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Sharfaei S, Sharifan A, Shariff M, Sharifi-Rad J, Sharma M, Sharma R, Sharma S, Sharma V, Shastry RP, Shavandi A, Shaw DH, Shayan AM, Shehabeldine AME, Sheikh A, Sheikhi RA, Shen J, Shenoy MM, Shetty BSK, Shetty RS, Shey RA, Shiani A, Shibuya K, Shiferaw D, Shigematsu M, Shin JI, Shin MJ, Shiri R, Shirkoohi R, Shittu A, Shiue I, Shivakumar KM, Shivarov V, Shool S, Shrestha S, Shuja KH, Shuval K, Si Y, Sibhat MM, Siddig EE, Sigfusdottir ID, Silva JP, Silva LMLR, Silva S, Simões JP, Simpson CR, Singal A, Singh A, Singh A, Singh A, Singh BB, Singh B, Singh M, Singh M, Singh NP, Singh P, Singh S, Siraj MS, Sitas F, Sivakumar S, Skryabin VY, Skryabina AA, Sleet DA, Slepak ELN, Sohrabi H, Soleimani H, Soliman SSM, Solmi M, Solomon Y, Song Y, Sorensen RJD, Soriano JB, Soyiri IN, Spartalis M, Sreeramareddy CT, Starnes JR, Starodubov VI, Starodubova AV, Stefan SC, Stein DJ, Steinbeis F, Steiropoulos P, Stockfelt L, Stokes MA, Stortecky S, Stranges S, Stroumpoulis K, Suleman M, Suliankatchi Abdulkader R, Sultana A, Sun J, Sunkersing D, Susanty S, Swain CK, Sykes BL, Szarpak L, Szeto MD, Szócska M, Tabaee Damavandi P, Tabatabaei Malazy O, Tabatabaeizadeh SA, Tabatabai S, Tabb KM, Tabish M, Taborda-Barata LM, Tabuchi T, Tadesse BT, Taheri A, Taheri Abkenar Y, Taheri Soodejani M, Taherkhani A, Taiba J, Tajbakhsh A, Talaat IM, Talukder A, Tamuzi JL, Tan KK, Tang H, Tang HK, Tat NY, Tat VY, Tavakoli Oliaee R, Tavangar SM, Taveira N, Tebeje TM, Tefera YM, Teimoori M, Temsah MH, Temsah RMH, Teramoto M, Tesfaye SH, Thangaraju P, Thankappan KR, Thapa R, Thapar R, Thomas N, Thrift AG, Thum CCC, Tian J, Tichopad A, Ticoalu JHV, Tiruye TY, Tohidast SA, Tonelli M, Touvier M, Tovani-Palone MR, Tram KH, Tran NM, Trico D, Trihandini I, Tromans SJ, Truong VT, Truyen TTTT, Tsermpini EE, Tumurkhuu M, Tung K, Tyrovolas S, Ubah CS, Udoakang AJ, Udoh A, Ulhaq I, Ullah S, Ullah S, Umair M, Umar TP, Umeokonkwo CD, Umesh A, Unim B, Unnikrishnan B, Upadhyay E, Urso D, Vacante M, Vahdani AM, Vaithinathan AG, Valadan Tahbaz S, Valizadeh R, Van den Eynde J, Varavikova E, Varga O, Varma SA, Vart P, Varthya SB, Vasankari TJ, Veerman LJ, Venketasubramanian N, Venugopal D, Verghese NA, Verma M, Verma P, Veroux M, Verras GI, Vervoort D, Vieira RJ, Villafañe JH, Villani L, Villanueva GI, Villeneuve PJ, Violante FS, Visontay R, Vlassov V, Vo B, Vollset SE, Volovat SR, Volovici V, Vongpradith A, Vos T, Vujcic IS, Vukovic R, Wado YD, Wafa HA, Waheed Y, Wamai RG, Wang C, Wang D, Wang F, Wang S, Wang S, Wang Y, Wang YP, Ward P, Watson S, Weaver MR, Weerakoon KG, Weiss DJ, Weldemariam AH, Wells KM, Wen YF, Werdecker A, Westerman R, Wickramasinghe DP, Wickramasinghe ND, Wijeratne T, Wilson S, Wojewodzic MW, Wool EE, Woolf AD, Wu D, Wulandari RD, Xiao H, Xu B, Xu X, Yadav L, Yaghoubi S, Yang L, Yano Y, Yao Y, Ye P, Yesera GE, Yesodharan R, Yesuf SA, Yiğit A, Yiğit V, Yip P, Yon DK, Yonemoto N, You Y, Younis MZ, Yu C, Zadey S, Zadnik V, Zafari N, Zahedi M, Zahid MN, Zahir M, Zakham F, Zaki N, Zakzuk J, Zamagni G, Zaman BA, Zaman SB, Zamora N, Zand R, Zandi M, Zandieh GGZ, Zanghì A, Zare I, Zastrozhin MS, Zeariya MGM, Zeng Y, Zhai C, Zhang C, Zhang H, Zhang H, Zhang Y, Zhang Z, Zhang Z, Zhao H, Zhao Y, Zhao Y, Zheng P, Zhong C, Zhou J, Zhu B, Zhu Z, Ziaeefar P, Zielińska M, Zou Z, Zumla A, Zweck E, Zyoud SH, Lim SS, Murray CJL. Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950-2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021. Lancet 2024:S0140-6736(24)00476-8. [PMID: 38484753 DOI: 10.1016/s0140-6736(24)00476-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 12/08/2023] [Accepted: 03/06/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020-21 COVID-19 pandemic period. METHODS 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. FINDINGS Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5-65·1] decline), and increased during the COVID-19 pandemic period (2020-21; 5·1% [0·9-9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98-5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50-6·01) in 2019. An estimated 131 million (126-137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7-17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8-24·8), from 49·0 years (46·7-51·3) to 71·7 years (70·9-72·5). Global life expectancy at birth declined by 1·6 years (1·0-2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67-8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4-52·7]) and south Asia (26·3% [9·0-44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. INTERPRETATION Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic. FUNDING Bill & Melinda Gates Foundation.
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Conti S, Fornari C, Ferrara P, Antonazzo IC, Madotto F, Traini E, Levi M, Cernigliaro A, Armocida B, Bragazzi NL, Cadum E, Carugno M, Crotti G, Deandrea S, Cortesi PA, Guido D, Iavicoli I, Iavicoli S, La Vecchia C, Lauriola P, Michelozzi P, Scondotto S, Stafoggia M, Violante FS, Abbafati C, Albano L, Barone-Adesi F, Biondi A, Bosetti C, Buonsenso D, Carreras G, Castelpietra G, Catapano A, Cattaruzza MS, Corso B, Damiani G, Esposito F, Gallus S, Golinelli D, Hay SI, Isola G, Ledda C, Mondello S, Pedersini P, Pensato U, Perico N, Remuzzi G, Sanmarchi F, Santoro R, Simonetti B, Unim B, Vacante M, Veroux M, Villafañe JH, Monasta L, Mantovani LG. Time-Trends in Air Pollution Impact on Health in Italy, 1990-2019: An Analysis From the Global Burden of Disease Study 2019. Int J Public Health 2023; 68:1605959. [PMID: 37347013 PMCID: PMC10280378 DOI: 10.3389/ijph.2023.1605959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 05/17/2023] [Indexed: 06/23/2023] Open
Abstract
Objectives: We explored temporal variations in disease burden of ambient particulate matter 2.5 μm or less in diameter (PM2.5) and ozone in Italy using estimates from the Global Burden of Disease Study 2019. Methods: We compared temporal changes and percent variations (95% Uncertainty Intervals [95% UI]) in rates of disability adjusted life years (DALYs), years of life lost, years lived with disability and mortality from 1990 to 2019, and variations in pollutant-attributable burden with those in the overall burden of each PM2.5- and ozone-related disease. Results: In 2019, 467,000 DALYs (95% UI: 371,000, 570,000) were attributable to PM2.5 and 39,600 (95% UI: 18,300, 61,500) to ozone. The crude DALY rate attributable to PM2.5 decreased by 47.9% (95% UI: 10.3, 65.4) from 1990 to 2019. For ozone, it declined by 37.0% (95% UI: 28.9, 44.5) during 1990-2010, but it increased by 44.8% (95% UI: 35.5, 56.3) during 2010-2019. Age-standardized rates declined more than crude ones. Conclusion: In Italy, the burden of ambient PM2.5 (but not of ozone) significantly decreased, even in concurrence with population ageing. Results suggest a positive impact of air quality regulations, fostering further regulatory efforts.
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Affiliation(s)
- Sara Conti
- Research Center on Public Health, University of Milan Bicocca, Monza, Italy
| | - Carla Fornari
- Research Center on Public Health, University of Milan Bicocca, Monza, Italy
| | - Pietro Ferrara
- Research Center on Public Health, University of Milan Bicocca, Monza, Italy
- Laboratory of Public Health, Auxologico Research Hospital—IRCCS, Milan, Italy
| | | | - Fabiana Madotto
- Dipartimento di Anestesia, Rianimazione ed Emergenza Urgenza, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Eugenio Traini
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, Netherlands
| | - Miriam Levi
- Epidemiology Unit, Department of Prevention, Central Tuscany Local Health Authority, Florence, Italy
| | - Achille Cernigliaro
- Health Activities and Epidemiological Observatory Department, Health Authority Sicily Region, Parlemo, Italy
- Clinical Pathology Complex Hospital Unit, Health Authority Trapani Province, Trapani, Italy
| | - Benedetta Armocida
- Department of Cardiovascular, Endocrine-Metabolic Disease and Aging, National Institute of Health (ISS), Rome, Italy
| | - Nicola L. Bragazzi
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, Faculty of Science, York University, Toronto, ON, Canada
| | - Ennio Cadum
- Department of Hygiene and Health Prevention and Complex Operative Unit Environmental Health and Innovative Projects, Health Protection Agency, Pavia, Italy
| | - Michele Carugno
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Epidemiology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giacomo Crotti
- Servizio Epidemiologico Aziendale, Agenzia di Tutela della Salute di Bergamo, Bergamo, Italy
| | - Silvia Deandrea
- Department of Hygiene and Health Prevention and Complex Operative Unit Environmental Health and Innovative Projects, Health Protection Agency, Pavia, Italy
| | - Paolo A. Cortesi
- Research Center on Public Health, University of Milan Bicocca, Monza, Italy
| | - Davide Guido
- Neurology, Public Health and Disability Unit, Carlo Besta Neurological Institute, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Ivo Iavicoli
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Sergio Iavicoli
- Department of Occupational and Environmental Medicine Epidemiology and Hygiene, Italian National Workers Compensation Authority (IIL), Monteporzio Catone, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Paolo Lauriola
- International Society Doctors for the Environment, Milan, Italy
| | - Paola Michelozzi
- Department of Epidemiology, Lazio Region Health Authority (ASL RM1), Rome, Italy
| | - Salvatore Scondotto
- Health Activities and Epidemiological Observatory Department, Health Authority Sicily Region, Parlemo, Italy
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Region Health Authority (ASL RM1), Rome, Italy
| | - Francesco S. Violante
- Occupational Health Unit, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Cristiana Abbafati
- Department of Juridical and Economic Studies, Faculty of Law, Sapienza University of Rome, Rome, Italy
| | - Luciana Albano
- Department of Experimental Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | | | - Antonio Biondi
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Cristina Bosetti
- Department of Oncology, Mario Negri Pharmacological Research Institute (IRCCS), Milano, Italy
| | - Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS (Agostino Gemelli University Polyclinic IRCCS), Rome, Italy
- Global Health Research Institute, Università Cattolica del Sacro Cuore (Catholic University of Sacred Heart), Rome, Italy
| | - Giulia Carreras
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Giulio Castelpietra
- Department of Medicine, University of Udine, Udine, Italy
- Department of Mental Health, Healthcare Agency “Friuli Occidentale”, Pordenone, Italy
| | - Alberico Catapano
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
- MultiMedica, IRCCS, Sesto San Giovanni, Italy
| | - Maria S. Cattaruzza
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Barbara Corso
- Institute of Neuroscience, National Research Council (CNR), Pisa, Italy
| | - Giovanni Damiani
- IRCCS Istituto Ortopedico Galeazzi (Galeazzi Orthopedic Institute IRCCS), University of Milan, Milan, Italy
- Department of Dermatology, Case Western Reserve University, Cleveland, OH, United States
| | - Francesco Esposito
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Silvano Gallus
- Department of Environmental Health Sciences, Mario Negri Institute for Pharmacological Research, Milan, Italy
| | - Davide Golinelli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Simon I. Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, United States
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, United States
| | - Gaetano Isola
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Caterina Ledda
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Stefania Mondello
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, Messina, Italy
| | - Paolo Pedersini
- Clinical Research Department, IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Umberto Pensato
- Department of Neurology, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Norberto Perico
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy
| | - Giuseppe Remuzzi
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy
| | - Francesco Sanmarchi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | | | - Biagio Simonetti
- Department of Law, Economics, Management and Quantitative Methods, University of Sannio, Benevento, Italy
- WSB University in Gdańsk, Gdańsk, Poland
| | - Brigid Unim
- Department of Cardiovascular, Endocrine-Metabolic Disease and Aging, National Institute of Health (ISS), Rome, Italy
| | - Marco Vacante
- Department of Oncology, Mario Negri Pharmacological Research Institute (IRCCS), Milano, Italy
| | - Massimiliano Veroux
- Department of Medical, Surgical Sciences and Advanced Technologies, University of Catania, Catania, Italy
| | - Jorge H. Villafañe
- Clinical Research Department, IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Lorenzo Monasta
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
| | - Lorenzo G. Mantovani
- Research Center on Public Health, University of Milan Bicocca, Monza, Italy
- Laboratory of Public Health, Auxologico Research Hospital—IRCCS, Milan, Italy
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De Simone B, Abu-Zidan FM, Chouillard E, Di Saverio S, Sartelli M, Podda M, Gomes CA, Moore EE, Moug SJ, Ansaloni L, Kluger Y, Coccolini F, Landaluce-Olavarria A, Estraviz-Mateos B, Uriguen-Etxeberria A, Giordano A, Luna AP, Amín LAH, Hernández AMP, Shabana A, Dzulkarnaen ZA, Othman MA, Sani MI, Balla A, Scaramuzzo R, Lepiane P, Bottari A, Staderini F, Cianchi F, Cavallaro A, Zanghì A, Cappellani A, Campagnacci R, Maurizi A, Martinotti M, Ruggieri A, Jusoh AC, Rahman KA, Zulkifli ASM, Petronio B, Matías-García B, Quiroga-Valcárcel A, Mendoza-Moreno F, Atanasov B, Campanile FC, Vecchioni I, Cardinali L, Travaglini G, Sebastiani E, Chooklin S, Chuklin S, Cianci P, Restini E, Capuzzolo S, Currò G, Filippo R, Rispoli M, Aparicio-Sánchez D, Muñóz-Cruzado VD, Barbeito SD, Delibegovic S, Kesetovic A, Sasia D, Borghi F, Giraudo G, Visconti D, Doria E, Santarelli M, Luppi D, Bonilauri S, Grossi U, Zanus G, Sartori A, Piatto G, De Luca M, Vita D, Conti L, Capelli P, Cattaneo GM, Marinis A, Vederaki SA, Bayrak M, Altıntas Y, Uzunoglu MY, Demirbas IE, Altinel Y, Meric S, Aktimur YE, Uymaz DS, Omarov N, Azamat I, Lostoridis E, Nagorni EA, Pujante A, Anania G, Bombardini C, Bagolini F, Gonullu E, Mantoglu B, Capoglu R, Cappato S, Muzio E, Colak E, Polat S, Koylu ZA, Altintoprak F, Bayhan Z, Akin E, Andolfi E, Rezart S, Kim JI, Jung SW, Shin YC, Enciu O, Toma EA, Medas F, Canu GL, Cappellacci F, D’Acapito F, Ercolani G, Solaini L, Roscio F, Clerici F, Gelmini R, Serra F, Rossi EG, Fleres F, Clarizia G, Spolini A, Ferrara F, Nita G, Sarnari J, Gachabayov M, Abdullaev A, Poillucci G, Palini GM, Veneroni S, Garulli G, Piccoli M, Pattacini GC, Pecchini F, Argenio G, Armellino MF, Brisinda G, Tedesco S, Fransvea P, Ietto G, Franchi C, Carcano G, Martines G, Trigiante G, Negro G, Vega GM, González AR, Ojeda L, Piccolo G, Bondurri A, Maffioli A, Guerci C, Sin BH, Zuhdi Z, Azman A, Mousa H, al Bahri S, Augustin G, Romic I, Moric T, Nikolopoulos I, Andreuccetti J, Pignata G, D’Alessio R, Kenig J, Skorus U, Fraga GP, Hirano ES, de Lima Bertuol JV, Isik A, Kurnaz E, Asghar MS, Afzal A, Akbar A, Nikolouzakis TK, Lasithiotakis K, Chrysos E, Das K, Özer N, Seker A, Ibrahim M, Hamid HKS, Babiker A, Bouliaris K, Koukoulis G, Kolla CC, Lucchi A, Agostinelli L, Taddei A, Fortuna L, Agostini C, Licari L, Viola S, Callari C, Laface L, Abate E, Casati M, Anastasi A, Canonico G, Gabellini L, Tosi L, Guariniello A, Zanzi F, Bains L, Sydorchuk L, Iftoda O, Sydorchuk A, Malerba M, Costanzo F, Galleano R, Monteleone M, Costanzi A, Riva C, Walędziak M, Kwiatkowski A, Czyżykowski Ł, Major P, Strzałka M, Matyja M, Natkaniec M, Valenti MR, Di Vita MDP, Sotiropoulou M, Kapiris S, Massalou D, Veroux M, Volpicelli A, Gioco R, Uccelli M, Bonaldi M, Olmi S, Nardi M, Livadoti G, Mesina C, Dumitrescu TV, Ciorbagiu MC, Ammendola M, Ammerata G, Romano R, Slavchev M, Misiakos EP, Pikoulis E, Papaconstantinou D, Elbahnasawy M, Abdel-elsalam S, Felsenreich DM, Jedamzik J, Michalopoulos NV, Sidiropoulos TA, Papadoliopoulou M, Cillara N, Deserra A, Cannavera A, Negoi I, Schizas D, Syllaios A, Vagios I, Gourgiotis S, Dai N, Gurung R, Norrey M, Pesce A, Feo CV, Fabbri N, Machairas N, Dorovinis P, Keramida MD, Mulita F, Verras GI, Vailas M, Yalkin O, Iflazoglu N, Yigit D, Baraket O, Ayed K, Ghalloussi MH, Patias P, Ntokos G, Rahim R, Bala M, Kedar A, Sawyer RG, Trinh A, Miller K, Sydorchuk R, Knut R, Plehutsa O, Liman RK, Ozkan Z, Kader SA, Gupta S, Gureh M, Saeidi S, Aliakbarian M, Dalili A, Shoko T, Kojima M, Nakamoto R, Atici SD, Tuncer GK, Kaya T, Delis SG, Rossi S, Picardi B, del Monte SR, Triantafyllou T, Theodorou D, Pintar T, Salobir J, Manatakis DK, Tasis N, Acheimastos V, Ioannidis O, Loutzidou L, Symeonidis S, de Sá TC, Rocha M, Guagni T, Pantalone D, Maltinti G, Khokha V, Abdel-elsalam W, Ghoneim B, López-Ruiz JA, Kara Y, Zainudin S, Hayati F, Azizan N, Khei VTP, Yi RCX, Sellappan H, Demetrashvili Z, Lekiashvili N, Tvaladze A, Froiio C, Bernardi D, Bonavina L, Gil-Olarte A, Grassia S, Romero-Vargas E, Bianco F, Gumbs AA, Dogjani A, Agresta F, Litvin A, Balogh ZJ, Gendrikson G, Martino C, Damaskos D, Pararas N, Kirkpatrick A, Kurtenkov M, Gomes FC, Pisanu A, Nardello O, Gambarini F, Aref H, Angelis ND, Agnoletti V, Biondi A, Vacante M, Griggio G, Tutino R, Massani M, Bisetto G, Occhionorelli S, Andreotti D, Lacavalla D, Biffl WL, Catena F. The ChoCO-W prospective observational global study: Does COVID-19 increase gangrenous cholecystitis? World J Emerg Surg 2022; 17:61. [PMID: 36527038 PMCID: PMC9755784 DOI: 10.1186/s13017-022-00466-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 10/15/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The incidence of the highly morbid and potentially lethal gangrenous cholecystitis was reportedly increased during the COVID-19 pandemic. The aim of the ChoCO-W study was to compare the clinical findings and outcomes of acute cholecystitis in patients who had COVID-19 disease with those who did not. METHODS Data were prospectively collected over 6 months (October 1, 2020, to April 30, 2021) with 1-month follow-up. In October 2020, Delta variant of SARS CoV-2 was isolated for the first time. Demographic and clinical data were analyzed and reported according to the STROBE guidelines. Baseline characteristics and clinical outcomes of patients who had COVID-19 were compared with those who did not. RESULTS A total of 2893 patients, from 42 countries, 218 centers, involved, with a median age of 61.3 (SD: 17.39) years were prospectively enrolled in this study; 1481 (51%) patients were males. One hundred and eighty (6.9%) patients were COVID-19 positive, while 2412 (93.1%) were negative. Concomitant preexisting diseases including cardiovascular diseases (p < 0.0001), diabetes (p < 0.0001), and severe chronic obstructive airway disease (p = 0.005) were significantly more frequent in the COVID-19 group. Markers of sepsis severity including ARDS (p < 0.0001), PIPAS score (p < 0.0001), WSES sepsis score (p < 0.0001), qSOFA (p < 0.0001), and Tokyo classification of severity of acute cholecystitis (p < 0.0001) were significantly higher in the COVID-19 group. The COVID-19 group had significantly higher postoperative complications (32.2% compared with 11.7%, p < 0.0001), longer mean hospital stay (13.21 compared with 6.51 days, p < 0.0001), and mortality rate (13.4% compared with 1.7%, p < 0.0001). The incidence of gangrenous cholecystitis was doubled in the COVID-19 group (40.7% compared with 22.3%). The mean wall thickness of the gallbladder was significantly higher in the COVID-19 group [6.32 (SD: 2.44) mm compared with 5.4 (SD: 3.45) mm; p < 0.0001]. CONCLUSIONS The incidence of gangrenous cholecystitis is higher in COVID patients compared with non-COVID patients admitted to the emergency department with acute cholecystitis. Gangrenous cholecystitis in COVID patients is associated with high-grade Clavien-Dindo postoperative complications, longer hospital stay and higher mortality rate. The open cholecystectomy rate is higher in COVID compared with non -COVID patients. It is recommended to delay the surgical treatment in COVID patients, when it is possible, to decrease morbidity and mortality rates. COVID-19 infection and gangrenous cholecystistis are not absolute contraindications to perform laparoscopic cholecystectomy, in a case by case evaluation, in expert hands.
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Affiliation(s)
- Belinda De Simone
- Department of Emergency, Digestive and Metabolic Minimally Invasive Surgery, Poissy and Saint Germain en Laye Hospitals, Poissy, France
| | - Fikri M. Abu-Zidan
- grid.43519.3a0000 0001 2193 6666The Research Office, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates., United Arab Emirates University, Al-Ain, UAE
| | - Elie Chouillard
- Department of Emergency, Digestive and Metabolic Minimally Invasive Surgery, Poissy and Saint Germain en Laye Hospitals, Poissy, France
| | - Salomone Di Saverio
- Department of General Surgery, Santa Maria del Soccorso Hospital, San Benedetto del Tronto, Ascoli Piceno, Italy
| | - Massimo Sartelli
- Department of General Surgery, Macerata Hospital, Macerata, Italy
| | - Mauro Podda
- grid.7763.50000 0004 1755 3242Department of Surgical Science, University of Cagliari, Cagliari, Italy
| | - Carlos Augusto Gomes
- Faculdade de Ciência Médicas e da Saúde de Juiz de Fora, Hospital Universitario Terezinha de Jesus (SUPREMA), Juiz de Fora, Brazil
| | - Ernest E. Moore
- grid.239638.50000 0001 0369 638XErnest E. Moore Shock Trauma Center at Denver Health, Denver, CO USA
| | - Susan J. Moug
- grid.8756.c0000 0001 2193 314XDepartment of Surgery, Royal Alexandra Hospital, Paisley and Golden Jubilee National Hospital, University of Glasgow, Glasgow, Scotland
| | - Luca Ansaloni
- grid.18887.3e0000000417581884Department of General Surgery, University Hospital of Pavia, Pavia, Italy
| | - Yoram Kluger
- Department of General Surgery, The Rambam Academic Hospital, Haifa, Israel
| | - Federico Coccolini
- grid.144189.10000 0004 1756 8209Department of General and Emergency Surgery, University Hospital of Pisa, Pisa, Italy
| | | | | | | | - Alessio Giordano
- General Surgery Unit ASL Toscana Centro, Santo Stefano Hospital, Prato, Italy
| | | | | | | | - Amanda Shabana
- grid.8348.70000 0001 2306 7492Emergency Surgery Department, John Radcliffe Hospital, Oxford, UK
| | - Zakaria Andee Dzulkarnaen
- grid.11875.3a0000 0001 2294 3534Department of Surgery, School of Medical Sciences and Hospital USM, Universiti Sains Malaysia, Kubang Kerian, Kelantan Malaysia
| | - Muhammad Asyraf Othman
- grid.11875.3a0000 0001 2294 3534Department of Surgery, School of Medical Sciences and Hospital USM, Universiti Sains Malaysia, Kubang Kerian, Kelantan Malaysia
| | - Mohamad Ikhwan Sani
- grid.11875.3a0000 0001 2294 3534Department of Surgery, School of Medical Sciences and Hospital USM, Universiti Sains Malaysia, Kubang Kerian, Kelantan Malaysia
| | - Andrea Balla
- UOC of General and Minimally Invasive Surgery, Hospital “San Paolo”, Largo Donatori del Sangue 1, 00053 Civitavecchia, Rome, Italy
| | - Rosa Scaramuzzo
- UOC of General and Minimally Invasive Surgery, Hospital “San Paolo”, Largo Donatori del Sangue 1, 00053 Civitavecchia, Rome, Italy
| | - Pasquale Lepiane
- UOC of General and Minimally Invasive Surgery, Hospital “San Paolo”, Largo Donatori del Sangue 1, 00053 Civitavecchia, Rome, Italy
| | - Andrea Bottari
- grid.24704.350000 0004 1759 9494SOD Chirurgia dell’Apparato Digerente, AOU Careggi, Florence, Italy
| | - Fabio Staderini
- grid.24704.350000 0004 1759 9494SOD Chirurgia dell’Apparato Digerente, AOU Careggi, Florence, Italy
| | - Fabio Cianchi
- grid.24704.350000 0004 1759 9494SOD Chirurgia dell’Apparato Digerente, AOU Careggi, Florence, Italy
| | - Andrea Cavallaro
- grid.8158.40000 0004 1757 1969Department of Surgery, University of Catania, Policlinico “G. Rodolico - San Marco” Hospital, Catania, Italy
| | - Antonio Zanghì
- grid.8158.40000 0004 1757 1969Department of Surgery, University of Catania, Policlinico “G. Rodolico - San Marco” Hospital, Catania, Italy
| | - Alessandro Cappellani
- grid.8158.40000 0004 1757 1969Department of Surgery, University of Catania, Policlinico “G. Rodolico - San Marco” Hospital, Catania, Italy
| | | | - Angela Maurizi
- U.O.C. of General Surgery, “Carlo Urbani” Hospital, Jesi, AN Italy
| | | | | | - Asri Che Jusoh
- Department of General Surgery, Hospital Sultan Ismail Petra, 18000 Kuala Krai, Kelantan Malaysia
| | - Karim Abdul Rahman
- Department of General Surgery, Hospital Sultan Ismail Petra, 18000 Kuala Krai, Kelantan Malaysia
| | - Anis Suraya M. Zulkifli
- Department of General Surgery, Hospital Sultan Ismail Petra, 18000 Kuala Krai, Kelantan Malaysia
| | - Barbara Petronio
- Chirurgia Generale e Mininvasiva, San Polo Monfalcone, Monfalcone, GO Italy
| | - Belén Matías-García
- grid.411336.20000 0004 1765 5855Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain
| | - Ana Quiroga-Valcárcel
- grid.411336.20000 0004 1765 5855Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain
| | - Fernando Mendoza-Moreno
- grid.411336.20000 0004 1765 5855Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain
| | - Boyko Atanasov
- grid.35371.330000 0001 0726 0380RIMU, Medical University of Plovdiv, UMHAT Eurohospital, Plovdiv, Bulgaria
| | | | - Ilaria Vecchioni
- Ospedale San Giovanni Decollato Andosilla – ASL, Civita Castellana, Viterbo, VT Italy
| | - Luca Cardinali
- UOC Chirurgia Generale, Ospedale “Madonna del Soccorso”, San Benedetto del Tronto, AP Italy
| | - Grazia Travaglini
- UOC Chirurgia Generale, Ospedale “Madonna del Soccorso”, San Benedetto del Tronto, AP Italy
| | - Elisa Sebastiani
- UOC Chirurgia Generale, Ospedale “Madonna del Soccorso”, San Benedetto del Tronto, AP Italy
| | | | | | - Pasquale Cianci
- grid.416083.80000 0004 1768 5712Lorenzo Bonomo Hospital, ASL BAT, Andria, Puglia Italy
| | - Enrico Restini
- grid.416083.80000 0004 1768 5712Lorenzo Bonomo Hospital, ASL BAT, Andria, Puglia Italy
| | - Sabino Capuzzolo
- grid.416083.80000 0004 1768 5712Lorenzo Bonomo Hospital, ASL BAT, Andria, Puglia Italy
| | - Giuseppe Currò
- grid.411489.10000 0001 2168 2547Generall Surgery Unit, Science of Health Department, “Mater Domini” Hospital, University “Magna Graecia” Medical School, Viale Europa, 88100 Germaneto, Catanzaro Italy
| | - Rosalinda Filippo
- grid.411489.10000 0001 2168 2547Generall Surgery Unit, Science of Health Department, “Mater Domini” Hospital, University “Magna Graecia” Medical School, Viale Europa, 88100 Germaneto, Catanzaro Italy
| | - Michele Rispoli
- grid.411489.10000 0001 2168 2547Generall Surgery Unit, Science of Health Department, “Mater Domini” Hospital, University “Magna Graecia” Medical School, Viale Europa, 88100 Germaneto, Catanzaro Italy
| | - Daniel Aparicio-Sánchez
- grid.411109.c0000 0000 9542 1158Emergency Surgery Unit, Hospital Virgen del Rocío, Seville, Spain
| | | | - Sandra Dios Barbeito
- grid.411109.c0000 0000 9542 1158Emergency Surgery Unit, Hospital Virgen del Rocío, Seville, Spain
| | - Samir Delibegovic
- grid.412410.20000 0001 0682 9061Clinic for Surgery, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina
| | - Amar Kesetovic
- grid.412410.20000 0001 0682 9061Clinic for Surgery, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina
| | - Diego Sasia
- grid.413179.90000 0004 0486 1959Santa Croce and Carle Hospital, Cuneo, Italy
| | - Felice Borghi
- grid.413179.90000 0004 0486 1959Santa Croce and Carle Hospital, Cuneo, Italy
| | - Giorgio Giraudo
- grid.413179.90000 0004 0486 1959Santa Croce and Carle Hospital, Cuneo, Italy
| | - Diego Visconti
- Chirurgia Generale d’Urgenza e PS - AOU Cittá della Salute e della Scienza, Turin, Italy
| | - Emanuele Doria
- Chirurgia Generale d’Urgenza e PS - AOU Cittá della Salute e della Scienza, Turin, Italy
| | - Mauro Santarelli
- Chirurgia Generale d’Urgenza e PS - AOU Cittá della Salute e della Scienza, Turin, Italy
| | - Davide Luppi
- General and Emergency Surgery, ASMN IRCCS REGGIO EMILIA, Reggio Emilia, Italy
| | - Stefano Bonilauri
- General and Emergency Surgery, ASMN IRCCS REGGIO EMILIA, Reggio Emilia, Italy
| | - Ugo Grossi
- grid.5608.b0000 0004 1757 3470Surgery Unit 2, Regional Hospital Treviso, DISCOG, University of Padua, Treviso, Italy
| | - Giacomo Zanus
- grid.5608.b0000 0004 1757 3470Surgery Unit 2, Regional Hospital Treviso, DISCOG, University of Padua, Treviso, Italy
| | - Alberto Sartori
- U.O. Chirurgia Generale e d’Urgenza Ospedale San Valentino, Montebelluna, Treviso, Italy
| | - Giacomo Piatto
- U.O. Chirurgia Generale e d’Urgenza Ospedale San Valentino, Montebelluna, Treviso, Italy
| | - Maurizio De Luca
- U.O. Chirurgia Generale e d’Urgenza Ospedale San Valentino, Montebelluna, Treviso, Italy
| | - Domenico Vita
- grid.5608.b0000 0004 1757 3470Surgery Unit 2, Regional Hospital Treviso, DISCOG, University of Padua, Treviso, Italy
| | - Luigi Conti
- grid.476050.0Department of Surgery, G. Da Saliceto Hospital, AUSL Piacenza, Piacenza, Italy
| | - Patrizio Capelli
- grid.476050.0Department of Surgery, G. Da Saliceto Hospital, AUSL Piacenza, Piacenza, Italy
| | - Gaetano Maria Cattaneo
- grid.476050.0Department of Surgery, G. Da Saliceto Hospital, AUSL Piacenza, Piacenza, Italy
| | - Athanasios Marinis
- grid.414012.20000 0004 0622 6596Styliani-Aikaterini Vederaki, Third Department of Surgery, “Tzaneio” General Hospital, Piraeus, Greece
| | - Styliani-Aikaterini Vederaki
- grid.414012.20000 0004 0622 6596Styliani-Aikaterini Vederaki, Third Department of Surgery, “Tzaneio” General Hospital, Piraeus, Greece
| | - Mehmet Bayrak
- Mehmet Bayrak, Clinic for Surgery, Private Ortadogu Hospital, Adana, Turkey
| | | | | | | | - Yuksel Altinel
- grid.488643.50000 0004 5894 3909Department of General Surgery, Bagcilar Training and Research Hospital, University of Health Science, Istanbul, Turkey
| | - Serhat Meric
- grid.488643.50000 0004 5894 3909Department of General Surgery, Bagcilar Training and Research Hospital, University of Health Science, Istanbul, Turkey
| | - Yunus Emre Aktimur
- grid.488643.50000 0004 5894 3909Department of General Surgery, Bagcilar Training and Research Hospital, University of Health Science, Istanbul, Turkey
| | - Derya Salim Uymaz
- grid.15876.3d0000000106887552General Surgery Department, Faculty of Medicine, Koc University, Istanbul, Turkey
| | - Nail Omarov
- grid.15876.3d0000000106887552General Surgery Department, Faculty of Medicine, Koc University, Istanbul, Turkey
| | - Ibrahim Azamat
- grid.15876.3d0000000106887552General Surgery Department, Faculty of Medicine, Koc University, Istanbul, Turkey
| | - Eftychios Lostoridis
- grid.513828.50000 0004 0623 027X1St Department of Surgery, Kavala General Hospital, Kavala, Greece
| | - Eleni-Aikaterini Nagorni
- grid.513828.50000 0004 0623 027X1St Department of Surgery, Kavala General Hospital, Kavala, Greece
| | - Antonio Pujante
- grid.513828.50000 0004 0623 027X1St Department of Surgery, Kavala General Hospital, Kavala, Greece
| | - Gabriele Anania
- grid.416315.4UO Chirurgia 1, Dipartimento Chirurgico, Arcispedale Sant’Anna, Azienda Ospedaliero-Universitaria’di Ferrara, Ferrara, Italy
| | - Cristina Bombardini
- grid.416315.4UO Chirurgia 1, Dipartimento Chirurgico, Arcispedale Sant’Anna, Azienda Ospedaliero-Universitaria’di Ferrara, Ferrara, Italy
| | - Francesco Bagolini
- grid.416315.4UO Chirurgia 1, Dipartimento Chirurgico, Arcispedale Sant’Anna, Azienda Ospedaliero-Universitaria’di Ferrara, Ferrara, Italy
| | - Emre Gonullu
- grid.459902.30000 0004 0386 5536Sakarya Training and Research Hospital, Sakarya, Turkey
| | - Baris Mantoglu
- grid.459902.30000 0004 0386 5536Sakarya Training and Research Hospital, Sakarya, Turkey
| | - Recayi Capoglu
- grid.459902.30000 0004 0386 5536Sakarya Training and Research Hospital, Sakarya, Turkey
| | - Stefano Cappato
- Department of General Surgery ASL 4, Lavagna Hospital, Genoa, Italy
| | - Elena Muzio
- Department of General Surgery ASL 4, Lavagna Hospital, Genoa, Italy
| | - Elif Colak
- grid.510471.60000 0004 7684 9991Samsun Training and Research Hospital, University of Samsun, Samsun, Turkey
| | - Suleyman Polat
- grid.510471.60000 0004 7684 9991Samsun Training and Research Hospital, University of Samsun, Samsun, Turkey
| | - Zehra Alan Koylu
- grid.510471.60000 0004 7684 9991Samsun Training and Research Hospital, University of Samsun, Samsun, Turkey
| | - Fatih Altintoprak
- grid.49746.380000 0001 0682 3030Department of General Surgery, Faculty of Medicine, Sakarya University, Serdivan, Turkey
| | - Zülfü Bayhan
- grid.49746.380000 0001 0682 3030Department of General Surgery, Faculty of Medicine, Sakarya University, Serdivan, Turkey
| | - Emrah Akin
- grid.49746.380000 0001 0682 3030Department of General Surgery, Faculty of Medicine, Sakarya University, Serdivan, Turkey
| | - Enrico Andolfi
- grid.416351.40000 0004 1789 6237General and Emergency Surgery Unit, San Donato Hospital, Arezzo, Italy
| | - Sulce Rezart
- grid.416351.40000 0004 1789 6237General and Emergency Surgery Unit, San Donato Hospital, Arezzo, Italy
| | - Jae Il Kim
- grid.411633.20000 0004 0371 8173Department of Surgery, Inje University Ilsan Paik Hospital, Goyang, South Korea
| | - Sung Won Jung
- grid.411633.20000 0004 0371 8173Department of Surgery, Inje University Ilsan Paik Hospital, Goyang, South Korea
| | - Yong Chan Shin
- grid.411633.20000 0004 0371 8173Department of Surgery, Inje University Ilsan Paik Hospital, Goyang, South Korea
| | - Octavian Enciu
- grid.8194.40000 0000 9828 7548Elias University Emergency Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Elena Adelina Toma
- grid.8194.40000 0000 9828 7548Elias University Emergency Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Fabio Medas
- grid.7763.50000 0004 1755 3242Department of Surgical Science, University of Cagliari, Cagliari, Italy
| | - Gian Luigi Canu
- grid.7763.50000 0004 1755 3242Department of Surgical Science, University of Cagliari, Cagliari, Italy
| | - Federico Cappellacci
- grid.7763.50000 0004 1755 3242Department of Surgical Science, University of Cagliari, Cagliari, Italy
| | - Fabrizio D’Acapito
- grid.415079.e0000 0004 1759 989XGeneral and Oncologic Surgery, Morgagni-Pierantoni Hospital, AUSL Romagna, Via C. Forlanini 34, 47121 Forlì, Italy
| | - Giorgio Ercolani
- grid.415079.e0000 0004 1759 989XGeneral and Oncologic Surgery, Morgagni-Pierantoni Hospital, AUSL Romagna, Via C. Forlanini 34, 47121 Forlì, Italy
| | - Leonardo Solaini
- grid.415079.e0000 0004 1759 989XGeneral and Oncologic Surgery, Morgagni-Pierantoni Hospital, AUSL Romagna, Via C. Forlanini 34, 47121 Forlì, Italy
| | | | | | - Roberta Gelmini
- grid.7548.e0000000121697570Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia School of Medicine AOU Policlinico Di Modena, Modena, Italy
| | - Francesco Serra
- grid.7548.e0000000121697570Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia School of Medicine AOU Policlinico Di Modena, Modena, Italy
| | - Elena Giulia Rossi
- grid.7548.e0000000121697570Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia School of Medicine AOU Policlinico Di Modena, Modena, Italy
| | - Francesco Fleres
- UOC General Surgery, Hospital Civil of Sondrio, ASST Valtellina e Alto Lario, Sondrio, Italy
| | - Guglielmo Clarizia
- UOC General Surgery, Hospital Civil of Sondrio, ASST Valtellina e Alto Lario, Sondrio, Italy
| | - Alessandro Spolini
- UOC General Surgery, Hospital Civil of Sondrio, ASST Valtellina e Alto Lario, Sondrio, Italy
| | - Francesco Ferrara
- grid.414126.40000 0004 1760 1507Department of Surgery, San Carlo Borromeo Hospital, ASST Santi Paolo e Carlo, Milan, Italy
| | - Gabriela Nita
- grid.458453.b0000 0004 1756 7652AUSL Reggio Emilia, Ospedale Sant’Anna, Castelnuovo ne Monti, Reggio Emilia, Italy
| | - Jlenia Sarnari
- grid.458453.b0000 0004 1756 7652AUSL Reggio Emilia, Ospedale Sant’Anna, Castelnuovo ne Monti, Reggio Emilia, Italy
| | - Mahir Gachabayov
- Department of Abdominal Surgery, Vladimir City Emergency Hospital, Vladimir, Russia
| | - Abakar Abdullaev
- Department of Abdominal Surgery, Vladimir City Emergency Hospital, Vladimir, Russia
| | | | - Gian Marco Palini
- grid.414614.2Chirurgia generale e d’urgenza, Ospedale Infermi di Rimini, AUSL Romagna, Rimini, Italy
| | - Simone Veneroni
- grid.414614.2Chirurgia generale e d’urgenza, Ospedale Infermi di Rimini, AUSL Romagna, Rimini, Italy
| | - Gianluca Garulli
- grid.414614.2Chirurgia generale e d’urgenza, Ospedale Infermi di Rimini, AUSL Romagna, Rimini, Italy
| | - Micaela Piccoli
- Department of General Surgery, Emergencies and New Technologies, Baggiovara Civil Hospital, Modena, Italy
| | - Gianmaria Casoni Pattacini
- Department of General Surgery, Emergencies and New Technologies, Baggiovara Civil Hospital, Modena, Italy
| | - Francesca Pecchini
- Department of General Surgery, Emergencies and New Technologies, Baggiovara Civil Hospital, Modena, Italy
| | - Giulio Argenio
- UOC Chirurgia d’Urgenza, AOU San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy
| | | | - Giuseppe Brisinda
- grid.414603.4Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Silvia Tedesco
- grid.414603.4Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Pietro Fransvea
- grid.414603.4Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Giuseppe Ietto
- grid.18147.3b0000000121724807General, Emergency and Transplant Surgery Department, ASST-Settelaghi and University of Insubria, Varese, Italy
| | - Caterina Franchi
- grid.18147.3b0000000121724807General, Emergency and Transplant Surgery Department, ASST-Settelaghi and University of Insubria, Varese, Italy
| | - Giulio Carcano
- grid.18147.3b0000000121724807General, Emergency and Transplant Surgery Department, ASST-Settelaghi and University of Insubria, Varese, Italy
| | - Gennaro Martines
- General Surgery Unit, Azienda Ospedaliero Universitaria Policlinico Bari - Italy, Bari, Italy
| | - Giuseppe Trigiante
- General Surgery Unit, Azienda Ospedaliero Universitaria Policlinico Bari - Italy, Bari, Italy
| | - Giulia Negro
- General Surgery Unit, Azienda Ospedaliero Universitaria Policlinico Bari - Italy, Bari, Italy
| | - Gustavo Machain Vega
- grid.412213.70000 0001 2289 5077Department of Surgery, Hospital de Clinicas, Universidad Nacional de Asunción, San Lorenzo, Paraguay
| | - Agustín Rodríguez González
- grid.412213.70000 0001 2289 5077Department of Surgery, Hospital de Clinicas, Universidad Nacional de Asunción, San Lorenzo, Paraguay
| | - Leonardo Ojeda
- grid.412213.70000 0001 2289 5077Department of Surgery, Hospital de Clinicas, Universidad Nacional de Asunción, San Lorenzo, Paraguay
| | - Gaetano Piccolo
- grid.4708.b0000 0004 1757 2822Unit of HepatoBilioPancreatic and Digestive Surgery, Department of Health Sciences, San Paolo Hospital, University of Milan, Via Di Rudinì 8, 20142 Milan, Italy
| | - Andrea Bondurri
- grid.4708.b0000 0004 1757 2822Department of General Surgery, Department of Biomedical and Clinical Sciences Luigi Sacco, Luigi Sacco University Hospital, Università degli Studi di Milano, Milan, Italy
| | - Anna Maffioli
- grid.4708.b0000 0004 1757 2822Department of General Surgery, Department of Biomedical and Clinical Sciences Luigi Sacco, Luigi Sacco University Hospital, Università degli Studi di Milano, Milan, Italy
| | - Claudio Guerci
- grid.4708.b0000 0004 1757 2822Department of General Surgery, Department of Biomedical and Clinical Sciences Luigi Sacco, Luigi Sacco University Hospital, Università degli Studi di Milano, Milan, Italy
| | - Boo Han Sin
- HPB Unit, Department of Surgery, Hospital Canselor Tuanku Muhriz, Kuala Lumpur, Malaysia
| | - Zamri Zuhdi
- HPB Unit, Department of Surgery, Hospital Canselor Tuanku Muhriz, Kuala Lumpur, Malaysia
| | - Azlanudin Azman
- HPB Unit, Department of Surgery, Hospital Canselor Tuanku Muhriz, Kuala Lumpur, Malaysia
| | - Hussam Mousa
- grid.43519.3a0000 0001 2193 6666College of Medicine, Tawam Hospital, UAE University, Al-Ain, UAE
| | - Shadi al Bahri
- grid.43519.3a0000 0001 2193 6666College of Medicine, Tawam Hospital, UAE University, Al-Ain, UAE
| | - Goran Augustin
- grid.412688.10000 0004 0397 9648Department of Surgery, University Hospital Centre, Zagreb, Croatia
| | - Ivan Romic
- grid.412688.10000 0004 0397 9648Department of Surgery, University Hospital Centre, Zagreb, Croatia
| | - Trpimir Moric
- grid.412688.10000 0004 0397 9648Department of Surgery, University Hospital Centre, Zagreb, Croatia
| | | | - Jacopo Andreuccetti
- grid.412725.72nd Department of General Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Giusto Pignata
- grid.412725.72nd Department of General Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Rossella D’Alessio
- grid.412725.72nd Department of General Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Jakub Kenig
- grid.5522.00000 0001 2162 9631Department of General, Gastrointestinal, Oncologic Surgery and Transplantology, Jagiellonian University Medical College, Kraków, Poland
| | - Urszula Skorus
- grid.5522.00000 0001 2162 9631Department of General, Gastrointestinal, Oncologic Surgery and Transplantology, Jagiellonian University Medical College, Kraków, Poland
| | - Gustavo Pereira Fraga
- grid.411087.b0000 0001 0723 2494Division of Trauma Surgery, School of Medical Sciences, University of Campinas (Unicamp), Campinas, Brazil
| | - Elcio Shiyoiti Hirano
- grid.411087.b0000 0001 0723 2494Division of Trauma Surgery, School of Medical Sciences, University of Campinas (Unicamp), Campinas, Brazil
| | | | - Arda Isik
- grid.412176.70000 0001 1498 7262School of Medicine, Erzincan University, Erzincan, Turkey
| | - Eray Kurnaz
- grid.412176.70000 0001 1498 7262School of Medicine, Erzincan University, Erzincan, Turkey
| | | | - Ameer Afzal
- grid.412129.d0000 0004 0608 7688King Edward Medical University, Lahore, Pakistan
| | - Ali Akbar
- grid.412129.d0000 0004 0608 7688King Edward Medical University, Lahore, Pakistan
| | | | - Konstantinos Lasithiotakis
- grid.412481.a0000 0004 0576 5678Department of General Surgery, University General Hospital of Heraklion, 71110 Heraklion, Crete, Greece
| | - Emmanuel Chrysos
- grid.412481.a0000 0004 0576 5678Department of General Surgery, University General Hospital of Heraklion, 71110 Heraklion, Crete, Greece
| | - Koray Das
- Department of General Surgery, Adana City Training and Research Hospital, University of Health Sciences, Adana, Turkey
| | - Nazmi Özer
- Department of General Surgery, Adana City Training and Research Hospital, University of Health Sciences, Adana, Turkey
| | - Ahmet Seker
- Department of General Surgery, Adana City Training and Research Hospital, University of Health Sciences, Adana, Turkey
| | | | | | | | - Konstantinos Bouliaris
- Surgical Department, Koutlimbaneio and Triantafylleio General Hospital of Larissa, Larisa, Greece
| | - George Koukoulis
- Surgical Department, Koutlimbaneio and Triantafylleio General Hospital of Larissa, Larisa, Greece
| | | | - Andrea Lucchi
- U.O. Chirurgia Generale Ospedale “Ceccarini” Riccione, Riccione, Italy
| | - Laura Agostinelli
- U.O. Chirurgia Generale Ospedale “Ceccarini” Riccione, Riccione, Italy
| | - Antonio Taddei
- grid.24704.350000 0004 1759 9494Hepatobiliary Surgery, Department of Clinical and Experimental Medicine, University of Florence, AOU Careggi, Florence, Italy
| | - Laura Fortuna
- grid.24704.350000 0004 1759 9494Hepatobiliary Surgery, Department of Clinical and Experimental Medicine, University of Florence, AOU Careggi, Florence, Italy
| | - Carlotta Agostini
- grid.24704.350000 0004 1759 9494Hepatobiliary Surgery, Department of Clinical and Experimental Medicine, University of Florence, AOU Careggi, Florence, Italy
| | - Leo Licari
- grid.10776.370000 0004 1762 5517Department of Surgical, Oncological and Oral Sciences (DICHIRONS), Policlinico P. Giaccone, University of Palermo, Via Liborio Giuffré 5, 90127 Palermo, Italy
| | - Simona Viola
- grid.10776.370000 0004 1762 5517University of Palermo, Palermo, Italy
| | - Cosimo Callari
- Department of Surgery, Buccheri La Ferla Hospital, Via Messina Marine, 197, 90123 Palermo, Italy
| | - Letizia Laface
- Department of General Surgery, Vittorio Emanuele III Hospital, Carate Brianza - ASST Brianza, Carate Brianza, Italy
| | - Emmanuele Abate
- Department of General Surgery, Vittorio Emanuele III Hospital, Carate Brianza - ASST Brianza, Carate Brianza, Italy
| | - Massimiliano Casati
- Department of General Surgery, Vittorio Emanuele III Hospital, Carate Brianza - ASST Brianza, Carate Brianza, Italy
| | | | | | - Linda Gabellini
- Chirurgia Generale, Ospedale San Giovanni Di Dio, Florence, Italy
| | - Lorenzo Tosi
- grid.6292.f0000 0004 1757 1758Residency Program in General Surgery, University of Bologna, Bologna, Italy
| | - Anna Guariniello
- grid.415207.50000 0004 1760 3756Section of Emergency Surgery, Department of Surgery, S.Maria delle Croci Hospital Ravenna, Ravenna, Italy
| | - Federico Zanzi
- grid.415207.50000 0004 1760 3756Section of Emergency Surgery, Department of Surgery, S.Maria delle Croci Hospital Ravenna, Ravenna, Italy
| | - Lovenish Bains
- grid.414698.60000 0004 1767 743XDepartment of Surgery, Maulana Azad Medical College and Nayak Hospital, New Delhi, 110002 India
| | - Larysa Sydorchuk
- grid.445372.30000 0004 4906 2392Bukovinian State Medical University, Chernivtsi, Ukraine
| | - Oksana Iftoda
- grid.445372.30000 0004 4906 2392Bukovinian State Medical University, Chernivtsi, Ukraine
| | - Andrii Sydorchuk
- grid.445372.30000 0004 4906 2392Bukovinian State Medical University, Chernivtsi, Ukraine
| | | | | | | | - Michela Monteleone
- Andrea Costanzi, Carlo Riva, O.U. of General Surgery, San Leopoldo Mandic Hospital, Merate, ASST, Lecco, Italy
| | - Andrea Costanzi
- Andrea Costanzi, Carlo Riva, O.U. of General Surgery, San Leopoldo Mandic Hospital, Merate, ASST, Lecco, Italy
| | - Carlo Riva
- Andrea Costanzi, Carlo Riva, O.U. of General Surgery, San Leopoldo Mandic Hospital, Merate, ASST, Lecco, Italy
| | - Maciej Walędziak
- grid.415641.30000 0004 0620 0839Department of General, Oncological, Metabolic and Thoracic Surgery, Military Institute of Medicine, Warsaw, Poland
| | - Andrzej Kwiatkowski
- grid.415641.30000 0004 0620 0839Department of General, Oncological, Metabolic and Thoracic Surgery, Military Institute of Medicine, Warsaw, Poland
| | - Łukasz Czyżykowski
- grid.415641.30000 0004 0620 0839Department of General, Oncological, Metabolic and Thoracic Surgery, Military Institute of Medicine, Warsaw, Poland
| | - Piotr Major
- grid.5522.00000 0001 2162 9631Department of General and Emergency Surgery, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Marcin Strzałka
- grid.5522.00000 0001 2162 9631Department of General and Emergency Surgery, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Maciej Matyja
- grid.5522.00000 0001 2162 9631Department of General and Emergency Surgery, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Michal Natkaniec
- grid.5522.00000 0001 2162 9631Department of General and Emergency Surgery, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Maria Rosaria Valenti
- U.O. General Surgery, Azienda Ospedaliera Universitaria “Policlinico - San Marco”, Catania, Italy
| | | | - Maria Sotiropoulou
- grid.414655.70000 0004 4670 43293Rd Surgical Department, Evangelismos General Hospital, Athens, Greece
| | - Stylianos Kapiris
- grid.414655.70000 0004 4670 43293Rd Surgical Department, Evangelismos General Hospital, Athens, Greece
| | - Damien Massalou
- grid.410528.a0000 0001 2322 4179Department of Emergency Surgery, Centre Hospitalier Universitaire de Nice (CHU de Nice), Université Côte d’Azur, Nice, France
| | | | | | - Rossella Gioco
- General Surgery, Azienda Policlinico San Marco, Catania, Italy
| | - Matteo Uccelli
- General and Oncological Surgery Department, San Marco Hospital GSD, Zingonia, BG Italy
| | - Marta Bonaldi
- General and Oncological Surgery Department, San Marco Hospital GSD, Zingonia, BG Italy
| | - Stefano Olmi
- General and Oncological Surgery Department, San Marco Hospital GSD, Zingonia, BG Italy
| | - Matteo Nardi
- San Giovanni Calibita Hospital- Fondazione Fatebenefratelli, Rome, Italy
| | - Giada Livadoti
- San Giovanni Calibita Hospital- Fondazione Fatebenefratelli, Rome, Italy
| | - Cristian Mesina
- grid.452359.c0000 0004 4690 999XDepartment of Surgery, Emergency County Hospital of Craiova, Craiova, Romania
| | - Theodor Viorel Dumitrescu
- grid.452359.c0000 0004 4690 999XDepartment of Surgery, Emergency County Hospital of Craiova, Craiova, Romania
| | - Mihai Calin Ciorbagiu
- grid.452359.c0000 0004 4690 999XDepartment of Surgery, Emergency County Hospital of Craiova, Craiova, Romania
| | - Michele Ammendola
- grid.411489.10000 0001 2168 2547Science of Health Department, Digestive Surgery Unit, “Mater Domini” Hospital, University “Magna Graecia” Medical School, Viale Europa, 88100 Germaneto, Catanzaro Italy
| | - Giorgio Ammerata
- grid.411489.10000 0001 2168 2547Science of Health Department, Digestive Surgery Unit, “Mater Domini” Hospital, University “Magna Graecia” Medical School, Viale Europa, 88100 Germaneto, Catanzaro Italy
| | - Roberto Romano
- grid.411489.10000 0001 2168 2547Science of Health Department, Digestive Surgery Unit, “Mater Domini” Hospital, University “Magna Graecia” Medical School, Viale Europa, 88100 Germaneto, Catanzaro Italy
| | - Mihail Slavchev
- Department of General Surgery, University Hospital Eurohospital, Plovdiv, Bulgaria
| | - Evangelos P. Misiakos
- grid.5216.00000 0001 2155 08003Rd Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Emmanouil Pikoulis
- grid.5216.00000 0001 2155 08003Rd Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Papaconstantinou
- grid.5216.00000 0001 2155 08003Rd Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Mohamed Elbahnasawy
- grid.412258.80000 0000 9477 7793Emergency Medicine and Traumatology Department, Tanta University Faculty of Medicine, Tanta, Egypt
| | - Sherief Abdel-elsalam
- grid.412258.80000 0000 9477 7793Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Daniel M. Felsenreich
- grid.22937.3d0000 0000 9259 8492Division of Visceral Surgery, Department of General Surgery, Medical University of Vienna, Vienna, Austria
| | - Julia Jedamzik
- grid.22937.3d0000 0000 9259 8492Division of Visceral Surgery, Department of General Surgery, Medical University of Vienna, Vienna, Austria
| | - Nikolaos V. Michalopoulos
- grid.5216.00000 0001 2155 08004Rd Department of Surgery Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Theodoros A. Sidiropoulos
- grid.5216.00000 0001 2155 08004Rd Department of Surgery Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Papadoliopoulou
- grid.5216.00000 0001 2155 08004Rd Department of Surgery Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Nicola Cillara
- grid.459832.1Surgery Department, Santissima Trinità Hospital, Cagliari, Italy
| | - Antonello Deserra
- grid.459832.1Surgery Department, Santissima Trinità Hospital, Cagliari, Italy
| | | | - Ionuţ Negoi
- grid.8194.40000 0000 9828 7548General Surgery Department, Carol Davila University of Medicine and Pharmacy, Emergency Hospital of Bucharest, Bucharest, Romania
| | - Dimitrios Schizas
- grid.411565.20000 0004 0621 2848First Department of Surgery, National and Kapodistrian University of Athens, Laiko General Hospital, 11527 Athens, Greece
| | - Athanasios Syllaios
- grid.411565.20000 0004 0621 2848First Department of Surgery, National and Kapodistrian University of Athens, Laiko General Hospital, 11527 Athens, Greece
| | - Ilias Vagios
- grid.411565.20000 0004 0621 2848First Department of Surgery, National and Kapodistrian University of Athens, Laiko General Hospital, 11527 Athens, Greece
| | - Stavros Gourgiotis
- grid.5335.00000000121885934Addenbrooke’s Hospital, Cambridge University, Cambridge, UK
| | - Nick Dai
- grid.5335.00000000121885934Addenbrooke’s Hospital, Cambridge University, Cambridge, UK
| | - Rekha Gurung
- grid.5335.00000000121885934Addenbrooke’s Hospital, Cambridge University, Cambridge, UK
| | - Marcus Norrey
- grid.5335.00000000121885934Addenbrooke’s Hospital, Cambridge University, Cambridge, UK
| | - Antonio Pesce
- grid.8484.00000 0004 1757 2064Department of Surgery, Delta Hospital, Azienda USL of Ferrara, University of Ferrara, Ferrara, Italy
| | - Carlo Vittorio Feo
- grid.8484.00000 0004 1757 2064Department of Surgery, Delta Hospital, Azienda USL of Ferrara, University of Ferrara, Ferrara, Italy
| | - Nicolo’ Fabbri
- grid.8484.00000 0004 1757 2064Department of Surgery, Delta Hospital, Azienda USL of Ferrara, University of Ferrara, Ferrara, Italy
| | - Nikolaos Machairas
- grid.5216.00000 0001 2155 08002Nd Department of Propaedeutic Surgery, National and Kapodistrian University of Athens, General Hospital Laiko, Athens, Greece
| | - Panagiotis Dorovinis
- grid.5216.00000 0001 2155 08002Nd Department of Propaedeutic Surgery, National and Kapodistrian University of Athens, General Hospital Laiko, Athens, Greece
| | - Myrto D. Keramida
- grid.5216.00000 0001 2155 08002Nd Department of Propaedeutic Surgery, National and Kapodistrian University of Athens, General Hospital Laiko, Athens, Greece
| | - Francesk Mulita
- grid.412458.eDepartment of Surgery, General University Hospital of Patras, Patras, Greece
| | | | - Michail Vailas
- grid.412458.eDepartment of Surgery, General University Hospital of Patras, Patras, Greece
| | - Omer Yalkin
- Department of Surgical Oncology and Gastroenterological Surgery, Bursa City Hospital, Bursa, Turkey
| | - Nidal Iflazoglu
- Department of Surgical Oncology and Gastroenterological Surgery, Bursa City Hospital, Bursa, Turkey
| | - Direnc Yigit
- Department of Surgical Oncology and Gastroenterological Surgery, Bursa City Hospital, Bursa, Turkey
| | - Oussama Baraket
- grid.265234.40000 0001 2177 9066Department of General Surgery, Habib Bougatfa Hospital, University Tunis El Manar, Bizerte, Tunisia
| | - Karim Ayed
- grid.265234.40000 0001 2177 9066Department of General Surgery, Habib Bougatfa Hospital, University Tunis El Manar, Bizerte, Tunisia
| | - Mohamed hedi Ghalloussi
- grid.265234.40000 0001 2177 9066Department of General Surgery, Habib Bougatfa Hospital, University Tunis El Manar, Bizerte, Tunisia
| | - Parmenion Patias
- grid.414012.20000 0004 0622 65962nd Department of Surgery, General Hospital of Athens “G.Gennimatas”, Athens, Greece
| | - Georgios Ntokos
- grid.414012.20000 0004 0622 65962nd Department of Surgery, General Hospital of Athens “G.Gennimatas”, Athens, Greece
| | - Razrim Rahim
- grid.462995.50000 0001 2218 9236Department of Surgery, Universiti Sains Islam Malaysia, Nilai, Malaysia
| | - Miklosh Bala
- grid.9619.70000 0004 1937 0538Department of General Surgery and Trauma, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Asaf Kedar
- grid.9619.70000 0004 1937 0538Department of General Surgery and Trauma, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Robert G. Sawyer
- grid.268187.20000 0001 0672 1122Western Michigan University School of Medicine, Kalamazoo, USA
| | - Anna Trinh
- grid.268187.20000 0001 0672 1122Western Michigan University School of Medicine, Kalamazoo, USA
| | - Kelsey Miller
- grid.268187.20000 0001 0672 1122Western Michigan University School of Medicine, Kalamazoo, USA
| | | | - Ruslan Knut
- Regional Emergency Hospital, Chernivtsi, Ukraine
| | | | | | - Zeynep Ozkan
- General Surgery Clinic, Elazig Fethi Sekin City Hospital, Elazig, Turkey
| | - Saleh Abdel Kader
- Egypt and NMC Specialty Hospital Al Ain, Ain Shams University, Al-Ain, UAE
| | - Sanjay Gupta
- grid.413220.60000 0004 1767 2831Government Medical College and Hospital, Chandigarh, India
| | - Monika Gureh
- grid.413220.60000 0004 1767 2831Government Medical College and Hospital, Chandigarh, India
| | - Sara Saeidi
- grid.411583.a0000 0001 2198 6209Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohsen Aliakbarian
- grid.411583.a0000 0001 2198 6209Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amin Dalili
- grid.411583.a0000 0001 2198 6209Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Tomohisa Shoko
- grid.410818.40000 0001 0720 6587Department of Emergency and Critical Care Medicine, Department of Acute Care Surgery Center, Adachi Medical Center, Tokyo Women’s Medical University, Tokyo, Japan
| | - Mitsuaki Kojima
- grid.410818.40000 0001 0720 6587Department of Emergency and Critical Care Medicine, Department of Acute Care Surgery Center, Adachi Medical Center, Tokyo Women’s Medical University, Tokyo, Japan
| | - Raira Nakamoto
- grid.410818.40000 0001 0720 6587Department of Emergency and Critical Care Medicine, Department of Acute Care Surgery Center, Adachi Medical Center, Tokyo Women’s Medical University, Tokyo, Japan
| | - Semra Demirli Atici
- grid.414882.30000 0004 0643 0132Department of General Surgery, University of Health Sciences Tepecik Training and Research Hospital, Izmir, Turkey
| | - Gizem Kilinc Tuncer
- grid.414882.30000 0004 0643 0132Department of General Surgery, University of Health Sciences Tepecik Training and Research Hospital, Izmir, Turkey
| | - Tayfun Kaya
- grid.414882.30000 0004 0643 0132Department of General Surgery, University of Health Sciences Tepecik Training and Research Hospital, Izmir, Turkey
| | | | - Stefano Rossi
- grid.416357.2Department of General and Emergency Surgery, San Filippo Neri Hospital, ASL Roma 1, Rome, Italy
| | - Biagio Picardi
- grid.416357.2Department of General and Emergency Surgery, San Filippo Neri Hospital, ASL Roma 1, Rome, Italy
| | - Simone Rossi del Monte
- grid.416357.2Department of General and Emergency Surgery, San Filippo Neri Hospital, ASL Roma 1, Rome, Italy
| | - Tania Triantafyllou
- grid.5216.00000 0001 2155 0800Department of Surgery, Hippocration General Hospital of Athens, University of Athens, Athens, Greece
| | - Dimitrios Theodorou
- grid.5216.00000 0001 2155 0800Department of Surgery, Hippocration General Hospital of Athens, University of Athens, Athens, Greece
| | - Tadeja Pintar
- grid.29524.380000 0004 0571 7705Department of Abdominal Surgery, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Jure Salobir
- grid.29524.380000 0004 0571 7705Department of Abdominal Surgery, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Dimitrios K. Manatakis
- grid.414025.60000 0004 0638 8093Vasileios Acheimastos, Athens Naval and Veterans Hospital, Athens, Greece
| | - Nikolaos Tasis
- grid.414025.60000 0004 0638 8093Vasileios Acheimastos, Athens Naval and Veterans Hospital, Athens, Greece
| | - Vasileios Acheimastos
- grid.414025.60000 0004 0638 8093Vasileios Acheimastos, Athens Naval and Veterans Hospital, Athens, Greece
| | - Orestis Ioannidis
- grid.414012.20000 0004 0622 65964Th Department of Surgery, Medical School Aristotle University of Thessaloniki, General Hospital “George Papanikolaou”, Thessaloniki, Greece
| | - Lydia Loutzidou
- grid.414012.20000 0004 0622 65964Th Department of Surgery, Medical School Aristotle University of Thessaloniki, General Hospital “George Papanikolaou”, Thessaloniki, Greece
| | - Savvas Symeonidis
- grid.414012.20000 0004 0622 65964Th Department of Surgery, Medical School Aristotle University of Thessaloniki, General Hospital “George Papanikolaou”, Thessaloniki, Greece
| | - Tiago Correia de Sá
- grid.466592.aGeneral Surgery Department, Centro Hospitalar Do Tâmega e Sousa Penafiel, Penafiel, Portugal
| | - Mónica Rocha
- grid.466592.aGeneral Surgery Department, Centro Hospitalar Do Tâmega e Sousa Penafiel, Penafiel, Portugal
| | - Tommaso Guagni
- grid.24704.350000 0004 1759 9494Department of general surgery, Careggi University Hospital, Florence, Italy
| | - Desiré Pantalone
- grid.24704.350000 0004 1759 9494Department of general surgery, Careggi University Hospital, Florence, Italy
| | - Gherardo Maltinti
- grid.24704.350000 0004 1759 9494Department of general surgery, Careggi University Hospital, Florence, Italy
| | | | - Wafaa Abdel-elsalam
- grid.411978.20000 0004 0578 3577Anesthesia and Surgical Intensive Care Department, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
| | - Basma Ghoneim
- grid.411978.20000 0004 0578 3577Anesthesia and Surgical Intensive Care Department, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
| | - José Antonio López-Ruiz
- grid.411375.50000 0004 1768 164XAngeles Gil-Olarte, Estela Romero-Vargas, Hospital Universitario Virgen Macarena, Seville, Spain
| | - Yasin Kara
- grid.414850.c0000 0004 0642 8921General Surgery Clinic Health Sciences University Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey
| | - Syaza Zainudin
- grid.265727.30000 0001 0417 0814Faculty of Medicine and Health Sciences, Queen Elisabeth Hospital, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Firdaus Hayati
- grid.265727.30000 0001 0417 0814Faculty of Medicine and Health Sciences, Queen Elisabeth Hospital, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Nornazirah Azizan
- grid.265727.30000 0001 0417 0814Faculty of Medicine and Health Sciences, Queen Elisabeth Hospital, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Victoria Tan Phooi Khei
- grid.265727.30000 0001 0417 0814Department of Surgery, Queen Elizabeth Hospital, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Rebecca Choy Xin Yi
- grid.265727.30000 0001 0417 0814Department of Surgery, Queen Elizabeth Hospital, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Harivinthan Sellappan
- grid.265727.30000 0001 0417 0814Department of Surgery, Queen Elizabeth Hospital, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | | | | | - Ana Tvaladze
- N.Kipshidze Central University Hospital, Tbilisi, Georgia
| | - Caterina Froiio
- grid.4708.b0000 0004 1757 2822IRCCS Policlinico San Donato, University of Milan, Milan, Italy
| | - Daniele Bernardi
- grid.4708.b0000 0004 1757 2822IRCCS Policlinico San Donato, University of Milan, Milan, Italy
| | - Luigi Bonavina
- grid.4708.b0000 0004 1757 2822IRCCS Policlinico San Donato, University of Milan, Milan, Italy
| | - Angeles Gil-Olarte
- grid.411375.50000 0004 1768 164XAngeles Gil-Olarte, Estela Romero-Vargas, Hospital Universitario Virgen Macarena, Seville, Spain
| | - Sebastiano Grassia
- General Surgery Unit, S. Leonardo Hospital, Castellammare Di Stabia, Naples, Italy
| | - Estela Romero-Vargas
- grid.411375.50000 0004 1768 164XAngeles Gil-Olarte, Estela Romero-Vargas, Hospital Universitario Virgen Macarena, Seville, Spain
| | - Francesco Bianco
- General Surgery Unit, S. Leonardo Hospital, Castellammare Di Stabia, Naples, Italy
| | - Andrew A. Gumbs
- Department of Emergency, Digestive and Metabolic Minimally Invasive Surgery, Poissy and Saint Germain en Laye Hospitals, Poissy, France
| | - Agron Dogjani
- Department of General Surgery, University Hospital of Tirana, Tirana, Albania
| | - Ferdinando Agresta
- Department of General Surgery, AULSS2 Trevigiana del Veneto, Ospedale di Vittorio Veneto, Vittorio Veneto, TV Italy
| | - Andrey Litvin
- grid.410686.d0000 0001 1018 9204Department of Surgical Disciplines, Immanuel Kant Baltic Federal University, Regional Clinical Hospital, Kalingrad, Russia
| | - Zsolt J. Balogh
- grid.414724.00000 0004 0577 6676Department of Traumatology, John Hunter Hospital and University of Newcastle, Newcastle, NSW Australia
| | - George Gendrikson
- grid.410686.d0000 0001 1018 9204Department of Surgical Disciplines, Immanuel Kant Baltic Federal University, Regional Clinical Hospital, Kalingrad, Russia
| | - Costanza Martino
- Anesthesia and Intensive Care Unit, Umberto I Hospital, AUSL Romagna, Lugo, Italy
| | - Dimitrios Damaskos
- grid.4305.20000 0004 1936 7988Department of General and Emergency Surgery, Royal Infirmary of Edinburgh, University of Edinburgh, Edinburgh, UK
| | - Nikolaos Pararas
- grid.411335.10000 0004 1758 7207Department of General Surgery, Dr. Sulaiman Al Habib Hospital, Alfaisal University, Riyadh, Saudi Arabia
| | - Andrew Kirkpatrick
- grid.414959.40000 0004 0469 2139General, Acute Care, Abdominal Wall Reconstruction, and Trauma Surgery, Foothills Medical Centre, Calgary, AB Canada
| | - Mikhail Kurtenkov
- grid.410686.d0000 0001 1018 9204Department of Surgical Disciplines, Immanuel Kant Baltic Federal University, Regional Clinical Hospital, Kalingrad, Russia
| | - Felipe Couto Gomes
- Faculdade de Ciência Médicas e da Saúde de Juiz de Fora, Hospital Universitario Terezinha de Jesus (SUPREMA), Juiz de Fora, Brazil
| | - Adolfo Pisanu
- grid.7763.50000 0004 1755 3242Department of Surgical Science, University of Cagliari, Cagliari, Italy
| | - Oreste Nardello
- grid.7763.50000 0004 1755 3242Department of Surgical Science, University of Cagliari, Cagliari, Italy
| | | | - Hager Aref
- Department of Emergency, Digestive and Metabolic Minimally Invasive Surgery, Poissy and Saint Germain en Laye Hospitals, Poissy, France
| | - Nicola de’ Angelis
- grid.412116.10000 0004 1799 3934Unit of Digestive and HPB Surgery, CARE Department, Henri Mondor Hospital and University Paris-Est, Creteil, France
| | - Vanni Agnoletti
- grid.414682.d0000 0004 1758 8744Department of General and Trauma Surgery, Bufalini Hospital, Cesena, Italy
| | - Antonio Biondi
- grid.8158.40000 0004 1757 1969Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Marco Vacante
- grid.8158.40000 0004 1757 1969Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Giulia Griggio
- grid.8158.40000 0004 1757 1969Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Roberta Tutino
- grid.10776.370000 0004 1762 5517Chirurgia 1; Dipartimento di Discipline Chirurgiche , Oncologiche e Stomatologiche (DI.CHIR.ON.S), Ospedale “Ca’Foncell”; Univerità degli studi di Palermo, Treviso; Palermo, Italy
| | - Marco Massani
- grid.10776.370000 0004 1762 5517Chirurgia 1; Dipartimento di Discipline Chirurgiche , Oncologiche e Stomatologiche (DI.CHIR.ON.S), Ospedale “Ca’Foncell”; Univerità degli studi di Palermo, Treviso; Palermo, Italy
| | - Giovanni Bisetto
- grid.5608.b0000 0004 1757 3470Dipartimento di Scienze Chirurgiche, Oncologiche e Gastroenterologica (DI.SC.O.G.), Chirurgia 1-Ospedale “Ca Foncello”- Treviso, Università degli Studi di Padova, Padua, Italy
| | - Savino Occhionorelli
- grid.8484.00000 0004 1757 2064Department of General Surgery, Arcispedale Sant’Anna-University of Ferrara, Ferrara, Italy
| | - Dario Andreotti
- grid.8484.00000 0004 1757 2064Department of General Surgery, Arcispedale Sant’Anna-University of Ferrara, Ferrara, Italy
| | - Domenico Lacavalla
- grid.8484.00000 0004 1757 2064Department of General Surgery, Arcispedale Sant’Anna-University of Ferrara, Ferrara, Italy
| | - Walter L. Biffl
- grid.415401.5Department of Emergency and Trauma Surgery, Scripps Clinic Medical Group, La Jolla, CA USA
| | - Fausto Catena
- grid.414682.d0000 0004 1758 8744Department of General and Trauma Surgery, Bufalini Hospital, Cesena, Italy
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Haakenstad A, Yearwood JA, Fullman N, Bintz C, Bienhoff K, Weaver MR, Nandakumar V, LeGrand KE, Knight M, Abbafati C, Abbasi-Kangevari M, Abdoli A, Abeldaño Zuñiga RA, Adedeji IA, Adekanmbi V, Adetokunboh OO, Afzal MS, Afzal S, Agudelo-Botero M, Ahinkorah BO, Ahmad S, Ahmadi A, Ahmadi S, Ahmed A, Ahmed Rashid T, Aji B, Akande-Sholabi W, Alam K, Al Hamad H, Alhassan RK, Ali L, Alipour V, Aljunid SM, Ameyaw EK, Amin TT, Amu H, Amugsi DA, Ancuceanu R, Andrade PP, Anjum A, Arabloo J, Arab-Zozani M, Ariffin H, Arulappan J, Aryan Z, Ashraf T, Atnafu DD, Atreya A, Ausloos M, Avila-Burgos L, Ayano G, Ayanore MA, Azari S, Badiye AD, Baig AA, Bairwa M, Bakkannavar SM, Baliga S, Banik PC, Bärnighausen TW, Barra F, Barrow A, Basu S, Bayati M, Belete R, Bell AW, Bhagat DS, Bhagavathula AS, Bhardwaj P, Bhardwaj N, Bhaskar S, Bhattacharyya K, Bhurtyal A, Bhutta ZA, Bibi S, Bijani A, Bikbov B, Biondi A, Bolarinwa OA, Bonny A, Brenner H, Buonsenso D, Burkart K, Busse R, Butt ZA, Butt NS, Caetano dos Santos FL, Cahuana-Hurtado L, Cámera LA, Cárdenas R, Carneiro VLA, Catalá-López F, Chandan JS, Charan J, Chavan PP, Chen S, Chen S, Choudhari SG, Chowdhury EK, Chowdhury MAK, Cirillo M, Corso B, Dadras O, Dahlawi SMA, Dai X, Dandona L, Dandona R, Dangel WJ, Dávila-Cervantes CA, Davletov K, Deuba K, Dhimal M, Dhimal ML, Djalalinia S, Do HP, Doshmangir L, Duncan BB, Effiong A, Ehsani-Chimeh E, Elgendy IY, Elhadi M, El Sayed I, El Tantawi M, Erku DA, Eskandarieh S, Fares J, Farzadfar F, Ferrero S, Ferro Desideri L, Fischer F, Foigt NA, Foroutan M, Fukumoto T, Gaal PA, Gaihre S, Gardner WM, Garg T, Getachew Obsa A, Ghafourifard M, Ghashghaee A, Ghith N, Gilani SA, Gill PS, Goharinezhad S, Golechha M, Guadamuz JS, Guo Y, Gupta RD, Gupta R, Gupta VK, Gupta VB, Hamiduzzaman M, Hanif A, Haro JM, Hasaballah AI, Hasan MM, Hasan MT, Hashi A, Hay SI, Hayat K, Heidari M, Heidari G, Henry NJ, Herteliu C, Holla R, Hossain S, Hossain SJ, Hossain MBH, Hosseinzadeh M, Hostiuc S, Hoveidamanesh S, Hsieh VCR, Hu G, Huang J, Huda MM, Ifeagwu SC, Ikuta KS, Ilesanmi OS, Irvani SSN, Islam RM, Islam SMS, Ismail NE, Iso H, Isola G, Itumalla R, Iwagami M, Jahani MA, Jahanmehr N, Jain R, Jakovljevic M, Janodia MD, Jayapal SK, Jayaram S, Jha RP, Jonas JB, Joo T, Joseph N, Jürisson M, Kabir A, Kalankesh LR, Kalhor R, Kamath AM, Kamenov K, Kandel H, Kantar RS, Kapoor N, Karanikolos M, Katikireddi SV, Kavetskyy T, Kawakami N, Kayode GA, Keikavoosi-Arani L, Keykhaei M, Khader YS, Khajuria H, Khalilov R, Khammarnia M, Khan MN, Khan MAB, Khan M, Khezeli M, Kim MS, Kim YJ, Kisa S, Kisa A, Klymchuk V, Koly KN, Korzh O, Kosen S, Koul PA, Kuate Defo B, Kumar GA, Kusuma D, Kyu HH, Larsson AO, Lasrado S, Lee WC, Lee YH, Lee CB, Li S, Lucchetti G, Mahajan PB, Majeed A, Makki A, Malekzadeh R, Malik AA, Malta DC, Mansournia MA, Mantovani LG, Martinez-Valle A, Martins-Melo FR, Masoumi SZ, Mathur MR, Maude RJ, Maulik PK, McKee M, Mendoza W, Menezes RG, Mensah GA, Meretoja A, Meretoja TJ, Mestrovic T, Michalek IM, Mirrakhimov EM, Misganaw A, Misra S, Moazen B, Mohammadi M, Mohammed S, Moitra M, Mokdad AH, Molokhia M, Monasta L, Moni MA, Moradi G, Moreira RS, Mosser JF, Mostafavi E, Mouodi S, Nagarajan AJ, Nagata C, Naghavi M, Nangia V, Narasimha Swamy S, Narayana AI, Nascimento BR, Nassereldine H, Nayak BP, Nazari J, Negoi I, Nepal S, Neupane Kandel S, Ngunjiri JW, Nguyen HLT, Nguyen CT, Ningrum DNA, Noubiap JJ, Oancea B, Oghenetega OB, Oh IH, Olagunju AT, Olakunde BO, Omar Bali A, Omer E, Onwujekwe OE, Otoiu A, Padubidri JR, Palladino R, Pana A, Panda-Jonas S, Pandi-Perumal SR, Pardhan S, Pasupula DK, Pathak PK, Patton GC, Pawar S, Pereira J, Pilania M, Piroozi B, Podder V, Pokhrel KN, Postma MJ, Prada SI, Quazi Syed Z, Rabiee N, Radhakrishnan RA, Rahman MM, Rahman M, Rahman M, Rahman MHU, Rahmani AM, Ranabhat CL, Rao CR, Rao SJ, Rasella D, Rawaf S, Rawaf DL, Rawal L, Renzaho AM, Reshmi B, Resnikoff S, Rezapour A, Riahi SM, Ripon RK, Sacco S, Sadeghi M, Saeed U, Sahebkar A, Sahiledengle B, Sahoo H, Sahu M, Salama JS, Salamati P, Samy AM, Sanabria J, Santric-Milicevic MM, Sathian B, Sawhney M, Schmidt MI, Seidu AA, Sepanlou SG, Seylani A, Shaikh MA, Sheikh A, Shetty A, Shigematsu M, Shiri R, Shivakumar KM, Shokri A, Singh JA, Sinha DN, Skryabin VY, Skryabina AA, Sofi-Mahmudi A, Sousa RARC, Stephens JH, Sun J, Szócska M, Tabarés-Seisdedos R, Tadbiri H, Tamiru AT, Thankappan KR, Topor-Madry R, Tovani-Palone MR, Tran MTN, Tran BX, Tripathi N, Tripathy JP, Troeger CE, Uezono DR, Ullah S, Ullah A, Unnikrishnan B, Vacante M, Valadan Tahbaz S, Valdez PR, Vasic M, Veroux M, Vervoort D, Violante FS, Vladimirov SK, Vlassov V, Vo B, Waheed Y, Wamai RG, Wang YP, Wang Y, Ward P, Wiangkham T, Yadav L, Yahyazadeh Jabbari SH, Yamagishi K, Yaya S, Yazdi-Feyzabadi V, Yi S, Yiğit V, Yonemoto N, Younis MZ, Yu C, Yunusa I, Zaman SB, Zastrozhin MS, Zhang ZJ, Zhong C, Zuniga YMH, Lim SS, Murray CJL, Lozano R. Assessing performance of the Healthcare Access and Quality Index, overall and by select age groups, for 204 countries and territories, 1990-2019: a systematic analysis from the Global Burden of Disease Study 2019. Lancet Glob Health 2022; 10:e1715-e1743. [PMID: 36209761 PMCID: PMC9666426 DOI: 10.1016/s2214-109x(22)00429-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 05/13/2022] [Accepted: 09/23/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Health-care needs change throughout the life course. It is thus crucial to assess whether health systems provide access to quality health care for all ages. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019), we measured the Healthcare Access and Quality (HAQ) Index overall and for select age groups in 204 locations from 1990 to 2019. METHODS We distinguished the overall HAQ Index (ages 0-74 years) from scores for select age groups: the young (ages 0-14 years), working (ages 15-64 years), and post-working (ages 65-74 years) groups. For GBD 2019, HAQ Index construction methods were updated to use the arithmetic mean of scaled mortality-to-incidence ratios (MIRs) and risk-standardised death rates (RSDRs) for 32 causes of death that should not occur in the presence of timely, quality health care. Across locations and years, MIRs and RSDRs were scaled from 0 (worst) to 100 (best) separately, putting the HAQ Index on a different relative scale for each age group. We estimated absolute convergence for each group on the basis of whether the HAQ Index grew faster in absolute terms between 1990 and 2019 in countries with lower 1990 HAQ Index scores than countries with higher 1990 HAQ Index scores and by Socio-demographic Index (SDI) quintile. SDI is a summary metric of overall development. FINDINGS Between 1990 and 2019, the HAQ Index increased overall (by 19·6 points, 95% uncertainty interval 17·9-21·3), as well as among the young (22·5, 19·9-24·7), working (17·2, 15·2-19·1), and post-working (15·1, 13·2-17·0) age groups. Large differences in HAQ Index scores were present across SDI levels in 2019, with the overall index ranging from 30·7 (28·6-33·0) on average in low-SDI countries to 83·4 (82·4-84·3) on average in high-SDI countries. Similarly large ranges between low-SDI and high-SDI countries, respectively, were estimated in the HAQ Index for the young (40·4-89·0), working (33·8-82·8), and post-working (30·4-79·1) groups. Absolute convergence in HAQ Index was estimated in the young group only. In contrast, divergence was estimated among the working and post-working groups, driven by slow progress in low-SDI countries. INTERPRETATION Although major gaps remain across levels of social and economic development, convergence in the young group is an encouraging sign of reduced disparities in health-care access and quality. However, divergence in the working and post-working groups indicates that health-care access and quality is lagging at lower levels of social and economic development. To meet the needs of ageing populations, health systems need to improve health-care access and quality for working-age adults and older populations while continuing to realise gains among the young. FUNDING Bill & Melinda Gates Foundation.
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Tran KB, Lang JJ, Compton K, Xu R, Acheson AR, Henrikson HJ, Kocarnik JM, Penberthy L, Aali A, Abbas Q, Abbasi B, Abbasi-Kangevari M, Abbasi-Kangevari Z, Abbastabar H, Abdelmasseh M, Abd-Elsalam S, Abdelwahab AA, Abdoli G, Abdulkadir HA, Abedi A, Abegaz KH, Abidi H, Aboagye RG, Abolhassani H, Absalan A, Abtew YD, Abubaker Ali H, Abu-Gharbieh E, Achappa B, Acuna JM, Addison D, Addo IY, Adegboye OA, Adesina MA, Adnan M, Adnani QES, Advani SM, Afrin S, Afzal MS, Aggarwal M, Ahinkorah BO, Ahmad AR, Ahmad R, Ahmad S, Ahmad S, Ahmadi S, Ahmed H, Ahmed LA, Ahmed MB, Ahmed Rashid T, Aiman W, Ajami M, Akalu GT, Akbarzadeh-Khiavi M, Aklilu A, Akonde M, Akunna CJ, Al Hamad H, Alahdab F, Alanezi FM, Alanzi TM, Alessy SA, Algammal AM, Al-Hanawi MK, Alhassan RK, Ali BA, Ali L, Ali SS, Alimohamadi Y, Alipour V, Aljunid SM, Alkhayyat M, Al-Maweri SAA, Almustanyir S, Alonso N, Alqalyoobi S, Al-Raddadi RM, Al-Rifai RHH, Al-Sabah SK, Al-Tammemi AB, Altawalah H, Alvis-Guzman N, Amare F, Ameyaw EK, Aminian Dehkordi JJ, Amirzade-Iranaq MH, Amu H, Amusa GA, Ancuceanu R, Anderson JA, Animut YA, Anoushiravani A, Anoushirvani AA, Ansari-Moghaddam A, Ansha MG, Antony B, Antwi MH, Anwar SL, Anwer R, Anyasodor AE, Arabloo J, Arab-Zozani M, Aremu O, Argaw AM, Ariffin H, Aripov T, Arshad M, Artaman A, Arulappan J, Aruleba RT, Aryannejad A, Asaad M, Asemahagn MA, Asemi Z, Asghari-Jafarabadi M, Ashraf T, Assadi R, Athar M, Athari SS, Atout MMW, Attia S, Aujayeb A, Ausloos M, Avila-Burgos L, Awedew AF, Awoke MA, Awoke T, Ayala Quintanilla BP, Ayana TM, Ayen SS, Azadi D, Azadnajafabad S, Azami-Aghdash S, Azanaw MM, Azangou-Khyavy M, Azari Jafari A, Azizi H, Azzam AYY, Babajani A, Badar M, Badiye AD, Baghcheghi N, Bagheri N, Bagherieh S, Bahadory S, Baig AA, Baker JL, Bakhtiari A, Bakshi RK, Banach M, Banerjee I, Bardhan M, Barone-Adesi F, Barra F, Barrow A, Bashir NZ, Bashiri A, Basu S, Batiha AMM, Begum A, Bekele AB, Belay AS, Belete MA, Belgaumi UI, Bell AW, Belo L, Benzian H, Berhie AY, Bermudez ANC, Bernabe E, Bhagavathula AS, Bhala N, Bhandari BB, Bhardwaj N, Bhardwaj P, Bhattacharyya K, Bhojaraja VS, Bhuyan SS, Bibi S, Bilchut AH, Bintoro BS, Biondi A, Birega MGB, Birhan HE, Bjørge T, Blyuss O, Bodicha BBA, Bolla SR, Boloor A, Bosetti C, Braithwaite D, Brauer M, Brenner H, Briko AN, Briko NI, Buchanan CM, Bulamu NB, Bustamante-Teixeira MT, Butt MH, Butt NS, Butt ZA, Caetano dos Santos FL, Cámera LA, Cao C, Cao Y, Carreras G, Carvalho M, Cembranel F, Cerin E, Chakraborty PA, Charalampous P, Chattu VK, Chimed-Ochir O, Chirinos-Caceres JL, Cho DY, Cho WCS, Christopher DJ, Chu DT, Chukwu IS, Cohen AJ, Conde J, Cortés S, Costa VM, Cruz-Martins N, Culbreth GT, Dadras O, Dagnaw FT, Dahlawi SMA, Dai X, Dandona L, Dandona R, Daneshpajouhnejad P, Danielewicz A, Dao ATM, Darvishi Cheshmeh Soltani R, Darwesh AM, Das S, Davitoiu DV, Davtalab Esmaeili E, De la Hoz FP, Debela SA, Dehghan A, Demisse B, Demisse FW, Denova-Gutiérrez E, Derakhshani A, Derbew Molla M, Dereje D, Deribe KS, Desai R, Desalegn MD, Dessalegn FN, Dessalegni SAA, Dessie G, Desta AA, Dewan SMR, Dharmaratne SD, Dhimal M, Dianatinasab M, Diao N, Diaz D, Digesa LE, Dixit SG, Doaei S, Doan LP, Doku PN, Dongarwar D, dos Santos WM, Driscoll TR, Dsouza HL, Durojaiye OC, Edalati S, Eghbalian F, Ehsani-Chimeh E, Eini E, Ekholuenetale M, Ekundayo TC, Ekwueme DU, El Tantawi M, Elbahnasawy MA, Elbarazi I, Elghazaly H, Elhadi M, El-Huneidi W, Emamian MH, Engelbert Bain L, Enyew DB, Erkhembayar R, Eshetu T, Eshrati B, Eskandarieh S, Espinosa-Montero J, Etaee F, Etemadimanesh A, Eyayu T, Ezeonwumelu IJ, Ezzikouri S, Fagbamigbe AF, Fahimi S, Fakhradiyev IR, Faraon EJA, Fares J, Farmany A, Farooque U, Farrokhpour H, Fasanmi AO, Fatehizadeh A, Fatima W, Fattahi H, Fekadu G, Feleke BE, Ferrari AA, Ferrero S, Ferro Desideri L, Filip I, Fischer F, Foroumadi R, Foroutan M, Fukumoto T, Gaal PA, Gad MM, Gadanya MA, Gaipov A, Galehdar N, Gallus S, Garg T, Gaspar Fonseca M, Gebremariam YH, Gebremeskel TG, Gebremichael MA, Geda YF, Gela YY, Gemeda BNB, Getachew M, Getachew ME, Ghaffari K, Ghafourifard M, Ghamari SH, Ghasemi Nour M, Ghassemi F, Ghimire A, Ghith N, Gholamalizadeh M, Gholizadeh Navashenaq J, Ghozy S, Gilani SA, Gill PS, Ginindza TG, Gizaw ATT, Glasbey JC, Godos J, Goel A, Golechha M, Goleij P, Golinelli D, Golitaleb M, Gorini G, Goulart BNG, Grosso G, Guadie HA, Gubari MIM, Gudayu TW, Guerra MR, Gunawardane DA, Gupta B, Gupta S, Gupta VB, Gupta VK, Gurara MK, Guta A, Habibzadeh P, Haddadi Avval A, Hafezi-Nejad N, Hajj Ali A, Haj-Mirzaian A, Halboub ES, Halimi A, Halwani R, Hamadeh RR, Hameed S, Hamidi S, Hanif A, Hariri S, Harlianto NI, Haro JM, Hartono RK, Hasaballah AI, Hasan SMM, Hasani H, Hashemi SM, Hassan AM, Hassanipour S, Hayat K, Heidari G, Heidari M, Heidarymeybodi Z, Herrera-Serna BY, Herteliu C, Hezam K, Hiraike Y, Hlongwa MM, Holla R, Holm M, Horita N, Hoseini M, Hossain MM, Hossain MBH, Hosseini MS, Hosseinzadeh A, Hosseinzadeh M, Hostiuc M, Hostiuc S, Househ M, Huang J, Hugo FN, Humayun A, Hussain S, Hussein NR, Hwang BF, Ibitoye SE, Iftikhar PM, Ikuta KS, Ilesanmi OS, Ilic IM, Ilic MD, Immurana M, Innos K, Iranpour P, Irham LM, Islam MS, Islam RM, Islami F, Ismail NE, Isola G, Iwagami M, J LM, Jaiswal A, Jakovljevic M, Jalili M, Jalilian S, Jamshidi E, Jang SI, Jani CT, Javaheri T, Jayarajah UU, Jayaram S, Jazayeri SB, Jebai R, Jemal B, Jeong W, Jha RP, Jindal HA, John-Akinola YO, Jonas JB, Joo T, Joseph N, Joukar F, Jozwiak JJ, Jürisson M, Kabir A, Kacimi SEO, Kadashetti V, Kahe F, Kakodkar PV, Kalankesh LR, Kalankesh LR, Kalhor R, Kamal VK, Kamangar F, Kamath A, Kanchan T, Kandaswamy E, Kandel H, Kang H, Kanno GG, Kapoor N, Kar SS, Karanth SD, Karaye IM, Karch A, Karimi A, Kassa BG, Katoto PDMC, Kauppila JH, Kaur H, Kebede AG, Keikavoosi-Arani L, Kejela GG, Kemp Bohan PM, Keramati M, Keykhaei M, Khajuria H, Khan A, Khan AAK, Khan EA, Khan G, Khan MN, Khan MAB, Khanali J, Khatab K, Khatatbeh MM, Khatib MN, Khayamzadeh M, Khayat Kashani HR, Khazeei Tabari MA, Khezeli M, Khodadost M, Kim MS, Kim YJ, Kisa A, Kisa S, Klugar M, Klugarová J, Kolahi AA, Kolkhir P, Kompani F, Koul PA, Koulmane Laxminarayana SL, Koyanagi A, Krishan K, Krishnamoorthy Y, Kucuk Bicer B, Kugbey N, Kulimbet M, Kumar A, Kumar GA, Kumar N, Kurmi OP, Kuttikkattu A, La Vecchia C, Lahiri A, Lal DK, Lám J, Lan Q, Landires I, Larijani B, Lasrado S, Lau J, Lauriola P, Ledda C, Lee SW, Lee SWH, Lee WC, Lee YY, Lee YH, Legesse SM, Leigh J, Leong E, Li MC, Lim SS, Liu G, Liu J, Lo CH, Lohiya A, Lopukhov PD, Lorenzovici L, Lotfi M, Loureiro JA, Lunevicius R, Madadizadeh F, Mafi AR, Magdeldin S, Mahjoub S, Mahmoodpoor A, Mahmoudi M, Mahmoudimanesh M, Mahumud RA, Majeed A, Majidpoor J, Makki A, Makris KC, Malakan Rad E, Malekpour MR, Malekzadeh R, Malik AA, Mallhi TH, Mallya SD, Mamun MA, Manda AL, Mansour-Ghanaei F, Mansouri B, Mansournia MA, Mantovani LG, Martini S, Martorell M, Masoudi S, Masoumi SZ, Matei CN, Mathews E, Mathur MR, Mathur V, McKee M, Meena JK, Mehmood K, Mehrabi Nasab E, Mehrotra R, Melese A, Mendoza W, Menezes RG, Mengesha SID, Mensah LG, Mentis AFA, Mera-Mamián AYM, Meretoja TJ, Merid MW, Mersha AG, Meselu BT, Meshkat M, Mestrovic T, Miao Jonasson J, Miazgowski T, Michalek IM, Mijena GFW, Miller TR, Mir SA, Mirinezhad SK, Mirmoeeni S, Mirza-Aghazadeh-Attari M, Mirzaei H, Mirzaei HR, Misganaw AS, Misra S, Mohammad KA, Mohammadi E, Mohammadi M, Mohammadian-Hafshejani A, Mohammadpourhodki R, Mohammed A, Mohammed S, Mohan S, Mohseni M, Moka N, Mokdad AH, Molassiotis A, Molokhia M, Momenzadeh K, Momtazmanesh S, Monasta L, Mons U, Montasir AA, Montazeri F, Montero A, Moosavi MA, Moradi A, Moradi Y, Moradi Sarabi M, Moraga P, Morawska L, Morrison SD, Morze J, Mosapour A, Mostafavi E, Mousavi SM, Mousavi Isfahani H, Mousavi Khaneghah A, Mpundu-Kaambwa C, Mubarik S, Mulita F, Munblit D, Munro SB, Murillo-Zamora E, Musa J, Nabhan AF, Nagarajan AJ, Nagaraju SP, Nagel G, Naghipour M, Naimzada MD, Nair TS, Naqvi AA, Narasimha Swamy S, Narayana AI, Nassereldine H, Natto ZS, Nayak BP, Ndejjo R, Nduaguba SO, Negash WW, Nejadghaderi SA, Nejati K, Neupane Kandel S, Nguyen HVN, Niazi RK, Noor NM, Noori M, Noroozi N, Nouraei H, Nowroozi A, Nuñez-Samudio V, Nzoputam CI, Nzoputam OJ, Oancea B, Odukoya OO, Oghenetega OB, Ogunsakin RE, Oguntade AS, Oh IH, Okati-Aliabad H, Okekunle AP, Olagunju AT, Olagunju TO, Olakunde BO, Olufadewa II, Omer E, Omonisi AEE, Ong S, Onwujekwe OE, Orru H, Otstavnov SS, Oulhaj A, Oumer B, Owopetu OF, Oyinloye BE, P A M, Padron-Monedero A, Padubidri JR, Pakbin B, Pakshir K, Pakzad R, Palicz T, Pana A, Pandey A, Pandey A, Pant S, Pardhan S, Park EC, Park EK, Park S, Patel J, Pati S, Paudel R, Paudel U, Paun M, Pazoki Toroudi H, Peng M, Pereira J, Pereira RB, Perna S, Perumalsamy N, Pestell RG, Pezzani R, Piccinelli C, Pillay JD, Piracha ZZ, Pischon T, Postma MJ, Pourabhari Langroudi A, Pourshams A, Pourtaheri N, Prashant A, Qadir MMF, Quazi Syed Z, Rabiee M, Rabiee N, Radfar A, Radhakrishnan RA, Radhakrishnan V, Raeisi M, Rafiee A, Rafiei A, Raheem N, Rahim F, Rahman MO, Rahman M, Rahman MA, Rahmani AM, Rahmani S, Rahmanian V, Rajai N, Rajesh A, Ram P, Ramezanzadeh K, Rana J, Ranabhat K, Ranasinghe P, Rao CR, Rao SJ, Rashedi S, Rashidi A, Rashidi M, Rashidi MM, Ratan ZA, Rawaf DL, Rawaf S, Rawal L, Rawassizadeh R, Razeghinia MS, Rehman AU, Rehman IU, Reitsma MB, Renzaho AMN, Rezaei M, Rezaei N, Rezaei N, Rezaei N, Rezaei S, Rezaeian M, Rezapour A, Riad A, Rikhtegar R, Rios-Blancas M, Roberts TJ, Rohloff P, Romero-Rodríguez E, Roshandel G, Rwegerera GM, S M, Saber-Ayad MM, Saberzadeh-Ardestani B, Sabour S, Saddik B, Sadeghi E, Saeb MR, Saeed U, Safaei M, Safary A, Sahebazzamani M, Sahebkar A, Sahoo H, Sajid MR, Salari H, Salehi S, Salem MR, Salimzadeh H, Samodra YL, Samy AM, Sanabria J, Sankararaman S, Sanmarchi F, Santric-Milicevic MM, Saqib MAN, Sarveazad A, Sarvi F, Sathian B, Satpathy M, Sayegh N, Schneider IJC, Schwarzinger M, Šekerija M, Senthilkumaran S, Sepanlou SG, Seylani A, Seyoum K, Sha F, Shafaat O, Shah PA, Shahabi S, Shahid I, Shahrbaf MA, Shahsavari HR, Shaikh MA, Shaka MF, Shaker E, Shannawaz M, Sharew MMS, Sharifi A, Sharifi-Rad J, Sharma P, Shashamo BB, Sheikh A, Sheikh M, Sheikhbahaei S, Sheikhi RA, Sheikhy A, Shepherd PR, Shetty A, Shetty JK, Shetty RS, Shibuya K, Shirkoohi R, Shirzad-Aski H, Shivakumar KM, Shivalli S, Shivarov V, Shobeiri P, Shokri Varniab Z, Shorofi SA, Shrestha S, Sibhat MM, Siddappa Malleshappa SK, Sidemo NB, Silva DAS, Silva LMLR, Silva Julian G, Silvestris N, Simegn W, Singh AD, Singh A, Singh G, Singh H, Singh JA, Singh JK, Singh P, Singh S, Sinha DN, Sinke AH, Siraj MS, Sitas F, Siwal SS, Skryabin VY, Skryabina AA, Socea B, Soeberg MJ, Sofi-Mahmudi A, Solomon Y, Soltani-Zangbar MS, Song S, Song Y, Sorensen RJD, Soshnikov S, Sotoudeh H, Sowe A, Sufiyan MB, Suk R, Suleman M, Suliankatchi Abdulkader R, Sultana S, Sur D, Szócska M, Tabaeian SP, Tabarés-Seisdedos R, Tabatabaei SM, Tabuchi T, Tadbiri H, Taheri E, Taheri M, Taheri Soodejani M, Takahashi K, Talaat IM, Tampa M, Tan KK, Tat NY, Tat VY, Tavakoli A, Tavakoli A, Tehrani-Banihashemi A, Tekalegn Y, Tesfay FH, Thapar R, Thavamani A, Thoguluva Chandrasekar V, Thomas N, Thomas NK, Ticoalu JHV, Tiyuri A, Tollosa DN, Topor-Madry R, Touvier M, Tovani-Palone MR, Traini E, Tran MTN, Tripathy JP, Ukke GG, Ullah I, Ullah S, Ullah S, Unnikrishnan B, Vacante M, Vaezi M, Valadan Tahbaz S, Valdez PR, Vardavas C, Varthya SB, Vaziri S, Velazquez DZ, Veroux M, Villeneuve PJ, Violante FS, Vladimirov SK, Vlassov V, Vo B, Vu LG, Wadood AW, Waheed Y, Walde MT, Wamai RG, Wang C, Wang F, Wang N, Wang Y, Ward P, Waris A, Westerman R, Wickramasinghe ND, Woldemariam M, Woldu B, Xiao H, Xu S, Xu X, Yadav L, Yahyazadeh Jabbari SH, Yang L, Yazdanpanah F, Yeshaw Y, Yismaw Y, Yonemoto N, Younis MZ, Yousefi Z, Yousefian F, Yu C, Yu Y, Yunusa I, Zahir M, Zaki N, Zaman BA, Zangiabadian M, Zare F, Zare I, Zareshahrabadi Z, Zarrintan A, Zastrozhin MS, Zeineddine MA, Zhang D, Zhang J, Zhang Y, Zhang ZJ, Zhou L, Zodpey S, Zoladl M, Vos T, Hay SI, Force LM, Murray CJL. The global burden of cancer attributable to risk factors, 2010-19: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2022; 400:563-591. [PMID: 35988567 PMCID: PMC9395583 DOI: 10.1016/s0140-6736(22)01438-6] [Citation(s) in RCA: 189] [Impact Index Per Article: 94.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 05/13/2022] [Accepted: 07/28/2022] [Indexed: 02/06/2023]
Abstract
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. FUNDING Bill & Melinda Gates Foundation.
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Licata L, Di Fidio CA, Vacante M, Basile F, Biondi A, Richiusa P, Gurrera A, Ciuni R. A Rare Case of Negative Serum Calcitonin in Metastatic Medullary Thyroid Carcinoma: Diagnosis, Treatment, and Follow-Up Strategy. Am J Case Rep 2022; 23:e935207. [PMID: 36088532 PMCID: PMC9475495 DOI: 10.12659/ajcr.935207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Patient: Male, 39-year-old
Final Diagnosis: Medullary thyroid carcinoma
Symptoms: Painful left latero-cervical mass of 2.5 cm
Medication: —
Clinical Procedure: —
Specialty: Endocrinology and Metabolic • Surgery
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Affiliation(s)
- Lorena Licata
- Department of General Surgery and Medical Surgical Specialties, G. Rodolico Hospital; Surgical Division, University of Catania, Catania, Italy
| | - Cristina A. Di Fidio
- Department of General Surgery and Medical Surgical Specialties, G. Rodolico Hospital; Surgical Division, University of Catania, Catania, Italy
| | - Marco Vacante
- Department of General Surgery and Medical Surgical Specialties, G. Rodolico Hospital; Surgical Division, University of Catania, Catania, Italy
| | - Francesco Basile
- Department of General Surgery and Medical Surgical Specialties, G. Rodolico Hospital; Surgical Division, University of Catania, Catania, Italy
| | - Antonio Biondi
- Department of General Surgery and Medical Surgical Specialties, G. Rodolico Hospital; Surgical Division, University of Catania, Catania, Italy
| | - Pierina Richiusa
- Department of Endocrinology, Paolo Giaccone Hospital, University of Palermo, Palermo, Italy
| | - Alessandra Gurrera
- Department of Pathological Anatomy, University of Catania, San Marco Hospital, Catania, Italy
| | - Roberto Ciuni
- Department of General Surgery and Medical Surgical Specialties, G. Rodolico Hospital; Surgical Division, University of Catania, Catania, Italy
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Sharma R, Abbasi-Kangevari M, Abd-Rabu R, Abidi H, Abu-Gharbieh E, Acuna JM, Adhikari S, Advani SM, Afzal MS, Aghaie Meybodi M, Ahinkorah BO, Ahmad S, Ahmadi A, Ahmadi S, Ahmed H, Ahmed LA, Ahmed MB, Al Hamad H, Alahdab F, Alanezi FM, Alanzi TM, Alhalaiqa FAN, Alimohamadi Y, Alipour V, Aljunid SM, Alkhayyat M, Almustanyir S, Al-Raddadi RM, Alvand S, Alvis-Guzman N, Amini S, Ancuceanu R, Anoushiravani A, Anoushirvani AA, Ansari-Moghaddam A, Arabloo J, Aryannejad A, Asghari Jafarabadi M, Athari SS, Ausloos F, Ausloos M, Awedew AF, Awoke MA, Ayana TM, Azadnajafabad S, Azami H, Azangou-Khyavy M, Azari Jafari A, Badiye AD, Bagherieh S, Bahadory S, Baig AA, Baker JL, Banach M, Barrow A, Berhie AY, Besharat S, Bhagat DS, Bhagavathula AS, Bhala N, Bhattacharyya K, Bhojaraja VS, Bibi S, Bijani A, Biondi A, Bjørge T, Bodicha BBA, Braithwaite D, Brenner H, Calina D, Cao C, Cao Y, Carreras G, Carvalho F, Cerin E, Chakinala RC, Cho WCS, Chu DT, Conde J, Costa VM, Cruz-Martins N, Dadras O, Dai X, Dandona L, Dandona R, Danielewicz A, Demeke FM, Demissie GD, Desai R, Dhamnetiya D, Dianatinasab M, Diaz D, Didehdar M, Doaei S, Doan LP, Dodangeh M, Eghbalian F, Ejeta DD, Ekholuenetale M, Ekundayo TC, El Sayed I, Elhadi M, Enyew DB, Eyayu T, Ezzeddini R, Fakhradiyev IR, Farooque U, Farrokhpour H, Farzadfar F, Fatehizadeh A, Fattahi H, Fattahi N, Fereidoonnezhad M, Fernandes E, Fetensa G, Filip I, Fischer F, Foroutan M, Gaal PA, Gad MM, Gallus S, Garg T, Getachew T, Ghamari SH, Ghashghaee A, Ghith N, Gholamalizadeh M, Gholizadeh Navashenaq J, Gizaw AT, Glasbey JC, Golechha M, Goleij P, Gonfa KB, Gorini G, Guha A, Gupta S, Gupta VB, Gupta VK, Haddadi R, Hafezi-Nejad N, Haj-Mirzaian A, Halwani R, Haque S, Hariri S, Hasaballah AI, Hassanipour S, Hay SI, Herteliu C, Holla R, Hosseini MS, Hosseinzadeh M, Hostiuc M, Househ M, Huang J, Humayun A, Iavicoli I, Ilesanmi OS, Ilic IM, Ilic MD, Islami F, Iwagami M, Jahani MA, Jakovljevic M, Javaheri T, Jayawardena R, Jebai R, Jha RP, Joo T, Joseph N, Joukar F, Jozwiak JJ, Kabir A, Kalhor R, Kamath A, Kapoor N, Karaye IM, Karimi A, Kauppila JH, Kazemi A, Keykhaei M, Khader YS, Khajuria H, Khalilov R, Khanali J, Khayamzadeh M, Khodadost M, Kim H, Kim MS, Kisa A, Kisa S, Kolahi AA, Koohestani HR, Kopec JA, Koteeswaran R, Koyanagi A, Krishnamoorthy Y, Kumar GA, Kumar M, Kumar V, La Vecchia C, Lami FH, Landires I, Ledda C, Lee SW, Lee WC, Lee YY, Leong E, Li B, Lim SS, Lobo SW, Loureiro JA, Lunevicius R, Madadizadeh F, Mahmoodpoor A, Majeed A, Malekpour MR, Malekzadeh R, Malik AA, Mansour-Ghanaei F, Mantovani LG, Martorell M, Masoudi S, Mathur P, Meena JK, Mehrabi Nasab E, Mendoza W, Mentis AFA, Mestrovic T, Miao Jonasson J, Miazgowski B, Miazgowski T, Mijena GFW, Mirmoeeni S, Mirza-Aghazadeh-Attari M, Mirzaei H, Misra S, Mohammad KA, Mohammadi E, Mohammadi S, Mohammadi SM, Mohammadian-Hafshejani A, Mohammed S, Mohammed TA, Moka N, Mokdad AH, Mokhtari Z, Molokhia M, Momtazmanesh S, Monasta L, Moradi G, Moradzadeh R, Moraga P, Morgado-da-Costa J, Mubarik S, Mulita F, Naghavi M, Naimzada MD, Nam HS, Natto ZS, Nayak BP, Nazari J, Nazemalhosseini-Mojarad E, Negoi I, Nguyen CT, Nguyen SH, Noor NM, Noori M, Noori SMA, Nuñez-Samudio V, Nzoputam CI, Oancea B, Odukoya OO, Oguntade AS, Okati-Aliabad H, Olagunju AT, Olagunju TO, Ong S, Ostroff SM, Padron-Monedero A, Pakzad R, Pana A, Pandey A, Pashazadeh Kan F, Patel UK, Paudel U, Pereira RB, Perumalsamy N, Pestell RG, Piracha ZZ, Pollok RCG, Pourshams A, Pourtaheri N, Prashant A, Rabiee M, Rabiee N, Radfar A, Rafiei S, Rahman M, Rahmani AM, Rahmanian V, Rajai N, Rajesh A, Ramezani-Doroh V, Ramezanzadeh K, Ranabhat K, Rashedi S, Rashidi A, Rashidi M, Rashidi MM, Rastegar M, Rawaf DL, Rawaf S, Rawassizadeh R, Razeghinia MS, Renzaho AMN, Rezaei N, Rezaei N, Rezaei S, Rezaeian M, Rezazadeh-Khadem S, Roshandel G, Saber-Ayad MM, Saberzadeh-Ardestani B, Saddik B, Sadeghi H, Saeed U, Sahebazzamani M, Sahebkar A, Salek Farrokhi A, Salimi A, Salimzadeh H, Samadi P, Samaei M, Samy AM, Sanabria J, Santric-Milicevic MM, Saqib MAN, Sarveazad A, Sathian B, Satpathy M, Schneider IJC, Šekerija M, Sepanlou SG, Seylani A, Sha F, Shafiee SM, Shaghaghi Z, Shahabi S, Shaker E, Sharifian M, Sharifi-Rad J, Sheikhbahaei S, Shetty JK, Shirkoohi R, Shobeiri P, Siddappa Malleshappa SK, Silva DAS, Silva Julian G, Singh AD, Singh JA, Siraj MS, Sivandzadeh GR, Skryabin VY, Skryabina AA, Socea B, Solmi M, Soltani-Zangbar MS, Song S, Szerencsés V, Szócska M, Tabarés-Seisdedos R, Tabibian E, Taheri M, TaheriAbkenar Y, Taherkhani A, Talaat IM, Tan KK, Tbakhi A, Tesfaye B, Tiyuri A, Tollosa DN, Touvier M, Tran BX, Tusa BS, Ullah I, Ullah S, Vacante M, Valadan Tahbaz S, Veroux M, Vo B, Vos T, Wang C, Westerman R, Woldemariam M, Yahyazadeh Jabbari SH, Yang L, Yazdanpanah F, Yu C, Yuce D, Yunusa I, Zadnik V, Zahir M, Zare I, Zhang ZJ, Zoladl M. Global, regional, and national burden of colorectal cancer and its risk factors, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Gastroenterol Hepatol 2022; 7:627-647. [PMID: 35397795 PMCID: PMC9192760 DOI: 10.1016/s2468-1253(22)00044-9] [Citation(s) in RCA: 154] [Impact Index Per Article: 77.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 01/30/2022] [Accepted: 02/04/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Colorectal cancer is the third leading cause of cancer deaths worldwide. Given the recent increasing trends in colorectal cancer incidence globally, up-to-date information on the colorectal cancer burden could guide screening, early detection, and treatment strategies, and help effectively allocate resources. We examined the temporal patterns of the global, regional, and national burden of colorectal cancer and its risk factors in 204 countries and territories across the past three decades. METHODS Estimates of incidence, mortality, and disability-adjusted life years (DALYs) for colorectal cancer were generated as a part of the Global Burden of Diseases, Injuries and Risk Factors Study (GBD) 2019 by age, sex, and geographical location for the period 1990-2019. Mortality estimates were produced using the cause of death ensemble model. We also calculated DALYs attributable to risk factors that had evidence of causation with colorectal cancer. FINDINGS Globally, between 1990 and 2019, colorectal cancer incident cases more than doubled, from 842 098 (95% uncertainty interval [UI] 810 408-868 574) to 2·17 million (2·00-2·34), and deaths increased from 518 126 (493 682-537 877) to 1·09 million (1·02-1·15). The global age-standardised incidence rate increased from 22·2 (95% UI 21·3-23·0) per 100 000 to 26·7 (24·6-28·9) per 100 000, whereas the age-standardised mortality rate decreased from 14·3 (13·5-14·9) per 100 000 to 13·7 (12·6-14·5) per 100 000 and the age-standardised DALY rate decreased from 308·5 (294·7-320·7) per 100 000 to 295·5 (275·2-313·0) per 100 000 from 1990 through 2019. Taiwan (province of China; 62·0 [48·9-80·0] per 100 000), Monaco (60·7 [48·5-73·6] per 100 000), and Andorra (56·6 [42·8-71·9] per 100 000) had the highest age-standardised incidence rates, while Greenland (31·4 [26·0-37·1] per 100 000), Brunei (30·3 [26·6-34·1] per 100 000), and Hungary (28·6 [23·6-34·0] per 100 000) had the highest age-standardised mortality rates. From 1990 through 2019, a substantial rise in incidence rates was observed in younger adults (age <50 years), particularly in high Socio-demographic Index (SDI) countries. Globally, a diet low in milk (15·6%), smoking (13·3%), a diet low in calcium (12·9%), and alcohol use (9·9%) were the main contributors to colorectal cancer DALYs in 2019. INTERPRETATION The increase in incidence rates in people younger than 50 years requires vigilance from researchers, clinicians, and policy makers and a possible reconsideration of screening guidelines. The fast-rising burden in low SDI and middle SDI countries in Asia and Africa calls for colorectal cancer prevention approaches, greater awareness, and cost-effective screening and therapeutic options in these regions. FUNDING Bill & Melinda Gates Foundation.
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Burkart K, Causey K, Cohen AJ, Wozniak SS, Salvi DD, Abbafati C, Adekanmbi V, Adsuar JC, Ahmadi K, Alahdab F, Al-Aly Z, Alipour V, Alvis-Guzman N, Amegah AK, Andrei CL, Andrei T, Ansari F, Arabloo J, Aremu O, Aripov T, Babaee E, Banach M, Barnett A, Bärnighausen TW, Bedi N, Behzadifar M, Béjot Y, Bennett DA, Bensenor IM, Bernstein RS, Bhattacharyya K, Bijani A, Biondi A, Bohlouli S, Breitner S, Brenner H, Butt ZA, Cámera LA, Cantu-Brito C, Carvalho F, Cerin E, Chattu VK, Chauhan BG, Choi JYJ, Chu DT, Dai X, Dandona L, Dandona R, Daryani A, Davletov K, de Courten B, Demeke FM, Denova-Gutiérrez E, Dharmaratne SD, Dhimal M, Diaz D, Djalalinia S, Duncan BB, El Sayed Zaki M, Eskandarieh S, Fareed M, Farzadfar F, Fattahi N, Fazlzadeh M, Fernandes E, Filip I, Fischer F, Foigt NA, Freitas M, Ghashghaee A, Gill PS, Ginawi IA, Gopalani SV, Guo Y, Gupta RD, Habtewold TD, Hamadeh RR, Hamidi S, Hankey GJ, Hasanpoor E, Hassen HY, Hay SI, Heibati B, Hole MK, Hossain N, Househ M, Irvani SSN, Jaafari J, Jakovljevic M, Jha RP, Jonas JB, Jozwiak JJ, Kasaeian A, Kaydi N, Khader YS, Khafaie MA, Khan EA, Khan J, Khan MN, Khatab K, Khater AM, Kim YJ, Kimokoti RW, Kisa A, Kivimäki M, Knibbs LD, Kosen S, Koul PA, Koyanagi A, Kuate Defo B, Kugbey N, Lauriola P, Lee PH, Leili M, Lewycka S, Li S, Lim LL, Linn S, Liu Y, Lorkowski S, Mahasha PW, Mahotra NB, Majeed A, Maleki A, Malekzadeh R, Mamun AA, Manafi N, Martini S, Meharie BG, Menezes RG, Mestrovic T, Miazgowski B, Miazgowski T, Miller TR, Mini GK, Mirica A, Mirrakhimov EM, Mohajer B, Mohammed S, Mohan V, Mokdad AH, Monasta L, Moraga P, Morrison SD, Mueller UO, Mukhopadhyay S, Mustafa G, Muthupandian S, Naik G, Nangia V, Ndwandwe DE, Negoi RI, Ningrum DNA, Noubiap JJ, Ogbo FA, Olagunju AT, Onwujekwe OE, Ortiz A, Owolabi MO, P A M, Panda-Jonas S, Park EK, Pashazadeh Kan F, Pirsaheb M, Postma MJ, Pourjafar H, Radfar A, Rafiei A, Rahim F, Rahimi-Movaghar V, Rahman MA, Rai RK, Ranabhat CL, Raoofi S, Rawal L, Renzaho AMN, Rezapour A, Ribeiro D, Roever L, Ronfani L, Sabour S, Saddik B, Sadeghi E, Saeedi Moghaddam S, Sahebkar A, Sahraian MA, Salimzadeh H, Salvi SS, Samy AM, Sanabria J, Sarmiento-Suárez R, Sathish T, Schmidt MI, Schutte AE, Sepanlou SG, Shaikh MA, Sharafi K, Sheikh A, Shigematsu M, Shiri R, Shirkoohi R, Shuval K, Soyiri IN, Tabarés-Seisdedos R, Tefera YM, Tehrani-Banihashemi A, Temsah MH, Thankappan KR, Topor-Madry R, Tudor Car L, Ullah I, Vacante M, Valdez PR, Vasankari TJ, Violante FS, Waheed Y, Wolfe CDA, Yamada T, Yonemoto N, Yu C, Zaman SB, Zhang Y, Zodpey S, Lim SS, Stanaway JD, Brauer M. Estimates, trends, and drivers of the global burden of type 2 diabetes attributable to PM 2·5 air pollution, 1990-2019: an analysis of data from the Global Burden of Disease Study 2019. Lancet Planet Health 2022; 6:e586-e600. [PMID: 35809588 PMCID: PMC9278144 DOI: 10.1016/s2542-5196(22)00122-x] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 05/09/2022] [Accepted: 05/12/2022] [Indexed: 05/17/2023]
Abstract
BACKGROUND Experimental and epidemiological studies indicate an association between exposure to particulate matter (PM) air pollution and increased risk of type 2 diabetes. In view of the high and increasing prevalence of diabetes, we aimed to quantify the burden of type 2 diabetes attributable to PM2·5 originating from ambient and household air pollution. METHODS We systematically compiled all relevant cohort and case-control studies assessing the effect of exposure to household and ambient fine particulate matter (PM2·5) air pollution on type 2 diabetes incidence and mortality. We derived an exposure-response curve from the extracted relative risk estimates using the MR-BRT (meta-regression-Bayesian, regularised, trimmed) tool. The estimated curve was linked to ambient and household PM2·5 exposures from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019, and estimates of the attributable burden (population attributable fractions and rates per 100 000 population of deaths and disability-adjusted life-years) for 204 countries from 1990 to 2019 were calculated. We also assessed the role of changes in exposure, population size, age, and type 2 diabetes incidence in the observed trend in PM2·5-attributable type 2 diabetes burden. All estimates are presented with 95% uncertainty intervals. FINDINGS In 2019, approximately a fifth of the global burden of type 2 diabetes was attributable to PM2·5 exposure, with an estimated 3·78 (95% uncertainty interval 2·68-4·83) deaths per 100 000 population and 167 (117-223) disability-adjusted life-years (DALYs) per 100 000 population. Approximately 13·4% (9·49-17·5) of deaths and 13·6% (9·73-17·9) of DALYs due to type 2 diabetes were contributed by ambient PM2·5, and 6·50% (4·22-9·53) of deaths and 5·92% (3·81-8·64) of DALYs by household air pollution. High burdens, in terms of numbers as well as rates, were estimated in Asia, sub-Saharan Africa, and South America. Since 1990, the attributable burden has increased by 50%, driven largely by population growth and ageing. Globally, the impact of reductions in household air pollution was largely offset by increased ambient PM2·5. INTERPRETATION Air pollution is a major risk factor for diabetes. We estimated that about a fifth of the global burden of type 2 diabetes is attributable PM2·5 pollution. Air pollution mitigation therefore might have an essential role in reducing the global disease burden resulting from type 2 diabetes. FUNDING Bill & Melinda Gates Foundation.
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Sheena BS, Hiebert L, Han H, Ippolito H, Abbasi-Kangevari M, Abbasi-Kangevari Z, Abbastabar H, Abdoli A, Abubaker Ali H, Adane MM, Adegboye OA, Adnani QES, Advani SM, Afzal MS, Afzal S, Aghaie Meybodi M, Ahadinezhad B, Ahinkorah BO, Ahmad S, Ahmad T, Ahmadi S, Ahmed H, Ahmed MB, Ahmed Rashid T, Akalu GT, Aklilu A, Akram T, Al Hamad H, Alahdab F, Alem AZ, Alem DT, Alhalaiqa FAN, Alhassan RK, Ali L, Ali MA, Alimohamadi Y, Alipour V, Alkhayyat M, Almustanyir S, Al-Raddadi RM, Altawalah H, Amini S, Amu H, Ancuceanu R, Andrei CL, Andrei T, Anoushiravani A, Ansar A, Anyasodor AE, Arabloo J, Arab-Zozani M, Argaw AM, Argaw ZG, Arshad M, Artamonov AA, Ashraf T, Atlaw D, Ausloos F, Ausloos M, Azadnajafabad S, Azangou-Khyavy M, Azari Jafari A, Azarian G, Bagheri S, Bahadory S, Baig AA, Banach M, Barati N, Barrow A, Batiha AMM, Bejarano Ramirez DF, Belgaumi UI, Berhie AY, Bhagat DS, Bhardwaj N, Bhardwaj P, Bhattacharyya K, Bhojaraja VS, Bijani A, Biondi A, Bodicha BBA, Bojia HA, Boloor A, Bosetti C, Braithwaite D, Briko NI, Butt ZA, Cámera LA, Chakinala RC, Chakraborty PA, Charan J, Chen S, Choi JYJ, Choudhari SG, Chowdhury FR, Chu DT, Chung SC, Cortesi PA, Cowie BC, Culbreth GT, Dadras O, Dai X, Dandona L, Dandona R, De la Hoz FP, Debela SA, Dedefo MG, Demeke FM, Demie TGG, Demissie GD, Derbew Molla M, Desta AA, Dhamnetiya D, Dhimal ML, Dhimal M, Didehdar M, Doan LP, Dorostkar F, Drake TM, Eghbalian F, Ekholuenetale M, El Sayed I, El Sayed Zaki M, Elhadi M, Elmonem MA, Elsharkawy A, Enany S, Enyew DB, Erkhembayar R, Eskandarieh S, Esmaeilzadeh F, Ezzikouri S, Farrokhpour H, Fetensa G, Fischer F, Foroutan M, Gad MM, Gaidhane AM, Gaidhane S, Galles NC, Gallus S, Gebremeskel TG, Gebreyohannes EAA, Ghadiri K, Ghaffari K, Ghafourifard M, Ghamari SH, Ghashghaee A, Gholami A, Gholizadeh A, Gilani A, Goel A, Golechha M, Goleij P, Golinelli D, Gorini G, Goshu YA, Griswold MG, Gubari MIM, Gupta B, Gupta S, Gupta VB, Gupta VK, Haddadi R, Halwani R, Hamid SS, Hamidi S, Hanif A, Haque S, Harapan H, Hargono A, Hariri S, Hasaballah AI, Hasan SMM, Hassanipour S, Hassankhani H, Hay SI, Hayat K, Heidari G, Herteliu C, Heyi DZ, Hezam K, Holla R, Hosseini MS, Hosseini M, Hosseinzadeh M, Hostiuc M, Househ M, Huang J, Hussein NR, Iavicoli I, Ibitoye SE, Ilesanmi OS, Ilic IM, Ilic MD, Irham LM, Islam JY, Ismail NE, Jacobsen KH, Jadidi-Niaragh F, Javadi Mamaghani A, Jayaram S, Jayawardena R, Jebai R, Jha RP, Joseph N, Joukar F, Kaambwa B, Kabir A, Kabir Z, Kalhor R, Kandel H, Kanko TKT, Kantar RS, Karaye IM, Kassa BG, Kemp Bohan PM, Keykhaei M, Khader YS, Khajuria H, Khan G, Khan IA, Khan J, Khan MAB, Khanali J, Khater AM, Khatib MN, Khodadost M, Khoja AT, Khosravizadeh O, Khubchandani J, Kim GR, Kim H, Kim MS, Kim YJ, Kocarnik JM, Kolahi AA, Koteeswaran R, Kumar GA, La Vecchia C, Lal DK, Landires I, Lasrado S, Lazarus JV, Ledda C, Lee DW, Lee SW, Lee YY, Levi M, Li J, Lim SS, Lobo SW, Lopukhov PD, Loureiro JA, MacLachlan JH, Magdy Abd El Razek H, Magdy Abd El Razek M, Majeed A, Makki A, Malekpour MR, Malekzadeh R, Malik AA, Mansour-Ghanaei F, Mansournia MA, Martins-Melo FR, Matthews PC, Mendoza W, Menezes RG, Meretoja TJ, Mersha AG, Mestrovic T, Miller TR, Minh LHN, Mirica A, Mirmoeeni S, Mirrakhimov EM, Misra S, Mithra P, Moazen B, Mohamadkhani A, Mohammadi M, Mohammed S, Moka N, Mokdad AH, Moludi J, Momtazmanesh S, Monasta L, Moradi G, Moradzadeh M, Moradzadeh R, Moraga P, Mostafavi E, Mubarik S, Muniyandi M, Murray CJL, Naghavi M, Naimzada MD, Narasimha Swamy S, Natto ZS, Nayak BP, Nazari J, Negoi I, Negru SM, Nejadghaderi SA, Neupane Kandel S, Nguyen HLT, Ngwa CH, Niazi RK, Nnaji CA, Noubiap JJ, Nowroozi A, Nuñez-Samudio V, Oancea B, Ochir C, Odukoya OO, Oh IH, Olagunju AT, Olakunde BO, Omar Bali A, Omer E, Otstavnov SS, Oumer B, Padubidri JR, Pana A, Pandey A, Park EC, Pashazadeh Kan F, Patel UK, Paudel U, Petcu IR, Piracha ZZ, Pollok RCG, Postma MJ, Pourshams A, Poustchi H, Rabiee M, Rabiee N, Rafiei A, Rafiei S, Raghuram PM, Rahman M, Rahmani AM, Rahmawaty S, Rajesh A, Ranasinghe P, Rao CR, Rao SJ, Rashidi M, Rashidi MM, Rawaf DL, Rawaf S, Rawassizadeh R, Rezaei N, Rezapour A, Rezazadeh-Khadem S, Rodriguez JAB, Rwegerera GM, Sabour S, Saddik B, Saeb MR, Saeed U, Sahebkar A, Saif-Ur-Rahman KM, Salahi S, Salimzadeh H, Sampath C, Samy AM, Sanabria J, Sanmarchi F, Santric-Milicevic MM, Sarveazad A, Sathian B, Sawhney M, Seidu AA, Sepanlou SG, Seylani A, Shahabi S, Shaikh MA, Shaker E, Shakhmardanov MZ, Shannawaz M, Shenoy SM, Shetty JK, Shetty PH, Shibuya K, Shin JI, Shobeiri P, Sibhat MM, Singh AD, Singh JA, Singh S, Skryabin VY, Skryabina AA, Sohrabpour AA, Song S, Tabaeian SP, Tadesse EG, Taheri M, Tampa M, Tan KK, Tavakoli A, Tbakhi A, Tefera BN, Tehrani-Banihashemi A, Tesfaw HM, Thapar R, Thavamani A, Tohidast SA, Tollosa DN, Tosti ME, Tovani-Palone MR, Traini E, Tran MTN, Trihandini I, Tusa BS, Ullah I, Vacante M, Valadan Tahbaz S, Valdez PR, Varthya SB, Vo B, Waheed Y, Weldesenbet AB, Woldemariam M, Xu S, Yahyazadeh Jabbari SH, Yaseri M, Yeshaw Y, Yiğit V, Yirdaw BW, Yonemoto N, Yu C, Yunusa I, Zahir M, Zaki L, Zamani M, Zamanian M, Zastrozhin MS, Vos T, Ward JW, Dirac MA. Global, regional, and national burden of hepatitis B, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Gastroenterol Hepatol 2022; 7:796-829. [PMID: 35738290 PMCID: PMC9349325 DOI: 10.1016/s2468-1253(22)00124-8] [Citation(s) in RCA: 174] [Impact Index Per Article: 87.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 04/02/2022] [Accepted: 04/04/2022] [Indexed: 12/23/2022]
Abstract
Background Combating viral hepatitis is part of the UN Sustainable Development Goals (SDGs), and WHO has put forth hepatitis B elimination targets in its Global Health Sector Strategy on Viral Hepatitis (WHO-GHSS) and Interim Guidance for Country Validation of Viral Hepatitis Elimination (WHO Interim Guidance). We estimated the global, regional, and national prevalence of hepatitis B virus (HBV), as well as mortality and disability-adjusted life-years (DALYs) due to HBV, as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. This included estimates for 194 WHO member states, for which we compared our estimates to WHO elimination targets. Methods The primary data sources were population-based serosurveys, claims and hospital discharges, cancer registries, vital registration systems, and published case series. We estimated chronic HBV infection and the burden of HBV-related diseases, defined as an aggregate of cirrhosis due to hepatitis B, liver cancer due to hepatitis B, and acute hepatitis B. We used DisMod-MR 2.1, a Bayesian mixed-effects meta-regression tool, to estimate the prevalence of chronic HBV infection, cirrhosis, and aetiological proportions of cirrhosis. We used mortality-to-incidence ratios modelled with spatiotemporal Gaussian process regression to estimate the incidence of liver cancer. We used the Cause of Death Ensemble modelling (CODEm) model, a tool that selects models and covariates on the basis of out-of-sample performance, to estimate mortality due to cirrhosis, liver cancer, and acute hepatitis B. Findings In 2019, the estimated global, all-age prevalence of chronic HBV infection was 4·1% (95% uncertainty interval [UI] 3·7 to 4·5), corresponding to 316 million (284 to 351) infected people. There was a 31·3% (29·0 to 33·9) decline in all-age prevalence between 1990 and 2019, with a more marked decline of 76·8% (76·2 to 77·5) in prevalence in children younger than 5 years. HBV-related diseases resulted in 555 000 global deaths (487 000 to 630 000) in 2019. The number of HBV-related deaths increased between 1990 and 2019 (by 5·9% [–5·6 to 19·2]) and between 2015 and 2019 (by 2·9% [–5·9 to 11·3]). By contrast, all-age and age-standardised death rates due to HBV-related diseases decreased during these periods. We compared estimates for 2019 in 194 WHO locations to WHO-GHSS 2020 targets, and found that four countries achieved a 10% reduction in deaths, 15 countries achieved a 30% reduction in new cases, and 147 countries achieved a 1% prevalence in children younger than 5 years. As of 2019, 68 of 194 countries had already achieved the 2030 target proposed in WHO Interim Guidance of an all-age HBV-related death rate of four per 100 000. Interpretation The prevalence of chronic HBV infection declined over time, particularly in children younger than 5 years, since the introduction of hepatitis B vaccination. HBV-related death rates also decreased, but HBV-related death counts increased as a result of population growth, ageing, and cohort effects. By 2019, many countries had met the interim seroprevalence target for children younger than 5 years, but few countries had met the WHO-GHSS interim targets for deaths and new cases. Progress according to all indicators must be accelerated to meet 2030 targets, and there are marked disparities in burden and progress across the world. HBV interventions, such as vaccination, testing, and treatment, must be strategically supported and scaled up to achieve elimination. Funding Bill & Melinda Gates Foundation.
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Kocarnik JM, Compton K, Dean FE, Fu W, Gaw BL, Harvey JD, Henrikson HJ, Lu D, Pennini A, Xu R, Ababneh E, Abbasi-Kangevari M, Abbastabar H, Abd-Elsalam SM, Abdoli A, Abedi A, Abidi H, Abolhassani H, Adedeji IA, Adnani QES, Advani SM, Afzal MS, Aghaali M, Ahinkorah BO, Ahmad S, Ahmad T, Ahmadi A, Ahmadi S, Ahmed Rashid T, Ahmed Salih Y, Akalu GT, Aklilu A, Akram T, Akunna CJ, Al Hamad H, Alahdab F, Al-Aly Z, Ali S, Alimohamadi Y, Alipour V, Aljunid SM, Alkhayyat M, Almasi-Hashiani A, Almasri NA, Al-Maweri SAA, Almustanyir S, Alonso N, Alvis-Guzman N, Amu H, Anbesu EW, Ancuceanu R, Ansari F, Ansari-Moghaddam A, Antwi MH, Anvari D, Anyasodor AE, Aqeel M, Arabloo J, Arab-Zozani M, Aremu O, Ariffin H, Aripov T, Arshad M, Artaman A, Arulappan J, Asemi Z, Asghari Jafarabadi M, Ashraf T, Atorkey P, Aujayeb A, Ausloos M, Awedew AF, Ayala Quintanilla BP, Ayenew T, Azab MA, Azadnajafabad S, Azari Jafari A, Azarian G, Azzam AY, Badiye AD, Bahadory S, Baig AA, Baker JL, Balakrishnan S, Banach M, Bärnighausen TW, Barone-Adesi F, Barra F, Barrow A, Behzadifar M, Belgaumi UI, Bezabhe WMM, Bezabih YM, Bhagat DS, Bhagavathula AS, Bhardwaj N, Bhardwaj P, Bhaskar S, Bhattacharyya K, Bhojaraja VS, Bibi S, Bijani A, Biondi A, Bisignano C, Bjørge T, Bleyer A, Blyuss O, Bolarinwa OA, Bolla SR, Braithwaite D, Brar A, Brenner H, Bustamante-Teixeira MT, Butt NS, Butt ZA, Caetano dos Santos FL, Cao Y, Carreras G, Catalá-López F, Cembranel F, Cerin E, Cernigliaro A, Chakinala RC, Chattu SK, Chattu VK, Chaturvedi P, Chimed-Ochir O, Cho DY, Christopher DJ, Chu DT, Chung MT, Conde J, Cortés S, Cortesi PA, Costa VM, Cunha AR, Dadras O, Dagnew AB, Dahlawi SMA, Dai X, Dandona L, Dandona R, Darwesh AM, das Neves J, De la Hoz FP, Demis AB, Denova-Gutiérrez E, Dhamnetiya D, Dhimal ML, Dhimal M, Dianatinasab M, Diaz D, Djalalinia S, Do HP, Doaei S, Dorostkar F, dos Santos Figueiredo FW, Driscoll TR, Ebrahimi H, Eftekharzadeh S, El Tantawi M, El-Abid H, Elbarazi I, Elhabashy HR, Elhadi M, El-Jaafary SI, Eshrati B, Eskandarieh S, Esmaeilzadeh F, Etemadi A, Ezzikouri S, Faisaluddin M, Faraon EJA, Fares J, Farzadfar F, Feroze AH, Ferrero S, Ferro Desideri L, Filip I, Fischer F, Fisher JL, Foroutan M, Fukumoto T, Gaal PA, Gad MM, Gadanya MA, Gallus S, Gaspar Fonseca M, Getachew Obsa A, Ghafourifard M, Ghashghaee A, Ghith N, Gholamalizadeh M, Gilani SA, Ginindza TG, Gizaw ATT, Glasbey JC, Golechha M, Goleij P, Gomez RS, Gopalani SV, Gorini G, Goudarzi H, Grosso G, Gubari MIM, Guerra MR, Guha A, Gunasekera DS, Gupta B, Gupta VB, Gupta VK, Gutiérrez RA, Hafezi-Nejad N, Haider MR, Haj-Mirzaian A, Halwani R, Hamadeh RR, Hameed S, Hamidi S, Hanif A, Haque S, Harlianto NI, Haro JM, Hasaballah AI, Hassanipour S, Hay RJ, Hay SI, Hayat K, Heidari G, Heidari M, Herrera-Serna BY, Herteliu C, Hezam K, Holla R, Hossain MM, Hossain MBH, Hosseini MS, Hosseini M, Hosseinzadeh M, Hostiuc M, Hostiuc S, Househ M, Hsairi M, Huang J, Hugo FN, Hussain R, Hussein NR, Hwang BF, Iavicoli I, Ibitoye SE, Ida F, Ikuta KS, Ilesanmi OS, Ilic IM, Ilic MD, Irham LM, Islam JY, Islam RM, Islam SMS, Ismail NE, Isola G, Iwagami M, Jacob L, Jain V, Jakovljevic MB, Javaheri T, Jayaram S, Jazayeri SB, Jha RP, Jonas JB, Joo T, Joseph N, Joukar F, Jürisson M, Kabir A, Kahrizi D, Kalankesh LR, Kalhor R, Kaliyadan F, Kalkonde Y, Kamath A, Kameran Al-Salihi N, Kandel H, Kapoor N, Karch A, Kasa AS, Katikireddi SV, Kauppila JH, Kavetskyy T, Kebede SA, Keshavarz P, Keykhaei M, Khader YS, Khalilov R, Khan G, Khan M, Khan MN, Khan MAB, Khang YH, Khater AM, Khayamzadeh M, Kim GR, Kim YJ, Kisa A, Kisa S, Kissimova-Skarbek K, Kopec JA, Koteeswaran R, Koul PA, Koulmane Laxminarayana SL, Koyanagi A, Kucuk Bicer B, Kugbey N, Kumar GA, Kumar N, Kumar N, Kurmi OP, Kutluk T, La Vecchia C, Lami FH, Landires I, Lauriola P, Lee SW, Lee SWH, Lee WC, Lee YH, Leigh J, Leong E, Li J, Li MC, Liu X, Loureiro JA, Lunevicius R, Magdy Abd El Razek M, Majeed A, Makki A, Male S, Malik AA, Mansournia MA, Martini S, Masoumi SZ, Mathur P, McKee M, Mehrotra R, Mendoza W, Menezes RG, Mengesha EW, Mesregah MK, Mestrovic T, Miao Jonasson J, Miazgowski B, Miazgowski T, Michalek IM, Miller TR, Mirzaei H, Mirzaei HR, Misra S, Mithra P, Moghadaszadeh M, Mohammad KA, Mohammad Y, Mohammadi M, Mohammadi SM, Mohammadian-Hafshejani A, Mohammed S, Moka N, Mokdad AH, Molokhia M, Monasta L, Moni MA, Moosavi MA, Moradi Y, Moraga P, Morgado-da-Costa J, Morrison SD, Mosapour A, Mubarik S, Mwanri L, Nagarajan AJ, Nagaraju SP, Nagata C, Naimzada MD, Nangia V, Naqvi AA, Narasimha Swamy S, Ndejjo R, Nduaguba SO, Negoi I, Negru SM, Neupane Kandel S, Nguyen CT, Nguyen HLT, Niazi RK, Nnaji CA, Noor NM, Nuñez-Samudio V, Nzoputam CI, Oancea B, Ochir C, Odukoya OO, Ogbo FA, Olagunju AT, Olakunde BO, Omar E, Omar Bali A, Omonisi AEE, Ong S, Onwujekwe OE, Orru H, Ortega-Altamirano DV, Otstavnov N, Otstavnov SS, Owolabi MO, P A M, Padubidri JR, Pakshir K, Pana A, Panagiotakos D, Panda-Jonas S, Pardhan S, Park EC, Park EK, Pashazadeh Kan F, Patel HK, Patel JR, Pati S, Pattanshetty SM, Paudel U, Pereira DM, Pereira RB, Perianayagam A, Pillay JD, Pirouzpanah S, Pishgar F, Podder I, Postma MJ, Pourjafar H, Prashant A, Preotescu L, Rabiee M, Rabiee N, Radfar A, Radhakrishnan RA, Radhakrishnan V, Rafiee A, Rahim F, Rahimzadeh S, Rahman M, Rahman MA, Rahmani AM, Rajai N, Rajesh A, Rakovac I, Ram P, Ramezanzadeh K, Ranabhat K, Ranasinghe P, Rao CR, Rao SJ, Rawassizadeh R, Razeghinia MS, Renzaho AMN, Rezaei N, Rezaei N, Rezapour A, Roberts TJ, Rodriguez JAB, Rohloff P, Romoli M, Ronfani L, Roshandel G, Rwegerera GM, S M, Sabour S, Saddik B, Saeed U, Sahebkar A, Sahoo H, Salehi S, Salem MR, Salimzadeh H, Samaei M, Samy AM, Sanabria J, Sankararaman S, Santric-Milicevic MM, Sardiwalla Y, Sarveazad A, Sathian B, Sawhney M, Saylan M, Schneider IJC, Sekerija M, Seylani A, Shafaat O, Shaghaghi Z, Shaikh MA, Shamsoddin E, Shannawaz M, Sharma R, Sheikh A, Sheikhbahaei S, Shetty A, Shetty JK, Shetty PH, Shibuya K, Shirkoohi R, Shivakumar KM, 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Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life Years for 29 Cancer Groups From 2010 to 2019: A Systematic Analysis for the Global Burden of Disease Study 2019. JAMA Oncol 2022; 8:420-444. [PMID: 34967848 PMCID: PMC8719276 DOI: 10.1001/jamaoncol.2021.6987] [Citation(s) in RCA: 585] [Impact Index Per Article: 292.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
IMPORTANCE The Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019) provided systematic estimates of incidence, morbidity, and mortality to inform local and international efforts toward reducing cancer burden. OBJECTIVE To estimate cancer burden and trends globally for 204 countries and territories and by Sociodemographic Index (SDI) quintiles from 2010 to 2019. EVIDENCE REVIEW The GBD 2019 estimation methods were used to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life years (DALYs) in 2019 and over the past decade. Estimates are also provided by quintiles of the SDI, a composite measure of educational attainment, income per capita, and total fertility rate for those younger than 25 years. Estimates include 95% uncertainty intervals (UIs). FINDINGS In 2019, there were an estimated 23.6 million (95% UI, 22.2-24.9 million) new cancer cases (17.2 million when excluding nonmelanoma skin cancer) and 10.0 million (95% UI, 9.36-10.6 million) cancer deaths globally, with an estimated 250 million (235-264 million) DALYs due to cancer. Since 2010, these represented a 26.3% (95% UI, 20.3%-32.3%) increase in new cases, a 20.9% (95% UI, 14.2%-27.6%) increase in deaths, and a 16.0% (95% UI, 9.3%-22.8%) increase in DALYs. Among 22 groups of diseases and injuries in the GBD 2019 study, cancer was second only to cardiovascular diseases for the number of deaths, years of life lost, and DALYs globally in 2019. Cancer burden differed across SDI quintiles. The proportion of years lived with disability that contributed to DALYs increased with SDI, ranging from 1.4% (1.1%-1.8%) in the low SDI quintile to 5.7% (4.2%-7.1%) in the high SDI quintile. While the high SDI quintile had the highest number of new cases in 2019, the middle SDI quintile had the highest number of cancer deaths and DALYs. From 2010 to 2019, the largest percentage increase in the numbers of cases and deaths occurred in the low and low-middle SDI quintiles. CONCLUSIONS AND RELEVANCE The results of this systematic analysis suggest that the global burden of cancer is substantial and growing, with burden differing by SDI. These results provide comprehensive and comparable estimates that can potentially inform efforts toward equitable cancer control around the world.
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Affiliation(s)
| | | | - Kelly Compton
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Frances E. Dean
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Weijia Fu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Brian L. Gaw
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - James D. Harvey
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Hannah Jacqueline Henrikson
- Department of Global Health, Boston University, Boston, Massachusetts
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Dan Lu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Alyssa Pennini
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Rixing Xu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Emad Ababneh
- Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio
| | - Mohsen Abbasi-Kangevari
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hedayat Abbastabar
- Advanced Diagnostic and Interventional Radiology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Amir Abdoli
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Aidin Abedi
- Department of Orthopaedic Surgery, University of Southern California, Los Angeles
| | - Hassan Abidi
- Laboratory Technology Sciences Department, Yasouj University, Yasuj, Iran
| | - Hassan Abolhassani
- Department of Laboratory Medicine, Karolinska University Hospital, Huddinge, Sweden
- Research Center for Immunodeficiencies, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Qorinah Estiningtyas Sakilah Adnani
- Department of Midwifery, Karya Husada Institute of Health Sciences, Kediri, Indonesia
- Department of Midwifery, Auckland University of Technology, Auckland, New Zealand
| | - Shailesh M. Advani
- Terasaki Institute for Biomedical Innovation, Los Angeles, California
- School of Medicine, Georgetown University, Washington, DC
| | - Muhammad Sohail Afzal
- Department of Life Sciences, University of Management and Technology, Lahore, Pakistan
| | - Mohammad Aghaali
- Department of Epidemiology and Biostatistics, Qom University of Medical Sciences, Qom, Iran
| | - Bright Opoku Ahinkorah
- The Australian Centre for Public and Population Health Research, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Sajjad Ahmad
- Foundation University Medical College, Foundation University Islamabad, Islamabad, Pakistan
| | - Tauseef Ahmad
- Department of Epidemiology and Health Statistics, Southeast University, Nanjing, China
| | - Ali Ahmadi
- Department of Epidemiology and Biostatistics, Shahrekord University of Medical Sciences, Shahrekord, Iran
- Department of Epidemiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sepideh Ahmadi
- School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Tarik Ahmed Rashid
- Department of Computer Science and Engineering, University of Kurdistan Hewler, Erbil, Iraq
| | - Yusra Ahmed Salih
- Database Technology Department, Sulaimani Polytechnic University, Sulaymaniyah, Iraq
- College of Informatics, Sulaimani Polytechnic University, Sulaymaniyah, Iraq
| | - Gizachew Taddesse Akalu
- Microbiology, Immunology and Parasitology Department, St Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
- Microbial, Cellular and Molecular Biology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Addis Aklilu
- Department of Medical Laboratory Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Tayyaba Akram
- School of Mathematical Sciences, University of Science Malaysia, Penang, Malaysia
| | - Chisom Joyqueenet Akunna
- Department of Public Health, Intercountry Centre for Oral Health for Africa, Jos, Nigeria
- Department of Public Health, Federal Ministry of Health, Garki, Nigeria
| | - Hanadi Al Hamad
- Geriatric and Long-Term Care Department, Hamad Medical Corporation, Doha, Qatar
- Rumailah Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Fares Alahdab
- Mayo Evidence-Based Practice Center, Mayo Clinic Foundation for Medical Education and Research, Rochester, Minnesota
| | - Ziyad Al-Aly
- John T. Milliken Department of Internal Medicine, Washington University in St Louis, St Louis, Missouri
- Clinical Epidemiology Center, Department of Veterans Affairs, St Louis, Missouri
| | - Saqib Ali
- Department of Information Systems, Sultan Qaboos University, Muscat, Oman
| | - Yousef Alimohamadi
- Pars Hospital, Iran University of Medical Sciences, Tehran, Iran
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
| | - Vahid Alipour
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Health Economics, Iran University of Medical Sciences, Tehran, Iran
| | - Syed Mohamed Aljunid
- Department of Health Policy and Management, Kuwait University, Safat, Kuwait
- International Centre for Casemix and Clinical Coding, National University of Malaysia, Bandar Tun Razak, Malaysia
| | | | | | | | - Sadeq Ali Ali Al-Maweri
- College of Dental Medicine, Qatar University, Doha, Qatar
- Faculty of Dentistry, Sana'a University, Sana’a, Yemen
| | - Sami Almustanyir
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
- Ministry of Health, Riyadh, Saudi Arabia
| | - Nivaldo Alonso
- Department of Surgery, University of São Paulo, São Paulo, Brazil
| | - Nelson Alvis-Guzman
- Research Group in Hospital Management and Health Policies, Universidad de la Costa, Barranquilla, Colombia
- Research Group in Health Economics, University of Cartagena, Cartagena, Colombia
| | - Hubert Amu
- Department of Population and Behavioural Sciences, University of Health and Allied Sciences, Ho, Ghana
| | | | - Robert Ancuceanu
- Pharmacy Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Fereshteh Ansari
- Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
- Razi Vaccine and Serum Research Institute, Agricultural Research, Education, and Extension Organization, Tehran, Iran
| | - Alireza Ansari-Moghaddam
- Department of Epidemiology and Biostatistics, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Maxwell Hubert Antwi
- Clinical Laboratory Department, Ghana Health Service, Kumasi, Ghana
- Department of Molecular Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Davood Anvari
- Department of Parasitology, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Parasitology, Iranshahr University of Medical Sciences, Iranshahr, Iran
| | | | - Muhammad Aqeel
- Department of Psychology, Foundation University Islamabad, Rawalpandi, Pakistan
| | - Jalal Arabloo
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Morteza Arab-Zozani
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Olatunde Aremu
- Department of Public Health, Birmingham City University, Birmingham, England
| | - Hany Ariffin
- Department of Paediatrics, University of Malaya, Kuala Lumpur, Malaysia
- University of Malaya Medical Centre, University of Malaya, Kuala Lumpur, Malaysia
| | - Timur Aripov
- Public Health and Healthcare Management, Tashkent Institute of Postgraduate Medical Education, Tashkent, Uzbekistan
- Boston Children's Hospital, Boston, Massachusetts
| | - Muhammad Arshad
- Allied Health Sciences, Khyber Medical University, Timergara, Lower Dir, Pakistan
| | - Al Artaman
- Zayed University, Abu Dhabi, United Arab Emirates
| | - Judie Arulappan
- Department of Maternal and Child Health, Sultan Qaboos University, Muscat, Oman
| | - Zatollah Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohammad Asghari Jafarabadi
- Department of Biostatistics and Epidemiology, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Biostatistics and Epidemiology, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Tahira Ashraf
- Institute of Radiological Sciences and Medical Imaging Technology, University of Lahore, Lahore, Pakistan
| | - Prince Atorkey
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter New England Population Health, Wallsend, New South Wales, Australia
| | - Avinash Aujayeb
- Northumbria HealthCare National Health Service (NHS) Foundation Trust, NHS England, Newcastle upon Tyne, England
| | - Marcel Ausloos
- School of Business, University of Leicester, Leicester, England
- Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
| | | | | | - Temesgen Ayenew
- Department of Nursing, Debre Markos University, Debre Markos, Ethiopia
| | | | | | | | - Ghasem Azarian
- Department of Environmental Health Engineering, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ahmed Y. Azzam
- Faculty of Medicine, October 6 University, 6th of October City, Egypt
| | - Ashish D. Badiye
- Department of Forensic Science, Government Institute of Forensic Science, Nagpur, India
| | - Saeed Bahadory
- Department of Parasitology, Tarbiat Modares University, Tehran, Iran
- Department of Parasitology, Alborz University of Medical Sciences, Karaj, Iran
| | - Atif Amin Baig
- Unit of Biochemistry, Universiti Sultan Zainal Abidin, Kuala Terengganu, Malaysia
| | - Jennifer L. Baker
- Center for Clinical Research and Prevention, Bispebjerg University Hospital, Frederiksberg, Denmark
| | | | - Maciej Banach
- Department of Hypertension, Medical University of Lodz, Lodz, Poland
- Polish Mothers' Memorial Hospital Research Institute, Lodz, Poland
| | - Till Winfried Bärnighausen
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
- T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | | | - Fabio Barra
- Academic Unit of Obstetrics and Gynecology, University of Genoa, Genoa, Italy
| | - Amadou Barrow
- Department of Public and Environmental Health, University of the Gambia, Brikama, The Gambia
- Epidemiology and Disease Control Unit, Ministry of Health, Kotu, The Gambia
| | - Masoud Behzadifar
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Uzma Iqbal Belgaumi
- Department of Oral Pathology and Microbiology, Krishna Institute of Medical Sciences, Karad, India
| | | | - Yihienew Mequanint Bezabih
- Department of Internal Medicine, Bahir Dar University, Bahir Dar, Ethiopia
- One Health, University of Nantes, Nantes, France
| | - Devidas S. Bhagat
- Department of Forensic Chemistry, Government Institute of Forensic Science, Aurangabad, India
| | - Akshaya Srikanth Bhagavathula
- Department of Social and Clinical Pharmacy, Charles University, Hradec Kralova, Czech Republic
- Institute of Public Health, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Nikha Bhardwaj
- Department of Anatomy, Government Medical College Pali, Pali, India
| | - Pankaj Bhardwaj
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Jodhpur, India
- School of Public Health, All India Institute of Medical Sciences, Jodhpur, India
| | - Sonu Bhaskar
- Neurovascular Imaging Laboratory, New South Wales Brain Clot Bank, Sydney, New South Wales, Australia
- Department of Neurology and Neurophysiology, South West Sydney Local Heath District and Liverpool Hospital, Sydney, New South Wales, Australia
| | - Krittika Bhattacharyya
- Department of Statistical and Computational Genomics, National Institute of Biomedical Genomics, Kalyani, India
- Department of Statistics, University of Calcutta, Kolkata, India
| | | | - Sadia Bibi
- Institute of Soil and Environmental Sciences, University of Agriculture, Faisalabad, Faisalabad, Pakistan
| | - Ali Bijani
- Social Determinants of Health Research Center, Babol University of Medical Sciences, Babol, Iran
| | - Antonio Biondi
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Catherine Bisignano
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Tone Bjørge
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Cancer Registry of Norway, Oslo, Norway
| | - Archie Bleyer
- Department of Radiation Medicine, Oregon Health and Science University, Portland
- McGovern Medical School, University of Texas, Houston
| | - Oleg Blyuss
- School of Physics, Engineering and Computer Science, University of Hertfordshire, Hatfield, England
- Institute for Women's Health, University College London, London, England
| | | | - Srinivasa Rao Bolla
- Department of Biomedical Sciences, Nazarbayev University, Nur-Sultan City, Kazakhstan
| | - Dejana Braithwaite
- Department of Epidemiology, University of Florida, Gainesville
- Cancer Population Sciences Program, University of Florida Health Cancer Center, Gainesville
| | - Amanpreet Brar
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
| | | | - Nadeem Shafique Butt
- Department of Family and Community Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Zahid A. Butt
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
- Al Shifa School of Public Health, Al Shifa Trust Eye Hospital, Rawalpindi, Pakistan
| | | | - Yin Cao
- Department of Surgery, Washington University in St Louis, St Louis, Missouri
| | - Giulia Carreras
- Institute for Cancer Research, Prevention and Clinical Network, Florence, Italy
| | - Ferrán Catalá-López
- National School of Public Health, Institute of Health Carlos III, Madrid, Spain
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Francieli Cembranel
- Department of Nutrition, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Ester Cerin
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
- School of Public Health, University of Hong Kong, Hong Kong, China
| | - Achille Cernigliaro
- Regional Epidemiological Observatory Department, Sicilian Regional Health Authority, Palermo, Italy
| | | | | | - Vijay Kumar Chattu
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Saveetha Medical College, Saveetha University, Chennai, India
| | - Pankaj Chaturvedi
- Center for Cancer Epidemiology, Tata Memorial Hospital, Navi Mumbai, India
- Department of Head Neck Surgery, Tata Memorial Hospital, Mumbai, India
| | - Odgerel Chimed-Ochir
- Department of Public Health and Health Policy, Hiroshima University, Hiroshima, Japan
| | | | | | - Dinh-Toi Chu
- Center for Biomedicine and Community Health, VNU International School, Hanoi, Vietnam
| | - Michael T. Chung
- Department of Otolaryngology, Wayne State University, Detroit, Michigan
| | - Joao Conde
- Nova Medical School, Nova University of Lisbon, Lisbon, Portugal
| | - Sanda Cortés
- Department of Public Health, Pontifical Catholic University of Chile, Santiago, Chile
- Research Line in Environmental Exposures and Health Effects at Population Level, Centro de Desarrollo Urbano Sustentable, Santiago, Chile
| | | | - Vera Marisa Costa
- Research Unit on Applied Molecular Biosciences, University of Porto, Porto, Portugal
| | - Amanda Ramos Cunha
- Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Omid Dadras
- School of Public Health, Walailak University, Nakhon Si Thammarat, Thailand
- Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | | | - Saad M. A. Dahlawi
- Environmental Health Department, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Xiaochen Dai
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Lalit Dandona
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Public Health Foundation of India, Gurugram, India
- Indian Council of Medical Research, New Delhi, India
| | - Rakhi Dandona
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
- Public Health Foundation of India, Gurugram, India
| | - Aso Mohammad Darwesh
- Department of Information Technology, University of Human Development, Sulaymaniyah, Iraq
| | - José das Neves
- Institute for Research and Innovation in Health, University of Porto, Porto, Portugal
- Institute of Biomedical Engineering, University of Porto, Porto, Portugal
| | | | - Asmamaw Bizuneh Demis
- Department of Nursing, Woldia University, Woldia, Ethiopia
- School of Nursing, Jimma University, Jimma, Ethiopia
| | - Edgar Denova-Gutiérrez
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Deepak Dhamnetiya
- Department of Community Medicine, Dr Baba Saheb Ambedkar Medical College and Hospital, Delhi, India
| | - Mandira Lamichhane Dhimal
- Policy Research Institute, Kathmandu, Nepal
- Global Institute for Interdisciplinary Studies, Kathmandu, Nepal
| | - Meghnath Dhimal
- Health Research Section, Nepal Health Research Council, Kathmandu, Nepal
| | - Mostafa Dianatinasab
- Department of Epidemiology and Biostatistics, Shahroud University of Medical Sciences, Shahroud, Iran
- Department of Epidemiology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Daniel Diaz
- Center of Complexity Sciences, National Autonomous University of Mexico, Mexico City, Mexico
- Faculty of Veterinary Medicine and Zootechnics, Autonomous University of Sinaloa, Culiacán Rosales, Mexico
| | - Shirin Djalalinia
- Development of Research and Technology Center, Ministry of Health and Medical Education, Tehran, Iran
| | - Huyen Phuc Do
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Saeid Doaei
- School of Health, Guilan University of Medical Sciences, Rasht, Iran
- Department of Community Nutrition, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fariba Dorostkar
- Department of Medical Laboratory Sciences, Iran University of Medical Sciences, Tehran, Iran
| | | | - Tim Robert Driscoll
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Hedyeh Ebrahimi
- Noncommunicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Liver and Pancreaticobilliary Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Eftekharzadeh
- Division of Urology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Maha El Tantawi
- Pediatric Dentistry and Dental Public Health Department, Alexandria University, Alexandria, Egypt
| | - Hassan El-Abid
- Direction de L'épidémiologie et la Lutte Contre les Maladies, Ministry of Health, Rabat, Morocco
| | - Iffat Elbarazi
- Institute of Public Health, United Arab Emirates University, Al Ain, United Arab Emirates
| | | | | | | | - Babak Eshrati
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Sharareh Eskandarieh
- Multiple Sclerosis Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Firooz Esmaeilzadeh
- Department of Public Health, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Arash Etemadi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Sayeh Ezzikouri
- Department of Virology, Pasteur Institute of Morocco, Casablanca, Morocco
| | - Mohammed Faisaluddin
- Department of Internal Medicine, Rochester General Hospital, Rochester, New York
| | - Emerito Jose A. Faraon
- Department of Health Policy and Administration, University of the Philippines Manila, Manila, Philippines
| | - Jawad Fares
- Department of Neurological Surgery, Northwestern University, Chicago, Illinois
| | - Farshad Farzadfar
- Noncommunicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Abdullah Hamid Feroze
- Department of Neurological Surgery, University of Washington, Seattle
- Human Biology Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Simone Ferrero
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | | | - Irina Filip
- Psychiatry Department, Kaiser Permanente, Fontana, California
- School of Health Sciences, A.T. Still University, Mesa, Arizona
| | - Florian Fischer
- Institute of Gerontological Health Services and Nursing Research, Ravensburg-Weingarten University of Applied Sciences, Weingarten, Germany
| | | | - Masoud Foroutan
- Department of Medical Parasitology, Abadan University of Medical Sciences, Abadan, Iran
- Faculty of Medicine, Abadan University of Medical Sciences, Abadan, Iran
| | | | - Peter Andras Gaal
- Health Services Management Training Centre, Semmelweis University, Budapest, Hungary
- Department of Applied Social Sciences, Sapientia Hungarian University of Transylvania, Târgu-Mureş, Romania
| | - Mohamed M. Gad
- Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio
- Gillings School of Global Public Health, University of North Carolina Chapel Hill, Chapel Hill
| | - Muktar A. Gadanya
- Community Medicine Department, Bayero University, Kano, Kano, Nigeria
- Department of Community Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Silvano Gallus
- Department of Environmental Health Sciences, Mario Negri Institute for Pharmacological Research, Milan, Italy
| | | | | | - Mansour Ghafourifard
- Department of Medical Surgical Nursing, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ahmad Ghashghaee
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
- Student Research Committee, Iran University of Medical Sciences, Tehran, Iran
| | - Nermin Ghith
- Research Group for Genomic Epidemiology, Technical University of Denmark, Copenhagen, Denmark
| | - Maryam Gholamalizadeh
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Syed Amir Gilani
- Faculty of Allied Health Sciences, University of Lahore, Lahore, Pakistan
- Afro-Asian Institute, Lahore, Pakistan
| | - Themba G. Ginindza
- Discipline of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa
| | | | - James C. Glasbey
- National Institute for Health Research Global Health Research Unit on Global Surgery, University of Birmingham, Birmingham, England
| | - Mahaveer Golechha
- Health Systems and Policy Research, Indian Institute of Public Health, Gandhinagar, India
| | - Pouya Goleij
- Department of Genetics, Sana Institute of Higher Education, Sari, Iran
| | - Ricardo Santiago Gomez
- Department of Oral Surgery and Pathology, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Sameer Vali Gopalani
- Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City
- Department of Health and Social Affairs, Government of the Federated States of Micronesia, Palikir, Federated States of Micronesia
| | - Giuseppe Gorini
- Oncological Network, Prevention and Research Institute, Institute for Cancer Research, Prevention and Clinical Network, Florence, Italy
| | - Houman Goudarzi
- Department of Respiratory Medicine, Hokkaido University, Sapporo, Japan
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Giuseppe Grosso
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | | | | | - Avirup Guha
- Harrington Heart and Vascular Institute, Case Western Reserve University, Cleveland, Ohio
- Division of Cardiovascular Medicine, Ohio State University, Columbus
| | | | - Bhawna Gupta
- Department of Public Health, Torrens University, Melbourne, Victoria, Australia
| | - Veer Bala Gupta
- School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Vivek Kumar Gupta
- Department of Clinical Medicine, Macquarie University, Sydney, New South Wales, Australia
| | - Reyna Alma Gutiérrez
- Department of Epidemiology and Psychosocial Research, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Nima Hafezi-Nejad
- Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Arvin Haj-Mirzaian
- Department of Pharmacology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Obesity Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Rabih Halwani
- Clinical Sciences Department, University of Sharjah, Sharjah, United Arab Emirates
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Randah R. Hamadeh
- Department of Family and Community Medicine, Arabian Gulf University, Manama, Bahrain
| | - Sajid Hameed
- University Institute of Public Health, University of Lahore, Lahore, Pakistan
| | - Samer Hamidi
- School of Health and Environmental Studies, Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates
| | - Asif Hanif
- University Institute of Public Health, University of Lahore, Lahore, Pakistan
| | - Shafiul Haque
- Research & Scientific Studies Unit, Jazan University, Jazan, Saudi Arabia
| | - Netanja I. Harlianto
- Faculty of Medicine, Utrecht University, Utrecht, Netherlands
- Department of Radiology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Josep Maria Haro
- Research Unit, University of Barcelona, Barcelona, Spain
- Biomedical Research Networking Center for Mental Health Network, Barcelona, Spain
| | | | - Soheil Hassanipour
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
- Caspian Digestive Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Roderick J. Hay
- International Foundation for Dermatology, London, England
- St John's Institute of Dermatology, King's College London, London, England
| | - Simon I. Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Khezar Hayat
- Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, Lahore, Pakistan
- Department of Pharmacy Administration and Clinical Pharmacy, Xian Jiaotong University, Xian, China
| | | | - Mohammad Heidari
- Community-Oriented Nursing Midwifery Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | | | - Claudiu Herteliu
- Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
- School of Business, London South Bank University, London, England
| | - Kamal Hezam
- Department of Applied Microbiology, Taiz University, Taiz, Yemen
- Department of Microbiology, Nankai University, Tianjin, China
| | - Ramesh Holla
- Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Md Mahbub Hossain
- Social and Environmental Health Research, Nature Study Society of Bangladesh, Khulna, Bangladesh
- Department of Health Promotion and Community Health Sciences, Texas A&M University, College Station
| | | | | | - Mostafa Hosseini
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
- Pediatric Chronic Kidney Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Hosseinzadeh
- Institute of Research and Development, Duy Tan University, Da Nang, Vietnam
- Department of Computer Science, University of Human Development, Sulaymaniyah, Iraq
| | - Mihaela Hostiuc
- Internal Medicine Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Sorin Hostiuc
- Department of Legal Medicine and Bioethics, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Clinical Legal Medicine Department, National Institute of Legal Medicine Mina Minovici, Bucharest, Romania
| | - Mowafa Househ
- College of Science and Engineering, Hamad Bin Khalifa University, Doha, Qatar
| | - Mohamed Hsairi
- Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Junjie Huang
- Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China
| | - Fernando N. Hugo
- Department of Preventive and Social Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Rabia Hussain
- School of Pharmaceutical Sciences, University of Science Malaysia, Penang, Malaysia
| | - Nawfal R. Hussein
- Department of Biomolecular Sciences, University of Zakho, Zakho, Iraq
| | - Bing-Fang Hwang
- Department of Occupational Safety and Health, China Medical University, Taichung, Taiwan
| | - Ivo Iavicoli
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | | | - Fidelia Ida
- Pharmacoepidemiology Department, Sanofi, Cambridge, Massachusetts
| | - Kevin S. Ikuta
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Division of Allergy and Infectious Diseases, University of Washington, Seattle
| | - Olayinka Stephen Ilesanmi
- Department of Community Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Community Medicine, University College Hospital, Ibadan, Ibadan, Nigeria
| | - Irena M. Ilic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Milena D. Ilic
- Department of Epidemiology, University of Kragujevac, Kragujevac, Serbia
| | - Lalu Muhammad Irham
- School of Pharmacy, Taipei Medical University, Taipei, Taiwan
- Faculty of Pharmacy, Ahmad Dahlan University, Yogyakarta, Indonesia
| | - Jessica Y. Islam
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Rakibul M. Islam
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, Victoria, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | | | - Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, University of Catania, Catania, Italy
| | - Masao Iwagami
- Department of Health Services Research, University of Tsukuba, Tsukuba, Japan
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, England
| | - Louis Jacob
- Research and Development Unit, Biomedical Research Networking Center for Mental Health Network, Sant Boi de Llobregat, Spain
- Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | - Vardhmaan Jain
- Department of Internal Medicine, Cleveland Clinic, Cleveland, Ohio
| | - Mihajlo B. Jakovljevic
- Institute of Comparative Economic Studies, Hosei University, Tokyo, Japan
- Department of Global Health, Economics and Policy, University of Kragujevac, Kragujevac, Serbia
| | | | - Shubha Jayaram
- Department of Biochemistry, Government Medical College, Mysuru, India
| | | | - Ravi Prakash Jha
- Department of Community Medicine, Dr Baba Saheb Ambedkar Medical College and Hospital, Delhi, India
- Department of Community Medicine, Banaras Hindu University, Varanasi, India
| | - Jost B. Jonas
- Department of Ophthalmology, Heidelberg University, Heidelberg, Germany
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing, China
| | - Tamas Joo
- Health Services Management Training Centre, Semmelweis University, Budapest, Hungary
| | - Nitin Joseph
- Department of Community Medicine, Manipal Academy of Higher Education, Mangalore, India
| | - Farahnaz Joukar
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
- Caspian Digestive Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Mikk Jürisson
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Ali Kabir
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Danial Kahrizi
- Department of Genetics, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Leila R. Kalankesh
- School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Rohollah Kalhor
- Institute for Prevention of Non-communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
- Health Services Management Department, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Feroze Kaliyadan
- Dermatology Department, King Faisal University, Hofuf, Saudi Arabia
| | - Yogeshwar Kalkonde
- Public Health Division, Society for Education, Action and Research in Community Health, Gadchiroli, India
| | - Ashwin Kamath
- Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
- Manipal Academy of Higher Education, Manipal, India
| | | | - Himal Kandel
- Save Sight Institute, University of Sydney, Sydney, New South Wales, Australia
- Sydney Eye Hospital, South Eastern Sydney Local Health District, Sydney, New South Wales, Australia
| | - Neeti Kapoor
- Department of Forensic Science, Government Institute of Forensic Science, Nagpur, India
| | - André Karch
- Institute for Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Ayele Semachew Kasa
- Department of Adult Health Nursing, Bahir Dar University, Bahir Dar, Ethiopia
| | - Srinivasa Vittal Katikireddi
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland
| | - Joonas H. Kauppila
- Surgery Research Unit, University of Oulu, Oulu, Finland
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
| | - Taras Kavetskyy
- Department of Surface Engineering, John Paul II Catholic University of Lublin, Lublin, Poland
- Drohobych Ivan Franko State Pedagogical University, Drohobych, Ukraine
| | - Sewnet Adem Kebede
- Department of Epidemiology and Biostatistics, University of Gondar, Gondar, Faroe Islands
| | - Pedram Keshavarz
- School of Science and Technology, University of Georgia, Tbilisi, Georgia
- Department of Diagnostic and Interventional Radiology, New Hospitals LTD, Tbilisi, Georgia
| | - Mohammad Keykhaei
- Noncommunicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Students Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Yousef Saleh Khader
- Department of Public Health, Jordan University of Science and Technology, Irbid, Jordan
| | - Rovshan Khalilov
- Department of Biophysics and Biochemistry, Baku State University, Baku, Azerbaijan
- Russian Institute for Advanced Study, Moscow State Pedagogical University, Moscow, Russia
| | - Gulfaraz Khan
- Department of Medical Microbiology and Immunology, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Maseer Khan
- Epidemiology Department, Jazan University, Jazan, Saudi Arabia
| | - Md Nuruzzaman Khan
- Department of Population Science, Jatiya Kabi Kazi Nazrul Islam University, Mymensingh, Bangladesh
| | - Moien A. B. Khan
- Family Medicine Department, United Arab Emirates University, Al Ain, United Arab Emirates
- Primary Care Department, NHS North West London, London, England
| | - Young-Ho Khang
- Department of Health Policy and Management, Seoul National University, Seoul, South Korea
- Institute of Health Policy and Management, Seoul National University, Seoul, South Korea
| | - Amir M. Khater
- National Hepatology and Tropical Medicine Research Institute, Cairo University, Cairo, Egypt
| | - Maryam Khayamzadeh
- Shahid Beheshti University of Medical Sciences, Tehran, Iran
- The Iranian Academy of Medical Sciences, Tehran, Iran
| | - Gyu Ri Kim
- Department of Preventive Medicine, Yonsei University, Seoul, South Korea
| | - Yun Jin Kim
- School of Traditional Chinese Medicine, Xiamen University Malaysia, Sepang, Malaysia
| | - Adnan Kisa
- School of Health Sciences, Kristiania University College, Oslo, Norway
- Department of Global Community Health and Behavioral Sciences, Tulane University, New Orleans, Louisiana
| | - Sezer Kisa
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | | | - Jacek A. Kopec
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- Arthritis Research Canada, Richmond, British Columbia, Canada
| | | | - Parvaiz A. Koul
- Department of Internal and Pulmonary Medicine, Sheri Kashmir Institute of Medical Sciences, Srinagar, India
| | | | - Ai Koyanagi
- Biomedical Research Networking Center for Mental Health Network, San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain
- Catalan Institution for Research and Advanced Studies, Barcelona, Spain
| | | | - Nuworza Kugbey
- University of Environment and Sustainable Development, Somanya, Ghana
| | | | - Narinder Kumar
- Department of Orthopaedics, Medanta Hospital, Lucknow, India
| | - Nithin Kumar
- Department of Community Medicine, Manipal Academy of Higher Education, Mangalore, India
| | - Om P. Kurmi
- Faculty of Health and Life Sciences, Coventry University, Coventry, England
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Tezer Kutluk
- Department of Pediatric Oncology, Hacettepe University, Ankara, Turkey
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Faris Hasan Lami
- Department of Community and Family Medicine, University of Baghdad, Baghdad, Iraq
| | - Iván Landires
- Unit of Genetics and Public Health, Institute of Medical Sciences, Las Tablas, Panama
- Ministry of Health, Herrera, Panama
| | - Paolo Lauriola
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Sang-woong Lee
- Pattern Recognition and Machine Learning Lab, Gachon University, Seongnam, South Korea
| | - Shaun Wen Huey Lee
- School of Pharmacy, Monash University, Bandar Sunway, Malaysia
- School of Pharmacy, Taylor's University Lakeside Campus, Subang Jaya, Malaysia
| | - Wei-Chen Lee
- Office of Health Policy & Legislative Affairs, University of Texas, Galveston
| | - Yo Han Lee
- Graduate School of Public Health, Ajou University, Suwon-si, South Korea
| | - James Leigh
- Asbestos Diseases Research Institute, University of Sydney, Sydney, New South Wales, Australia
| | - Elvynna Leong
- Faculty of Science, Universiti Brunei Darussalam, Bandar Seri Begawan, Brunei
| | - Jiarui Li
- Department of Medical Oncology, Peking Union Medical College, Beijing, China
| | - Ming-Chieh Li
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan
| | - Xuefeng Liu
- Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
- Department of Quantitative Health Science, Case Western Reserve University, Cleveland, Ohio
| | - Joana A. Loureiro
- Laboratory for Process Engineering, Environment, Biotechnology and Energy, University of Porto, Porto, Portugal
- School of Health, Polytechnic Institute of Porto, Portugal
| | - Raimundas Lunevicius
- Department of General Surgery, Liverpool University Hospitals NHS Foundation Trust, Liverpool, England
- Department of Surgery, University of Liverpool, Liverpool, England
| | | | - Azeem Majeed
- Department of Primary Care and Public Health, Imperial College London, London, England
| | - Alaa Makki
- Mass Communication Department, University of Sharjah, Sharjah, United Arab Emirates
| | - Shilpa Male
- Department of Ophthalmology, M M Joshi Eye Institute, Hubli, India
| | - Ahmad Azam Malik
- University Institute of Public Health, University of Lahore, Lahore, Pakistan
- Rabigh Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
| | - Santi Martini
- Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia
- Indonesian Public Health Association, Surabaya, Indonesia
| | | | - Prashant Mathur
- National Centre for Disease Informatics and Research, Indian Council of Medical Research, Bengaluru, India
| | - Martin McKee
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, England
| | - Ravi Mehrotra
- India Cancer Research Consortium, Indian Council of Medical Research, New Delhi, India
| | - Walter Mendoza
- Peru Country Office, United Nations Population Fund, Lima, Peru
| | - Ritesh G. Menezes
- Forensic Medicine Division, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | | | - Mohamed Kamal Mesregah
- Department of Orthopaedic Surgery, Menoufia University Faculty of Medicine, Shebin El-Kom, Egypt
| | - Tomislav Mestrovic
- Clinical Microbiology and Parasitology Unit, Polyclinic “Dr. Zora Profozic”, Zagreb, Croatia
- University Centre Varazdin, University North, Varazdin, Croatia
| | - Junmei Miao Jonasson
- School of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Bartosz Miazgowski
- Center for Innovation in Medical Education, Pomeranian Medical University, Szczecin, Poland
- Pomeranian Medical University, Szczecin, Poland
| | - Tomasz Miazgowski
- Department of Propedeutics of Internal Diseases and Arterial Hypertension, Pomeranian Medical University, Szczecin, Poland
| | | | - Ted R. Miller
- Pacific Institute for Research and Evaluation, Calverton, Maryland
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Hamed Mirzaei
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Hamid Reza Mirzaei
- Department of Medical Immunology, Tehran University of Medical Sciences, Tehran, Iran
| | - Sanjeev Misra
- Department of Surgical Oncology, All India Institute of Medical Sciences, Jodhpur, India
| | - Prasanna Mithra
- Department of Community Medicine, Manipal Academy of Higher Education, Mangalore, India
| | - Masoud Moghadaszadeh
- Biotechnology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Molecular Medicine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Yousef Mohammad
- Internal Medicine Department, King Saud University, Riyadh, Saudi Arabia
| | - Mokhtar Mohammadi
- Department of Information Technology, Lebanese French University, Erbil, Iraq
| | | | | | - Shafiu Mohammed
- Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria
- Department of Health Care Management, Technical University of Berlin, Berlin, Germany
| | - Nagabhishek Moka
- Oncology Department, Appalachian Regional Healthcare, Hazard, Kentucky
- Internal Medicine, University of Kentucky, Lexington
| | - Ali H. Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Mariam Molokhia
- Faculty of Life Sciences and Medicine, King's College London, London, England
| | - Lorenzo Monasta
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
| | - Mohammad Ali Moni
- Department of Computer Science and Engineering, Pabna University of Science and Technology, Pabna, Bangladesh
| | - Mohammad Amin Moosavi
- Department of Molecular Medicine, National Institute of Genetic Engineering and Biotechnology, Tehran, Iran
| | - Yousef Moradi
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Paula Moraga
- Computer, Electrical, and Mathematical Sciences and Engineering Division, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia
| | | | | | - Abbas Mosapour
- Department of Clinical Biochemistry, Babol University of Medical Sciences, Babol, Iran
- Department of Clinical Biochemistry, Tarbiat Modares University, Tehran, Iran
| | - Sumaira Mubarik
- Department of Epidemiology and Biostatistics, Wuhan University, Wuhan, China
| | - Lillian Mwanri
- College of Medicine and Public Health, Flinders University, Adeaide, South Australia, Australia
| | - Ahamarshan Jayaraman Nagarajan
- Research and Analytics Department, Initiative for Financing Health and Human Development, Chennai, India
- Department of Research and Analytics, Bioinsilico Technologies, Chennai, India
| | | | - Chie Nagata
- Department of Education for Clinical Research, National Center for Child Health and Development, Tokyo, Japan
| | - Mukhammad David Naimzada
- Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia
- Experimental Surgery and Oncology Laboratory, Kursk State Medical University, Kursk, Russia
| | | | - Atta Abbas Naqvi
- Department of Pharmacy Practice, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
- Discipline of Social and Administrative Pharmacy, University of Science, Malaysia, Penang, Malaysia
| | | | - Rawlance Ndejjo
- Department of Disease Control and Environmental Health, Makerere University, Kampala, Uganda
| | - Sabina O. Nduaguba
- Pharmaceutical Outcomes and Policy Department, University of Florida, Gainesville
| | - Ionut Negoi
- Department of General Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Department of General Surgery, Emergency Hospital of Bucharest, Bucharest, Romania
| | - Serban Mircea Negru
- Department of Oncology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | | | - Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Hanoi, Vietnam
| | | | | | - Chukwudi A. Nnaji
- South African Medical Research Council, Cape Town, South Africa
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Nurulamin M. Noor
- Medical Research Council Clinical Trials Unit, University College London, London, England
- Department of Gastroenterology, Cambridge University Hospitals, Cambridge, England
| | - Virginia Nuñez-Samudio
- Unit of Microbiology and Public Health, Institute of Medical Sciences, Las Tablas, Panama
- Department of Public Health, Ministry of Health, Herrera, Panama
| | | | - Bogdan Oancea
- Administrative and Economic Sciences Department, University of Bucharest, Bucharest, Romania
| | - Chimedsuren Ochir
- Department of International Cyber Education, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
- Advisory Board, Ministry of Health, Ulaanbaatar, Mongolia
| | - Oluwakemi Ololade Odukoya
- Department of Community Health and Primary Care, University of Lagos, Idi Araba, Nigeria
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City
| | - Felix Akpojene Ogbo
- Translational Health Research Institute, Western Sydney University, Sydney, New South Wales, Australia
| | - Andrew T. Olagunju
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Department of Psychiatry, University of Lagos, Lagos, Nigeria
| | | | - Emad Omar
- Mass Communication Department, Ajman University, Dubai, United Arab Emirates
| | - Ahmed Omar Bali
- Diplomacy and Public Relations Department, University of Human Development, Sulaymaniyah, Iraq
| | - Abidemi E. Emmanuel Omonisi
- Department of Anatomic Pathology, Ekiti State University, Ado-Ekiti, Nigeria
- Department of Anatomic Pathology, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
| | - Sokking Ong
- Noncommunicable Disease Prevention Unit, Ministry of Health, Bandar Seri Begawan, Brunei
- Early Detection and Cancer Prevention Services, Pantai Jerudong Specialist Centre, Bandar Seri Begawan, Brunei
| | - Obinna E. Onwujekwe
- Department of Pharmacology and Therapeutics, University of Nigeria Nsukka, Enugu, Nigeria
| | - Hans Orru
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
- Section of Sustainable Health, Umeå University, Umea, Sweden
| | | | - Nikita Otstavnov
- Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia
| | - Stanislav S. Otstavnov
- Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia
- Department of Project Management, National Research University Higher School of Economics, Moscow, Russia
| | - Mayowa O. Owolabi
- Department of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Medicine, University College Hospital, Ibadan, Ibadan, Nigeria
| | - Mahesh P A
- Department of Respiratory Medicine, Jagadguru Sri Shivarathreeswara Academy of Health Education and Research, Mysore, India
| | - Jagadish Rao Padubidri
- Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Keyvan Pakshir
- Department of Medical Mycology and Parasitology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Adrian Pana
- Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
- Department of Health Metrics, Center for Health Outcomes and Evaluation, Bucharest, Romania
| | | | | | - Shahina Pardhan
- Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, England
| | - Eun-Cheol Park
- Department of Preventive Medicine, Yonsei University, Seoul, South Korea
- Institute of Health Services Research, Yonsei University, Seoul, South Korea
| | - Eun-Kee Park
- Department of Medical Humanities and Social Medicine, Kosin University, Busan, South Korea
| | | | - Harsh K. Patel
- Department of Internal Medicine, Ochsner Medical Center, New Orleans, Louisiana
| | - Jenil R. Patel
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston School of Public Health, Dallas
- Department of Epidemiology, University of Arkansas for Medical Sciences, Little Rock
| | - Siddhartha Pati
- Centre of Excellence, Khallikote University, Berhampur, India
- Research Division, Association for Biodiversity Conservation and Research, Balasore, India
| | | | - Uttam Paudel
- Research Section, Nepal Health Research Council, Kathmandu, Nepal
- Faculty of Humanities and Social Sciences, Tribhuvan University, Kathmandu, Nepal
| | - David M. Pereira
- Associated Laboratory for Green Chemistry, University of Porto, Porto, Portugal
| | | | - Arokiasamy Perianayagam
- Department of Development Studies, International Institute for Population Sciences, Mumbai, India
| | - Julian David Pillay
- Basic Medical Sciences Department, Durban University of Technology, Durban, South Africa
| | - Saeed Pirouzpanah
- Department of Biochemistry and Dietetics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Farhad Pishgar
- Noncommunicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Urooncology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Indrashis Podder
- Department of Dermatology, College of Medicine and Sagore Dutta Hospital, Kolkata, India
| | - Maarten J. Postma
- University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- School of Economics and Business, University of Groningen, Groningen, Netherlands
| | - Hadi Pourjafar
- Department of Nutrition and Food Sciences, Maragheh University of Medical Sciences, Maragheh, Iran
- Dietary Supplements and Probiotic Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Akila Prashant
- Department of Biochemistry, Jagadguru Sri Shivarathreeswara University, Mysuru, India
| | - Liliana Preotescu
- National Institute of Infectious Diseases, Bucuresti, Romania
- Department of Infectious Diseases, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Mohammad Rabiee
- Biomedical Engineering Department, Amirkabir University of Technology, Tehran, Iran
| | - Navid Rabiee
- Department of Physics, Sharif University of Technology, Tehran, Iran
| | - Amir Radfar
- College of Medicine, University of Central Florida, Orlando
| | | | | | - Ata Rafiee
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Fakher Rahim
- Metabolomics and Genomics Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Shadi Rahimzadeh
- Department of Natural Science, Middlesex University, London, England
| | - Mosiur Rahman
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh
| | - Muhammad Aziz Rahman
- School of Nursing and Healthcare Professions, Federation University Australia, Berwick, Victoria, Australia
- School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
| | - Amir Masoud Rahmani
- Future Technology Research Center, National Yunlin University of Science and Technology, Yunlin, Taiwan
| | - Nazanin Rajai
- Department of Internal Medicine, Harvard University, Boston, Massachusetts
| | - Aashish Rajesh
- Department of Surgery, University of Texas Health Science Center at San Antonio, San Antonio
| | - Ivo Rakovac
- European Office for the Prevention and Control of Noncommunicable Diseases, World Health Organization, Moscow, Russia
| | - Pradhum Ram
- Department of Cardiology, Emory University, Atlanta, Georgia
| | - Kiana Ramezanzadeh
- Department of Pharmacology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kamal Ranabhat
- Health Emergency Operation Center, Ministry of Health and Population, Kathmandu, Nepal
- Central Department of Public Health, Institute of Medicine, Kathmandu, Nepal
| | | | - Chythra R. Rao
- Department of Community Medicine, Manipal Academy of Higher Education, Manipal, India
| | - Sowmya J. Rao
- Department of Oral Pathology, Srinivas Institute of Dental Sciences, Mangalore, India
| | - Reza Rawassizadeh
- Department of Computer Science, Boston University, Boston, Massachusetts
| | - Mohammad Sadegh Razeghinia
- Department of Immunology and Laboratory Sciences, Sirjan School of Medical Sciences, Sirjan, Iran
- Department of Immunology, Kerman University of Medical Sciences, Kerman, Iran
| | - Andre M. N. Renzaho
- School of Medicine, Western Sydney University, Campbelltown, New South Wales, Australia
- Translational Health Research Institute, Western Sydney University, Campbelltown, New South Wales, Australia
| | - Negar Rezaei
- Noncommunicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Tehran University of Medical Sciences, Tehran, Iran
- Network of Immunity in Infection, Malignancy and Autoimmunity, Universal Scientific Education and Research Network, Tehran, Iran
| | - Aziz Rezapour
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | | | - Peter Rohloff
- Department of Global Health and Population, Harvard University, Boston, Massachusetts
- Center for Indigenous Health Research, Wuqu' Kawoq Maya Health Alliance, Tecpan, Guatemala
| | | | - Luca Ronfani
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
| | - Gholamreza Roshandel
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | | | - Manjula S
- Oral and Maxillofacial Surgery, Jagadguru Sri Shivarathreeswara University, Mysore, India
| | - Siamak Sabour
- Department of Epidemiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Basema Saddik
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates
| | - Umar Saeed
- Research and Development, Islamabad Diagnostic Center Pakistan, Islamabad, Pakistan
- Biological Production Development, National Institute of Health, Islamabad, Pakistan
| | - Amirhossein Sahebkar
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Harihar Sahoo
- Department of Development Studies, International Institute for Population Sciences, Mumbai, India
| | - Sana Salehi
- Department of Radiology, University of Southern California, Los Angeles
| | - Marwa Rashad Salem
- Public Health and Community Medicine Department, Cairo University, Giza, Egypt
| | - Hamideh Salimzadeh
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrnoosh Samaei
- Emergency Department, Brown University, Providence, Rhode Island
| | | | - Juan Sanabria
- Department of Surgery, Marshall University, Huntington, West Virginia
- Department of Nutrition and Preventive Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Senthilkumar Sankararaman
- Department of Pediatrics, University Hospitals Rainbow Babies & Children's Hospital, Cleveland, Ohio
- Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio
| | - Milena M. Santric-Milicevic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- School of Public Health and Health Management, University of Belgrade, Belgrade, Serbia
| | - Yaeesh Sardiwalla
- Division of Plastic and Reconstructive Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Arash Sarveazad
- Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Brijesh Sathian
- Geriatric and Long-Term Care Department, Hamad Medical Corporation, Doha, Qatar
- Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, England
| | - Monika Sawhney
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte
| | | | | | - Mario Sekerija
- Department of Medical Statistics, Epidemiology and Medical Informatics, University of Zagreb, Zagreb, Croatia
- Department of Epidemiology and Prevention of Chronic Noncommunicable Diseases, Croatian Institute of Public Health, Zagreb, Croatia
| | - Allen Seylani
- National Heart, Lung, and Blood Institute, National Institutes of Health, Rockville, Maryland
| | - Omid Shafaat
- Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland
- Department of Radiology and Interventional Neuroradiology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Shaghaghi
- Clinical Research Development Unit of Farshchian Heart Center, Hamedan University of Medical Sciences, Hamadan, Iran
| | | | - Erfan Shamsoddin
- Department of Oral Health, Non-Communicable Diseases Research Center, Tehran, Iran
- Noncommunicable Diseases Committee, National Institute for Medical Research Developmen, Tehran, Iran
| | - Mohammed Shannawaz
- Symbiosis Medical College for Women, Symbiosis International University, Pune, India
| | - Rajesh Sharma
- University School of Management and Entrepreneurship, Delhi Technological University, Delhi, India
| | - Aziz Sheikh
- Centre for Medical Informatics, University of Edinburgh, Edinburgh, Scotland
- Division of General Internal Medicine, Harvard University, Boston, Massachusetts
| | - Sara Sheikhbahaei
- Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland
| | - Adithi Shetty
- Department of Obstetrics and Gynaecology, Manipal Academy of Higher Education, Mangalore, India
| | - Jeevan K. Shetty
- Department of Biochemistry, Manipal University College Melaka, Melaka, Malaysia
| | - Pavanchand H. Shetty
- Department of Forensic Medicine, Manipal Academy of Higher Education, Mangalore, India
| | | | - Reza Shirkoohi
- Cancer Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Cancer Biology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - K. M. Shivakumar
- Public Health Dentistry Department, Krishna Institute of Medical Sciences, Karad, India
| | - Velizar Shivarov
- Clinical Immunology and Hematology, Sofiamed University Hospital, Sofia, Bulgaria
- Department of Genetics, Sofia University St. Kliment Ohridiski, Sofia, Bulgaria
| | - Soraya Siabani
- Department of Health Education and Health Promotion, Kermanshah University of Medical Sciences, Kermanshah, Iran
- School of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | | | | | - Jasvinder A. Singh
- School of Medicine, University of Alabama at Birmingham, Birmingham
- Medicine Service Department of Veterans Affairs, Birmingham, Alabama
| | | | | | | | - Matthew J. Soeberg
- Asbestos Diseases Research Institute, Sydney, New South Wales, Australia
| | - Ahmad Sofi-Mahmudi
- Department of Oral Health, Non-Communicable Diseases Research Center, Tehran, Iran
- Cochrane Iran Associate Centre, National Institute for Medical Research Development, Iranian Ministry of Health and Medical Education, Tehran, Iran
| | - Houman Sotoudeh
- Department of Radiology, University of Alabama at Birmingham, Birmingham
| | | | - Kurt Straif
- Schiller Institute, Boston College, Boston, Massachusetts
- Barcelona Institute for Global Health, Barcelona, Spain
| | | | | | - Iyad Sultan
- Pediatric Services, King Hussein Cancer Center, Amman, Jordan
- Pediatrics, University of Jordan, Amman, Jordan
| | - Saima Sultana
- Maternal and Child Health, Projahnmo Research Foundation, Dhaka, Bangladesh
| | - Daniel Sur
- Department of Medical Oncology, The Oncology Institute “Prof Dr Ion Chiricuţă” Cluj-Napoca, Cluj-Napoca, Romania
- Department of Medical Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Viktória Szerencsés
- Health Services Management Training Centre, Semmelweis University, Budapest, Hungary
| | - Miklós Szócska
- Faculty of Health and Public Administration, Semmelweis University, Budapest, Hungary
| | - Rafael Tabarés-Seisdedos
- Department of Medicine, University of Valencia, Valencia, Spain
- Carlos III Health Institute, Biomedical Research Networking Center for Mental Health Network, Madrid, Spain
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | | | - Amir Taherkhani
- Research Center for Molecular Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ken Takahashi
- Asbestos Diseases Research Institute, Sydney, New South Wales, Australia
| | - Iman M. Talaat
- Clinical Sciences Department, University of Sharjah, Sharjah, United Arab Emirates
- Pathology Department, Alexandria University, Alexandria, Egypt
| | - Ker-Kan Tan
- Department of Surgery, National University of Singapore, Singapore, Singapore
| | - Vivian Y. Tat
- Department of Pathology, University of Texas, Galveston
| | - Bemnet Amare A. Tedla
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Queensland, Australia
- University of Gondar, Gondar, Ethiopia
| | | | - Arash Tehrani-Banihashemi
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Community and Family Medicine, Iran University of Medical Sciences, Tehran, Iran
| | | | - Fisaha Haile Tesfay
- School of Public Health, Mekelle University, Mekelle, Ethiopia
- Southgate Institute for Health and Society, Flinders University, Adelaide, South Australia, Australia
| | - Gizachew Assefa Tessema
- School of Public Health, Curtin University, Perth, Western Australia, Australia
- School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
| | - Rekha Thapar
- Department of Community Medicine, Manipal Academy of Higher Education, Mangalore, India
| | - Aravind Thavamani
- Department of Pediatrics, University Hospitals Rainbow Babies & Children's Hospital, Cleveland, Ohio
- Division of Pediatric Gastroenterology, Case Western Reserve University, Cleveland, Ohio
| | | | - Nihal Thomas
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College and Hospital, Vellore, India
| | - Hamid Reza Tohidinik
- HIV/STI Surveillance Research Center and World Health Organization Collaborating Center for HIV Surveillance, Kerman University of Medical Sciences, Kerman, Iran
| | - Mathilde Touvier
- Nutritional Epidemiology Research Team, National Institute for Health and Medical Research Institut national de la santé et de la recherche médicale, Paris, France
- Department of Health, Medicine and Human Biology, Sorbonne Paris Nord University, Bobigny, France
| | - Marcos Roberto Tovani-Palone
- Department of Pathology and Legal Medicine, University of São Paulo, Ribeirão Preto, Brazil
- Modestum LTD, London, England
| | - Eugenio Traini
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | - Bach Xuan Tran
- Department of Health Economics, Hanoi Medical University, Hanoi, Vietnam
| | - Khanh Bao Tran
- Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
- Clinical Hematology and Toxicology, Maurice Wilkins Centre, Auckland, New Zealand
| | - Mai Thi Ngoc Tran
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
- Health Informatics Department, Nursing and Midwifery Faculty, Hanoi Medical University, Ha Noi, Vietnam
| | - Jaya Prasad Tripathy
- Department of Community Medicine, All India Institute of Medical Sciences, Nagpur, India
| | - Biruk Shalmeno Tusa
- Department of Epidemiology and Biostatistics, Haramaya University, Haramaya, Ethiopia
| | - Irfan Ullah
- Department of Allied Health Sciences, Iqra National University, Peshawar, Pakistan
- Pakistan Council for Science and Technology, Ministry of Science and Technology, Islamabad, Pakistan
| | - Saif Ullah
- Institute of Soil and Environmental Sciences, University of Agriculture, Faisalabad, Faisalabad, Pakistan
| | | | | | - Era Upadhyay
- Amity Institute of Biotechnology, Amity University Rajasthan, Jaipur, India
| | - Marco Vacante
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Maryam Vaezi
- Alzahra Teaching Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
- Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sahel Valadan Tahbaz
- Clinical Cancer Research Center, Milad General Hospital, Tehran, Iran
- Department of Microbiology, Islamic Azad University, Tehran, Iran
| | - Diana Zuleika Velazquez
- Faculty of Veterinary Medicine and Zootechnics, Autonomous University of Sinaloa, Culiacán Rosales, Mexico
| | - Massimiliano Veroux
- Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, Catania, Italy
| | - Francesco S. Violante
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- Occupational Health Unit, Sant'Orsola Malpighi Hospital, Bologna, Italy
| | - Vasily Vlassov
- Department of Health Care Administration and Economics, National Research University Higher School of Economics, Moscow, Russia
| | - Bay Vo
- Faculty of Information Technology, Ho Chi Minh City University of Technology, Ho Chi Minh City, Vietnam
| | - Victor Volovici
- Department of Neurosurgery, Erasmus University Medical Center, Rotterdam, Netherlands
- Center for Experimental Microsurgery, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Giang Thu Vu
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Yasir Waheed
- Foundation University Medical College, Foundation University Islamabad, Islamabad, Pakistan
| | - Richard G. Wamai
- Cultures, Societies and Global Studies, Integrated Initiative for Global Health, Northeastern University, Boston, Massachusetts
- School of Public Health, University of Nairobi, Nairobi, Kenya
| | - Paul Ward
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Yi Feng Wen
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Stomatological Hospital (College) of Xi'an Jiaotong University, Xi'an, China
| | - Ronny Westerman
- Competence Center of Mortality-Follow-Up of the German National Cohort, Federal Institute for Population Research, Wiesbaden, Germany
| | - Andrea Sylvia Winkler
- Institute of Health and Society, University of Oslo, Oslo, Norway
- Department of Neurology, Technical University of Munich, Munich, Germany
| | - Lalit Yadav
- Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
- Research and Development Division, The George Institute for Global Health, New Delhi, India
| | | | - Lin Yang
- Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, British Columbia, Canada
- Department of Oncology, University of Calgary, Calgary, Alberta, Canada
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, Ontario, Canada
- George Institute for Global Health, University of Oxford, Oxford, England
| | | | - Yigizie Yeshaw
- Department of Epidemiology and Biostatistics, University of Gondar, Gondar, Ethiopia
| | - Naohiro Yonemoto
- Department of Neuropsychopharmacology, National Center of Neurology and Psychiatry, Kodaira, Japan
- Department of Public Health, Juntendo University, Tokyo, Japan
| | - Mustafa Z. Younis
- Department of Health Policy and Management, Jackson State University, Jackson, Mississippi
- School of Medicine, Tsinghua University, Beijing, China
| | - Zabihollah Yousefi
- Department of Environmental Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, Wuhan University, Wuhan, China
| | - Deniz Yuce
- Cancer Institute, Hacettepe University, Ankara, Turkey
| | - Ismaeel Yunusa
- Department of Clinical Pharmacy and Outcomes Sciences, University of South Carolina, Columbia
| | - Vesna Zadnik
- Epidemiology and Cancer Registry Sector, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Fariba Zare
- Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mikhail Sergeevich Zastrozhin
- Laboratory of Genetics and Genomics, Moscow Research and Practical Centre on Addictions, Moscow, Russia
- Addictology Department, Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | - Anasthasia Zastrozhina
- Pediatrics Department, Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | - Jianrong Zhang
- Department of General Practice, University of Melbourne, Melbourne, Victoria, Australia
- Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Australia
| | - Chenwen Zhong
- Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China
| | - Linghui Zhou
- Bone Marrow Transplantation Center, Zhejiang University, Hangzhou, China
| | - Cong Zhu
- Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center at Houston, Houston
| | - Arash Ziapour
- Department of Health Education and Health Promotion, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Christina Fitzmaurice
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Division of Hematology, University of Washington, Seattle
| | - Christopher J. L. Murray
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Lisa M. Force
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
- Division of Pediatric Hematology-Oncology, University of Washington, Seattle
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Alvarez EM, Force LM, Xu R, Compton K, Lu D, Henrikson HJ, Kocarnik JM, Harvey JD, Pennini A, Dean FE, Fu W, Vargas MT, Keegan THM, Ariffin H, Barr RD, Erdomaeva YA, Gunasekera DS, John-Akinola YO, Ketterl TG, Kutluk T, Malogolowkin MH, Mathur P, Radhakrishnan V, Ries LAG, Rodriguez-Galindo C, Sagoyan GB, Sultan I, Abbasi B, Abbasi-Kangevari M, Abbasi-Kangevari Z, Abbastabar H, Abdelmasseh M, Abd-Elsalam S, Abdoli A, Abebe H, Abedi A, Abidi H, Abolhassani H, Abubaker Ali H, Abu-Gharbieh E, Achappa B, Acuna JM, Adedeji IA, Adegboye OA, Adnani QES, Advani SM, Afzal MS, Aghaie Meybodi M, Ahadinezhad B, Ahinkorah BO, Ahmad S, Ahmadi S, Ahmed MB, Ahmed Rashid T, Ahmed Salih Y, Aiman W, Akalu GT, Al Hamad H, Alahdab F, AlAmodi AA, Alanezi FM, Alanzi TM, Alem AZ, Alem DT, Alemayehu Y, Alhalaiqa FN, Alhassan RK, Ali S, Alicandro G, Alipour V, Aljunid SM, Alkhayyat M, Alluri S, Almasri NA, Al-Maweri SA, Almustanyir S, Al-Raddadi RM, Alvis-Guzman N, Ameyaw EK, Amini S, Amu H, Ancuceanu R, Andrei CL, Andrei T, Ansari F, Ansari-Moghaddam A, Anvari D, Anyasodor AE, Arabloo J, Arab-Zozani M, Argaw AM, Arshad M, Arulappan J, Aryannejad A, Asemi Z, Asghari Jafarabadi M, Atashzar MR, Atorkey P, Atreya A, Attia S, Aujayeb A, Ausloos M, Avila-Burgos L, Awedew AF, Ayala Quintanilla BP, Ayele AD, Ayen SS, Azab MA, Azadnajafabad S, Azami H, Azangou-Khyavy M, Azari Jafari A, Azarian G, Azzam AY, Bahadory S, Bai J, Baig AA, Baker JL, Banach M, Bärnighausen TW, Barone-Adesi F, Barra F, Barrow A, Basaleem H, Batiha AMM, Behzadifar M, Bekele NC, Belete R, Belgaumi UI, Bell AW, Berhie AY, Bhagat DS, Bhagavathula AS, Bhardwaj N, Bhardwaj P, Bhaskar S, Bhattacharyya K, Bhojaraja VS, Bibi S, Bijani A, Biondi A, Birara S, Bjørge T, Bolarinwa OA, Bolla SR, Boloor A, Braithwaite D, Brenner H, Bulamu NB, Burkart K, Bustamante-Teixeira MT, Butt NS, Butt ZA, Caetano dos Santos FL, Cao C, Cao Y, Carreras G, Catalá-López F, Cembranel F, Cerin E, Chakinala RC, Chakraborty PA, Chattu VK, Chaturvedi P, Chaurasia A, Chavan PP, Chimed-Ochir O, Choi JYJ, Christopher DJ, Chu DT, Chung MT, Conde J, Costa VM, Da'ar OB, Dadras O, Dahlawi SMA, Dai X, Damiani G, D'Amico E, Dandona L, Dandona R, Daneshpajouhnejad P, Darwish AH, Daryani A, De la Hoz FP, Debela SA, Demie TGG, Demissie GD, Demissie ZG, Denova-Gutiérrez E, Derbew Molla M, Desai R, Desta AA, Dhamnetiya D, Dharmaratne SD, Dhimal ML, Dhimal M, Dianatinasab M, Didehdar M, Diress M, Djalalinia S, Do HP, Doaei S, Dorostkar F, dos Santos WM, Drake TM, Ekholuenetale M, El Sayed I, El Sayed Zaki M, El Tantawi M, El-Abid H, Elbahnasawy MA, Elbarazi I, Elhabashy HR, Elhadi M, El-Jaafary SI, Enyew DB, Erkhembayar R, Eshrati B, Eskandarieh S, Faisaluddin M, Fares J, Farooque U, Fasanmi AO, Fatima W, Ferreira de Oliveira JMP, Ferrero S, Ferro Desideri L, Fetensa G, Filip I, Fischer F, Fisher JL, Foroutan M, Fukumoto T, Gaal PA, Gad MM, Gaewkhiew P, Gallus S, Garg T, Gebremeskel TG, Gemeda BNB, Getachew T, Ghafourifard M, Ghamari SH, Ghashghaee A, Ghassemi F, Ghith N, Gholami A, Gholizadeh Navashenaq J, Gilani SA, Ginindza TG, Gizaw AT, Glasbey JC, Goel A, Golechha M, Goleij P, Golinelli D, Gopalani SV, Gorini G, Goudarzi H, Goulart BNG, Grada A, Gubari MIM, Guerra MR, Guha A, Gupta B, Gupta S, Gupta VB, Gupta VK, Haddadi R, Hafezi-Nejad N, Hailu A, Haj-Mirzaian A, Halwani R, Hamadeh RR, Hambisa MT, Hameed S, Hamidi S, Haque S, Hariri S, Haro JM, Hasaballah AI, Hasan SMM, Hashemi SM, Hassan TS, Hassanipour S, Hay SI, Hayat K, Hebo SH, Heidari G, Heidari M, Herrera-Serna BY, Herteliu C, Heyi DZ, Hezam K, Hole MK, Holla R, Horita N, Hossain MM, Hossain MB, Hosseini MS, Hosseini M, Hosseinzadeh A, Hosseinzadeh M, Hostiuc M, Hostiuc S, Househ M, Hsairi M, Huang J, Hussein NR, Hwang BF, Ibitoye SE, Ilesanmi OS, Ilic IM, Ilic MD, Innos K, Irham LM, Islam RM, Islam SMS, Ismail NE, Isola G, Iwagami M, Jacob L, Jadidi-Niaragh F, Jain V, Jakovljevic M, Janghorban R, Javadi Mamaghani A, Jayaram S, Jayawardena R, Jazayeri SB, Jebai R, Jha RP, Joo T, Joseph N, Joukar F, Jürisson M, Kaambwa B, Kabir A, Kalankesh LR, Kaliyadan F, Kamal Z, Kamath A, Kandel H, Kar SS, Karaye IM, Karimi A, Kassa BG, Kauppila JH, Kemp Bohan PM, Kengne AP, Kerbo AA, Keykhaei M, Khader YS, Khajuria H, Khalili N, Khalili N, Khan EA, Khan G, Khan M, Khan MN, Khan MAB, Khanali J, Khayamzadeh M, Khosravizadeh O, Khubchandani J, Khundkar R, Kim MS, Kim YJ, Kisa A, Kisa S, Kissimova-Skarbek K, Kolahi AA, Kopec JA, Koteeswaran R, Koulmane Laxminarayana SL, Koyanagi A, Kugbey N, Kumar GA, Kumar N, Kwarteng A, La Vecchia C, Lan Q, Landires I, Lasrado S, Lauriola P, Ledda C, Lee SW, Lee WC, Lee YY, Lee YH, Leigh J, Leong E, Li B, Li J, Li MC, Lim SS, Liu X, Lobo SW, Loureiro JA, Lugo A, Lunevicius R, Magdy Abd El Razek H, Magdy Abd El Razek M, Mahmoudi M, Majeed A, Makki A, Male S, Malekpour MR, Malekzadeh R, Malik AA, Mamun MA, Manafi N, Mansour-Ghanaei F, Mansouri B, Mansournia MA, Martini S, Masoumi SZ, Matei CN, Mathur MR, McAlinden C, Mehrotra R, Mendoza W, Menezes RG, Mentis AFA, Meretoja TJ, Mersha AG, Mesregah MK, Mestrovic T, Miao Jonasson J, Miazgowski B, Michalek IM, Miller TR, Mingude AB, Mirmoeeni S, Mirzaei H, Misra S, Mithra P, Mohammad KA, Mohammadi M, Mohammadi SM, Mohammadian-Hafshejani A, Mohammadpourhodki R, Mohammed A, Mohammed S, Mohammed TA, Moka N, Mokdad AH, Molokhia M, Momtazmanesh S, Monasta L, Moni MA, Moradi G, Moradi Y, Moradzadeh M, Moradzadeh R, Moraga P, Morrison SD, Mostafavi E, Mousavi Khaneghah A, Mpundu-Kaambwa C, Mubarik S, Mwanri L, Nabhan AF, Nagaraju SP, Nagata C, Naghavi M, Naimzada MD, Naldi L, Nangia V, Naqvi AA, Narasimha Swamy S, Narayana AI, Nayak BP, Nayak VC, Nazari J, Nduaguba SO, Negoi I, Negru SM, Nejadghaderi SA, Nepal S, Neupane Kandel S, Nggada HA, Nguyen CT, Nnaji CA, Nosrati H, Nouraei H, Nowroozi A, Nuñez-Samudio V, Nwatah VE, Nzoputam CI, Oancea B, Odukoya OO, Oguntade AS, Oh IH, Olagunju AT, Olagunju TO, Olakunde BO, Oluwasanu MM, Omar E, Omar Bali A, Ong S, Onwujekwe OE, Ortega-Altamirano DV, Otstavnov N, Otstavnov SS, Oumer B, Owolabi MO, P A M, Padron-Monedero A, Padubidri JR, Pakshir K, Pana A, Pandey A, Pardhan S, Pashazadeh Kan F, Pasovic M, Patel JR, Pati S, Pattanshetty SM, Paudel U, Pereira RB, Peres MFP, Perianayagam A, Postma MJ, Pourjafar H, Pourshams A, Prashant A, Pulakunta T, Qadir MMFF, Rabiee M, Rabiee N, Radfar A, Radhakrishnan RA, Rafiee A, Rafiei A, Rafiei S, Rahim F, Rahimzadeh S, Rahman M, Rahman MA, Rahmani AM, Rajesh A, Ramezani-Doroh V, Ranabhat K, Ranasinghe P, Rao CR, Rao SJ, Rashedi S, Rashidi M, Rashidi MM, Rath GK, Rawaf DL, Rawaf S, Rawal L, Rawassizadeh R, Razeghinia MS, Regasa MT, Renzaho AMN, Rezaei M, Rezaei N, Rezaei N, Rezaeian M, Rezapour A, Rezazadeh-Khadem S, Riad A, Rios Lopez LE, Rodriguez JAB, Ronfani L, Roshandel G, Rwegerera GM, Saber-Ayad MM, Sabour S, Saddik B, Sadeghi E, Sadeghian S, Saeed U, Sahebkar A, Saif-Ur-Rahman KM, Sajadi SM, Salahi S, Salehi S, Salem MR, Salimzadeh H, Samy AM, Sanabria J, Sanmarchi F, Sarveazad A, Sathian B, Sawhney M, Sawyer SM, Saylan M, Schneider IJC, Seidu AA, Šekerija M, Sendo EG, Sepanlou SG, Seylani A, Seyoum K, Sha F, Shafaat O, Shaikh MA, Shamsoddin E, Shannawaz M, Sharma R, Sheikhbahaei S, Shetty A, Shetty BSK, Shetty PH, Shin JI, Shirkoohi R, Shivakumar KM, Shobeiri P, Siabani S, Sibhat MM, Siddappa Malleshappa SK, Sidemo NB, Silva DAS, Silva Julian G, Singh AD, Singh JA, Singh JK, Singh S, Sinke AH, Sintayehu Y, Skryabin VY, Skryabina AA, Smith L, Sofi-Mahmudi A, Soltani-Zangbar MS, Song S, Spurlock EE, Steiropoulos P, Straif K, Subedi R, Sufiyan MB, Suliankatchi Abdulkader R, Sultana S, Szerencsés V, Szócska M, Tabaeian SP, Tabarés-Seisdedos R, Tabary M, Tabuchi T, Tadbiri H, Taheri M, Taherkhani A, Takahashi K, Tampa M, Tan KK, Tat VY, Tavakoli A, Tbakhi A, Tehrani-Banihashemi A, Temsah MH, Tesfay FH, Tesfaye B, Thakur JS, Thapar R, Thavamani A, Thiyagarajan A, Thomas N, Tobe-Gai R, Togtmol M, Tohidast SA, Tohidinik HR, Tolani MA, Tollosa DN, Touvier M, Tovani-Palone MR, Traini E, Tran BX, Tran MTN, Tripathy JP, Tusa BS, Ukke GG, Ullah I, Ullah S, Umapathi KK, Unnikrishnan B, Upadhyay E, Ushula TW, Vacante M, Valadan Tahbaz S, Varthya SB, Veroux M, Villeneuve PJ, Violante FS, Vlassov V, Vu GT, Waheed Y, Wang N, Ward P, Weldesenbet AB, Wen YF, Westerman R, Winkler AS, Wubishet BL, Xu S, Yahyazadeh Jabbari SH, Yang L, Yaya S, Yazdi-Feyzabadi V, Yazie TS, Yehualashet SS, Yeshaneh A, Yeshaw Y, Yirdaw BW, Yonemoto N, Younis MZ, Yousefi Z, Yu C, Yunusa I, Zadnik V, Zahir M, Zahirian Moghadam T, Zamani M, Zamanian M, Zandian H, Zare F, Zastrozhin MS, Zastrozhina A, Zhang J, Zhang ZJ, Ziapour A, Zoladl M, Murray CJL, Fitzmaurice C, Bleyer A, Bhakta N. The global burden of adolescent and young adult cancer in 2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Oncol 2022; 23:27-52. [PMID: 34871551 PMCID: PMC8716339 DOI: 10.1016/s1470-2045(21)00581-7] [Citation(s) in RCA: 87] [Impact Index Per Article: 43.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/28/2021] [Accepted: 09/29/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND In estimating the global burden of cancer, adolescents and young adults with cancer are often overlooked, despite being a distinct subgroup with unique epidemiology, clinical care needs, and societal impact. Comprehensive estimates of the global cancer burden in adolescents and young adults (aged 15-39 years) are lacking. To address this gap, we analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, with a focus on the outcome of disability-adjusted life-years (DALYs), to inform global cancer control measures in adolescents and young adults. METHODS Using the GBD 2019 methodology, international mortality data were collected from vital registration systems, verbal autopsies, and population-based cancer registry inputs modelled with mortality-to-incidence ratios (MIRs). Incidence was computed with mortality estimates and corresponding MIRs. Prevalence estimates were calculated using modelled survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated as age-specific cancer deaths multiplied by the standard life expectancy at the age of death. The main outcome was DALYs (the sum of YLLs and YLDs). Estimates were presented globally and by Socio-demographic Index (SDI) quintiles (countries ranked and divided into five equal SDI groups), and all estimates were presented with corresponding 95% uncertainty intervals (UIs). For this analysis, we used the age range of 15-39 years to define adolescents and young adults. FINDINGS There were 1·19 million (95% UI 1·11-1·28) incident cancer cases and 396 000 (370 000-425 000) deaths due to cancer among people aged 15-39 years worldwide in 2019. The highest age-standardised incidence rates occurred in high SDI (59·6 [54·5-65·7] per 100 000 person-years) and high-middle SDI countries (53·2 [48·8-57·9] per 100 000 person-years), while the highest age-standardised mortality rates were in low-middle SDI (14·2 [12·9-15·6] per 100 000 person-years) and middle SDI (13·6 [12·6-14·8] per 100 000 person-years) countries. In 2019, adolescent and young adult cancers contributed 23·5 million (21·9-25·2) DALYs to the global burden of disease, of which 2·7% (1·9-3·6) came from YLDs and 97·3% (96·4-98·1) from YLLs. Cancer was the fourth leading cause of death and tenth leading cause of DALYs in adolescents and young adults globally. INTERPRETATION Adolescent and young adult cancers contributed substantially to the overall adolescent and young adult disease burden globally in 2019. These results provide new insights into the distribution and magnitude of the adolescent and young adult cancer burden around the world. With notable differences observed across SDI settings, these estimates can inform global and country-level cancer control efforts. FUNDING Bill & Melinda Gates Foundation, American Lebanese Syrian Associated Charities, St Baldrick's Foundation, and the National Cancer Institute.
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Biondi A, Di Mauro G, Morici R, Sangiorgio G, Vacante M, Basile F. Intracorporeal versus Extracorporeal Anastomosis for Laparoscopic Right Hemicolectomy: Short-Term Outcomes. J Clin Med 2021; 10:jcm10245967. [PMID: 34945264 PMCID: PMC8705171 DOI: 10.3390/jcm10245967] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 12/13/2021] [Accepted: 12/15/2021] [Indexed: 11/16/2022] Open
Abstract
Laparoscopic right hemicolectomy represents an effective therapeutic approach for right colon cancer (RCC). The primary aim of this study was to evaluate bowel function recovery, length of hospital stay, operative time, and the number of general and anastomosis-related postoperative complications from intracorporeal anastomosis (ICA) vs. extracorporeal anastomosis (ECA); the secondary outcome was the number of lymph nodes retrieved. This observational study was conducted on 108 patients who underwent right hemicolectomy for RCC; after surgical resection, 64 patients underwent ICA and 44 underwent ECA. The operative time was slightly longer in the ICA group than in the ECA group, even though the difference was not significant (199.31 ± 48.90 min vs. 183.64 ± 35.80 min; p = 0.109). The length of hospital stay (7.53 ± 1.91 days vs. 8.77 ± 3.66 days; p = 0.036) and bowel function recovery (2.21 ± 1.01 days vs. 3.45 ± 1.82 days; p < 0.0001) were significantly lower in the ICA group. There were no significant differences in postoperative complications (12% in ICA group vs. 9% in ECA group), wound infection (6% in ICA group vs. 7% in ECA group), or anastomotic leakage (6% in ICA group vs. 9% in ECA group). We did not observe a significant difference between the two groups in the number of lymph nodes collected (19.46 ± 7.06 in ICA group vs. 22.68 ± 8.79 in ECA group; p = 0.086). ICA following laparoscopic right hemicolectomy, compared to ECA, could lead to a significant improvement in bowel function recovery and a reduction in the length of hospital stay in RCC patients.
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Affiliation(s)
- Antonio Biondi
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Via S. Sofia 78, 95123 Catania, Italy; (A.B.); (R.M.); (G.S.); (F.B.)
| | - Gianluca Di Mauro
- Unit of General Surgery, University Hospital Policlinico-San Marco, 95123 Catania, Italy;
| | - Riccardo Morici
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Via S. Sofia 78, 95123 Catania, Italy; (A.B.); (R.M.); (G.S.); (F.B.)
| | - Giuseppe Sangiorgio
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Via S. Sofia 78, 95123 Catania, Italy; (A.B.); (R.M.); (G.S.); (F.B.)
| | - Marco Vacante
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Via S. Sofia 78, 95123 Catania, Italy; (A.B.); (R.M.); (G.S.); (F.B.)
- Correspondence:
| | - Francesco Basile
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Via S. Sofia 78, 95123 Catania, Italy; (A.B.); (R.M.); (G.S.); (F.B.)
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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 BF, Iavicoli I, Ibitoye SE, Ilesanmi OS, Ilic IM, Ilic MD, Inbaraj LR, Intarut N, Iqbal U, Irvani SSN, Islam MM, Islam SMS, 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 MN, Khatab K, Khater MM, Khatib MN, Khayamzadeh M, Khazaie H, Khoja AT, Kieling C, Kim YE, 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, Lansingh VC, 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 MC, Li S, Lim LL, 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 GK, 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, Mousavi Khaneghah A, 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 IH, Oladnabi M, Olagunju AT, Olusanya BO, Olusanya JO, Omar Bali A, Omer MO, Onwujekwe OE, Ortiz A, Otoiu A, Otstavnov N, Otstavnov SS, Øverland S, Owolabi MO, P A M, Padubidri JR, Pakshir K, Palladino R, Pana A, Panda-Jonas S, Pandey A, Panelo CIA, Park EK, 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, Quazi Syed Z, 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, 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, Saeedi Moghaddam S, 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 MI, Thankappan KR, Thapar R, Thomas N, Titova MV, Tonelli M, Tovani-Palone MR, Tran BX, Travillian RS, Tsai AC, Tsatsakis A, Tudor Car L, Uddin R, Unim B, Unnikrishnan B, Upadhyay E, Vacante M, Valadan Tahbaz S, 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, Wang YP, Westerman R, Wickramasinghe ND, Wu AM, Wu C, Yahyazadeh Jabbari SH, Yamagishi K, Yano Y, Yaya S, Yazdi-Feyzabadi V, Yeshitila YG, Yip P, Yonemoto N, Yoon SJ, Younis MZ, Yousefinezhadi T, Yu C, Yu Y, Yuce D, Zaidi SS, Zaman SB, Zamani M, Zamanian M, Zarafshan H, Zarei A, Zastrozhin MS, Zhang Y, Zhang ZJ, Zhao XJG, Zhu C, Patton GC, Viner RM. 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. Lancet 2021; 398:1593-1618. [PMID: 34755628 PMCID: PMC8576274 DOI: 10.1016/s0140-6736(21)01546-4] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 05/07/2021] [Accepted: 06/30/2021] [Indexed: 02/07/2023]
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.
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Paulson KR, Kamath AM, Alam T, Bienhoff K, Abady GG, Abbas J, Abbasi-Kangevari M, Abbastabar H, Abd-Allah F, Abd-Elsalam SM, Abdoli A, Abedi A, Abolhassani H, Abreu LG, Abu-Gharbieh E, Abu-Rmeileh NME, Abushouk AI, Adamu AL, Adebayo OM, Adegbosin AE, Adekanmbi V, Adetokunboh OO, Adeyinka DA, Adsuar JC, Afshari K, Aghaali M, Agudelo-Botero M, Ahinkorah BO, Ahmad T, Ahmadi K, Ahmed MB, Aji B, Akalu Y, Akinyemi OO, Aklilu A, Al-Aly Z, Alam K, Alanezi FM, Alanzi TM, Alcalde-Rabanal JE, Al-Eyadhy A, Ali T, Alicandro G, Alif SM, Alipour V, Alizade H, Aljunid SM, Almasi-Hashiani A, Almasri NA, Al-Mekhlafi HM, Alonso J, Al-Raddadi RM, Altirkawi KA, Alumran AK, Alvis-Guzman N, Alvis-Zakzuk NJ, Ameyaw EK, Amini S, Amini-Rarani M, Amit AML, Amugsi DA, Ancuceanu R, Anderlini D, Andrei CL, Ansari F, Ansari-Moghaddam A, Antonio CAT, Antriyandarti E, Anvari D, Anwer R, Aqeel M, Arabloo J, Arab-Zozani M, Aripov T, Ärnlöv J, Artanti KD, Arzani A, Asaad M, Asadi-Aliabadi M, Asadi-Pooya AA, Asghari Jafarabadi M, Athari SS, Athari SM, Atnafu DD, Atreya A, Atteraya MS, Ausloos M, Awan AT, Ayala Quintanilla BP, Ayano G, Ayanore MA, Aynalem YA, Azari S, Azarian G, Azene ZN, B DB, Babaee E, Badiye AD, Baig AA, Banach M, Banik PC, Barker-Collo SL, Barqawi HJ, Bassat Q, Basu S, Baune BT, Bayati M, Bedi N, Beghi E, Beghi M, Bell ML, Bendak S, Bennett DA, Bensenor IM, Berhe K, Berman AE, Bezabih YM, Bhagavathula AS, Bhandari D, Bhardwaj N, Bhardwaj P, Bhattacharyya K, Bhattarai S, Bhutta ZA, Bikbov B, Biondi A, Birihane BM, Biswas RK, Bohlouli S, Bragazzi NL, Breusov AV, Brunoni AR, Burkart K, Burugina Nagaraja S, Busse R, Butt ZA, Caetano dos Santos FL, Cahuana-Hurtado L, Camargos P, Cámera LA, Cárdenas R, Carreras G, Carrero JJ, Carvalho F, Castaldelli-Maia JM, Castañeda-Orjuela CA, Castelpietra G, Cerin E, Chang JC, Chanie WF, Charan J, Chatterjee S, Chattu SK, Chattu VK, Chaturvedi S, Chen S, Cho DY, Choi JYJ, Chu DT, Ciobanu LG, Cirillo M, Conde J, Costa VM, Couto RAS, Dachew BA, Dahlawi SMA, Dai H, Dai X, Dandona L, Dandona R, Daneshpajouhnejad P, Darmstadt GL, Das JK, Dávila-Cervantes CA, Davis AC, Davletov K, De la Hoz FP, De Leo D, Deeba F, Denova-Gutiérrez E, Dervenis N, Desalew A, Deuba K, Dey S, Dharmaratne SD, Dhingra S, Dhungana GP, Dias da Silva D, Diaz D, Dorostkar F, Doshmangir L, Dubljanin E, Duraes AR, Eagan AW, Edinur HA, Efendi F, Eftekharzadeh S, El Sayed I, El Tantawi M, Elbarazi I, Elgendy IY, El-Jaafary SI, Emami A, Enany S, Eyawo O, Ezzikouri S, Faris PS, Farzadfar F, Fattahi N, Fauk NK, Fazlzadeh M, Feigin VL, Ferede TY, Fereshtehnejad SM, Fernandes E, Ferrara P, Filip I, Fischer F, Fisher JL, Foigt NA, Folayan MO, Foroutan M, Franklin RC, Freitas M, Friedman SD, Fukumoto T, Gad MM, Gaidhane AM, Gaidhane S, Gaihre S, Gallus S, Garcia-Basteiro AL, Garcia-Gordillo MA, Gardner WM, Gaspar Fonseca M, Gebremedhin KB, Getacher L, Ghashghaee A, Gholamian A, Gilani SA, Gill TK, Giussani G, Gnedovskaya EV, Godinho MA, Goel A, Golechha M, Gona PN, Gopalani SV, Goudarzi H, Grivna M, Gugnani HC, Guido D, Guimarães RA, Gupta RD, Gupta R, Hafezi-Nejad N, Haider MR, Haj-Mirzaian A, Hamidi S, Hanif A, Hankey GJ, Hargono A, Hasaballah AI, Hasan MM, Hasan SS, Hassan A, Hassanipour S, Hassankhani H, Havmoeller RJ, Hayat K, Heidari-Soureshjani R, Henry NJ, Herteliu C, Hole MK, Holla R, Hossain N, Hosseini M, Hosseinzadeh M, Hostiuc M, Hostiuc S, Househ M, Huang J, Humayun A, Hwang BF, Iavicoli I, Ibitoye SE, Ikuta KS, Ilesanmi OS, Ilic IM, Ilic MD, Inamdar S, Inbaraj LR, Iqbal K, Iqbal U, Islam MM, Islam SMS, Iso H, Iwagami M, Iwu CCD, Jaafari J, Jacobsen KH, Jagnoor J, Jain V, Janodia MD, Javaheri T, Javanmardi F, Jayaram S, Jayatilleke AU, Jenabi E, Jha RP, Ji JS, John O, Jonas JB, Joo T, Joseph N, Joukar F, Jozwiak JJ, Jürisson M, Kabir A, Kabir Z, Kalankesh LR, Kamyari N, Kanchan T, Kapoor N, Karami Matin B, Karch A, Karimi SE, Kassahun G, Kayode GA, Kazemi Karyani A, Kemmer L, Khalid N, Khalilov R, Khammarnia M, Khan EA, Khan G, Khan M, Khan MN, Khang YH, Khatab K, Khater AM, Khater MM, Khayamzadeh M, Khosravi A, Kim D, Kim YE, Kim YJ, Kimokoti RW, Kisa A, Kisa S, Kissoon N, Kopec JA, Kosen S, Koul PA, Koulmane Laxminarayana SL, Koyanagi A, Krishan K, Krishnamoorthy V, Kuate Defo B, Kucuk Bicer B, Kulkarni V, Kumar GA, Kumar M, Kumar N, Kurmi OP, Kusuma D, La Vecchia C, Lacey B, Lalloo R, Lami FH, Landires I, Larsson AO, Lasrado S, Lassi ZS, Lauriola P, Lee PH, Lee SWH, Lee YH, Leigh J, Leonardi M, Lewycka S, Li B, Li S, Liang J, Lim LL, Limenih MA, Lin RT, Liu X, Lodha R, Lopez AD, Lozano R, Lugo A, Lunevicius R, Mackay MT, Madhava Kunjathur S, Magnani FG, Mahadeshwara Prasad DR, Maheri M, Mahmoudi M, Majeed A, Maled V, Maleki A, Maleki S, Malekzadeh R, Malik AA, Malta DC, Mamun AA, Mansouri B, Mansournia MA, Martinez G, Martini S, Martins-Melo FR, Masoumi SZ, Maulik PK, McAlinden C, McGrath JJ, Medina-Solís CE, Mehrabi Nasab E, Mejia-Rodriguez F, Memish ZA, Mendoza W, Menezes RG, Mengesha EW, Mensah GA, Meretoja A, Meretoja TJ, Mersha AM, Mestrovic T, Miazgowski B, Miazgowski T, Michalek IM, Miller TR, Mini GK, Miri M, Mirica A, Mirrakhimov EM, Mirzaei H, Mirzaei M, Moazen B, Moghadaszadeh M, Mohajer B, Mohamad O, Mohammad Y, Mohammadi SM, Mohammadian-Hafshejani A, Mohammed S, Mokdad AH, Molokhia M, Monasta L, Mondello S, Moni MA, Moore CE, Moradi G, Moradi M, Moradzadeh R, Moraga P, Morawska L, Morrison SD, Mosser JF, Mousavi Khaneghah A, Mustafa G, Naderi M, Nagarajan AJ, Nagaraju SP, Naghavi M, Naghshtabrizi B, Naimzada MD, Nangia V, Narasimha Swamy S, Nascimento BR, Naveed M, Nazari J, Ndejjo R, Negoi I, Negoi RI, Nena E, Nepal S, Netsere HB, Nguefack-Tsague G, Ngunjiri JW, Nguyen CTY, Nguyen CT, Nguyen HLT, Nigatu YT, Nigussie SN, Nixon MR, Nnaji CA, Nomura S, Noor NM, Noubiap JJ, Nuñez-Samudio V, Nwatah VE, Oancea B, Odukoya OO, Ogbo FA, Olusanya BO, Olusanya JO, Omar Bali A, Onwujekwe OE, Ortiz A, Otoiu A, Otstavnov N, Otstavnov SS, Owolabi MO, P A M, Padubidri JR, Pakhale S, Pakshir K, Pal PK, Palladino R, Pana A, Panda-Jonas S, Pandey A, Pandey A, Pandi-Perumal SR, Pangaribuan HU, Pardo-Montaño AM, Park EK, Patel SK, Patton GC, Pawar S, Pazoki Toroudi H, Peden AE, Pepito VCF, Peprah EK, Pereira J, Pérez-Gómez J, Perico N, Pesudovs K, Pilgrim T, Pinheiro M, Piradov MA, Pirsaheb M, Platts-Mills JA, Pokhrel KN, Postma MJ, Pourjafar H, Prada SI, Prakash S, Pupillo E, Quazi Syed Z, Rabiee N, Radfar A, Rafiee A, Rafiei A, Raggi A, Rahimzadeh S, Rahman MHU, Rahmani AM, Ramezanzadeh K, Rana J, Ranabhat CL, Rao SJ, Rasella D, Rastogi P, Rathi P, Rawaf DL, Rawaf S, Rawasia WF, Rawassizadeh R, Reiner Jr RC, Remuzzi G, Renzaho AMN, Reshmi B, Resnikoff S, Rezaei N, Rezaei N, Rezapour A, Riahi SM, Ribeiro D, Rickard J, Roever L, Ronfani L, Rothenbacher D, Rubagotti E, Rumisha SF, Ryan PM, Saddik B, Sadeghi E, Saeedi Moghaddam S, Sagar R, Sahebkar A, Salahshoor MR, Salehi S, Salem MR, Salimzadeh H, Salomon JA, Samodra YL, Samy AM, Sanabria J, Santric-Milicevic MM, Saraswathy SYI, Sarker AR, Sarrafzadegan N, Sarveazad A, Sathian B, Sathish T, Sattin D, Saxena S, Saya GK, Saylan M, Schiavolin S, Schlaich MP, Schwebel DC, Schwendicke F, Senthilkumaran S, Sepanlou SG, Serván-Mori E, Sha F, Shafaat O, Shahabi S, Shahbaz M, Shaheen AA, Shahid I, Shaikh MA, Shakiba S, Shalash AS, Shams-Beyranvand M, Shannawaz M, Sharafi K, Sheikh A, Sheikhbahaei S, Shiferaw WS, Shigematsu M, Shin JI, Shiri R, Shiue I, Shuval K, Siddiqi TJ, Sidemo NB, Sigfusdottir ID, Sigurvinsdottir R, Silva JP, Silverberg JIS, Simonetti B, Singh BB, Singh JA, Singhal D, Sinha DN, Skiadaresi E, Skryabin VY, Skryabina AA, Sleet DA, Sobaih BH, Sobhiyeh MR, Soltani S, Soriano JB, Spurlock EE, Sreeramareddy CT, Steiropoulos P, Stokes MA, Stortecky S, Sufiyan MB, Suliankatchi Abdulkader R, Sulo G, Swope CB, Sykes BL, Szeto MD, Szócska M, Tabarés-Seisdedos R, Tadesse EG, Taherkhani A, Tamiru AT, Tareque MI, Tehrani-Banihashemi A, Temsah MH, Tesfay FH, Tessema GA, Tessema ZT, Thankappan KR, Thapar R, Tolani MA, Tovani-Palone MR, Traini E, Tran BX, Tripathy JP, Tsapparellas G, Tsatsakis A, Tudor Car L, Uddin R, Ullah A, Umeokonkwo CD, Unim B, Unnikrishnan B, Upadhyay E, Usman MS, Vacante M, Vaezi M, Valadan Tahbaz S, Valdez PR, Vasankari TJ, Venketasubramanian N, Verma M, Violante FS, Vlassov V, Vo B, Vu GT, Wado YD, Waheed Y, Wamai RG, Wang Y, Wang Y, Wang YP, Ward P, Werdecker A, Westerman R, Wickramasinghe ND, Wilner LB, Wiysonge CS, Wu AM, Wu C, Xie Y, Yahyazadeh Jabbari SH, Yamagishi K, Yandrapalli S, Yaya S, Yazdi-Feyzabadi V, Yip P, Yonemoto N, Yoon SJ, Younis MZ, Yousefi Z, Yousefinezhadi T, Yu C, Yusuf SS, Zaidi SS, Zaman SB, Zamani M, Zamanian M, Zastrozhin MS, Zastrozhina A, Zhang Y, Zhang ZJ, Zhao XJG, Ziapour A, Hay SI, Murray CJL, Wang H, Kassebaum NJ. Global, regional, and national progress towards Sustainable Development Goal 3.2 for neonatal and child health: all-cause and cause-specific mortality findings from the Global Burden of Disease Study 2019. Lancet 2021; 398:870-905. [PMID: 34416195 PMCID: PMC8429803 DOI: 10.1016/s0140-6736(21)01207-1] [Citation(s) in RCA: 183] [Impact Index Per Article: 61.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 05/25/2021] [Accepted: 05/25/2021] [Indexed: 02/07/2023]
Abstract
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 (U5MR). 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 [UI] 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 U5MR 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 3·53-4·02]) 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 U5MR. Given the widespread effects of COVID-19, considerable effort will be required to maintain and accelerate progress. FUNDING Bill & Melinda Gates Foundation.
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Galles NC, Liu PY, Updike RL, Fullman N, Nguyen J, Rolfe S, Sbarra AN, Schipp MF, Marks A, Abady GG, Abbas KM, Abbasi SW, Abbastabar H, Abd-Allah F, Abdoli A, Abolhassani H, Abosetugn AE, Adabi M, Adamu AA, Adetokunboh OO, Adnani QES, Advani SM, Afzal S, Aghamir SMK, Ahinkorah BO, Ahmad S, Ahmad T, Ahmadi S, Ahmed H, Ahmed MB, Ahmed Rashid T, Ahmed Salih Y, Akalu Y, Aklilu A, Akunna CJ, Al Hamad H, Alahdab F, Albano L, Alemayehu Y, Alene KA, Al-Eyadhy A, Alhassan RK, Ali L, Aljunid SM, Almustanyir S, Altirkawi KA, Alvis-Guzman N, Amu H, Andrei CL, Andrei T, Ansar A, Ansari-Moghaddam A, Antonazzo IC, Antony B, Arabloo J, Arab-Zozani M, Artanti KD, Arulappan J, Awan AT, Awoke MA, Ayza MA, Azarian G, Azzam AY, B DB, Babar ZUD, Balakrishnan S, Banach M, Bante SA, Bärnighausen TW, Barqawi HJ, Barrow A, Bassat Q, Bayarmagnai N, Bejarano Ramirez DF, Bekuma TT, Belay HG, Belgaumi UI, Bhagavathula AS, Bhandari D, Bhardwaj N, Bhardwaj P, Bhaskar S, Bhattacharyya K, Bibi S, Bijani A, Biondi A, Boloor A, Braithwaite D, Buonsenso D, Butt ZA, Camargos P, Carreras G, Carvalho F, Castañeda-Orjuela CA, Chakinala RC, Charan J, Chatterjee S, Chattu SK, Chattu VK, Chowdhury FR, Christopher DJ, Chu DT, Chung SC, Cortesi PA, Costa VM, Couto RAS, Dadras O, Dagnew AB, Dagnew B, Dai X, Dandona L, Dandona R, De Neve JW, Derbew Molla M, Derseh BT, Desai R, Desta AA, Dhamnetiya D, Dhimal ML, Dhimal M, Dianatinasab M, Diaz D, Djalalinia S, Dorostkar F, Edem B, Edinur HA, Eftekharzadeh S, El Sayed I, El Sayed Zaki M, Elhadi M, El-Jaafary SI, Elsharkawy A, Enany S, Erkhembayar R, Esezobor CI, Eskandarieh S, Ezeonwumelu IJ, Ezzikouri S, Fares J, Faris PS, Feleke BE, Ferede TY, Fernandes E, Fernandes JC, Ferrara P, Filip I, Fischer F, Francis MR, Fukumoto T, Gad MM, Gaidhane S, Gallus S, Garg T, Geberemariyam BS, Gebre T, Gebregiorgis BG, Gebremedhin KB, Gebremichael B, Gessner BD, Ghadiri K, Ghafourifard M, Ghashghaee A, Gilani SA, Glăvan IR, Glushkova EV, Golechha M, Gonfa KB, Gopalani SV, Goudarzi H, Gubari MIM, Guo Y, Gupta VB, Gupta VK, Gutiérrez RA, Haeuser E, Halwani R, Hamidi S, Hanif A, Haque S, Harapan H, Hargono A, Hashi A, Hassan S, Hassanein MH, Hassanipour S, Hassankhani H, Hay SI, Hayat K, Hegazy MI, Heidari G, Hezam K, Holla R, Hoque ME, Hosseini M, Hosseinzadeh M, Hostiuc M, Househ M, Hsieh VCR, Huang J, Humayun A, Hussain R, Hussein NR, Ibitoye SE, Ilesanmi OS, Ilic IM, Ilic MD, Inamdar S, Iqbal U, Irham LM, Irvani SSN, Islam SMS, Ismail NE, Itumalla R, Jha RP, Joukar F, Kabir A, Kabir Z, Kalhor R, Kamal Z, Kamande SM, Kandel H, Karch A, Kassahun G, Kassebaum NJ, Katoto PDMC, Kelkay B, Kengne AP, Khader YS, Khajuria H, Khalil IA, Khan EA, Khan G, Khan J, Khan M, Khan MAB, Khang YH, Khoja AT, Khubchandani J, Kim GR, Kim MS, Kim YJ, Kimokoti RW, Kisa A, Kisa S, Korshunov VA, Kosen S, Kuate Defo B, Kulkarni V, Kumar A, Kumar GA, Kumar N, Kwarteng A, La Vecchia C, Lami FH, Landires I, Lasrado S, Lassi ZS, Lee H, Lee YY, Levi M, Lewycka S, Li S, Liu X, Lobo SW, Lopukhov PD, Lozano R, Lutzky Saute R, Magdy Abd El Razek M, Makki A, Malik AA, Mansour-Ghanaei F, Mansournia MA, Mantovani LG, Martins-Melo FR, Matthews PC, Medina JRC, Mendoza W, Menezes RG, Mengesha EW, Meretoja TJ, Mersha AG, Mesregah MK, Mestrovic T, Miazgowski B, Milne GJ, Mirica A, Mirrakhimov EM, Mirzaei HR, Misra S, Mithra P, Moghadaszadeh M, Mohamed TA, Mohammad KA, Mohammad Y, Mohammadi M, Mohammadian-Hafshejani A, Mohammed A, Mohammed S, Mohapatra A, Mokdad AH, Molokhia M, Monasta L, Moni MA, Montasir AA, Moore CE, Moradi G, Moradzadeh R, Moraga P, Mueller UO, Munro SB, Naghavi M, Naimzada MD, Naveed M, Nayak BP, Negoi I, Neupane Kandel S, Nguyen TH, Nikbakhsh R, Ningrum DNA, Nixon MR, Nnaji CA, Noubiap JJ, Nuñez-Samudio V, Nwatah VE, Oancea B, Ochir C, Ogbo FA, Olagunju AT, Olakunde BO, Onwujekwe OE, Otstavnov N, Otstavnov SS, Owolabi MO, Padubidri JR, Pakshir K, Park EC, Pashazadeh Kan F, Pathak M, Paudel R, Pawar S, Pereira J, Peres MFP, Perianayagam A, Pinheiro M, Pirestani M, Podder V, Polibin RV, Pollok RCG, Postma MJ, Pottoo FH, Rabiee M, Rabiee N, Radfar A, Rafiei A, Rahimi-Movaghar V, Rahman M, Rahmani AM, Rahmawaty S, Rajesh A, Ramshaw RE, Ranasinghe P, Rao CR, Rao SJ, Rathi P, Rawaf DL, Rawaf S, Renzaho AMN, Rezaei N, Rezai MS, Rios-Blancas M, Rogowski ELB, Ronfani L, Rwegerera GM, Saad AM, Sabour S, Saddik B, Saeb MR, Saeed U, Sahebkar A, Sahraian MA, Salam N, Salimzadeh H, Samaei M, Samy AM, Sanabria J, Sanmarchi F, Santric-Milicevic MM, Sartorius B, Sarveazad A, Sathian B, Sawhney M, Saxena D, Saxena S, Seidu AA, Seylani A, Shaikh MA, Shamsizadeh M, Shetty PH, Shigematsu M, Shin JI, Sidemo NB, Singh A, Singh JA, Sinha S, Skryabin VY, Skryabina AA, Soheili A, Tadesse EG, Tamiru AT, Tan KK, Tekalegn Y, Temsah MH, Thakur B, Thapar R, Thavamani A, Tobe-Gai R, Tohidinik HR, Tovani-Palone MR, Traini E, Tran BX, Tripathi M, Tsegaye B, Tsegaye GW, Ullah A, Ullah S, Ullah S, Unim B, Vacante M, Velazquez DZ, Vo B, Vollmer S, Vu GT, Vu LG, Waheed Y, Winkler AS, Wiysonge CS, Yiğit V, Yirdaw BW, Yon DK, Yonemoto N, Yu C, Yuce D, Yunusa I, Zamani M, Zamanian M, Zewdie DT, Zhang ZJ, Zhong C, Zumla A, Murray CJL, Lim SS, Mosser JF. Measuring routine childhood vaccination coverage in 204 countries and territories, 1980-2019: a systematic analysis for the Global Burden of Disease Study 2020, Release 1. Lancet 2021; 398:503-521. [PMID: 34273291 PMCID: PMC8358924 DOI: 10.1016/s0140-6736(21)00984-3] [Citation(s) in RCA: 73] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/16/2021] [Accepted: 04/22/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Measuring routine childhood vaccination is crucial to inform global vaccine policies and programme implementation, and to track progress towards targets set by the Global Vaccine Action Plan (GVAP) and Immunization Agenda 2030. Robust estimates of routine vaccine coverage are needed to identify past successes and persistent vulnerabilities. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020, Release 1, we did a systematic analysis of global, regional, and national vaccine coverage trends using a statistical framework, by vaccine and over time. METHODS For this analysis we collated 55 326 country-specific, cohort-specific, year-specific, vaccine-specific, and dose-specific observations of routine childhood vaccination coverage between 1980 and 2019. Using spatiotemporal Gaussian process regression, we produced location-specific and year-specific estimates of 11 routine childhood vaccine coverage indicators for 204 countries and territories from 1980 to 2019, adjusting for biases in country-reported data and reflecting reported stockouts and supply disruptions. We analysed global and regional trends in coverage and numbers of zero-dose children (defined as those who never received a diphtheria-tetanus-pertussis [DTP] vaccine dose), progress towards GVAP targets, and the relationship between vaccine coverage and sociodemographic development. FINDINGS By 2019, global coverage of third-dose DTP (DTP3; 81·6% [95% uncertainty interval 80·4-82·7]) more than doubled from levels estimated in 1980 (39·9% [37·5-42·1]), as did global coverage of the first-dose measles-containing vaccine (MCV1; from 38·5% [35·4-41·3] in 1980 to 83·6% [82·3-84·8] in 2019). Third-dose polio vaccine (Pol3) coverage also increased, from 42·6% (41·4-44·1) in 1980 to 79·8% (78·4-81·1) in 2019, and global coverage of newer vaccines increased rapidly between 2000 and 2019. The global number of zero-dose children fell by nearly 75% between 1980 and 2019, from 56·8 million (52·6-60·9) to 14·5 million (13·4-15·9). However, over the past decade, global vaccine coverage broadly plateaued; 94 countries and territories recorded decreasing DTP3 coverage since 2010. Only 11 countries and territories were estimated to have reached the national GVAP target of at least 90% coverage for all assessed vaccines in 2019. INTERPRETATION After achieving large gains in childhood vaccine coverage worldwide, in much of the world this progress was stalled or reversed from 2010 to 2019. These findings underscore the importance of revisiting routine immunisation strategies and programmatic approaches, recentring service delivery around equity and underserved populations. Strengthening vaccine data and monitoring systems is crucial to these pursuits, now and through to 2030, to ensure that all children have access to, and can benefit from, lifesaving vaccines. FUNDING Bill & Melinda Gates Foundation.
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Zappalà A, Piazza VG, Schillaci R, Vacante M, Biondi A, Piazza D. Short-term outcomes after laparoscopic right hemicolectomy for colon cancer: intracorporeal versus extracorporeal anastomosis. Minerva Surg 2021; 77:237-244. [PMID: 34338461 DOI: 10.23736/s2724-5691.21.08934-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The purpose of this study was to compare the short-term outcomes of laparoscopic right hemicolectomy between intracorporeal (IA) and extracorporeal (EA) anastomosis techniques. METHODS A retrospective chart review of 77 consecutive patients who underwent laparoscopic right hemicolectomy from January 2016 to June 2018 was performed. The intracorporeal group included 36 patients and the extracorporeal group 41 patients. RESULTS Patient demographics and disease-related characteristics were similar. Mean operative time was 152±38.3 minutes in IA vs. 148±34.8 minutes in EA (p = 0.664). IA was not associated with less overall postoperative complications and decreased rate of surgical site infections. There was no statistically significant difference in the incidence of postoperative leak, length of stay, mortality in both groups. There was no perioperative difference in median number of lymph node harvested. There was statistically significant difference in the length of larger incision [50 (50-70) mm in IA vs 80 (70-100) mm in EA; p<0.001], length of the specimen (323 ±52.7 mm in IA vs 295±64.7 mm in EA; p<0.05), free tumor margin (113.6±47.4 in IA vs 75.6±37.4 mm in EA; p<0.001). There was a statistically significant difference in IA in the less postoperative use of analgesics (p<0.032), and return of bowel function (p<0.021). CONCLUSIONS IA seems feasible and safe; it does not significantly affect the length of surgery, and it guarantees maintenance of radical oncological standards. Furthermore, IA significantly improves cosmesis and patient comfort postoperatively, reducing the rates of emesis, which leads to higher rates of early regular diet tolerance. Therefore, laparoscopic right hemicolectomy with intracorporeal anastomosis is associated with improved short-term outcomes.
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Affiliation(s)
- Angelo Zappalà
- Department of General Surgery, Santissimo Salvatore Paternò Hospital District, Paternò, Catania, Italy
| | - Vincenzo G Piazza
- Surgical Oncology Unit, Department of Oncology, Garibaldi-Nesima Hospital, Catania, Italy
| | - Riccardo Schillaci
- Department of General Surgery, Santissimo Salvatore Paternò Hospital District, Paternò, Catania, Italy
| | - Marco Vacante
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy -
| | - Antonio Biondi
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Diego Piazza
- Department of General Surgery, Santissimo Salvatore Paternò Hospital District, Paternò, Catania, Italy
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Podda M, Sylla P, Baiocchi G, Adamina M, Agnoletti V, Agresta F, Ansaloni L, Arezzo A, Avenia N, Biffl W, Biondi A, Bui S, Campanile FC, Carcoforo P, Commisso C, Crucitti A, De'Angelis N, De'Angelis GL, De Filippo M, De Simone B, Di Saverio S, Ercolani G, Fraga GP, Gabrielli F, Gaiani F, Guerrieri M, Guttadauro A, Kluger Y, Leppaniemi AK, Loffredo A, Meschi T, Moore EE, Ortenzi M, Pata F, Parini D, Pisanu A, Poggioli G, Polistena A, Puzziello A, Rondelli F, Sartelli M, Smart N, Sugrue ME, Tejedor P, Vacante M, Coccolini F, Davies J, Catena F. Multidisciplinary management of elderly patients with rectal cancer: recommendations from the SICG (Italian Society of Geriatric Surgery), SIFIPAC (Italian Society of Surgical Pathophysiology), SICE (Italian Society of Endoscopic Surgery and new technologies), and the WSES (World Society of Emergency Surgery) International Consensus Project. World J Emerg Surg 2021; 16:35. [PMID: 34215310 PMCID: PMC8254305 DOI: 10.1186/s13017-021-00378-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 06/18/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND AND AIMS Although rectal cancer is predominantly a disease of older patients, current guidelines do not incorporate optimal treatment recommendations for the elderly and address only partially the associated specific challenges encountered in this population. This results in a wide variation and disparity in delivering a standard of care to this subset of patients. As the burden of rectal cancer in the elderly population continues to increase, it is crucial to assess whether current recommendations on treatment strategies for the general population can be adopted for the older adults, with the same beneficial oncological and functional outcomes. This multidisciplinary experts' consensus aims to refine current rectal cancer-specific guidelines for the elderly population in order to help to maximize rectal cancer therapeutic strategies while minimizing adverse impacts on functional outcomes and quality of life for these patients. METHODS The discussion among the steering group of clinical experts and methodologists from the societies' expert panel involved clinicians practicing in general surgery, colorectal surgery, surgical oncology, geriatric oncology, geriatrics, gastroenterologists, radiologists, oncologists, radiation oncologists, and endoscopists. Research topics and questions were formulated, revised, and unanimously approved by all experts in two subsequent modified Delphi rounds in December 2020-January 2021. The steering committee was divided into nine teams following the main research field of members. Each conducted their literature search and drafted statements and recommendations on their research question. Literature search has been updated up to 2020 and statements and recommendations have been developed according to the GRADE methodology. A modified Delphi methodology was implemented to reach agreement among the experts on all statements and recommendations. CONCLUSIONS The 2021 SICG-SIFIPAC-SICE-WSES consensus for the multidisciplinary management of elderly patients with rectal cancer aims to provide updated evidence-based statements and recommendations on each of the following topics: epidemiology, pre-intervention strategies, diagnosis and staging, neoadjuvant chemoradiation, surgery, watch and wait strategy, adjuvant chemotherapy, synchronous liver metastases, and emergency presentation of rectal cancer.
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Affiliation(s)
- Mauro Podda
- Department of Emergency Surgery, Cagliari University Hospital "D. Casula", Azienda Ospedaliero-Universitaria di Cagliari, Cagliari, Italy.
| | - Patricia Sylla
- Division of Colon and Rectal Surgery, Mount Sinai Hospital, New York, NY, USA
| | - Gianluca Baiocchi
- ASST Cremona, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Michel Adamina
- Department of Colorectal Surgery, Cantonal Hospital of Winterthur, Winterthur - University of Basel, Basel, Switzerland
| | | | - Ferdinando Agresta
- Department of General Surgery, Vittorio Veneto Hospital, AULSS2 Trevigiana del Veneto, Vittorio Veneto, Italy
| | - Luca Ansaloni
- 1st General Surgery Unit, University of Pavia, Pavia, Italy
| | - Alberto Arezzo
- Department of Surgical Sciences, University of Torino, Torino, Italy
| | - Nicola Avenia
- SC Chirurgia Generale e Specialità Chirurgiche Azienda Ospedaliera Santa Maria, Università degli Studi di Perugia, Terni, Italy
| | - Walter Biffl
- Trauma and Acute Care Surgery, Scripps Memorial Hospital, La Jolla, CA, USA
| | - Antonio Biondi
- Department of General Surgery and Medical - Surgical Specialties, University of Catania, Catania, Italy
| | - Simona Bui
- Department of Medical Oncology, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Fabio C Campanile
- Department of Surgery, ASL VT - Ospedale "San Giovanni Decollato - Andosilla", Civita Castellana, Italy
| | - Paolo Carcoforo
- Department of Surgery, Unit of General Surgery, University Hospital of Ferrara, University of Ferrara, Ferrara, Italy
| | - Claudia Commisso
- Department of Radiology, University Hospital of Parma, Parma, Italy
| | - Antonio Crucitti
- General and Minimally Invasive Surgery Unit, Cristo Re Hospital and Catholic University, Rome, Italy
| | - Nicola De'Angelis
- Unit of Minimally Invasive and Robotic Digestive Surgery, Regional General Hospital F. Miulli, Acquaviva delle Fonti, Bari, Italy
| | - Gian Luigi De'Angelis
- Department of Medicine and Surgery, Gastroenterology and Endoscopy Unit, University of Parma, Parma, Italy
| | | | - Belinda De Simone
- Department of General and Metabolic Surgery, Poissy and Saint Germain en Laye Hospitals, Poissy, France
| | | | - Giorgio Ercolani
- General and Oncologic Surgery, Morgagni-Pierantoni Hospital, AUSL Romagna, Forlì, Italy
| | - Gustavo P Fraga
- Division of Trauma Surgery, School of Medical Sciences, University of Campinas, Campinas, SP, Brazil
| | | | - Federica Gaiani
- Department of Medicine and Surgery, Gastroenterology and Endoscopy Unit, University of Parma, Parma, Italy
| | | | | | - Yoram Kluger
- Division of General Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Ari K Leppaniemi
- Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Andrea Loffredo
- UOC Chirurgia Generale - AOU san Giovanni di Dio e Ruggi d'Aragona, Università di Salerno, Salerno, Italy
| | - Tiziana Meschi
- Department of Medicine and Surgery, University of Parma Geriatric-Rehabilitation Department, Parma University Hospital, Parma, Italy
| | - Ernest E Moore
- Ernest E Moore Shock Trauma Center at Denver Health, Denver, USA
| | | | | | - Dario Parini
- Santa Maria della Misericordia Hospital, Rovigo, Italy
| | - Adolfo Pisanu
- Department of Emergency Surgery, Cagliari University Hospital "D. Casula", Azienda Ospedaliero-Universitaria di Cagliari, Cagliari, Italy
| | - Gilberto Poggioli
- Surgery of the Alimentary Tract, Sant'Orsola Hospital, Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Andrea Polistena
- Dipartimento di Chirurgia Pietro Valdoni Policlinico Umberto I, Sapienza Università degli Studi di Roma, Rome, Italy
| | - Alessandro Puzziello
- UOC Chirurgia Generale - AOU san Giovanni di Dio e Ruggi d'Aragona, Università di Salerno, Salerno, Italy
| | - Fabio Rondelli
- SC Chirurgia Generale e Specialità Chirurgiche Azienda Ospedaliera Santa Maria, Università degli Studi di Perugia, Terni, Italy
| | | | | | - Michael E Sugrue
- Letterkenny University Hospital and CPM sEUBP Interreg Project, Letterkenny, Ireland
| | | | - Marco Vacante
- Department of General Surgery and Medical - Surgical Specialties, University of Catania, Catania, Italy
| | - Federico Coccolini
- General, Emergency and Trauma Surgery Department, Pisa University Hospital, Pisa, Italy
| | - Justin Davies
- Cambridge Colorectal Unit, Addenbrooke's Hospital, Cambridge, UK
| | - Fausto Catena
- Department of Emergency Surgery, Parma Maggiore Hospital, Parma, Italy
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Kendrick PJ, Reitsma MB, Abbasi-Kangevari M, Abdoli A, Abdollahi M, Abedi A, Abhilash ES, Aboyans V, Adebayo OM, Advani SM, Ahinkorah BO, Ahmad S, Ahmadi K, Ahmed H, Aji B, Akalu Y, Akunna CJ, Alahdab F, Al-Aly Z, Alanezi FM, Alanzi TM, Alhabib KF, Ali T, Alif SM, Alipour V, Aljunid SM, Alomari MA, Amin TT, Amini S, Amu H, Ancuceanu R, Anderson JA, Andrei CL, Andrei T, Ansari-Moghaddam A, Antony B, Anvari D, Arabloo J, Arian ND, Arora M, Artanti KD, Asmare WN, Atnafu DD, Ausloos M, Awan AT, Ayano G, Aynalem GL, Azari S, B DB, Badiye AD, Baig AA, Banach M, Banerjee SK, Barker-Collo SL, Bärnighausen TW, Barqawi HJ, Basu S, Bayati M, Bazargan-Hejazi S, Bekuma TT, Bennett DA, Bensenor IM, Benzian H, Benziger CP, Berman AE, Bhagavathula AS, Bhala N, Bhardwaj N, Bhardwaj P, Bhattacharyya K, Bibi S, Bijani A, Biondi A, Braithwaite D, Brenner H, Brunoni AR, Burkart K, Burugina Nagaraja S, Butt ZA, Caetano dos Santos FL, Car J, Carreras G, Castaldelli-Maia JM, Cattaruzza MSS, Chang JC, Chaturvedi P, Chen S, Chido-Amajuoyi OG, Chu DT, Chung SC, Ciobanu LG, Costa VM, Couto RAS, Dagnew B, Dai X, Damasceno AAM, Damiani G, Dandona L, Dandona R, Daneshpajouhnejad P, Darega Gela J, Derbew Molla M, Desta AA, Dharmaratne SD, Dhimal M, Eagan AW, Ebrahimi Kalan M, Edvardsson K, Effiong A, El Tantawi M, Elbarazi I, Esmaeilnejad S, Fadhil I, Faraon EJA, Farwati M, Farzadfar F, Fazlzadeh M, Feigin VL, Feldman R, Filip I, Filippidis F, Fischer F, Flor LS, Foigt NA, Folayan MO, Foroutan M, Gad MM, Gallus S, Geberemariyam BS, Gebregiorgis BG, Getacher L, Getachew Obsa A, Ghafourifard M, Ghanei Gheshlagh R, Ghashghaee A, Ghith N, Gil GF, Gill PS, Ginawi IA, Goharinezhad S, Golechha M, Gopalani SV, Gorini G, Grivna M, Guha A, Guimarães RA, Guo Y, Gupta RD, Gupta R, Gupta T, Gupta V, Hafezi-Nejad N, Haider MR, Hamadeh RR, Hankey GJ, Hargono A, Hay SI, Heidari G, Herteliu C, Hezam K, Hird TR, Holla R, Hosseinzadeh M, Hostiuc M, Hostiuc S, Househ M, Hsiao T, Huang J, Ibeneme CU, Ibitoye SE, Ilic IM, Ilic MD, Inbaraj LR, Irvani SSN, Islam JY, Islam RM, Islam SMS, Islami F, Iso H, Itumalla R, Jaafari J, Jain V, Jakovljevic M, Jang SI, Jayaram S, Jeemon P, Jha RP, Jonas JB, Jürisson M, Kabir A, Kabir Z, Kalankesh LR, Kanchan T, Kandel H, Kapoor N, Karch A, Karimi SE, Kebede KM, Kelkay B, Kennedy RD, Khader YS, Khan EA, Khayamzadeh M, Kim GR, Kimokoti RW, Kivimäki M, Kosen S, Koulmane Laxminarayana SL, Koyanagi A, Krishan K, Kugbey N, Kumar GA, Kumar N, Kurmi OP, Kusuma D, Lacey B, Landires I, Lasrado S, Lauriola P, Lee DW, Lee YH, Leung J, Li S, Lin H, Liu W, Lugo A, Madhava Kunjathur S, Majeed A, Maleki A, Malekzadeh R, Malta DC, Mamun AA, Manjunatha N, Mansouri B, Mansournia MA, Martini S, Mathur MR, Mathur P, Mazidi M, McKee M, Medina-Solís CE, Mehata S, Mendoza W, Menezes RG, Miazgowski B, Michalek IM, Miller TR, Mini GK, Mirica A, Mirrakhimov EM, Mirzaei H, Misra S, Mohammad Y, Mohammadian-Hafshejani A, Mohammed S, Mokdad AH, Molokhia M, Monasta L, Moni MA, Moradzadeh R, Morrison SD, Mossie TB, Mubarik S, Mullany EC, Murray CJL, Nagaraju SP, Naghavi M, Naik N, Nalini M, Nangia V, Naqvi AA, Narasimha Swamy S, Naveed M, Nazari J, Nduaguba SO, Negoi RI, Neupane Kandel S, Nguyen HLT, Nigatu YT, Nixon MR, Nnaji CA, Noubiap JJ, Nowak C, Nuñez-Samudio V, Ogbo FA, Oguntade AS, Oh IH, Olagunju AT, Owolabi MO, P A M, Pakshir K, Pana A, Panagiotakos D, Panda-Jonas S, Pandey A, Parekh U, Park EC, Park EK, Pashazadeh Kan F, Pathak M, Pawar S, Pestell RG, Pham HQ, Pinheiro M, Pokhrel KN, Pourshams A, Prashant A, Radfar A, Rahimi-Movaghar V, Rahman MHU, Rahman MA, Rahmani AM, Ram P, Rana J, Ranabhat CL, Rathi P, Rawaf DL, Rawaf S, Rawassizadeh R, Renzaho AMN, Rezapour A, Riaz MA, Roever L, Ronfani L, Roshandel G, Roy A, Roy B, Saddik B, Sahebkar A, Salehi S, Salimzadeh H, Samy AM, Sanabria J, Santric-Milicevic MM, Sao Jose BP, Sathian B, Sawhney M, Saya GK, Schwendicke F, Seidu AA, Senthil Kumar N, Sepanlou SG, Shafaat O, Shah SM, Shaikh MA, Shannawaz M, Sharafi K, Sheikh A, Sheikhbahaei S, Shigematsu M, Shiri R, Shishani K, Shivakumar KM, Shivalli S, Shrestha R, Siabani S, Sidemo NB, Sigfusdottir ID, Sigurvinsdottir R, Silva JP, Singh A, Singh JA, Singh V, Sinha DN, Skryabin VY, Skryabina AA, Soroush A, Soyiri IN, Sreeramareddy CT, Stein DJ, Steiropoulos P, Stortecky S, Straif K, Suliankatchi Abdulkader R, Sulo G, Sundström J, Tabuchi T, Tadesse EG, Tamiru AT, Tareke M, Tareque MI, Tarigan IU, Thakur B, Thankappan KR, Thapar R, Tolani MA, Tovani-Palone MR, Tran BX, Tripathy JP, Tsegaye GW, Tymeson HD, Ullah S, Unim B, Updike RL, Uthman OA, Vacante M, Vardavas C, Venketasubramanian N, Verma M, Vidale S, Vo B, Vu GT, Waheed Y, Wang Y, Welding K, Werdecker A, Whisnant JL, Wickramasinghe ND, Wubishet BL, Yamagishi K, Yano Y, Yazdi-Feyzabadi V, Yeshaw Y, Yimmer MZ, Yonemoto N, Yousefi Z, Yu C, Yunusa I, Yusefzadeh H, Zaman MS, Zamani M, Zamanian M, Zastrozhin MS, Zastrozhina A, Zhang J, Zhang ZJ, Zhong C, Zuniga YMH, Gakidou E. Spatial, temporal, and demographic patterns in prevalence of chewing tobacco use in 204 countries and territories, 1990-2019: a systematic analysis from the Global Burden of Disease Study 2019. Lancet Public Health 2021; 6:e482-e499. [PMID: 34051920 PMCID: PMC8251505 DOI: 10.1016/s2468-2667(21)00065-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 03/12/2021] [Accepted: 03/16/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Chewing tobacco and other types of smokeless tobacco use have had less attention from the global health community than smoked tobacco use. However, the practice is popular in many parts of the world and has been linked to several adverse health outcomes. Understanding trends in prevalence with age, over time, and by location and sex is important for policy setting and in relation to monitoring and assessing commitment to the WHO Framework Convention on Tobacco Control. METHODS We estimated prevalence of chewing tobacco use as part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 using a modelling strategy that used information on multiple types of smokeless tobacco products. We generated a time series of prevalence of chewing tobacco use among individuals aged 15 years and older from 1990 to 2019 in 204 countries and territories, including age-sex specific estimates. We also compared these trends to those of smoked tobacco over the same time period. FINDINGS In 2019, 273·9 million (95% uncertainty interval 258·5 to 290·9) people aged 15 years and older used chewing tobacco, and the global age-standardised prevalence of chewing tobacco use was 4·72% (4·46 to 5·01). 228·2 million (213·6 to 244·7; 83·29% [82·15 to 84·42]) chewing tobacco users lived in the south Asia region. Prevalence among young people aged 15-19 years was over 10% in seven locations in 2019. Although global age-standardised prevalence of smoking tobacco use decreased significantly between 1990 and 2019 (annualised rate of change: -1·21% [-1·26 to -1·16]), similar progress was not observed for chewing tobacco (0·46% [0·13 to 0·79]). Among the 12 highest prevalence countries (Bangladesh, Bhutan, Cambodia, India, Madagascar, Marshall Islands, Myanmar, Nepal, Pakistan, Palau, Sri Lanka, and Yemen), only Yemen had a significant decrease in the prevalence of chewing tobacco use, which was among males between 1990 and 2019 (-0·94% [-1·72 to -0·14]), compared with nine of 12 countries that had significant decreases in the prevalence of smoking tobacco. Among females, none of these 12 countries had significant decreases in prevalence of chewing tobacco use, whereas seven of 12 countries had a significant decrease in the prevalence of tobacco smoking use for the period. INTERPRETATION Chewing tobacco remains a substantial public health problem in several regions of the world, and predominantly in south Asia. We found little change in the prevalence of chewing tobacco use between 1990 and 2019, and that control efforts have had much larger effects on the prevalence of smoking tobacco use than on chewing tobacco use in some countries. Mitigating the health effects of chewing tobacco requires stronger regulations and policies that specifically target use of chewing tobacco, especially in countries with high prevalence. FUNDING Bloomberg Philanthropies and the Bill & Melinda Gates Foundation.
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Reitsma MB, Kendrick PJ, Ababneh E, Abbafati C, Abbasi-Kangevari M, Abdoli A, Abedi A, Abhilash ES, Abila DB, Aboyans V, Abu-Rmeileh NME, Adebayo OM, Advani SM, Aghaali M, Ahinkorah BO, Ahmad S, Ahmadi K, Ahmed H, Aji B, Akunna CJ, Al-Aly Z, Alanzi TM, Alhabib KF, Ali L, Alif SM, Alipour V, Aljunid SM, Alla F, Allebeck P, Alvis-Guzman N, Amin TT, Amini S, Amu H, Amul GGH, Ancuceanu R, Anderson JA, Ansari-Moghaddam A, Antonio CAT, Antony B, Anvari D, Arabloo J, Arian ND, Arora M, Asaad M, Ausloos M, Awan AT, Ayano G, Aynalem GL, Azari S, B DB, Badiye AD, Baig AA, Bakhshaei MH, Banach M, Banik PC, Barker-Collo SL, Bärnighausen TW, Barqawi HJ, Basu S, Bayati M, Bazargan-Hejazi S, Behzadifar M, Bekuma TT, Bennett DA, Bensenor IM, Berfield KSS, Bhagavathula AS, Bhardwaj N, Bhardwaj P, Bhattacharyya K, Bibi S, Bijani A, Bintoro BS, Biondi A, Birara S, Braithwaite D, Brenner H, Brunoni AR, Burkart K, Butt ZA, Caetano dos Santos FL, Cámera LA, Car J, Cárdenas R, Carreras G, Carrero JJ, Castaldelli-Maia JM, Cattaruzza MSS, Chang JC, Chen S, Chu DT, Chung SC, Cirillo M, Costa VM, Couto RAS, Dadras O, Dai X, Damasceno AAM, Damiani G, Dandona L, Dandona R, Daneshpajouhnejad P, Darega Gela J, Davletov K, Derbew Molla M, Dessie GA, Desta AA, Dharmaratne SD, Dianatinasab M, Diaz D, Do HT, Douiri A, Duncan BB, Duraes AR, Eagan AW, Ebrahimi Kalan M, Edvardsson K, Elbarazi I, El Tantawi M, Esmaeilnejad S, Fadhil I, Faraon EJA, Farinha CSES, Farwati M, Farzadfar F, Fazlzadeh M, Feigin VL, Feldman R, Fernandez Prendes C, Ferrara P, Filip I, Filippidis F, Fischer F, Flor LS, Foigt NA, Folayan MO, Foroutan M, Gad MM, Gaidhane AM, Gallus S, Geberemariyam BS, Ghafourifard M, Ghajar A, Ghashghaee A, Giampaoli S, Gill PS, Glozah FN, Gnedovskaya EV, Golechha M, Gopalani SV, Gorini G, Goudarzi H, Goulart AC, Greaves F, Guha A, Guo Y, Gupta B, Gupta RD, Gupta R, Gupta T, Gupta V, Hafezi-Nejad N, Haider MR, Hamadeh RR, Hankey GJ, Hargono A, Hartono RK, Hassankhani H, Hay SI, Heidari G, Herteliu C, Hezam K, Hird TR, Hole MK, Holla R, Hosseinzadeh M, Hostiuc S, Househ M, Hsiao T, Huang J, Iannucci VC, Ibitoye SE, Idrisov B, Ilesanmi OS, Ilic IM, Ilic MD, Inbaraj LR, Irvani SSN, Islam JY, Islam RM, Islam SMS, Islami F, Iso H, Itumalla R, Iwagami M, Jaafari J, Jain V, Jakovljevic M, Jang SI, Janjani H, Jayaram S, Jeemon P, Jha RP, Jonas JB, Joo T, Jürisson M, Kabir A, Kabir Z, Kalankesh LR, Kanchan T, Kandel H, Kapoor N, Karimi SE, Katikireddi SV, Kebede HK, Kelkay B, Kennedy RD, Khoja AT, Khubchandani J, Kim GR, Kim YE, Kimokoti RW, Kivimäki M, Kosen S, Koulmane Laxminarayana SL, Koyanagi A, Krishan K, Kugbey N, Kumar GA, Kumar N, Kurmi OP, Kusuma D, Lacey B, Lam JO, Landires I, Lasrado S, Lauriola P, Lee DW, Lee YH, Leung J, Li S, Lin H, Linn S, Liu W, Lopez AD, Lopukhov PD, Lorkowski S, Lugo A, Majeed A, Maleki A, Malekzadeh R, Malta DC, Mamun AA, Manjunatha N, Mansouri B, Mansournia MA, Martinez-Raga J, Martini S, Mathur MR, Medina-Solís CE, Mehata S, Mendoza W, Menezes RG, Meretoja A, Meretoja TJ, Miazgowski B, Michalek IM, Miller TR, Mirrakhimov EM, Mirzaei H, Mirzaei-Alavijeh M, Misra S, Moghadaszadeh M, Mohammad Y, Mohammadian-Hafshejani A, Mohammed S, Mokdad AH, Monasta L, Moni MA, Moradi G, Moradi-Lakeh M, Moradzadeh R, Morrison SD, Mossie TB, Mubarik S, Mullany EC, Murray CJL, Naghavi M, Naghshtabrizi B, Nair S, Nalini M, Nangia V, Naqvi AA, Narasimha Swamy S, Naveed M, Nayak S, Nayak VC, Nazari J, Nduaguba SO, Neupane Kandel S, Nguyen CT, Nguyen HLT, Nguyen SH, Nguyen TH, Nixon MR, Nnaji CA, Norrving B, Noubiap JJ, Nowak C, Ogbo FA, Oguntade AS, Oh IH, Olagunju AT, Oren E, Otstavnov N, Otstavnov SS, Owolabi MO, P A M, Pakhale S, Pakshir K, Palladino R, Pana A, Panda-Jonas S, Pandey A, Parekh U, Park EC, Park EK, Pashazadeh Kan F, Patton GC, Pawar S, Pestell RG, Pinheiro M, Piradov MA, Pirouzpanah S, Pokhrel KN, Polibin RV, Prashant A, Pribadi DRA, Radfar A, Rahimi-Movaghar V, Rahman A, Rahman MHU, Rahman MA, Rahmani AM, Rajai N, Ram P, Ranabhat CL, Rathi P, Rawal L, Renzaho AMN, Reynales-Shigematsu LM, Rezapour A, Riahi SM, Riaz MA, Roever L, Ronfani L, Roshandel G, Roy A, Roy B, Sacco S, Saddik B, Sahebkar A, Salehi S, Salimzadeh H, Samaei M, Samy AM, Santos IS, Santric-Milicevic MM, Sarrafzadegan N, Sathian B, Sawhney M, Saylan M, Schaub MP, Schmidt MI, Schneider IJC, Schutte AE, Schwendicke F, Seidu AA, Senthil Kumar N, Sepanlou SG, Seylani A, Shafaat O, Shah SM, Shaikh MA, Shalash AS, Shannawaz M, Sharafi K, Sheikh A, Sheikhbahaei S, Shigematsu M, Shiri R, Shishani K, Shivakumar KM, Shivalli S, Shrestha R, Siabani S, Sidemo NB, Sigfusdottir ID, Sigurvinsdottir R, Silva DAS, Silva JP, Singh A, Singh JA, Singh V, Sinha DN, Sitas F, Skryabin VY, Skryabina AA, Soboka M, Soriano JB, Soroush A, Soshnikov S, Soyiri IN, Spurlock EE, Sreeramareddy CT, Stein DJ, Steiropoulos P, Stortecky S, Straif K, Suliankatchi Abdulkader R, Sulo G, Sundström J, Tabuchi T, Tadakamadla SK, Taddele BW, Tadesse EG, Tamiru AT, Tareke M, Tareque MI, Tarigan IU, Temsah MH, Thankappan KR, Thapar R, Tichopad A, Tolani MA, Topouzis F, Tovani-Palone MR, Tran BX, Tripathy JP, Tsegaye GW, Tsilimparis N, Tymeson HD, Ullah A, Ullah S, Unim B, Updike RL, Vacante M, Valdez PR, Vardavas C, Varona Pérez P, Vasankari TJ, Venketasubramanian N, Verma M, Vetrova MV, Vo B, Vu GT, Waheed Y, Wang Y, Welding K, Werdecker A, Whisnant JL, Wickramasinghe ND, Yamagishi K, Yandrapalli S, Yatsuya H, Yazdi-Feyzabadi V, Yeshaw Y, Yimmer MZ, Yonemoto N, Yu C, Yunusa I, Yusefzadeh H, Zahirian Moghadam T, Zaman MS, Zamanian M, Zandian H, Zar HJ, Zastrozhin MS, Zastrozhina A, Zavala-Arciniega L, Zhang J, Zhang ZJ, Zhong C, Zuniga YMH, Gakidou E. Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990-2019: a systematic analysis from the Global Burden of Disease Study 2019. Lancet 2021; 397:2337-2360. [PMID: 34051883 PMCID: PMC8223261 DOI: 10.1016/s0140-6736(21)01169-7] [Citation(s) in RCA: 496] [Impact Index Per Article: 165.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 02/15/2021] [Accepted: 05/19/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Ending the global tobacco epidemic is a defining challenge in global health. Timely and comprehensive estimates of the prevalence of smoking tobacco use and attributable disease burden are needed to guide tobacco control efforts nationally and globally. METHODS We estimated the prevalence of smoking tobacco use and attributable disease burden for 204 countries and territories, by age and sex, from 1990 to 2019 as part of the Global Burden of Diseases, Injuries, and Risk Factors Study. We modelled multiple smoking-related indicators from 3625 nationally representative surveys. We completed systematic reviews and did Bayesian meta-regressions for 36 causally linked health outcomes to estimate non-linear dose-response risk curves for current and former smokers. We used a direct estimation approach to estimate attributable burden, providing more comprehensive estimates of the health effects of smoking than previously available. FINDINGS Globally in 2019, 1·14 billion (95% uncertainty interval 1·13-1·16) individuals were current smokers, who consumed 7·41 trillion (7·11-7·74) cigarette-equivalents of tobacco in 2019. Although prevalence of smoking had decreased significantly since 1990 among both males (27·5% [26·5-28·5] reduction) and females (37·7% [35·4-39·9] reduction) aged 15 years and older, population growth has led to a significant increase in the total number of smokers from 0·99 billion (0·98-1·00) in 1990. Globally in 2019, smoking tobacco use accounted for 7·69 million (7·16-8·20) deaths and 200 million (185-214) disability-adjusted life-years, and was the leading risk factor for death among males (20·2% [19·3-21·1] of male deaths). 6·68 million [86·9%] of 7·69 million deaths attributable to smoking tobacco use were among current smokers. INTERPRETATION In the absence of intervention, the annual toll of 7·69 million deaths and 200 million disability-adjusted life-years attributable to smoking will increase over the coming decades. Substantial progress in reducing the prevalence of smoking tobacco use has been observed in countries from all regions and at all stages of development, but a large implementation gap remains for tobacco control. Countries have a clear and urgent opportunity to pass strong, evidence-based policies to accelerate reductions in the prevalence of smoking and reap massive health benefits for their citizens. FUNDING Bloomberg Philanthropies and the Bill & Melinda Gates Foundation.
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Biondi A, Basile F, Vacante M. Familial adenomatous polyposis and changes in the gut microbiota: New insights into colorectal cancer carcinogenesis. World J Gastrointest Oncol 2021; 13:495-508. [PMID: 34163569 PMCID: PMC8204352 DOI: 10.4251/wjgo.v13.i6.495] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 03/15/2021] [Accepted: 05/08/2021] [Indexed: 02/06/2023] Open
Abstract
Patients with familial adenomatous polyposis (FAP), an autosomal dominant hereditary colorectal cancer syndrome, have a lifetime risk of developing cancer of nearly 100%. Recent studies have pointed out that the gut microbiota could play a crucial role in the development of colorectal adenomas and the consequent progression to colorectal cancer. Some gut bacteria, such as Fusobacterium nucleatum, Escherichia coli, Clostridium difficile, Peptostreptococcus, and enterotoxigenic Bacteroides fragilis, could be implicated in colorectal carcinogenesis through different mechanisms, including the maintenance of a chronic inflammatory state, production of bioactive tumorigenic metabolites, and DNA damage. Studies using the adenomatous polyposis coliMin/+ mouse model, which resembles FAP in most respects, have shown that specific changes in the intestinal microbial community could influence a multistep progression, the intestinal "adenoma-carcinoma sequence", which involves mucosal barrier injury, low-grade inflammation, activation of the Wnt pathway. Therefore, modulation of gut microbiota might represent a novel therapeutic target for patients with FAP. Administration of probiotics, prebiotics, antibiotics, and nonsteroidal anti-inflammatory drugs could potentially prevent the progression of the adenoma-carcinoma sequence in FAP. The aim of this review was to summarize the best available knowledge on the role of gut microbiota in colorectal carcinogenesis in patients with FAP.
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Affiliation(s)
- Antonio Biondi
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania 95123, Italy
- Multidisciplinary Research Center for Rare Diseases, University of Catania, Catania 95123, Italy
| | - Francesco Basile
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania 95123, Italy
- Multidisciplinary Research Center for Rare Diseases, University of Catania, Catania 95123, Italy
| | - Marco Vacante
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania 95123, Italy
- Multidisciplinary Research Center for Rare Diseases, University of Catania, Catania 95123, Italy
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Emanuele Liardo RL, Borzì AM, Spatola C, Martino B, Privitera G, Basile F, Biondi A, Vacante M. Effects of infections on the pathogenesis of cancer. Indian J Med Res 2021; 153:431-445. [PMID: 34380789 PMCID: PMC8354054 DOI: 10.4103/ijmr.ijmr_339_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Several studies have shown an inverse relationship between acute infections and cancer development. On the other hand, there is a growing evidence that chronic infections may contribute significantly to the carcinogenesis. Factors responsible for increased susceptibility to infections may include modifications of normal defence mechanisms or impairment of host immunity due to altered immune function, genetic polymorphisms, ageing and malnourishment. Studies have demonstrated that children exposed to febrile infectious diseases show a subsequent reduced risk for ovarian cancer, melanoma and many other cancers, while common acute infections in adults are associated with reduced risks for melanoma, glioma, meningioma and multiple cancers. Chronic inflammation associated with certain infectious diseases has been suggested as a cause for the development of tumours. Mechanisms of carcinogenesis due to infections include cell proliferation and DNA replication by mitogen-activated protein kinase pathway, production of toxins that affect the cell cycle and lead to abnormal cell growth and inhibition of apoptosis. This review was aimed to summarize the available evidence on acute infections as a means of cancer prevention and on the role of chronic infections in the development and progression of cancer.
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Affiliation(s)
- Rocco Luca Emanuele Liardo
- Radiodiagnostic & Oncological Radiotherapy Unit, University of Catania, ‘Policlinico G. Rodolico – San Marco’ Catania, Italy
| | - Antonio Maria Borzì
- Department of General Surgery & Medical-Surgical Specialties, University of Catania, ‘Policlinico G. Rodolico – San Marco‘ Catania, Italy
| | - Corrado Spatola
- Radiodiagnostic & Oncological Radiotherapy Unit, University of Catania, ‘Policlinico G. Rodolico – San Marco’ Catania, Italy
| | - Barbara Martino
- Department of General Surgery & Medical-Surgical Specialties, University of Catania, ‘Policlinico G. Rodolico – San Marco‘ Catania, Italy
| | - Giuseppe Privitera
- Radiodiagnostic & Oncological Radiotherapy Unit, University of Catania, ‘Policlinico G. Rodolico – San Marco’ Catania, Italy
| | - Francesco Basile
- Department of General Surgery & Medical-Surgical Specialties, University of Catania, ‘Policlinico G. Rodolico – San Marco‘ Catania, Italy
| | - Antonio Biondi
- Department of General Surgery & Medical-Surgical Specialties, University of Catania, ‘Policlinico G. Rodolico – San Marco‘ Catania, Italy
| | - Marco Vacante
- Department of General Surgery & Medical-Surgical Specialties, University of Catania, ‘Policlinico G. Rodolico – San Marco‘ Catania, Italy
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Crispino P, Gino M, Barbagelata E, Ciarambino T, Politi C, Ambrosino I, Ragusa R, Marranzano M, Biondi A, Vacante M. Gender Differences and Quality of Life in Parkinson's Disease. Int J Environ Res Public Health 2020; 18:E198. [PMID: 33383855 PMCID: PMC7795924 DOI: 10.3390/ijerph18010198] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 12/05/2020] [Accepted: 12/26/2020] [Indexed: 12/15/2022]
Abstract
Parkinson's disease has been found to significantly affect health-related quality of life. The gender differences of the health-related quality of life of subjects with Parkinson's disease have been observed in a number of studies. These differences have been reported in terms of the age at onset, clinical manifestations, and response to therapy. In general, women with Parkinson's disease showed more positive disease outcomes with regard to emotion processing, non-motor symptoms, and cognitive functions, although women report more Parkinson's disease-related clinical manifestations. Female gender predicted poor physical functioning and socioemotional health-related quality of life, while male gender predicted the cognitive domain of health-related quality of life. Some studies reported gender differences in the association between health-related quality of life and non-motor symptoms. Depression and fatigue were the main causes of poorer health-related quality of life in women, even in the early stages of Parkinson's disease. The aim of this review was to collect the best available evidence on gender differences in the development of Parkinson's disease symptoms and health-related quality of life.
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Affiliation(s)
- Pietro Crispino
- Internal Medicine Department, Lagonegro Hospital, 85042 Lagonegro (PZ), Italy;
| | - Miriam Gino
- Department of Internal Medicine, Rivoli Hospital, 10098 Rivoli (TO), Italy;
| | - Elena Barbagelata
- Department of Internal Medicine, ASL 4 Chiavarese, Sestri Levante Hospital, 16039 Sestri Levante (GE), Italy;
| | - Tiziana Ciarambino
- Department of Medical, Surgical, Neurological, Metabolic and Geriatrics Sciences, Marcianise Hospital, ASL Caserta, University of Campania “L. Vanvitelli”, 81025 Naples, Italy;
| | - Cecilia Politi
- Department of Internal Medicine, Veneziale Hospital, 86170 Isernia, Italy;
| | | | - Rosalia Ragusa
- Health Technology Assessment Committee, University Hospital G. Rodolico, 95123 Catania, Italy;
| | - Marina Marranzano
- Department of Medical, Surgical and Advanced Sciences, University of Catania, 95123 Catania, Italy;
| | - Antonio Biondi
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, 95123 Catania, Italy;
| | - Marco Vacante
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, 95123 Catania, Italy;
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Vacante M, Ciuni R, Basile F, Biondi A. Gut Microbiota and Colorectal Cancer Development: A Closer Look to the Adenoma-Carcinoma Sequence. Biomedicines 2020; 8:E489. [PMID: 33182693 PMCID: PMC7697438 DOI: 10.3390/biomedicines8110489] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 11/06/2020] [Accepted: 11/08/2020] [Indexed: 12/13/2022] Open
Abstract
There is wide evidence that CRC could be prevented by regular physical activity, keeping a healthy body weight, and following a healthy and balanced diet. Many sporadic CRCs develop via the traditional adenoma-carcinoma pathway, starting as premalignant lesions represented by conventional, tubular or tubulovillous adenomas. The gut bacteria play a crucial role in regulating the host metabolism and also contribute to preserve intestinal barrier function and an effective immune response against pathogen colonization. The microbiota composition is different among people, and is conditioned by many environmental factors, such as diet, chemical exposure, and the use of antibiotic or other medication. The gut microbiota could be directly involved in the development of colorectal adenomas and the subsequent progression to CRC. Specific gut bacteria, such as Fusobacterium nucleatum, Escherichia coli, and enterotoxigenic Bacteroides fragilis, could be involved in colorectal carcinogenesis. Potential mechanisms of CRC progression may include DNA damage, promotion of chronic inflammation, and release of bioactive carcinogenic metabolites. The aim of this review was to summarize the current knowledge on the role of the gut microbiota in the development of CRC, and discuss major mechanisms of microbiota-related progression of the adenoma-carcinoma sequence.
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Affiliation(s)
- Marco Vacante
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Via S. Sofia 78, 95123 Catania, Italy; (R.C.); (F.B.); (A.B.)
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Lozano R, Fullman N, Mumford JE, Knight M, Barthelemy CM, Abbafati C, Abbastabar H, Abd-Allah F, Abdollahi M, Abedi A, Abolhassani H, Abosetugn AE, Abreu LG, Abrigo MRM, Abu Haimed AK, Abushouk AI, Adabi M, Adebayo OM, Adekanmbi V, Adelson J, Adetokunboh OO, Adham D, Advani SM, Afshin A, Agarwal G, Agasthi P, Aghamir SMK, Agrawal A, Ahmad T, Akinyemi RO, Alahdab F, Al-Aly Z, Alam K, Albertson SB, Alemu YM, Alhassan RK, Ali M, Ali S, Alipour V, Aljunid SM, Alla F, Almadi MAH, Almasi A, Almasi-Hashiani A, Almasri NA, Al-Mekhlafi HM, Almulhim AM, Alonso J, Al-Raddadi RM, Altirkawi KA, Alvis-Guzman N, Alvis-Zakzuk NJ, Amini S, Amini-Rarani M, Amiri F, Amit AML, Amugsi DA, Ancuceanu R, Anderlini D, Andrei CL, Androudi S, Ansari F, Ansari-Moghaddam A, Antonio CAT, Antony CM, Antriyandarti E, Anvari D, Anwer R, Arabloo J, Arab-Zozani M, Aravkin AY, Aremu O, Ärnlöv J, Asaad M, Asadi-Aliabadi M, Asadi-Pooya AA, Ashbaugh C, Athari SS, Atout MMW, Ausloos M, Avila-Burgos L, Ayala Quintanilla BP, Ayano G, Ayanore MA, Aynalem YA, Aynalem GL, Ayza MA, Azari S, Azzopardi PS, B DB, Babaee E, Badiye AD, Bahrami MA, Baig AA, Bakhshaei MH, Bakhtiari A, Bakkannavar SM, Balachandran A, Balassyano S, Banach M, Banerjee SK, Banik PC, Bante AB, Bante SA, Barker-Collo SL, Bärnighausen TW, Barrero LH, Bassat Q, Basu S, Baune BT, Bayati M, Baye BA, Bedi N, Beghi E, Behzadifar M, Bekuma TTT, Bell ML, Bensenor IM, Berman AE, Bernabe E, Bernstein RS, Bhagavathula AS, Bhandari D, Bhardwaj P, Bhat AG, Bhattacharyya K, Bhattarai S, Bhutta ZA, Bijani A, Bikbov B, Bilano V, Biondi A, Birihane BM, Bockarie MJ, Bohlouli S, Bojia HA, Bolla SRR, Boloor A, Brady OJ, Braithwaite D, Briant PS, Briggs AM, Briko NI, Burugina Nagaraja S, Busse R, Butt ZA, Caetano dos Santos FL, Cahuana-Hurtado L, Cámera LA, Cárdenas R, Carreras G, Carrero JJ, Carvalho F, Castaldelli-Maia JM, Castañeda-Orjuela CA, Castelpietra G, Castro F, Catalá-López F, Causey K, Cederroth CR, Cercy KM, Cerin E, Chandan JS, Chang AY, Charan J, Chattu VK, Chaturvedi S, Chin KL, Cho DY, Choi JYJ, Christensen H, Chu DT, Chung MT, Ciobanu LG, Cirillo M, Comfort H, Compton K, Cortesi PA, Costa VM, Cousin E, Dahlawi SMA, Damiani G, Dandona L, Dandona R, Darega Gela J, Darwesh AM, Daryani A, Dash AP, Davey G, Dávila-Cervantes CA, Davletov K, De Neve JW, Denova-Gutiérrez E, Deribe K, Dervenis N, Desai R, Dharmaratne SD, Dhungana GP, Dianatinasab M, Dias da Silva D, Diaz D, Dippenaar IN, Do HT, Dorostkar F, Doshmangir L, Duncan BB, Duraes AR, Eagan AW, Edvardsson D, El Sayed I, El Tantawi M, Elgendy IY, Elyazar IRF, Eskandari K, Eskandarieh S, Esmaeilnejad S, Esteghamati A, Ezekannagha O, Farag T, Farahmand M, Faraon EJA, Farinha CSES, Farioli A, Faris PS, Faro A, Fazlzadeh M, Feigin VL, Fernandes E, Ferrara P, Feyissa GT, Filip I, Fischer F, Fisher JL, Flor LS, Foigt NA, Folayan MO, Fomenkov AA, Foroutan M, Francis JM, Fu W, Fukumoto T, Furtado JM, Gad MM, Gaidhane AM, Gakidou E, Galles NC, Gallus S, Gardner WM, Geberemariyam BS, Gebrehiwot AM, Gebremeskel LG, Gebremeskel GG, Gesesew HA, Ghadiri K, Ghafourifard M, Ghashghaee A, Ghith N, Gholamian A, Gilani SA, Gill PS, Gill TK, Ginindza TG, Gitimoghaddam M, Giussani G, Glagn M, Gnedovskaya EV, Godinho MA, Goharinezhad S, Gopalani SV, Goudarzian AH, Goulart BNG, Gubari MIM, Guimarães RA, Guled RA, Gultie T, Guo Y, Gupta R, Gupta R, Hafezi-Nejad N, Hafiz A, Haile TG, Hamadeh RR, Hameed S, Hamidi S, Han C, Han H, Handiso DW, Hanif A, Hankey GJ, Haro JM, Hasaballah AI, Hasan MM, Hashi A, Hassan S, Hassan A, Hassanipour S, Hassankhani H, Havmoeller RJ, Hay SI, Hayat K, Heidari G, Heidari-Soureshjani R, Hendrie D, Herteliu C, Hird TR, Ho HC, Hole MK, Holla R, Hollingsworth B, Hoogar P, Hopf KP, Horita N, Hossain N, Hosseini M, Hosseinzadeh M, Hostiuc M, Hostiuc S, Househ M, Hsieh VCR, Hu G, Huda TM, Humayun A, Hwang BF, Iavicoli I, Ibitoye SE, Ikeda N, Ilesanmi OS, Ilic IM, Ilic MD, Inbaraj LR, Iqbal U, Irvani SSN, Irvine CMS, Islam MM, Islam SMS, Islami F, Iso H, 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Y, Xu R, Yahyazadeh Jabbari SH, Yamagishi K, Yano Y, Yaya S, Yazdi-Feyzabadi V, Yearwood JA, Yeshitila YG, Yip P, Yonemoto N, Younis MZ, Yousefi Z, Yousefinezhadi T, Yusefzadeh H, Zadey S, Zahirian Moghadam T, Zaidi SS, Zaki L, Zaman SB, Zamani M, Zamanian M, Zandian H, Zastrozhin MS, Zewdie KA, Zhang Y, Zhao XJG, Zhao Y, Zheng P, Zhu C, Ziapour A, Zlavog BS, Zodpey S, Murray CJL. 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. Lancet 2020; 396:1250-1284. [PMID: 32861314 PMCID: PMC7562819 DOI: 10.1016/s0140-6736(20)30750-9] [Citation(s) in RCA: 251] [Impact Index Per Article: 62.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 03/05/2020] [Accepted: 03/23/2020] [Indexed: 02/07/2023]
Abstract
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. FUNDING Bill & Melinda Gates Foundation.
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Zandian H, Zangeneh A, Zastrozhin MS, Zewdie KA, Zhang Y, Zhang ZJ, Zhao JT, Zhao Y, Zheng P, Zhou M, Ziapour A, Zimsen SRM, Naghavi M, Murray CJL. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2020; 396:1204-1222. [PMID: 33069326 PMCID: PMC7567026 DOI: 10.1016/s0140-6736(20)30925-9] [Citation(s) in RCA: 6299] [Impact Index Per Article: 1574.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 02/27/2020] [Accepted: 04/14/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. METHODS GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. FINDINGS Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990-2010 time period, with the greatest annualised rate of decline occurring in the 0-9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10-24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10-24 years were also in the top ten in the 25-49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50-74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. INTERPRETATION As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and development investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. FUNDING Bill & Melinda Gates Foundation.
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Prada SI, Prakash V, Pribadi DRA, Pupillo E, Quazi Syed Z, Rabiee M, Rabiee N, Radfar A, Rafiee A, Raggi A, Rahman MA, Rajabpour-Sanati A, Rajati F, Rakovac I, Ram P, Ramezanzadeh K, Ranabhat CL, Rao PC, Rao SJ, Rashedi V, Rathi P, Rawaf DL, Rawaf S, Rawal L, Rawassizadeh R, Rawat R, Razo C, Redford SB, Reiner RC, Reitsma MB, Remuzzi G, Renjith V, Renzaho AMN, Resnikoff S, Rezaei N, Rezaei N, Rezapour A, Rhinehart PA, Riahi SM, Ribeiro DC, Ribeiro D, Rickard J, Rivera JA, Roberts NLS, Rodríguez-Ramírez S, Roever L, Ronfani L, Room R, Roshandel G, Roth GA, Rothenbacher D, Rubagotti E, Rwegerera GM, Sabour S, Sachdev PS, Saddik B, Sadeghi E, Sadeghi M, Saeedi R, Saeedi Moghaddam S, Safari Y, Safi S, Safiri S, Sagar R, Sahebkar A, Sajadi SM, Salam N, Salamati P, Salem H, Salem MRR, Salimzadeh H, Salman OM, Salomon JA, Samad Z, Samadi Kafil H, Sambala EZ, Samy AM, Sanabria J, Sánchez-Pimienta TG, Santomauro DF, Santos IS, Santos JV, Santric-Milicevic MM, Saraswathy SYI, Sarmiento-Suárez R, Sarrafzadegan N, Sartorius B, Sarveazad A, Sathian B, Sathish T, Sattin D, Saxena S, Schaeffer LE, Schiavolin S, Schlaich MP, Schmidt MI, Schutte AE, Schwebel DC, Schwendicke F, Senbeta AM, Senthilkumaran S, Sepanlou SG, Serdar B, Serre ML, Shadid J, Shafaat O, Shahabi S, Shaheen AA, Shaikh MA, Shalash AS, Shams-Beyranvand M, Shamsizadeh M, Sharafi K, Sheikh A, Sheikhtaheri A, Shibuya K, Shield KD, Shigematsu M, Shin JI, Shin MJ, Shiri R, Shirkoohi R, Shuval K, Siabani S, Sierpinski R, Sigfusdottir ID, Sigurvinsdottir R, Silva JP, Simpson KE, Singh JA, Singh P, Skiadaresi E, Skou ST, Skryabin VY, Smith EUR, Soheili A, Soltani S, Soofi M, Sorensen RJD, Soriano JB, Sorrie MB, Soshnikov S, Soyiri IN, Spencer CN, Spotin A, Sreeramareddy CT, Srinivasan V, Stanaway JD, Stein C, Stein DJ, Steiner C, Stockfelt L, Stokes MA, Straif K, Stubbs JL, Sufiyan MB, Suleria HAR, Suliankatchi Abdulkader R, Sulo G, Sultan I, Szumowski Ł, Tabarés-Seisdedos R, Tabb KM, Tabuchi T, Taherkhani A, Tajdini M, Takahashi K, Takala JS, Tamiru AT, Taveira N, Tehrani-Banihashemi A, Temsah MH, Tesema GA, Tessema ZT, Thurston GD, Titova MV, Tohidinik HR, Tonelli M, Topor-Madry R, Topouzis F, Torre AE, Touvier M, Tovani-Palone MRR, Tran BX, Travillian R, Tsatsakis A, Tudor Car L, Tyrovolas S, Uddin R, Umeokonkwo CD, Unnikrishnan B, Upadhyay E, Vacante M, Valdez PR, van Donkelaar A, Vasankari TJ, Vasseghian Y, Veisani Y, Venketasubramanian N, Violante FS, Vlassov V, Vollset SE, Vos T, Vukovic R, Waheed Y, Wallin MT, Wang Y, Wang YP, Watson A, Wei J, Wei MYW, Weintraub RG, Weiss J, Werdecker A, West JJ, Westerman R, Whisnant JL, Whiteford HA, Wiens KE, Wolfe CDA, Wozniak SS, Wu AM, Wu J, Wulf Hanson S, Xu G, Xu R, Yadgir S, Yahyazadeh Jabbari SH, Yamagishi K, Yaminfirooz M, Yano Y, Yaya S, Yazdi-Feyzabadi V, Yeheyis TY, Yilgwan CS, Yilma MT, Yip P, Yonemoto N, Younis MZ, Younker TP, Yousefi B, Yousefi Z, Yousefinezhadi T, Yousuf AY, Yu C, Yusefzadeh H, Zahirian Moghadam T, Zamani M, Zamanian M, Zandian H, Zastrozhin MS, Zhang Y, Zhang ZJ, Zhao JT, Zhao XJG, Zhao Y, Zhou M, Ziapour A, Zimsen SRM, Brauer M, Afshin A, Lim SS. Global burden of 87 risk factors in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2020; 396:1223-1249. [PMID: 33069327 PMCID: PMC7566194 DOI: 10.1016/s0140-6736(20)30752-2] [Citation(s) in RCA: 3208] [Impact Index Per Article: 802.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 03/21/2020] [Accepted: 03/23/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Rigorous analysis of levels and trends in exposure to leading risk factors and quantification of their effect on human health are important to identify where public health is making progress and in which cases current efforts are inadequate. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a standardised and comprehensive assessment of the magnitude of risk factor exposure, relative risk, and attributable burden of disease. METHODS GBD 2019 estimated attributable mortality, years of life lost (YLLs), years of life lived with disability (YLDs), and disability-adjusted life-years (DALYs) for 87 risk factors and combinations of risk factors, at the global level, regionally, and for 204 countries and territories. GBD uses a hierarchical list of risk factors so that specific risk factors (eg, sodium intake), and related aggregates (eg, diet quality), are both evaluated. This method has six analytical steps. (1) We included 560 risk-outcome pairs that met criteria for convincing or probable evidence on the basis of research studies. 12 risk-outcome pairs included in GBD 2017 no longer met inclusion criteria and 47 risk-outcome pairs for risks already included in GBD 2017 were added based on new evidence. (2) Relative risks were estimated as a function of exposure based on published systematic reviews, 81 systematic reviews done for GBD 2019, and meta-regression. (3) Levels of exposure in each age-sex-location-year included in the study were estimated based on all available data sources using spatiotemporal Gaussian process regression, DisMod-MR 2.1, a Bayesian meta-regression method, or alternative methods. (4) We determined, from published trials or cohort studies, the level of exposure associated with minimum risk, called the theoretical minimum risk exposure level. (5) Attributable deaths, YLLs, YLDs, and DALYs were computed by multiplying population attributable fractions (PAFs) by the relevant outcome quantity for each age-sex-location-year. (6) PAFs and attributable burden for combinations of risk factors were estimated taking into account mediation of different risk factors through other risk factors. Across all six analytical steps, 30 652 distinct data sources were used in the analysis. Uncertainty in each step of the analysis was propagated into the final estimates of attributable burden. Exposure levels for dichotomous, polytomous, and continuous risk factors were summarised with use of the summary exposure value to facilitate comparisons over time, across location, and across risks. Because the entire time series from 1990 to 2019 has been re-estimated with use of consistent data and methods, these results supersede previously published GBD estimates of attributable burden. FINDINGS The largest declines in risk exposure from 2010 to 2019 were among a set of risks that are strongly linked to social and economic development, including household air pollution; unsafe water, sanitation, and handwashing; and child growth failure. Global declines also occurred for tobacco smoking and lead exposure. The largest increases in risk exposure were for ambient particulate matter pollution, drug use, high fasting plasma glucose, and high body-mass index. In 2019, the leading Level 2 risk factor globally for attributable deaths was high systolic blood pressure, which accounted for 10·8 million (95% uncertainty interval [UI] 9·51-12·1) deaths (19·2% [16·9-21·3] of all deaths in 2019), followed by tobacco (smoked, second-hand, and chewing), which accounted for 8·71 million (8·12-9·31) deaths (15·4% [14·6-16·2] of all deaths in 2019). The leading Level 2 risk factor for attributable DALYs globally in 2019 was child and maternal malnutrition, which largely affects health in the youngest age groups and accounted for 295 million (253-350) DALYs (11·6% [10·3-13·1] of all global DALYs that year). The risk factor burden varied considerably in 2019 between age groups and locations. Among children aged 0-9 years, the three leading detailed risk factors for attributable DALYs were all related to malnutrition. Iron deficiency was the leading risk factor for those aged 10-24 years, alcohol use for those aged 25-49 years, and high systolic blood pressure for those aged 50-74 years and 75 years and older. INTERPRETATION Overall, the record for reducing exposure to harmful risks over the past three decades is poor. Success with reducing smoking and lead exposure through regulatory policy might point the way for a stronger role for public policy on other risks in addition to continued efforts to provide information on risk factor harm to the general public. FUNDING Bill & Melinda Gates Foundation.
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Wang H, Abbas KM, Abbasifard M, Abbasi-Kangevari M, Abbastabar H, Abd-Allah F, Abdelalim A, Abolhassani H, Abreu LG, Abrigo MRM, Abushouk AI, Adabi M, Adair T, Adebayo OM, Adedeji IA, Adekanmbi V, Adeoye AM, Adetokunboh OO, Advani SM, Afshin A, Aghaali M, Agrawal A, Ahmadi K, Ahmadieh H, Ahmed MB, Al-Aly Z, Alam K, Alam T, Alanezi FM, Alanzi TM, Alcalde-Rabanal JE, Ali M, Alicandro G, Alijanzadeh M, Alinia C, Alipour V, Alizade H, Aljunid SM, Allebeck P, Almadi MAH, Almasi-Hashiani A, Al-Mekhlafi HM, Altirkawi KA, Alumran AK, Alvis-Guzman N, Amini-Rarani M, Aminorroaya A, Amit AML, Ancuceanu R, Andrei CL, Androudi S, Angus C, Anjomshoa M, Ansari F, Ansari I, Ansari-Moghaddam A, Antonio CAT, Antony CM, Anvari D, Appiah SCY, Arabloo J, Arab-Zozani M, Aravkin AY, Aremu O, Ärnlöv J, Aryal KK, Asadi-Pooya AA, Asgari S, Asghari Jafarabadi M, Atteraya MS, Ausloos M, Avila-Burgos L, Avokpaho EFGA, Ayala Quintanilla BP, Ayano G, Ayanore MA, Azarian G, Babaee E, Badiye AD, Bagli E, Bahrami MA, Bakhtiari A, Balassyano S, Banach M, Banik PC, Barker-Collo SL, Bärnighausen TW, Barzegar A, Basu S, Baune BT, Bayati M, Bazmandegan G, Bedi N, Bell ML, Bennett DA, Bensenor IM, Berhe K, Berman AE, Bertolacci GJ, Bhageerathy R, Bhala N, Bhattacharyya K, Bhutta ZA, Bijani A, Biondi A, Bisanzio D, Bisignano C, Biswas RK, Bjørge T, Bohlouli S, Bohluli M, Bolla SRR, Borzì AM, Borzouei S, Brady OJ, Braithwaite D, Brauer M, Briko AN, Briko NI, Bumgarner BR, Burugina Nagaraja S, Butt ZA, Caetano dos Santos FL, Cai T, Callender CSKH, Cámera LLAA, Campos-Nonato IR, Cárdenas R, Carreras G, Carrero JJ, Carvalho F, Castaldelli-Maia JM, Castelpietra G, Castro F, Catalá-López F, Cederroth CR, Cerin E, Chattu VK, Chin KL, Chu DT, Ciobanu LG, Cirillo M, Comfort H, Costa VM, Cowden RG, Cromwell EA, Croneberger AJ, Cunningham M, Dahlawi SMA, Damiani G, D'Amico E, Dandona L, Dandona R, Dargan PI, Darwesh AM, Daryani A, Das Gupta R, das Neves J, Davletov K, De Leo D, Denova-Gutiérrez E, Deribe K, Dervenis N, Desai R, Dhungana GP, Dias da Silva D, Diaz D, Dippenaar IN, Djalalinia S, Do HT, Dokova K, Doku DT, Dorostkar F, Doshi CP, Doshmangir L, Doyle KE, Dubljanin E, Duraes AR, Edvardsson D, Effiong A, El Sayed I, El Tantawi M, Elbarazi I, El-Jaafary SI, Emamian MH, Eskandarieh S, Esmaeilzadeh F, Estep K, Farahmand M, Faraj A, Fareed M, Faridnia R, Faro A, Farzadfar F, Fattahi N, Fazaeli AA, Fazlzadeh M, Feigin VL, Fereshtehnejad SM, Fernandes E, Ferreira ML, Filip I, Fischer F, Flohr C, Foigt NA, Folayan MO, Fomenkov AA, Freitas M, Fukumoto T, Fuller JE, Furtado JM, Gad MM, Gakidou E, Gallus S, Gebrehiwot AM, Gebremedhin KB, Gething PW, Ghamari F, Ghashghaee A, Gholamian A, Gilani SA, Gitimoghaddam M, Glushkova EV, Gnedovskaya EV, Gopalani SV, Goulart AC, Gugnani HC, Guo Y, Gupta R, Gupta SS, Haagsma JA, Haj-Mirzaian A, Haj-Mirzaian A, Halvaei I, Hamadeh RR, Hamagharib Abdullah K, Han C, Handiso DW, Hankey GJ, Haririan H, Haro JM, Hasaballah AI, Hassanipour S, Hassankhani H, Hay SI, Heibati B, Heidari-Soureshjani R, Henny K, Henry NJ, Herteliu C, Heydarpour F, Hole MK, Hoogar P, Hosgood HD, Hossain N, Hosseinzadeh M, Hostiuc M, Hostiuc S, Househ M, Hoy DG, Hu G, Huda TM, Ibitoye SE, Ikuta KS, Ilesanmi OS, Ilic IM, Ilic MD, Imani-Nasab MH, Islam M, Iso H, Iwu CJ, Jaafari J, Jacobsen KH, Jahagirdar D, Jahanmehr N, Jalali A, Jalilian F, James SL, Janjani H, Jenabi E, Jha RP, Jha V, Ji JS, Jonas JB, Joukar F, Jozwiak JJ, Jürisson M, Kabir Z, Kalani H, Kalankesh LR, Kamiab Z, Kanchan T, Kapoor N, Karch A, Karimi SE, Karimi SA, Kassebaum NJ, Katikireddi SV, Kawakami N, Kayode GA, Keiyoro PN, Keller C, Khader YS, Khalid N, Khan EA, Khan M, Khang YH, Khater AM, Khater MM, Khazaei S, Khazaie H, Khodayari MT, Khubchandani J, Kianipour N, Kim CI, Kim YE, Kim YJ, Kinfu Y, Kisa A, Kisa S, Kissimova-Skarbek K, Kivimäki M, Komaki H, Kopec JA, Kosen S, Koul PA, Koyanagi A, Kravchenko MA, Krishan K, Krohn KJ, Kuate Defo B, Kumar GA, Kumar M, Kumar P, Kumar V, Kusuma D, Kyu HH, La Vecchia C, Lacey B, Lal DK, Lalloo R, Lami FH, Lansky S, Larson SL, Larsson AO, Lasrado S, Lassi ZS, Lazarus JV, Lee PH, Lee SWH, Leever AT, LeGrand KE, Leonardi M, Li S, Lim LL, Lim SS, Linn S, Lodha R, Logroscino G, Lopez AD, Lopukhov PD, Lotufo PA, Lozano R, Lu A, Lunevicius R, Madadin M, Maddison ER, Magdy Abd El Razek H, Magdy Abd El Razek M, Mahasha PW, Mahdavi MM, Malekzadeh R, Mamun AA, Manafi N, Mansour-Ghanaei F, Mansouri B, Mansournia MA, Mapoma CC, Martini S, Martins-Melo FR, Masaka A, Mastrogiacomo CI, Mathur MR, May EA, McAlinden C, McGrath JJ, McKee M, Mehndiratta MM, Mehri F, Mehta KM, Meitei WB, Memiah PTN, Mendoza W, Menezes RG, Mengesha EW, Mensah GA, Meretoja A, Meretoja TJ, Mestrovic T, Michalek IM, Mihretie KM, Miller TR, Mills EJ, Milne GJ, Mirrakhimov EM, Mirzaei H, Mirzaei M, Mirzaei-Alavijeh M, Misganaw AT, Moazen B, Moghadaszadeh M, Mohamadi E, Mohammad DK, Mohammad Y, Mohammad Gholi Mezerji N, Mohammadbeigi A, Mohammadian-Hafshejani A, Mohammadpourhodki R, Mohammed H, Mohammed S, Mohebi F, Mohseni Bandpei MA, Mokari A, Mokdad AH, Momen NC, Monasta L, Mooney MD, Moradi G, Moradi M, Moradi-Joo M, Moradi-Lakeh M, Moradzadeh R, Moraga P, Moreno Velásquez I, Morgado-da-Costa J, Morrison SD, Mosser JF, Mouodi S, Mousavi SM, Mousavi Khaneghah A, Mueller UO, Musa KI, Muthupandian S, Nabavizadeh B, Naderi M, Nagarajan AJ, Naghavi M, Naghshtabrizi B, Naik G, Najafi F, Nangia V, Nansseu JR, Ndwandwe DE, Negoi I, Negoi RI, Ngunjiri JW, Nguyen HLT, Nguyen TH, Nigatu YT, Nikbakhsh R, Nikpoor AR, Nixon MR, Nnaji CA, Nomura S, Noubiap JJ, Nouraei Motlagh S, Nowak C, Oţoiu A, Odell CM, Oh IH, Oladnabi M, Olagunju AT, Olusanya BO, Olusanya JO, Omar Bali A, Ong KL, Onwujekwe OE, Ortiz A, Otstavnov N, Otstavnov SS, Øverland S, Owolabi MO, P A M, Padubidri JR, Pakshir K, Palladino R, Pana A, Panda-Jonas S, Park J, Pasupula DK, Patel JR, Patel SK, Patton GC, Paulson KR, Pazoki Toroudi H, Pease SA, Peden AE, Pepito VCF, Peprah EK, Pereira A, Pereira DM, Perico N, Pigott DM, Pilgrim T, Pilz TM, Piradov MA, Pirsaheb M, Pokhrel KN, Postma MJ, Pourjafar H, Pourmalek F, Pourshams A, Poznańska A, Prada SI, Prakash S, Preotescu L, Quazi Syed Z, Rabiee M, Rabiee N, Radfar A, Rafiei A, Raggi A, Rahman MA, Rajabpour-Sanati A, Ram P, Ranabhat CL, Rao SJ, Rasella D, Rashedi V, Rastogi P, Rathi P, Rawal L, Remuzzi G, Renjith V, Renzaho AMN, Resnikoff S, Rezaei N, Rezai MS, Rezapour A, Rickard J, Roever L, Ronfani L, Roshandel G, Rostamian M, Rubagotti E, Rwegerera GM, Sabour S, Saddik B, Sadeghi E, Sadeghi M, Saeedi Moghaddam S, Safari Y, Safi S, Safiri S, Sagar R, Sahebkar A, Sahraian MA, Sajadi SM, Salahshoor MR, Salama JS, Salamati P, Salem MRR, Salimi Y, Salomon JA, Salz I, Samad Z, Samy AM, Sanabria J, Santric-Milicevic MM, Saraswathy SYI, Sartorius B, Sarveazad A, Sathian B, Sathish T, Sattin D, Saylan M, Schaeffer LE, Schiavolin S, Schwebel DC, Schwendicke F, Sekerija M, Senbeta AM, Senthilkumaran S, Sepanlou SG, Serván-Mori E, Shabani M, Shahabi S, Shahbaz M, Shaheen AA, Shaikh MA, Shalash AS, Shams-Beyranvand M, Shamsi M, Shamsizadeh M, Shannawaz M, Sharafi K, Sharafi Z, Sharara F, Sharma R, Shaw DH, Sheikh A, Shin JI, Shiri R, Shrime MG, Shuval K, Siabani S, Sigfusdottir ID, Sigurvinsdottir R, Silva DAS, Simonetti B, Simpson KE, Singh JA, Skiadaresi E, Skryabin VY, Soheili A, Sokhan A, Sorensen RJD, Soriano JB, Sorrie MB, Soyiri IN, Spurlock EE, Sreeramareddy CT, Stockfelt L, Stokes MA, Stubbs JL, Sudaryanto A, Sufiyan MB, Suliankatchi Abdulkader R, Sykes BL, Tabarés-Seisdedos R, Tabb KM, Tadakamadla SK, Taherkhani A, Tang M, Taveira N, Taylor HJ, Teagle WL, Tehrani-Banihashemi A, Teklehaimanot BF, Tessema ZT, Thankappan KR, Thomas N, Thrift AG, Titova MV, Tohidinik HR, Tonelli M, Topor-Madry R, Topouzis F, Tovani-Palone MRR, Traini E, Tran BX, Travillian R, Trias-Llimós S, Truelsen TC, Tudor Car L, Unnikrishnan B, Upadhyay E, Vacante M, Vakilian A, Valdez PR, Valli A, Vardavas C, Vasankari TJ, Vasconcelos AMN, Vasseghian Y, Veisani Y, Venketasubramanian N, Vidale S, Violante FS, Vlassov V, Vollset SE, Vos T, Vujcic IS, Vukovic A, Vukovic R, Waheed Y, Wallin MT, Walters MK, Wang H, Wang YP, Watson S, Wei J, Weiss J, Weldesamuel GT, Werdecker A, Westerman R, Whiteford HA, Wiangkham T, Wiens KE, Wijeratne T, Wiysonge CS, Wojtyniak B, Wolfe CDA, Wondmieneh AB, Wool EE, Wu AM, Wu J, Xu G, Yamada T, Yamagishi K, Yano Y, Yaya S, Yazdi-Feyzabadi V, Yearwood JA, Yeheyis TY, Yilgwan CS, Yip P, Yonemoto N, Yoon SJ, Yoosefi Lebni J, York HW, Younis MZ, Younker TP, Yousefi Z, Yousefinezhadi T, Yousuf AY, Yusefzadeh H, Zahirian Moghadam T, Zakzuk J, Zaman SB, Zamani M, Zamanian M, Zandian H, Zhang ZJ, Zheng P, Zhou M, Ziapour A, Murray CJL. Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950-2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019. Lancet 2020; 396:1160-1203. [PMID: 33069325 PMCID: PMC7566045 DOI: 10.1016/s0140-6736(20)30977-6] [Citation(s) in RCA: 701] [Impact Index Per Article: 175.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 03/10/2020] [Accepted: 04/20/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Accurate and up-to-date assessment of demographic metrics is crucial for understanding a wide range of social, economic, and public health issues that affect populations worldwide. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 produced updated and comprehensive demographic assessments of the key indicators of fertility, mortality, migration, and population for 204 countries and territories and selected subnational locations from 1950 to 2019. METHODS 8078 country-years of vital registration and sample registration data, 938 surveys, 349 censuses, and 238 other sources were identified and used to estimate age-specific fertility. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate age-specific fertility rates for 5-year age groups between ages 15 and 49 years. With extensions to age groups 10-14 and 50-54 years, the total fertility rate (TFR) was then aggregated using the estimated age-specific fertility between ages 10 and 54 years. 7417 sources were used for under-5 mortality estimation and 7355 for adult mortality. ST-GPR was used to synthesise data sources after correction for known biases. Adult mortality was measured as the probability of death between ages 15 and 60 years based on vital registration, sample registration, and sibling histories, and was also estimated using ST-GPR. HIV-free life tables were then estimated using estimates of under-5 and adult mortality rates using a relational model life table system created for GBD, which closely tracks observed age-specific mortality rates from complete vital registration when available. Independent estimates of HIV-specific mortality generated by an epidemiological analysis of HIV prevalence surveys and antenatal clinic serosurveillance and other sources were incorporated into the estimates in countries with large epidemics. Annual and single-year age estimates of net migration and population for each country and territory were generated using a Bayesian hierarchical cohort component model that analysed estimated age-specific fertility and mortality rates along with 1250 censuses and 747 population registry years. We classified location-years into seven categories on the basis of the natural rate of increase in population (calculated by subtracting the crude death rate from the crude birth rate) and the net migration rate. We computed healthy life expectancy (HALE) using years lived with disability (YLDs) per capita, life tables, and standard demographic methods. Uncertainty was propagated throughout the demographic estimation process, including fertility, mortality, and population, with 1000 draw-level estimates produced for each metric. FINDINGS The global TFR decreased from 2·72 (95% uncertainty interval [UI] 2·66-2·79) in 2000 to 2·31 (2·17-2·46) in 2019. Global annual livebirths increased from 134·5 million (131·5-137·8) in 2000 to a peak of 139·6 million (133·0-146·9) in 2016. Global livebirths then declined to 135·3 million (127·2-144·1) in 2019. Of the 204 countries and territories included in this study, in 2019, 102 had a TFR lower than 2·1, which is considered a good approximation of replacement-level fertility. All countries in sub-Saharan Africa had TFRs above replacement level in 2019 and accounted for 27·1% (95% UI 26·4-27·8) of global livebirths. Global life expectancy at birth increased from 67·2 years (95% UI 66·8-67·6) in 2000 to 73·5 years (72·8-74·3) in 2019. The total number of deaths increased from 50·7 million (49·5-51·9) in 2000 to 56·5 million (53·7-59·2) in 2019. Under-5 deaths declined from 9·6 million (9·1-10·3) in 2000 to 5·0 million (4·3-6·0) in 2019. Global population increased by 25·7%, from 6·2 billion (6·0-6·3) in 2000 to 7·7 billion (7·5-8·0) in 2019. In 2019, 34 countries had negative natural rates of increase; in 17 of these, the population declined because immigration was not sufficient to counteract the negative rate of decline. Globally, HALE increased from 58·6 years (56·1-60·8) in 2000 to 63·5 years (60·8-66·1) in 2019. HALE increased in 202 of 204 countries and territories between 2000 and 2019. INTERPRETATION Over the past 20 years, fertility rates have been dropping steadily and life expectancy has been increasing, with few exceptions. Much of this change follows historical patterns linking social and economic determinants, such as those captured by the GBD Socio-demographic Index, with demographic outcomes. More recently, several countries have experienced a combination of low fertility and stagnating improvement in mortality rates, pushing more populations into the late stages of the demographic transition. Tracking demographic change and the emergence of new patterns will be essential for global health monitoring. FUNDING Bill & Melinda Gates Foundation.
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Ambrosino I, Vacante M, Politi C, Barbagelata E, Ciarambino T. Sexual differences regarding Alzheimer’s disease: a narrative review. JGG 2020. [DOI: 10.36150/2499-6564-376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Vacante M, Ciuni R, Basile F, Biondi A. The Liquid Biopsy in the Management of Colorectal Cancer: An Overview. Biomedicines 2020; 8:E308. [PMID: 32858879 PMCID: PMC7555636 DOI: 10.3390/biomedicines8090308] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 08/19/2020] [Accepted: 08/24/2020] [Indexed: 02/07/2023] Open
Abstract
Currently, there is a crucial need for novel diagnostic and prognostic biomarkers with high specificity and sensitivity in patients with colorectal cancer. A "liquid biopsy" is characterized by the isolation of cancer-derived components, such as circulating tumor cells, circulating tumor DNA, microRNAs, long non-coding RNAs, and proteins, from peripheral blood or other body fluids and their genomic or proteomic assessment. The liquid biopsy is a minimally invasive and repeatable technique that could play a significant role in screening and diagnosis, and predict relapse and metastasis, as well as monitoring minimal residual disease and chemotherapy resistance in colorectal cancer patients. However, there are still some practical issues that need to be addressed before liquid biopsy can be widely used in clinical practice. Potential challenges may include low amounts of circulating tumor cells and circulating tumor DNA in samples, lack of pre-analytical and analytical consensus, clinical validation, and regulatory endorsement. The aim of this review was to summarize the current knowledge of the role of liquid biopsy in the management of colorectal cancer.
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Affiliation(s)
- Marco Vacante
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Via S. Sofia 78, 95123 Catania, Italy; (R.C.); (F.B.); (A.B.)
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Zappalà A, Vacante M, Reina GA, Reina C, Mascali D, Piazza D, Biondi A, Piazza VG. Altemeir procedure in a singular case of irreducible total rectal prolapse. MINERVA CHIR 2020; 75:474-475. [PMID: 32773742 DOI: 10.23736/s0026-4733.20.08356-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Angelo Zappalà
- Department of General Surgery, SS. Salvatore Hospital, Paternò, Catania, Italy -
| | - Marco Vacante
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Giuseppe A Reina
- Department of General Surgery, SS. Salvatore Hospital, Paternò, Catania, Italy
| | - Carlo Reina
- Faculty of General Surgery, University of Catania, Catania, Italy
| | - Davide Mascali
- Unit of Surgical Oncology, Department of Oncology, Garibaldi Nesima Hospital, Catania, Italy
| | - Diego Piazza
- Unit of Surgical Oncology, Department of Oncology, Garibaldi Nesima Hospital, Catania, Italy
| | - Antonio Biondi
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Vincenzo G Piazza
- Unit of Surgical Oncology, Department of Oncology, Garibaldi Nesima Hospital, Catania, Italy
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Abstract
INTRODUCTION Abdominal pain (AP) is one of the most frequent clinical condition observed in elderly patients. The differential diagnosis is wide and definitive diagnosis is often difficult due to delayed symptoms, altered laboratory parameters, pre-existing medical disorders, abuse of drugs and in absence of an accurate medical history. EVIDENCE ACQUISITION A systematic literature review was carried out through PubMed database for studies published in the last ten years. The following search string was used: {("geriatric"[Title] OR "older"[Title] OR "aged"[Title] OR "elderly"[Title]) AND ((("abdomen"[Title] AND "acute"[Title]) OR "acute abdomen"[Title] OR ("acute"[Title] AND "abdomen"[Title])) OR ("abdominal"[Title] AND "pain"[title]) OR "abdominal pain"[Title])}. Full articles and abstracts were included. Case reports, commentaries, editorials and letters were excluded from the analysis. EVIDENCE SYNTHESIS As the age of people presenting AP advances, both rates of surgical procedures and mortality rate increase. CONCLUSIONS A systematic approach based on the organization of differential diagnoses into categories, may provide a helpful framework by the combined use of history-taking, physical examination, and results of diagnostic studies. In elderly patients admitted to the emergency department, a crucial role is played by a prompt use of radiological investigations in order to discriminate between older subjects admitted to the emergency department with abdominal pain and pathological cases requiring immediate surgical treatment.
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Affiliation(s)
- Giuseppe Sangiorgio
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Antonio Biondi
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Francesco Basile
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Marco Vacante
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy -
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Sepanlou SG, Safiri S, Bisignano C, Ikuta KS, Merat S, Saberifiroozi M, Poustchi H, Tsoi D, Colombara DV, Abdoli A, Adedoyin RA, Afarideh M, Agrawal S, Ahmad S, Ahmadian E, Ahmadpour E, Akinyemiju T, Akunna CJ, Alipour V, Almasi-Hashiani A, Almulhim AM, Al-Raddadi RM, Alvis-Guzman N, Anber NH, Angus C, Anoushiravani A, Arabloo J, Araya EM, Asmelash D, Ataeinia B, Ataro Z, Atout MMW, Ausloos F, Awasthi A, Badawi A, Banach M, Bejarano Ramirez DF, Bhagavathula AS, Bhala N, Bhattacharyya K, Biondi A, Bolla SR, Boloor A, Borzì AM, Butt ZA, Cámera LLAA, Campos-Nonato IR, Carvalho F, Chu DT, Chung SC, Cortesi PA, Costa VM, Cowie BC, Daryani A, de Courten B, Demoz GT, Desai R, Dharmaratne SD, Djalalinia S, Do HT, Dorostkar F, Drake TM, Dubey M, Duncan BB, Effiong A, Eftekhari A, Elsharkawy A, Etemadi A, Farahmand M, Farzadfar F, Fernandes E, Filip I, Fischer F, Gebremedhin KBB, Geta B, Gilani SA, Gill PS, Gutirrez RA, Haile MT, Haj-Mirzaian A, Hamid SS, Hasankhani M, Hasanzadeh A, Hashemian M, Hassen HY, Hay SI, Hayat K, Heidari B, Henok A, Hoang CL, Hostiuc M, Hostiuc S, Hsieh VCR, Igumbor EU, Ilesanmi OS, Irvani SSN, Jafari Balalami N, James SL, Jeemon P, Jha RP, Jonas JB, Jozwiak JJ, Kabir A, Kasaeian A, Kassaye HG, Kefale AT, Khalilov R, Khan MA, Khan EA, Khater A, Kim YJ, Koyanagi A, La Vecchia C, Lim LL, Lopez AD, Lorkowski S, Lotufo PA, Lozano R, Magdy Abd El Razek M, Mai HT, Manafi N, Manafi A, Mansournia MA, Mantovani LG, Mazzaglia G, Mehta D, Mendoza W, Menezes RG, Mengesha MM, Meretoja TJ, Mestrovic T, Miazgowski B, Miller TR, Mirrakhimov EM, Mithra P, Moazen B, Moghadaszadeh M, Mohammadian-Hafshejani A, Mohammed S, Mokdad AH, Montero-Zamora PA, Moradi G, Naimzada MD, Nayak V, Negoi I, Nguyen TH, Ofori-Asenso R, Oh IH, Olagunju TO, Padubidri JR, Pakshir K, Pana A, Pathak M, Pourshams A, Rabiee N, Radfar A, Rafiei A, Ramezanzadeh K, Rana SMM, Rawaf S, Rawaf DL, Reiner RC, Roever L, Room R, Roshandel G, Safari S, Samy AM, Sanabria J, Sartorius B, Schmidt MI, Senthilkumaran S, Shaikh MA, Sharif M, Sharifi A, Shigematsu M, Singh JA, Soheili A, Suleria HAR, Teklehaimanot BF, Tesfay BE, Vacante M, Vahedian-Azimi A, Valdez PR, Vasankari TJ, Vu GT, Waheed Y, Weldegwergs KG, Werdecker A, Westerman R, Wondafrash DZ, Wondmieneh AB, Yeshitila YG, Yonemoto N, Yu C, Zaidi Z, Zarghi A, Zelber-Sagi S, Zewdie KA, Zhang ZJ, Zhao XJ, Naghavi M, Malekzadeh R. The global, regional, and national burden of cirrhosis by cause in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet Gastroenterol Hepatol 2020; 5:245-266. [PMID: 31981519 PMCID: PMC7026710 DOI: 10.1016/s2468-1253(19)30349-8] [Citation(s) in RCA: 711] [Impact Index Per Article: 177.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 10/08/2019] [Accepted: 10/09/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Cirrhosis and other chronic liver diseases (collectively referred to as cirrhosis in this paper) are a major cause of morbidity and mortality globally, although the burden and underlying causes differ across locations and demographic groups. We report on results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 on the burden of cirrhosis and its trends since 1990, by cause, sex, and age, for 195 countries and territories. METHODS We used data from vital registrations, vital registration samples, and verbal autopsies to estimate mortality. We modelled prevalence of total, compensated, and decompensated cirrhosis on the basis of hospital and claims data. Disability-adjusted life-years (DALYs) were calculated as the sum of years of life lost due to premature death and years lived with disability. Estimates are presented as numbers and age-standardised or age-specific rates per 100 000 population, with 95% uncertainty intervals (UIs). All estimates are presented for five causes of cirrhosis: hepatitis B, hepatitis C, alcohol-related liver disease, non-alcoholic steatohepatitis (NASH), and other causes. We compared mortality, prevalence, and DALY estimates with those expected according to the Socio-demographic Index (SDI) as a proxy for the development status of regions and countries. FINDINGS In 2017, cirrhosis caused more than 1·32 million (95% UI 1·27-1·45) deaths (440 000 [416 000-518 000; 33·3%] in females and 883 000 [838 000-967 000; 66·7%] in males) globally, compared with less than 899 000 (829 000-948 000) deaths in 1990. Deaths due to cirrhosis constituted 2·4% (2·3-2·6) of total deaths globally in 2017 compared with 1·9% (1·8-2·0) in 1990. Despite an increase in the number of deaths, the age-standardised death rate decreased from 21·0 (19·2-22·3) per 100 000 population in 1990 to 16·5 (15·8-18·1) per 100 000 population in 2017. Sub-Saharan Africa had the highest age-standardised death rate among GBD super-regions for all years of the study period (32·2 [25·8-38·6] deaths per 100 000 population in 2017), and the high-income super-region had the lowest (10·1 [9·8-10·5] deaths per 100 000 population in 2017). The age-standardised death rate decreased or remained constant from 1990 to 2017 in all GBD regions except eastern Europe and central Asia, where the age-standardised death rate increased, primarily due to increases in alcohol-related liver disease prevalence. At the national level, the age-standardised death rate of cirrhosis was lowest in Singapore in 2017 (3·7 [3·3-4·0] per 100 000 in 2017) and highest in Egypt in all years since 1990 (103·3 [64·4-133·4] per 100 000 in 2017). There were 10·6 million (10·3-10·9) prevalent cases of decompensated cirrhosis and 112 million (107-119) prevalent cases of compensated cirrhosis globally in 2017. There was a significant increase in age-standardised prevalence rate of decompensated cirrhosis between 1990 and 2017. Cirrhosis caused by NASH had a steady age-standardised death rate throughout the study period, whereas the other four causes showed declines in age-standardised death rate. The age-standardised prevalence of compensated and decompensated cirrhosis due to NASH increased more than for any other cause of cirrhosis (by 33·2% for compensated cirrhosis and 54·8% for decompensated cirrhosis) over the study period. From 1990 to 2017, the number of prevalent cases more than doubled for compensated cirrhosis due to NASH and more than tripled for decompensated cirrhosis due to NASH. In 2017, age-standardised death and DALY rates were lower among countries and territories with higher SDI. INTERPRETATION Cirrhosis imposes a substantial health burden on many countries and this burden has increased at the global level since 1990, partly due to population growth and ageing. Although the age-standardised death and DALY rates of cirrhosis decreased from 1990 to 2017, numbers of deaths and DALYs and the proportion of all global deaths due to cirrhosis increased. Despite the availability of effective interventions for the prevention and treatment of hepatitis B and C, they were still the main causes of cirrhosis burden worldwide, particularly in low-income countries. The impact of hepatitis B and C is expected to be attenuated and overtaken by that of NASH in the near future. Cost-effective interventions are required to continue the prevention and treatment of viral hepatitis, and to achieve early diagnosis and prevention of cirrhosis due to alcohol-related liver disease and NASH. FUNDING Bill & Melinda Gates Foundation.
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Fitzmaurice C, Abate D, Abbasi N, Abbastabar H, Abd-Allah F, Abdel-Rahman O, Abdelalim A, Abdoli A, Abdollahpour I, Abdulle ASM, Abebe ND, Abraha HN, Abu-Raddad LJ, Abualhasan A, Adedeji IA, Advani SM, Afarideh M, Afshari M, Aghaali M, Agius D, Agrawal S, Ahmadi A, Ahmadian E, Ahmadpour E, Ahmed MB, Akbari ME, Akinyemiju T, Al-Aly Z, AlAbdulKader AM, Alahdab F, Alam T, Alamene GM, Alemnew BTT, Alene KA, Alinia C, Alipour V, Aljunid SM, Bakeshei FA, Almadi MAH, Almasi-Hashiani A, Alsharif U, Alsowaidi S, Alvis-Guzman N, Amini E, Amini S, Amoako YA, Anbari Z, Anber NH, Andrei CL, Anjomshoa M, Ansari F, Ansariadi A, Appiah SCY, Arab-Zozani M, Arabloo J, Arefi Z, Aremu O, Areri HA, Artaman A, Asayesh H, Asfaw ET, Ashagre AF, Assadi R, Ataeinia B, Atalay HT, Ataro Z, Atique S, Ausloos M, Avila-Burgos L, Avokpaho EFGA, Awasthi A, Awoke N, Ayala Quintanilla BP, Ayanore MA, Ayele HT, Babaee E, Bacha U, Badawi A, Bagherzadeh M, Bagli E, Balakrishnan S, Balouchi A, Bärnighausen TW, Battista RJ, Behzadifar M, Behzadifar M, Bekele BB, Belay YB, Belayneh YM, Berfield KKS, Berhane A, Bernabe E, Beuran M, Bhakta N, Bhattacharyya K, Biadgo B, Bijani A, Bin Sayeed MS, Birungi C, Bisignano C, Bitew H, Bjørge T, Bleyer A, Bogale KA, Bojia HA, Borzì AM, Bosetti C, Bou-Orm IR, Brenner H, Brewer JD, Briko AN, Briko NI, Bustamante-Teixeira MT, Butt ZA, Carreras G, Carrero JJ, Carvalho F, Castro C, Castro F, Catalá-López F, Cerin E, Chaiah Y, Chanie WF, Chattu VK, Chaturvedi P, Chauhan NS, Chehrazi M, Chiang PPC, Chichiabellu TY, Chido-Amajuoyi OG, Chimed-Ochir O, Choi JYJ, Christopher DJ, Chu DT, Constantin MM, Costa VM, Crocetti E, Crowe CS, Curado MP, Dahlawi SMA, Damiani G, Darwish AH, Daryani A, das Neves J, Demeke FM, Demis AB, Demissie BW, Demoz GT, Denova-Gutiérrez E, Derakhshani A, Deribe KS, Desai R, Desalegn BB, Desta M, Dey S, Dharmaratne SD, Dhimal M, Diaz D, Dinberu MTT, Djalalinia S, Doku DT, Drake TM, Dubey M, Dubljanin E, Duken EE, Ebrahimi H, Effiong A, Eftekhari A, El Sayed I, Zaki MES, El-Jaafary SI, El-Khatib Z, Elemineh DA, Elkout H, Ellenbogen RG, Elsharkawy A, Emamian MH, Endalew DA, Endries AY, Eshrati B, Fadhil I, Fallah Omrani V, Faramarzi M, Farhangi MA, Farioli A, Farzadfar F, Fentahun N, Fernandes E, Feyissa GT, Filip I, Fischer F, Fisher JL, Force LM, Foroutan M, Freitas M, Fukumoto T, Futran ND, Gallus S, Gankpe FG, Gayesa RT, Gebrehiwot TT, Gebremeskel GG, Gedefaw GA, Gelaw BK, Geta B, Getachew S, Gezae KE, Ghafourifard M, Ghajar A, Ghashghaee A, Gholamian A, Gill PS, Ginindza TTG, Girmay A, Gizaw M, Gomez RS, Gopalani SV, Gorini G, Goulart BNG, Grada A, Ribeiro Guerra M, Guimaraes ALS, Gupta PC, Gupta R, Hadkhale K, Haj-Mirzaian A, Haj-Mirzaian A, Hamadeh RR, Hamidi S, Hanfore LK, Haro JM, Hasankhani M, Hasanzadeh A, Hassen HY, Hay RJ, Hay SI, Henok A, Henry NJ, Herteliu C, Hidru HD, Hoang CL, Hole MK, Hoogar P, Horita N, Hosgood HD, Hosseini M, Hosseinzadeh M, Hostiuc M, Hostiuc S, Househ M, Hussen MM, Ileanu B, Ilic MD, Innos K, Irvani SSN, Iseh KR, Islam SMS, Islami F, Jafari Balalami N, Jafarinia M, Jahangiry L, Jahani MA, Jahanmehr N, Jakovljevic M, James SL, Javanbakht M, Jayaraman S, Jee SH, Jenabi E, Jha RP, Jonas JB, Jonnagaddala J, Joo T, Jungari SB, Jürisson M, Kabir A, Kamangar F, Karch A, Karimi N, Karimian A, Kasaeian A, Kasahun GG, Kassa B, Kassa TD, Kassaw MW, Kaul A, Keiyoro PN, Kelbore AG, Kerbo AA, Khader YS, Khalilarjmandi M, Khan EA, Khan G, Khang YH, Khatab K, Khater A, Khayamzadeh M, Khazaee-Pool M, Khazaei S, Khoja AT, Khosravi MH, Khubchandani J, Kianipour N, Kim D, Kim YJ, Kisa A, Kisa S, Kissimova-Skarbek K, Komaki H, Koyanagi A, Krohn KJ, Bicer BK, Kugbey N, Kumar V, Kuupiel D, La Vecchia C, Lad DP, Lake EA, Lakew AM, Lal DK, Lami FH, Lan Q, Lasrado S, Lauriola P, Lazarus JV, Leigh J, Leshargie CT, Liao Y, Limenih MA, Listl S, Lopez AD, Lopukhov PD, Lunevicius R, Madadin M, Magdeldin S, El Razek HMA, Majeed A, Maleki A, Malekzadeh R, Manafi A, Manafi N, Manamo WA, Mansourian M, Mansournia MA, Mantovani LG, Maroufizadeh S, Martini SMS, Mashamba-Thompson TP, Massenburg BB, Maswabi MT, Mathur MR, McAlinden C, McKee M, Meheretu HAA, Mehrotra R, Mehta V, Meier T, Melaku YA, Meles GG, Meles HG, Melese A, Melku M, Memiah PTN, Mendoza W, Menezes RG, Merat S, Meretoja TJ, Mestrovic T, Miazgowski B, Miazgowski T, Mihretie KMM, Miller TR, Mills EJ, Mir SM, Mirzaei H, Mirzaei HR, Mishra R, Moazen B, Mohammad DK, Mohammad KA, Mohammad Y, Darwesh AM, Mohammadbeigi A, Mohammadi H, Mohammadi M, Mohammadian M, Mohammadian-Hafshejani A, Mohammadoo-Khorasani M, Mohammadpourhodki R, Mohammed AS, Mohammed JA, Mohammed S, Mohebi F, Mokdad AH, Monasta L, Moodley Y, Moosazadeh M, Moossavi M, Moradi G, Moradi-Joo M, Moradi-Lakeh M, Moradpour F, Morawska L, Morgado-da-Costa J, Morisaki N, Morrison SD, Mosapour A, Mousavi SM, Muche AA, Muhammed OSS, Musa J, Nabhan AF, Naderi M, Nagarajan AJ, Nagel G, Nahvijou A, Naik G, Najafi F, Naldi L, Nam HS, Nasiri N, Nazari J, Negoi I, Neupane S, Newcomb PA, Nggada HA, Ngunjiri JW, Nguyen CT, Nikniaz L, Ningrum DNA, Nirayo YL, Nixon MR, Nnaji CA, Nojomi M, Nosratnejad S, Shiadeh MN, Obsa MS, Ofori-Asenso R, Ogbo FA, Oh IH, Olagunju AT, Olagunju TO, Oluwasanu MM, Omonisi AE, Onwujekwe OE, Oommen AM, Oren E, Ortega-Altamirano DDV, Ota E, Otstavnov SS, Owolabi MO, P A M, Padubidri JR, Pakhale S, Pakpour AH, Pana A, Park EK, Parsian H, Pashaei T, Patel S, Patil ST, Pennini A, Pereira DM, Piccinelli C, Pillay JD, Pirestani M, Pishgar F, Postma MJ, Pourjafar H, Pourmalek F, Pourshams A, Prakash S, Prasad N, Qorbani M, Rabiee M, Rabiee N, Radfar A, Rafiei A, Rahim F, Rahimi M, Rahman MA, Rajati F, Rana SM, Raoofi S, Rath GK, Rawaf DL, Rawaf S, Reiner RC, Renzaho AMN, Rezaei N, Rezapour A, Ribeiro AI, Ribeiro D, Ronfani L, Roro EM, Roshandel G, Rostami A, Saad RS, Sabbagh P, Sabour S, Saddik B, Safiri S, Sahebkar A, Salahshoor MR, Salehi F, Salem H, Salem MR, Salimzadeh H, Salomon JA, Samy AM, Sanabria J, Santric Milicevic MM, Sartorius B, Sarveazad A, Sathian B, Satpathy M, Savic M, Sawhney M, Sayyah M, Schneider IJC, Schöttker B, Sekerija M, Sepanlou SG, Sepehrimanesh M, Seyedmousavi S, Shaahmadi F, Shabaninejad H, Shahbaz M, Shaikh MA, Shamshirian A, Shamsizadeh M, Sharafi H, Sharafi Z, Sharif M, Sharifi A, Sharifi H, Sharma R, Sheikh A, Shirkoohi R, Shukla SR, Si S, Siabani S, Silva DAS, Silveira DGA, Singh A, Singh JA, Sisay S, Sitas F, Sobngwi E, Soofi M, Soriano JB, Stathopoulou V, Sufiyan MB, Tabarés-Seisdedos R, Tabuchi T, Takahashi K, Tamtaji OR, Tarawneh MR, Tassew SG, Taymoori P, Tehrani-Banihashemi A, Temsah MH, Temsah O, Tesfay BE, Tesfay FH, Teshale MY, Tessema GA, Thapa S, Tlaye KG, Topor-Madry R, Tovani-Palone MR, Traini E, Tran BX, Tran KB, Tsadik AG, Ullah I, Uthman OA, Vacante M, Vaezi M, Varona Pérez P, Veisani Y, Vidale S, Violante FS, Vlassov V, Vollset SE, Vos T, Vosoughi K, Vu GT, Vujcic IS, Wabinga H, Wachamo TM, Wagnew FS, Waheed Y, Weldegebreal F, Weldesamuel GT, Wijeratne T, Wondafrash DZ, Wonde TE, Wondmieneh AB, Workie HM, Yadav R, Yadegar A, Yadollahpour A, Yaseri M, Yazdi-Feyzabadi V, Yeshaneh A, Yimam MA, Yimer EM, Yisma E, Yonemoto N, Younis MZ, Yousefi B, Yousefifard M, Yu C, Zabeh E, Zadnik V, Moghadam TZ, Zaidi Z, Zamani M, Zandian H, Zangeneh A, Zaki L, Zendehdel K, Zenebe ZM, Zewale TA, Ziapour A, Zodpey S, Murray CJL. Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-Years for 29 Cancer Groups, 1990 to 2017: A Systematic Analysis for the Global Burden of Disease Study. JAMA Oncol 2019; 5:1749-1768. [PMID: 31560378 PMCID: PMC6777271 DOI: 10.1001/jamaoncol.2019.2996] [Citation(s) in RCA: 1424] [Impact Index Per Article: 284.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Importance Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data. Objective To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning. Evidence Review We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence. Findings In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572 000 deaths and 15.2 million DALYs), and stomach cancer (542 000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819 000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601 000 deaths and 17.4 million DALYs), TBL cancer (596 000 deaths and 12.6 million DALYs), and colorectal cancer (414 000 deaths and 8.3 million DALYs). Conclusions and Relevance The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care.
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Affiliation(s)
| | - Christina Fitzmaurice
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Division of Hematology, University of Washington, Seattle
| | | | - Naghmeh Abbasi
- Department of Clinical Biochemistry, Babol University of Medical Sciences, Babol, Iran
| | - Hedayat Abbastabar
- Iranian Center of Neurological Research, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Omar Abdel-Rahman
- Department of Oncology, University of Calgary, Calgary, Alberta, Canada
- Department of Oncology, Ain Shams University, Cairo, Egypt
| | | | - Amir Abdoli
- Department of Parasitology and Mycology, Jahrom University of Medical Sciences, Jahrom, Iran
- Research Center for Non-communicable Diseases, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Ibrahim Abdollahpour
- Department of Epidemiology, Arak University of Medical Sciences, Arak, Iran
- Multiple Sclerosis Research Center, Tehran, Iran
| | - Abdishakur S M Abdulle
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Nebiyu Dereje Abebe
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Public Health, Wachemo University, Hossana, Ethiopia
| | | | - Laith Jamal Abu-Raddad
- Department of Healthcare Policy and Research, Weill Cornell Medical College in Qatar, Doha, Qatar
| | | | | | - Shailesh M Advani
- Social Behavioral Research Branch, National Institutes of Health, Bethesda, Maryland
- Cancer Prevention and Control Program, Georgetown University, Washington, DC
| | - Mohsen Afarideh
- Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mohammad Aghaali
- Department of Epidemiology and Biostatistics, Qom University of Medical Sciences, Qom, Iran
| | - Dominic Agius
- Department of Health, Directorate for Health Information and Research, Pieta, Malta
| | - Sutapa Agrawal
- Public Health Foundation of India, Gurugram, India
- Vital Strategies, Gurugram, India
| | - Ayat Ahmadi
- Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Ahmadian
- Department of Pharmacology and Toxicology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ehsan Ahmadpour
- Department of Parasitology and Mycology, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | | | - Tomi Akinyemiju
- Department of Population Health Sciences, Duke University, Durham, North Carolina
- Duke Global Health Institute, Duke University, Durham, North Carolina
| | - Ziyad Al-Aly
- John T. Milliken Department of Internal Medicine, Washington University in St. Louis, St Louis, Missouri
- Clinical Epidemiology Center, VA Saint Louis Health Care System, Department of Veterans Affairs, St Louis, Missouri
| | - Assim M AlAbdulKader
- Department of Family and Community Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
- Department of Family Medicine and Community Health, Case Western Reserve University, Cleveland, Ohio
| | - Fares Alahdab
- Evidence-Based Practice Research Center, Mayo Clinic Foundation for Medical Education and Research, Rochester, Minnesota
| | - Tahiya Alam
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | - Birhan Tamene T Alemnew
- Department of Health Sciences, Woldia University, Woldia, Ethiopia
- Department of Microbiology, Immunology, and Parasitology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Kefyalew Addis Alene
- Institute of Public Health, University of Gondar, Gondar, Ethiopia
- Research School of Population Health, Australian National University, Canberra, Australian Capitol Territory, Australia
| | - Cyrus Alinia
- Department of Health Care Management and Economics, Urmia University of Medical Science, Urmia, Iran
| | - Vahid Alipour
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Health Economics, Iran University of Medical Sciences, Tehran, Iran
| | - Syed Mohamed Aljunid
- Department of Health Policy and Management, Kuwait University, Safat, Kuwait
- International Centre for Casemix and Clinical Coding, National University of Malaysia, Bandar Tun Razak, Malaysia
| | | | - Majid Abdulrahman Hamad Almadi
- Department of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Gastroenterology and Hepatology, McGill University, Montreal, Québec, Canada
| | | | - Ubai Alsharif
- Department of Oral and Maxillofacial Surgery, University Hospital Knappschaftskrankenhaus Bochum, Bochum, Germany
| | - Shirina Alsowaidi
- College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Nelson Alvis-Guzman
- Research Group in Health Economics, Universidad de Cartagena, Cartagena, Colombia
- Research Group in Hospital Management and Health Policies, Universidad de la Costa, Barranquilla, Colombia
| | - Erfan Amini
- Department of Urology, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeed Amini
- Department of Health Services Management, Arak University of Medical Sciences, Arak, Iran
| | - Yaw Ampem Amoako
- Department of Internal Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Zohreh Anbari
- Department of Health Services Management, Arak University of Medical Sciences, Arak, Iran
| | | | | | - Mina Anjomshoa
- Social Determinants of Health Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Fereshteh Ansari
- Research Center for Evidence Based Medicine, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Seth Christopher Yaw Appiah
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Center for International Health, Ludwig Maximilians University, Munich, Germany
| | - Morteza Arab-Zozani
- Department of Healthcare Management, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Jalal Arabloo
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Zohreh Arefi
- Department of Health Education and Health Promotion, Tehran University of Medical Sciences, Tehran, Iran
| | - Olatunde Aremu
- School of Health Sciences, Birmingham City University, Birmingham, England, United Kingdom
| | - Habtamu Abera Areri
- School of Nursing and Midwifery, Addis Ababa University, Addis Ababa, Ethiopia
| | - Al Artaman
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | | | | | | | - Reza Assadi
- Education Development Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Bahar Ataeinia
- Non-communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Zerihun Ataro
- Department of Medical Laboratory Science, Haramaya University, Harar, Ethiopia
| | - Suleman Atique
- University Institute of Public Health, The University of Lahore, Lahore, Pakistan
- College ofPublic Health, University of Hail, Hail, Saudi Arabia
| | - Marcel Ausloos
- School of Business, University of Leicester, Leicester, England, United Kingdom
| | - Leticia Avila-Burgos
- Center for Health Systems Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Euripide F G A Avokpaho
- Bénin Clinical Research Institute, Abomey-Calavi, Benin
- Contrôle des Maladies Infectieuses, Laboratory of Studies and Research-Action in Health, Porto Novo, Benin
| | - Ashish Awasthi
- Public Health Foundation of India, Gurugram, India
- Indian Institute of Public Health, Gandhinagar, India
| | - Nefsu Awoke
- Department of Nursing, Wolaita Sodo University, Sodo, Ethiopia
| | - Beatriz Paulina Ayala Quintanilla
- The Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia
- General Office for Research and Technological Transfer, Peruvian National Institute of Health, Lima, Peru
| | - Martin Amogre Ayanore
- Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | - Henok Tadesse Ayele
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Québec, Canada
- Public Health Department, Dilla University, Dilla, Ethiopia
| | - Ebrahim Babaee
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Umar Bacha
- School of Health Sciences, University of Management and Technology, Lahore, Pakistan
| | - Alaa Badawi
- Public Health Risk Sciences Division, Public Health Agency of Canada, Toronto, Ontario, Canada
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | | | - Eleni Bagli
- Department of Ophthalmology, University Hospital of Ioannina, Ioannina, Greece
- Institute of Molecular Biology & Biotechnology, Foundation for Research & Technology, Ioannina, Greece
| | | | - Abbas Balouchi
- School of Nursing and Allied Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Till Winfried Bärnighausen
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- Harvard T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | | | - Masoud Behzadifar
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | | | - Bayu Begashaw Bekele
- Institute of Public Health, University of Gondar, Gondar, Ethiopia
- Public Health Department, Mizan-Tepi University, Teppi, Ethiopia
| | - Yared Belete Belay
- Department of Pharmacoepidemiology and Social Pharmacy, Mekelle University, Mekelle, Ethiopia
- AC Environments Foundation, Cuernavaca, Mexico
| | | | | | - Adugnaw Berhane
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Eduardo Bernabe
- Dental Institute, King's College London, London, England, United Kingdom
| | - Mircea Beuran
- Emergency Hospital of Bucharest, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Nickhill Bhakta
- Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Krittika Bhattacharyya
- Department of Biostatistics and Bioinformatics, National Institute of Biomedical Genomics, Kalyani, India
| | - Belete Biadgo
- Department of Clinical Chemistry, University of Gondar, Gondar, Ethiopia
| | - Ali Bijani
- Social Determinants of Health Research Center, Babol University of Medical Sciences, Babol, Iran
| | - Muhammad Shahdaat Bin Sayeed
- National Centre for Epidemiology & Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
- Department of Clinical Pharmacy and Pharmacology, University of Dhaka, Ramna, Bangladesh
| | - Charles Birungi
- The UCL Centre for Global Health Economics, University College London, London, England, United Kingdom
- Fast-Track Implementation Department, United Nations Programme on HIV/AIDS, Gaborone, Botswana
| | - Catherine Bisignano
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Helen Bitew
- School of Pharmacy, Mekelle University, Mekelle, Ethiopia
| | - Tone Bjørge
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Cancer Registry of Norway, Oslo, Norway
| | - Archie Bleyer
- Department of Radiation Medicine, Oregon Health and Science University, Portland
- Department of Pediatrics, The University of Texas, Houston
| | | | - Hunduma Amensisa Bojia
- School of Pharmacy, College of Medicine and Health Science, Haramaya University, Harar, Ethiopia
| | - Antonio M Borzì
- Department of Clinical and Molecular Biomedicine, University of Catania, Catania, Italy
| | - Cristina Bosetti
- Department of Oncology, Mario Negri Institute for Pharmacological Research, Milan, Italy
| | | | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
| | - Jerry D Brewer
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota
| | | | - Nikolay Ivanovich Briko
- Department of Epidemiology and Evidence-Based Medicine, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | | | - Zahid A Butt
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- Al Shifa School of Public Health, Al Shifa Trust Eye Hospital, Rawalpindi, Pakistan
| | - Giulia Carreras
- Institute for Cancer Research, Prevention and Clinical Network, Florence, Italy
| | - Juan J Carrero
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Félix Carvalho
- Applied Molecular Biosciences Unit, University of Porto, Porto, Portugal
- Institute of Public Health, University of Porto, Porto, Portugal
| | - Clara Castro
- Department of Epidemiology, Portuguese Oncology Institute of Porto, Porto, Portugal
- EpiUnit, Instituto de Saúde Pública, University of Cartagena, Cartagena, Colombia
| | - Franz Castro
- Department of Research and Health Technology Assessment, Gorgas Memorial Institute for Health Studies, Panama City, Panama
| | - Ferrán Catalá-López
- National School of Public Health, Carlos III Health Institute, Madrid, Spain
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Ester Cerin
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Yazan Chaiah
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | | | - Vijay Kumar Chattu
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- China Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Pankaj Chaturvedi
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, India
| | - Neelima Singh Chauhan
- Department of Obstetrics and Gynecology, People's College of Medical Sciences and Research Centre, Bhopal, India
| | - Mohammad Chehrazi
- Department of Biostatistics and Epidemiology, Babol University of Medical Sciences, Babol, Iran
- Epidemiology Research Center, Royan Institute, Tehran, Iran
| | | | | | - Onyema Greg Chido-Amajuoyi
- Department of Epidemiology, Human Genetics, and Environmental Sciences, The University of Texas, Houston
| | - Odgerel Chimed-Ochir
- Institute of Industrial Ecological Science, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Jee-Young J Choi
- Departments ofBiochemistry and Biomedical Science, Seoul National University Hospital, Seoul, South Korea
| | | | - Dinh-Toi Chu
- Faculty of Biology, Hanoi National University of Education, Hanoi, Vietnam
- Department of Cancer Immunology, Oslo University Hospital, Oslo, Norway
| | - Maria-Magdalena Constantin
- Department of Dermatology, 2nd Clinic of Dermatology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- 2nd Department of Dermatology, Colentina Clinical Hospital, Bucharest, Romania
| | - Vera M Costa
- UCIBIO/REQUIMTE, Laboratory of Toxicology, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Emanuele Crocetti
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | | | - Maria Paula Curado
- Department of Epidemiology, A. C. Camargo Cancer Center, Sao Paulo, Brazil
| | - Saad M A Dahlawi
- Department of Environmental Health, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Giovanni Damiani
- Department of Dermatology, Case Western Reserve University, Cleveland, Ohio
| | | | - Ahmad Daryani
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - José das Neves
- Institute for Research and Innovation in Health (i3S), University of Porto, Porto, Portugal
- Institute of Biomedical Engineering (INEB), University of Porto, Porto, Portugal
| | - Feleke Mekonnen Demeke
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Asmamaw Bizuneh Demis
- Nursing Department, Woldia University, Woldia, Ethiopia
- Department of Nursing, Jimma University, Jimma, Ethiopia
| | | | - Gebre Teklemariam Demoz
- School of Pharmacy, Aksum University, Aksum, Ethiopia
- Addis Ababa University, Addis Ababa, Ethiopia
| | - Edgar Denova-Gutiérrez
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Afshin Derakhshani
- Department of Immunology, Birjand University of Medical Sciences, Birjand, Iran
| | | | - Rupak Desai
- Division of Cardiology, Atlanta Veterans Affairs Medical Center, Decatur, Georgia
| | | | - Melaku Desta
- Department of Midwifery, Debre Berhan University, Debre Berhan, Ethiopia
- Faculty of Veterinary Medicine and Zootechnics, Autonomous University of Sinaloa, Culiacán Rosales, Mexico
| | | | - Samath Dhamminda Dharmaratne
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Community Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Meghnath Dhimal
- Health Research Section, Nepal Health Research Council, Kathmandu, Nepal
| | - Daniel Diaz
- Faculty of Veterinary Medicine and Zootechnics, Autonomous University of Sinaloa, Culiacán Rosales, Mexico
- Center of Complexity Sciences, National Autonomous University of Mexico, Mexico City, Mexico
| | | | - Shirin Djalalinia
- Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
| | - David Teye Doku
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
- Faculty of Social Sciences, Health Sciences, University of Tampere, Tampere, Finland
| | - Thomas M Drake
- Department of Clinical Surgery, University of Edinburgh, Edinburgh, Scotland, United Kingdom
| | - Manisha Dubey
- United Nations World Food Programme, New Delhi, India
| | | | - Eyasu Ejeta Duken
- College of Health Sciences, Wollega University, Nekemte, Ethiopia
- Mycobacteriology Research Center, Jimma University, Jimma, Ethiopia
| | - Hedyeh Ebrahimi
- Non-communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Liver and Pancreaticobiliary Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Andem Effiong
- Department of Clinical Epidemiology and Biostatistics, University of Newcastle, Newcastle, New South Wales, Australia
| | - Aziz Eftekhari
- Department of Pharmacology and Toxicology, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Basic Sciences, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Iman El Sayed
- Medical Research Institute, Alexandria University, Alexandria, Egypt
| | | | | | - Ziad El-Khatib
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | | | - Hajer Elkout
- Department of Community Medicine, Tripoli University, Tripoli, Libya
- Department of Health Information, World Health Organization, Tripoli, Libya
| | - Richard G Ellenbogen
- Department of Neurology, University of Washington, Seattle
- Department of Surgery, Seattle Children's Hospital, Seattle, Washington
| | - Aisha Elsharkawy
- Endemic Medicine and Hepatogastroenterology Department, Cairo University, Cairo, Egypt
| | - Mohammad Hassan Emamian
- Ophthalmic Epidemiology Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | | | - Aman Yesuf Endries
- Public Health Department, St Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Babak Eshrati
- Center of Communicable Disease Control, Ministry of Health and Medical Education, Tehran, Iran
- School of Public Health, Arak University of Medical Sciences, Arak, Iran
| | - Ibtihal Fadhil
- Department of Non-communicable Diseases, Ministry of Public Health, Dubai, United Arab Emirates
| | | | | | | | - Andrea Farioli
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Farshad Farzadfar
- Non-communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Netsanet Fentahun
- Department of Public Health Nutrition, Bahir Dar University, Bahir Dar, Ethiopia
| | | | - Garumma Tolu Feyissa
- Department of Health Education and Behavioral Sciences, Jimma University, Jimma, Ethiopia
- Jimma University, Jimma, Ethiopia
| | - Irina Filip
- Department of Psychiatry, Kaiser Permanente, Fontana, California
- School of Health Sciences, A.T. Still University, Mesa, Arizona
| | - Florian Fischer
- School of Public Health Medicine, Bielefeld University, Bielefeld, Germany
| | - James L Fisher
- James Cancer Hospital, Ohio State University, Columbus, Ohio
| | - Lisa M Force
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | | | - Marisa Freitas
- Department of Chemical Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Takeshi Fukumoto
- Gene Expression and Regulation Program, Cancer Institute, Philadelphia, Pennsylvania
- Department of Dermatology, Kobe University, Kobe, Japan
| | - Neal D Futran
- Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle
| | - Silvano Gallus
- Department of Environmental Health Science, Mario Negri Institute for Pharmacological Research, Milan, Italy
| | - Fortune Gbetoho Gankpe
- Faculty of Medicine and Pharmacy of Fez, University Sidi Mohammed Ben Abdellah, Fez, Morocco
- Non-communicable Disease Department, Laboratory of Studies and Research-Action in Health, Porto Novo, Benin
| | | | | | | | - Getnet Azeze Gedefaw
- Bahir Dar University, Bahir Dar, Ethiopia
- Haramaya University, Dire Dawa, Ethiopia
| | | | - Birhanu Geta
- Department of Pharmacy, Wollo University, Dessie, Ethiopia
| | - Sefonias Getachew
- Department of Preventive Medicine, Addis Ababa University, Addis Ababa, Ethiopia
- Institute of Epidemiology, Biostatistics and Informatics, Martin Luther University Halle-Wittenberg, Halle, Germany
| | | | - Mansour Ghafourifard
- Medical Surgical Department, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Alireza Ghajar
- Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Medicine, Massachusetts General Hospital, Boston
| | - Ahmad Ghashghaee
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Asadollah Gholamian
- Physiology Department, Iran University of Medical Sciences, Tehran, Iran
- Medical Department, Islamic Azad University, Rasht, Iran
| | - Paramjit Singh Gill
- Unit of Academic Primary Care, University of Warwick, Coventry, England, United Kingdom
| | - Themba T G Ginindza
- Department of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa
- University of KwaZulu-Natal, Durban, South Africa
| | - Alem Girmay
- Department of Nursing, A.C.S. Medical College and Hospital, Aksum, Ethiopia
| | - Muluken Gizaw
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Sameer Vali Gopalani
- Department of Biostatistics and Epidemiology, University of Oklahoma, Oklahoma City
- Department of Health and Social Affairs, Government of the Federated States of Micronesia, Palikir, Federated States of Micronesia
| | - Giuseppe Gorini
- Occupational and Environmental Epidemiology Section, Cancer Prevention and Research Institute, Florence, Italy
| | | | - Ayman Grada
- School of Medicine, Boston University, Boston, Massachusetts
| | | | | | - Prakash C Gupta
- Harvard T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts
- Department of Epidemiology, Healis Sekhsaria Institute for Public Health, Mumbai, India
| | - Rahul Gupta
- West Virginia Bureau for Public Health, Charleston
- Department of Health Policy, Management & Leadership, West Virginia University, Morgantown
| | | | - Arvin Haj-Mirzaian
- Department of Pharmacology, Tehran University of Medical Sciences, Tehran, Iran
- Obesity Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arya Haj-Mirzaian
- Department of Pharmacology, Tehran University of Medical Sciences, Tehran, Iran
- Department of Radiology, Johns Hopkins University, Baltimore, Maryland
| | - Randah R Hamadeh
- Department of Family and Community Medicine, Arabian Gulf University, Manama, Bahrain
| | - Samer Hamidi
- School of Health and Environmental Studies, Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates
| | | | - Josep Maria Haro
- Biomedical Research Networking Center for Mental Health Network, Madrid, Spain
- Research and Development Unit, San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain
| | - Milad Hasankhani
- School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amir Hasanzadeh
- Department of Microbiology, Maragheh University of Medical Sciences, Maragheh, Iran
- Department of Microbiology, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Yimam Hassen
- Public Health Department, Mizan-Tepi University, Teppi, Ethiopia
- Unit of Epidemiology and Social Medicine, University Hospital Antwerp, Wilrijk, Belgium
| | - Roderick J Hay
- International Foundation for Dermatology, London, England, United Kingdom
- St John's Institute of Dermatology, King's College London, London, England, United Kingdom
| | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | | | - Nathaniel J Henry
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Claudiu Herteliu
- Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
| | - Hagos D Hidru
- Department of Epidemiology, Adigrat University, Adigrat, Ethiopia
| | - Chi Linh Hoang
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | | | - Praveen Hoogar
- Transdisciplinary Centre for Qualitative Methods, Manipal University, Manipal, India
| | - Nobuyuki Horita
- Department of Pulmonology, Yokohama City University, Kanazawa-ku, Yokohama, Japan
- National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
| | - H Dean Hosgood
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Mostafa Hosseini
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Hosseinzadeh
- Department of Computer Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran
- Department of Computer Science, University of Human Development, Sulaimaniyah, Iraq
| | - Mihaela Hostiuc
- Department of General Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Department of Internal Medicine, Bucharest Emergency Hospital, Bucharest, Romania
| | - Sorin Hostiuc
- Faculty of Dentistry, Department of Legal Medicine and Bioethics, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Department of Clinical Legal Medicine, National Institute of Legal Medicine Mina Minovici, Bucharest, Romania
| | - Mowafa Househ
- Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Doha, Qatar
- Qatar Foundation, Doha, Qatar
| | | | - Bogdan Ileanu
- Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
- Center for Health Outcomes & Evaluation, Bucharest, Romania
| | - Milena D Ilic
- Department of Epidemiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Kaire Innos
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia
| | - Seyed Sina Naghibi Irvani
- Non-communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kufre Robert Iseh
- Department of Surgery, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
| | - Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, Victoria, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Farhad Islami
- Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia
| | | | - Morteza Jafarinia
- ,Department of Immunology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Leila Jahangiry
- Health Education and Health Promotion Department, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Nader Jahanmehr
- School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Spencer L James
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | - Sudha Jayaraman
- Department of Surgery, Virginia Commonwealth University, Richmond
| | - Sun Ha Jee
- Department of Public Health, Yonsei University, Seoul, South Korea
- Harvard Medical School, Harvard University, Boston, Massachusetts
| | - Ensiyeh Jenabi
- Faculty of Nursing & Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ravi Prakash Jha
- Department of Community Medicine, Banaras Hindu University, Varanasi, India
| | - Jost B Jonas
- Department of Ophthalmology, Heidelberg University, Mannheim, Germany
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing, China
| | - Jitendra Jonnagaddala
- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
- NSW Health, Sydney, New South Wales, Australia
| | - Tamas Joo
- Health Services Management Training Centre, Semmelweis University, Budapest, Hungary
| | | | - Mikk Jürisson
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Ali Kabir
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Farin Kamangar
- Department of Biology, Morgan State University, Baltimore, Maryland
| | - André Karch
- Institute for Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Narges Karimi
- Immunogenetics Research Center, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Neurology, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ansar Karimian
- Cellular and Molecular Biology Research Center, Babol University of Medical Sciences, Babol, Iran
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amir Kasaeian
- Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Hematologic Malignancies Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Belete Kassa
- Department of Pharmacology and Clinical Pharmacy, Addis Ababa University, Dessie, Ethiopia
| | | | - Mesfin Wudu Kassaw
- Nursing Department, Woldia University, Woldia, Ethiopia
- Department of Public Health, Amhara Public Health Institute, Bahir Dar, Ethiopia
| | - Anil Kaul
- School of Health Care Administration, Oklahoma State University, Tulsa
- Health Care Delivery Sciences, University of Tulsa, Tulsa, Oklahoma
| | | | | | - Amene Abebe Kerbo
- Department of Public Health, Madda Walabu University, Goba, Ethiopia
- School of Public Health, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Yousef Saleh Khader
- Department of Public Health and Community Medicine, Jordan University of Science and Technology, Ramtha, Jordan
| | - Maryam Khalilarjmandi
- Department of Clinical Biochemistry, Babol University of Medical Sciences, Babol, Iran
| | - Ejaz Ahmad Khan
- Epidemiology and Biostatistics Department, Health Services Academy, Islamabad, Pakistan
| | - Gulfaraz Khan
- Department of Medical Microbiology & Immunology, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Young-Ho Khang
- Division of Health Policy and Management, Seoul National University, Seoul, South Korea
| | - Khaled Khatab
- Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield, United Kingdom
- College of Arts and Sciences, Ohio University, Zanesville
| | - Amir Khater
- Internal Medicine and Gastroenterology Department, National Hepatology and Tropical Research Institute, Cairo, Egypt
| | - Maryam Khayamzadeh
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Academy of Medical Sciences, Tehran, Iran
| | - Maryam Khazaee-Pool
- Department of Public Health, Mazandaran University of Medical Sciences, Sari, Iran
- Health Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Salman Khazaei
- Department of Epidemiology, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Abdullah T Khoja
- Department of Public Health, Imam Muhammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
- Department of Health Policy and Management, Johns Hopkins University, Baltimore, Maryland
| | - Mohammad Hossein Khosravi
- Student Research Committee, Baqiyatallah University of Medical Sciences, Tehran, Iran
- International Otorhinolaryngology Research Association, Tehran, Iran
| | - Jagdish Khubchandani
- Department of Nutrition and Health Science, Ball State University, Muncie, Indiana
| | - Neda Kianipour
- Department of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Daniel Kim
- Department of Health Sciences, Northeastern University, Boston, Massachusetts
| | - Yun Jin Kim
- School of Medicine, Xiamen University Malaysia, Sepang, Malaysia
| | - Adnan Kisa
- Department of Health Management and Health Economics, Kristiania University College, Oslo, Norway
- Department of Health Services Policy & Management, University of South Carolina, Columbia
| | - Sezer Kisa
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | | | - Hamidreza Komaki
- Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
- Brain Engineering Research Center, Institute for Research in Fundamental Sciences, Tehran, Iran
| | - Ai Koyanagi
- Networking Center for Mental Health Network, San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain
- Catalan Institution for Research and Advanced Studies, Barcelona, Spain
| | - Kristopher J Krohn
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Burcu Kucuk Bicer
- Department of Public Health, Yüksek Ihtisas University, Ankara, Turkey
- Department of Public Health, Hacettepe University, Ankara, Turkey
| | - Nuworza Kugbey
- Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Ho, Ghana
- Department of Psychology and Health Promotion, University of KwaZulu-Natal, Durban, South Africa
| | - Vivek Kumar
- Department of Medicine Brigham and Women's Hospital, Harvard University, Boston, Massachusetts
| | - Desmond Kuupiel
- Department of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa
- Department of Nursing, St. John of God Hospital, Duayaw Nkwanta, Ghana
| | - Carlo La Vecchia
- Clinical Medicine and Community Health, A.C.S. Medical College and Hospital, Milan, Italy
| | - Deepesh P Lad
- Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Eyasu Alem Lake
- Department of Nursing, Wolaita Sodo University, Sodo, Ethiopia
| | - Ayenew Molla Lakew
- Department of Epidemiology and Biostatistics, University of Gondar, Gondar, Ethiopia
| | | | - Faris Hasan Lami
- Department of Community and Family Medicine, Academy of Medical Science, Baghdad, Iraq
| | - Qing Lan
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Savita Lasrado
- Department of Otorhinolaryngology-Head and Neck Surgery, Father Muller Medical College, Mangalore, India
| | - Paolo Lauriola
- Institute of Clinical Physiology, Italian National Research Council, Pisa, Italy
| | | | - James Leigh
- Asbestos Diseases Research Institute, University of Sydney, Sydney, New South Wales, Australia
| | | | - Yu Liao
- Department of Medical Statistics and Epidemiology, Sun Yat-sen University, Guangzhou, China
- Alliance for Improving Health Outcomes, Inc, Quezon City, Philippines
| | | | - Stefan Listl
- Department of Dentistry, Radboud University, Nijmegen, Netherlands
- Section for Translational Health Economics, Heidelberg University Hospital, Heidelberg, Germany
| | - Alan D Lopez
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- University of Melbourne, Melbourne, Queensland, Australia
| | - Platon D Lopukhov
- Department of Epidemiology and Evidence-Based Medicine, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Raimundas Lunevicius
- Department of General Surgery, Aintree University Hospital National Health Service Foundation Trust, Liverpool, England, United Kingdom
- Department of Surgery, University of Liverpool, Liverpool, England, United Kingdom
| | - Mohammed Madadin
- Department of Pathology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Sameh Magdeldin
- Proteomics and Metabolomics Unit, Suez Canal University, Cairo, Egypt
- Department of Physiology, Suez Canal University, Ismailia, Egypt
| | | | - Azeem Majeed
- Department of Primary Care and Public Health, Imperial College London, London, England, United Kingdom
| | - Afshin Maleki
- Department of Environmental Health, Tehran University of Medical Sciences, Tehran, Iran
- Environmental Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Reza Malekzadeh
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Non-communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Manafi
- Department of Plastic Surgery, Iran University of Medical Sciences, Tehran, Iran
| | - Navid Manafi
- Department of Ophthalmology, Iran University of Medical Sciences, Tehran, Iran
- Department of Ophthalmology, University of Manitoba, Winnipeg, Manitoba, Canada
| | | | - Morteza Mansourian
- Department of Health Education and Promotion, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Saman Maroufizadeh
- School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Santi Martini S Martini
- Department of Epidemiology, Airlangga University, Surabaya, Indonesia
- Indonesian Public Health Association, Surabaya, Indonesia
| | | | | | | | - Manu Raj Mathur
- Public Health Foundation of India, Gurugram, India
- Department of Epidemiology and Public Health, University College London, London, England, United Kingdom
| | - Colm McAlinden
- Department of Ophthalmology, Hywel Dda University Health Board, Carmarthen, Wales, United Kingdom
| | - Martin McKee
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, England, United Kingdom
| | - Hailemariam Abiy Alemu Meheretu
- Department of Nursing, Debre Markos University, Debre Markos, Ethiopia
- School of Public Health, Bahir Dar University, Bahir Dar, Ethiopia
| | - Ravi Mehrotra
- Department of Preventive Oncology, National Institute of Cancer Prevention and Research, Noida, India
| | - Varshil Mehta
- Department of Internal Medicine, SevenHills Hospital, Mumbai, India
| | - Toni Meier
- Institute for Agricultural and Nutritional Sciences, Martin Luther University Halle-Wittenberg, Halle, Germany
- Innovation Office, Competence Cluster for Nutrition and Cardiovascular Health, Halle, Germany
| | - Yohannes A Melaku
- Institute of Public Health, University of Gondar, Gondar, Ethiopia
- Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | | | | | - Addisu Melese
- Department of Medical Laboratory Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Mulugeta Melku
- Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Peter T N Memiah
- Department of Public Health, University of West Florida, Pensacola, Florida
| | - Walter Mendoza
- Peru Country Office, United Nations Population Fund, Lima, Peru
| | - Ritesh G Menezes
- Forensic Medicine Division, Department of Pathology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Shahin Merat
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Tuomo J Meretoja
- Breast Surgery Unit, Helsinki University Hospital, Helsinki, Finland
- University of Helsinki, Helsinki, Finland
| | - Tomislav Mestrovic
- Clinical Microbiology and Parasitology Unit, Dr. Zora Profozic Polyclinic, Zagreb, Croatia
- University Centre Varazdin, University North, Varazdin, Croatia
| | - Bartosz Miazgowski
- Center for Innovation in Medical Education, Pomeranian Medical University, Szczecin, Poland
- Pomeranian Medical University, Szczecin, Poland
| | - Tomasz Miazgowski
- Department of Hypertension, Pomeranian Medical University, Szczecin, Poland
| | | | - Ted R Miller
- Pacific Institute for Research and Evaluation, Calverton, Maryland
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Edward J Mills
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Seyed Mostafa Mir
- Department of Clinical Biochemistry, Babol University of Medical Sciences, Babol, Iran
- Golestan University of Medical Sciences, Golestan, Iran
| | - Hamed Mirzaei
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Hamid Reza Mirzaei
- Department of Medical Immunology, Tehran University of Medical Sciences, Tehran, Iran
| | - Rashmi Mishra
- Department of Oral Medicine, University of Washington, Seattle
| | - Babak Moazen
- Institute of Public Health, Heidelberg University, Heidelberg, Germany
- Institute of Addiction Research, Frankfurt University of Applied Sciences, Frankfurt, Germany
| | - Dara K Mohammad
- Department of Biology, Salahaddin University, Erbil, Iraq
- Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
| | | | - Yousef Mohammad
- Department of Internal Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Aso Mohammad Darwesh
- Department of Information Technology, University of Human Development, Sulaymaniyah, Iraq
| | - Abolfazl Mohammadbeigi
- Department of Epidemiology and Biostatistics, Qom University of Medical Sciences, Qom, Iran
| | - Hiwa Mohammadi
- Department of Neurology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Moslem Mohammadi
- Department of Physiology and Pharmacology, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahdi Mohammadian
- Department of Epidemiology and Biostatistics, Bushehr University of Medical Sciences, Bushehr, Iran
| | | | | | | | - Ammas Siraj Mohammed
- School of Pharmacy, College of Medicine and Health Science, Haramaya University, Harar, Ethiopia
| | | | - Shafiu Mohammed
- Institute of Public Health, Heidelberg University, Heidelberg, Germany
- Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria
| | - Farnam Mohebi
- Non-communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Iran National Institute of Health Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Lorenzo Monasta
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
| | - Yoshan Moodley
- Department of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Mahmood Moosazadeh
- Health Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Maryam Moossavi
- Department of Molecular Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Ghobad Moradi
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
- Department of Epidemiology and Biostatistics, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Mohammad Moradi-Joo
- Department of Economics and Management Sciences for Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Maziar Moradi-Lakeh
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Farhad Moradpour
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Lidia Morawska
- International Laboratory for Air Quality and Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | | | - Naho Morisaki
- Department of Social Medicine, National Center for Child Health and Development, Setagaya, Japan
| | | | - Abbas Mosapour
- Department of Clinical Biochemistry, Babol University of Medical Sciences, Babol, Iran
- Department of Clinical Biochemistry, Tarbiat Modares University, Tehran, Iran
| | - Seyyed Meysam Mousavi
- Department of Health Management and Economics, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Oumer Sada S Muhammed
- Department of Pharmacology and Clinical Pharmacy, Addis Ababa University, Addis Ababa, Ethiopia
| | - Jonah Musa
- Department of Obstetrics and Gynecology, University of Jos, Jos, Nigeria
- Center for Global Health, Northwestern University, Chicago, Illinois
| | - Ashraf F Nabhan
- Department of Obstetrics and Gynecology, Ain Shams University, Cairo, Egypt
- Knowledge Translation and Utilization, Egyptian Center for Evidence Based Medicine, Cairo, Egypt
| | - Mehdi Naderi
- School of Paramedical Sciences, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ahamarshan Jayaraman Nagarajan
- Department of Research and Analytics, Initiative for Financing Health and Human Development, Chennai, India
- Department of Research and Analytics, Bioinsilico Technologies, Chennai, India
| | - Gabriele Nagel
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Azin Nahvijou
- Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Gurudatta Naik
- O'NealComprehensive Cancer Center, University of Alabama at Birmingham
| | - Farid Najafi
- Department of Epidemiology and Biostatistics, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Luigi Naldi
- Department of Dermatology, San Bortolo Hospital, Vicenza, Italy
- GISED Study Center, Bergamo, Italy
| | - Hae Sung Nam
- Department of Preventive Medicine and Public Health, Chungnam National University School of Medicine, Daejeon, South Korea
- Daejeon Regional Cancer Center, Chungnam National University Hospital, Daejeon, South Korea
| | - Naser Nasiri
- Department of Public Health, School of Public Health, Jiroft University of Medical Sciences, Jiroft, Iran
| | - Javad Nazari
- Department of Pediatrics, Arak University of Medical Sciences, Arak, Iran
- Ministry of Health and Medical Education, Tehran, Iran
| | - Ionut Negoi
- Emergency Hospital of Bucharest, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Subas Neupane
- Faculty of Health Sciences, University of Tampere, Tampere, Finland
| | - Polly A Newcomb
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
- Department of Epidemiology, University of Washington, Seattle
| | - Haruna Asura Nggada
- Department of Histopathology, University of Maiduguri Teaching Hospital, Maiduguri, Nigeria
- Department of Human Pathology, University of Maiduguri, Maiduguri, Nigeria
| | | | - Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Hanoi, Vietnam
| | - Leila Nikniaz
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Dina Nur Anggraini Ningrum
- Department of Public Health Sciences, State University of Semarang, Semarang, Indonesia
- Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei City, Taiwan
| | | | - Molly R Nixon
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Chukwudi A Nnaji
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Marzieh Nojomi
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Community and Family Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Shirin Nosratnejad
- Department of Health Economics, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | | | - Richard Ofori-Asenso
- Centre of Cardiovascular Research and Education in Therapeutics, Monash University, Melbourne, Victoria, Australia
- Independent consultant, Accra, Ghana
| | - Felix Akpojene Ogbo
- Translational Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
| | - In-Hwan Oh
- Department of Preventive Medicine, Kyung Hee University, Dongdaemun-gu, South Korea
| | - Andrew T Olagunju
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Department of Psychiatry, University of Lagos, Lagos, Nigeria
| | - Tinuke O Olagunju
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Mojisola Morenike Oluwasanu
- Department of Health Promotion and Education, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Abidemi E Omonisi
- Department of Anatomic Pathology, Ekiti State University, Ado- Ekiti, Nigeria
- Department of Anatomic Pathology, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
| | - Obinna E Onwujekwe
- Department of Pharmacology and Therapeutics, University of Nigeria, Nsukka, Enugu, Nigeria
| | - Anu Mary Oommen
- Department of Community Health, Christian Medical College, Vellore, India
| | - Eyal Oren
- Department of Epidemiology, University of Washington, Seattle
- Graduate School of Public Health, San Diego State University, San Diego, California
| | | | - Erika Ota
- Department of Global Health Nursing, St. Luke's International University, Chuo-ku, Japan
| | | | - Mayowa Ojo Owolabi
- Institute for Advanced Medical Research and Training, University of Ibadan, Ibadan, Nigeria
| | - Mahesh P A
- Department of TB & Respiratory Medicine, Jagadguru Sri Shivarathreeswara University, Mysore, India
| | | | - Smita Pakhale
- Department of Medicine, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Amir H Pakpour
- Department of Public Health, Qazvin University of Medical Sciences, Qazvin, Iran
- Department of Nursing, Jönköping University, Jönköping, Sweden
| | - Adrian Pana
- Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
- Center for Health Outcomes & Evaluation, Bucharest, Romania
| | - Eun-Kee Park
- Department of Medical Humanities and Social Medicine, Kosin University, Busan, South Korea
| | - Hadi Parsian
- Department of Clinical Biochemistry, Babol University of Medical Sciences, Babol, Iran
| | - Tahereh Pashaei
- Environmental Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Shanti Patel
- Department of Medicine, Maimonides Medical Center, Brooklyn, New York
| | - Snehal T Patil
- Krishna Institute of Medical Sciences, Deemed University, Karad, India
| | - Alyssa Pennini
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - David M Pereira
- Requimte/LAQV, University of Porto, Porto, Portugal
- University of Cartagena, Cartagena, Colombia
| | - Cristiano Piccinelli
- ReferenceCenter for Epidemiology and Cancer Prevention, CPO Piedmont, Torino, Italy
| | - Julian David Pillay
- Basic Medical Sciences Department, Durban University of Technology, Durban, South Africa
| | - Majid Pirestani
- Departments of Parasitology and Entomology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Farhad Pishgar
- Non-communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Uro-Oncology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Maarten J Postma
- University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- Faculty of Economics and Business, University of Groningen, Groningen, Netherlands
| | - Hadi Pourjafar
- Department of Public Health, Maragheh University of Medical Sciences, Maragheh, Iran
- Department of Nutrition and Food Sciences, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Farshad Pourmalek
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Akram Pourshams
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Swayam Prakash
- Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Narayan Prasad
- Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Mohammad Rabiee
- Department of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran
| | - Navid Rabiee
- Department of Chemistry, Sharif University of Technology, Tehran, Iran
- Divisions of Chemistry and Diseases, Advanced Technologies Research Group, Tehran, Iran
| | | | - Alireza Rafiei
- Department of Immunology, Mazandaran University of Medical Sciences, Sari, Iran
- Molecular and Cell Biology Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Fakher Rahim
- Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Thalassemia and Hemoglobinopathy Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mahdi Rahimi
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Muhammad Aziz Rahman
- Austin Health Clinical School of Nursing, La Trobe University, Heidelberg, Victoria, Australia
- National Centre for Farmer Health, Deakin University, Waurn Ponds, Victoria, Australia
| | - Fatemeh Rajati
- Department of Health Education and Promotion, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Saleem M Rana
- Department of Public Health, Contech School of Public Health, Lahore, Pakistan
- Public Health Department, University of Health Sciences, Lahore, Pakistan
| | - Samira Raoofi
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Goura Kishor Rath
- Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - David Laith Rawaf
- WHO Collaborating Centre for Public Health Education and Training, Imperial College London, London, England, United Kingdom
- University College London Hospitals, London, England, United Kingdom
| | - Salman Rawaf
- Department of Primary Care and Public Health, Imperial College London, London, England, United Kingdom
- Academic Public Health, Public Health England, London, England, United Kingdom
| | - Robert C Reiner
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Andre M N Renzaho
- School of Social Sciences and Psychology, Western Sydney University, Penrith, New South Wales, Australia
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Network of Immunity in Infection, Malignancy, and Autoimmunity, Universal Scientific Education and Research Network, Tehran, Iran
| | - Aziz Rezapour
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ana Isabel Ribeiro
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
| | - Daniela Ribeiro
- Department of Applied Chemistry, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Luca Ronfani
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
| | - Elias Merdassa Roro
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Public Health, Wollega University, Nekemte, Ethiopia
| | - Gholamreza Roshandel
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Ali Rostami
- Infectious Diseases and Tropical Medicine Research Center, Babol University of Medical Sciences, Babol, Iran
| | | | - Parisa Sabbagh
- Infectious Diseases and Tropical Medicine Research Center, Babol University of Medical Sciences, Babol, Iran
| | - Siamak Sabour
- Department of Epidemiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Basema Saddik
- Medical Department, University of Sharjah, Sharjah, United Arab Emirates
| | - Saeid Safiri
- Managerial Epidemiology Research Center, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Farkhonde Salehi
- Taleghani Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hosni Salem
- Department of Urology, Cairo University, Cairo, Egypt
| | - Marwa Rashad Salem
- Public Health and Community Medicine Department, Cairo University, Giza, Egypt
| | - Hamideh Salimzadeh
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Joshua A Salomon
- Center for Health Policy and Center for Primary Care and Outcomes Research, Stanford University, Stanford, California
| | - Abdallah M Samy
- Department of Entomology, Ain Shams University, Cairo, Egypt
| | - Juan Sanabria
- Department of Surgery, Marshall University, Huntington, West Virginia
- Departments of Nutrition and Preventive Medicine, Case Western Reserve University, Cleveland, Ohio
| | | | - Benn Sartorius
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, England, United Kingdom
| | - Arash Sarveazad
- Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Brijesh Sathian
- Surgery Department, Hamad Medical Corporation, Doha, Qatar
- Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, England, United Kingdom
| | - Maheswar Satpathy
- UGC Centre of Advanced Study in Psychology, Utkal University, Bhubaneswar, India
- Udyam-Global Association for Sustainable Development, Bhubaneswar, India
| | | | - Monika Sawhney
- Department of Public Health Sciences, University of North Carolina at Charlotte
| | - Mehdi Sayyah
- Education Development Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ione J C Schneider
- School of Health Sciences, Federal University of Santa Catarina, Ararangua, Brazil
| | - Ben Schöttker
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
| | - Mario Sekerija
- Department of Medical Statistics, Epidemiology and Medical Informatics, University of Zagreb, Zagreb, Croatia
- Division of Epidemiology and Prevention of Chronic Noncommunicable Diseases, Croatian Institute of Public Health, Zagreb, Croatia
| | - Sadaf G Sepanlou
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Non-communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masood Sepehrimanesh
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Seyedmojtaba Seyedmousavi
- Center of Expertise in Microbiology, Tehran University of Medical Sciences, Tehran, Iran
- Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Faramarz Shaahmadi
- Department of Health Promotion and Education, Alborz University of Medical Sciences, Karaj, Iran
| | - Hosein Shabaninejad
- Department of Health Policy, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Shahbaz
- Department of Epidemiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Amir Shamshirian
- Department of Medical Laboratory Sciences, Mazandaran University of Medical Sciences, Sari, Iran
| | - Morteza Shamsizadeh
- Chronic Diseases (Home Care) Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Heidar Sharafi
- Department of Molecular Hepatology, Middle East Liver Disease Center, Tehran, Iran
| | - Zeinab Sharafi
- Razi Herbal Medicines Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Mehdi Sharif
- Department of Basic Sciences, Islamic Azad University, Sari, Iran
- Department of Laboratory Sciences, Islamic Azad University, Sari, Iran
| | - Ali Sharifi
- Department of Ophthalmology, Kerman University of Medical Sciences, Kerman, Iran
| | - Hamid Sharifi
- HIV/STI Surveillance Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Rajesh Sharma
- University School of Management and Entrepreneurship, Delhi Technological University, New Delhi, India
| | - Aziz Sheikh
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland, United Kingdom
- Division of General Internal Medicine and Primary Care, Harvard University, Boston, Massachusetts
| | - Reza Shirkoohi
- Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
- Cancer Biology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Sharvari Rahul Shukla
- Symbiosis Institute of Health Sciences, Symbiosis International University, Pune, Maharashtra, India
| | - Si Si
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Soraya Siabani
- Imam Ali Cardiovascular Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | | | - Dayane Gabriele Alves Silveira
- University of Brasília, Brasília, Brazil
- Department of the Health Industrial Complex and Innovation in Health, Ministry of Health, Brasília, Brazil
| | - Ambrish Singh
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
- Global Patient Outcome and Real World Evidence, Eli Lilly and Company, Indianapolis, Indiana
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- Department of Medicine, University of Alabama at Birmingham
- Department of Epidemiology, University of Alabama at Birmingham
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- Medical Department, German Leprosy and TB Relief Association, Addis Ababa, Ethiopia
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- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Eugène Sobngwi
- Department of Internal Medicine and Specialties, University of Yaoundé I, Yaoundé, Cameroon
- Department of Endocrinology and Diabetes, Central Hospital of Yaoundé, Yaoundé, Cameroon
| | - Moslem Soofi
- Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Joan B Soriano
- Hospital Universitario de la Princesa, Autonomous University of Madrid, Madrid, Spain
- Centro de Investigación en Red de Enfermedades Respiratorias, Institute of Health Carlos III, Madrid, Spain
| | - Vasiliki Stathopoulou
- Department of Occupational Therapy, Athens University of Applied Sciences, Athens, Greece
| | | | - Rafael Tabarés-Seisdedos
- Department of Medicine, University of Valencia, Valencia, Spain
- Biomedical Research Networking Center for Mental Health Network, Carlos III Health Institute, Madrid, Spain
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | - Ken Takahashi
- Asbestos Diseases Research Institute, University of Sydney, Sydney, New South Wales, Australia
- University of Sydney, Sydney, New South Wales, Australia
| | - Omid Reza Tamtaji
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | | | | | - Parvaneh Taymoori
- Department of Public Health, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Arash Tehrani-Banihashemi
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Community Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mohamad-Hani Temsah
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
- Department of Pediatrics, King Saud University, Riyadh, Saudi Arabia
| | - Omar Temsah
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | | | - Fisaha Haile Tesfay
- Mekelle University, Mekelle, Ethiopia
- Southgate Institute for Health, Society and Equity, Flinders University, Adelaide, South Australia, Australia
| | | | - Gizachew Assefa Tessema
- Institute of Public Health, University of Gondar, Gondar, Ethiopia
- School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
| | - Subash Thapa
- Department of Public Health, University of Southern Denmark, Odense, Denmark
| | | | - Roman Topor-Madry
- Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
- The Agency for Health Technology Assessment and Tariff System, Warsaw, Poland
| | | | - Eugenio Traini
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
| | - Bach Xuan Tran
- Department of Health Economics, Hanoi Medical University, Hanoi, Vietnam
| | - Khanh Bao Tran
- Department of Molecular Medicine and Pathology, The University of Auckland, Auckland, New Zealand
- Department of Clinical Hematology and Toxicology, Military Medical University, Hanoi, Vietnam
| | | | - Irfan Ullah
- Gomal Center of Biochemistry and Biotechnology, Gomal University, Dera Ismail Khan, Pakistan
| | - Olalekan A Uthman
- Division of Health Sciences, University of Warwick, Coventry, England, United Kingdom
| | - Marco Vacante
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Maryam Vaezi
- Women's Reproductive Health Research Center, A.C.S. Medical College and Hospital, Tabriz, Iran
- Alzahra Teaching Hospital, Tabriz, Iran
| | - Patricia Varona Pérez
- Department for International Development, Health Network of Cuba, Havana, Cuba
- Centre of Research in Environmental Epidemiology, Barcelona Institute for Global Health, Barcelona, Spain
| | - Yousef Veisani
- Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran
| | - Simone Vidale
- Department of Neurology & Stroke Unit, Sant'Anna Hospital, Como, Italy
| | - Francesco S Violante
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- Occupational Health Unit, Sant'Orsola Malpighi Hospital, Bologna, Italy
| | - Vasily Vlassov
- Department of Health Care Administration and Economy, National Research University Higher School of Economics, Moscow, Russia
| | - Stein Emil Vollset
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Theo Vos
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Kia Vosoughi
- Department of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, Maryland
| | - Giang Thu Vu
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | | | - Henry Wabinga
- Department of Pathology, Makerere University, Kampala, Uganda
| | | | | | - Yasir Waheed
- Foundation University Medical College, Foundation University, Rawalpindi, Pakistan
| | - Fitsum Weldegebreal
- Department of Medical Laboratory Science, Haramaya University, Harar, Ethiopia
| | | | - Tissa Wijeratne
- Department of Psychology and Counselling, University of Melbourne, Melbourne, Victoria, Australia
- Department of Medicine, University of Melbourne, St Albans, Victoria, Australia
| | - Dawit Zewdu Wondafrash
- Department of Pharmacology and Clinical Pharmacy, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Pharmacology and Toxicology, Mekelle University, Mekelle, Ethiopia
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- Department of Nursing, Wollo University, Dessie, Ethiopia
- Department of Nursing, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Rajaram Yadav
- Department of Population Studies, International Institute for Population Sciences, Mumbai, India
| | - Abbas Yadegar
- Foodborne and Waterborne Diseases Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Yadollahpour
- Department of Medical Physics, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mehdi Yaseri
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Vahid Yazdi-Feyzabadi
- Department of Health Management, Policy, and Economics, Kerman University of Medical Sciences, Kerman, Iran
- Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | | | | | | | - Engida Yisma
- School of Allied Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Naohiro Yonemoto
- Department of Neuropsychopharmacology, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Mustafa Z Younis
- Health Economics & Finance, Global Health, Jackson State University, Jackson, Mississippi
- Department of Public Health, Tsinghua University, Beijing, China
| | - Bahman Yousefi
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Clinical Biochemistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahmoud Yousefifard
- Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, Wuhan University, Wuhan, China
- Global Health Institute, Wuhan University, Wuhan, China
| | - Erfan Zabeh
- Department of Electrical Engineering, Institute for Research in Fundamental Sciences, Tehran, Iran
- Department of Electrical Engineering, Bioelectric Group, Sharif University of Technology, Tehran, Iran
| | - Vesna Zadnik
- Epidemiology and Cancer Registry Sector, Institute of Oncology, Ljubljana, Slovenia
| | - Telma Zahirian Moghadam
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
- Social Determinants of Health Research Center, Ardabil University of Medical Science, Ardabil, Iran
| | - Zoubida Zaidi
- Department of Epidemiology, University Hospital of Setif, Setif, Algeria
| | - Mohammad Zamani
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Hamed Zandian
- Social Determinants of Health Research Center, Ardabil University of Medical Science, Ardabil, Iran
| | - Alireza Zangeneh
- Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Leila Zaki
- Department of Parasitology, Tarbiat Modares University, Tehran, Iran
| | - Kazem Zendehdel
- Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Taye Abuhay Zewale
- Department of Epidemiology and Biostatistics, Bahir Dar University, Bahir Dar, Ethiopia
| | - Arash Ziapour
- Health Promotion Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Christopher J L Murray
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
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Monasta L, Abbafati C, Logroscino G, Remuzzi G, Perico N, Bikbov B, Tamburlini G, Beghi E, Traini E, Redford SB, Ariani F, Borzì AM, Bosetti C, Carreras G, Caso V, Castelpietra G, Cirillo M, Conti S, Cortesi PA, Damiani G, D'Angiolella LS, Fanzo J, Fornari C, Gallus S, Giussani G, Gorini G, Grosso G, Guido D, La Vecchia C, Lauriola P, Leonardi M, Levi M, Madotto F, Mondello S, Naldi L, Olgiati S, Palladino R, Piccinelli C, Piccininni M, Pupillo E, Raggi A, Rubino S, Santalucia P, Vacante M, Vidale S, Violante FS, Naghavi M, Ronfani L. Italy's health performance, 1990-2017: findings from the Global Burden of Disease Study 2017. Lancet Public Health 2019; 4:e645-e657. [PMID: 31759893 PMCID: PMC7098474 DOI: 10.1016/s2468-2667(19)30189-6] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 08/27/2019] [Accepted: 09/04/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Through a comprehensive analysis of Italy's estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, we aimed to understand the patterns of health loss and response of the health-care system, and offer evidence-based policy indications in light of the demographic transition and government health spending in the country. METHODS Estimates for Italy were extracted from GBD 2017. Data on Italy are presented for 1990 and 2017, on prevalence, causes of death, years of life lost, years lived with disability, disability-adjusted life-years (DALYs), life expectancy at birth and at age 65 years, healthy life expectancy, and Healthcare Access and Quality (HAQ) Index. We compared the estimates for Italy with those of 15 other western European countries. FINDINGS The quality of the universal health system and healthy behaviours contribute to favourable overall health, even in comparison with other western European countries. In 2017, life expectancy and HAQ Index score in Italy were among the highest globally, with life expectancy at birth reaching 85·3 years for females and 80·8 for males in 2017, ranking Italy eighth globally for females and sixth for males, and an HAQ Index score of 94·9 in 2016 compared with 81·54 in 1990, keeping Italy ranked as ninth globally. Between 1990 and 2017 age-standardised death rates for cardiovascular diseases decreased by 53·7% (95% uncertainty interval -56·1 to -51·4), for neoplasms decreased by 28·2% (-32·3 to -24·6), and for transport injuries decreased by 62·1% (-64·6 to -59·2). However, population ageing is causing an increase in the burden of specific diseases, such as Alzheimer's disease and other dementias (DALYs increased by 77·9% [68·4 to 87·2]) and pancreatic (DALYs increased by 39·7% [28·4 to 51·7]) and uterine cancers (DALYs increased by 164·7% [129·7 to 202·5]). Behavioural risk factors, which are potentially modifiable, still have a strong effect, particularly on cardiovascular diseases and neoplasms. For instance, in 2017, 44 400 (41 200 to 47 800) cancer deaths were attributed to smoking, 12 000 (9600 to 14 800) to alcohol use, and 9500 (5400 to 14 200) to high body-mass index, while 47 000 (31 100 to 65 700) deaths due to cardiovascular diseases could be attributed to high LDL cholesterol, 28 700 (19 700 to 38 500) to diets low in whole grains, and 15 900 (8500 to 24 900) to low physical activity. INTERPRETATION Italy provides an interesting example of the results that can be achieved by a mix of relatively healthy lifestyles and a universal health system. Two main issues require attention, population ageing and gradual decrease of public health financing, which both pose several challenges to the future of Italy's health status. Our findings should be useful to Italy's policy makers and health system experts elsewhere. FUNDING Bill & Melinda Gates Foundation.
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Borzì AM, Biondi A, Basile F, Vacante M. Diagnosis and treatment of hypothyroidism in old people : A new old challenge. Wien Klin Wochenschr 2019; 132:161-167. [PMID: 31773270 DOI: 10.1007/s00508-019-01579-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 11/01/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE To review the diagnosis and the treatment of both subclinical and overt hypothyroidism in old people, which could represent a challenge for the clinicians. METHODS Narrative literature review. An extensive literature search was performed using the databases of Scopus, Medline through PubMed, and Google Scholar from January 1975 to May 2019. The search terms were "hypothyroidism," "older adults," "elderly," and "myxedema." RESULTS Hypothyroidism is more common among older subjects in comparison to the younger counterparts. The hypothalamic-pituitary-thyroid axis and its hormones undergo significant changes due to the physiological aging process. For a correct diagnosis of hypothyroidism in old people clinicians must take such age-related changes into account. CONCLUSIONS The administration of replacement therapy in older adults should consider frailty, polypharmacy and a high risk to develop overtreatment symptoms. On the other hand, older patients with untreated or undertreated hypothyroidism may develop a state of myxedema coma.
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Affiliation(s)
- Antonio Maria Borzì
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Via S. Sofia,78, 95123, Catania, Italy
| | - Antonio Biondi
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Via S. Sofia,78, 95123, Catania, Italy
| | - Francesco Basile
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Via S. Sofia,78, 95123, Catania, Italy
| | - Marco Vacante
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Via S. Sofia,78, 95123, Catania, Italy.
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Borzì AM, Condorelli G, Biondi A, Basile F, Vicari ESD, Buscemi C, Luca S, Vacante M. Effects of vildagliptin, a DPP-4 inhibitor, in elderly diabetic patients with mild cognitive impairment. Arch Gerontol Geriatr 2019; 84:103896. [PMID: 31204117 DOI: 10.1016/j.archger.2019.06.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 06/02/2019] [Accepted: 06/02/2019] [Indexed: 01/06/2023]
Abstract
INTRODUCTION There is an unclear association between type 2 diabetes and mild cognitive impairment in the elderly. Both diseases are more prevalent in the older adults compared to the younger counterpart. Some anti-diabetic drugs seem to influence positively the evolution of mild cognitive impairment. This retrospective study investigated the effect of vildagliptin, an inhibitor of the enzyme dipeptidyl peptidase-4 (DPP-4), on the cognitive functioning of elderly diabetic patients with mild cognitive impairment (MCI) documented at mini mental state examination (MMSE). METHODS We included 60 diabetic elderly people which were divided in 2 groups: Group A, 30 patients with HbA1c (glycated hemoglobin) ≤7.5% and treated with metformin, and Group B, 30 patients with HbA1c >7.5%, and treated with metformin plus vildagliptin. We collected data on MMSE, fasting plasma glucose (FPG) and HbA1c at baseline and after 180 ± 10 days from the beginning of treatment. RESULTS The two groups exhibited significantly different values in FPG (P < 0.05) and HbA1c (P < 0.01) at baseline, and in MMSE score (P < 0.001) after treatment. The intragroup comparison showed a significant (P < 0.05) reduction in MMSE score in group A, and in HbA1c (P = 0.01) in group B. CONCLUSION Vildagliptin in addition to metformin resulted in the maintenance of MMSE score, showing a protecting role on cognitive functioning compared to the metformin only group.
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Affiliation(s)
- Antonio Maria Borzì
- Department of Clinical and Experimental Medicine, Specialization School in Geriatrics, University of Catania, AOU Policlinico, Catania, Italy.
| | - Giovanni Condorelli
- Department of Clinical and Experimental Medicine, Specialization School in Geriatrics, University of Catania, AOU Policlinico, Catania, Italy.
| | - Antonio Biondi
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy.
| | - Francesco Basile
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy.
| | - Enzo Saretto Dante Vicari
- Department of Clinical and Experimental Medicine, Specialization School in Geriatrics, University of Catania, AOU Policlinico, Catania, Italy.
| | - Carola Buscemi
- Department of Clinical and Experimental Medicine, Specialization School in Geriatrics, University of Catania, AOU Policlinico, Catania, Italy.
| | - Salvatore Luca
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy.
| | - Marco Vacante
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy.
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Vacante M, Biondi A, Basile F, Ciuni R, Luca S, Di Saverio S, Buscemi C, Vicari ESD, Borzì AM. Hypothyroidism as a Predictor of Surgical Outcomes in the Elderly. Front Endocrinol (Lausanne) 2019; 10:258. [PMID: 31068905 PMCID: PMC6491643 DOI: 10.3389/fendo.2019.00258] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 04/04/2019] [Indexed: 12/30/2022] Open
Abstract
There is a high prevalence of hypothyroidism in the elderly population, mainly among women. The most important cause is autoimmune thyroiditis, but also iodine deficiency, radioiodine ablation, and surgery may be responsible for hypothyroidism in elderly hospitalized patients. Thyroid-related symptoms are sometimes comparable to physiological manifestations of the aging process, and hypothyroidism may be related with many symptoms which can be present in critical patients, such as cognitive impairment, cardiovascular, gastrointestinal, and hematological alterations, and eventually myxedema coma which is a severe and life-threatening condition in older adults. Adequate thyroid hormone levels are required to achieve optimal outcomes from any kind of surgical intervention. However, only few randomized clinical trials investigated the association between non-thyroidal illness (or low-T3 syndrome), and adverse surgical outcomes, so far. The goal of this review is to discuss the role of thyroid function as a predictor of surgical outcomes in the elderly.
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Affiliation(s)
- Marco Vacante
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Antonio Biondi
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Francesco Basile
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Roberto Ciuni
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Salvatore Luca
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Salomone Di Saverio
- Cambridge Colorectal Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Carola Buscemi
- Department of Clinical and Experimental Medicine, Specialization School in Geriatrics, University of Catania, Catania, Italy
| | - Enzo Saretto Dante Vicari
- Department of Clinical and Experimental Medicine, Specialization School in Geriatrics, University of Catania, Catania, Italy
| | - Antonio Maria Borzì
- Department of Clinical and Experimental Medicine, Specialization School in Geriatrics, University of Catania, Catania, Italy
- *Correspondence: Antonio Maria Borzì
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Vacante M, Borzì AM, Basile F, Biondi A. Biomarkers in colorectal cancer: Current clinical utility and future perspectives. World J Clin Cases 2018; 6:869-881. [PMID: 30568941 PMCID: PMC6288499 DOI: 10.12998/wjcc.v6.i15.869] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 10/30/2018] [Accepted: 11/07/2018] [Indexed: 02/05/2023] Open
Abstract
Colorectal cancer (CRC) is a major cause of cancer death worldwide. CRC has poor prognosis and there is a crucial need for new diagnostic and prognostic biomarkers to avoid CRC-related deaths. CRC can be considered a sporadic disease in most cases (75%-80%), but it has been suggested that crosstalk between gene mutations (i.e., mutations of BRAF, KRAS, and p53 as well as microsatellite instability) and epigenetic alterations (i.e., DNA methylation of CpG island promoter regions) could play a pivotal role in cancer development. A number of studies have focused on molecular testing to guide targeted and conventional treatments for patients with CRC, sometimes with contrasting results. Some of the most useful innovations in the management of CRC include the possibility to detect the absence of KRAS, BRAF, NRAS and PIK3CA gene mutations with the subsequent choice to administer targeted adjuvant therapy with anti-epidermal growth factor receptor antibodies. Moreover, CRC patients can benefit from tests for microsatellite instability and for the detection of loss of heterozygosity of chromosome 18q that can be helpful in guiding therapeutic decisions as regards the administration of 5-FU. The aim of this review was to summarize the most recent evidence on the possible use of genetic or epigenetic biomarkers for diagnosis, prognosis and response to therapy in CRC patients.
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Affiliation(s)
- Marco Vacante
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania 95123, Italy
| | - Antonio Maria Borzì
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania 95123, Italy
| | - Francesco Basile
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania 95123, Italy
| | - Antonio Biondi
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania 95123, Italy
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Biondi A, Di Saverio S, Basile F, Vacante M. Laparoscopic surgery for colorectal cancer: towards a lower cost surgery? Ann Laparosc Endosc Surg 2018. [DOI: 10.21037/ales.2018.06.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Ambrosino I, Riccardo A, Gnerre P, Massiah G, Castelnovo L, Muscariello R, Vacante M. The management of the patient with osteoporosis: from evidence to clinical practice. Ital J Med 2017. [DOI: 10.4081/itjm.2017.784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Osteoporosis is the most common bone disease and is an important problem of public health. In fact, it represents the main cause of age-related fractures and disabilities with a consequent increasing sanitary, social and economic impact. Unfortunately, often osteoporosis is not as thoroughly investigated as it would be desirable and it is underestimated in diagnosis and therapy. The aim of this monograph is to sensitize medical internists to a careful evaluation and an efficacious treatment of osteoporosis in order to reduce the risks of this disease, in particular the fractures, with a view to improving the quality of patients’ life.
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Malaguarnera G, Bertino G, Chisari G, Motta M, Vecchio M, Vacante M, Caraci F, Greco C, Drago F, Nunnari G, Malaguarnera M. Silybin supplementation during HCV therapy with pegylated interferon-α plus ribavirin reduces depression and anxiety and increases work ability. BMC Psychiatry 2016; 16:398. [PMID: 27842532 PMCID: PMC5109776 DOI: 10.1186/s12888-016-1115-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 11/07/2016] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Hepatitis C virus infection and interferon treatment are often associated with anxiety, depressive symptoms and poor health-related quality of life. To evaluate the Silybin-vitamin E-phospholipids complex effect on work ability and whether health related factors (anxiety and depression) were associated with work ability in subjects with chronic hepatitis C treated with Pegylated-Interferon-α2b (Peg-IFN) and Ribavirin (RBV). METHODS Thirty-one patients (Group A) with chronic hepatitis and other 31 subjects in Group B were recruited in a randomized, prospective, placebo controlled, double blind clinical trial. Group A received 1.5 mg/kg per week of Peg-IFN plus RBV and placebo, while Group B received the same dosage of Peg-IFN plus RBV plus association of Silybin 94 mg + vitamin E 30 mg + phospholipids 194 mg in pills for 12 months. All subjects underwent to laboratory exams and questionnaires to evaluate depression (Beck Depression Inventory - BDI), anxiety (State-trait anxiety inventory - STAI) and work ability (Work ability Index - WAI). RESULTS The comparison between group A and group B showed significant differences after 6 months in ALT (P < 0.001), and viremia (P < 0.05), after 12 months in ALT (P < 0.001), and AST (P < 0.001), at follow up in AST (P < 0.05), and ALT (P < 0.001). Significant difference were observed after 1 month in WAI (p < 0.001) and BDI (P < 0.05), after 6 months in WAI (P < 0.05) and STAI (P < 0.05), after 12 months and at follow up in WAI, STAI and BDI (p < 0.01). CONCLUSIONS The supplementation with Silybin-vitamin E -phospholipids complex increased work ability and reduced depression and anxiety in patients treated with Peg-IFN and RBV. TRIAL REGISTRATION NCT01957319 , First received: September 25, 2013. Last updated: September 30, 2013 (retrospectively registered).
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Affiliation(s)
- Giulia Malaguarnera
- Research Center "The Great Senescence", University of Catania, Catania, Italy. .,Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy.
| | - Gaetano Bertino
- Department of Experimental and Clinical Medicine, University of Catania, Catania, Italy
| | - Giuseppe Chisari
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Massimo Motta
- Research Center “The Great Senescence”, University of Catania, Catania, Italy ,Department of Experimental and Clinical Medicine, University of Catania, Catania, Italy
| | - Michele Vecchio
- U.O.C Physical Medicine and Rehabilitation, A.O.U. Policlinico Vittorio Emanuele, Catania, Italy
| | - Marco Vacante
- Research Center “The Great Senescence”, University of Catania, Catania, Italy
| | - Filippo Caraci
- Department of Drug Sciences, University of Catania, Catania, Italy ,IRCCS Associazione Oasi Maria S.S., Institute for Research on Mental Retardation and Brain Aging, Troina, Italy
| | - Carmela Greco
- Research Center “The Great Senescence”, University of Catania, Catania, Italy
| | - Filippo Drago
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Giuseppe Nunnari
- Department of Experimental and Clinical Medicine, University of Catania, Catania, Italy
| | - Michele Malaguarnera
- Research Center “The Great Senescence”, University of Catania, Catania, Italy ,Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
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Biondi A, Vacante M, Ambrosino I, Cristaldi E, Pietrapertosa G, Basile F. Role of surgery for colorectal cancer in the elderly. World J Gastrointest Surg 2016; 8:606-613. [PMID: 27721923 PMCID: PMC5037333 DOI: 10.4240/wjgs.v8.i9.606] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 06/15/2016] [Accepted: 07/18/2016] [Indexed: 02/06/2023] Open
Abstract
The prevalence of subjects with colorectal cancer is expected to grow in the next future decades and surgery represents the most successful treatment modality for these patients. Anyway, currently elderly subjects undergo less elective surgical procedures than younger patients mainly due to the high rates of postoperative morbidity and mortality. Some authors suggest extensive surgery, including multistage procedures, as carried out in younger patients while others promote less aggressive surgery. In older patients, laparoscopic-assisted colectomy showed a number of advantages compared to conventional open surgery that include lower stress, higher rate of independency after surgery, quicker return to prior activities and a decrease in costs. The recent advances in chemotherapy and the introduction of new surgical procedures such as the endoluminal stenting, suggest the need for a revisitation of surgical practice patterns and the role of palliative surgery, mainly for patients with advanced disease. In this article, we discuss the current role of surgery for elderly patients with colorectal cancer.
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Biondi A, Di Stefano C, Ferrara F, Bellia A, Vacante M, Piazza L. Laparoscopic versus open appendectomy: a retrospective cohort study assessing outcomes and cost-effectiveness. World J Emerg Surg 2016; 11:44. [PMID: 27582784 PMCID: PMC5006397 DOI: 10.1186/s13017-016-0102-5] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 08/17/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Appendectomy is the most common surgical procedure performed in emergency surgery. Because of lack of consensus about the most appropriate technique, appendectomy is still being performed by both open (OA) and laparoscopic (LA) methods. In this retrospective analysis, we aimed to compare the laparoscopic approach and the conventional technique in the treatment of acute appendicitis. METHODS Retrospectively collected data from 593 consecutive patients with acute appendicitis were studied. These comprised 310 patients who underwent conventional appendectomy and 283 patients treated laparoscopically. The two groups were compared for operative time, length of hospital stay, postoperative pain, complication rate, return to normal activity and cost. RESULTS Laparoscopic appendectomy was associated with a shorter hospital stay (2.7 ± 2.5 days in LA and 1.4 ± 0.6 days in OA), with a less need for analgesia and with a faster return to daily activities (11.5 ± 3.1 days in LA and 16.1 ± 3.3 in OA). Operative time was significantly shorter in the open group (31.36 ± 11.13 min in OA and 54.9 ± 14.2 in LA). Total number of complications was less in the LA group with a significantly lower incidence of wound infection (1.4 % vs 10.6 %, P <0.001). The total cost of treatment was higher by 150 € in the laparoscopic group. CONCLUSION The laparoscopic approach is a safe and efficient operative procedure in appendectomy and it provides clinically beneficial advantages over open method (including shorter hospital stay, decreased need for postoperative analgesia, early food tolerance, earlier return to work, lower rate of wound infection) against only marginally higher hospital costs. TRIAL REGISTRATION NCT02867072 Registered 10 August 2016. Retrospectively registered.
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Affiliation(s)
- Antonio Biondi
- Department of Surgery, Vittorio Emanuele Hospital, University of Catania, Via Plebiscito, 628, 95124 Catania, Italy
| | - Carla Di Stefano
- General and Emergency Surgery Department, Garibaldi Hospital, 95100 Catania, Italy
| | - Francesco Ferrara
- General and Emergency Surgery Department, Garibaldi Hospital, 95100 Catania, Italy
| | - Angelo Bellia
- General and Emergency Surgery Department, Garibaldi Hospital, 95100 Catania, Italy
| | - Marco Vacante
- Department of Medical and Pediatric Sciences, University of Catania, 95125 Catania, Italy
| | - Luigi Piazza
- General and Emergency Surgery Department, Garibaldi Hospital, 95100 Catania, Italy
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Vacante M, Alessandria I, Cataudella E, Fichera R, Malatino L. An Unexpected Cause of Marked Weight Loss Associated with Vomiting in an Adult Man: Gastric Phytobeozar. Eur J Case Rep Intern Med 2015; 3:000258. [PMID: 30755850 PMCID: PMC6346827 DOI: 10.12890/2015_000258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 08/09/2015] [Indexed: 11/05/2022] Open
Abstract
Objectives We present the case of an edentulous 47-year-old farmer referred to our Department of Internal Medicine because of postprandial vomiting, hyporexia, asthenia and weight loss. He ate a mostly vegetarian diet. Materials and methods An oesophagogastroduodenoscopy revealed the presence of a phytobezoar at the level of the fundus and body of the stomach. Endoscopic fragmentation and removal of the phytobezoar were unsuccessful and the patient had to undergo open surgery. Results Recovery was uneventful and free of complications. Conclusion Phytobezoars should be taken into account in the differential diagnosis of unexplained vomiting and weight loss. LEARNING POINTS Bezoars are concretions of indigestible materials located in the gastrointestinal tract.Gastric phytobezoars may cause unexplained vomiting and weight loss even in young people.The diagnosis of phytobezoars may be complex and endoscopy is helpful in most cases.
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Affiliation(s)
- Marco Vacante
- Department of Internal Medicine, University of Catania, Ospedale Cannizzaro, Catania, Italy
| | - Innocenza Alessandria
- Department of Internal Medicine, University of Catania, Ospedale Cannizzaro, Catania, Italy
| | - Emanuela Cataudella
- Department of Internal Medicine, University of Catania, Ospedale Cannizzaro, Catania, Italy
| | - Rosangela Fichera
- Department of Internal Medicine, University of Catania, Ospedale Cannizzaro, Catania, Italy
| | - Lorenzo Malatino
- Department of Internal Medicine, University of Catania, Ospedale Cannizzaro, Catania, Italy
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Malaguarnera M, Motta M, Vacante M, Malaguarnera G, Caraci F, Nunnari G, Gagliano C, Greco C, Chisari G, Drago F, Bertino G. Silybin-vitamin E-phospholipids complex reduces liver fibrosis in patients with chronic hepatitis C treated with pegylated interferon α and ribavirin. Am J Transl Res 2015; 7:2510-2518. [PMID: 26807195 PMCID: PMC4697727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 10/31/2015] [Indexed: 06/05/2023]
Abstract
Chronic hepatitis C is both a virologic and a fibrotic disease, with mortality resulting mainly from the complications of cirrhosis and HCC. The aim was to evaluate the impact on of supplementation with a new pharmaceutical complex of silybinvitamin E-phospholipids in patients with chronic hepatitis C treated with Pegylated-Interferon-α2b plus Ribavirin. In this prospective, randomized, placebo controlled, double blind clinical trial, 32 subjects with chronic hepatitis, received Pegylated-Interferon-α2b (1.5 mg/kg per week) plus Ribavirin and placebo, while 32 subjects received the same dosage of Pegylated-Interferon-α2b plus Ribavirin plus association of Silybin 47 mg + vitamin E 15 mg + phospholipids 97 mg in two pill for 12 months. Serum levels of the following markers of liver fibrosis were evaluated: transforming growth factor beta, hyaluronic acid, metalloproteinase 2, amino-terminal pro-peptide of type III procollagen, tissue inhibitor of matrix metalloproteinase type I. The comparison between group A and group B showed a significant difference in ALT (P<0.001), and viremia (P<0.05) after 12 months; in TGF beta levels after 12 months and at follow up (P<0.05); in MMP-2 after 6 months (P<0.05); in PIIINP after 6, 12 months and at follow up (P<0.05); in TIMP-1 after 6, 12 months and at follow up (P<0.001). In conclusion, the supplementation with silybin-vitamin E-phosholipids complex ameliorated the response to Peg-IFN plus RBV treatment and reduced serum levels of markers of liver fibrosis. The ameliorative effect of the complex maybe related to a direct effect on the activation of hepatic stellate cells, or mediated via antioxidants.
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Affiliation(s)
- Michele Malaguarnera
- Research Center, The Great Senescence, University of CataniaItaly
- Department of Biomedical and Biotechnological Sciences, University of CataniaItaly
| | - Massimo Motta
- Research Center, The Great Senescence, University of CataniaItaly
| | - Marco Vacante
- Research Center, The Great Senescence, University of CataniaItaly
| | - Giulia Malaguarnera
- Research Center, The Great Senescence, University of CataniaItaly
- Department of Biomedical and Biotechnological Sciences, University of CataniaItaly
| | - Filippo Caraci
- IRCCS Oasi Maria S.S. Institute for Research on Mental Retardation and Brain AgingTroina, Enna, Italy
- Department of Drug Sciences, University of CataniaItaly
| | - Giuseppe Nunnari
- Department of Experimental and Clinical Medicine, University of CataniaItaly
| | - Caterina Gagliano
- Research Center, The Great Senescence, University of CataniaItaly
- Neurovisual Science Technology (NEST) CataniaItaly
| | - Carmela Greco
- Research Center, The Great Senescence, University of CataniaItaly
| | - Giuseppe Chisari
- Department of Biomedical and Biotechnological Sciences, University of CataniaItaly
| | - Filippo Drago
- Department of Biomedical and Biotechnological Sciences, University of CataniaItaly
| | - Gaetano Bertino
- Department of Experimental and Clinical Medicine, University of CataniaItaly
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Malaguarnera G, Vacante M, Drago F, Bertino G, Motta M, Giordano M, Malaguarnera M. Endozepine-4 levels are increased in hepatic coma. World J Gastroenterol 2015; 21:9103-10. [PMID: 26290636 PMCID: PMC4533041 DOI: 10.3748/wjg.v21.i30.9103] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2014] [Revised: 03/11/2015] [Accepted: 05/07/2015] [Indexed: 02/06/2023] Open
Abstract
AIM To evaluate the serum levels of endozepine-4, their relation with ammonia serum levels, the grading of coma and the severity of cirrhosis, in patients with hepatic coma. METHODS In this study we included 20 subjects with Hepatic coma, 20 subjects with minimal hepatic encephalopathy (MHE) and 20 subjects control. All subjects underwent blood analysis, Child Pugh and Model for End - stage liver disease (MELD) assessment, endozepine-4 analysis. RESULTS Subjects with hepatic coma showed significant difference in endozepine-4 (P < 0.001) and NH3 levels (P < 0.001) compared both to MHE and controls patients. Between NH3 and endozepine-4 we observed a significant correlation (P = 0.009; Pearson correlation 0.570). There was a significant correlation between endozepine-4 and MELD (P = 0.017; Pearson correlation = 0.529). In our study blood ammonia concentration was noted to be raised in patients with hepatic coma, with the highest ammonia levels being found in those who were comatose. We also found a high correlation between endozepine-4 and ammonia (P < 0.001). In patients with grade IV hepatic coma, endozepine levels were significantly higher compared to other groups. CONCLUSION This study suggests that an increased level of endozepine in subjects with higher levels of MELD was observed. In conclusion, data concerning involvement of the GABA-ergic system in HE coma could be explained by stage-specific alterations.
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Smailagic N, Vacante M, Hyde C, Martin S, Ukoumunne O, Sachpekidis C. ¹⁸F-FDG PET for the early diagnosis of Alzheimer's disease dementia and other dementias in people with mild cognitive impairment (MCI). Cochrane Database Syst Rev 2015; 1:CD010632. [PMID: 25629415 PMCID: PMC7081123 DOI: 10.1002/14651858.cd010632.pub2] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND ¹⁸F-FDFG uptake by brain tissue as measured by positron emission tomography (PET) is a well-established method for assessment of brain function in people with dementia. Certain findings on brain PET scans can potentially predict the decline of mild cognitive Impairment (MCI) to Alzheimer's disease dementia or other dementias. OBJECTIVES To determine the diagnostic accuracy of the ¹⁸F-FDG PET index test for detecting people with MCI at baseline who would clinically convert to Alzheimer's disease dementia or other forms of dementia at follow-up. SEARCH METHODS We searched the Cochrane Register of Diagnostic Test Accuracy Studies, MEDLINE, EMBASE, Science Citation Index, PsycINFO, BIOSIS previews, LILACS, MEDION, (Meta-analyses van Diagnostisch Onderzoek), DARE (Database of Abstracts of Reviews of Effects), HTA (Health Technology Assessment Database), ARIF (Aggressive Research Intelligence Facility) and C-EBLM (International Federation of Clinical Chemistry and Laboratory Medicine Committee for Evidence-based Laboratory Medicine) databases to January 2013. We checked the reference lists of any relevant studies and systematic reviews for additional studies. SELECTION CRITERIA We included studies that evaluated the diagnostic accuracy of ¹⁸F-FDG PET to determine the conversion from MCI to Alzheimer's disease dementia or to other forms of dementia, i.e. any or all of vascular dementia, dementia with Lewy bodies, and fronto-temporal dementia. These studies necessarily employ delayed verification of conversion to dementia and are sometimes labelled as 'delayed verification cross-sectional studies'. DATA COLLECTION AND ANALYSIS Two blinded review authors independently extracted data, resolving disagreement by discussion, with the option to involve a third review author as arbiter if necessary. We extracted and summarised graphically the data for two-by-two tables. We conducted exploratory analyses by plotting estimates of sensitivity and specificity from each study on forest plots and in receiver operating characteristic (ROC) space. When studies had mixed thresholds, we derived estimates of sensitivity and likelihood ratios at fixed values (lower quartile, median and upper quartile) of specificity from the hierarchical summary ROC (HSROC) models. MAIN RESULTS We included 14 studies (421 participants) in the analysis. The sensitivities for conversion from MCI to Alzheimer's disease dementia were between 25% and 100% while the specificities were between 15% and 100%. From the summary ROC curve we fitted we estimated that the sensitivity was 76% (95% confidence interval (CI): 53.8 to 89.7) at the included study median specificity of 82%. This equates to a positive likelihood ratio of 4.03 (95% CI: 2.97 to 5.47), and a negative likelihood ratio of 0.34 (95% CI: 0.15 to 0.75). Three studies recruited participants from the same Alzheimer's Disease Neuroimaging Initiative (ADNI) cohort but only the largest ADNI study (Herholz 2011) is included in the meta-analysis. In order to demonstrate whether the choice of ADNI study or discriminating brain region (Chételat 2003) or reader assessment (Pardo 2010) make a difference to the pooled estimate, we performed five additional analyses. At the median specificity of 82%, the estimated sensitivity was between 74% and 76%. There was no impact on our findings. In addition to evaluating Alzheimer's disease dementia, five studies evaluated the accuracy of ¹⁸F-FDG PET for all types of dementia. The sensitivities were between 46% and 95% while the specificities were between 29% and 100%; however, we did not conduct a meta-analysis because of too few studies, and those studies which we had found recruited small numbers of participants. Our findings are based on studies with poor reporting, and the majority of included studies had an unclear risk of bias, mainly for the reference standard and participant selection domains. According to the assessment of Index test domain, more than 50% of studies were of poor methodological quality. AUTHORS' CONCLUSIONS It is difficult to determine to what extent the findings from the meta-analysis can be applied to clinical practice. Given the considerable variability of specificity values and lack of defined thresholds for determination of test positivity in the included studies, the current evidence does not support the routine use of ¹⁸F-FDG PET scans in clinical practice in people with MCI. The ¹⁸F-FDG PET scan is a high-cost investigation, and it is therefore important to clearly demonstrate its accuracy and to standardise the process of ¹⁸F-FDG PET diagnostic modality prior to its being widely used. Future studies with more uniform approaches to thresholds, analysis and study conduct may provide a more homogeneous estimate than the one available from the included studies we have identified.
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Affiliation(s)
- Nadja Smailagic
- University of CambridgeInstitute of Public HealthForvie SiteRobinson WayCambridgeUKCB2 0SR
| | - Marco Vacante
- University of Oxford, John Radcliffe HospitalNuffield Department of Medicine ‐ OPTIMAHeadly WayHeadingtonOxfordOxfordshireUKOX3 9DU
| | - Chris Hyde
- University of Exeter Medical School, University of ExeterInstitute of Health ResearchVeysey BuildingSalmon Pool LaneExeterUKEX2 4SG
| | - Steven Martin
- University of CambridgeInstitute of Public HealthForvie SiteRobinson WayCambridgeUKCB2 0SR
| | - Obioha Ukoumunne
- University of Exeter Medical School, University of ExeterNIHR CLAHRC South West Peninsula (PenCLAHRC)Veysey BuildingSalmon Pool LaneExeterDevonUKEX2 4SG
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Malaguarnera G, Bertino G, Vacante M, Malaguarnera M. Hepatocellular carcinoma markers in the omics era: the glycomic analysis. Hepatobiliary Surg Nutr 2015; 3:407-9. [PMID: 25568863 DOI: 10.3978/j.issn.2304-3881.2014.07.04] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 07/01/2014] [Indexed: 12/19/2022]
Abstract
Recently, Kamiyama et al. performed N-glycan profile in hepatocellular carcinoma (HCC) using the quantitative N-glycomics procedure by way of glycoblotting technology and using an automated glycan purification system. The study showed significant differences of N-glycans profile between healthy volunteers and liver cancer patients. The glycomic approach showed us the usefulness of new tools for identification and application of a new biomarkers for cancer diagnosis and treatment. These findings reveal a new field for future markers discovery.
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Affiliation(s)
- Giulia Malaguarnera
- 1 International PhD programme in Neuropharmacology, 2 Department of Medical and Pediatric Sciences, 3 Research Center "The Great Senescence", University of Catania, Catania, Italy
| | - Gaetano Bertino
- 1 International PhD programme in Neuropharmacology, 2 Department of Medical and Pediatric Sciences, 3 Research Center "The Great Senescence", University of Catania, Catania, Italy
| | - Marco Vacante
- 1 International PhD programme in Neuropharmacology, 2 Department of Medical and Pediatric Sciences, 3 Research Center "The Great Senescence", University of Catania, Catania, Italy
| | - Michele Malaguarnera
- 1 International PhD programme in Neuropharmacology, 2 Department of Medical and Pediatric Sciences, 3 Research Center "The Great Senescence", University of Catania, Catania, Italy
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Malaguarnera G, Pennisi M, Gagliano C, Vacante M, Malaguarnera M, Salomone S, Drago F, Bertino G, Caraci F, Nunnari G, Malaguarnera M. Acetyl-L-Carnitine Supplementation During HCV Therapy With Pegylated Interferon-α 2b Plus Ribavirin: Effect on Work Performance; A Randomized Clinical Trial. Hepat Mon 2014; 14:e11608. [PMID: 24910702 PMCID: PMC4030263 DOI: 10.5812/hepatmon.11608] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Revised: 08/02/2013] [Accepted: 09/25/2013] [Indexed: 02/07/2023]
Abstract
BACKGROUND The health status of employees with chronic hepatitis C has major implications for organizations and labour market. OBJECTIVES To assess the effects of Acetyl-L-Carnitine administration on work productivity, daily activity, and fatigue in subjects with chronic hepatitis C treated with Pegylated-Interferon-α2b and Ribavirin. PATIENTS AND METHODS In this prospective, randomized, placebo controlled, double blind clinical trial, 30 subjects (Group A) with chronic hepatitis, received Pegylated-Interferon-α2b (1.5 mg/kg per week) plus Ribavirin and placebo, while 32 subjects (Group B) received the same dosage of Pegylated-Interferon-α2b plus Ribavirin plus 2g Acetyl-L-Carnitine twice per day, for 12 months. Work productivity loss, impairment in daily activities, presenteeism, absenteeism, have been assessed using the Work Productivity and Activity Impairment questionnaire. We also evaluated severity of fatigue, mental fatigue and physical fatigue. RESULTS Significant difference were observed in physical fatigue, mental fatigue and severity of fatigue, aspartate aminotransferase, alanine aminotransferase, and viremia after 12 months treatment. In Group B we observed a significant decrease of presenteeism and daily activity impairment after 6 months, 12 months and at follow up. A significant increase of work productivity was observed after 12 months and at follow up. CONCLUSIONS Office workers with chronic hepatitis C, treated with Pegylated-Interferon-α2b plus Ribavirin, had work performance loss. In subjects treated with Acetyl-L-Carnitine supplementation we observed increased daily activity and reduced presenteeism and fatigue. Acetyl-L-Carnitinegroup had a smaller reduction of productivity comparing to placebo group.
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Affiliation(s)
- Giulia Malaguarnera
- Department of Clinical and Molecular Biomedicine, Section of Pharmacology and Biochemistry, University of Catania, Catania, Italy
| | - Manuela Pennisi
- Department of Neurosciences, University of Catania, Catania, Italy
| | - Caterina Gagliano
- The Great Senescence Research Center, University of Catania, Catania, Italy
| | - Marco Vacante
- The Great Senescence Research Center, University of Catania, Catania, Italy
| | - Michele Malaguarnera
- Department of Clinical and Molecular Biomedicine, Section of Pharmacology and Biochemistry, University of Catania, Catania, Italy
- The Great Senescence Research Center, University of Catania, Catania, Italy
- Corresponding Author: Michele Malaguarnera, The Great Senescence Research Center, University of Catania, Catania, Italy. Tel: +39-957262008, Fax: +39-957262011, E-mail:
| | - Salvatore Salomone
- Department of Clinical and Molecular Biomedicine, Section of Pharmacology and Biochemistry, University of Catania, Catania, Italy
| | - Filippo Drago
- Department of Clinical and Molecular Biomedicine, Section of Pharmacology and Biochemistry, University of Catania, Catania, Italy
| | - Gaetano Bertino
- Department of Internal Medicine and Systemic Diseases, University of Catania, Catania, Italy
| | - Filippo Caraci
- Department of Educational Sciences, University of Catania, Catania, Italy
- Institute for Research on Mental Retardation and Brain Aging, Troina, Italy
| | - Giuseppe Nunnari
- Department of Clinical and Molecular Biomedicine, Division of Infectious Diseases, University of Catania, Catania, Italy
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Malaguarnera G, Gagliano C, Giordano M, Salomone S, Vacante M, Bucolo C, Caraci F, Reibaldi M, Drago F, Avitabile T, Motta M. Homocysteine serum levels in diabetic patients with non proliferative, proliferative and without retinopathy. Biomed Res Int 2014; 2014:191497. [PMID: 24877066 PMCID: PMC4022262 DOI: 10.1155/2014/191497] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Accepted: 04/06/2014] [Indexed: 12/12/2022]
Abstract
Homocysteine has been associated with extracellular matrix changes. The diabetic retinopathy is a neurovascular complication of diabetes mellitus and it is the leading cause of vision loss among working adults worldwide. In this study, we evaluate the role of homocysteine in diabetic retinopathy analyzing the plasma levels of homocysteine in 63 diabetic type 2 patients with nonproliferative retinopathy (NPDR), 62 patients with proliferative diabetic retinopathy (PDR), 50 healthy subjects used as control group, and 75 randomly selected patients.
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Affiliation(s)
- Giulia Malaguarnera
- International Ph.D. programme in Neuropharmacology, University of Catania, 95123 Catania, Italy
| | - Caterina Gagliano
- Department of Ophthalmology, University of Catania, 95123 Catania, Italy
| | - Maria Giordano
- Research Center “The Great Senescence”, University of Catania, 95125 Catania, Italy
| | - Salvatore Salomone
- International Ph.D. programme in Neuropharmacology, University of Catania, 95123 Catania, Italy
- Section of Pharmacology and Biochemistry, Department of Clinical and Molecular Biomedicine, University of Catania, Viale Andrea Doria 6, 95125 Catania, Italy
| | - Marco Vacante
- Research Center “The Great Senescence”, University of Catania, 95125 Catania, Italy
| | - Claudio Bucolo
- International Ph.D. programme in Neuropharmacology, University of Catania, 95123 Catania, Italy
- Section of Pharmacology and Biochemistry, Department of Clinical and Molecular Biomedicine, University of Catania, Viale Andrea Doria 6, 95125 Catania, Italy
| | - Filippo Caraci
- International Ph.D. programme in Neuropharmacology, University of Catania, 95123 Catania, Italy
- IRCCS, Oasi Maria S.S.-Institute for Research on Mental Retardation and Brain Aging, 94018 Troina, Italy
- Department of Educational Sciences, University of Catania, Via Teatro Greco 84, 95124 Catania, Italy
| | - Michele Reibaldi
- Department of Ophthalmology, University of Catania, 95123 Catania, Italy
| | - Filippo Drago
- International Ph.D. programme in Neuropharmacology, University of Catania, 95123 Catania, Italy
- Section of Pharmacology and Biochemistry, Department of Clinical and Molecular Biomedicine, University of Catania, Viale Andrea Doria 6, 95125 Catania, Italy
| | - Teresio Avitabile
- Department of Ophthalmology, University of Catania, 95123 Catania, Italy
| | - Massimo Motta
- Research Center “The Great Senescence”, University of Catania, 95125 Catania, Italy
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