E, Sreeramareddy, C, Stanaway, J, Steel, N, Stein, C, Stokes, M, Sufiyan, M, Suleria, H, Sultan, I, Szumowski, Ł, Tabarés-Seisdedos, R, Tabuchi, T, Tadakamadla, S, Taddele, B, Tadesse, D, Taherkhani, A, Tamiru, A, Tanser, F, Tareque, M, Tarigan, I, Teagle, W, Tediosi, F, Tefera, Y, Tela, F, Tessema, Z, Thakur, B, Titova, M, Tonelli, M, Topor-Madry, R, Topouzis, F, Tovani-Palone, M, Tran, B, Travillian, R, Troeger, C, Tudor Car, L, Uddin, R, Ullah, I, Umeokonkwo, C, Unnikrishnan, B, Upadhyay, E, Uthman, O, Vacante, M, Valdez, P, Varughese, S, Vasankari, T, Vasseghian, Y, Venketasubramanian, N, Violante, F, Vlassov, V, Vollset, S, Vongpradith, A, Vos, T, Waheed, Y, Walters, M, Wamai, R, Wang, H, Wang, Y, Weintraub, R, Weiss, J, Werdecker, A, Westerman, R, Wilner, L, Woldu, G, Wolfe, C, Wu, A, Wulf Hanson, S, Xie, Y, Xu, R, Yahyazadeh Jabbari, S, Yamagishi, K, Yano, Y, Yaya, S, Yazdi-Feyzabadi, V, Yearwood, J, Yeshitila, Y, Yip, P, Yonemoto, N, Younis, M, Yousefi, Z, Yousefinezhadi, T, Yusefzadeh, H, Zadey, S, Zahirian Moghadam, T, Zaidi, S, Zaki, L, Zaman, S, Zamani, M, Zamanian, M, Zandian, H, Zastrozhin, M, Zewdie, K, Zhang, Y, Zhao, X, Zhao, Y, Zheng, P, Zhu, C, Ziapour, A, Zlavog, B, Zodpey, S, Murray, C, Tampere University, Health Sciences, 10922180 - Schutte, Aletta Elisabeth, Lozano, R., Fullman, N., Mumford, J. E., Knight, M., Barthelemy, C. M., Abbafati, C., Abbastabar, H., Abd-Allah, F., Abdollahi, M., Abedi, A., Abolhassani, H., Abosetugn, A. E., Abreu, L. G., Abrigo, M. R. M., Abu Haimed, A. K., Abushouk, A. I., Adabi, M., Adebayo, O. M., Adekanmbi, V., Adelson, J., Adetokunboh, O. O., Adham, D., Advani, S. M., Afshin, A., Agarwal, G., Agasthi, P., Aghamir, S. M. K., Agrawal, A., Ahmad, T., Akinyemi, R. O., Alahdab, F., Al-Aly, Z., Alam, K., Albertson, S. B., Alemu, Y. M., Alhassan, R. K., Ali, M., Ali, S., Alipour, V., Aljunid, S. M., Alla, F., Almadi, M. A. H., Almasi, A., Almasi-Hashiani, A., Almasri, N. A., Al-Mekhlafi, H. M., Almulhim, A. M., Alonso, J., Al-Raddadi, R. M., Altirkawi, K. A., Alvis-Guzman, N., Alvis-Zakzuk, N. J., Amini, S., Amini-Rarani, M., Amiri, F., Amit, A. M. L., Amugsi, D. A., Ancuceanu, R., Anderlini, D., Andrei, C. L., Androudi, S., Ansari, F., Ansari-Moghaddam, A., Antonio, C. A. T., Antony, C. M., Antriyandarti, E., Anvari, D., Anwer, R., Arabloo, J., Arab-Zozani, M., Aravkin, A. Y., Aremu, O., Arnlov, J., Asaad, M., Asadi-Aliabadi, M., Asadi-Pooya, A. A., Athari, S. S., Atout, M. M. W., Ausloos, M., Avila-Burgos, L., Ayala Quintanilla, B. P., Ayano, G., Ayanore, M. A., Aynalem, Y. A., Aynalem, G. L., Ayza, M. A., Azari, S., Azzopardi, P. S., B, D. B., Babaee, E., Badiye, A. D., Bahrami, M. A., Baig, A. A., Bakhshaei, M. H., Bakhtiari, A., Bakkannavar, S. M., Balachandran, A., Banach, M., Banerjee, S. K., Banik, P. C., Bante, A. B., Bante, S. A., Barker-Collo, S. L., Barnighausen, T. W., Barrero, L. H., Bassat, Q., Basu, S., Baune, B. T., Bayati, M., Baye, B. A., Bedi, N., Beghi, E., Behzadifar, M., Bekuma, T. T. T., Bell, M. L., Bensenor, I. M., Berman, A. E., Bernabe, E., Bernstein, R. S., Bhagavathula, A. S., Bhandari, D., Bhardwaj, P., Bhat, A. G., Bhattacharyya, K., Bhattarai, S., Bhutta, Z. A., Bijani, A., Bikbov, B., Bilano, V., Biondi, A., Birihane, B. M., Bockarie, M. J., Bohlouli, S., Bojia, H. A., Bolla, S. R. R., Boloor, A., Brady, O. J., Braithwaite, D., Briggs, A. M., Briko, N. I., Burugina Nagaraja, S., Busse, R., Butt, Z. A., Caetano dos Santos, F. L., Cahuana-Hurtado, L., Camera, L. A., Cardenas, R., Carreras, G., Carrero, J. J., Carvalho, F., Castaldelli-Maia, J. M., Castaneda-Orjuela, C. A., Castelpietra, G., Castro, F., Catala-Lopez, F., Cederroth, C. R., Cerin, E., Chandan, J. S., Chang, A. Y., Charan, J., Chattu, V. K., Chaturvedi, S., Chin, K. L., Cho, D. Y., Choi, J. -Y. J., Christensen, H., Chu, D. -T., Chung, M. T., Ciobanu, L. G., Cirillo, M., Compton, K., Cortesi, P. A., Costa, V. M., Cousin, E., Dahlawi, S. M. A., Damiani, G., Dandona, L., Dandona, R., Darega Gela, J., Darwesh, A. M., Daryani, A., Dash, A. P., Davey, G., Davila-Cervantes, C. A., Davletov, K., De Neve, J. -W., Denova-Gutierrez, E., Deribe, K., Dervenis, N., Desai, R., Dharmaratne, S. D., Dhungana, G. P., Dianatinasab, M., Dias da Silva, D., Diaz, D., Dippenaar, I. N., Do, H. T., Dorostkar, F., Doshmangir, L., Duncan, B. B., Duraes, A. R., Eagan, A. W., Edvardsson, D., El Sayed, I., El Tantawi, M., Elgendy, I. Y., Elyazar, I. R., Eskandari, K., Eskandarieh, S., Esmaeilnejad, S., Esteghamati, A., Ezekannagha, O., Farag, T., Farahmand, M., Faraon, E. J. A., Farinha, C. S. E. S., Farioli, A., Faris, P. S., Faro, A., Fazlzadeh, M., Feigin, V. L., Fernandes, E., Ferrara, P., Feyissa, G. T., Filip, I., Fischer, F., Fisher, J. L., Flor, L. S., Foigt, N. A., Folayan, M. O., Fomenkov, A. A., Foroutan, M., Francis, J. M., Fu, W., Fukumoto, T., Furtado, J. M., Gad, M. M., Gaidhane, A. M., Gakidou, E., Galles, N. C., Gallus, S., Gardner, W. M., Geberemariyam, B. S., Gebrehiwot, A. M., Gebremeskel, L. G., Gebremeskel, G. G., Gesesew, H. A., Ghadiri, K., Ghafourifard, M., Ghashghaee, A., Ghith, N., Gholamian, A., Gilani, S. A., Gill, P. S., Gill, T. K., Ginindza, T. G., Gitimoghaddam, M., Giussani, G., Glagn, M., Gnedovskaya, E. V., Godinho, M. A., Goharinezhad, S., Gopalani, S. V., Goudarzian, A. H., Goulart, B. N. G., Gubari, M. I. M., Guimaraes, R. A., Guled, R. A., Gultie, T., Guo, Y., Gupta, R., Hafezi-Nejad, N., Hafiz, A., Haile, T. G., Hamadeh, R. R., Hameed, S., Hamidi, S., Han, C., Han, H., Handiso, D. W., Hanif, A., Hankey, G. J., Haro, J. M., Hasaballah, A. I., Hasan, M. M., Hashi, A., Hassan, S., Hassan, A., Hassanipour, S., Hassankhani, H., Havmoeller, R. J., Hay, S. I., Hayat, K., Heidari, G., Heidari-Soureshjani, R., Hendrie, D., Herteliu, C., Hird, T. R., Ho, H. C., Hole, M. K., Holla, R., Hoogar, P., Hopf, K. P., Horita, N., Hossain, N., Hosseini, M., Hosseinzadeh, M., Hostiuc, M., Hostiuc, S., Househ, M., Hsieh, V. C. -R., Hu, G., Huda, T. M., Humayun, A., Hwang, B. -F., Iavicoli, I., Ibitoye, S. E., Ikeda, N., Ilesanmi, O. S., Ilic, M. D., Inbaraj, L. R., Iqbal, U., Irvani, S. S. N., Irvine, C. M. S., Islam, M. M., Islam, S. M. S., Islami, F., Iso, H., Iwu, C. J., Jaafari, J., Jadidi-Niaragh, F., Jafarinia, M., Jahagirdar, D., Jahani, M. A., Jahanmehr, N., Jakovljevic, M., Janjani, H., Javaheri, T., Jayatilleke, A. U., Jenabi, E., Jha, R. P., Jha, V., Ji, J. S., Jia, P., John-Akinola, Y. O., Jonas, J. B., Joukar, F., Jozwiak, J. J., Jurisson, M., Kabir, Z., Kalankesh, L. R., Kalhor, R., Kamath, A. M., Kanchan, T., Kapoor, N., Karami Matin, B., Karanikolos, M., Karimi, S. M., Kassebaum, N. J., Katikireddi, S. V., Kayode, G. A., Keiyoro, P. N., Khader, Y. S., Khammarnia, M., Khan, M., Khan, E. A., Khang, Y. -H., Khatab, K., Khater, A. M., Khater, M. M., Khatib, M. N., Khayamzadeh, M., Khubchandani, J., Kianipour, N., Kim, Y. J., Kimokoti, R. W., Kinfu, Y., Kisa, A., Kissimova-Skarbek, K., Kivimaki, M., Kneib, C. J., Kocarnik, J. M., Kochhar, S., Kohler, S., Kopec, J. A., Korotkova, A. V., Korshunov, V. A., Kosen, S., Kotlo, A., Koul, P. A., Koyanagi, A., Krishan, K., Krohn, K. J., Kugbey, N., Kulkarni, V., Kumar, G. A., Kumar, N., Kumar, M., Kurmi, O. P., Kusuma, D., Kyu, H. H., La Vecchia, C., Lacey, B., Lal, D. K., Lalloo, R., Landires, I., Lansingh, V. C., Larsson, A. O., Lasrado, S., Lau, K. M. -M., Lauriola, P., Lazarus, J. V., Ledesma, J. R., Lee, P. H., Lee, S. W. H., Leever, A. T., Legrand, K. E., Leigh, J., Leonardi, M., Li, S., Lim, S. S., Lim, L. -L., Liu, X., Logroscino, G., Lopez, A. D., Lopukhov, P. D., Lotufo, P. A., Lu, A., Ma, J., Madadin, M., Mahasha, P. W., Mahmoudi, M., Majeed, A., Malagon-Rojas, J. N., Maleki, S., Malta, D. C., Mansouri, B., Mansournia, M. A., Martini, S., Martins-Melo, F. R., Martopullo, I., Massenburg, B. B., Mastrogiacomo, C. I., Mathur, M. R., Mcalinden, C., Mckee, M., Medina-Solis, C. E., Meharie, B. G., Mehndiratta, M. M., Mehrabi Nasab, E., Mehri, F., Mehrotra, R., Mekonnen, T., Melese, A., Memiah, P. T. N., Mendoza, W., Menezes, R. G., Mensah, G. A., Meretoja, T. J., Meretoja, A., Mestrovic, T., Miazgowski, B., Michalek, I. M., Mirrakhimov, E. M., Mirzaei, M., Mirzaei-Alavijeh, M., Mitchell, P. B., Moazen, B., Moghadaszadeh, M., Mohamadi, E., Mohammad, Y., Mohammad, D. K., Mohammad Gholi Mezerji, N., Mohammadian-Hafshejani, A., Mohammed, S., Mohammed, J. A., Mokdad, A. H., Monasta, L., Mondello, S., Moradi, M., Moradi-Lakeh, M., Moradzadeh, R., Moraga, P., Morgado-da-Costa, J., Morrison, S. D., Mosapour, A., Mosser, J. F., Mousavi Khaneghah, A., Muriithi, M. K., Mustafa, G., Nabhan, A. F., Naderi, M., Nagarajan, A. J., Naghavi, M., Naghshtabrizi, B., Naimzada, M. D., Nangia, V., Nansseu, J. R., Nayak, V. C., Nazari, J., Ndejjo, R., Negoi, I., Negoi, R. I., Neupane, S., Ngari, K. N., Nguefack-Tsague, G., Ngunjiri, J. W., Nguyen, C. T., Nguyen, D. N., Nguyen, H. L. T., Nnaji, C. A., Nomura, S., Norheim, O. F., Noubiap, J. J., Nowak, C., Nunez-Samudio, V., Otoiu, A., Ogbo, F. A., Oghenetega, O. B., Oh, I. -H., Okunga, E. W., Oladnabi, M., Olagunju, A. T., Olusanya, J. O., Olusanya, B. O., Oluwasanu, M. M., Omar Bali, A., Omer, M. O., Ong, K. L., Onwujekwe, O. E., Ortega-Altamirano, D. V. V., Ortiz, A., Ostojic, S. M., Otstavnov, N., Otstavnov, S. S., Overland, S., Owolabi, M. O., Padubidri, J. R., Pakhale, S., Palladino, R., Pana, A., Panda-Jonas, S., Pangaribuan, H. U., Pathak, M., Patton, G. C., Paudel, S., Pazoki Toroudi, H., Pease, S. A., Peden, A. E., Pennini, A., Peprah, E. K., Pereira, J., Pigott, D. M., Pilgrim, T., Pilz, T. M., Pinheiro, M., Piradov, M. A., Pirsaheb, M., Pokhrel, K. N., Postma, M. J., Pourjafar, H., Pourmalek, F., Pourmirza Kalhori, R., Pourshams, A., Prada, S. I., Pribadi, D. R. A., Pupillo, E., Quazi Syed, Z., Radfar, A., Rafiee, A., Rafiei, A., Raggi, A., Rahim, F., Rahman, M. A., Rajabpour-Sanati, A., Rana, S. M., Ranabhat, C. L., Rao, S. J., Rasella, D., Rashedi, V., Rath, G. K., Rathi, P., Rawaf, S., Rawaf, D. L., Rawal, L., Rawassizadeh, R., Razo, C., Renjith, V., Renzaho, A. M. N., Reshmi, B., Rezaei, N., Riahi, S. M., Ribeiro, D. C., Rickard, J., Roberts, N. L. S., Roever, L., Romoli, M., Ronfani, L., Roshandel, G., Rubagotti, E., Rwegerera, G. M., Sabour, S., Sachdev, P. S., Saddik, B., Sadeghi, M., Sadeghi, E., Safari, Y., Sagar, R., Sahebkar, A., Sahraian, M. A., Sajadi, S. M., Salahshoor, M. R., Salem, M. R. R., Salem, H., Salomon, J., Samadi Kafil, H., Samy, A. M., Sanabria, J., Santric-Milicevic, M. M., Saraswathy, S. Y. I., Sarmiento-Suarez, R., Sartorius, B., Sarveazad, A., Sathian, B., Sathish, T., Sattin, D., Savic, M., Sawyer, S. M., Saxena, D., Sbarra, A. N., Schaeffer, L. E., Schiavolin, S., Schmidt, M. I., Schutte, A. E., Schwebel, D. C., Schwendicke, F., Seedat, S., Sha, F., Shahabi, S., Shaheen, A. A., Shaikh, M. A., Shamsizadeh, M., Shannawaz, M., Sharafi, K., Sharara, F., Sharifi, H., Shaw, D. H., Sheikh, A., Sheikhtaheri, A., Shetty, B. S. K., Shibuya, K., Shiferaw, W. S., Shigematsu, M., Shin, J. I., Shiri, R., Shirkoohi, R., Shivakumar, K. M., Shrime, M. G., Shuval, K., Siabani, S., Sierpinski, R., Sigfusdottir, I. D., Sigurvinsdottir, R., Silva, D. A. S., Silva, J. P., Simonetti, B., Simpson, K. E., Singh, J. A., Singh, P., Sinha, D. N., Skryabin, V. Y., Smith, E. U. R., Soheili, A., Soltani, S., Soofi, M., Sorensen, R. J. D., Soriano, J. B., Sorrie, M. B., Soyiri, I. N., Spurlock, E. E., Sreeramareddy, C. T., Stanaway, J. D., Steel, N., Stein, C., Stokes, M. A., Sufiyan, M. B., Suleria, H. A. R., Sultan, I., Szumowski, L., Tabares-Seisdedos, R., Tabuchi, T., Tadakamadla, S. K., Taddele, B. W., Tadesse, D. B., Taherkhani, A., Tamiru, A. T., Tanser, F. C., Tareque, M. I., Tarigan, I. U., Teagle, W. L., Tediosi, F., Tefera, Y. G. G., Tela, F. G., Tessema, Z. T., Thakur, B., Titova, M. V., Tonelli, M., Topor-Madry, R., Topouzis, F., Tovani-Palone, M. R. R., Tran, B. X., Travillian, R., Troeger, C. E., Tudor Car, L., Uddin, R., Ullah, I., Umeokonkwo, C. D., Unnikrishnan, B., Upadhyay, E., Uthman, O. A., Vacante, M., Valdez, P. R., Varughese, S., Vasankari, T. J., Vasseghian, Y., Venketasubramanian, N., Violante, F. S., Vlassov, V., Vollset, S. E., Vongpradith, A., Vos, T., Waheed, Y., Walters, M. K., Wamai, R. G., Wang, H., Wang, Y. -P., Weintraub, R. G., Weiss, J., Werdecker, A., Westerman, R., Wilner, L. B., Woldu, G., Wolfe, C. D. A., Wu, A. -M., Wulf Hanson, S., Xie, Y., Yahyazadeh Jabbari, S. H., Yamagishi, K., Yano, Y., Yaya, S., Yazdi-Feyzabadi, V., Yearwood, J. A., Yeshitila, Y. G., Yip, P., Yonemoto, N., Younis, M. Z., Yousefi, Z., Yousefinezhadi, T., Yusefzadeh, H., Zadey, S., Zahirian Moghadam, T., Zaidi, S. S., Zaki, L., Zaman, S. B., Zamanian, M., Zandian, H., Zastrozhin, M. S., Zewdie, K. A., Zhang, Y., Zhao, X. -J. G., Zhao, Y., Zheng, P., Zhu, C., Ziapour, A., Zlavog, B. S., Zodpey, S., and Murray, C. J. L.
Subjects: Index (economics), Servicios de Salud, SUSTAINABLE DEVELOPMENT GOALS, 030204 cardiovascular system & hematology, universal health coverage, sustaibale develpment goal, global burden of disease, performance, systematic analysis, Global Burden of Disease, 0302 clinical medicine, Universal Health Insurance, RA0421, 11. Sustainability, Per capita, Medical economics, Disease, 030212 general & internal medicine, 10. No inequality, 11 Medical and Health Sciences, effective coverage of health services, GBD 2019 Universal Health Coverage Collaborators, education.field_of_study, Public health, Medical care, Sjúkdómar, 4. Education, 1. No poverty, Health coverage, Public Health, Global Health, Social Medicine and Epidemiology, General Medicine, Hälsovetenskaper, 3142 Public health care science, environmental and occupational health, Health services, 3. Good health, Global burden of disease, Health Expenditures, Humans, World Health Organization, Purchasing power parity, Scale (social sciences), Lýðheilsa, universal health coverag, CANCER SURVIVAL, ACCESS, Human, Heilsuhagfræði, medicine.medical_specialty, Health coverage, GBD, GBD, Universal health, GBD 2019, Population, Health expenditures, 3122 Cancers, Population health, 03 medical and health sciences, Health systems, Heilbrigðisvísindi, SDG 3 - Good Health and Well-being, General & Internal Medicine, Development economics, Health Sciences, medicine, Heilbrigðisstefna, Alþjóðaheilbrigðisstofnunin, QUALITY, Global Burden of Disease Study, education, PROGRESS, Disease burden, Health services accessibility, CARE, Heilbrigðisþjónusta, purl.org/pe-repo/ocde/ford#3.02.00 [https], Health Expenditure, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, 3121 General medicine, internal medicine and other clinical medicine, Morbility, Administración de los Servicios de Salud, Medical policy, Business, Heilbrigðiskerfi
Abstract: Publisher's version (útgefin grein), Background Achieving universal health coverage (UHC) involves all people receiving the health services they need, of high quality, without experiencing financial hardship. Making progress towards UHC is a policy priority for both countries and global institutions, as highlighted by the agenda of the UN Sustainable Development Goals (SDGs) and WHO's Thirteenth General Programme of Work (GPW13). Measuring effective coverage at the health-system level is important for understanding whether health services are aligned with countries' health profiles and are of sufficient quality to produce health gains for populations of all ages. Methods Based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we assessed UHC effective coverage for 204 countries and territories from 1990 to 2019. Drawing from a measurement framework developed through WHO's GPW13 consultation, we mapped 23 effective coverage indicators to a matrix representing health service types (eg, promotion, prevention, and treatment) and five population-age groups spanning from reproductive and newborn to older adults (>= 65 years). Effective coverage indicators were based on intervention coverage or outcome-based measures such as mortality-to-incidence ratios to approximate access to quality care; outcome-based measures were transformed to values on a scale of 0-100 based on the 2.5th and 97.5th percentile of location-year values. We constructed the UHC effective coverage index by weighting each effective coverage indicator relative to its associated potential health gains, as measured by disability-adjusted life-years for each location-year and population-age group. For three tests of validity (content, known-groups, and convergent), UHC effective coverage index performance was generally better than that of other UHC service coverage indices from WHO (ie, the current metric for SDG indicator 3.8.1 on UHC service coverage), the World Bank, and GBD 2017. We quantified frontiers of UHC effective coverage performance on the basis of pooled health spending per capita, representing UHC effective coverage index levels achieved in 2019 relative to country-level government health spending, prepaid private expenditures, and development assistance for health. To assess current trajectories towards the GPW13 UHC billion target-1 billion more people benefiting from UHC by 2023-we estimated additional population equivalents with UHC effective coverage from 2018 to 2023. Findings Globally, performance on the UHC effective coverage index improved from 45.8 (95% uncertainty interval 44.2-47.5) in 1990 to 60.3 (58.7-61.9) in 2019, yet country-level UHC effective coverage in 2019 still spanned from 95 or higher in Japan and Iceland to lower than 25 in Somalia and the Central African Republic. Since 2010, sub-Saharan Africa showed accelerated gains on the UHC effective coverage index (at an average increase of 2.6% [1.9-3.3] per year up to 2019); by contrast, most other GBD super-regions had slowed rates of progress in 2010-2019 relative to 1990-2010. Many countries showed lagging performance on effective coverage indicators for non-communicable diseases relative to those for communicable diseases and maternal and child health, despite non-communicable diseases accounting for a greater proportion of potential health gains in 2019, suggesting that many health systems are not keeping pace with the rising non-communicable disease burden and associated population health needs. In 2019, the UHC effective coverage index was associated with pooled health spending per capita (r=0.79), although countries across the development spectrum had much lower UHC effective coverage than is potentially achievable relative to their health spending. Under maximum efficiency of translating health spending into UHC effective coverage performance, countries would need to reach $1398 pooled health spending per capita (US$ adjusted for purchasing power parity) in order to achieve 80 on the UHC effective coverage index. From 2018 to 2023, an estimated 388.9 million (358.6-421.3) more population equivalents would have UHC effective coverage, falling well short of the GPW13 target of 1 billion more people benefiting from UHC during this time. Current projections point to an estimated 3.1 billion (3.0-3.2) population equivalents still lacking UHC effective coverage in 2023, with nearly a third (968.1 million [903.5-1040.3]) residing in south Asia. Interpretation The present study demonstrates the utility of measuring effective coverage and its role in supporting improved health outcomes for all people-the ultimate goal of UHC and its achievement. Global ambitions to accelerate progress on UHC service coverage are increasingly unlikely unless concerted action on non-communicable diseases occurs and countries can better translate health spending into improved performance. Focusing on effective coverage and accounting for the world's evolving health needs lays the groundwork for better understanding how close-or how far-all populations are in benefiting from UHC., Lucas Guimaraes Abreu acknowledges support from Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior -Brasil (Capes) -Finance Code 001, Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq) and Fundacao de Amparo a Pesquisa do Estado de Minas Gerais (FAPEMIG). Olatunji O Adetokunboh acknowledges South African Department of Science & Innovation, and National Research Foundation. Anurag Agrawal acknowledges support from the Wellcome Trust DBT India Alliance Senior Fellowship IA/CPHS/14/1/501489. Rufus Olusola Akinyemi acknowledges Grant U01HG010273 from the National Institutes of Health (NIH) as part of the H3Africa Consortium. Rufus Olusola Akinyemi is further supported by the FLAIR fellowship funded by the UK Royal Society and the African Academy of Sciences. Syed Mohamed Aljunid acknowledges the Department of Health Policy and Management, Faculty of Public Health, Kuwait University and International Centre for Casemix and Clinical Coding, Faculty of Medicine, National University of Malaysia for the approval and support to participate in this research project. Marcel Ausloos, Claudiu Herteliu, and Adrian Pana acknowledge partial support by a grant of the Romanian National Authority for Scientific Research and Innovation, CNDSUEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084. Till Winfried Barnighausen acknowledges support from the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor award, funded by the German Federal Ministry of Education and Research. Juan J Carrero was supported by the Swedish Research Council (2019-01059). Felix Carvalho acknowledges UID/MULTI/04378/2019 and UID/QUI/50006/2019 support with funding from FCT/MCTES through national funds. Vera Marisa Costa acknowledges support from grant (SFRH/BHD/110001/2015), received by Portuguese national funds through Fundacao para a Ciencia e a Tecnologia (FCT), IP, under the Norma TransitA3ria DL57/2016/CP1334/CT0006. Jan-Walter De Neve acknowledges support from the Alexander von Humboldt Foundation. Kebede Deribe acknowledges support by Wellcome Trust grant number 201900/Z/16/Z as part of his International Intermediate Fellowship. Claudiu Herteliu acknowledges partial support by a grant co-funded by European Fund for Regional Development through Operational Program for Competitiveness, Project ID P_40_382. Praveen Hoogar acknowledges the Centre for Bio Cultural Studies (CBiCS), Manipal Academy of Higher Education(MAHE), Manipal and Centre for Holistic Development and Research (CHDR), Kalghatgi. Bing-Fang Hwang acknowledges support from China Medical University (CMU108-MF-95), Taichung, Taiwan. Mihajlo Jakovljevic acknowledges the Serbian part of this GBD contribution was co-funded through the Grant OI175014 of the Ministry of Education Science and Technological Development of the Republic of Serbia. Aruna M Kamath acknowledges funding from the National Institutes of Health T32 grant (T32GM086270). Srinivasa Vittal Katikireddi acknowledges funding from the Medical Research Council (MC_UU_12017/13 & MC_UU_12017/15), Scottish Government Chief Scientist Office (SPHSU13 & SPHSU15) and an NRS Senior Clinical Fellowship (SCAF/15/02). Yun Jin Kim acknowledges support from the Research Management Centre, Xiamen University Malaysia (XMUMRF/2018-C2/ITCM/0001). Kewal Krishan acknowledges support from the DST PURSE grant and UGC Center of Advanced Study (CAS II) awarded to the Department of Anthropology, Panjab University, Chandigarh, India. Manasi Kumar acknowledges support from K43 TW010716 Fogarty International Center/NIMH. Ben Lacey acknowledges support from the NIHR Oxford Biomedical Research Centre and the BHF Centre of Research Excellence, Oxford. Ivan Landires is a member of the Sistema Nacional de InvestigaciA3n (SNI), which is supported by the Secretaria Nacional de Ciencia Tecnologia e Innovacion (SENACYT), Panama. Jeffrey V Lazarus acknowledges support by a Spanish Ministry of Science, Innovation and Universities Miguel Servet grant (Instituto de Salud Carlos III/ESF, European Union [CP18/00074]). Peter T N Memiah acknowledges CODESRIA; HISTP. Subas Neupane acknowledges partial support from the Competitive State Research Financing of the Expert Responsibility area of Tampere University Hospital. Shuhei Nomura acknowledges support from the Ministry of Education, Culture, Sports, Science, and Technology of Japan (18K10082). Alberto Ortiz acknowledges support by ISCIII PI19/00815, DTS18/00032, ISCIII-RETIC REDinREN RD016/0009 Fondos FEDER, FRIAT, Comunidad de Madrid B2017/BMD-3686 CIFRA2-CM. These funding sources had no role in the writing of the manuscript or the decision to submit it for publication. George C Patton acknowledges support from a National Health & Medical Research Council Fellowship. Marina Pinheiro acknowledges support from FCT for funding through program DL 57/2016 -Norma transitA3ria. Alberto Raggi, David Sattin, and Silvia Schiavolin acknowledge support by a grant from the Italian Ministry of Health (Ricerca Corrente, Fondazione Istituto Neurologico C Besta, Linea 4 -Outcome Research: dagli Indicatori alle Raccomandazioni Cliniche). Daniel Cury Ribeiro acknowledges support from the Sir Charles Hercus Health Research Fellowship -Health Research Council of New Zealand (18/111). Perminder S Sachdev acknowledges funding from the NHMRC Australia. Abdallah M Samy acknowledges support from a fellowship from the Egyptian Fulbright Mission Program. Milena M Santric-Milicevic acknowledges support from the Ministry of Education, Science and Technological Development of the Republic of Serbia (Contract No. 175087). Rodrigo Sarmiento-Suarez acknowledges institutional support from University of Applied and Environmental Sciences in Bogota, Colombia, and Carlos III Institute of Health in Madrid, Spain. Maria Ines Schmidt acknowledges grants from the Foundation for the Support of Research of the State of Rio Grande do Sul (IATS and PrInt) and the Brazilian Ministry of Health. Sheikh Mohammed Shariful Islam acknowledges a fellowship from the National Heart Foundation of Australia and Deakin University. Aziz Sheikh acknowledges support from Health Data Research UK. Kenji Shibuya acknowledges Japan Ministry of Education, Culture, Sports, Science and Technology. Joan B Soriano acknowledges support by Centro de Investigacion en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. Rafael Tabares-Seisdedos acknowledges partial support from grant PI17/00719 from ISCIII-FEDER. Santosh Kumar Tadakamadla acknowledges support from the National Health and Medical Research Council Early Career Fellowship, Australia. Marcello Tonelli acknowledges the David Freeze Chair in Health Services Research at the University of Calgary, AB, Canada., "Peer Reviewed"
Published: 2020
Full Text: View/download PDF

37. Prospective qualification of early cerebral biomarkers in a randomised trial of treatment with xenon combined with moderate hypothermia after birth asphyxiaResearch in context

Author: Denis Azzopardi, Andrew T. Chew, Aniko Deierl, Angela Huertas, Nicola J. Robertson, Nora Tusor, and A. David Edwards
Subjects: Medicine, Medicine (General), R5-920
Abstract: Background: The TOBY-Xe proof of concept randomised trial found no effect of xenon combined with hypothermia after birth asphyxia on the lactate to N-acetyl aspartate ratio (Lac/NAA) in the thalamus and fractional anisotropy (FA) in white matter tracts measured within 15 days of birth. To confirm that these biomarkers are qualified to predict long-term outcome after neural rescue therapy we assessed surviving participants at 2–3 years of age. Methods: Of the 92 infants in TOBY-Xe, one was omitted from the study, 69 survived and we assessed 62 participants, 32 in the hypothermia and xenon and 30 in the hypothermia only groups. We examined the relation between Lac/NAA and FA and the scores of the Bayley Scales of Infant and Toddler Development III and calculated their predictive accuracy for moderate or severe disability or death. Results: Fifteen of 62 participants (24%) developed moderate/severe disability, and 22/92 (24%) died.The Lac/NAA ratio (difference in medians 0.628, 95% CI -0.392 to 4.684) and FA (difference in means −0.055, 95% CI -0.033 to −0.077) differed significantly between participants with or without moderate or severe disability or death and were significantly related with development scores in both groups. Adverse outcomes were correctly identified in 95.65% of cases by Lac/NAA and 78.79% by FA, with adequate mean calibration of the model. Interpretation: The results confirm the qualification of the cerebral magnetic resonance biomarkers employed in the TOBY-Xe study as predictors of outcome after neuroprotective therapy. Fund: The Centre for the Developing Brain, King's College London, UK. Keywords: Encephalopathy, Asphyxia, Biomarkers, Magnetic resonance spectroscopy, Magnetic resonance tensor imaging, Perinatal brain injury
Published: 2019
Full Text: View/download PDF

38. A three-year post-graduate Doctorate in Pharmacy course incorporating professional, experiential and research activities: A collaborative innovative approach

Author: Janis Vella, Maresca Attard Pizzuto, Nicolette Sammut Bartolo, Francesca Wirth, Louise Grech, Jennifer Pham, Christina Mactal Haaf, Alan Lau, Anthony Serracino Inglott, and Lilian M. Azzopardi
Subjects: Bologna declaration, Doctorate in Pharmacy, leadership, Pharmacy education, Special aspects of education, LC8-6691, Medicine
Abstract: Background A three-year post-graduate international Doctorate in Pharmacy collaborative course, was launched by the Department of Pharmacy, University of Malta in collaboration with the College of Pharmacy, University of Illinois at Chicago. Aim and rationale To demonstrate that the professional Doctorate in Pharmacy (i) fits the requirements of a Level 8 degree according to the Bologna process, (ii) helps graduates develop competencies and attributes in proficiency in clinical and professional aspects, (iii) has a research component that provides the right level of abilities to participate in research initiatives and to interpret research outcomes, (iv) enables graduates to obtain leadership characteristics. Approach The unique characteristics of the course were evaluated through an outcomes result-oriented measurement. Leadership aspects were measured through policies and strategies presented by students and graduates. Outcomes i) course is in line with the Bologna declaration, ii) research work shown in the dissertation satisfied competencies required iii) research abilities have been examined through a third party and found to be compliant with acquiring of concepts in the design, carrying out, assessment of outcomes and interpretation of results of the research study carried out by each student, and iv) leadership characteristics were shown by the positions taken up by the graduates and early outcomes from these positions. Conclusion Learning activities enable development of professionals able to merge scientific and practice aspects in the evaluation of innovative therapies, the use of medicines and patient monitoring, and in pharmaceutical policy development and regulation. Leadership positions taken up by graduates point to the acquisition of leadership skills by graduates. Next Steps The authors are happy to extend collaboration for this model to be adapted by other institutions for the curricular development entailed in this programme to enhance and improve an innovative aspect in the evolvement of the pharmacy profession on the international scenario.
Published: 2021

39. Variegate Porphyria Triggered by Acute Hepatitis A Infection

Author: Daniel Micallef, Charlton Agius, Charles Mallia-Azzopardi, Gerald Buhagiar, and Lawrence Scerri
Subjects: variegate porphyria, hepatitis a, Medicine
Abstract: Background: Variegate porphyria (VP) is a rare disorder of haem biosynthesis. We report a novel association with hepatitis A infection. Patient and methods: A 31-year-old man was diagnosed with acute hepatitis A infection. During recovery, he presented with abdominal pain and a photoaggravated blistering skin eruption. Results: Urine porphyrin precursors were markedly raised with high coproporphyrin III isomer levels. Faecal protoporphyrin levels were markedly increased and a maximum plasma fluorescence emission at 629 nm was noted. Discussion: Acute hepatitis A infection, and the associated metabolic stress exerted on the haem biosynthetic pathway, induced overt presentation of latent VP.
Published: 2020
Full Text: View/download PDF

40. Lymphadenopathy after Initiating HAART in an HIV-positive Patient with Kaposi's Sarcoma: a Case of Multicentric Castleman's Disease

Author: Daniel Micallef, Jason Attard, Charles Mallia Azzopardi, and Michael John Boffa
Subjects: Castleman's disease, Kaposi's sarcoma, immune reconstitution inflammatory syndrome, Medicine
Abstract: We present the case of a 33-year-old lady who was diagnosed with disseminated Kaposi’s sarcoma and HIV infection. The patient improved on highly active antiretroviral therapy (HAART), however, nine days into treatment, she became febrile and dyspnoeic and developed tender cervical and axillary lymphadenopathy. Despite treatment for suspected sepsis and immune reconstitution, she died in intensive care. Lymph node biopsies revealed coexistent Castleman’s disease and Kaposi’s sarcoma. Initiation of HAART can be rarely associated with unmasking and rapid progression of Castleman’s disease, a phenomenon called immune reconstitution. Urgent investigation and treatment with agents such as steroids and cytotoxic drugs can be life-saving.
Published: 2015
Full Text: View/download PDF

41. Laryngeal Lymphoma: The High and Low Grades of Rare Lymphoma Involvement Sites

Author: Charles Paul Azzopardi, James Degaetano, Alexandra Betts, Eric Farrugia, Claude Magri, Nicholas Refalo, Alexander Gatt, and David J. Camilleri
Subjects: Medicine
Abstract: The larynx is an extremely rare site of involvement by lymphomatous disease. We present two cases of isolated laryngeal high-grade and another low-grade lymphoma, together with a literature review of laryngeal lymphoma management.
Published: 2014
Full Text: View/download PDF

42. A push-pull CORF model of a simple cell with antiphase inhibition improves SNR and contour detection.

Author: George Azzopardi, Antonio Rodríguez-Sánchez, Justus Piater, and Nicolai Petkov
Subjects: Medicine, Science
Abstract: We propose a computational model of a simple cell with push-pull inhibition, a property that is observed in many real simple cells. It is based on an existing model called Combination of Receptive Fields or CORF for brevity. A CORF model uses as afferent inputs the responses of model LGN cells with appropriately aligned center-surround receptive fields, and combines their output with a weighted geometric mean. The output of the proposed model simple cell with push-pull inhibition, which we call push-pull CORF, is computed as the response of a CORF model cell that is selective for a stimulus with preferred orientation and preferred contrast minus a fraction of the response of a CORF model cell that responds to the same stimulus but of opposite contrast. We demonstrate that the proposed push-pull CORF model improves signal-to-noise ratio (SNR) and achieves further properties that are observed in real simple cells, namely separability of spatial frequency and orientation as well as contrast-dependent changes in spatial frequency tuning. We also demonstrate the effectiveness of the proposed push-pull CORF model in contour detection, which is believed to be the primary biological role of simple cells. We use the RuG (40 images) and Berkeley (500 images) benchmark data sets of images with natural scenes and show that the proposed model outperforms, with very high statistical significance, the basic CORF model without inhibition, Gabor-based models with isotropic surround inhibition, and the Canny edge detector. The push-pull CORF model that we propose is a contribution to a better understanding of how visual information is processed in the brain as it provides the ability to reproduce a wider range of properties exhibited by real simple cells. As a result of push-pull inhibition a CORF model exhibits an improved SNR, which is the reason for a more effective contour detection.
Published: 2014
Full Text: View/download PDF

43. Implementation and conduct of therapeutic hypothermia for perinatal asphyxial encephalopathy in the UK--analysis of national data.

Author: Denis Azzopardi, Brenda Strohm, Louise Linsell, Anna Hobson, Edmund Juszczak, Jennifer J Kurinczuk, Peter Brocklehurst, A David Edwards, and UK TOBY Cooling Register
Subjects: Medicine, Science
Abstract: Delay in implementing new treatments into clinical practice results in considerable health and economic opportunity costs. Data from the UK TOBY Cooling Register provides the opportunity to examine how one new effective therapy for newborn infants suspected of suffering asphyxial encephalopathy--therapeutic hypothermia- was implemented in the UK.We analysed returned data forms from inception of the Register in December 2006 to the end of July 2011. Data forms were received for 1384 (67%) of the 2069 infants registered. The monthly rate of notifications increased from median {IQR} 18 {15-31} to 33 {30-39} after the announcement of the results of the recent TOBY trial, and to 50 {36-55} after their publication. This rate further increased to 70 {64-83} following official endorsement of the therapy, and is now close to the expected numbers of eligible infants. Cooling was started at 3.3 {1.5-5.5} hours after birth and the time taken to achieve the target 33-34 °C rectal temperature was 1 {0-3} hours. The rectal temperature was in the target range in 83% of measurements. From 2006 to 2011 there was evidence of extension of treatment to slightly less severely affected infants. 278 of 1362 (20%) infants died at 2.9 {1.4-4.1} days of age. The rates of death fell slightly over the period of the Register and, at two years of age cerebral palsy was diagnosed in 22% of infants; half of these were spastic bilateral. Factors independently associated with adverse outcome were clinical seizures prior to cooling (p
Published: 2012
Full Text: View/download PDF

44. Roles of electrostatics and conformation in protein-crystal interactions.

Author: Paul V Azzopardi, Jason O'Young, Gilles Lajoie, Mikko Karttunen, Harvey A Goldberg, and Graeme K Hunter
Subjects: Medicine, Science
Abstract: In vitro studies have shown that the phosphoprotein osteopontin (OPN) inhibits the nucleation and growth of hydroxyapatite (HA) and other biominerals. In vivo, OPN is believed to prevent the calcification of soft tissues. However, the nature of the interaction between OPN and HA is not understood. In the computational part of the present study, we used molecular dynamics simulations to predict the adsorption of 19 peptides, each 16 amino acids long and collectively covering the entire sequence of OPN, to the {100} face of HA. This analysis showed that there is an inverse relationship between predicted strength of adsorption and peptide isoelectric point (P
Published: 2010
Full Text: View/download PDF

45. A time and motion study of patients presenting at the accident and emergency department at Mater Dei Hospital

Author: Ellul Robert, Cutajar Karl, Cauchi Marija, Azzopardi Matthias, Mallia-Azzopardi Charles, and Grech Victor
Subjects: Medicine, Biology (General), QH301-705.5, Science (General), Q1-390
Abstract: Abstract Background To carry out a time and motion study of patients presenting at the Emergency Department (ED) by measuring waiting times at the ED dept throughout the day. The objectives were: • to determine whether waiting times are prolonged, and • if prolonged, at which station(s) bottlenecks occur most often in terms of duration and frequency. Results will be compared to the United Kingdom guidelines of stay at the emergency department. Methods A group of 11 medical students monitored all patients who attended ED between 0600 hours on the 25th August and 0600 hours on the 1st September 2008. For each 24 hour period, students were assigned to the triage room and the 3 priority areas where they monitored all patient-related activity, movement and waiting times so that length of stay (LOS) could be recorded. The key data recorded included patient characteristics, waiting times at various ED process stages, tests performed, specialist consultations and follow up until admitted, discharged, or referred to another hospital area. Average waiting times were calculated for each priority area. Bottle-necks and major limiting factors were identified. Results were compared against the United Kingdom benchmarks - i.e. 1 hour until first assessment, and 4 hours before admitting/discharge. Results 1779 patients presented to the ED in the week monitored. As expected, patients in the lesser priority areas (i.e. 2 & 3) waited longer before being assessed by staff. Patients requiring laboratory and imaging investigations had a prolonged length of stay, which varied depending on specific tests ordered. Specialty consultation was associated with longer waiting times. A major bottleneck identified was waiting times for inpatient admission. Conclusions In conclusion, it was found that 30.3% of priority 1 patients, 86.3% of priority 2 patients and 76.8% of priority 3 patients waited more than 1 hour for first assessment. We conclude by proposing several changes that may expedite throughput.
Published: 2011
Full Text: View/download PDF

Catalog

Books, media, physical & digital resources

See catalog results

Searchworks

Select search scope, currently: Articles Catalog books, media & more in Jio Institute collections Articles journal articles & other e-resources

Search

Search Constraints

Refine your results

Search Limiters

Topic

Publication Year Range

Language

Publication Type

Journal

Database

Publisher

45 results on '"Azzopardi P"'

Search Results

Catalog

Select search scope, currently: Articles

Catalog

books, media & more in Jio Institute collections

Articles

journal articles & other e-resources