Browsing by Subject "DEATHS"

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  • Haagsma, Juanita A.; James, Spencer L.; Castle, Chris D.; Dingels, Zachary; Fox, Jack T.; Hamilton, Erin B.; Liu, Zichen; Lucchesi, Lydia R.; Roberts, Nicholas L. S.; Sylte, Dillon O.; Adebayo, Oladimeji M.; Ahmadi, Alireza; Ahmed, Muktar Beshir; Aichour, Miloud Taki Eddine; Alahdab, Fares; Alghnam, Suliman A.; Aljunid, Syed Mohamed; Al-Raddadi, Rajaa M.; Alsharif, Ubai; Altirkawi, Khalid; Anjomshoa, Mina; Antonio, Carl Abelardo T.; Appiah, Seth Christopher Yaw; Aremu, Olatunde; Arora, Amit; Asayesh, Hamid; Assadi, Reza; Awasthi, Ashish; Ayala Quintanilla, Beatriz Paulina; Balalla, Shivanthi; Banstola, Amrit; Barker-Collo, Suzanne Lyn; Baernighausen, Till Winfried; Bazargan-Hejazi, Shahrzad; Bedi, Neeraj; Behzadifar, Masoud; Behzadifar, Meysam; Benjet, Corina; Bennett, Derrick A.; Bensenor, Isabela M.; Bhaumik, Soumyadeep; Bhutta, Zulfiqar A.; Bijani, Ali; Borges, Guilherme; Borschmann, Rohan; Bose, Dipan; Boufous, Soufiane; Brazinova, Alexandra; Rincon, Julio Cesar Campuzano; Cardenas, Rosario; Carrero, Juan J.; Carvalho, Felix; Castaneda-Orjuela, Carlos A.; Catala-Lopez, Ferran; Choi, Jee-Young J.; Christopher, Devasahayam J.; Crowe, Christopher Stephen; Dalal, Koustuv; Daryani, Ahmad; Davitoiu, Dragos Virgil; Degenhardt, Louisa; De Leo, Diego; De Neve, Jan-Walter; Deribe, Kebede; Dessie, Getenet Ayalew; deVeber, Gabrielle Aline; Dharmaratne, Samath Dhamminda; Linh Phuong Doan; Dolan, Kate A.; Driscoll, Tim Robert; Dubey, Manisha; El-Khatib, Ziad; Ellingsen, Christian Lycke; Zaki, Maysaa El Sayed; Endries, Aman Yesuf; Eskandarieh, Sharareh; Faro, Andre; Fereshtehnejad, Seyed-Mohammad; Fernandes, Eduarda; Filip, Irina; Fischer, Florian; Franklin, Richard Charles; Fukumoto, Takeshi; Gezae, Kebede Embaye; Gill, Tiffany K.; Goulart, Alessandra C.; Grada, Ayman; Guo, Yuming; Gupta, Rahul; Bidgoli, Hassan Haghparast; Haj-Mirzaian, Arvin; Haj-Mirzaian, Arya; Hamadeh, Randah R.; Hamidi, Samer; Maria Haro, Josep; Hassankhani, Hadi; Hassen, Hamid Yimam; Havmoeller, Rasmus; Hendrie, Delia; Henok, Andualem; Hijar, Martha; Hole, Michael K.; Rad, Enayatollah Homaie; Hossain, Naznin; Hostiuc, Sorin; Hu, Guoqing; Igumbor, Ehimario U.; Ilesanmi, Olayinka Stephen; Irvani, Seyed Sina Naghibi; Islam, Sheikh Mohammed Shariful; Ivers, Rebecca Q.; Jacobsen, Kathryn H.; Jahanmehr, Nader; Jakovljevic, Mihajlo; Jayatilleke, Achala Upendra; Jha, Ravi Prakash; Jonas, Jost B.; Shushtari, Zahra Jorjoran; Jozwiak, Jacek Jerzy; Jurisson, Mikk; Kabir, Ali; Kalani, Rizwan; Kasaeian, Amir; Kelbore, Abraham Getachew; Kengne, Andre Pascal; Khader, Yousef Saleh; Khafaie, Morteza Abdullatif; Khalid, Nauman; Khan, Ejaz Ahmad; Khoja, Abdullah T.; Kiadaliri, Aliasghar A.; Kim, Young-Eun; Kim, Daniel; Kisa, Adnan; Koyanagi, Ai; Defo, Barthelemy Kuate; Bicer, Burcu Kucuk; Kumar, Manasi; Lalloo, Ratilal; Lam, Hilton; Lami, Faris Hasan; Lansingh, Van C.; Leasher, Janet L.; Li, Shanshan; Linn, Shai; Lunevicius, Raimundas; Machado, Flavia R.; Abd El Razek, Hassan Magdy; Abd El Razek, Muhammed Magdy; Mahotra, Narayan Bahadur; Majdan, Marek; Majeed, Azeem; Malekzadeh, Reza; Malik, Manzoor Ahmad; Malta, Deborah Carvalho; Manda, Ana-Laura; Mansournia, Mohammad Ali; Massenburg, Benjamin Ballard; Maulik, Pallab K.; Meheretu, Hailemariam Abiy Alemu; Mehndiratta, Man Mohan; Melese, Addisu; Mendoza, Walter; Mengesha, Melkamu Merid; Meretoja, Tuomo J.; Meretoja, Atte; Mestrovic, Tomislav; Miazgowski, Tomasz; Miller, Ted R.; Mini, G. K.; Mirrakhimov, Erkin M.; Moazen, Babak; Mezerji, Naser Mohammad Gholi; Mohammadibakhsh, Roghayeh; Mohammed, Shafiu; Molokhia, Mariam; Monasta, Lorenzo; Mondello, Stefania; Montero-Zamora, Pablo A.; Moodley, Yoshan; Moosazadeh, Mahmood; Moradi, Ghobad; Moradi-Lakeh, Maziar; Morawska, Lidia; Moreno Velasquez, Ilais; Morrison, Shane Douglas; Moschos, Marilita M.; Mousavi, Seyyed Meysam; Murthy, Srinivas; Musa, Kamarul Imran; Naik, Gurudatta; Najafi, Farid; Nangia, Vinay; Nascimento, Bruno Ramos; Ndwandwe, Duduzile Edith; Negoi, Ionut; Trang Huyen Nguyen; Son Hoang Nguyen; Long Hoang Nguyen; Huong Lan Thi Nguyen; Ningrum, Dina Nur Anggraini; Nirayo, Yirga Legesse; Ofori-Asenso, Richard; Ogbo, Felix Akpojene; Oh, In-Hwan; Oladimeji, Olanrewaju; Olagunju, Andrew T.; Olagunju, Tinuke O.; Olivares, Pedro R.; Orpana, Heather M.; Otstavnov, Stanislav S.; Mahesh, P. A.; Pakhale, Smita; Park, Eun-Kee; Patton, George C.; Pesudovs, Konrad; Phillips, Michael R.; Polinder, Suzanne; Prakash, Swayam; Radfar, Amir; Rafay, Anwar; Rafiei, Alireza; Rahimi, Siavash; Rahimi-Movaghar, Vafa; Rahman, Muhammad Aziz; Rai, Rajesh Kumar; Ramezanzadeh, Kiana; Rawaf, Salman; Rawaf, David Laith; Renzaho, Andre M. N.; Resnikoff, Serge; Rezaeian, Shahab; Roever, Leonardo; Ronfani, Luca; Roshandel, Gholamreza; Sabde, Yogesh Damodar; Saddik, Basema; Salamati, Payman; Salimi, Yahya; Salz, Inbal; Samy, Abdallah M.; Sanabria, Juan; Riera, Lidia Sanchez; Milicevic, Milena M. Santric; Satpathy, Maheswar; Sawhney, Monika; Sawyer, Susan M.; Saxena, Sonia; Saylan, Mete; Schneider, Ione J. C.; Schwebel, David C.; Seedat, Soraya; Sepanlou, Sadaf G.; Shaikh, Masood Ali; Shams-Beyranvand, Mehran; Shamsizadeh, Morteza; Sharif-Alhoseini, Mahdi; Sheikh, Aziz; Shen, Jiabin; Shigematsu, Mika; Shiri, Rahman; Shiue, Ivy; Silva, Joao Pedro; Singh, Jasvinder A.; Sinha, Dhirendra Narain; Soares Filho, Adauto Martins; Soriano, Joan B.; Soshnikov, Sergey; Soyiri, Ireneous N.; Starodubov, Vladimir; Stein, Dan J.; Stokes, Mark A.; Sufiyan, Mu'awiyyah Babale; Sunshine, Jacob E.; Sykes, Bryan L.; Tabares-Seisdedos, Rafael; Tabb, Karen M.; Tehrani-Banihashemi, Arash; Tessema, Gizachew Assefa; Thakur, Jarnail Singh; Khanh Bao Tran; Bach Xuan Tran; Car, Lorainne Tudor; Uthman, Olalekan A.; Uzochukwu, Benjamin S. Chudi; Valdez, Pascual R.; Varavikova, Elena; Nogales Vasconcelos, Ana Maria; Venketasubramanian, Narayanaswamy; Violante, Francesco S.; Vlassov, Vasily; Waheed, Yasir; Wang, Yuan-Pang; Wijeratne, Tissa; Winkler, Andrea Sylvia; Yadav, Priyanka; Yano, Yuichiro; Yenesew, Muluken Azage; Yip, Paul; Yisma, Engida; Yonemoto, Naohiro; Younis, Mustafa Z.; Yu, Chuanhua; Zafar, Shamsa; Zaidi, Zoubida; Bin Zaman, Sojib; Zamani, Mohammad; Zhao, Yong; Zodpey, Sanjay; Hay, Simon; Lopez, Alan D.; Mokdad, Ali H.; Vos, Theo (2020)
    Background The epidemiological transition of non-communicable diseases replacing infectious diseases as the main contributors to disease burden has been well documented in global health literature. Less focus, however, has been given to the relationship between sociodemographic changes and injury. The aim of this study was to examine the association between disability-adjusted life years (DALYs) from injury for 195 countries and territories at different levels along the development spectrum between 1990 and 2017 based on the Global Burden of Disease (GBD) 2017 estimates. Methods Injury mortality was estimated using the GBD mortality database, corrections for garbage coding and CODEm-the cause of death ensemble modelling tool. Morbidity estimation was based on surveys and inpatient and outpatient data sets for 30 cause-of-injury with 47 nature-of-injury categories each. The Socio-demographic Index (SDI) is a composite indicator that includes lagged income per capita, average educational attainment over age 15 years and total fertility rate. Results For many causes of injury, age-standardised DALY rates declined with increasing SDI, although road injury, interpersonal violence and self-harm did not follow this pattern. Particularly for self-harm opposing patterns were observed in regions with similar SDI levels. For road injuries, this effect was less pronounced. Conclusions The overall global pattern is that of declining injury burden with increasing SDI. However, not all injuries follow this pattern, which suggests multiple underlying mechanisms influencing injury DALYs. There is a need for a detailed understanding of these patterns to help to inform national and global efforts to address injury-related health outcomes across the development spectrum.
  • Lohela, Terhi; Campbell, Oona M. R.; Gabrysch, Sabine (2012)
  • Vahamurto, Lauri; Pahkala, Katja; Magnussen, Costan G.; Mikkilä, Vera; Hutri-Kahonen, Nina; Kahonen, Mika; Laitinen, Tomi; Taittonen, Leena; Tosavainen, Paivi; Lehtimaki, Terho; Jokinen, Eero; Telama, Risto; Ronnemaa, Tapio; Viikari, Jorma; Juonala, Markus; Raitakari, Olli (2016)
    Background: Coronary heart disease mortality has been internationally high in eastern Finland. The excessive mortality risk in Eastern compared with western Finns is explained by differences in cardiometabolic risk profile. Current risk profile differences and association with migration have not been reported. We examined the association of place of residence (east west) and specifically migration with cardiometabolic risk markers and carotid intima media thickness (IMT). Methods: The study population included 2204 participants with data available from childhood/youth in 1980 and follow-up examination in 2007. Results: Participants residing in eastern Finland in adulthood had 0.022 +/- 0.004mm higher IMT than Western participants. Those who migrated east-to-west had lower IMT than those staying in the east (0.027 +/- 0.006mm, p
  • Arroyo-Quiroz, Carmen; o'flaherty, Martin; Guzman-Castillo, Maria; Capewell, Simon; Chuquiure-Valenzuela, Eduardo; Jerjes-Sanchez, Carlos; Barrientos-Gutierrez, Tonatiuh (2020)
    Background Mexico is still in the growing phase of the epidemic of coronary heart disease (CHD), with mortality increasing by 48% since 1980. However, no studies have analyzed the drivers of these trends. We aimed to model CHD deaths between 2000 and 2012 in Mexico and to quantify the proportion of the mortality change attributable to advances in medical treatments and to changes in population-wide cardiovascular risk factors. Methods We performed a retrospective analysis using the previously validated IMPACT model to explain observed changes in CHD mortality in Mexican adults. The model integrates nationwide data at two-time points (2000 and 2012) to quantify the effects on CHD mortality attributable to changes in risk factors and therapeutic trends. Results From 2000 to 2012, CHD mortality rates increased by 33.8% in men and by 22.8% in women. The IMPACT model explained 71% of the CHD mortality increase. Most of the mortality increases could be attributed to increases in population risk factors, such as diabetes (43%), physical inactivity (28%) and total cholesterol (24%). Improvements in medical and surgical treatments together prevented or postponed 40.3% of deaths; 10% was attributable to improvements in secondary prevention treatments following MI, while 5.3% to community heart failure treatments. Conclusions CHD mortality in Mexico is increasing due to adverse trends in major risk factors and suboptimal use of CHD treatments. Population-level interventions to reduce CHD risk factors are urgently needed, along with increased access and equitable distribution of therapies
  • Simonsen, K. Wiese; Kriikku, P.; Thelander, G.; Edvardsen, H. M. E.; Thordardottir, S.; Andersen, C. U.; Jonsson, A. K.; Frost, J.; Christoffersen, D. J.; Delaveris, G. J. M.; Ojanperä, I. (2020)
    This study is the seventh report on fatal poisonings among drug addicts in the Nordic countries. In this report, we analyse data from the five Nordic countries: Denmark, Finland, Iceland, Norway and Sweden. Data on gender, number of deaths, places of deaths, age, main intoxicants and substances detected in blood were recorded to obtain national and comparable Nordic data, and to allow comparison with earlier studies conducted in 1984, 1991, 1997, 2002, 2007 and 2012. The death rate (number of deaths per 100,000 inhabitants) was highest in Iceland (6.58) followed closely by Sweden (6.46) and then lowest in Denmark (4.29). The death rate increased in Finland (5.84), Iceland and Sweden and decreased in Denmark compared to earlier studies. The death rate in Norway, which has decreased since 2002, has stabilised around 5.7 as of 2017. Women accounted for 7-23% of the fatal poisonings. The percentage was lowest in Iceland and highest in Finland and Norway. The age range was 14-70 years. The median age (41 years) was highest in Denmark and Norway. The other countries had a median age between 33 and 35 years. Opioids were the main cause of death. Methadone remained the main intoxicant in Denmark, while heroin/morphine was still the main intoxicant in Norway, as was buprenorphine in Finland. However, the picture has changed in Sweden compared to 2012, where heroin/morphine caused most deaths in 2017. Sweden also experienced the highest number of deaths from fentanyl analogues (67 deaths) and buprenorphine (61 deaths). Deaths from fentanyl analogues also occurred in Denmark, Finland and Norway, but to a smaller extent. Over the years, the proportion of opioid deaths has decreased in all countries except Sweden, which has experienced an increase. This decline has been replaced by deaths from CNS stimulants like cocaine, amphetamine and methylenedioxymethamphetamine (MDMA). Cocaine deaths have occurred in all countries but most frequently in Denmark. MDMA deaths have increased in all countries but mostly in Finland. Poly-drug use was widespread, as seen in the earlier studies. The median number of detected drugs per case varied from 4-6. Heroin/morphine, methadone, buprenorphine, cocaine, amphetamine, methamphetamine, MDMA, tetrahydrocannabinol (THC) and benzodiazepines were frequently detected. Pregabalin and gabapentin were detected in all countries, especially pregabalin, which was detected in 42% of the Finnish cases. New psychoactive substances (NPS) occurred in all countries except Iceland. (C) 2020 Elsevier B.V. All rights reserved.
  • Ojanpera, Ilkka; Kriikku, Pirkko; Vuori, Erkki (2016)
    The fatal toxicity index (FTI) is the absolute number of fatal poisonings caused by a particular drug divided by its consumption figure. Consequently, it is a useful measure in evaluating toxicity of the drug and its relevance in fatal poisonings. In this study, we assessed the FTI of medicinal drugs in 3 years (2005, 2009, and 2013) in Finland. As the measure of drug consumption, we used the number of defined daily doses (DDD) per population in each year. There were 70 medicinal drugs in Finland for which the mean FTI expressed as the number of deaths per million DDD over the three study years was higher or equal to 0.1. The Anatomical Therapeutic Chemical (ATC) classification system was used for the classification of the active ingredients of medicinal drugs according to the organ or system which they act on. Of these 70 drugs, 55 drugs (78.6 %) acted on the nervous system (denoted by ATC code N), 11 (15.7 %) on the cardiovascular system (C), three (4.3 %) on the alimentary tract and metabolism (A), and one (1.4 %) on the musculoskeletal system (M). The nervous system drugs consisted of 20 psycholeptics, (ATC code N05), 20 psychoanaleptics (N06), eight analgesics (N02), six antiepileptics (N03), and one other nervous system drug (N07). The highest individual FTIs were associated with the opioids methadone, dextropropoxyphene, oxycodone, tramadol, and morphine; the antipsychotics levomepromazine and chlorprothixene; and the antidepressants doxepin, amitriptyline, trimipramine, and bupropion. Buprenorphine was not included in the study, because most of the fatal buprenorphine poisonings were due to smuggled tablets. A clearly increasing trend in FTI was observed with pregabalin and possibly with bupropion, both drugs emerging as abused substances.
  • Lunetta, Philippe; Kriikku, Pirkko; Tikka, Julius; Ojanpera, Ilkka (2020)
    We describe the sudden death of a middle-aged man while having a sauna under the influence of alpha-pyrrolidinovalerophenone (alpha-PVP) (PM blood concentration: 0.8 mg/L), amphetamine (0.34 mg/L), and other drugs (buprenorphine, benzodiazepines), and engaging in solitary sexual activities. The drugs' effects on the cardio-circulatory system and on body thermoregulation combined with the high temperatures are likely to have been central mechanisms leading to death. The high levels of adrenaline triggered by sexual arousal and the respiratory depression caused by buprenorphine, in association with benzodiazepines, may have also contributed to his death. This previously unreported type of accidental autoerotic death illustrates the risk of using amphetamine-like sympathomimetic drugs (e.g. cathinone derivates) in hot environments such as a sauna, and during sexual activities therein.
  • Gakidou, Emmanuela; Afshin, Ashkan; Abajobir, Amanuel Alemu; Abate, Kalkidan Hassen; Abbafati, Cristiana; Abbas, Kaja M.; Abd-Allah, Foad; Abdulle, Abdishakur M.; Abera, Semaw Ferede; Aboyans, Victor; Abu-Raddad, Laith J.; Abu-Rmeileh, Niveen M. E.; Abyu, Gebre Yitayih; Adedeji, Isaac Akinkunmi; Adetokunboh, Olatunji; Afarideh, Mohsen; Agrawal, Anurag; Agrawal, Sutapa; Kiadaliri, Aliasghar Ahmad; Ahmadieh, Hamid; Ahmed, Muktar Beshir; Aichour, Amani Nidhal; Aichour, Ibtihel; Aichour, Miloud Taki Eddine; Akinyemi, Rufus Olusola; Akseer, Nadia; Alahdab, Fares; Al-Aly, Ziyad; Alam, Khurshid; Alam, Noore; Alam, Tahiya; Alasfoor, Deena; Alene, Kefyalew Addis; Ali, Komal; Alizadeh-Navaei, Reza; Alkerwi, Ala'a; Alla, Francois; Allebeck, Peter; Al-Raddadi, Rajaa; Alsharif, Ubai; Altirkawi, Khalid A.; Alvis-Guzman, Nelson; Amare, Azmeraw T.; Amini, Erfan; Ammar, Walid; Kivimaki, Mika; Lallukka, Tea; Meretoja, Atte; Meretoja, Tuomo J.; Weiderpass, Elisabete; GBD Risk Factors Collaborators (2017)
    Background The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of risk factor exposure and attributable burden of disease. By providing estimates over a long time series, this study can monitor risk exposure trends critical to health surveillance and inform policy debates on the importance of addressing risks in context. Methods We used the comparative risk assessment framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2016. This study included 481 risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk (RR) and exposure estimates from 22 717 randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources, according to the GBD 2016 source counting methods. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. Finally, we explored four drivers of trends in attributable burden: population growth, population ageing, trends in risk exposure, and all other factors combined. Findings Since 1990, exposure increased significantly for 30 risks, did not change significantly for four risks, and decreased significantly for 31 risks. Among risks that are leading causes of burden of disease, child growth failure and household air pollution showed the most significant declines, while metabolic risks, such as body-mass index and high fasting plasma glucose, showed significant increases. In 2016, at Level 3 of the hierarchy, the three leading risk factors in terms of attributable DALYs at the global level for men were smoking (124.1 million DALYs [95% UI 111.2 million to 137.0 million]), high systolic blood pressure (122.2 million DALYs [110.3 million to 133.3 million], and low birthweight and short gestation (83.0 million DALYs [78.3 million to 87.7 million]), and for women, were high systolic blood pressure (89.9 million DALYs [80.9 million to 98.2 million]), high body-mass index (64.8 million DALYs [44.4 million to 87.6 million]), and high fasting plasma glucose (63.8 million DALYs [53.2 million to 76.3 million]). In 2016 in 113 countries, the leading risk factor in terms of attributable DALYs was a metabolic risk factor. Smoking remained among the leading five risk factors for DALYs for 109 countries, while low birthweight and short gestation was the leading risk factor for DALYs in 38 countries, particularly in sub-Saharan Africa and South Asia. In terms of important drivers of change in trends of burden attributable to risk factors, between 2006 and 2016 exposure to risks explains an 9.3% (6.9-11.6) decline in deaths and a 10.8% (8.3-13.1) decrease in DALYs at the global level, while population ageing accounts for 14.9% (12.7-17.5) of deaths and 6.2% (3.9-8.7) of DALYs, and population growth for 12.4% (10.1-14.9) of deaths and 12.4% (10.1-14.9) of DALYs. The largest contribution of trends in risk exposure to disease burden is seen between ages 1 year and 4 years, where a decline of 27.3% (24.9-29.7) of the change in DALYs between 2006 and 2016 can be attributed to declines in exposure to risks. Interpretation Increasingly detailed understanding of the trends in risk exposure and the RRs for each risk-outcome pair provide insights into both the magnitude of health loss attributable to risks and how modification of risk exposure has contributed to health trends. Metabolic risks warrant particular policy attention, due to their large contribution to global disease burden, increasing trends, and variable patterns across countries at the same level of development. GBD 2016 findings show that, while it has huge potential to improve health, risk modification has played a relatively small part in the past decade. Copyright (C) The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
  • GBD 2019 Under-5 Mortality Collabo; Paulson, Katherine R.; Kamath, Aruna M.; Alam, Tahiya; Meretoja, Atte; Meretoja, Tuomo J.; Shiri, Rahman; Wang, Yuan-Pang (2021)
    Background Sustainable Development Goal 3.2 has targeted elimination of preventable child mortality, reduction of neonatal death to less than 12 per 1000 livebirths, and reduction of death of children younger than 5 years to less than 25 per 1000 livebirths, for each country by 2030. To understand current rates, recent trends, and potential trajectories of child mortality for the next decade, we present the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 findings for all-cause mortality and cause-specific mortality in children younger than 5 years of age, with multiple scenarios for child mortality in 2030 that include the consideration of potential effects of COVID-19, and a novel framework for quantifying optimal child survival. Methods We completed all-cause mortality and cause-specific mortality analyses from 204 countries and territories for detailed age groups separately, with aggregated mortality probabilities per 1000 livebirths computed for neonatal mortality rate (NMR) and under-5 mortality rate (USMR). Scenarios for 2030 represent different potential trajectories, notably including potential effects of the COVID-19 pandemic and the potential impact of improvements preferentially targeting neonatal survival. Optimal child survival metrics were developed by age, sex, and cause of death across all GBD location-years. The first metric is a global optimum and is based on the lowest observed mortality, and the second is a survival potential frontier that is based on stochastic frontier analysis of observed mortality and Healthcare Access and Quality Index. Findings Global U5MR decreased from 71.2 deaths per 1000 livebirths (95% uncertainty interval WI] 68.3-74-0) in 2000 to 37.1 (33.2-41.7) in 2019 while global NMR correspondingly declined more slowly from 28.0 deaths per 1000 live births (26.8-29-5) in 2000 to 17.9 (16.3-19-8) in 2019. In 2019,136 (67%) of 204 countries had a USMR at or below the SDG 3.2 threshold and 133 (65%) had an NMR at or below the SDG 3.2 threshold, and the reference scenario suggests that by 2030,154 (75%) of all countries could meet the U5MR targets, and 139 (68%) could meet the NMR targets. Deaths of children younger than 5 years totalled 9.65 million (95% UI 9.05-10.30) in 2000 and 5.05 million (4.27-6.02) in 2019, with the neonatal fraction of these deaths increasing from 39% (3.76 million [95% UI 3.53-4.021) in 2000 to 48% (2.42 million; 2.06-2.86) in 2019. NMR and U5MR were generally higher in males than in females, although there was no statistically significant difference at the global level. Neonatal disorders remained the leading cause of death in children younger than 5 years in 2019, followed by lower respiratory infections, diarrhoeal diseases, congenital birth defects, and malaria. The global optimum analysis suggests NMR could be reduced to as low as 0.80 (95% UI 0.71-0.86) deaths per 1000 livebirths and U5MR to 1.44 (95% UI 1-27-1.58) deaths per 1000 livebirths, and in 2019, there were as many as 1.87 million (95% UI 1-35-2.58; 37% [95% UI 32-43]) of 5.05 million more deaths of children younger than 5 years than the survival potential frontier. Interpretation Global child mortality declined by almost half between 2000 and 2019, but progress remains slower in neonates and 65 (32%) of 204 countries, mostly in sub-Saharan Africa and south Asia, are not on track to meet either SDG 3.2 target by 2030. Focused improvements in perinatal and newborn care, continued and expanded delivery of essential interventions such as vaccination and infection prevention, an enhanced focus on equity, continued focus on poverty reduction and education, and investment in strengthening health systems across the development spectrum have the potential to substantially improve USMR. Given the widespread effects of COVID-19, considerable effort will be required to maintain and accelerate progress. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.
  • Kriikku, Pirkko; Hakkinen, Margareeta; Ojanpera, Ilkka (2018)
    Sublingual buprenorphine is used in opioid maintenance treatment but buprenorphine is also widely abused and causes fatal poisonings. The aim of this study was to investigate buprenorphine-positive fatalities in order to gain novel information on the magnitude and nature of buprenorphine abuse. All post-mortem toxicology cases positive for urinary buprenorphine, including fatal poisonings caused by buprenorphine and fatalities in which the cause of death was unrelated to buprenorphine, in the five year period of 2010-2014 in Finland were characterized according to urine buprenorphine and naloxone concentrations (n = 775). Urine concentrations were used to assess which buprenorphine preparation had been used; mono-buprenorphine or a buprenorphine-naloxone combination, and whether they had been administered parenterally. In at least 28.8% of the buprenorphine-positive cases the drug had been administered parenterally. The majority of the parenteral users (68.6%) had taken mono-buprenorphine. Fatal poisoning was significantly more common among the identified parenteral users (65.5%) than among other users of buprenorphine products (45.3%). The proportion of buprenorphine-related poisoning was similar in identified parenteral users of mono-buprenorphine (68.6%) and buprenorphine-naloxone (64.1%). In nearly all of the fatal poisoningss the deceased had used other drugs and/or alcohol along with buprenorphine (98.7%). The median age of the deceased increased significantly over the study period, from 32 to 38 years. Our results show that there is ongoing parenteral abuse of both mono-buprenorphine and buprenorphine-naloxone combination. Parenteral users of buprenorphine put themselves into a great risk of fatal poisoning or other accidental injury death which is further exacerbated by the frequent polydrug use. (c) 2018 Elsevier B.V. All rights reserved.
  • Rautalin, Ilari; Kallio, Miia; Korja, Miikka (2022)
    Background Postoperative opioid use plays an important role in the global opioid crisis, but little is known about in-hospital opioid use trends of large surgical units. We investigated whether postoperative in-hospital opioid consumption changed in a large academic neurosurgical unit between 2007 and 2018. Methods We extracted the data of consumed opioids in the neurosurgical intensive care unit and two bed wards between 2007 and 2018. Besides overall consumption, we analyzed the trends for weak (tramadol and codeine), strong, and the most commonly used opioids. The use of various opioids was standardized using the defined daily doses (DDDs) of each opioid agent. A linear regression analysis was performed to estimate annual treatment day-adjusted changes with 95% confidence intervals. Results Overall, 121 361 opioid DDDs were consumed during the 196 199 treatment days. Oxycodone was the most commonly used postoperative opioid (49% of all used opioids) in neurosurgery. In the bed wards, the use of oral oxycodone increased 375% (on average 13% (9-17%) per year), and the use of transdermal buprenorphine 930% (on average 26% (9-45%) per year) over the 12-year period. Despite the increased use of strong opioids in the bed wards (on average 3% (1-4%) per year), overall opioid use decreased 39% (on average 6% (4-7%) per year) between 2007 and 2018. Conclusions Due to the increase of strong opioid use in the surgical bed wards, we encourage other large teaching hospitals and surgical units to investigate whether their opioid use trends are similarly worrisome and whether the opioid consumption changes in the hospital setting are transferred to opioid use patterns or opioid-related harms after discharge.
  • Stickley, Andrew; Baburin, Aleksei; Jasilionis, Domantas; Krumins, Juris; Martikainen, Pekka; Kondo, Naoki; Leinsalu, Mall (2021)
    This study examined trends and inequalities in road traffic accident (RTA) mortality in the Baltic countries (Estonia, Latvia, Lithuania) and Finland in relation to large-scale macroeconomic changes in the 2000s. Educational inequalities in RTA mortality in 2000-2003, 2004-2007, 2008-2011 and 2012-2015 among 30-74 year olds were examined using census-linked longitudinal mortality data and by estimating the relative and slope index of inequality. Overall RTA mortality decreased substantially between 2000-2003 and 2012-2015. From 2004-2007 to 2008-2011, the RTA mortality decline accelerated but was larger in the Baltic countries. Among men the RTA mortality decline was mostly driven by a larger fall among the high and middle educated. Among women, the changes in RTA mortality by educational level had no clear pattern. From 2000-2003 to 2012-2015 relative educational inequalities in RTA mortality increased among men, although more in the Baltic countries. Among women the pattern was mixed across countries. Absolute inequalities fell in all countries among both sexes. Educational inequalities in male RTA mortality may be growing because of increasingly less access to safer cars and a more hazardous driving culture among the lower educated.
  • Local Burden Dis Diarrhoea; Wiens, Kirsten E.; Lindstedt, Paulina A.; Blacker, Brigette F.; Meretoja, Tuomo J.; Shiri, Rahman (2020)
    Background Oral rehydration solution (ORS) is a form of oral rehydration therapy (ORT) for diarrhoea that has the potential to drastically reduce child mortality; yet, according to UNICEF estimates, less than half of children younger than 5 years with diarrhoea in low-income and middle-income countries (LMICs) received ORS in 2016. A variety of recommended home fluids (RHF) exist as alternative forms of ORT; however, it is unclear whether RHF prevent child mortality. Previous studies have shown considerable variation between countries in ORS and RHF use, but subnational variation is unknown. This study aims to produce high-resolution geospatial estimates of relative and absolute coverage of ORS, RHF, and ORT (use of either ORS or RHF) in LMICs. Methods We used a Bayesian geostatistical model including 15 spatial covariates and data from 385 household surveys across 94 LMICs to estimate annual proportions of children younger than 5 years of age with diarrhoea who received ORS or RHF (or both) on continuous continent-wide surfaces in 2000-17, and aggregated results to policy-relevant administrative units. Additionally, we analysed geographical inequality in coverage across administrative units and estimated the number of diarrhoeal deaths averted by increased coverage over the study period. Uncertainty in the mean coverage estimates was calculated by taking 250 draws from the posterior joint distribution of the model and creating uncertainty intervals (UIs) with the 2 center dot 5th and 97 center dot 5th percentiles of those 250 draws. Findings While ORS use among children with diarrhoea increased in some countries from 2000 to 2017, coverage remained below 50% in the majority (62 center dot 6%; 12 417 of 19 823) of second administrative-level units and an estimated 6 519 000 children (95% UI 5 254 000-7 733 000) with diarrhoea were not treated with any form of ORT in 2017. Increases in ORS use corresponded with declines in RHF in many locations, resulting in relatively constant overall ORT coverage from 2000 to 2017. Although ORS was uniformly distributed subnationally in some countries, within-country geographical inequalities persisted in others; 11 countries had at least a 50% difference in one of their units compared with the country mean. Increases in ORS use over time were correlated with declines in RHF use and in diarrhoeal mortality in many locations, and an estimated 52 230 diarrhoeal deaths (36 910-68 860) were averted by scaling up of ORS coverage between 2000 and 2017. Finally, we identified key subnational areas in Colombia, Nigeria, and Sudan as examples of where diarrhoeal mortality remains higher than average, while ORS coverage remains lower than average. Interpretation To our knowledge, this study is the first to produce and map subnational estimates of ORS, RHF, and ORT coverage and attributable child diarrhoeal deaths across LMICs from 2000 to 2017, allowing for tracking progress over time. Our novel results, combined with detailed subnational estimates of diarrhoeal morbidity and mortality, can support subnational needs assessments aimed at furthering policy makers' understanding of within-country disparities. Over 50 years after the discovery that led to this simple, cheap, and life-saving therapy, large gains in reducing mortality could still be made by reducing geographical inequalities in ORS coverage. Copyright (c) 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
  • Joensuu, Johanna; Saarijärvi, Hannu; Rouhe, Hanna; Gissler, Mika; Ulander, Veli-Matti; Heinonen, Seppo; Mikkola, Tomi (2021)
    Objectives To explore how the time of delivery influences childbirth experience. Design A retrospective cohort study. Setting Childbirth in the four Helsinki and Uusimaa Hospital District hospitals, Finland, from 2012 to 2018. Participants 105 847 childbirths with a singleton live fetus. Main outcome measures Childbirth experience measured by Visual Analogue Scale (VAS). Results The major difference in average childbirth experience measured by VAS was between primiparas (8.03; 95% CI 8.01 to 8.04) and multiparas (8.47; 95% CI 8.45 to 8.48). Risk ratio (RR) of the low VAS ( Conclusion The maternal childbirth experience depended on the time of delivery. Giving birth during the evening led to impaired childbirth experience in both primiparas and multiparas, compared with delivery at other times. The impact of labour induction on childbirth experience should be further examined. The reorganisation of delivery services and the reduction of birth preparations might affect annual VAS. VAS is a simple method of measuring the complex entity of childbirth experience, and our results indicate its ability to capture temporal variation.
  • Kriikku, Pirkko; Ojanperä, Ilkka (2020)
    Background: Alcohol may cause death directly by acute poisoning, as well as induce illnesses or accidents that lead to death. Our research question was whether the current decreasing trend in acute fatal alcohol poisonings in Finland is a real phenomenon or an artefact caused by possible changes in the process of determining the cause of death. Methods: All cases in the national post-mortem toxicology database in which the underlying cause of death was acute alcohol poisoning in 1987-2018 were investigated in terms of blood alcohol concentration (BAC), age and gender. The number of acute alcohol poisonings was compared to the number of deaths from alcohol induced illness in the post-mortem toxicology database. Results: A total of 12 126 acute alcohol poisoning cases were retrieved. Between 2004 and 2017 the number of acute alcohol poisonings decreased 60.1 %. At the same time the number of alcohol induced illnesses in the study material remained stable or decreased marginally. The median BAC in all acute alcohol poisonings was 3.2 g/kg. The annual median BAC values showed a small but significant decrease over the study period. The proportion of women in acute alcohol poisonings increased significantly over the study period, from 17.1%-22.3%. Women were on average 2.5 years older than men. Conclusions: On grounds of the BAC statistics and supporting evidence, we conclude that the significant decrease in the number of fatal alcohol poisonings is true and likely reflects changes in the overall consumption of alcohol.
  • Radun, Igor; Parkkari, Inkeri; Radun, Jenni; Kaistinen, Jyrki; Kecklund, Göran; Olivier, Jake; Tervo, Timo; Theorell, Töres (2019)
    Objective: Road traffic suicides typically involve a passenger car driver crashing his or her vehicle into a heavy vehicle, because death is almost certain due to the large mass difference between these vehicles. For the same reason, heavy-vehicle drivers typically suffer minor injuries, if any, and have thus received little attention in the research literature. In this study, we focused on heavy-vehicle drivers who were involved as the second party in road suicides in Finland. Methods: We analyzed 138 road suicides (2011-2016) involving a passenger car crashing into a heavy vehicle. We used in-depth road crash investigation data from the Finnish Crash Data Institute. Results: The results showed that all but 2 crashes were head-on collisions. Almost 30% of truck drivers were injured, but only a few suffered serious injuries. More than a quarter reported sick leave following their crash. Injury insurance compensation to heavy-vehicle drivers was just above euro9,000 on average. Material damage to heavy vehicles was significant, with average insurance compensation paid being euro70,500. Three out of 4 truck drivers reported that drivers committing suicide acted abruptly and left them little opportunity for preventive action. Conclusions: Suicides by crashing into heavy vehicles can have an impact on drivers' well-being; however, it is difficult to see how heavy-vehicle drivers could avoid a suicide attempt involving their vehicle.
  • Haagsma, Juanita A.; Charalampous, Periklis; Ariani, Filippo; Gallay, Anne; Moesgaard Iburg, Kim; Nena, Evangelia; Ngwa, Che Henry; Rommel, Alexander; Zelviene, Ausra; Abegaz, Kedir Hussein; Al Hamad, Hanadi; Albano, Luciana; Liliana Andrei, Catalina; Andrei, Tudorel; Antonazzo, Ippazio Cosimo; Aremu, Olatunde; Arumugam, Ashokan; Atreya, Alok; Aujayeb, Avinash; Ayuso-Mateos, Jose Luis; Engelbert Bain, Luchuo; Banach, Maciej; Winfried Baernighausen, Till; Barone-Adesi, Francesco; Beghi, Massimiliano; Bennett, Derrick A.; Bhagavathula, Akshaya S.; Carvalho, Felix; Castelpietra, Giulio; Caterina, Ledda; Chandan, Joht Singh; Couto, Rosa A. S.; Cruz-Martins, Natalia; Damiani, Giovanni; Dastiridou, Anna; Demetriades, Andreas K.; Dias-da-Silva, Diana; Francis Fagbamigbe, Adeniyi; Fereshtehnejad, Seyed-Mohammad; Fernandes, Eduarda; Ferrara, Pietro; Fischer, Florian; Fra Paleo, Urbano; Ghirini, Silvia; Glasbey, James C.; Glavan, Ionela-Roxana; Gomes, Nelson G. M.; Grivna, Michal; Harlianto, Netanja I.; Haro, Josep Maria; Hasan, M. Tasdik; Hostiuc, Sorin; Iavicoli, Ivo; Ilic, Milena D.; Ilic, Irena M.; Jakovljevic, Mihajlo; Jonas, Jost B.; Jerzy Jozwiak, Jacek; Jurisson, Mikk; Kauppila, Joonas H.; Kayode, Gbenga A.; han, Moien A. B.; Kisa, Adnan; Kisa, Sezer; Koyanagi, Ai; Kumar, Manasi; Kurmi, Om P.; La-Vecchia, Carlo; Lamnisos, Demetris; Lasrado, Savita; Lauriola, Paolo; Linn, Shai; Loureiro, Joana A.; Lunevicius, Raimundas; Madureira-Carvalho, Aurea; Mechili, Enkeleint A.; Majeed, Azeem; Menezes, Ritesh G.; Mentis, Alexios-Fotios A.; Meretoja, Atte; Mestrovic, Tomislav; Miazgowski, Tomasz; Miazgowski, Bartosz; Mirica, Andreea; Molokhia, Mariam; Mohammed, Shafiu; Monasta, Lorenzo; Mulita, Francesk; David Naimzada, Mukhammad; Negoi, Ionut; Neupane, Subas; Oancea, Bogdan; Orru, Hans; Otoiu, Adrian; Otstavnov, Nikita; Otstavnov, Stanislav S.; Padron-Monedero, Alicia; Panda-Jonas, Songhomitra; Pardhan, Shahina; Patel, Jay; Pedersini, Paolo; Pinheiro, Marina; Rakovac, Ivo; Rao, Chythra R.; Rawaf, Salman; Rawaf, David Laith; Rodrigues, Violet; Ronfani, Luca; Sagoe, Dominic; Sanmarchi, Francesco; Santric-Milicevic, Milena M.; Sathian, Brijesh; Sheikh, Aziz; Shiri, Rahman; Shivalli, Siddharudha; Dora Sigfusdottir, Inga; Sigurvinsdottir, Rannveig; Yurievich Skryabin, Valentin; Aleksandrovna Skryabina, Anna; Smarandache, Catalin-Gabriel; Socea, Bogdan; Sousa, Raul A. R. C.; Steiropoulos, Paschalis; Tabares-Seisdedos, Rafael; Roberto Tovani-Palone, Marcos; Tozija, Fimka; Van de Velde, Sarah; Juhani Vasankari, Tommi; Veroux, Massimiliano; Violante, Francesco S.; Vlassov, Vasiliy; Wang, Yanzhong; Yadollahpour, Ali; Yaya, Sanni; Sergeevich Zastrozhin, Mikhail; Zastrozhina, Anasthasia; Polinder, Suzanne; Majdan, Marek (2022)
    Background Injury remains a major concern to public health in the European region. Previous iterations of the Global Burden of Disease (GBD) study showed wide variation in injury death and disability adjusted life year (DALY) rates across Europe, indicating injury inequality gaps between sub-regions and countries. The objectives of this study were to: 1) compare GBD 2019 estimates on injury mortality and DALYs across European sub-regions and countries by cause-of-injury category and sex; 2) examine changes in injury DALY rates over a 20 year-period by cause-of-injury category, sub-region and country; and 3) assess inequalities in injury mortality and DALY rates across the countries. Methods We performed a secondary database descriptive study using the GBD 2019 results on injuries in 44 European countries from 2000 to 2019. Inequality in DALY rates between these countries was assessed by calculating the DALY rate ratio between the highest-ranking country and lowest-ranking country in each year. Results In 2019, in Eastern Europe 80 [95% uncertainty interval (UI): 71 to 89] people per 100,000 died from injuries; twice as high compared to Central Europe (38 injury deaths per 100,000; 95% UI 34 to 42) and three times as high compared to Western Europe (27 injury deaths per 100,000; 95%UI 25 to 28). The injury DALY rates showed less pronounced differences between Eastern (5129 DALYs per 100,000; 95% UI: 4547 to 5864), Central (2940 DALYs per 100,000; 95% UI: 2452 to 3546) and Western Europe (1782 DALYs per 100,000; 95% UI: 1523 to 2115). Injury DALY rate was lowest in Italy (1489 DALYs per 100,000) and highest in Ukraine (5553 DALYs per 100,000). The difference in injury DALY rates by country was larger for males compared to females. The DALY rate ratio was highest in 2005, with DALY rate in the lowest-ranking country (Russian Federation) 6.0 times higher compared to the highest-ranking country (Malta). After 2005, the DALY rate ratio between the lowest- and the highest-ranking country gradually decreased to 3.7 in 2019. Conclusions Injury mortality and DALY rates were highest in Eastern Europe and lowest in Western Europe, although differences in injury DALY rates declined rapidly, particularly in the past decade. The injury DALY rate ratio of highest- and lowest-ranking country declined from 2005 onwards, indicating declining inequalities in injuries between European countries.
  • Khanh Bao Tran; Lang, Justin J.; Compton, Kelly; Xu, Rixing; Acheson, Alistair R.; Henrikson, Hannah Jacqueline; Kocarnik, Jonathan M.; Penberthy, Louise; Aali, Amirali; Abbas, Qamar; Abbasi, Behzad; Abbasi-Kangevari, Mohsen; Abbasi-Kangevari, Zeinab; Abbastabar, Hedayat; Abdelmasseh, Michael; Abd-Elsalam, Sherief; Abdelwahab, Ahmed Abdelwahab; Abdoli, Gholamreza; Abdulkadir, Hanan Abdulkadir; Abedi, Aidin; Abegaz, Kedir Hussein; Abidi, Hassan; Aboagye, Richard Gyan; Abolhassani, Hassan; Absalan, Abdorrahim; Abtew, Yonas Derso; Ali, Hiwa Abubaker; Abu-Gharbieh, Eman; Achappa, Basavaprabhu; Acuna, Juan Manuel; Addison, Daniel; Addo, Isaac Yeboah; Adegboye, Oyelola A.; Adesina, Miracle Ayomikun; Adnan, Mohammad; Adnani, Qorinah Estiningtyas Sakilah; Advani, Shailesh M.; Afrin, Sumia; Afzal, Muhammad Sohail; Aggarwal, Manik; Ahinkorah, Bright Opoku; Ahmad, Araz Ramazan; Ahmad, Rizwan; Ahmad, Sohail; Ahmadi, Sepideh; Ahmed, Haroon; Ahmed, Luai A.; Ahmed, Muktar Beshir; Rashid, Tarik Ahmed; Aiman, Wajeeha; Ajami, Marjan; Akalu, Gizachew Taddesse; Akbarzadeh-Khiavi, Mostafa; Aklilu, Addis; Akonde, Maxwell; Akunna, Chisom Joyqueenet; Al Hamad, Hanadi; Alahdab, Fares; Alanezi, Fahad Mashhour; Alanzi, Turki M.; Alessy, Saleh Ali; Algammal, Abdelazeem M.; Al-Hanawi, Mohammed Khaled; Alhassan, Robert Kaba; Ali, Beriwan Abdulqadir; Ali, Liaqat; Ali, Syed Shujait; Alimohamadi, Yousef; Alipour, Vahid; Aljunid, Syed Mohamed; Alkhayyat, Motasem; Al-Maweri, Sadeq Ali Ali; Almustanyir, Sami; Alonso, Nivaldo; Alqalyoobi, Shehabaldin; Al-Raddadi, Rajaa M.; Al-Rifai, Rami H. Hani; Al-Sabah, Salman Khalifah; Al-Tammemi, Alaa B.; Altawalah, Haya; Alvis-Guzman, Nelson; Amare, Firehiwot; Ameyaw, Edward Kwabena; Dehkordi, Javad Javad Aminian; Amirzade-Iranaq, Mohammad Hosein; Amu, Hubert; Amusa, Ganiyu Adeniyi; Ancuceanu, Robert; Anderson, Jason A.; Animut, Yaregal Animut; Anoushiravani, Amir; Anoushirvani, Ali Arash; Ansari-Moghaddam, Alireza; Ansha, Mustafa Geleto; Antony, Benny; Antwi, Maxwell Hubert; Anwar, Sumadi Lukman; Anwer, Razique; Anyasodor, Anayochukwu Edward; Arabloo, Jalal; Arab-Zozani, Morteza; Aremu, Olatunde; Argaw, Ayele Mamo; Ariffin, Hany; Aripov, Timur; Arshad, Muhammad; Al Artaman; Arulappan, Judie; Aruleba, Raphael Taiwo; Aryannejad, Armin; Asaad, Malke; Asemahagn, Mulusew A.; Asemi, Zatollah; Asghari-Jafarabadi, Mohammad; Ashraf, Tahira; Assadi, Reza; Athar, Mohammad; Athari, Seyyed Shamsadin; Null, Maha Mohd Wahbi Atout; Attia, Sameh; Aujayeb, Avinash; Ausloos, Marcel; Avila-Burgos, Leticia; Awedew, Atalel Fentahun; Awoke, Mamaru Ayenew; Awoke, Tewachew; Quintanilla, Beatriz Paulina Ayala; Ayana, Tegegn Mulatu; Ayen, Solomon Shitu; Azadi, Davood; Null, Sina Azadnajafabad; Azami-Aghdash, Saber; Azanaw, Melkalem Mamuye; Azangou-Khyavy, Mohammadreza; Jafari, Amirhossein Azari; Azizi, Hosein; Azzam, Ahmed Y. Y.; Babajani, Amirhesam; Badar, Muhammad; Badiye, Ashish D.; Baghcheghi, Nayereh; Bagheri, Nader; Bagherieh, Sara; Bahadory, Saeed; Baig, Atif Amin; Baker, Jennifer L.; Bakhtiari, Ahad; Bakshi, Ravleen Kaur; Banach, Maciej; Banerjee, Indrajit; Bardhan, Mainak; Barone-Adesi, Francesco; Barra, Fabio; Barrow, Amadou; Bashir, Nasir Z.; Bashiri, Azadeh; Basu, Saurav; Batiha, Abdul-Monim Mohammad; Begum, Aeysha; Bekele, Alehegn Bekele; Belay, Alemayehu Sayih; Belete, Melaku Ashagrie; Belgaumi, Uzma Iqbal; Bell, Arielle Wilder; Belo, Luis; Benzian, Habib; Berhie, Alemshet Yirga; Bermudez, Amiel Nazer C.; Bernabe, Eduardo; Bhagavathula, Akshaya Srikanth; Bhala, Neeraj; Bhandari, Bharti Bhandari; Bhardwaj, Nikha; Bhardwaj, Pankaj; Bhattacharyya, Krittika; Bhojaraja, Vijayalakshmi S.; Bhuyan, Soumitra S.; Bibi, Sadia; Bilchut, Awraris Hailu; Bintoro, Bagas Suryo; Biondi, Antonio; Birega, Mesfin Geremaw Birega; Birhan, Habitu Eshetu; Bjorge, Tone; Blyuss, Oleg; Bodicha, Belay Boda Abule; Bolla, Srinivasa Rao; Boloor, Archith; Bosetti, Cristina; Braithwaite, Dejana; Brauer, Michael; Brenner, Hermann; Briko, Andrey Nikolaevich; Briko, Nikolay Ivanovich; Buchanan, Christina Maree; Bulamu, Norma B.; Bustamante-Teixeira, Maria Teresa; Butt, Muhammad Hammad; Butt, Nadeem Shafique; Butt, Zahid A.; Caetano dos Santos, Florentino Luciano; Camera, Luis Alberto; Cao, Chao; Cao, Yin; Carreras, Giulia; Carvalho, Marcia; Cembranel, Francieli; Cerin, Ester; Chakraborty, Promit Ananyo; Charalampous, Periklis; Chattu, Vijay Kumar; Chimed-Ochir, Odgerel; Chirinos-Caceres, Jesus Lorenzo; Cho, Daniel Youngwhan; Cho, William C. S.; Christopher, Devasahayam J.; Chu, Dinh-Toi; Chukwu, Isaac Sunday; Cohen, Aaron J.; Conde, Joao; Cortas, Sandra; Costa, Vera Marisa; Cruz-Martins, Natalia; Culbreth, Garland T.; Dadras, Omid; Dagnaw, Fentaw Teshome; Dahlawi, Saad M. A.; Dai, Xiaochen; Dandona, Lalit; Dandona, Rakhi; Daneshpajouhnejad, Parnaz; Danielewicz, Anna; An Thi Minh Dao; Soltani, Reza Darvishi Cheshmeh; Darwesh, Aso Mohammad; Das, Saswati; Davitoiu, Dragos Virgil; Esmaeili, Elham Davtalab; De la Hoz, Fernando Pio; Debela, Sisay Abebe; Dehghan, Azizallah; Demisse, Biniyam; Demisse, Fitsum Wolde; DenovaGutiA, Edgar; Derakhshani, Afshin; Molla, Meseret Derbew; Dereje, Diriba; Deribe, Kalkidan Solomon; Desai, Rupak; Desalegn, Markos Desalegn; Dessalegn, Fikadu Nugusu; Dessalegni, Samuel Abebe A.; Dessie, Gashaw; Desta, Abebaw Alemayehu; Dewan, Syed Masudur Rahman; Dharmaratne, Samath Dhamminda; Dhimal, Meghnath; Dianatinasab, Mostafa; Diao, Nancy; Diaz, Daniel; Digesa, Lankamo Ena; Dixit, Shilpi Gupta; Doaei, Saeid; Linh Phuong Doan; Doku, Paul Narh; Dongarwar, Deepa; dos Santos, Wendel Mombaque; Driscoll, Tim Robert; Dsouza, Haneil Larson; Durojaiye, Oyewole Christopher; Edalati, Sareh; Eghbalian, Fatemeh; Ehsani-Chimeh, Elham; Eini, Ebrahim; Ekholuenetale, Michael; Ekundayo, Temitope Cyrus; Ekwueme, Donatus U.; El Tantawi, Maha; Elbahnasawy, Mostafa Ahmed; Elbarazi, Iffat; Elghazaly, Hesham; Elhadi, Muhammed; El-Huneidi, Waseem; Emamian, Mohammad Hassan; Bain, Luchuo Engelbert; Enyew, Daniel Berhanie; Erkhembayar, Ryenchindorj; Eshetu, Tegegne; Eshrati, Babak; Eskandarieh, Sharareh; Espinosa-Montero, Juan; Etaee, Farshid; Etemadimanesh, Azin; Eyayu, Tahir; Ezeonwumelu, Ifeanyi Jude; Ezzikouri, Sayeh; Fagbamigbe, Adeniyi Francis; Fahimi, Saman; Fakhradiyev, Ildar Ravisovich; Faraon, Emerito Jose A.; Fares, Jawad; Farmany, Abbas; Farooque, Umar; Farrokhpour, Hossein; Fasanmi, Abidemi Omolara; Fatehizadeh, Ali; Fatima, Wafa; Fattahi, Hamed; Fekadu, Ginenus; Feleke, Berhanu Elfu; Ferrari, Allegra Allegra; Ferrero, Simone; Desideri, Lorenzo Ferro; Filip, Irina; Fischer, Florian; Foroumadi, Roham; Foroutan, Masoud; Fukumoto, Takeshi; Gaal, Peter Andras; Gad, Mohamed M.; Gadanya, Muktar A.; Gaipov, Abduzhappar; Galehdar, Nasrin; Gallus, Silvano; Garg, Tushar; Fonseca, Mariana Gaspar; Gebremariam, Yosef Haile; Gebremeskel, Teferi Gebru; Gebremichael, Mathewos Alemu; Geda, Yohannes Fikadu; Gela, Yibeltal Yismaw; Gemeda, Belete Negese Belete; Getachew, Melaku; Getachew, Motuma Erena; Ghaffari, Kazem; Ghafourifard, Mansour; Ghamari, Seyyed-Hadi; Nour, Mohammad Ghasemi; Ghassemi, Fariba; Ghimire, Ajnish; Ghith, Nermin; Gholamalizadeh, Maryam; Navashenaq, Jamshid Gholizadeh; Ghozy, Sherief; Gilani, Syed Amir; Gill, Paramjit Singh; Ginindza, Themba G.; Gizaw, Abraham Tamirat T.; Glasbey, James C.; Godos, Justyna; Goel, Amit; Golechha, Mahaveer; Goleij, Pouya; Golinelli, Davide; Golitaleb, Mohamad; Gorini, Giuseppe; Goulart, Barbara Niegia Garcia; Grosso, Giuseppe; Guadie, Habtamu Alganeh; Gubari, Mohammed Ibrahim Mohialdeen; Gudayu, Temesgen Worku; Guerra, Maximiliano Ribeiro; Gunawardane, Damitha Asanga; Gupta, Bhawna; Gupta, Sapna; Gupta, VeerBala; Gupta, Vivek Kumar; Gurara, Mekdes Kondale; Guta, Alemu; Habibzadeh, Parham; Avval, Atlas Haddadi; Hafezi-Nejad, Nima; Ali, Adel Hajj; Haj-Mirzaian, Arvin; Halboub, Esam S.; Halimi, Aram; Halwani, Rabih; Hamadeh, Randah R.; Hameed, Sajid; Hamidi, Samer; Hanif, Asif; Hariri, Sanam; Harlianto, Netanja; Haro, Josep Maria; Hartono, Risky Kusuma; Hasaballah, Ahmed; Hasan, S. M. Mahmudul; Hasani, Hamidreza; Hashemi, Seyedeh Melika; Hassan, Abbas M.; Hassanipour, Soheil; Hayat, Khezar; Heidari, Golnaz; Heidari, Mohammad; Heidarymeybodi, Zahra; Herrera-Serna, Brenda Yuliana; Herteliu, Claudiu; Hezam, Kamal; Hiraike, Yuta; Hlongwa, Mbuzeleni Mbuzeleni; Holla, Ramesh; Holm, Marianne; Horita, Nobuyuki; Hoseini, Mohammad; Hossain, Md Mahbub; Hossain, Mohammad Bellal Hossain; Hosseini, Mohammad-Salar; Hosseinzadeh, Ali; Hosseinzadeh, Mehdi; Hostiuc, Mihaela; Hostiuc, Sorin; Househ, Mowafa; Huang, Junjie; Hugo, Fernando N.; Humayun, Ayesha; Hussain, Salman; Hussein, Nawfal R.; Hwang, Bing-Fang; Ibitoye, Segun Emmanuel; Iftikhar, Pulwasha Maria; Ikuta, Kevin S.; Ilesanmi, Olayinka Stephen; Ilic, Irena M.; Ilic, Milena D.; Immurana, Mustapha; Innos, Kaire; Iranpour, Pooya; Irham, Lalu Muhammad; Islam, Md Shariful; Islam, Rakibul M.; Islami, Farhad; Ismail, Nahlah Elkudssiah; Isola, Gaetano; Iwagami, Masao; Merin, Linda J.; Jaiswal, Abhishek; Jakovljevic, Mihajlo; Jalili, Mahsa; Jalilian, Shahram; Jamshidi, Elham; Jang, Sung-In; Jani, Chinmay T.; Javaheri, Tahereh; Jayarajah, Umesh Umesh; Jayaram, Shubha; Jazayeri, Seyed Behzad; Jebai, Rime; Jemal, Bedru; Jeong, Wonjeong; Jha, Ravi Prakash; Jindal, Har Ashish; John-Akinola, Yetunde O.; Jonas, Jost B.; Joo, Tamas; Joseph, Nitin; Joukar, Farahnaz; Jozwiak, Jacek Jerzy; Jarisson, Mikk; Kabir, Ali; Kacimi, Salah Eddine Oussama; Kadashetti, Vidya; Kahe, Farima; Kakodkar, Pradnya Vishal; Kalankesh, Leila R.; Kalhor, Rohollah; Kamal, Vineet Kumar; Kamangar, Farin; Kamath, Ashwin; Kanchan, Tanuj; Kandaswamy, Eswar; Kandel, Himal; Kang, HyeJung; Kanno, Girum Gebremeskel; Kapoor, Neeti; Kar, Sitanshu Sekhar; Karanth, Shama D.; Karaye, Ibraheem M.; Karch, AndrA; Karimi, Amirali; Kassa, Bekalu Getnet; Katoto, Patrick D. M. C.; Kauppila, Joonas H.; Kaur, Harkiran; Kebede, Abinet Gebremickael; Keikavoosi-Arani, Leila; Kejela, Gemechu Gemechu; Bohan, Phillip M. Kemp; Keramati, Maryam; Keykhaei, Mohammad; Khajuria, Himanshu; Khan, Abbas; Khan, Abdul Aziz Khan; Khan, Ejaz Ahmad; Khan, Gulfaraz; Khan, Md Nuruzzaman; Ab Khan, Moien; Khanali, Javad; Khatab, Khaled; Khatatbeh, Moawiah Mohammad; Khatib, Mahalaqua Nazli; Khayamzadeh, Maryam; Kashani, Hamid Reza Khayat; Tabari, Mohammad Amin Khazeei; Khezeli, Mehdi; Khodadost, Mahmoud; Kim, Min Seo; Kim, Yun Jin; Kisa, Adnan; Kisa, Sezer; Klugar, Miloslav; Klugarova, Jitka; Kolahi, Ali-Asghar; Kolkhir, Pavel; Kompani, Farzad; Koul, Parvaiz A.; Laxminarayana, Sindhura Lakshmi Koulmane; Koyanagi, Ai; Krishan, Kewal; Krishnamoorthy, Yuvaraj; Bicer, Burcu Kucuk; Kugbey, Nuworza; Kulimbet, Mukhtar; Kumar, Akshay; Kumar, G. Anil; Kumar, Narinder; Kurmi, Om P.; Kuttikkattu, Ambily; La Vecchia, Carlo; Lahiri, Arista; Lal, Dharmesh Kumar; Lam, Judit; Lan, Qing; Landires, Ivan; Larijani, Bagher; Lasrado, Savita; Lau, Jerrald; Lauriola, Paolo; Ledda, Caterina; Lee, Sang-woong; Lee, Shaun Wen Huey; Lee, Wei-Chen; Lee, Yeong Yeh; Lee, Yo Han; Legesse, Samson Mideksa; Leigh, James; Leong, Elvynna; Li, Ming-Chieh; Lim, Stephen S.; Liu, Gang; Liu, Jue; Lo, Chun-Han; Lohiya, Ayush; Lopukhov, Platon D.; Lorenzovici, Laszla; Lotfi, Mojgan; Loureiro, Joana A.; Lunevicius, Raimundas; Madadizadeh, Farzan; Mafi, Ahmad R.; Magdeldin, Sameh; Mahjoub, Soleiman; Mahmoodpoor, Ata; Mahmoudi, Morteza; Mahmoudimanesh, Marzieh; Mahumud, Rashidul Alam; Majeed, Azeem; Majidpoor, Jamal; Makki, Alaa; Makris, Konstantinos Christos; Rad, Elaheh Malakan; Malekpour, Mohammad-Reza; Malekzadeh, Reza; Malik, Ahmad Azam; Mallhi, Tauqeer Hussain; Mallya, Sneha Deepak; Mamun, Mohammed A.; Manda, Ana Laura; Mansour-Ghanaei, Fariborz; Mansouri, Borhan; Mansournia, Mohammad Ali; Mantovani, Lorenzo Giovanni; Martini, Santi; Martorell, Miquel; Masoudi, Sahar; Masoumi, Seyedeh Zahra; Matei, Clara N.; Mathews, Elezebeth; Mathur, Manu Raj; Mathur, Vasundhara; McKee, Martin; Meena, Jitendra Kumar; Mehmood, Khalid; Nasab, Entezar Mehrabi; Mehrotra, Ravi; Melese, Addisu; Mendoza, Walter; Menezes, Ritesh G.; Mengesha, SIsay Derso; Mensah, Laverne G.; Mentis, Alexios-Fotios A.; Mera-Mamian, Andry Yasmid Mera; Meretoja, Tuomo J.; Merid, Mehari Woldemariam; Mersha, Amanual Getnet; Meselu, Belsity Temesgen; Meshkat, Mahboobeh; Mestrovic, Tomislav; Jonasson, Junmei Miao; Miazgowski, Tomasz; Michalek, Irmina Maria; Mijena, Gelana Fekadu Worku; Miller, Ted R.; Mir, Shabir Ahmad; Mirinezhad, Seyed Kazem; Mirmoeeni, Seyyedmohammadsadeq; Mirza-Aghazadeh-Attari, Mohammad; Mirzaei, Hamed; Mirzaei, Hamid Reza; Misganaw, Abay Sisay; Misra, Sanjeev; AbdulmuhsinMohammad, Karzan; Mohammadi, Esmaeil; Mohammadi, Mokhtar; Mohammadian-Hafshejani, Abdollah; Mohammadpourhodki, Reza; Mohammed, Arif; Mohammed, Shafiu; Mohan, Syam; Mohseni, Mohammad; Moka, Nagabhishek; Mokdad, Ali H.; Molassiotis, Alex; Molokhia, Mariam; Momenzadeh, Kaveh; Momtazmanesh, Sara; Monasta, Lorenzo; Mons, Ute; Al Montasir, Ahmed; Montazeri, Fateme; Montero, Arnulfo; Moosavi, Mohammad Amin; Moradi, Abdolvahab; Moradi, Yousef; Sarabi, Mostafa Moradi; Moraga, Paula; Morawska, Lidia; Morrison, Shane Douglas; Morze, Jakub; Mosapour, Abbas; Mostafavi, Ebrahim; Mousavi, Seyyed Meysam; Isfahani, Haleh Mousavi; Khaneghah, Amin Mousavi; Mpundu-Kaambwa, Christine; Mubarik, Sumaira; Mulita, Francesk; Munblit, Daniel; Munro, Sandra B.; Murillo-Zamora, Efran; Musa, Jonah; Nabhan, Ashraf F.; Nagarajan, Ahamarshan Jayaraman; Nagaraju, Shankar Prasad; Nagel, Gabriele; Naghipour, Mohammadreza; Naimzada, Mukhammad David; Nair, Tapas Sadasivan; Naqvi, Atta Abbas; Swamy, Sreenivas Narasimha; Narayana, Aparna Ichalangod; Nassereldine, Hasan; Natto, Zuhair S.; Nayak, Biswa Prakash; Ndejjo, Rawlance; Nduaguba, Sabina Onyinye; Negash, Wogene Wogene; Nejadghaderi, Seyed Aria; Nejati, Kazem; Kandel, Sandhya Neupane; Huy Van Nguyen Nguyen; Niazi, Robina Khan; Noor, Nurulamin M.; Noori, Maryam; Noroozi, Nafise; Nouraei, Hasti; Nowroozi, Ali; Nunez-Samudio, Virginia; Nzoputam, Chimezie Igwegbe; Nzoputam, Ogochukwu Janet; Oancea, Bogdan; Odukoya, Oluwakemi Ololade; Oghenetega, Onome Bright; Ogunsakin, Ropo Ebenezer; Oguntade, Ayodipupo Sikiru; Oh, In-Hwan; Okati-Aliabad, Hassan; Okekunle, Akinkunmi Paul; Olagunju, Andrew T.; Olagunju, Tinuke O.; Olakunde, Babayemi Oluwaseun; Olufadewa, Isaac Iyinoluwa; Omer, Emad; Omonisi, Abidemi E. Emmanuel; Ong, Sokking; Onwujekwe, Obinna E.; Orru, Hans; Otstavnov, Stanislav S.; Oulhaj, Abderrahim; Oumer, Bilcha; Owopetu, Oluwatomi Funbi; Oyinloye, Babatunji Emmanuel; Mahesh, P. A.; Padron-Monedero, Alicia; Padubidri, Jagadish Rao; Pakbin, Babak; Pakshir, Keyvan; Pakzad, Reza; Palicz, Tamas; Pana, Adrian; Pandey, Ashok; Pant, Suman; Pardhan, Shahina; Park, Eun-Kee; Park, Seoyeon; Patel, Jay; Pati, Siddhartha; Paudel, Rajan; Paudel, Uttam; Paun, Mihaela; Toroudi, Hamidreza Pazoki; Peng, Minjin; Pereira, Jeevan; Pereira, Renato B.; Perna, Simone; Perumalsamy, Navaraj; Pestell, Richard G.; Pezzani, Raffaele; Piccinelli, Cristiano; Pillay, Julian David; Piracha, Zahra Zahid; Pischon, Tobias; Postma, Maarten J.; Langroudi, Ashkan Pourabhari; Pourshams, Akram; Pourtaheri, Naeimeh; Prashant, Akila; Qadir, Mirza Muhammad Fahd; Syed, Zahiruddin Quazi; Rabiee, Mohammad; Rabiee, Navid; Radfar, Amir; Radhakrishnan, Raghu Anekal; Radhakrishnan, Venkatraman; Raeisi, Mojtaba; Rafiee, Ata; Rafiei, Alireza; Raheem, Nasiru; Rahim, Fakher; Rahman, Md Obaidur; Rahman, Mosiur; Rahman, Muhammad Aziz; Rahmani, Amir Masoud; Rahmani, Shayan; Rahmanian, Vahid; Rajai, Nazanin; Rajesh, Aashish; Ram, Pradhum; Ramezanzadeh, Kiana; Rana, Juwel; Ranabhat, Kamal; Ranasinghe, Priyanga; Rao, Chythra R.; Rao, Sowmya J.; Rashedi, Sina; Rashidi, Amirfarzan; Rashidi, Mohammad-Mahdi; Ratan, Zubair Ahmed; Rawaf, David Laith; Rawaf, Salman; Rawal, Lal; Rawassizadeh, Reza; Razeghinia, Mohammad Sadegh; Rehman, Ashfaq Ur; Rehman, Inayat Ur; Reitsma, Marissa B.; Renzaho, Andre M. N.; Rezaei, Maryam; Rezaei, Nima; Rezaei, Saeid; Rezaeian, Mohsen; Rezapour, Aziz; Riad, Abanoub; Rikhtegar, Reza; Rios-Blancas, Maria; Roberts, Thomas J.; Rohloff, Peter; Romero-Rodriguez, Esperanza; Roshandel, Gholamreza; Rwegerera, Godfrey M.; Manjula, S.; Saber-Ayad, Maha Mohamed; Saberzadeh-Ardestani, Bahar; Sabour, Siamak; Saddik, Basema; Sadeghi, Erfan; Saeb, Mohammad Reza; Saeed, Umar; Safaei, Mohsen; Safary, Azam; Sahebazzamani, Maryam; Sahebkar, Amirhossein; Sahoo, Harihar; Sajid, Mirza Rizwan; Salari, Hedayat; Salehi, Sana; Salem, Marwa Rashad; Salimzadeh, Hamideh; Samodra, Yoseph Leonardo; Samy, Abdallah M.; Sanabria, Juan; Sankararaman, Senthilkumar; Sanmarchi, Francesco; Santric-Milicevic, Milena M.; Saqib, Muhammad Arif Nadeem; Sarveazad, Arash; Sarvi, Fatemeh; Sathian, Brijesh; Satpathy, Maheswar; Sayegh, Nicolas; Schneider, Ione Jayce Ceola; Schwarzinger, Michael; Ekerija, Mario A.; Senthilkumaran, Subramanian; Sepanlou, Sadaf G.; Seylani, Allen; Seyoum, Kenbon; Sha, Feng; Shafaat, Omid; Shah, Pritik A.; Shahabi, Saeed; Shahid, Izza; Shahrbaf, Mohammad Amin; Shahsavari, Hamid R.; Shaikh, Masood Ali; Shaka, Mohammed Feyisso; Shaker, Elaheh; Shannawaz, Mohammed; Sharew, Mequannent Melaku Sharew; Sharifi, Azam; Sharifi-Rad, Javad; Sharma, Purva; Shashamo, Bereket Beyene; Sheikh, Aziz; Sheikh, Mahdi; Sheikhbahaei, Sara; Sheikhi, Rahim Ali; Sheikhy, Ali; Shepherd, Peter Robin; Shetty, Adithi; Shetty, Jeevan K.; Shetty, Ranjitha S.; Shibuya, Kenji; Shirkoohi, Reza; Shirzad-Aski, Hesamaddin; Shivakumar, K. M.; Shivalli, Siddharudha; Shivarov, Velizar; Shobeiri, Parnian; Varniab, Zahra Shokri; Shorofi, Seyed Afshin; Shrestha, Sunil; Sibhat, Migbar Mekonnen; Malleshappa, SudeepK Siddappa; Sidemo, Negussie Boti; Silva, Diego Augusto Santos; Silva, Luas Manuel Lopes Rodrigues; Julian, Guilherme Silva; Silvestris, Nicola; Simegn, Wudneh; Singh, Achintya Dinesh; Singh, Ambrish; Singh, Garima; Singh, Harpreet; Singh, Jasvinder A.; Singh, Jitendra Kumar; Singh, Paramdeep; Singh, Surjit; Sinha, Dhirendra Narain; Sinke, Abiy H.; Siraj, Md Shahjahan; Sitas, Freddy; Siwal, Samarjeet Singh; Skryabin, Valentin Yurievich; Skryabina, Anna Aleksandrovna; Socea, Bogdan; Soeberg, Matthew J.; Sofi-Mahmudi, Ahmad; Solomon, Yonatan; Soltani-Zangbar, Mohammad Sadegh; Song, Suhang; Song, Yimeng; Sorensen, Reed J. D.; Soshnikov, Sergey; Sotoudeh, Houman; Sowe, Alieu; Sufiyan, Muawiyyah Babale; Suk, Ryan; Suleman, Muhammad; Abdulkader, Rizwan Suliankatchi; Sultana, Saima; Sur, Daniel; Szacska, Miklas; Tabaeian, Seidamir Pasha; Tabares-Seisdedos, Rafael; Tabatabaei, Seyyed Mohammad; Tabuchi, Takahiro; Tadbiri, Hooman; Taheri, Ensiyeh; Taheri, Majid; Soodejani, Moslem Taheri; Takahashi, Ken; Talaat, Iman M.; Tampa, Mircea; Tan, Ker-Kan; Tat, Nathan Y.; Tat, Vivian Y.; Tavakoli, Arash; Tehrani-Banihashemi, Arash; Tekalegn, Yohannes; Tesfay, Fisaha Haile; Thapar, Rekha; Thavamani, Aravind; Chandrasekar, Viveksandeep Thoguluva; Thomas, Nihal; Thomas, Nikhil Kenny; Ticoalu, Jansje Henny Vera; Tiyuri, Amir; Tollosa, Daniel Nigusse; Topor-Madry, Roman; Touvier, Mathilde; Tovani-Palone, Marcos Roberto; Traini, Eugenio; Mai Thi Ngoc Tran; Tripathy, Jaya Prasad; Ukke, Gebresilasea Gendisha; Ullah, Irfan; Ullah, Sana; Unnikrishnan, Bhaskaran; Vacante, Marco; Vaezi, Maryam; Tahbaz, Sahel Valadan; Valdez, Pascual R.; Vardavas, Constantine; Varthya, Shoban Babu; Vaziri, Siavash; Velazquez, Diana Zuleika; Veroux, Massimiliano; Villeneuve, Paul J.; Violante, Francesco S.; Vladimirov, Sergey Konstantinovitch; Vlassov, Vasily; Vo, Bay; Vu, Linh Gia; Wadood, Abdul Wadood; Waheed, Yasir; Walde, Mandaras Tariku; Wamai, Richard G.; Wang, Cong; Wang, Fang; Wang, Ning; Wang, Yu; Ward, Paul; Waris, Abdul; Westerman, Ronny; Wickramasinghe, Nuwan Darshana; Woldemariam, Melat; Woldu, Berhanu; Xiao, Hong; Xu, Suowen; Xu, Xiaoyue; Yadav, Lalit; Jabbari, Seyed Hossein Yahyazadeh; Yang, Lin; Yazdanpanah, Fereshteh; Yeshaw, Yigizie; Yismaw, Yazachew; Yonemoto, Naohiro; Younis, Mustafa Z.; Yousefi, Zabihollah; Yousefian, Fatemeh; Yu, Chuanhua; Yu, Yong; Yunusa, Ismaeel; Zahir, Mazyar; Zaki, Nazar; Zaman, Burhan Abdullah; Zangiabadian, Moein; Zare, Fariba; Zare, Iman; Zareshahrabadi, Zahra; Zarrintan, Armin; Zastrozhin, Mikhail Sergeevich; Zeineddine, Mohammad A.; Zhang, Dongyu; Zhang, Jianrong; Zhang, Yunquan; Zhang, Zhi-Jiang; Zhou, Linghui; Zodpey, Sanjay; Zoladl, Mohammad; Vos, Theo; Hay, Simon; Force, Lisa M.; Murray, Christopher J. L. (2022)
    Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
  • Karalis, Elina; Tapper, Anna-Maija; Gissler, Mika; Ulander, Veli-Matti (2018)
    Objectives: Our aim was to demonstrate the influence of increased number of low-risk deliveries on obstetric and neonatal outcome. Study design: The study hospital was Katiloopisto Maternity Hospital in Helsinki. Simultaneously, we studied all three delivery units in the Helsinki region in the population-based analysis. The study population was singleton hospital deliveries occurring between 2011 and 2012, and 2014-2015. The study hospital included 11 237 and 15 637 births and the population-based group included 28 950 and 27 979 births. We compared outcome measures in different periods by calculating adjusted odds ratios (AOR). Main outcome measures were induced delivery, mode of delivery, third or fourth degree perinea, tear, Apgar score at five minutes 7 days, and perinatal death. Results: In the study hospital, induction rate increased from 22.4% to 24.8% (AOR 1.06, 95% CI; 1.00-1.12) while in the population-based analysis the rate decreased from 22.2% to 21.5% (AOR 0.96, 95% CI; 0.92-1.00). Percentage of neonatal transfers, low Apgar scores, and severe perineal tears increased both in study hospital and in population-based group. Changes in operative delivery rate and other adverse perinatal outcomes were statistically insignificant. Conclusions: Increasing the volume of a delivery unit does not compromise maternal or neonatal outcome. Specific characteristics of a delivery unit affect the volume outcome association. (C) 2018 Elsevier B.V. All rights reserved.
  • Luostarinen, Teemu; Vehviläinen, Juho; Lindfors, Matias; Reinikainen, Matti; Bendel, Stepani; Laitio, Ruut; Hoppu, Sanna; Ala-Kokko, Tero; Skrifvars, Markus; Raj, Rahul (2022)
    Background Several studies have suggested no change in the outcome of patients with traumatic brain injury (TBI) treated in intensive care units (ICUs). This is mainly due to the shift in TBI epidemiology toward older and sicker patients. In Finland, the share of the population aged 65 years and over has increased the most in Europe during the last decade. We aimed to assess changes in 12-month and hospital mortality of patients with TBI treated in the ICU in Finland. Methods We used a national benchmarking ICU database (Finnish Intensive Care Consortium) to study adult patients who had been treated for TBI in four tertiary ICUs in Finland during 2003-2019. We divided admission years into quartiles and used multivariable logistic regression analysis, adjusted for case-mix, to assess the association between admission year and mortality. Results A total of 4535 patients were included. Between 2003-2007 and 2016-2019, the patient median age increased from 54 to 62 years, the share of patients having significant comorbidity increased from 8 to 11%, and patients being dependent on help in activities of daily living increased from 7 to 15%. Unadjusted hospital and 12-month mortality decreased from 18 and 31% to 10% and 23%, respectively. After adjusting for case-mix, a reduction in odds of 12-month and hospital mortality was seen in patients with severe TBI, intracranial pressure monitored patients, and mechanically ventilated patients. Despite a reduction in hospital mortality, 12-month mortality remained unchanged in patients aged >= 70 years. Conclusion A change in the demographics of ICU-treated patients with TBI care is evident. The outcome of younger patients with severe TBI appears to improve, whereas long-term mortality of elderly patients with less severe TBI has not improved. This has ramifications for further efforts to improve TBI care, especially among the elderly.