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Bharadwaj UU, Ben-Natan AR, Huang J, Pedoia V, Chou D, Majumdar S, Link TM, Chin CT. Evaluation of 2 Novel Ratio-Based Metrics for Lumbar Spinal Stenosis. AJNR Am J Neuroradiol 2022; 43:1530-1538. [PMID: 36109122 PMCID: PMC9575539 DOI: 10.3174/ajnr.a7638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 07/25/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND AND PURPOSE Quantitative metrics of the dural sac such as the cross-sectional area are commonly used to evaluate central canal stenosis. The aim of this study was to analyze 2 new metrics to measure spinal stenosis on the basis of the ratio between the dural sac and disc cross-sectional areas (DDRCA) and the dural sac and disc anterior-posterior diameters (DDRDIA) and compare them with established quantitative metrics of the dural sac. MATERIALS AND METHODS T2-weighted axial MR images (n = 260 patients) were retrospectively evaluated, graded for central canal stenosis as normal (no stenosis), mild, moderate, or severe from L1/L2 through L5/S1 with 1 grade per spinal level and annotated to measure the DDRCA and DDRDIA. Thresholds were obtained using a decision tree classifier on a subset of patients (n = 130) and evaluated on the remaining patients (n = 130) for accuracy and consistency across demographics, anatomic variation, and clinical outcomes. RESULTS DDRCA and DDRDIA had areas under the receiver operating characteristic curve of 98.6 (97.4-99.3) and 98.0 (96.7-98.9) compared with dural sac cross-sectional area at 96.5 (95.0-97.7) for binary classification. DDRDIA and DDRCA had κ scores of 0.75 (0.71-0.79) and 0.80 (0.75-0.83) compared with dural sac cross-sectional area at 0.62 (0.57-0.66) for multigrade classification. No significant differences (P > .1) in the area under the receiver operating characteristic curve were observed for the DDRDIA across variations in the body mass index. The DDRDIA also had the highest area under the receiver operating characteristic curve among symptomatic patients (visual analog scale ≥ 7) or patients who underwent surgery. CONCLUSIONS Ratio-based metrics (DDRDIA and DDRCA) are accurate and robust to anatomic and demographic variability compared with quantitative metrics of the dural sac and better correlated with symptomatology and surgical outcomes.
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Affiliation(s)
- U U Bharadwaj
- From the Departments of Radiology and Biomedical Imaging (U.U.B., V.P., S.M., T.M.L., C.T.C.)
| | - A R Ben-Natan
- Neurological Surgery (A.R.B.-N., J.H., D.C.), University of California San Francisco, San Francisco, California
| | - J Huang
- Neurological Surgery (A.R.B.-N., J.H., D.C.), University of California San Francisco, San Francisco, California
| | - V Pedoia
- From the Departments of Radiology and Biomedical Imaging (U.U.B., V.P., S.M., T.M.L., C.T.C.)
| | - D Chou
- Neurological Surgery (A.R.B.-N., J.H., D.C.), University of California San Francisco, San Francisco, California
| | - S Majumdar
- From the Departments of Radiology and Biomedical Imaging (U.U.B., V.P., S.M., T.M.L., C.T.C.)
| | - T M Link
- From the Departments of Radiology and Biomedical Imaging (U.U.B., V.P., S.M., T.M.L., C.T.C.)
| | - C T Chin
- From the Departments of Radiology and Biomedical Imaging (U.U.B., V.P., S.M., T.M.L., C.T.C.)
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Waseem S, Romann R, Davies BM, Rawal J, Hull P, Carrothers A, Chou D. Major trauma care at a regional trauma centre during the COVID-19 lockdown in England. Ann R Coll Surg Engl 2022; 104:594-599. [PMID: 34941462 PMCID: PMC9433184 DOI: 10.1308/rcsann.2021.0262] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2021] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The COVID-19 pandemic has changed the presentation of many medical and surgical conditions, including major trauma. We aimed to assess how lockdown changed the presentation, severity and management of major trauma patients at our level 1 trauma centre in England. METHODS Data were collected retrospectively from the Trauma Audit and Research Network's database between 23 March and 28 April 2020 and compared with the same period in 2019. Collected data included patient demographics, and the mechanism, severity and management of injuries. RESULTS We experienced a 56.4% reduction in major trauma admissions during the lockdown period when compared with 2019. In 2020, more patients arrived in haemodynamic shock (25.3% vs 12.2%, p=0.02); however, Glasgow Coma Scale and Injury Severity Score were unchanged. A higher proportion of incidents occurred at home (37.2% vs 53.5%, p=0.018), with no difference in trauma secondary to substance abuse or assault. During lockdown, patients had a significantly shorter hospital (17 vs 10 days, p=0.029) and critical care stay (2 vs 1 day, p=0.033). A higher proportion of major trauma patients were assessed by specialty trainees in the emergency department in 2020 (12.8% vs 53.1%, p=0.0001) with a lower proportion assessed by a consultant (69.8% vs 46.7%, p=0.001). CONCLUSIONS The COVID-19 pandemic and lockdown drastically changed human behaviour, as reflected in the change in presentation of major trauma. Changes in the management of these patients reflect adaptive measures to manage the pressures generated by the worldwide pandemic.
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Affiliation(s)
- S Waseem
- Cambridge University Hospitals NHS Foundation Trust, UK
| | - R Romann
- Cambridge University Hospitals NHS Foundation Trust, UK
| | | | - J Rawal
- Cambridge University Hospitals NHS Foundation Trust, UK
| | - P Hull
- Cambridge University Hospitals NHS Foundation Trust, UK
| | - A Carrothers
- Cambridge University Hospitals NHS Foundation Trust, UK
| | - D Chou
- Cambridge University Hospitals NHS Foundation Trust, UK
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3
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Harrison A, Ordas Bayon A, Chimutengwende-Gordon M, Fortune M, Chou D, Hull P, Carrothers A, Rawal J. 1319 Factors Associated with Mortality in Older Patients Sustaining Pelvic or Acetabular Fractures. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.1046] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
This study aimed to investigate potential factors, including delay to surgical stabilisation, affecting mortality in older patients sustaining pelvic or acetabular (PA) fractures.
Method
A retrospective review of the Trauma Audit and Research Network (TARN) database was performed to identify older patients (aged 65 and over) sustaining PA fractures treated surgically in a UK Major Trauma Centre (MTC) between 2015 and 2019. Chi-squared and Fisher tests were used to compare 1-year mortality rates following operative intervention between patients treated within 72-hours and after 72-hours. Kaplan-Meier curves were used to visualise survival probability; significant predictors of survival were found using Cox proportional hazard models.
Results
Of 564 older patients with PA fractures, 70 met the inclusion criteria. The mean age was 76.1 years. The overall 1-year mortality rate was 20%. When patients were grouped by time to surgery, there was no statistically significant difference in 1-year mortality. Patients whose surgery was delayed more than 72-hours were more likely to have longer hospital stays (p = 0.002) or to have suffered from polytrauma (p = 0.025). Age, Charlson Co-morbidities Index and pre-op mobility status were associated with statistically significant differences in overall mortality. Patient gender, mechanism of injury, polytrauma and head injury were not significant predictors of mortality.
Conclusions
Surgical intervention within 72-hours of injury did not result in decreased mortality in older patients with PA fractures. The 1–year mortality rate between older PA fractures and hip fractures was comparable. Consideration should be given to a combined multidisciplinary approach to managing these patients.
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Affiliation(s)
- A Harrison
- School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - A Ordas Bayon
- Department of Trauma and Orthopaedics, Addenbrookes Hospital, Cambridge, United Kingdom
| | | | - M Fortune
- School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - D Chou
- Department of Trauma and Orthopaedics, Addenbrookes Hospital, Cambridge, United Kingdom
| | - P Hull
- Department of Trauma and Orthopaedics, Addenbrookes Hospital, Cambridge, United Kingdom
| | - A Carrothers
- Department of Trauma and Orthopaedics, Addenbrookes Hospital, Cambridge, United Kingdom
| | - J Rawal
- Department of Trauma and Orthopaedics, Addenbrookes Hospital, Cambridge, United Kingdom
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4
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Lenihan J, Waseem S, Rawal J, Hull P, Carrothers A, Chou D. 1022 Equivalent Management for All Fragility Fractures Occurring in The Older Patient. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.1019] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Aim
Neck of femur fractures (NOFs) are painful and occur in a vulnerable group of our population. Complications occur if their pain is under treated. Optimal management in the United Kingdom is governed by Best Practice Tariff (BPT). This was extended in 2020 without supporting published evidence to include all femur fractures (ROFs).
We sought to compare PRPS for NOFs and ROFs throughout hospital admission.
Method
We performed a retrospective matched analysis of all isolated osteoporotic ROFs to NOFs at our centre between 2018-2019. We analysed electronic patient records for relevant data. Matching criteria included Age +/- 2 years; cognition; walking aids; ASA; and social residence. Primary outcome measure was patient-reported pain scores (PRPS) at set time points. Secondary outcome measures were peripheral nerve blocks (PNB); patient controlled analgesia (PCA); time to surgery; anaesthetic type; length of stay (LOS); weightbearing status and 30-day mortality. Data was statistically analysed.
Results
11 ROFs were matched to 104 NOFs. There was no statistical difference between the two groups for age, sex, nor cognition and no difference in time to surgery; anaesthetic type; LOS; nor 30-day mortality. ROFs were more painful at all time points although not statistically significant. ROFs were more likely to have traction; PCA both pre- and post-operatively and not to weight bear. NOFs were more likely to have a PNB.
Conclusions
ROFs are as painful if not more so than NOFs. Few ROFs receive PNB and require PCA. Better control of symptoms may improve outcomes. We support the extension of BPT.
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Affiliation(s)
- J Lenihan
- Addenbrooke's Hospital, Cambridge, United Kingdom
| | - S Waseem
- Addenbrooke's Hospital, Cambridge, United Kingdom
| | - J Rawal
- Addenbrooke's Hospital, Cambridge, United Kingdom
| | - P Hull
- Addenbrooke's Hospital, Cambridge, United Kingdom
| | - A Carrothers
- Addenbrooke's Hospital, Cambridge, United Kingdom
| | - D Chou
- Addenbrooke's Hospital, Cambridge, United Kingdom
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5
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Wong M, Ghobrial M, Han WM, Alsousou J, Chou D, Carrothers A, Hull P, Rawal J. 613 The Floating Hip: A Distinct Injury Pattern? A Descriptive Study and Case-Control Analysis. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.999] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Aim
A “Floating Hip” injury describes a simultaneous ipsilateral fracture of the femur and pelvis. We performed a descriptive study of the injury patterns, management, and outcomes of floating hip patients, and compared these patients to those with similar pelvic fractures without femoral involvement.
Method
This was a retrospective case-series review with secondary case-control analysis. Medical records of patients presenting with a floating hip injury to our tertiary orthopaedics department between 2015 and 2020 were reviewed. The control group comprised of patients with pelvic fractures but without associated femoral fractures, matched by age, sex, pelvic fracture classification, and mechanism of injury.
Results
46 Floating Hip cases were identified (34 males), of average age 39 (15-86) years. 20 had acetabular fractures, 21 had pelvic ring fractures and 5 had both fractures, concomitant with ipsilateral femoral fractures. The most common site of femoral fracture was mid-shaft (21.7%), followed by distal (19.6%). 69.6% of P/A fractures were managed surgically, with ORIF (43%) the most common option. 4 (12.50%) patients suffered complications, including 2 infections and 1 DVT. Compared to controls, Floating Hip patients were more likely to require surgical management (67.6% vs 47.8%, p = 0.03), and had higher rates of surgical complications (12.5% vs 4.6%), though not statistically significant (p = 0.3).
Conclusions
Our study describes the patterns, management, and outcomes of Floating Hip injuries, and observes differences in the management and complications compared to similar pelvic fractures without femoral involvement. These findings suggest Floating Hip cases may warrant consideration as a distinct injury pattern.
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Affiliation(s)
- M Wong
- School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
- Department of Trauma and Orthopaedic Surgery, Addenbrooke’s Hospital, Cambridge, United Kingdom
| | - M Ghobrial
- Department of Trauma and Orthopaedic Surgery, Addenbrooke’s Hospital, Cambridge, United Kingdom
| | - W M Han
- Department of Trauma and Orthopaedic Surgery, Addenbrooke’s Hospital, Cambridge, United Kingdom
| | - J Alsousou
- Department of Trauma and Orthopaedic Surgery, Addenbrooke’s Hospital, Cambridge, United Kingdom
| | - D Chou
- Department of Trauma and Orthopaedic Surgery, Addenbrooke’s Hospital, Cambridge, United Kingdom
| | - A Carrothers
- Department of Trauma and Orthopaedic Surgery, Addenbrooke’s Hospital, Cambridge, United Kingdom
| | - P Hull
- Department of Trauma and Orthopaedic Surgery, Addenbrooke’s Hospital, Cambridge, United Kingdom
| | - J Rawal
- Department of Trauma and Orthopaedic Surgery, Addenbrooke’s Hospital, Cambridge, United Kingdom
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6
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Hussain A, Ghobrial M, Davies B, Hull P, Carrothers A, Rawal J, Chou D. 1085 Equestrian Related Pelvic and Acetabular Fractures – Experience from a Major Trauma Centre in England. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.1025] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
Equestrianism is enjoyed by three million people in the UK; however, there is a lack of literature on pelvic and acetabular (P&A) injuries incurred through the sport. We aim to describe P&A injuries sustained in equestrian accidents, discuss management, and establish their outcomes.
Method
Data was extracted from a prospectively collected database of referrals to the P&A Service of a Major Trauma Centre (MTC) from 01/01/2016 to 31/12/2020 and cross-referenced with medical records.
Results
60 of the 1,218 P&A referrals were secondary to horse-riding accidents. Mean age 45 (SD 16.59); 46 female; 33 managed non-operatively and 27 managed operatively at the MTC. There was sufficient information for 59 cases to be classified; 46 of the injuries were pelvic fractures (10 anterior-posterior compression; 29 lateral compression; 4 sacral and 3 pubic rami fractures) and 13 were acetabular (2 anterior column; 1 anterior wall; 2 associated both columns; 1 posterior column and posterior wall; 1 posterior wall; 2 T-shaped and 4 transverse fractures). The operative group were managed by examination under anaesthesia (n = 3), open reduction internal fixation (n = 22) or percutaneous fixation (n = 2). Mean hospitalisation was 9.2 days (SD 5.44). 81% were non-weight-bearing post-operatively and mean time to independent mobilisation was 12.6 weeks (SD 7.09). Return-to-riding information was available for 8 patients with a mean of 29.5 weeks (SD 11.55).
Conclusions
Equestrianism can result in significant P&A injuries. Patients should be counselled that they may have a long recovery, a protracted return-to-riding time and some may never return to the sport.
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Affiliation(s)
- A Hussain
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - M Ghobrial
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - B Davies
- Division of Trauma and Orthopaedics, University of Cambridge, Cambridge, United Kingdom
| | - P Hull
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - A Carrothers
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - J Rawal
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - D Chou
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
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7
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Waseem S, Lenihan J, Davies B, Rawal J, Hull P, Carrothers A, Chou D. 1514 Higher Mortality in Pelvic Acetabular Fractures Is Associated with Lower Body Mass Index. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.1059] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Aim
Fractures of the pelvis and acetabulum can be life-threatening or life changing injuries. Multiple factors can contribute to outcome including age, frailty, and baseline nutritional status. The aim of this study was to identify if low BMI (<18.5) was a predictor of outcome for patients with such injuries in terms of morbidity and mortality.
Method
We retrospectively analysed 1033 patients with pelvic or acetabular fractures referred to a single level 1 major trauma centre over a 4.5-year period (August 2015 - January 2020). Of these patients, 569 were admitted to the centre and included in our analysis. Data was collected on demographics, injury pattern, operative intervention, and complications. Comparison was made between patients that were underweight (BMI<18.5) and patients that were not, for in-hospital and post discharge complications including pulmonary embolus (PE), deep venous thrombosis (DVT), ileus, infection, loss of reduction and mortality at 6 months.
Results
Underweight patients had a statistically significant increase in mortality both in-hospital (p = 0.019) and at 6 months post injury (p = 0.039) when compared to other BMI groups. No statistical significance was found between these BMI groups comparing morbidity: DVT (p = 0.712), PE (p = 0.736) nor ileus (p = 0.149). Covariate analysis showed that a low BMI was associated with 3 times increased in-hospital mortality after correction for age and energy of injury (adjusted OR 3.028, 95% CI 1.059-8.659).
Conclusions
This study suggests increased mortality in patients with pelvic or acetabular fractures who are underweight. Surgeons should consider these findings in initiating appropriate peri-operative optimisation for these patients.
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Affiliation(s)
- S Waseem
- Cambridge Orthopaedic Pelvic Unit (COPU), Addenbrookes Major Trauma Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - J Lenihan
- Cambridge Orthopaedic Pelvic Unit (COPU), Addenbrookes Major Trauma Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - B Davies
- Division of Trauma and Orthopaedics, University of Cambridge, Cambridge, United Kingdom
| | - J Rawal
- Cambridge Orthopaedic Pelvic Unit (COPU), Addenbrookes Major Trauma Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - P Hull
- Cambridge Orthopaedic Pelvic Unit (COPU), Addenbrookes Major Trauma Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - A Carrothers
- Cambridge Orthopaedic Pelvic Unit (COPU), Addenbrookes Major Trauma Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - D Chou
- Cambridge Orthopaedic Pelvic Unit (COPU), Addenbrookes Major Trauma Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
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8
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Arshad Z, majeed M, Thahir A, Anwar F, Rawal J, Hull P, Carrothers A, Chou D. 1213 Cycling-related Trauma Admissions to the Major Trauma Centre in the Cycling Capital of the United Kingdom. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.1031] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Aim
The number of cyclists travelling on roads in the United Kingdom (UK) is increasing. The government has recently introduced initiatives to promote cycling uptake and so these numbers are likely to increase. This study aims to characterise cycling related injuries presenting to a major trauma centre located within a region with the highest rates of cycling in the UK.
Method
A retrospective review of cycling related trauma admissions occurring between January 2012 and June 2020 was performed. All patients were split into three groups based on the mechanism of injury. Our institution’s electronic patient record system was used to collect data including age, gender, mechanism of injury, Glasgow coma scale score on arrival, incident date and time, injured body regions, 30-day mortality, helmet use, and length of stay.
Results
A total of 606 cycling related trauma cases were identified, with 52 being excluded due to incomplete data. The ‘cyclist v vehicle’ group was associated with a significantly higher Injury Severity score (ISS), lower GCS and longer hospital stay than the other two groups. Helmet wearers were significantly older than non-wearers and helmet use was associated with a significantly reduced risk of head injury, lower ISS and higher GCS.
Conclusions
With a likely increase in future cycling uptake, it is crucial that effective interventions are put in place to improve the safety of cyclists. A multi-faceted strategy involving driver and cyclist education, road infrastructure changes and helmet promotion campaigns targeting the younger generation could be employed.
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Affiliation(s)
- Z Arshad
- University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - M majeed
- University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - A Thahir
- Cambridge Orthopaedic Trauma Unit Addenbrooke’s Hospital Major Trauma Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - F Anwar
- Department of neurosciences, Addenbrooke's Hospital, Cambridge university NHS Foundation Trust, Cambridge, United Kingdom
| | - J Rawal
- Cambridge Orthopaedic Trauma Unit Addenbrooke’s Hospital Major Trauma Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - P Hull
- Cambridge Orthopaedic Trauma Unit Addenbrooke’s Hospital Major Trauma Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - A Carrothers
- Cambridge Orthopaedic Trauma Unit Addenbrooke’s Hospital Major Trauma Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - D Chou
- Cambridge Orthopaedic Trauma Unit Addenbrooke’s Hospital Major Trauma Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
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9
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Waseem S, Romann R, Lenihan J, Rawal J, Carrothers A, Hull P, Chou D. 1550 Experience from A Level-1 Major Trauma Centre in England of Trauma Epidemiology After Easing of Lockdown Restrictions. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.1062] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Aim
The COVID-19 pandemic transformed trauma care. We examined the effect of lockdown easing on trauma presentation and management.
Method
Data was retrospectively analysed from Trauma Audit and Research Network (TARN) on patients presenting to one Major Trauma Centre in the East of England with trauma. The first 47 days of lockdown (23rd March-9th May 2020, period 1) were compared with the next (10th May- 26th June 2020, period 2) and last 47 (27th June- 13th August 2020, period 3). Data collected included demographics, mechanism and severity of injury, management, and length of stay.
Results
1,249 patients were included; 62.2% were male with a mean age of 57.73. Footfall declined in April 2020 compared with 2019 (56 vs 143) but rebounded by May (123 v 120 patients). Road traffic collisions increased over periods 1-3 (18.8% v 23% v 30.1%, p = 0.038); deliberate self-harm (DSH) increased in period 2 compared with 1 and 3 (6.3% v 3.4% v 1.4%, p = 0.03) respectively. The 2020 patient age was younger than 2019, with less trauma relating to alcohol (7.3% v 13.2%, p = 0.009). Compared with 2019 reductions in total length of stay (14.1 v 17.4 days, p = <0.001), critical care length of stay (2.3 v 2.9 days, p = 0.04) and consultant driven care (54.9% v 64.9%, p < 0.001) were noted in lockdown.
Conclusions
Our study suggests that after lockdown easing, trauma footfall rapidly rebounded to 2019 levels. This should be acknowledged in resource allocation decisions if future lockdowns are necessitated.
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Affiliation(s)
- S Waseem
- Cambridge Orthopaedic Trauma Unit (COTU) Addenbrookes Major Trauma Centre Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - R Romann
- Cambridge Orthopaedic Trauma Unit (COTU) Addenbrookes Major Trauma Centre Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - J Lenihan
- Cambridge Orthopaedic Trauma Unit (COTU) Addenbrookes Major Trauma Centre Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - J Rawal
- Cambridge Orthopaedic Trauma Unit (COTU) Addenbrookes Major Trauma Centre Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - A Carrothers
- Cambridge Orthopaedic Trauma Unit (COTU) Addenbrookes Major Trauma Centre Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - P Hull
- Cambridge Orthopaedic Trauma Unit (COTU) Addenbrookes Major Trauma Centre Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - D Chou
- Cambridge Orthopaedic Trauma Unit (COTU) Addenbrookes Major Trauma Centre Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
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Lenihan J, Waseem S, Rawal J, Hull P, Carrothers A, Chou D. 1036 Operative Versus Non-Operative Management of Osteoporotic Femoral Fractures. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.1020] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Background
he incidence of diaphyseal and distal osteoporotic femoral fractures (OFFs) is increasing. This cohort of patients is often frail with multiple medical co-morbidities. No published data exists neither reporting severity of pain associated with these fractures nor pain in managing their fractures. There are no comparative studies investigating outcomes between conservative (CM) and surgical management (SM). We investigated pain and outcomes between CM and SM OFFs.
Method
We retrospectively analysed all OFFs admitted to our unit between 2018-2019. We analysed electronic patient records including patient-reported pain scores (PRPS). PRPS were calculated for set time periods: admission; 0-24hours CM versus day 1 post-operative; day 2-3; day 4-5. Primary outcome measure was PRPS. Secondary outcome measures included use of traction; PCA use; weightbearing status; length of stay (LOS); 30 day and 1 year mortality. Data was statistically analysed using SPSS software.
Results
22 patients were recruited (11CM, 11SM). There was no statistical difference between groups in terms of age; sex; cognition; Charlson Index; nor pre-morbid mobility status. There was no statistical difference for pain at admission nor PCA use. SM were less painful in the first 24-hour period postoperatively and in the first 3-day postoperative period compared to the same time period in CM. There was no difference in PRPS for the 72–120-hour period. There was no statistical difference between LOS; NWB status; 30 day nor 1 year mortality.
Conclusions
Operating on OFFs reduces pain in the perioperative period without increasing mortality or LOS in this frail population.
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Affiliation(s)
- J Lenihan
- Addenbrooke's Hospital, Cambridge, United Kingdom
| | - S Waseem
- Addenbrooke's Hospital, Cambridge, United Kingdom
| | - J Rawal
- Addenbrooke's Hospital, Cambridge, United Kingdom
| | - P Hull
- Addenbrooke's Hospital, Cambridge, United Kingdom
| | - A Carrothers
- Addenbrooke's Hospital, Cambridge, United Kingdom
| | - D Chou
- Addenbrooke's Hospital, Cambridge, United Kingdom
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Arshad Z, Thahir A, Rawal J, Hull P, Carrothers A, Krkovic M, Chou D. 657 Comparison of the Intramedullary Nail and Dynamic Hip Screw in the Treatment of Subtrochanteric Femoral Fractures. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.567] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Introduction
A subtrochanteric femoral fracture occurs in the 5cm of bone distal to the lesser trochanter. This study aims to compare peri-operative outcomes of patients with such fractures treated with either an IMN or a dynamic hip screw (DHS).
Method
We retrospectively reviewed subtrochanteric fractures presenting to our institution between October 2014 -May 2019, classifying them into two treatment groups: IMN and DHS. These groups
were compared using outcomes including surgical time, blood loss, radiation dose area product (DAP), stay length, re-operation rate and mortality.
Results
During the study period, 86 patients presented with a subtrochanteric fracture, 74 (86%) receiving an IMN and 12 (14%) receiving a DHS. The DHS group showed a significantly lower blood loss (776.19 ml) and DAP (150.30 mGy.cm2) compared to the IMN group (1028.74 ml and 288.86 mGy.cm2 respectively). All other outcome measures failed to reach statistical significance.
Conclusions
Although National Institute for Health and Care Excellence guidelines recommend treating all subtrochanteric fractures with an IMN; the outcomes assessed did not show use of an IMN to be superior. This, along with the reduced financial cost associated with a DHS; may support the use of DHS over IMN for certain subtrochanteric fractures.
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Affiliation(s)
- Z Arshad
- University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - A Thahir
- Addenbrooke's Hospital Department of Trauma & Orthopaedic Surgery, Cambridge, United Kingdom
| | - J Rawal
- Addenbrooke's Hospital Department of Trauma & Orthopaedic Surgery, Cambridge, United Kingdom
| | - P Hull
- Addenbrooke's Hospital Department of Trauma & Orthopaedic Surgery, Cambridge, United Kingdom
| | - A Carrothers
- Addenbrooke's Hospital Department of Trauma & Orthopaedic Surgery, Cambridge, United Kingdom
| | - M Krkovic
- Addenbrooke's Hospital Department of Trauma & Orthopaedic Surgery, Cambridge, United Kingdom
| | - D Chou
- Addenbrooke's Hospital Department of Trauma & Orthopaedic Surgery, Cambridge, United Kingdom
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Waseem S, Nayar S, Hull P, Carrothers A, Rawal J, Chou D, Khanduja V. The global burden of trauma during the COVID-19 pandemic: A scoping review. J Clin Orthop Trauma 2021; 12:200-207. [PMID: 33223749 PMCID: PMC7666557 DOI: 10.1016/j.jcot.2020.11.005] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [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: 10/23/2020] [Revised: 11/08/2020] [Accepted: 11/09/2020] [Indexed: 01/08/2023] Open
Abstract
Purpose; The COVID-19 pandemic has necessitated profound adaptations in the delivery of healthcare to manage a rise in critically unwell patients. In an attempt to slow the spread of the virus nationwide lockdown restrictions were introduced. This review aims to scope the literature on the impact of the pandemic and subsequent lockdown on the presentation and management of trauma globally. Methods; A scoping review was conducted in accordance with PRISMA-ScR guidelines. A systematic search was carried out on the Medline, EMBASE and Cochrane databases to identify papers investigating presentation and management of trauma during the COVID-19 pandemic. All studies based on patients admitted with orthopaedic trauma during the COVID-19 pandemic were included. Exclusion criteria were opinion-based reports, reviews, studies that did not provide quantitative data and papers not in English. Results; 665 studies were screened, with 57 meeting the eligibility criteria. Studies reported on the footfall of trauma in the UK, Europe, Asia, USA, Australia and New Zealand. A total of 29,591 patients during the pandemic were considered. Mean age was 43.7 years (range <1-103); 54.8% were male. Reported reductions in trauma footfall ranged from 20.3% to 84.6%, with a higher proportion of trauma occurring secondary to interpersonal violence, deliberate self-harm and falls from a height. A decrease was seen in road traffic collisions, sports injuries and trauma occurring outdoors. There was no significant change in the proportion of patients managed operatively, and the number of trauma patients reported to be COVID-19 positive was low. Conclusion; Whilst the worldwide COVID-19 pandemic has caused a reduction in the number of trauma patients; the services managing trauma have continued to function despite infrastructural, personnel and pathway changes in health systems. The substantial effect of the COVID-19 pandemic on elective orthopaedics is well described, however the contents of this review evidence minimal change in the delivery of effective trauma care despite resource constraints during this global COVID-19 pandemic.
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Affiliation(s)
- S. Waseem
- Major Trauma Centre, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB20QQ, United Kingdom
| | - S.K. Nayar
- Department of Trauma and Orthopaedics, Whittington Hospital, Madgala Avenue, London, N195NF, United Kingdom
| | - P. Hull
- Major Trauma Centre, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB20QQ, United Kingdom
| | - A. Carrothers
- Major Trauma Centre, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB20QQ, United Kingdom
| | - J. Rawal
- Major Trauma Centre, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB20QQ, United Kingdom
| | - D. Chou
- Major Trauma Centre, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB20QQ, United Kingdom
| | - V. Khanduja
- Major Trauma Centre, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB20QQ, United Kingdom,Corresponding author. Institutional address: Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB20QQ, United Kingdom
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Vardakis JC, Bonfanti M, Franzetti G, Guo L, Lassila T, Mitolo M, Hoz de Vila M, Greenwood JP, Maritati G, Chou D, Taylor ZA, Venneri A, Homer-Vanniasinkam S, Balabani S, Frangi AF, Ventikos Y, Diaz-Zuccarini V. Highly integrated workflows for exploring cardiovascular conditions: Exemplars of precision medicine in Alzheimer's disease and aortic dissection. Morphologie 2019; 103:148-160. [PMID: 31786098 DOI: 10.1016/j.morpho.2019.10.045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 10/12/2019] [Accepted: 10/16/2019] [Indexed: 12/31/2022]
Abstract
For precision medicine to be implemented through the lens of in silico technology, it is imperative that biophysical research workflows offer insight into treatments that are specific to a particular illness and to a particular subject. The boundaries of precision medicine can be extended using multiscale, biophysics-centred workflows that consider the fundamental underpinnings of the constituents of cells and tissues and their dynamic environments. Utilising numerical techniques that can capture the broad spectrum of biological flows within complex, deformable and permeable organs and tissues is of paramount importance when considering the core prerequisites of any state-of-the-art precision medicine pipeline. In this work, a succinct breakdown of two precision medicine pipelines developed within two Virtual Physiological Human (VPH) projects are given. The first workflow is targeted on the trajectory of Alzheimer's Disease, and caters for novel hypothesis testing through a multicompartmental poroelastic model which is integrated with a high throughput imaging workflow and subject-specific blood flow variability model. The second workflow gives rise to the patient specific exploration of Aortic Dissections via a multi-scale and compliant model, harnessing imaging, computational fluid-dynamics (CFD) and dynamic boundary conditions. Results relating to the first workflow include some core outputs of the multiporoelastic modelling framework, and the representation of peri-arterial swelling and peri-venous drainage solution fields. The latter solution fields were statistically analysed for a cohort of thirty-five subjects (stratified with respect to disease status, gender and activity level). The second workflow allowed for a better understanding of complex aortic dissection cases utilising both a rigid-wall model informed by minimal and clinically common datasets as well as a moving-wall model informed by rich datasets.
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Affiliation(s)
- J C Vardakis
- Centre for Computational Imaging & Simulation Technologies in Biomedicine (CISTIB), School of Computing, University of Leeds, UK.
| | - M Bonfanti
- Department of Mechanical Engineering, University College London, Torrington Place, London, WC1E 7JE, UK; Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), Department of Medical Physics and Biomedical Engineering, University College London, UK
| | - G Franzetti
- Department of Mechanical Engineering, University College London, Torrington Place, London, WC1E 7JE, UK
| | - L Guo
- Department of Mechanical Engineering, University College London, Torrington Place, London, WC1E 7JE, UK
| | - T Lassila
- Centre for Computational Imaging & Simulation Technologies in Biomedicine (CISTIB), School of Computing, University of Leeds, UK
| | - M Mitolo
- Functional MR Unit, Policlinico S. Orsola e Malpighi, Department of Biomedical and NeuroMotor Sciences (DiBiNeM), Bologna, Italy
| | - M Hoz de Vila
- Centre for Computational Imaging & Simulation Technologies in Biomedicine (CISTIB), School of Computing, University of Leeds, UK
| | - J P Greenwood
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, UK; Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - G Maritati
- Ospedale A. Perrino, Brindisi, Italy; Azienda Ospedaliera San Camillo-Forlanini, Rome, Italy
| | - D Chou
- Department of Mechanical Engineering, National Central University, Taoyuan County, Taiwan
| | - Z A Taylor
- Centre for Computational Imaging & Simulation Technologies in Biomedicine (CISTIB), School of Mechanical Engineering, University of Leeds, UK
| | - A Venneri
- Department of Neuroscience, Medical School, University of Sheffield, UK
| | - S Homer-Vanniasinkam
- Department of Mechanical Engineering, University College London, Torrington Place, London, WC1E 7JE, UK; Leeds Teaching Hospitals NHS Trust, Leeds, UK; University of Warwick Medical School & University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - S Balabani
- Department of Mechanical Engineering, University College London, Torrington Place, London, WC1E 7JE, UK
| | - A F Frangi
- Centre for Computational Imaging & Simulation Technologies in Biomedicine (CISTIB), School of Computing, University of Leeds, UK
| | - Y Ventikos
- Department of Mechanical Engineering, University College London, Torrington Place, London, WC1E 7JE, UK
| | - V Diaz-Zuccarini
- Department of Mechanical Engineering, University College London, Torrington Place, London, WC1E 7JE, UK; Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), Department of Medical Physics and Biomedical Engineering, University College London, UK.
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14
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Saar T, Conrad D, Pacquee S, Cario G, Rosen D, Chou D. Unexpected Parasitic Fibroid Necessitates Mandatory Contained Morcellation. J Minim Invasive Gynecol 2018. [DOI: 10.1016/j.jmig.2018.09.596] [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: 10/28/2022]
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15
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Conrad D, Saar T, Choi S, Rosen D, Cario G, Chou D. Contained Laparoscopic Power Morcellation for Large Pelvic Masses. J Minim Invasive Gynecol 2018. [DOI: 10.1016/j.jmig.2018.09.262] [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: 10/28/2022]
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16
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Conrad D, Pacquee S, Saar T, Choi S, Chou D, Cario G, Rosen D. Retropubic Tension Free Vaginal Tape Inserted Under Laparoscopic Vision. J Minim Invasive Gynecol 2018. [DOI: 10.1016/j.jmig.2018.09.691] [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: 10/28/2022]
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17
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Moran AC, Moller AB, Chou D, Morgan A, El Arifeen S, Hanson C, Say L, Diaz T, Askew I, Costello A. 'What gets measured gets managed': revisiting the indicators for maternal and newborn health programmes. Reprod Health 2018; 15:19. [PMID: 29394947 PMCID: PMC5797384 DOI: 10.1186/s12978-018-0465-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 12/14/2017] [Accepted: 01/23/2018] [Indexed: 11/21/2022] Open
Abstract
Background The health of women and children are critical for global development. The Sustainable Development Goals (SDG) agenda and the Global Strategy for Women’s, Children’s, and Adolescent’s Health 2016–2030 aim to reduce maternal and newborn deaths, disability, and enhancement of well-being. However, information and data on measuring countries’ progress are limited given the variety of methodological challenges of measuring care around the time of birth, when most maternal and neonatal deaths and morbidities occur. Main body In 2015, the World Health Organization launched Mother and Newborn Information for Tracking Outcomes and Results (MoNITOR), a technical advisory group to WHO. MoNITOR comprises 14 independent global experts from a variety of disciplines selected in a competitive process for their technical expertise and regional representation. MoNITOR will provide technical guidance to WHO to ensure harmonized guidance, messages, and tools so that countries can collect useful data to track progress toward achieving the Sustainable Development Goals. Short conclusion Ultimately, MoNITOR will provide technical guidance to WHO to ensure harmonized guidance, messages, and tools so that countries can collect useful data to track progress toward achieving the Sustainable Development Goals.
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Affiliation(s)
- A C Moran
- World Health Organization, Geneva, Switzerland.
| | - A B Moller
- World Health Organization, Geneva, Switzerland
| | - D Chou
- World Health Organization, Geneva, Switzerland
| | - A Morgan
- University of Melbourne, Melbourne, Australia
| | | | - C Hanson
- Karolinska Institutet, Stockholm, Sweden
| | - L Say
- World Health Organization, Geneva, Switzerland
| | - T Diaz
- World Health Organization, Geneva, Switzerland
| | - I Askew
- World Health Organization, Geneva, Switzerland
| | - A Costello
- World Health Organization, Geneva, Switzerland
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18
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Gerges B, Lu C, Reid S, Chou D, Chang T, Condous G. Sonographic evaluation of immobility of normal and endometriotic ovary in detection of deep endometriosis. Ultrasound Obstet Gynecol 2017; 49:793-798. [PMID: 27281370 DOI: 10.1002/uog.15990] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 05/23/2016] [Accepted: 06/05/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES To examine the association between ovarian immobility and presence of endometriomas and assess the diagnostic accuracy of transvaginal sonographic (TVS) ovarian immobility in the detection of deep infiltrating endometriosis (DIE). METHODS This was a multicenter prospective observational study of women presenting with chronic pelvic pain from January 2009 to March 2015. Women with or without history of endometriosis who were scheduled to undergo laparoscopic surgery for endometriosis gave a detailed history and underwent specialized TVS in a tertiary referral unit prior to laparoscopy. During TVS, ovarian mobility and the presence of endometriomas were assessed. The relationship between TVS ovarian mobility, with or without endometriomas, and DIE was correlated with the gold standard, diagnosis of endometriosis at laparoscopy. RESULTS Included in the analysis were 265 women with preoperative TVS and laparoscopic outcomes. Ovarian immobility on TVS was significantly associated with presence of endometriomas at surgery, with a prevalence of 12.2%, 10.8% and 52.7% for fixation of the left ovary only, the right ovary only and bilateral ovaries, respectively, compared with 4.2%, 3.7% and 7.3% for normal ovaries. The sensitivity, specificity, positive (PPV) and negative (NPV) predictive values and positive and negative likelihood ratios of TVS ovarian immobility for diagnosis at surgery of immobility of ovaries with endometriomas in the left ovary only were 44.4%, 92.3%, 44.4%, 92.3%, 5.8, 0.6, in the right ovary only were 50.0%, 98.5%, 80.0%, 94.2%, 33.0, 0.5 and bilaterally were 74.4%, 68.6%, 72.5%, 70.6%, 2.4, 0.4, while those for diagnosis of immobility of normal ovaries were 25.0%, 87.9%, 8.3%, 96.4%, 2.1, 0.9 for left ovary only, 14.3%, 92.9%, 7.1%, 96.6%, 2.0, 0.9 for right ovary only and 35.7%, 97.2%, 50.0%, 95.0%, 12.6, 0.7 bilaterally, respectively (P < 0.05 except for normal left and right ovaries with P = 0.2 and 0.4, respectively). The sensitivity, specificity, PPV and NPV for performance of ovarian immobility in the prediction of DIE for all women were 58.3%, 74.1%, 60.6%, 72.2% and in the prediction of need for bowel surgery were 78.2%, 71.1%, 41.3%, 92.6%, respectively. CONCLUSIONS There is a significant association between ovarian immobility and the presence of endometriomas. Ovarian immobility as a sonographic 'soft marker' of DIE performs better in the presence of endometriomas compared with in normal ovaries. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- B Gerges
- Acute Gynaecology, Early Pregnancy and Advanced Endosurgery Unit, Sydney Medical School Nepean, University of Sydney, Nepean Hospital, Penrith, NSW, Australia
| | - C Lu
- Department of Computer Sciences, University of Wales, Aberystwyth, UK
| | - S Reid
- Acute Gynaecology, Early Pregnancy and Advanced Endosurgery Unit, Sydney Medical School Nepean, University of Sydney, Nepean Hospital, Penrith, NSW, Australia
| | - D Chou
- Sydney Women's Endosurgery Centre (SWEC), Hurstville, NSW, Australia
| | - T Chang
- Nureva Women's Specialist Health, Campbelltown, NSW, Australia
- Laparoscopic Surgery for General Gynaecologist (LaSGeG), Sydney, NSW, Australia
| | - G Condous
- Acute Gynaecology, Early Pregnancy and Advanced Endosurgery Unit, Sydney Medical School Nepean, University of Sydney, Nepean Hospital, Penrith, NSW, Australia
- Laparoscopic Surgery for General Gynaecologist (LaSGeG), Sydney, NSW, Australia
- OMNI Gynaecological Care Centre for Women's Ultrasound and Early Pregnancy, St Leonards, NSW, Australia
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19
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Huntley C, Chou D, Doghramji K, Boon M. Preoperative Drug Induced Sleep Endoscopy Improves the Surgical Approach to Treatment of Obstructive Sleep Apnea. Ann Otol Rhinol Laryngol 2017; 126:478-482. [DOI: 10.1177/0003489417703408] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: Drug induced sleep endoscopy (DISE) allows for preoperative evaluation of the specific site and character of upper airway obstruction in obstructive sleep apnea (OSA). We aim to assess the impact DISE has on customizing the surgical plan and evaluate its role in surgical success. Methods: We retrospectively reviewed patients undergoing surgery for OSA. We compared those patients undergoing preoperative DISE to those that did not to assess procedures performed and surgical outcomes. Results: We found 87 patients undergoing surgery for OSA who had postoperative polysomnogram results. Of the group undergoing preoperative DISE, 8% had multilevel surgery. This compared to 59.5% in those not undergoing DISE ( p = .0004). The success rate of patients who had preoperative DISE was 86% compared to 51.4% in those who did not have preoperative DISE ( p < .001). We found no difference in age, gender, preoperative apnea-hypopnea index (AHI), oxygen nadir, Epworth sleepiness scale score (ESS), body mass index (BMI) and postoperative oxygen nadir, ESS, or BMI in the DISE and no DISE cohorts. Conclusion: The addition of DISE to our preoperative workup has contributed to a decreased rate of multilevel surgery and increased rate of surgical success through identification of the individual patient’s OSA architecture and customization of the surgical plan.
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Affiliation(s)
- Colin Huntley
- Thomas Jefferson University Department of Otolaryngology-Head & Neck Surgery, Philadelphia, Pennsylvania, USA
| | - David Chou
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Karl Doghramji
- Jefferson Sleep Disorders Center, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Maurits Boon
- Thomas Jefferson University Department of Otolaryngology-Head & Neck Surgery, Philadelphia, Pennsylvania, USA
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Wong V, Guzman Rojas R, Shek KL, Chou D, Moore KH, Dietz HP. Laparoscopic sacrocolpopexy: how low does the mesh go? Ultrasound Obstet Gynecol 2017; 49:404-408. [PMID: 26877210 DOI: 10.1002/uog.15882] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 02/04/2016] [Accepted: 02/09/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Laparoscopic sacrocolpopexy is becoming an increasingly popular surgical approach for repair of apical vaginal prolapse. The aim of this study was to document the postoperative anterior mesh position after laparoscopic sacrocolpopexy and to investigate the relationship between mesh location and anterior compartment support. METHODS This was an external audit of patients who underwent laparoscopic sacrocolpopexy for apical prolapse ≥ Stage 2 or advanced prolapse ≥ Stage 3, between January 2005 and June 2012. All patients were assessed with a standardized interview, clinical assessment using the International Continence Society Pelvic Organ Prolapse quantification and four-dimensional transperineal ultrasound to evaluate pelvic organ support and mesh location. Mesh position was assessed with respect to the symphysis pubis whilst distal mesh mobility was assessed using the formula √[(XValsalva - Xrest )2 + (YValsalva - Yrest )2 ], where X is the horizontal distance and Y is the vertical distance between the mesh and the inferior symphyseal margin, measured at rest and on Valsalva. RESULTS Ninety-seven women were assessed at a mean follow-up of 3.01 (range, 0.13-6.87) years after laparoscopic sacrocolpopexy, 88% (85/97) of whom considered themselves to be cured or improved, and none had required reoperation. On clinical examination, prolapse recurrence in the apical compartment was not diagnosed in any patient; however, 60 (62%) had recurrence in the anterior compartment and 43 (44%) in the posterior compartment. On ultrasound examination, mesh was visualized in the anterior compartment in 60 patients. Both mesh position and mobility on Valsalva were significantly associated with recurrent cystocele on clinical and on ultrasound assessment (all P < 0.01). For every mm that the mesh was located further from the bladder neck on Valsalva, the likelihood of cystocele recurrence increased by 6-7%. CONCLUSION At an average follow-up of 3 years, laparoscopic sacrocolpopexy was highly effective for apical support; however, cystocele recurrence was common despite an emphasis on anterior mesh extension. Prolapse recurrence seemed to be related to mesh position and mobility, suggesting that the lower the mesh is from the bladder neck, the lower the likelihood of anterior compartment prolapse recurrence. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- V Wong
- Nepean Clinical School, University of Sydney, Penrith, NSW, Australia
| | - R Guzman Rojas
- Nepean Clinical School, University of Sydney, Penrith, NSW, Australia
- Clinica Alemana de Santiago, Santiago, Chile
| | - K L Shek
- Nepean Clinical School, University of Sydney, Penrith, NSW, Australia
- Liverpool Hospital, University of Western Sydney, Penrith, NSW, Australia
| | - D Chou
- St George's Hospital, University of New South Wales, Kogarah, NSW, Australia
| | - K H Moore
- St George's Hospital, University of New South Wales, Kogarah, NSW, Australia
| | - H P Dietz
- Nepean Clinical School, University of Sydney, Penrith, NSW, Australia
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Gerges B, Reid S, Chou D, Chang T, Condous G. Prospective Validation of the Ultrasound Based Endometriosis Staging System (UBESS). J Minim Invasive Gynecol 2016. [DOI: 10.1016/j.jmig.2016.08.262] [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: 11/25/2022]
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22
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Allanson ER, Tunçalp Ӧ, Gardosi J, Pattinson RC, Vogel JP, Erwich JJHM, Flenady VJ, Frøen JF, Neilson J, Quach A, Francis A, Chou D, Mathai M, Say L, Gülmezoglu AM. Giving a voice to millions: developing the WHO application of ICD-10 to deaths during the perinatal period: ICD-PM. BJOG 2016; 123:1896-1899. [DOI: 10.1111/1471-0528.14243] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2016] [Indexed: 11/28/2022]
Affiliation(s)
- ER Allanson
- Faculty of Medicine, Dentistry and Health Sciences; School of Women's and Infants' Health; University of Western Australia; Crawley WA Australia
- Department of Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research; Development and Research Training in Human Reproduction (HRP); World Health Organization; Geneva Switzerland
| | - Ӧ Tunçalp
- Department of Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research; Development and Research Training in Human Reproduction (HRP); World Health Organization; Geneva Switzerland
| | | | - RC Pattinson
- Department of Obstetrics and Gynaecology; SAMRC Maternal and Infant Health Care Strategies unit; University of Pretoria; Pretoria South Africa
| | - JP Vogel
- Department of Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research; Development and Research Training in Human Reproduction (HRP); World Health Organization; Geneva Switzerland
| | - JJHM Erwich
- Department of Obstetrics; University of Groningen; University Medical Centre Groningen; Groningen the Netherlands
| | - VJ Flenady
- Mater Research Institute; The University of Queensland (MRI-UQ); Brisbane Qld Australia
- International Stillbirth Alliance; Bristol UK
| | - JF Frøen
- Department of International Public Health; Norwegian Institute of Public Health; Oslo Norway
- Centre for Intervention Science for Maternal and Child Health; University of Bergen; Bergen Norway
| | - J Neilson
- Centre for Women's Health Research; University of Liverpool; Liverpool UK
| | - A Quach
- Pacific Northwest University of Health Sciences; Yakima WA USA
| | | | - D Chou
- Department of Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research; Development and Research Training in Human Reproduction (HRP); World Health Organization; Geneva Switzerland
| | - M Mathai
- Maternal & Perinatal Health; Department of Maternal, Newborn Child & Adolescent Health; World Health Organization; Geneva Switzerland
| | - L Say
- Department of Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research; Development and Research Training in Human Reproduction (HRP); World Health Organization; Geneva Switzerland
| | - AM Gülmezoglu
- Department of Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research; Development and Research Training in Human Reproduction (HRP); World Health Organization; Geneva Switzerland
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23
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Allanson ER, Vogel JP, Tunçalp Ӧ, Gardosi J, Pattinson RC, Francis A, Erwich J, Flenady VJ, Frøen JF, Neilson J, Quach A, Chou D, Mathai M, Say L, Gülmezoglu AM. Application of ICD-PM to preterm-related neonatal deaths in South Africa and United Kingdom. BJOG 2016; 123:2029-2036. [PMID: 27527390 DOI: 10.1111/1471-0528.14245] [Citation(s) in RCA: 17] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVE We explore preterm-related neonatal deaths using the WHO application of the International Classification of Disease (ICD-10) to deaths during the perinatal period: ICD-PM as an informative case study, where ICD-PM can improve data use to guide clinical practice and programmatic decision-making. DESIGN Retrospective application of ICD-PM. SETTING South Africa, and the UK. POPULATION Perinatal death databases. METHODS Descriptive analysis of neonatal deaths and maternal conditions present. MAIN OUTCOME MEASURES Causes of preterm neonatal mortality and associated maternal conditions. RESULTS We included 98 term and 173 preterm early neonatal deaths from South Africa, and 956 term and 3248 preterm neonatal deaths from the UK. In the South African data set, the main causes of death were respiratory/cardiovascular disorders (34.7%), low birthweight/prematurity (29.2%), and disorders of cerebral status (25.5%). Amongst preterm deaths, low birthweight/prematurity (43.9%) and respiratory/cardiovascular disorders (32.4%) were the leading causes. In the data set from the UK, the leading causes of death were low birthweight/prematurity (31.6%), congenital abnormalities (27.4%), and deaths of unspecified cause (26.1%). In the preterm deaths, the leading causes were low birthweight/prematurity (40.9%) and deaths of unspecified cause (29.6%). In South Africa, 61% of preterm deaths resulted from the maternal condition of preterm spontaneous labour. Among the preterm deaths in the data set from the UK, no maternal condition was present in 36%, followed by complications of placenta, cord, and membranes (23%), and other complications of labour and delivery (22%). CONCLUSIONS ICD-PM can be used to appraise the maternal and newborn conditions contributing to preterm deaths, and can inform practice. TWEETABLE ABSTRACT ICD-PM can be used to appraise maternal and newborn contributors to preterm deaths to improve quality of care.
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Affiliation(s)
- E R Allanson
- School of Women's and Infants' Health, Faculty of Medicine, Dentistry and Health Sciences, University of Western Australia, Crawley, WA, Australia. .,Department of Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland.
| | - J P Vogel
- Department of Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | - Ӧ Tunçalp
- Department of Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | - J Gardosi
- Perinatal Institute, Edgbaston, Birmingham, UK
| | - R C Pattinson
- SAMRC Maternal and Infant Health Care Strategies Unit, Department of Obstetrics and Gynaecology, University of Pretoria, Pretoria, South Africa
| | - A Francis
- Perinatal Institute, Edgbaston, Birmingham, UK
| | - Jjhm Erwich
- Department of Obstetrics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - V J Flenady
- Mater Research Institute, The University of Queensland (MRI-UQ), Brisbane, QLD, Australia.,International Stillbirth Alliance, Bristol, UK
| | - J F Frøen
- Department of International Public Health, Norwegian Institute of Public Health, Oslo, Norway.,Centre for Intervention Science for Maternal and Child Health, University of Bergen, Bergen, Norway
| | - J Neilson
- Centre for Women's Health Research, University of Liverpool, Liverpool, UK
| | - A Quach
- Pacific Northwest University of Health Sciences, Yakima, WA, USA
| | - D Chou
- Department of Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | - M Mathai
- Maternal & Perinatal Health, Department of Maternal, Newborn, Child & Adolescent Health, World Health Organization, Geneva, Switzerland
| | - L Say
- Department of Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | - A M Gülmezoglu
- Department of Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
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Allanson ER, Tunçalp Ö, Gardosi J, Pattinson RC, Francis A, Vogel JP, Erwich J, Flenady VJ, Frøen JF, Neilson J, Quach A, Chou D, Mathai M, Say L, Gülmezoglu AM. The WHO application of ICD-10 to deaths during the perinatal period (ICD-PM): results from pilot database testing in South Africa and United Kingdom. BJOG 2016; 123:2019-2028. [PMID: 27527122 DOI: 10.1111/1471-0528.14244] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To apply the World Health Organization (WHO) Application of the International Classification of Diseases, tenth revision (ICD-10) to deaths during the perinatal period: ICD-Perinatal Mortality (ICD-PM) to existing perinatal death databases. DESIGN Retrospective application of ICD-PM. SETTING South Africa, UK. POPULATION Perinatal death databases. METHODS Deaths were grouped according to timing of death and then by the ICD-PM cause of death. The main maternal condition at the time of perinatal death was assigned to each case. MAIN OUTCOME MEASURES Causes of perinatal mortality, associated maternal conditions. RESULTS In South Africa 344/689 (50%) deaths occurred antepartum, 11% (n = 74) intrapartum and 39% (n = 271) in the early neonatal period. In the UK 4377/9067 (48.3%) deaths occurred antepartum, with 457 (5%) intrapartum and 4233 (46.7%) in the neonatal period. Antepartum deaths were due to unspecified causes (59%), chromosomal abnormalities (21%) or problems related to fetal growth (14%). Intrapartum deaths followed acute intrapartum events (69%); neonatal deaths followed consequences of low birthweight/ prematurity (31%), chromosomal abnormalities (26%), or unspecified causes in healthy mothers (25%). Mothers were often healthy; 53%, 38% and 45% in the antepartum, intrapartum and neonatal death groups, respectively. Where there was a maternal condition, it was most often maternal medical conditions, and complications of placenta, cord and membranes. CONCLUSIONS The ICD-PM can be a globally applicable perinatal death classification system that emphasises the need for a focus on the mother-baby dyad as we move beyond 2015. TWEETABLE ABSTRACT ICD-PM is a global system that classifies perinatal deaths and links them to maternal conditions.
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Affiliation(s)
- E R Allanson
- Faculty of Medicine, Dentistry and Health Sciences, School of Women's and Infants' Health, University of Western Australia, Crawley, Western Australia, Australia. , .,Department of Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland. ,
| | - Ö Tunçalp
- Department of Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | | | - R C Pattinson
- SAMRC Maternal and Infant Health Care Strategies Unit, Department of Obstetrics and Gynaecology, University of Pretoria, Pretoria, South Africa
| | | | - J P Vogel
- Department of Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | - Jjhm Erwich
- Department of Obstetrics, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | - V J Flenady
- Mater Research Institute, The University of Queensland (MRI-UQ), Brisbane, Queensland, Australia.,International Stillbirth Alliance, Bristol, UK
| | - J F Frøen
- Department of International Public Health, Norwegian Institute of Public Health, Oslo, Norway
| | - J Neilson
- Centre for Intervention Science for Maternal and Child Health, University of Bergen, Bergen, Norway.,Centre for Women's Health Research, University of Liverpool, Liverpool, UK
| | - A Quach
- Pacific Northwest University of Health Sciences, Yakima, Washington, USA
| | - D Chou
- Department of Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | - M Mathai
- Maternal & Perinatal Health, Department of Maternal, Newborn, Child & Adolescent Health, World Health Organization, Geneva, Switzerland
| | - L Say
- Department of Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | - A M Gülmezoglu
- Department of Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
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Allanson ER, Tunçalp Ӧ, Gardosi J, Pattinson RC, Francis A, Vogel JP, Erwich J, Flenady VJ, Frøen JF, Neilson J, Quach A, Chou D, Mathai M, Say L, Gülmezoglu AM. Optimising the International Classification of Diseases to identify the maternal condition in the case of perinatal death. BJOG 2016; 123:2037-2046. [PMID: 27527550 DOI: 10.1111/1471-0528.14246] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The WHO application of the tenth edition of the International Classification of Diseases (ICD-10) to deaths during the perinatal period (ICD Perinatal Mortality, ICD-PM) captures the essential characteristics of the mother-baby dyad that contribute to perinatal deaths. We compare the capture of maternal conditions in the existing ICD-PM with the maternal codes from the WHO application of ICD-10 to deaths during pregnancy, childbirth, and the puerperium (ICD Maternal Mortality, ICD-MM) to explore potential benefits in the quality of data received. DESIGN Retrospective application of ICD-PM. SETTING South Africa and the UK. POPULATION Perinatal death databases. METHODS The maternal conditions were classified using the ICD-PM groupings for maternal condition in perinatal death, and then mapped to the ICD-MM groupings of maternal conditions. MAIN OUTCOME MEASURES Main maternal conditions in perinatal deaths. RESULTS We reviewed 9661 perinatal deaths. The largest group (4766 cases, 49.3%) in both classifications captures deaths where there was no contributing maternal condition. Each of the other ICD-PM groups map to between three and six ICD-MM groups. If the cases in each ICD-PM group are re-coded using ICD-MM, each group becomes multiple, more specific groups. For example, the 712 cases in group M4 in ICD-PM become 14 different and more specific main disease categories when the ICD-MM is applied instead. CONCLUSIONS As we move towards ICD-11, the use of the more specific, applicable, and relevant codes outlined in ICD-MM for both maternal deaths and the maternal condition at the time of a perinatal death would be preferable, and would provide important additional information about perinatal deaths. TWEETABLE ABSTRACT Improving the capture of maternal conditions in perinatal deaths provides important actionable information.
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Affiliation(s)
- E R Allanson
- Faculty of Medicine, Dentistry, and Health Sciences, School of Women's and Infants' Health, University of Western Australia, Crawley, WA, Australia. .,Department of Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland.
| | - Ӧ Tunçalp
- Department of Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | - J Gardosi
- Perinatal Institute, Edgbaston, Birmingham, UK
| | - R C Pattinson
- SAMRC Maternal and Infant Health Care Strategies Unit, Department of Obstetrics and Gynaecology, University of Pretoria, Pretoria, South Africa
| | - A Francis
- Perinatal Institute, Edgbaston, Birmingham, UK
| | - J P Vogel
- Department of Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | - Jjhm Erwich
- Department of Obstetrics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - V J Flenady
- Mater Research Institute, The University of Queensland (MRI-UQ), Brisbane, QLD, Australia.,International Stillbirth Alliance, Bristol, UK
| | - J F Frøen
- Department of International Public Health, Norwegian Institute of Public Health, Oslo, Norway.,Centre for Intervention Science for Maternal and Child Health, University of Bergen, Bergen, Norway
| | - J Neilson
- Centre for Women's Health Research, University of Liverpool, Liverpool, UK
| | - A Quach
- Pacific Northwest University of Health Sciences, Yakima, WA, USA
| | - D Chou
- Department of Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | - M Mathai
- Maternal & Perinatal Health, Department of Maternal, Newborn, Child & Adolescent Health, World Health Organization, Geneva, Switzerland
| | - L Say
- Department of Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | - A M Gülmezoglu
- Department of Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
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Berliner N, Kurra C, Chou D. CASE RECORDS of the MASSACHUSETTS GENERAL HOSPITAL. Case 1-2016. An 18-Year-Old Man with Fever, Abdominal Pain, and Thrombocytopenia. N Engl J Med 2016; 374:165-73. [PMID: 26760088 DOI: 10.1056/nejmcpc1501306] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Reid S, Lu C, Hardy N, Casikar I, Reid G, Cario G, Chou D, Almashat D, Condous G. Reply: New ultrasound technologies to classify deep pelvic endometriosis. Ultrasound Obstet Gynecol 2015; 45:356-357. [PMID: 25736853 DOI: 10.1002/uog.14756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- S Reid
- Acute Gynaecology, Early Pregnancy and Advanced Endosurgery Unit, Nepean Medical School, Nepean Hospital, University of Sydney, Penrith, NSW, Australia
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Muehle A, Chou D, Shah A, Khoynezhad A. Experiences with ascending aortic endografts using FDA IDE approved devices. What has been done, what lesions can be treated and what challenges remain. J Cardiovasc Surg (Torino) 2015; 56:11-18. [PMID: 25374411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Thoracic endovascular aortic repair (TEVAR) has become an attractive treatment option for thoracic aortic disease. New devices and advanced image-guided procedures are continuously expanding the indications. With improving device technology, diverse stent-graft availability, and imaging modalities, TEVAR has become safer and holds promising potential to expand treatment options, especially for ascending aorta and aortic arch pathology. This article focuses on current evolving endovascular solutions for thoracic ascending aortic diseases and starts with an overview of historical TEVAR landmarks, followed by indications for TEVAR, and concludes with present day challenges.
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Affiliation(s)
- A Muehle
- Division of Cardiothoracic Surgery Cedars‑Sinai Heart Institute, Los Angeles, CA, USA -
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Mühle A, Chou D, Te Winkel M, Khoynezhad A. Thoracoscopic Ablation of Persistent Atrial Fibrillation on the Beating Heart. Thorac Cardiovasc Surg 2015. [DOI: 10.1055/s-0035-1544498] [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: 10/24/2022]
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Vardakis J, Tully BJ, Guo L, Ventikos Y, Chou D. Investigating hydrocephalus using Multiple-network Poroelastic Theory. Fluids Barriers CNS 2015. [PMCID: PMC4582815 DOI: 10.1186/2045-8118-12-s1-p54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Llovet JM, Bruix J, Lim S, Shibuya K, Aboyans V, Abraham J, Adair T, Aggarwal R, Ahn SY, Alvarado M, Anderson HR, Anderson LM, Andrews KG, Atkinson C, Baddour LM, Barker-Collo S, Bartels DH, Bell ML, Benjamin EJ, Bennett D, Bhalla K, Bikbov B, Bin Abdulhak A, Birbeck G, Blyth F, Bolliger I, Boufous S, Bucello C, Burch M, Burney P, Carapetis J, Chen H, Chou D, Chugh SS, Coffeng LE, Colan SD, Colquhoun S, Colson KE, Condon J, Connor MD, Cooper LT, Corriere M, Cortinovis M, de Vaccaro KC, Couser W, Cowie BC, Criqui MH, Cross M, Dabhadkar KC, Dahodwala N, De Leo D, Degenhardt L, Delossantos A, Denenberg J, Des Jarlais DC, Dharmaratne SD, Dorsey ER, Driscoll T, Duber H, Ebel B, Erwin PJ, Espindola P, Ezzati M, Feigin V, Flaxman AD, Forouzanfar MH, Fowkes FGR, Franklin R, Fransen M, Freeman MK, Gabriel SE, Gakidou E, Gaspari F, Gillum RF, Gonzalez-Medina D, Halasa YA, Haring D, Harrison JE, Havmoeller R, Hay RJ, Hoen B, Hotez PJ, Hoy D, Jacobsen KH, James SL, Jasrasaria R, Jayaraman S, Johns N, Karthikeyan G, Kassebaum N, Keren A, Khoo JP, Knowlton LM, Kobusingye O, Koranteng A, Krishnamurthi R, Lipnick M, Lipshultz SE, Ohno SL, Mabweijano J, MacIntyre MF, Mallinger L, March L, Marks GB, Marks R, Matsumori A, Matzopoulos R, Mayosi BM, McAnulty JH, McDermott MM, McGrath J, Mensah GA, Merriman TR, Michaud C, Miller M, Miller TR, Mock C, Mocumbi AO, Mokdad AA, Moran A, Mulholland K, Nair MN, Naldi L, Narayan KMV, Nasseri K, Norman P, O'Donnell M, Omer SB, Ortblad K, Osborne R, Ozgediz D, Pahari B, Pandian JD, Rivero AP, Padilla RP, Perez-Ruiz F, Perico N, Phillips D, Pierce K, Pope CA, Porrini E, Pourmalek F, Raju M, Ranganathan D, Rehm JT, Rein DB, Remuzzi G, Rivara FP, Roberts T, De León FR, Rosenfeld LC, Rushton L, Sacco RL, Salomon JA, Sampson U, Sanman E, Schwebel DC, Segui-Gomez M, Shepard DS, Singh D, Singleton J, Sliwa K, Smith E, Steer A, Taylor JA, Thomas B, Tleyjeh IM, Towbin JA, Truelsen T, Undurraga EA, Venketasubramanian N, Vijayakumar L, Vos T, Wagner GR, Wang M, Wang W, Watt K, Weinstock MA, Weintraub R, Wilkinson JD, Woolf AD, Wulf S, Yeh PH, Yip P, Zabetian A, Zheng ZJ, Lopez AD, Murray CJL, AlMazroa MA, Memish ZA. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2014. [PMID: 25530442 DOI: 10.1016/s0140-6736] [Citation(s) in RCA: 467] [Impact Index Per Article: 46.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Up-to-date evidence on levels and trends for age-sex-specific all-cause and cause-specific mortality is essential for the formation of global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013) we estimated yearly deaths for 188 countries between 1990, and 2013. We used the results to assess whether there is epidemiological convergence across countries. METHODS We estimated age-sex-specific all-cause mortality using the GBD 2010 methods with some refinements to improve accuracy applied to an updated database of vital registration, survey, and census data. We generally estimated cause of death as in the GBD 2010. Key improvements included the addition of more recent vital registration data for 72 countries, an updated verbal autopsy literature review, two new and detailed data systems for China, and more detail for Mexico, UK, Turkey, and Russia. We improved statistical models for garbage code redistribution. We used six different modelling strategies across the 240 causes; cause of death ensemble modelling (CODEm) was the dominant strategy for causes with sufficient information. Trends for Alzheimer's disease and other dementias were informed by meta-regression of prevalence studies. For pathogen-specific causes of diarrhoea and lower respiratory infections we used a counterfactual approach. We computed two measures of convergence (inequality) across countries: the average relative difference across all pairs of countries (Gini coefficient) and the average absolute difference across countries. To summarise broad findings, we used multiple decrement life-tables to decompose probabilities of death from birth to exact age 15 years, from exact age 15 years to exact age 50 years, and from exact age 50 years to exact age 75 years, and life expectancy at birth into major causes. For all quantities reported, we computed 95% uncertainty intervals (UIs). We constrained cause-specific fractions within each age-sex-country-year group to sum to all-cause mortality based on draws from the uncertainty distributions. FINDINGS Global life expectancy for both sexes increased from 65.3 years (UI 65.0-65.6) in 1990, to 71.5 years (UI 71.0-71.9) in 2013, while the number of deaths increased from 47.5 million (UI 46.8-48.2) to 54.9 million (UI 53.6-56.3) over the same interval. Global progress masked variation by age and sex: for children, average absolute differences between countries decreased but relative differences increased. For women aged 25-39 years and older than 75 years and for men aged 20-49 years and 65 years and older, both absolute and relative differences increased. Decomposition of global and regional life expectancy showed the prominent role of reductions in age-standardised death rates for cardiovascular diseases and cancers in high-income regions, and reductions in child deaths from diarrhoea, lower respiratory infections, and neonatal causes in low-income regions. HIV/AIDS reduced life expectancy in southern sub-Saharan Africa. For most communicable causes of death both numbers of deaths and age-standardised death rates fell whereas for most non-communicable causes, demographic shifts have increased numbers of deaths but decreased age-standardised death rates. Global deaths from injury increased by 10.7%, from 4.3 million deaths in 1990 to 4.8 million in 2013; but age-standardised rates declined over the same period by 21%. For some causes of more than 100,000 deaths per year in 2013, age-standardised death rates increased between 1990 and 2013, including HIV/AIDS, pancreatic cancer, atrial fibrillation and flutter, drug use disorders, diabetes, chronic kidney disease, and sickle-cell anaemias. Diarrhoeal diseases, lower respiratory infections, neonatal causes, and malaria are still in the top five causes of death in children younger than 5 years. The most important pathogens are rotavirus for diarrhoea and pneumococcus for lower respiratory infections. Country-specific probabilities of death over three phases of life were substantially varied between and within regions. INTERPRETATION For most countries, the general pattern of reductions in age-sex specific mortality has been associated with a progressive shift towards a larger share of the remaining deaths caused by non-communicable disease and injuries. Assessing epidemiological convergence across countries depends on whether an absolute or relative measure of inequality is used. Nevertheless, age-standardised death rates for seven substantial causes are increasing, suggesting the potential for reversals in some countries. Important gaps exist in the empirical data for cause of death estimates for some countries; for example, no national data for India are available for the past decade. FUNDING Bill & Melinda Gates Foundation.
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Reid S, Lu C, Hardy N, Casikar I, Reid G, Cario G, Chou D, Almashat D, Condous G. Office gel sonovaginography for the prediction of posterior deep infiltrating endometriosis: a multicenter prospective observational study. Ultrasound Obstet Gynecol 2014; 44:710-718. [PMID: 24862965 DOI: 10.1002/uog.13422] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2013] [Revised: 04/21/2014] [Accepted: 04/29/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To use office gel sonovaginography (SVG) to predict posterior deep infiltrating endometriosis (DIE) in women undergoing laparoscopy. METHODS This was a multicenter prospective observational study carried out between January 2009 and February 2013. All women were of reproductive age, had a history of chronic pelvic pain and underwent office gel SVG assessment for the prediction of posterior compartment DIE prior to laparoscopic endometriosis surgery. Gel SVG findings were compared with laparoscopic findings to determine the diagnostic accuracy of office gel SVG for the prediction of posterior compartment DIE. RESULTS In total, 189 women underwent preoperative gel SVG and laparoscopy for endometriosis. At laparoscopy, 57 (30%) women had posterior DIE and 43 (23%) had rectosigmoid/anterior rectal DIE. For the prediction of rectosigmoid/anterior rectal (i.e. bowel) DIE, gel SVG had an accuracy of 92%, sensitivity of 88%, specificity of 93%, positive predictive value (PPV) of 79%, negative predictive value (NPV) of 97%, positive likelihood ratio (LR+) of 12.9 and negative likelihood ratio (LR-) of 0.12 (P = 3.98E-25); for posterior vaginal wall and rectovaginal septum (RVS) DIE, respectively, the accuracy was 95% and 95%, sensitivity was 18% and 18%, specificity was 99% and 100%, PPV was 67% and 100%, NPV was 95% and 95%, LR+ was 32.4 and infinity and LR- was 0.82 and 0.82 (P = 0.009 and P = 0.003). CONCLUSIONS Office gel SVG appears to be an effective outpatient imaging technique for the prediction of bowel DIE, with a higher accuracy for the prediction of rectosigmoid compared with anterior rectal DIE. Although the sensitivity for vaginal and RVS DIE was limited, gel SVG had a high specificity and NPV for all forms of posterior DIE, indicating that a negative gel SVG examination is highly suggestive of the absence of DIE at laparoscopy.
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Affiliation(s)
- S Reid
- Acute Gynaecology, Early Pregnancy and Advanced Endosurgery Unit, Nepean Medical School, Nepean Hospital, University of Sydney, Penrith, NSW, Australia
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Lee HW, Wang HT, Weng MW, Hu Y, Chen WS, Chou D, Liu Y, Donin N, Huang WC, Lepor H, Wu XR, Wang H, Beland FA, Tang MS. Acrolein- and 4-Aminobiphenyl-DNA adducts in human bladder mucosa and tumor tissue and their mutagenicity in human urothelial cells. Oncotarget 2014; 5:3526-40. [PMID: 24939871 PMCID: PMC4116500 DOI: 10.18632/oncotarget.1954] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Accepted: 05/06/2014] [Indexed: 01/12/2023] Open
Abstract
Tobacco smoke (TS) is a major cause of human bladder cancer (BC). Two components in TS, 4-aminobiphenyl (4-ABP) and acrolein, which also are environmental contaminants, can cause bladder tumor in rat models. Their role in TS related BC has not been forthcoming. To establish the relationship between acrolein and 4-ABP exposure and BC, we analyzed acrolein-deoxyguanosine (dG) and 4-ABP-DNA adducts in normal human urothelial mucosa (NHUM) and bladder tumor tissues (BTT), and measured their mutagenicity in human urothelial cells. We found that the acrolein-dG levels in NHUM and BTT are 10-30 fold higher than 4-ABP-DNA adduct levels and that the acrolein-dG levels in BTT are 2 fold higher than in NHUM. Both acrolein-dG and 4-ABP-DNA adducts are mutagenic; however, the former are 5 fold more mutagenic than the latter. These two types of DNA adducts induce different mutational signatures and spectra. We found that acrolein inhibits nucleotide excision and base excision repair and induces repair protein degradation in urothelial cells. Since acrolein is abundant in TS, inhaled acrolein is excreted into urine and accumulates in the bladder and because acrolein inhibits DNA repair and acrolein-dG DNA adducts are mutagenic, we propose that acrolein is a major bladder carcinogen in TS.
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Affiliation(s)
- Hyun-Wook Lee
- Department of Environmental Medicine, New York University School of Medicine, Tuxedo Park, New York
| | - Hsiang-Tsui Wang
- Department of Environmental Medicine, New York University School of Medicine, Tuxedo Park, New York
| | - Mao-wen Weng
- Department of Environmental Medicine, New York University School of Medicine, Tuxedo Park, New York
| | - Yu Hu
- Department of Environmental Medicine, New York University School of Medicine, Tuxedo Park, New York
| | - Wei-sheng Chen
- Department of Environmental Medicine, New York University School of Medicine, Tuxedo Park, New York
| | - David Chou
- Department of Environmental Medicine, New York University School of Medicine, Tuxedo Park, New York
| | - Yan Liu
- Department of Urology, New York University School of Medicine, New York, New York
| | - Nicholas Donin
- Department of Urology, New York University School of Medicine, New York, New York
| | - William C. Huang
- Department of Urology, New York University School of Medicine, New York, New York
| | - Herbert Lepor
- Department of Urology, New York University School of Medicine, New York, New York
| | - Xue-Ru Wu
- Department of Urology, New York University School of Medicine, New York, New York
| | - Hailin Wang
- The State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
| | - Frederick A. Beland
- Division of Biochemical Toxicology, National Center for Toxicological Research, Jefferson, AR
| | - Moon-shong Tang
- Department of Environmental Medicine, New York University School of Medicine, Tuxedo Park, New York
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van West H, Hodgson B, Parent E, Samuel S, Hodgson B, Ferland C, Soroceanu A, Soroceanu A, Protopsaltis T, Protopsaltis T, Radovanovic I, Amritanand R, Shamji M, Haugo K, Malham G, Jarzem P, Rampersaud Y, Tomkins-Lane C, Manson N, Malham G, Rampersaud Y, Malham G, Malham G, King V, Goldstein C, Fisher C, Fehlings M, Fisher C, Wong E, Sardar Z, Christie S, Patel A, Pinkoski C, Ahn H, Drew B, Dvorak M, Pezeshki P, Altaf F, Wilde P, Rampersaud Y, Sparrey C, Tetreault L, Fehlings M, Tetreault L, Rampersaud R, Jack A, Johnstone R, Fernandes A, Urquhart J, Morokoff A, Manson N, Tomkins-Lane C, Phan P, Evaniew N, Shamji M, Manson J, Rampersaud Y, Nault ML, St-Pierre GH, Larouche J, Lewis S, Wilgenbusch C, Lewis S, Rampersaud Y, Johnson R, Cushnie D, Sridharan S, Street J, Gregg C, Missiuna P, Abraham E, Abraham E, Manson N, Huang E, Passmore S, Mac-Thiong JM, Labelle H, Moulin D, Turgeon I, Roy-Beaudry M, Bourassa N, Petit Y, Parent. S, Chabot S, Westover L, Hill D, Moreau M, Hedden D, Lou E, Adeeb. S, Smith M, Bridge C, Hsu B, Gray. R, Group PORSCHES, Saran N, Mac-Thiong JM, Stone L, Ouellet. J, Protopsaltis T, Terran J, Bronsard N, Smith J, Klineberg E, Mundis G, Hostin R, Hart R, Shaffrey C, Bess S, Ames C, Schwab F, Lafage. V, Schwab F, Lafage V, Protopsaltis T, Ames C, Bess S, Smith J, Errico. T, Schwab F, Soroceanu A, Bronsard N, Smith J, Klineberg E, Mundis G, Hostin R, Hart R, Burton D, Ames C, Shaffrey C, Bess S, Errico T, Lafage. V, Terran J, Soroceanu A, Bronsard N, Smith J, Klineberg E, Mundis G, Kim HJ, Hostin R, Hart R, Shaffrey C, Bess S, Ames C, Schwab F, Lafage. V, Urquhart J, Gananapathy V, Siddiqi F, Gurr K, Bailey C, Ravi B, David K, Rampersaud. R, Tu Y, Salter. M, Nichol H, Fourney D, Kelly. M, Parker R, Ellis N, Blecher C, Chow F, Claydon. M, Sardar Z, Alexander D, Oxner W, Plessis SD, Yee A, Wai. E, Lewis S, Davey J, Gandhi R, Mahomed. N, Hu R, Thomas K, Hepler C, Choi K, Rowed K, Haig. A, Lam. K, Parker R, Blecher C, Seex. K, Perruccio A, Gandhi R, Program. UHNA, Ellis N, Parker R, Goss B, Blecher C, Ballok. Z, Parker R, Ellis N, Chan P, Varma. D, Swart A, Winder M, Varga PP, Gokaslan Z, Boriani S, Luzzati A, Rhines L, Fisher C, Chou D, Williams R, Dekutoski M, Quraishi N, Bettegowda C, Kawahara N, Fehlings. M, Versteeg A, Boriani S, Varga PP, Dekutoski M, Luzzati A, Gokaslan Z, Williams R, Reynolds J, Fehlings M, Bettegowda C, Rhines. L, Zamorano J, Nater A, Tetrault L, Varga P, Gokaslan Z, Boriani S, Fisher C, Rhines L, Bettegowda C, Kawahara N, Chou. D, Fehlings M, Kopjar B, Vaccaro A, Arnold P, Schuster J, Finkelstein J, Rhines L, Dekutoski M, Gokaslan Z, France. J, Whyne C, Singh D, Ford. M, Aldebeyan W, Ouellet J, Steffen T, Beckman L, Weber M, Jarzem. P, Kwon B, Ahn H, Bailey C, Fehlings M, Fourney D, Gagnon D, Tsai E, Tsui D, Parent S, Chen J, Dvorak M, Noonan V, Rivers C, Network RHSCIR, Batke J, Lenehan B, Fisher C, Dvorak M, Street. J, Fox R, Nataraj A, Bailey C, Christie S, Duggal N, Fehlings M, Finkelstein J, Fourney D, Hurlbert R, Kwon B, Townson A, Tsai E, Attabib N, Chen J, Dvorak M, Noonan V, Rivers C, Network. RHSCIR, Fehlings M, Paquet J, Ahn H, Attabib N, Bailey C, Christie S, Duggal N, Finkelstein J, Fourney D, Hurlbert R, Johnson M, Kwon B, Parent S, Tsai E, Dvorak M, Noonan V, Rivers C, Shen T, Network. RHSCIR, Fisher C, Kwon B, Drew B, Fehlings M, Paquet J, Ahn H, Attabib N, Bailey C, Christie S, Duggal N, Finkelstein J, Fourney D, Hurlbert R, Johnson M, Mac-Thiong JM, Parent S, Tsai E, Fallah N, Noonan V, Rivers C, Network RHSCIR, Davidson S, McCann C, Akens M, Murphy K, Whyne C, Sherar M, Yee. A, Belanger L, Ronco J, Dea N, Paquette S, Boyd M, Street J, Fisher C, Dvorak M, Kwon B, Gonzalvo A, Fitt G, Liew S, de la Harpe D, Turner P, Rogers M, Bidos A, Fanti C, Young B, Drew B, Puskas. D, Tam H, Manansala S, Nosov V, Delva M, Alshafai N, Kopjar B, Tan G, Arnold P, Fehlings. M, Kopjar B, Arnold P, Ibrahim A, Tetrault. L, Kopjar B, Arnold P, Fehlings. M, Sundararajan K, Eng. S, St-Pierre G, Nataraj A, Urquhart J, Rosas-Arellano P, Tallon C, Gurr K, Siddiqi F, Bailey S, Bailey C, Sundararajan K, Rampersaud. R, Rosa-Arellano P, Tallon C, Bailey S, Gurr K, Bailey. C, Parker R, Milili L, Goss B, Malham. G, Green A, McKeon M, Abraham. E, Lafave L, Parnell J, Rempel J, Moriartey S, Andreas Y, Wilson P, Hepler C, Ray H, Hu. R, Ploumis A, Hess K, Wood. K, Yarascavitch B, Madden K, Ghert M, Drew B, Bhandari M, Kwok D, Tu YS, Salter. M, Hadlow. A, Tso P, Walker K, Lewis S, Davey J, Mahomed N, Coyte. P, Mac-Thiong JM, Roy-Beaudry M, Turgeon I, Labelle H, deGuise J, Parent. S, Jack A, Fox R, Nataraj A, Paquette S, Leroux T, Yee A, Ahn H, Broad R, Fisher C, Hall H, Nataraj A, Hedden D, Christie S, Carey T, Mehta V, Fehlings M, Wadey. V, Dear T, Hashem. M, Fourney D, Goldstein S, Bodrogi A, Lipkus M, Dear T, Keshen S, Veillette C, Gandhi R, Adams D, Briggs N, Davey J, Fehlings M, Lau J, Lewis S, Magtoto R, Marshall K, Massicotte E, Ogilvie-Harris D, Sarro A, Syed K, Mohamed. N, Perera S, Taha A, Urquhart J, Gurr K, Siddiqi F, Bailey C, Thomas K, Cho R, Swamy G, Power C, Henari S, Lenehan. B, McIntosh G, Hall H, Hoffman. C, Karachi A, Pazionis T, AlShaya O, Green A, McKeon M, Manson. N, Green A, McKeon M, Manson. N, Green A, McKeon M, Murray J, Abraham. E, Thomas K, Suttor S, Goyal T, Littlewood J, Bains I, Bouchard J, Hu R, Jacobs B, Cho R, Swamy G, Johnson M, Pelleck V, Amad Y, Ramos E, Glazebrook C. Combined Spine Conference of the Canadian Spine Society New Zealand Orthopaedic Spine Society, Spine Society of Australia: Fairmont Château Lake Louise, Lake, Louise, Alberta, Tuesday, Feb. 25 to Saturday, Mar. 1, 20141.1.01 The use of suspension radiographs to predict LIV tilt.1.1.02 Surgical correction of adolescent idiopathic scoliosis without fusion: an animal model.1.1.03 Are full torso surface topography postural measurements more sensitive to change than back only parameters in adolescents with idiopathic scoliosis and a main thoracic curve?1.2.04 Restoration of thoracic kyphosis in adolescent idiopathic kyphosis: comparative radiographic analysis of round versus rail rods.1.2.05 Scoliosis surgery in spastic quadriplegic cerebral palsy: Is fusion to the pelvis always necessary? A 4–18-year follow-up study.1.2.06 Identification and validation of pain-related biomarkers surrounding spinal surgery in adolescents.1.3.07 Cervical sagittal deformity develops after PJK in adult throacolumbar deformity correction: radiographic analysis using a novel global sagittal angular parameter, the CTPA.1.3.08 Impact of obesity on complications and patient-reported outcomes in adult spinal deformity surgery.1.3.09 The T1 pelvic angle, a novel radiographic measure of sagittal deformity, accounts for both pelvic retroversion and truncal inclination and correlates strongly with HRQOL.1.4.10 Determining cervical sagittal deformity when it is concurrent with thoracolumbar deformity.1.4.11 The influence of sagittal balance and pelvic parameters on the outcome of surgically treated patients with degenerative spondylolisthesis.1.4.12 Predictors of degenerative spondylolisthesis and loading translation in surgical lumbar spinal stenosis patients.2.1.13 Mechanical allodynia following disc herniation requires intraneural macrophage infiltration and can be blocked by systemic selenium delivery or attenuation of BDNF activity.2.1.14 The effect of alanyl-glutamine on epidural fibrosis in a rat laminectomy model.2.1.15 Anterior lumbar interbody fusion using recombinant human bone morphogenetic protein-2: a prospective study of complications.2.2.16 2-year results of a Canadian, multicentre, blinded, pilot study of a novel peptide in promoting lumbar spine fusion.2.2.17 Comparative outcomes and cost-utility following surgical treatment of focal lumbar spinal stenosis compared with osteoarthritis of the hip or knee: long-term change in health-related quality of life.2.2.18 Changes in objectively measured walking performance, function, and pain following surgery for spondylolisthesis and lumbar spinal stenosis.2.3.19 A prospective multicentre observational data-monitored study of minimally invasive fusion to treat degenerative lumbar disorders: complications and outcomes at 1-year follow-up.2.3.20 Assessment and classification of subsidence in lateral interbody fusion using serial computed tomography.2.3.21 Predictors of willingness to undergo spinal and orthopaedic surgery after surgical consultation.2.4.22 Indirect foraminal decompression is independent of facet arthropathy in extreme lateral interbody fusion.2.4.23 Cervical artificial disc replacement with ProDisc-C: clinical and radiographic outcomes with long-term follow-up.2.4.24 Tantalum trabecular metal implants in anterior cervical corpectomy and fusion.3.1.25 Hemangiomas of the spine: results of surgical management and prognostic variables for local recurrence and mortality in a multicentre study.3.1.26 Chondrosarcomas of the spine: prognostic variables for local recurrence and mortality in a multicentre study.3.1.27 Risk factors for recurrence of surgically treated spine schwannomas: analysis of 169 patients from a multicentre international database.3.2.28 Survival pattern and the effect of surgery on health related quality of life and functional outcome in patients with metastatic epidural spinal cord compression from lung cancer — the AOSpine North America prospective multicentre study.3.2.29 A biomechanical assessment of kyphoplasty as a stand-alone treatment in a human cadaveric burst fracture model.3.2.30 What is safer in incompetent vertebrae with posterior wall defects, kyphoplasty or vertebroplasty: a study in vertebral analogs.3.3.31 Feasibility of recruiting subjects for acute spinal cord injury (SCI) clinical trials in Canada.3.3.32 Prospective analysis of adverse events in elderly patients with traumatic spinal cord injury.3.3.33 Does traction before surgery influence time to neural decompression in patients with spinal cord injury?3.4.34 Current treatment of individuals with traumatic spinal cord injury: Do we need age-specific guidelines?3.4.35 Current surgical practice for traumatic spinal cord injury in Canada.3.4.36 The importance of “time to surgery” for traumatic spinal cord injured patients: results from an ambispective Canadian cohort of 949 patients.3.5.37 Assessment of a novel coil-shaped radiofrequency probe in the porcine spine.3.5.38 The effect of norepinephrine and dopamine on cerebrospinal fluid pressure after acute spinal cord injury.3.5.39 The learning curve of pedicle screw placement: How many screws are enough?4.1.40 Preliminary report from the Ontario Inter-professional Spine Assessment and Education Clinics (ISAEC).4.1.41 A surrogate model of the spinal cord complex for simulating bony impingement.4.1.42 Clinical and surgical predictors of specific complications following surgery for the treatment of degenerative cervical myelopathy: results from the multicentre, prospective AOSpine international study on 479 patients.4.2.43 Outcomes of surgical management of cervical spondylotic myelopathy: results of the prospective, multicentre, AOSpine international study in 479 patients.4.2.44 A clinical prediction rule for clinical outcomes in patients undergoing surgery for degenerative cervical myelopathy: analysis of an international AOSpine prospective multicentre data set of 757 subjects.4.2.45 The prevalence and impact of low back and leg pain among aging Canadians: a cross-sectional survey.4.3.46 Adjacent segment pathology: Progressive disease course or a product of iatrogenic fusion?4.3.47 Natural history of degenerative lumbar spondylolisthesis in patients with spinal stenosis.4.3.48 Changes in self-reported clinical status and health care utilization during wait time for surgical spine consultation: a prospective observational study.4.3.49 The Canadian surgical wait list for lumbar degenerative spinal stenosis has a detrimental effect on patient outcomes.4.3.50 Segmental lordosis is independent of interbody cage position in XLIF.4.3.51 Elevated patient BMI does not negatively affect self-reported outcomes of thoracolumbar surgery.1.5.52 The Spinal Stenosis Pedometer and Nutrition Lifestyle Intervention (SSPANLI): development and pilot.1.5.53 Study evaluating the variability of surgical strategy planning for patients with adult spinal deformity.1.5.54 Atlantoaxial instability in acute odontoid fractures is associated with nonunion and mortality.1.5.55 Peripheral hypersensitivity to subthreshold stimuli persists after resolution of acute experimental disc-herniation neuropathy.1.5.56 Radiation induced lumbar spinal osteonecrosis: case report and literature review.1.5.57 Comparative outcomes and cost-utility following surgical treatment of focal lumbar spinal stenosis compared with osteoarthritis of the hip or knee: Part 2 — estimated lifetime incremental cost-utility ratios.1.5.58 A predictive model of progression for adolescent idiopathic scoliosis based on 3D spine parameters at first visit.1.5.59 Development of a clinical prediction model for surgical decision making in patients with degenerative lumbar spine disease.2.5.60 Canadian spine surgery fellowship education: evaluating opportunity in developing a nationally based training curriculum.2.5.61 Pedicle subtraction osteotomy for severe proximal thoracic junctional kyphosis.2.5.62 A comparison of spine surgery referrals triaged through a multidisciplinary care pathway versus conventional referrals.2.5.63 Results and complications of posterior-based 3 column osteotomies in patients with previously fused spinal deformities.2.5.64 Orthopaedic Surgical AdVerse Event Severity (Ortho-SAVES) system: identifying opportunities for improved patient safety and resource utilization.2.5.65 Spontaneous spinal extra-axial haematomas — surgical experience in Otago and Southland 2011–2013.2.5.66 Obesity and spinal epidural lipomatosis in cauda equina syndrome.2.5.67 Factors affecting restoration of lumbar lordosis in adult degenerative scoliosis patients treated with lateral trans-psoas interbody fusion.3.6.68 Systematic review of complications in spinal surgery: a comparison of retrospective and prospective study design.3.6.69 Postsurgical rehabilitation patients have similar fear avoidance behaviour levels as those in nonoperative care.3.6.70 Outcomes of surgical treatment of adolescent spondyloptosis: a case series.3.6.71 Surgical success in primary versus revision thoracolumbar spine surgery.3.6.72 The effect of smoking on subjective patient outcomes in thoracolumbar surgery.3.6.73 Modelling patient recovery to predict outcomes following elective thoracolumbar surgery for degenerative pathologies.3.6.74 Outcomes from trans-psoas versus open approaches in the treatment of adult degenerative scoliosis.3.6.75 Lumbar spinal stenosis and presurgical assessment: the impact of walking induced strain on a performance-based outcome measure. Can J Surg 2014. [DOI: 10.1503/cjs.005614] [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: 11/01/2022] Open
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Liou D, Gangi A, Chou D, Barmparas G, Ley E. Omentum versus Bowel Evisceration after Abdominal Stab Wounds: Who Requires an Operation? J Surg Res 2014. [DOI: 10.1016/j.jss.2013.11.1041] [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: 10/25/2022]
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Murray CJL, Atkinson C, Bhalla K, Birbeck G, Burstein R, Chou D, Dellavalle R, Danaei G, Ezzati M, Fahimi A, Flaxman D, Foreman, Gabriel S, Gakidou E, Kassebaum N, Khatibzadeh S, Lim S, Lipshultz SE, London S, Lopez, MacIntyre MF, Mokdad AH, Moran A, Moran AE, Mozaffarian D, Murphy T, Naghavi M, Pope C, Roberts T, Salomon J, Schwebel DC, Shahraz S, Sleet DA, Murray, Abraham J, Ali MK, Atkinson C, Bartels DH, Bhalla K, Birbeck G, Burstein R, Chen H, Criqui MH, Dahodwala, Jarlais, Ding EL, Dorsey ER, Ebel BE, Ezzati M, Fahami, Flaxman S, Flaxman AD, Gonzalez-Medina D, Grant B, Hagan H, Hoffman H, Kassebaum N, Khatibzadeh S, Leasher JL, Lin J, Lipshultz SE, Lozano R, Lu Y, Mallinger L, McDermott MM, Micha R, Miller TR, Mokdad AA, Mokdad AH, Mozaffarian D, Naghavi M, Narayan KMV, Omer SB, Pelizzari PM, Phillips D, Ranganathan D, Rivara FP, Roberts T, Sampson U, Sanman E, Sapkota A, Schwebel DC, Sharaz S, Shivakoti R, Singh GM, Singh D, Tavakkoli M, Towbin JA, Wilkinson JD, Zabetian A, Murray, Abraham J, Ali MK, Alvardo M, Atkinson C, Baddour LM, Benjamin EJ, Bhalla K, Birbeck G, Bolliger I, Burstein R, Carnahan E, Chou D, Chugh SS, Cohen A, Colson KE, Cooper LT, Couser W, Criqui MH, Dabhadkar KC, Dellavalle RP, Jarlais, Dicker D, Dorsey ER, Duber H, Ebel BE, Engell RE, Ezzati M, Felson DT, Finucane MM, Flaxman S, Flaxman AD, Fleming T, Foreman, Forouzanfar MH, Freedman G, Freeman MK, Gakidou E, Gillum RF, Gonzalez-Medina D, Gosselin R, Gutierrez HR, Hagan H, Havmoeller R, Hoffman H, Jacobsen KH, James SL, Jasrasaria R, Jayarman S, Johns N, Kassebaum N, Khatibzadeh S, Lan Q, Leasher JL, Lim S, Lipshultz SE, London S, Lopez, Lozano R, Lu Y, Mallinger L, Meltzer M, Mensah GA, Michaud C, Miller TR, Mock C, Moffitt TE, Mokdad AA, Mokdad AH, Moran A, Naghavi M, Narayan KMV, Nelson RG, Olives C, Omer SB, Ortblad K, Ostro B, Pelizzari PM, Phillips D, Raju M, Razavi H, Ritz B, Roberts T, Sacco RL, Salomon J, Sampson U, Schwebel DC, Shahraz S, Shibuya K, Silberberg D, Singh JA, Steenland K, Taylor JA, Thurston GD, Vavilala MS, Vos T, Wagner GR, Weinstock MA, Weisskopf MG, Wulf S, Murray. The state of US health, 1990-2010: burden of diseases, injuries, and risk factors. JAMA 2013; 310:591-608. [PMID: 23842577 PMCID: PMC5436627 DOI: 10.1001/jama.2013.13805] [Citation(s) in RCA: 1731] [Impact Index Per Article: 157.4] [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: 11/14/2022]
Abstract
IMPORTANCE Understanding the major health problems in the United States and how they are changing over time is critical for informing national health policy. OBJECTIVES To measure the burden of diseases, injuries, and leading risk factors in the United States from 1990 to 2010 and to compare these measurements with those of the 34 countries in the Organisation for Economic Co-operation and Development (OECD) countries. DESIGN We used the systematic analysis of descriptive epidemiology of 291 diseases and injuries, 1160 sequelae of these diseases and injuries, and 67 risk factors or clusters of risk factors from 1990 to 2010 for 187 countries developed for the Global Burden of Disease 2010 Study to describe the health status of the United States and to compare US health outcomes with those of 34 OECD countries. Years of life lost due to premature mortality (YLLs) were computed by multiplying the number of deaths at each age by a reference life expectancy at that age. Years lived with disability (YLDs) were calculated by multiplying prevalence (based on systematic reviews) by the disability weight (based on population-based surveys) for each sequela; disability in this study refers to any short- or long-term loss of health. Disability-adjusted life-years (DALYs) were estimated as the sum of YLDs and YLLs. Deaths and DALYs related to risk factors were based on systematic reviews and meta-analyses of exposure data and relative risks for risk-outcome pairs. Healthy life expectancy (HALE) was used to summarize overall population health, accounting for both length of life and levels of ill health experienced at different ages. RESULTS US life expectancy for both sexes combined increased from 75.2 years in 1990 to 78.2 years in 2010; during the same period, HALE increased from 65.8 years to 68.1 years. The diseases and injuries with the largest number of YLLs in 2010 were ischemic heart disease, lung cancer, stroke, chronic obstructive pulmonary disease, and road injury. Age-standardized YLL rates increased for Alzheimer disease, drug use disorders, chronic kidney disease, kidney cancer, and falls. The diseases with the largest number of YLDs in 2010 were low back pain, major depressive disorder, other musculoskeletal disorders, neck pain, and anxiety disorders. As the US population has aged, YLDs have comprised a larger share of DALYs than have YLLs. The leading risk factors related to DALYs were dietary risks, tobacco smoking, high body mass index, high blood pressure, high fasting plasma glucose, physical inactivity, and alcohol use. Among 34 OECD countries between 1990 and 2010, the US rank for the age-standardized death rate changed from 18th to 27th, for the age-standardized YLL rate from 23rd to 28th, for the age-standardized YLD rate from 5th to 6th, for life expectancy at birth from 20th to 27th, and for HALE from 14th to 26th. CONCLUSIONS AND RELEVANCE From 1990 to 2010, the United States made substantial progress in improving health. Life expectancy at birth and HALE increased, all-cause death rates at all ages decreased, and age-specific rates of years lived with disability remained stable. However, morbidity and chronic disability now account for nearly half of the US health burden, and improvements in population health in the United States have not kept pace with advances in population health in other wealthy nations.
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Affiliation(s)
- Christopher J L Murray
- Institute for Health Metrics and Evaluation, 2301 Fifth Ave., Suite 600, Seattle, WA, 98121, USA.
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Kelada S, Sethupathy P, Okoye IS, Kistasis E, Czieso S, White SD, Chou D, Martens C, Ricklefs SM, Virtaneva K, Sturdevant DE, Porcella SF, Belkaid Y, Wynn TA, Wilson MS. miR-182 and miR-10a are key regulators of Treg specialisation and stability during Schistosome and Leishmania-associated inflammation. PLoS Pathog 2013; 9:e1003451. [PMID: 23825948 PMCID: PMC3695057 DOI: 10.1371/journal.ppat.1003451] [Citation(s) in RCA: 90] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Accepted: 05/07/2013] [Indexed: 12/22/2022] Open
Abstract
A diverse suite of effector immune responses provide protection against various pathogens. However, the array of effector responses must be immunologically regulated to limit pathogen- and immune-associated damage. CD4+Foxp3+ regulatory T cells (Treg) calibrate immune responses; however, how Treg cells adapt to control different effector responses is unclear. To investigate the molecular mechanism of Treg diversity we used whole genome expression profiling and next generation small RNA sequencing of Treg cells isolated from type-1 or type-2 inflamed tissue following Leishmania major or Schistosoma mansoni infection, respectively. In-silico analyses identified two miRNA “regulatory hubs” miR-10a and miR-182 as critical miRNAs in Th1- or Th2-associated Treg cells, respectively. Functionally and mechanistically, in-vitro and in-vivo systems identified that an IL-12/IFNγ axis regulated miR-10a and its putative transcription factor, Creb. Importantly, reduced miR-10a in Th1-associated Treg cells was critical for Treg function and controlled a suite of genes preventing IFNγ production. In contrast, IL-4 regulated miR-182 and cMaf in Th2-associed Treg cells, which mitigated IL-2 secretion, in part through repression of IL2-promoting genes. Together, this study indicates that CD4+Foxp3+ cells can be shaped by local environmental factors, which orchestrate distinct miRNA pathways preserving Treg stability and suppressor function. The diversity of pathogens that the immune system encounters are controlled by a diverse suite of immunological effector responses. Preserving a well-controlled protective immune response is essential. Too vigorous an effector response can be as damaging as too little. Regulatory T cells (Treg) calibrate immune responses; however, how Treg cells adapt to control the diverse suite of effector responses is unclear. In this study we investigated the molecular identity of regulatory T cells that control distinct effector immune responses against two discrete pathogens, an intracellular parasitic protozoa, Leishmania major, and an extracellular helminth parasite, Schitsosoma mansoni. The two Treg populations studied were phenotypically and functionally different. We identified molecular pathways that influence this diversity and more specifically, we identified that two miRNAs (miR-182 and miR-10a) act as “regulatory hubs” critically controlling distinct properties within each Treg population. This is the first study identifying the upstream molecular pathways controlling Treg cell specialization and provides a new platform of Treg cell manipulation to fine-tune their function.
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Affiliation(s)
- Samir Kelada
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Praveen Sethupathy
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Isobel S. Okoye
- Division of Molecular Immunology, MRC, National Institute for Medical Research, London, United Kingdom
| | - Eleni Kistasis
- Division of Molecular Immunology, MRC, National Institute for Medical Research, London, United Kingdom
| | - Stephanie Czieso
- Division of Molecular Immunology, MRC, National Institute for Medical Research, London, United Kingdom
| | - Sandra D. White
- Laboratory of Parasitic Diseases, National Institutes of Allergy and Infectious Disease, Bethesda, Maryland, United States of America
| | - David Chou
- Laboratory of Parasitic Diseases, National Institutes of Allergy and Infectious Disease, Bethesda, Maryland, United States of America
| | - Craig Martens
- Research Technologies Section, Rocky Mountain Laboratories, Hamilton, Montana, United States of America
| | - Stacy M. Ricklefs
- Research Technologies Section, Rocky Mountain Laboratories, Hamilton, Montana, United States of America
| | - Kimmo Virtaneva
- Research Technologies Section, Rocky Mountain Laboratories, Hamilton, Montana, United States of America
| | - Dan E. Sturdevant
- Research Technologies Section, Rocky Mountain Laboratories, Hamilton, Montana, United States of America
| | - Stephen F. Porcella
- Research Technologies Section, Rocky Mountain Laboratories, Hamilton, Montana, United States of America
| | - Yasmine Belkaid
- Laboratory of Parasitic Diseases, National Institutes of Allergy and Infectious Disease, Bethesda, Maryland, United States of America
| | - Thomas A. Wynn
- Laboratory of Parasitic Diseases, National Institutes of Allergy and Infectious Disease, Bethesda, Maryland, United States of America
| | - Mark S. Wilson
- Division of Molecular Immunology, MRC, National Institute for Medical Research, London, United Kingdom
- * E-mail:
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Reid S, Lu C, Casikar I, Reid G, Abbott J, Cario G, Chou D, Kowalski D, Cooper M, Condous G. Prediction of pouch of Douglas obliteration in women with suspected endometriosis using a new real-time dynamic transvaginal ultrasound technique: the sliding sign. Ultrasound Obstet Gynecol 2013; 41:685-691. [PMID: 23001892 DOI: 10.1002/uog.12305] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/20/2012] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To evaluate preoperative real-time dynamic transvaginal sonography (TVS) in the prediction of pouch of Douglas (POD) obliteration in women undergoing laparoscopy for suspected endometriosis. METHODS This was a multicenter prospective observational study undertaken from January 2009 to November 2011. All women with symptoms suggestive of endometriosis who were scheduled for laparoscopy underwent detailed preoperative TVS, in particular to ascertain whether the POD was obliterated. POD obliteration was assessed using a real-time TVS technique called the 'sliding sign'. Preoperative TVS sliding sign findings were then compared to gold standard laparoscopic POD findings. RESULTS One hundred consecutive women with preoperative TVS and laparoscopic outcomes were included in the final analysis. Mean age was 32.8 years and mean age at diagnosis of endometriosis was 27.4 years. At laparoscopy, 84/100 (84%) were found to have some form of endometriosis (73% peritoneal endometriosis, 35% ovarian endometrioma(s), 33% deep infiltrating endometriosis). At laparoscopy, 30/100 (30%) had an obliterated POD and 19/30 (63.3%) of these women also had evidence of bowel endometriosis. The sonographic sliding sign technique had an accuracy of 93.0%, sensitivity of 83.3%, specificity of 97.1%, positive predictive value of 92.6%, negative predictive value of 93.2%, positive likelihood ratio of 29.2 and negative likelihood ratio of 0.17 in the prediction of POD obliteration (P = 1.8E-16). CONCLUSIONS Preoperative real-time dynamic TVS evaluation using the sliding sign seems to establish with a high degree of certainty whether the POD is obliterated. Given the increased risk of deep infiltrating endometriosis in women with POD obliteration, the TVS sliding sign technique may also be useful in the identification of women who may be at a higher risk for bowel endometriosis.
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Affiliation(s)
- S Reid
- Acute Gynaecology, Early Pregnancy and Advanced Endosurgery Unit, Nepean Medical School, Nepean Hospital, University of Sydney, Penrith, NSW, Australia.
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Schankin CJ, Maniyar F, Hoffmann J, Chou D, Goadsby PJ. Clinical characterization of "visual snow" (Positive Persistent Visual Disturbance). J Headache Pain 2013. [PMCID: PMC3620302 DOI: 10.1186/1129-2377-14-s1-p132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, Abraham J, Adair T, Aggarwal R, Ahn SY, Alvarado M, Anderson HR, Anderson LM, Andrews KG, Atkinson C, Baddour LM, Barker-Collo S, Bartels DH, Bell ML, Benjamin EJ, Bennett D, Bhalla K, Bikbov B, Bin Abdulhak A, Birbeck G, Blyth F, Bolliger I, Boufous S, Bucello C, Burch M, Burney P, Carapetis J, Chen H, Chou D, Chugh SS, Coffeng LE, Colan SD, Colquhoun S, Colson KE, Condon J, Connor MD, Cooper LT, Corriere M, Cortinovis M, de Vaccaro KC, Couser W, Cowie BC, Criqui MH, Cross M, Dabhadkar KC, Dahodwala N, De Leo D, Degenhardt L, Delossantos A, Denenberg J, Des Jarlais DC, Dharmaratne SD, Dorsey ER, Driscoll T, Duber H, Ebel B, Erwin PJ, Espindola P, Ezzati M, Feigin V, Flaxman AD, Forouzanfar MH, Fowkes FGR, Franklin R, Fransen M, Freeman MK, Gabriel SE, Gakidou E, Gaspari F, Gillum RF, Gonzalez-Medina D, Halasa YA, Haring D, Harrison JE, Havmoeller R, Hay RJ, Hoen B, Hotez PJ, Hoy D, Jacobsen KH, James SL, Jasrasaria R, Jayaraman S, Johns N, Karthikeyan G, Kassebaum N, Keren A, Khoo JP, Knowlton LM, Kobusingye O, Koranteng A, Krishnamurthi R, Lipnick M, Lipshultz SE, Ohno SL, Mabweijano J, MacIntyre MF, Mallinger L, March L, Marks GB, Marks R, Matsumori A, Matzopoulos R, Mayosi BM, McAnulty JH, McDermott MM, McGrath J, Mensah GA, Merriman TR, Michaud C, Miller M, Miller TR, Mock C, Mocumbi AO, Mokdad AA, Moran A, Mulholland K, Nair MN, Naldi L, Narayan KMV, Nasseri K, Norman P, O'Donnell M, Omer SB, Ortblad K, Osborne R, Ozgediz D, Pahari B, Pandian JD, Rivero AP, Padilla RP, Perez-Ruiz F, Perico N, Phillips D, Pierce K, Pope CA, Porrini E, Pourmalek F, Raju M, Ranganathan D, Rehm JT, Rein DB, Remuzzi G, Rivara FP, Roberts T, De León FR, Rosenfeld LC, Rushton L, Sacco RL, Salomon JA, Sampson U, Sanman E, Schwebel DC, Segui-Gomez M, Shepard DS, Singh D, Singleton J, Sliwa K, Smith E, Steer A, Taylor JA, Thomas B, Tleyjeh IM, Towbin JA, Truelsen T, Undurraga EA, Venketasubramanian N, Vijayakumar L, Vos T, Wagner GR, Wang M, Wang W, Watt K, Weinstock MA, Weintraub R, Wilkinson JD, Woolf AD, Wulf S, Yeh PH, Yip P, Zabetian A, Zheng ZJ, Lopez AD, Murray CJL, AlMazroa MA, Memish ZA. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2013. [PMID: 23245604 DOI: 10.1016/s01406736(12)61728-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Reliable and timely information on the leading causes of death in populations, and how these are changing, is a crucial input into health policy debates. In the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010), we aimed to estimate annual deaths for the world and 21 regions between 1980 and 2010 for 235 causes, with uncertainty intervals (UIs), separately by age and sex. METHODS We attempted to identify all available data on causes of death for 187 countries from 1980 to 2010 from vital registration, verbal autopsy, mortality surveillance, censuses, surveys, hospitals, police records, and mortuaries. We assessed data quality for completeness, diagnostic accuracy, missing data, stochastic variations, and probable causes of death. We applied six different modelling strategies to estimate cause-specific mortality trends depending on the strength of the data. For 133 causes and three special aggregates we used the Cause of Death Ensemble model (CODEm) approach, which uses four families of statistical models testing a large set of different models using different permutations of covariates. Model ensembles were developed from these component models. We assessed model performance with rigorous out-of-sample testing of prediction error and the validity of 95% UIs. For 13 causes with low observed numbers of deaths, we developed negative binomial models with plausible covariates. For 27 causes for which death is rare, we modelled the higher level cause in the cause hierarchy of the GBD 2010 and then allocated deaths across component causes proportionately, estimated from all available data in the database. For selected causes (African trypanosomiasis, congenital syphilis, whooping cough, measles, typhoid and parathyroid, leishmaniasis, acute hepatitis E, and HIV/AIDS), we used natural history models based on information on incidence, prevalence, and case-fatality. We separately estimated cause fractions by aetiology for diarrhoea, lower respiratory infections, and meningitis, as well as disaggregations by subcause for chronic kidney disease, maternal disorders, cirrhosis, and liver cancer. For deaths due to collective violence and natural disasters, we used mortality shock regressions. For every cause, we estimated 95% UIs that captured both parameter estimation uncertainty and uncertainty due to model specification where CODEm was used. We constrained cause-specific fractions within every age-sex group to sum to total mortality based on draws from the uncertainty distributions. FINDINGS In 2010, there were 52·8 million deaths globally. At the most aggregate level, communicable, maternal, neonatal, and nutritional causes were 24·9% of deaths worldwide in 2010, down from 15·9 million (34·1%) of 46·5 million in 1990. This decrease was largely due to decreases in mortality from diarrhoeal disease (from 2·5 to 1·4 million), lower respiratory infections (from 3·4 to 2·8 million), neonatal disorders (from 3·1 to 2·2 million), measles (from 0·63 to 0·13 million), and tetanus (from 0·27 to 0·06 million). Deaths from HIV/AIDS increased from 0·30 million in 1990 to 1·5 million in 2010, reaching a peak of 1·7 million in 2006. Malaria mortality also rose by an estimated 19·9% since 1990 to 1·17 million deaths in 2010. Tuberculosis killed 1·2 million people in 2010. Deaths from non-communicable diseases rose by just under 8 million between 1990 and 2010, accounting for two of every three deaths (34·5 million) worldwide by 2010. 8 million people died from cancer in 2010, 38% more than two decades ago; of these, 1·5 million (19%) were from trachea, bronchus, and lung cancer. Ischaemic heart disease and stroke collectively killed 12·9 million people in 2010, or one in four deaths worldwide, compared with one in five in 1990; 1·3 million deaths were due to diabetes, twice as many as in 1990. The fraction of global deaths due to injuries (5·1 million deaths) was marginally higher in 2010 (9·6%) compared with two decades earlier (8·8%). This was driven by a 46% rise in deaths worldwide due to road traffic accidents (1·3 million in 2010) and a rise in deaths from falls. Ischaemic heart disease, stroke, chronic obstructive pulmonary disease (COPD), lower respiratory infections, lung cancer, and HIV/AIDS were the leading causes of death in 2010. Ischaemic heart disease, lower respiratory infections, stroke, diarrhoeal disease, malaria, and HIV/AIDS were the leading causes of years of life lost due to premature mortality (YLLs) in 2010, similar to what was estimated for 1990, except for HIV/AIDS and preterm birth complications. YLLs from lower respiratory infections and diarrhoea decreased by 45-54% since 1990; ischaemic heart disease and stroke YLLs increased by 17-28%. Regional variations in leading causes of death were substantial. Communicable, maternal, neonatal, and nutritional causes still accounted for 76% of premature mortality in sub-Saharan Africa in 2010. Age standardised death rates from some key disorders rose (HIV/AIDS, Alzheimer's disease, diabetes mellitus, and chronic kidney disease in particular), but for most diseases, death rates fell in the past two decades; including major vascular diseases, COPD, most forms of cancer, liver cirrhosis, and maternal disorders. For other conditions, notably malaria, prostate cancer, and injuries, little change was noted. INTERPRETATION Population growth, increased average age of the world's population, and largely decreasing age-specific, sex-specific, and cause-specific death rates combine to drive a broad shift from communicable, maternal, neonatal, and nutritional causes towards non-communicable diseases. Nevertheless, communicable, maternal, neonatal, and nutritional causes remain the dominant causes of YLLs in sub-Saharan Africa. Overlaid on this general pattern of the epidemiological transition, marked regional variation exists in many causes, such as interpersonal violence, suicide, liver cancer, diabetes, cirrhosis, Chagas disease, African trypanosomiasis, melanoma, and others. Regional heterogeneity highlights the importance of sound epidemiological assessments of the causes of death on a regular basis. FUNDING Bill & Melinda Gates Foundation.
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Affiliation(s)
- Rafael Lozano
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
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Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, Abraham J, Adair T, Aggarwal R, Ahn SY, Alvarado M, Anderson HR, Anderson LM, Andrews KG, Atkinson C, Baddour LM, Barker-Collo S, Bartels DH, Bell ML, Benjamin EJ, Bennett D, Bhalla K, Bikbov B, Bin Abdulhak A, Birbeck G, Blyth F, Bolliger I, Boufous S, Bucello C, Burch M, Burney P, Carapetis J, Chen H, Chou D, Chugh SS, Coffeng LE, Colan SD, Colquhoun S, Colson KE, Condon J, Connor MD, Cooper LT, Corriere M, Cortinovis M, de Vaccaro KC, Couser W, Cowie BC, Criqui MH, Cross M, Dabhadkar KC, Dahodwala N, De Leo D, Degenhardt L, Delossantos A, Denenberg J, Des Jarlais DC, Dharmaratne SD, Dorsey ER, Driscoll T, Duber H, Ebel B, Erwin PJ, Espindola P, Ezzati M, Feigin V, Flaxman AD, Forouzanfar MH, Fowkes FGR, Franklin R, Fransen M, Freeman MK, Gabriel SE, Gakidou E, Gaspari F, Gillum RF, Gonzalez-Medina D, Halasa YA, Haring D, Harrison JE, Havmoeller R, Hay RJ, Hoen B, Hotez PJ, Hoy D, Jacobsen KH, James SL, Jasrasaria R, Jayaraman S, Johns N, Karthikeyan G, Kassebaum N, Keren A, Khoo JP, Knowlton LM, Kobusingye O, Koranteng A, Krishnamurthi R, Lipnick M, Lipshultz SE, Ohno SL, Mabweijano J, MacIntyre MF, Mallinger L, March L, Marks GB, Marks R, Matsumori A, Matzopoulos R, Mayosi BM, McAnulty JH, McDermott MM, McGrath J, Mensah GA, Merriman TR, Michaud C, Miller M, Miller TR, Mock C, Mocumbi AO, Mokdad AA, Moran A, Mulholland K, Nair MN, Naldi L, Narayan KMV, Nasseri K, Norman P, O'Donnell M, Omer SB, Ortblad K, Osborne R, Ozgediz D, Pahari B, Pandian JD, Rivero AP, Padilla RP, Perez-Ruiz F, Perico N, Phillips D, Pierce K, Pope CA, Porrini E, Pourmalek F, Raju M, Ranganathan D, Rehm JT, Rein DB, Remuzzi G, Rivara FP, Roberts T, De León FR, Rosenfeld LC, Rushton L, Sacco RL, Salomon JA, Sampson U, Sanman E, Schwebel DC, Segui-Gomez M, Shepard DS, Singh D, Singleton J, Sliwa K, Smith E, Steer A, Taylor JA, Thomas B, Tleyjeh IM, Towbin JA, Truelsen T, Undurraga EA, Venketasubramanian N, Vijayakumar L, Vos T, Wagner GR, Wang M, Wang W, Watt K, Weinstock MA, Weintraub R, Wilkinson JD, Woolf AD, Wulf S, Yeh PH, Yip P, Zabetian A, Zheng ZJ, Lopez AD, Murray CJL, AlMazroa MA, Memish ZA. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2013. [PMID: 23245604 DOI: 10.1016/s0140-6736(12)61728-0s] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Reliable and timely information on the leading causes of death in populations, and how these are changing, is a crucial input into health policy debates. In the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010), we aimed to estimate annual deaths for the world and 21 regions between 1980 and 2010 for 235 causes, with uncertainty intervals (UIs), separately by age and sex. METHODS We attempted to identify all available data on causes of death for 187 countries from 1980 to 2010 from vital registration, verbal autopsy, mortality surveillance, censuses, surveys, hospitals, police records, and mortuaries. We assessed data quality for completeness, diagnostic accuracy, missing data, stochastic variations, and probable causes of death. We applied six different modelling strategies to estimate cause-specific mortality trends depending on the strength of the data. For 133 causes and three special aggregates we used the Cause of Death Ensemble model (CODEm) approach, which uses four families of statistical models testing a large set of different models using different permutations of covariates. Model ensembles were developed from these component models. We assessed model performance with rigorous out-of-sample testing of prediction error and the validity of 95% UIs. For 13 causes with low observed numbers of deaths, we developed negative binomial models with plausible covariates. For 27 causes for which death is rare, we modelled the higher level cause in the cause hierarchy of the GBD 2010 and then allocated deaths across component causes proportionately, estimated from all available data in the database. For selected causes (African trypanosomiasis, congenital syphilis, whooping cough, measles, typhoid and parathyroid, leishmaniasis, acute hepatitis E, and HIV/AIDS), we used natural history models based on information on incidence, prevalence, and case-fatality. We separately estimated cause fractions by aetiology for diarrhoea, lower respiratory infections, and meningitis, as well as disaggregations by subcause for chronic kidney disease, maternal disorders, cirrhosis, and liver cancer. For deaths due to collective violence and natural disasters, we used mortality shock regressions. For every cause, we estimated 95% UIs that captured both parameter estimation uncertainty and uncertainty due to model specification where CODEm was used. We constrained cause-specific fractions within every age-sex group to sum to total mortality based on draws from the uncertainty distributions. FINDINGS In 2010, there were 52·8 million deaths globally. At the most aggregate level, communicable, maternal, neonatal, and nutritional causes were 24·9% of deaths worldwide in 2010, down from 15·9 million (34·1%) of 46·5 million in 1990. This decrease was largely due to decreases in mortality from diarrhoeal disease (from 2·5 to 1·4 million), lower respiratory infections (from 3·4 to 2·8 million), neonatal disorders (from 3·1 to 2·2 million), measles (from 0·63 to 0·13 million), and tetanus (from 0·27 to 0·06 million). Deaths from HIV/AIDS increased from 0·30 million in 1990 to 1·5 million in 2010, reaching a peak of 1·7 million in 2006. Malaria mortality also rose by an estimated 19·9% since 1990 to 1·17 million deaths in 2010. Tuberculosis killed 1·2 million people in 2010. Deaths from non-communicable diseases rose by just under 8 million between 1990 and 2010, accounting for two of every three deaths (34·5 million) worldwide by 2010. 8 million people died from cancer in 2010, 38% more than two decades ago; of these, 1·5 million (19%) were from trachea, bronchus, and lung cancer. Ischaemic heart disease and stroke collectively killed 12·9 million people in 2010, or one in four deaths worldwide, compared with one in five in 1990; 1·3 million deaths were due to diabetes, twice as many as in 1990. The fraction of global deaths due to injuries (5·1 million deaths) was marginally higher in 2010 (9·6%) compared with two decades earlier (8·8%). This was driven by a 46% rise in deaths worldwide due to road traffic accidents (1·3 million in 2010) and a rise in deaths from falls. Ischaemic heart disease, stroke, chronic obstructive pulmonary disease (COPD), lower respiratory infections, lung cancer, and HIV/AIDS were the leading causes of death in 2010. Ischaemic heart disease, lower respiratory infections, stroke, diarrhoeal disease, malaria, and HIV/AIDS were the leading causes of years of life lost due to premature mortality (YLLs) in 2010, similar to what was estimated for 1990, except for HIV/AIDS and preterm birth complications. YLLs from lower respiratory infections and diarrhoea decreased by 45-54% since 1990; ischaemic heart disease and stroke YLLs increased by 17-28%. Regional variations in leading causes of death were substantial. Communicable, maternal, neonatal, and nutritional causes still accounted for 76% of premature mortality in sub-Saharan Africa in 2010. Age standardised death rates from some key disorders rose (HIV/AIDS, Alzheimer's disease, diabetes mellitus, and chronic kidney disease in particular), but for most diseases, death rates fell in the past two decades; including major vascular diseases, COPD, most forms of cancer, liver cirrhosis, and maternal disorders. For other conditions, notably malaria, prostate cancer, and injuries, little change was noted. INTERPRETATION Population growth, increased average age of the world's population, and largely decreasing age-specific, sex-specific, and cause-specific death rates combine to drive a broad shift from communicable, maternal, neonatal, and nutritional causes towards non-communicable diseases. Nevertheless, communicable, maternal, neonatal, and nutritional causes remain the dominant causes of YLLs in sub-Saharan Africa. Overlaid on this general pattern of the epidemiological transition, marked regional variation exists in many causes, such as interpersonal violence, suicide, liver cancer, diabetes, cirrhosis, Chagas disease, African trypanosomiasis, melanoma, and others. Regional heterogeneity highlights the importance of sound epidemiological assessments of the causes of death on a regular basis. FUNDING Bill & Melinda Gates Foundation.
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Affiliation(s)
- Rafael Lozano
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
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Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, Shibuya K, Salomon JA, Abdalla S, Aboyans V, Abraham J, Ackerman I, Aggarwal R, Ahn SY, Ali MK, Alvarado M, Anderson HR, Anderson LM, Andrews KG, Atkinson C, Baddour LM, Bahalim AN, Barker-Collo S, Barrero LH, Bartels DH, Basáñez MG, Baxter A, Bell ML, Benjamin EJ, Bennett D, Bernabé E, Bhalla K, Bhandari B, Bikbov B, Bin Abdulhak A, Birbeck G, Black JA, Blencowe H, Blore JD, Blyth F, Bolliger I, Bonaventure A, Boufous S, Bourne R, Boussinesq M, Braithwaite T, Brayne C, Bridgett L, Brooker S, Brooks P, Brugha TS, Bryan-Hancock C, Bucello C, Buchbinder R, Buckle G, Budke CM, Burch M, Burney P, Burstein R, Calabria B, Campbell B, Canter CE, Carabin H, Carapetis J, Carmona L, Cella C, Charlson F, Chen H, Cheng ATA, Chou D, Chugh SS, Coffeng LE, Colan SD, Colquhoun S, Colson KE, Condon J, Connor MD, Cooper LT, Corriere M, Cortinovis M, de Vaccaro KC, Couser W, Cowie BC, Criqui MH, Cross M, Dabhadkar KC, Dahiya M, Dahodwala N, Damsere-Derry J, Danaei G, Davis A, De Leo D, Degenhardt L, Dellavalle R, Delossantos A, Denenberg J, Derrett S, Des Jarlais DC, Dharmaratne SD, Dherani M, Diaz-Torne C, Dolk H, Dorsey ER, Driscoll T, Duber H, Ebel B, Edmond K, Elbaz A, Ali SE, Erskine H, Erwin PJ, Espindola P, Ewoigbokhan SE, Farzadfar F, Feigin V, Felson DT, Ferrari A, Ferri CP, Fèvre EM, Finucane MM, Flaxman S, Flood L, Foreman K, Forouzanfar MH, Fowkes FGR, Franklin R, Fransen M, Freeman MK, Gabbe BJ, Gabriel SE, Gakidou E, Ganatra HA, Garcia B, Gaspari F, Gillum RF, Gmel G, Gosselin R, Grainger R, Groeger J, Guillemin F, Gunnell D, Gupta R, Haagsma J, Hagan H, Halasa YA, Hall W, Haring D, Haro JM, Harrison JE, Havmoeller R, Hay RJ, Higashi H, Hill C, Hoen B, Hoffman H, Hotez PJ, Hoy D, Huang JJ, Ibeanusi SE, Jacobsen KH, James SL, Jarvis D, Jasrasaria R, Jayaraman S, Johns N, Jonas JB, Karthikeyan G, Kassebaum N, Kawakami N, Keren A, Khoo JP, King CH, Knowlton LM, Kobusingye O, Koranteng A, Krishnamurthi R, Lalloo R, Laslett LL, Lathlean T, Leasher JL, Lee YY, Leigh J, Lim SS, Limb E, Lin JK, Lipnick M, Lipshultz SE, Liu W, Loane M, Ohno SL, Lyons R, Ma J, Mabweijano J, MacIntyre MF, Malekzadeh R, Mallinger L, Manivannan S, Marcenes W, March L, Margolis DJ, Marks GB, Marks R, Matsumori A, Matzopoulos R, Mayosi BM, McAnulty JH, McDermott MM, McGill N, McGrath J, Medina-Mora ME, Meltzer M, Mensah GA, Merriman TR, Meyer AC, Miglioli V, Miller M, Miller TR, Mitchell PB, Mocumbi AO, Moffitt TE, Mokdad AA, Monasta L, Montico M, Moradi-Lakeh M, Moran A, Morawska L, Mori R, Murdoch ME, Mwaniki MK, Naidoo K, Nair MN, Naldi L, Narayan KMV, Nelson PK, Nelson RG, Nevitt MC, Newton CR, Nolte S, Norman P, Norman R, O'Donnell M, O'Hanlon S, Olives C, Omer SB, Ortblad K, Osborne R, Ozgediz D, Page A, Pahari B, Pandian JD, Rivero AP, Patten SB, Pearce N, Padilla RP, Perez-Ruiz F, Perico N, Pesudovs K, Phillips D, Phillips MR, Pierce K, Pion S, Polanczyk GV, Polinder S, Pope CA, Popova S, Porrini E, Pourmalek F, Prince M, Pullan RL, Ramaiah KD, Ranganathan D, Razavi H, Regan M, Rehm JT, Rein DB, Remuzzi G, Richardson K, Rivara FP, Roberts T, Robinson C, De Leòn FR, Ronfani L, Room R, Rosenfeld LC, Rushton L, Sacco RL, Saha S, Sampson U, Sanchez-Riera L, Sanman E, Schwebel DC, Scott JG, Segui-Gomez M, Shahraz S, Shepard DS, Shin H, Shivakoti R, Singh D, Singh GM, Singh JA, Singleton J, Sleet DA, Sliwa K, Smith E, Smith JL, Stapelberg NJC, Steer A, Steiner T, Stolk WA, Stovner LJ, Sudfeld C, Syed S, Tamburlini G, Tavakkoli M, Taylor HR, Taylor JA, Taylor WJ, Thomas B, Thomson WM, Thurston GD, Tleyjeh IM, Tonelli M, Towbin JA, Truelsen T, Tsilimbaris MK, Ubeda C, Undurraga EA, van der Werf MJ, van Os J, Vavilala MS, Venketasubramanian N, Wang M, Wang W, Watt K, Weatherall DJ, Weinstock MA, Weintraub R, Weisskopf MG, Weissman MM, White RA, Whiteford H, Wiersma ST, Wilkinson JD, Williams HC, Williams SRM, Witt E, Wolfe F, Woolf AD, Wulf S, Yeh PH, Zaidi AKM, Zheng ZJ, Zonies D, Lopez AD, Murray CJL, AlMazroa MA, Memish ZA. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012; 380:2163-96. [PMID: 23245607 PMCID: PMC6350784 DOI: 10.1016/s0140-6736(12)61729-2] [Citation(s) in RCA: 5394] [Impact Index Per Article: 449.5] [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: 10/27/2022]
Abstract
BACKGROUND Non-fatal health outcomes from diseases and injuries are a crucial consideration in the promotion and monitoring of individual and population health. The Global Burden of Disease (GBD) studies done in 1990 and 2000 have been the only studies to quantify non-fatal health outcomes across an exhaustive set of disorders at the global and regional level. Neither effort quantified uncertainty in prevalence or years lived with disability (YLDs). METHODS Of the 291 diseases and injuries in the GBD cause list, 289 cause disability. For 1160 sequelae of the 289 diseases and injuries, we undertook a systematic analysis of prevalence, incidence, remission, duration, and excess mortality. Sources included published studies, case notification, population-based cancer registries, other disease registries, antenatal clinic serosurveillance, hospital discharge data, ambulatory care data, household surveys, other surveys, and cohort studies. For most sequelae, we used a Bayesian meta-regression method, DisMod-MR, designed to address key limitations in descriptive epidemiological data, including missing data, inconsistency, and large methodological variation between data sources. For some disorders, we used natural history models, geospatial models, back-calculation models (models calculating incidence from population mortality rates and case fatality), or registration completeness models (models adjusting for incomplete registration with health-system access and other covariates). Disability weights for 220 unique health states were used to capture the severity of health loss. YLDs by cause at age, sex, country, and year levels were adjusted for comorbidity with simulation methods. We included uncertainty estimates at all stages of the analysis. FINDINGS Global prevalence for all ages combined in 2010 across the 1160 sequelae ranged from fewer than one case per 1 million people to 350,000 cases per 1 million people. Prevalence and severity of health loss were weakly correlated (correlation coefficient -0·37). In 2010, there were 777 million YLDs from all causes, up from 583 million in 1990. The main contributors to global YLDs were mental and behavioural disorders, musculoskeletal disorders, and diabetes or endocrine diseases. The leading specific causes of YLDs were much the same in 2010 as they were in 1990: low back pain, major depressive disorder, iron-deficiency anaemia, neck pain, chronic obstructive pulmonary disease, anxiety disorders, migraine, diabetes, and falls. Age-specific prevalence of YLDs increased with age in all regions and has decreased slightly from 1990 to 2010. Regional patterns of the leading causes of YLDs were more similar compared with years of life lost due to premature mortality. Neglected tropical diseases, HIV/AIDS, tuberculosis, malaria, and anaemia were important causes of YLDs in sub-Saharan Africa. INTERPRETATION Rates of YLDs per 100,000 people have remained largely constant over time but rise steadily with age. Population growth and ageing have increased YLD numbers and crude rates over the past two decades. Prevalences of the most common causes of YLDs, such as mental and behavioural disorders and musculoskeletal disorders, have not decreased. Health systems will need to address the needs of the rising numbers of individuals with a range of disorders that largely cause disability but not mortality. Quantification of the burden of non-fatal health outcomes will be crucial to understand how well health systems are responding to these challenges. Effective and affordable strategies to deal with this rising burden are an urgent priority for health systems in most parts of the world. FUNDING Bill & Melinda Gates Foundation.
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Affiliation(s)
- Theo Vos
- School of Population Health, Brisbane, QLD, Australia
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Murray CJL, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, Ezzati M, Shibuya K, Salomon JA, Abdalla S, Aboyans V, Abraham J, Ackerman I, Aggarwal R, Ahn SY, Ali MK, Alvarado M, Anderson HR, Anderson LM, Andrews KG, Atkinson C, Baddour LM, Bahalim AN, Barker-Collo S, Barrero LH, Bartels DH, Basáñez MG, Baxter A, Bell ML, Benjamin EJ, Bennett D, Bernabé E, Bhalla K, Bhandari B, Bikbov B, Bin Abdulhak A, Birbeck G, Black JA, Blencowe H, Blore JD, Blyth F, Bolliger I, Bonaventure A, Boufous S, Bourne R, Boussinesq M, Braithwaite T, Brayne C, Bridgett L, Brooker S, Brooks P, Brugha TS, Bryan-Hancock C, Bucello C, Buchbinder R, Buckle G, Budke CM, Burch M, Burney P, Burstein R, Calabria B, Campbell B, Canter CE, Carabin H, Carapetis J, Carmona L, Cella C, Charlson F, Chen H, Cheng ATA, Chou D, Chugh SS, Coffeng LE, Colan SD, Colquhoun S, Colson KE, Condon J, Connor MD, Cooper LT, Corriere M, Cortinovis M, de Vaccaro KC, Couser W, Cowie BC, Criqui MH, Cross M, Dabhadkar KC, Dahiya M, Dahodwala N, Damsere-Derry J, Danaei G, Davis A, De Leo D, Degenhardt L, Dellavalle R, Delossantos A, Denenberg J, Derrett S, Des Jarlais DC, Dharmaratne SD, Dherani M, Diaz-Torne C, Dolk H, Dorsey ER, Driscoll T, Duber H, Ebel B, Edmond K, Elbaz A, Ali SE, Erskine H, Erwin PJ, Espindola P, Ewoigbokhan SE, Farzadfar F, Feigin V, Felson DT, Ferrari A, Ferri CP, Fèvre EM, Finucane MM, Flaxman S, Flood L, Foreman K, Forouzanfar MH, Fowkes FGR, Fransen M, Freeman MK, Gabbe BJ, Gabriel SE, Gakidou E, Ganatra HA, Garcia B, Gaspari F, Gillum RF, Gmel G, Gonzalez-Medina D, Gosselin R, Grainger R, Grant B, Groeger J, Guillemin F, Gunnell D, Gupta R, Haagsma J, Hagan H, Halasa YA, Hall W, Haring D, Haro JM, Harrison JE, Havmoeller R, Hay RJ, Higashi H, Hill C, Hoen B, Hoffman H, Hotez PJ, Hoy D, Huang JJ, Ibeanusi SE, Jacobsen KH, James SL, Jarvis D, Jasrasaria R, Jayaraman S, Johns N, Jonas JB, Karthikeyan G, Kassebaum N, Kawakami N, Keren A, Khoo JP, King CH, Knowlton LM, Kobusingye O, Koranteng A, Krishnamurthi R, Laden F, Lalloo R, Laslett LL, Lathlean T, Leasher JL, Lee YY, Leigh J, Levinson D, Lim SS, Limb E, Lin JK, Lipnick M, Lipshultz SE, Liu W, Loane M, Ohno SL, Lyons R, Mabweijano J, MacIntyre MF, Malekzadeh R, Mallinger L, Manivannan S, Marcenes W, March L, Margolis DJ, Marks GB, Marks R, Matsumori A, Matzopoulos R, Mayosi BM, McAnulty JH, McDermott MM, McGill N, McGrath J, Medina-Mora ME, Meltzer M, Mensah GA, Merriman TR, Meyer AC, Miglioli V, Miller M, Miller TR, Mitchell PB, Mock C, Mocumbi AO, Moffitt TE, Mokdad AA, Monasta L, Montico M, Moradi-Lakeh M, Moran A, Morawska L, Mori R, Murdoch ME, Mwaniki MK, Naidoo K, Nair MN, Naldi L, Narayan KMV, Nelson PK, Nelson RG, Nevitt MC, Newton CR, Nolte S, Norman P, Norman R, O'Donnell M, O'Hanlon S, Olives C, Omer SB, Ortblad K, Osborne R, Ozgediz D, Page A, Pahari B, Pandian JD, Rivero AP, Patten SB, Pearce N, Padilla RP, Perez-Ruiz F, Perico N, Pesudovs K, Phillips D, Phillips MR, Pierce K, Pion S, Polanczyk GV, Polinder S, Pope CA, Popova S, Porrini E, Pourmalek F, Prince M, Pullan RL, Ramaiah KD, Ranganathan D, Razavi H, Regan M, Rehm JT, Rein DB, Remuzzi G, Richardson K, Rivara FP, Roberts T, Robinson C, De Leòn FR, Ronfani L, Room R, Rosenfeld LC, Rushton L, Sacco RL, Saha S, Sampson U, Sanchez-Riera L, Sanman E, Schwebel DC, Scott JG, Segui-Gomez M, Shahraz S, Shepard DS, Shin H, Shivakoti R, Singh D, Singh GM, Singh JA, Singleton J, Sleet DA, Sliwa K, Smith E, Smith JL, Stapelberg NJC, Steer A, Steiner T, Stolk WA, Stovner LJ, Sudfeld C, Syed S, Tamburlini G, Tavakkoli M, Taylor HR, Taylor JA, Taylor WJ, Thomas B, Thomson WM, Thurston GD, Tleyjeh IM, Tonelli M, Towbin JA, Truelsen T, Tsilimbaris MK, Ubeda C, Undurraga EA, van der Werf MJ, van Os J, Vavilala MS, Venketasubramanian N, Wang M, Wang W, Watt K, Weatherall DJ, Weinstock MA, Weintraub R, Weisskopf MG, Weissman MM, White RA, Whiteford H, Wiebe N, Wiersma ST, Wilkinson JD, Williams HC, Williams SRM, Witt E, Wolfe F, Woolf AD, Wulf S, Yeh PH, Zaidi AKM, Zheng ZJ, Zonies D, Lopez AD, AlMazroa MA, Memish ZA. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012; 380:2197-223. [PMID: 23245608 DOI: 10.1016/s0140-6736(12)61689-4] [Citation(s) in RCA: 5812] [Impact Index Per Article: 484.3] [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: 11/28/2022]
Abstract
BACKGROUND Measuring disease and injury burden in populations requires a composite metric that captures both premature mortality and the prevalence and severity of ill-health. The 1990 Global Burden of Disease study proposed disability-adjusted life years (DALYs) to measure disease burden. No comprehensive update of disease burden worldwide incorporating a systematic reassessment of disease and injury-specific epidemiology has been done since the 1990 study. We aimed to calculate disease burden worldwide and for 21 regions for 1990, 2005, and 2010 with methods to enable meaningful comparisons over time. METHODS We calculated DALYs as the sum of years of life lost (YLLs) and years lived with disability (YLDs). DALYs were calculated for 291 causes, 20 age groups, both sexes, and for 187 countries, and aggregated to regional and global estimates of disease burden for three points in time with strictly comparable definitions and methods. YLLs were calculated from age-sex-country-time-specific estimates of mortality by cause, with death by standardised lost life expectancy at each age. YLDs were calculated as prevalence of 1160 disabling sequelae, by age, sex, and cause, and weighted by new disability weights for each health state. Neither YLLs nor YLDs were age-weighted or discounted. Uncertainty around cause-specific DALYs was calculated incorporating uncertainty in levels of all-cause mortality, cause-specific mortality, prevalence, and disability weights. FINDINGS Global DALYs remained stable from 1990 (2·503 billion) to 2010 (2·490 billion). Crude DALYs per 1000 decreased by 23% (472 per 1000 to 361 per 1000). An important shift has occurred in DALY composition with the contribution of deaths and disability among children (younger than 5 years of age) declining from 41% of global DALYs in 1990 to 25% in 2010. YLLs typically account for about half of disease burden in more developed regions (high-income Asia Pacific, western Europe, high-income North America, and Australasia), rising to over 80% of DALYs in sub-Saharan Africa. In 1990, 47% of DALYs worldwide were from communicable, maternal, neonatal, and nutritional disorders, 43% from non-communicable diseases, and 10% from injuries. By 2010, this had shifted to 35%, 54%, and 11%, respectively. Ischaemic heart disease was the leading cause of DALYs worldwide in 2010 (up from fourth rank in 1990, increasing by 29%), followed by lower respiratory infections (top rank in 1990; 44% decline in DALYs), stroke (fifth in 1990; 19% increase), diarrhoeal diseases (second in 1990; 51% decrease), and HIV/AIDS (33rd in 1990; 351% increase). Major depressive disorder increased from 15th to 11th rank (37% increase) and road injury from 12th to 10th rank (34% increase). Substantial heterogeneity exists in rankings of leading causes of disease burden among regions. INTERPRETATION Global disease burden has continued to shift away from communicable to non-communicable diseases and from premature death to years lived with disability. In sub-Saharan Africa, however, many communicable, maternal, neonatal, and nutritional disorders remain the dominant causes of disease burden. The rising burden from mental and behavioural disorders, musculoskeletal disorders, and diabetes will impose new challenges on health systems. Regional heterogeneity highlights the importance of understanding local burden of disease and setting goals and targets for the post-2015 agenda taking such patterns into account. Because of improved definitions, methods, and data, these results for 1990 and 2010 supersede all previously published Global Burden of Disease results. FUNDING Bill & Melinda Gates Foundation.
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Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, Abraham J, Adair T, Aggarwal R, Ahn SY, AlMazroa MA, Alvarado M, Anderson HR, Anderson LM, Andrews KG, Atkinson C, Baddour LM, Barker-Collo S, Bartels DH, Bell ML, Benjamin EJ, Bennett D, Bhalla K, Bikbov B, Abdulhak AB, Birbeck G, Blyth F, Bolliger I, Boufous S, Bucello C, Burch M, Burney P, Carapetis J, Chen H, Chou D, Chugh SS, Coffeng LE, Colan SD, Colquhoun S, Colson KE, Condon J, Connor MD, Cooper LT, Corriere M, Cortinovis M, de Vaccaro KC, Couser W, Cowie BC, Criqui MH, Cross M, Dabhadkar KC, Dahodwala N, Leo DD, Degenhardt L, Delossantos A, Denenberg J, Jarlais DCD, Dharmaratne SD, Dorsey ER, Driscoll T, Duber H, Ebel B, Erwin PJ, Espindola P, Ezzati M, Feigin V, Flaxman AD, Forouzanfar MH, Fowkes FGR, Franklin R, Fransen M, Freeman MK, Gabriel SE, Gakidou E, Gaspari F, Gillum RF, Gonzalez-Medina D, Halasa YA, Haring D, Harrison JE, Havmoeller R, Hay RJ, Hoen B, Hotez PJ, Hoy D, Jacobsen KH, James SL, Jasrasaria R, Jayaraman S, Johns N, Karthikeyan G, Kassebaum N, Keren A, Khoo JP, Knowlton LM, Kobusingye O, Koranteng A, Krishnamurthi R, Lipnick M, Lipshultz SE, Ohno SL, Mabweijano J, MacIntyre MF, Mallinger L, March L, Marks GB, Marks R, Matsumori A, Matzopoulos R, Mayosi BM, McAnulty JH, McDermott MM, McGrath J, Memish ZA, Mensah GA, Merriman TR, Michaud C, Miller M, Miller TR, Mock C, Mocumbi AO, Mokdad AA, Moran A, Mulholland K, Nair MN, Naldi L, Narayan KMV, Nasseri K, Norman P, O’Donnell M, Omer SB, Ortblad K, Osborne R, Ozgediz D, Pahari B, Pandian JD, Rivero AP, Padilla RP, Perez-Ruiz F, Perico N, Phillips D, Pierce K, Pope CA, Porrini E, Pourmalek F, Raju M, Ranganathan D, Rehm JT, Rein DB, Remuzzi G, Rivara FP, Roberts T, De León FR, Rosenfeld LC, Rushton L, Sacco RL, Salomon JA, Sampson U, Sanman E, Schwebel DC, Segui-Gomez M, Shepard DS, Singh D, Singleton J, Sliwa K, Smith E, Steer A, Taylor JA, Thomas B, Tleyjeh IM, Towbin JA, Truelsen T, Undurraga EA, Venketasubramanian N, Vijayakumar L, Vos T, Wagner GR, Wang M, Wang W, Watt K, Weinstock MA, Weintraub R, Wilkinson JD, Woolf AD, Wulf S, Yeh PH, Yip P, Zabetian A, Zheng ZJ, Lopez AD, Murray CJL. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012; 380:2095-128. [PMID: 23245604 PMCID: PMC10790329 DOI: 10.1016/s0140-6736(12)61728-0] [Citation(s) in RCA: 9117] [Impact Index Per Article: 759.8] [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: 11/25/2022]
Abstract
BACKGROUND Reliable and timely information on the leading causes of death in populations, and how these are changing, is a crucial input into health policy debates. In the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010), we aimed to estimate annual deaths for the world and 21 regions between 1980 and 2010 for 235 causes, with uncertainty intervals (UIs), separately by age and sex. METHODS We attempted to identify all available data on causes of death for 187 countries from 1980 to 2010 from vital registration, verbal autopsy, mortality surveillance, censuses, surveys, hospitals, police records, and mortuaries. We assessed data quality for completeness, diagnostic accuracy, missing data, stochastic variations, and probable causes of death. We applied six different modelling strategies to estimate cause-specific mortality trends depending on the strength of the data. For 133 causes and three special aggregates we used the Cause of Death Ensemble model (CODEm) approach, which uses four families of statistical models testing a large set of different models using different permutations of covariates. Model ensembles were developed from these component models. We assessed model performance with rigorous out-of-sample testing of prediction error and the validity of 95% UIs. For 13 causes with low observed numbers of deaths, we developed negative binomial models with plausible covariates. For 27 causes for which death is rare, we modelled the higher level cause in the cause hierarchy of the GBD 2010 and then allocated deaths across component causes proportionately, estimated from all available data in the database. For selected causes (African trypanosomiasis, congenital syphilis, whooping cough, measles, typhoid and parathyroid, leishmaniasis, acute hepatitis E, and HIV/AIDS), we used natural history models based on information on incidence, prevalence, and case-fatality. We separately estimated cause fractions by aetiology for diarrhoea, lower respiratory infections, and meningitis, as well as disaggregations by subcause for chronic kidney disease, maternal disorders, cirrhosis, and liver cancer. For deaths due to collective violence and natural disasters, we used mortality shock regressions. For every cause, we estimated 95% UIs that captured both parameter estimation uncertainty and uncertainty due to model specification where CODEm was used. We constrained cause-specific fractions within every age-sex group to sum to total mortality based on draws from the uncertainty distributions. FINDINGS In 2010, there were 52·8 million deaths globally. At the most aggregate level, communicable, maternal, neonatal, and nutritional causes were 24·9% of deaths worldwide in 2010, down from 15·9 million (34·1%) of 46·5 million in 1990. This decrease was largely due to decreases in mortality from diarrhoeal disease (from 2·5 to 1·4 million), lower respiratory infections (from 3·4 to 2·8 million), neonatal disorders (from 3·1 to 2·2 million), measles (from 0·63 to 0·13 million), and tetanus (from 0·27 to 0·06 million). Deaths from HIV/AIDS increased from 0·30 million in 1990 to 1·5 million in 2010, reaching a peak of 1·7 million in 2006. Malaria mortality also rose by an estimated 19·9% since 1990 to 1·17 million deaths in 2010. Tuberculosis killed 1·2 million people in 2010. Deaths from non-communicable diseases rose by just under 8 million between 1990 and 2010, accounting for two of every three deaths (34·5 million) worldwide by 2010. 8 million people died from cancer in 2010, 38% more than two decades ago; of these, 1·5 million (19%) were from trachea, bronchus, and lung cancer. Ischaemic heart disease and stroke collectively killed 12·9 million people in 2010, or one in four deaths worldwide, compared with one in five in 1990; 1·3 million deaths were due to diabetes, twice as many as in 1990. The fraction of global deaths due to injuries (5·1 million deaths) was marginally higher in 2010 (9·6%) compared with two decades earlier (8·8%). This was driven by a 46% rise in deaths worldwide due to road traffic accidents (1·3 million in 2010) and a rise in deaths from falls. Ischaemic heart disease, stroke, chronic obstructive pulmonary disease (COPD), lower respiratory infections, lung cancer, and HIV/AIDS were the leading causes of death in 2010. Ischaemic heart disease, lower respiratory infections, stroke, diarrhoeal disease, malaria, and HIV/AIDS were the leading causes of years of life lost due to premature mortality (YLLs) in 2010, similar to what was estimated for 1990, except for HIV/AIDS and preterm birth complications. YLLs from lower respiratory infections and diarrhoea decreased by 45-54% since 1990; ischaemic heart disease and stroke YLLs increased by 17-28%. Regional variations in leading causes of death were substantial. Communicable, maternal, neonatal, and nutritional causes still accounted for 76% of premature mortality in sub-Saharan Africa in 2010. Age standardised death rates from some key disorders rose (HIV/AIDS, Alzheimer's disease, diabetes mellitus, and chronic kidney disease in particular), but for most diseases, death rates fell in the past two decades; including major vascular diseases, COPD, most forms of cancer, liver cirrhosis, and maternal disorders. For other conditions, notably malaria, prostate cancer, and injuries, little change was noted. INTERPRETATION Population growth, increased average age of the world's population, and largely decreasing age-specific, sex-specific, and cause-specific death rates combine to drive a broad shift from communicable, maternal, neonatal, and nutritional causes towards non-communicable diseases. Nevertheless, communicable, maternal, neonatal, and nutritional causes remain the dominant causes of YLLs in sub-Saharan Africa. Overlaid on this general pattern of the epidemiological transition, marked regional variation exists in many causes, such as interpersonal violence, suicide, liver cancer, diabetes, cirrhosis, Chagas disease, African trypanosomiasis, melanoma, and others. Regional heterogeneity highlights the importance of sound epidemiological assessments of the causes of death on a regular basis. FUNDING Bill & Melinda Gates Foundation.
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Affiliation(s)
- Rafael Lozano
- Institute for Health Metrics and Evaluation (Prof R Lozano MD, M Naghavi PhD, S S Lim PhD, S Y Ahn MPH, M Alvarado BA, K G Andrews MPH, C Atkinson BS, I Bolliger AB, D Chou BA, K E Colson BA, A Delossantos BS, Prof S D Dharmaratne MBBS, A D Flaxman PhD, M H Forouzanfar MD, M K Freeman BA, E Gakidou PhD, D Gonzalez-Medina BA, D Haring BS, S L James MPH, R Jasrasaria BA, N Johns BA, S Lockett Ohno BA, M F MacIntyre EdM, L Mallinger MPH, A A Mokdad MD, M N Nair MD, K Ortblad BA, D Phillips BS, K Pierce BA, D Ranganathan BS, T Roberts BA, L C Rosenfeld MPH, E Sanman BS, M Wang MPH, S Wulf MPH, Prof C J L Murray MD), Department of Anesthesiology and Pain Medicine (N Kassebaum MD), Department of Epidemiology, School of Public Health (L M Anderson PhD), University of Washington, Seattle, WA, USA (Prof W Couser MD, H Duber MD, B Ebel MD, Prof C Mock MD, Prof F P Rivara MD, B Thomas MD); School of Public Health (Prof M Ezzati PhD), Imperial College London, London, UK (K Foreman MPH, Prof P Burney MD, L Rushton PhD); Department of Global Health, University of Tokyo, Tokyo, Japan (Prof K Shibuya MD); Department of Cardiology, Dupuytren University Hospital, Limoges, France (Prof V Aboyans MD); School of Medicine, University of Texas, San Antonio, TX, USA (J Abraham MPH); School of Population Health (T Adair PhD, Prof A D Lopez PhD, Prof T Vos PhD), Queensland Centre for Mental Health Research (J-P Khoo MBBS), Queensland Brain Institute, University of Queensland, Brisbane, QLD, Australia (Prof J McGrath MD); Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India (Prof R Aggarwal MD); Ministry of Health, Riyadh, Saudi Arabia (M A AlMazroa MD, Prof Z A Memish MD); St George’s, University of London, London, UK (Prof H R Anderson MD); Mayo Clinic, Rochester, MN, USA (Prof L M Baddour MD, P J Erwin MLS, Prof S E Gabriel MD); University of Auckland, Auckland, New Zealand (S Barker-Collo PhD); Brigham and Women’s Hospital (S Jayaraman MD), Harvard Medical School (D H Bartels BA, Prof S D Colan MD), Harvard Humanitarian Initiative (L M Knowlton MD), School of Public Health (M Miller MD, Prof J A Salomon PhD), Harvard University, Boston, MA, USA (K Bhalla PhD); Global Partners in Anesthesia and Surgery (D Ozgediz MD), Yale University, New Haven, CT, USA (Prof M L Bell PhD); Boston University, Boston, MA, USA (Prof E J Benjamin MD); Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, UK (D Bennett PhD); Research Institute of Transplantology and Artificial Organs, Moscow State University of Medicine and Dentistry, Moscow, Russia (B Bikbov MD); King Fahad Medical City, Riyadh, Saudi Arabia (A Bin Abdulhak MD, I M Tleyjeh MD); Michigan State University, East Lansing, MI, USA (Prof G Birbeck MD); School of Public Health (T Driscoll PhD), Faculty of Health Sciences (M Fransen PhD), Department of Rheumatology, Northern Clinical School (E Smith PhD), Institute of Bone and Joint Research (Prof L March MD), University of Sydney, Sydney, NSW, Australia (F Blyth PhD, Prof G B Marks PhD, M Cross PhD); Transport and Road Safety Research (S Boufous PhD), National Drug and Alcohol Research Centre (J Singleton MIPH, Prof L Degenhardt PhD), University of New South Wales, Sydney, NSW, Australia (C Bucello BPsych); Great Ormond Street Hospital, London, UK (M Burch MD); Telethon Institute for Child Health Research, Centre for Child Health Research (Prof J Carapetis MBBS), University of Western Australia, Perth, WA, Australia (Prof P Norman MD); National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA (H Chen PhD); Cedars-Sinai Medical Center, Los Angeles, CA, USA (Prof S S Chugh MD, R Havmoeller MD); Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands (L E Coffeng MD); Menzies School of Health Research, Darwin, NT, Australia (S Colquhoun MPH, J Condon PhD); National Health Services, Fife, Edinburgh, UK (M D Connor PhD); University of Edinburgh, Edinburgh, UK (M D Connor, Prof F G R Fowkes FRCPE); University of the Witwatersrand, Johannesburg, South Africa (M D Connor); Loyola University Medical School, Chicago, IL, USA (Prof L T Cooper MD); Department of Epidemiology, School of Public Health Sciences, Wake Forest University, Winston-Salem, NC, USA (M Corriere MD); Mario Negri Institute for Pharmacological Research, Bergamo, Italy (M Cortinovis BiotechD, F Gaspari ChemD, N Perico MD, Prof G Remuzzi MD); Hospital Dr Gustavo N Collado, Puerto Chitre, Panama (K Courville de Vaccaro MD); Victorian Infectious Diseases Reference Laboratory, Melbourne, VIC, Australia (B C Cowie MBBS); University of California, San Diego, San Diego, CA, USA (Prof M H Criqui MD, J Denenberg MA); Schools of Public Health and Medicine (S B Omer MBBS), Emory University, Atlanta, GA, USA (K C Dabhadkar MBBS, A Zabetian MD, K M V Narayan MD); University of Pennsylvania, Philadelphia, PA, USA (N Dahodwala MD); Griffith University, Brisbane, QLD, Australia (Prof D De Leo DSc); Beth Israel Medical Center, New York City, NY, USA (D C Des Jarlais PhD); University of Peradeniya, Peradeniya, Sri Lanka (Prof S D Dharmaratne); Johns Hopkins University, Baltimore, MD, USA (E R Dorsey MD); Hospital Maciel, Montevideo, Uruguay (P Espindola MD); MRC-HPA Centre for Environment and Health, London, UK (Prof M Ezzati PhD); National Institute for Stroke and Applied Neurosciences, Auckland Technical University, Auckland, New Zealand (Prof V Feigin MD, R Krishnamurthi PhD); Royal Life Saving Society, Sydney, NSW, Australia (R Franklin PhD); James Cook University, Townsville, QLD, Australia (K Watt PhD, R Franklin PhD); Howard University College of Medicine, Washington, DC, USA (Prof R F Gillum MD); Brandeis University, Waltham, MA, USA (Y A Halasa DDS, Prof D S Shepard PhD, E A Undurraga PhD); Flinders University, Adelaide, SA, Australia (Prof J E Harrison MBBS); Karolinska University Hospital, Stockholm, Sweden (R Havmoeller MD); King’s College Hospital NHS Trust, King’s College, London, UK (Prof R J Hay DM); Université de Franche-Comté, Besançon, France (Prof B Hoen MD); Centre Hospitalier Régional Universitaire de Basençon, Besançon, France (Prof B Hoen); National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, USA (Prof P J Hotez MD); Monash University, Melbourne, VIC, Australia (D Hoy PhD); George Mason University, Fairfax, VA, USA (K H Jacobsen PhD); All India Institute of Medical Sciences, New Delhi, India (G Karthikeyan MD); Department of Cardiology, Hebrew University Hadassah Medical School, Jerusalem, Israel (Prof A Keren MD); School of Public Health (O Kobusingye MMed), Makerere University, Kampala, Uganda (J Mabweijano MMed); University of South Africa, Johannesburg, South Africa (O Kobusingye MMed); Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (A Koranteng MSc); University of California, San Francisco, San Francisco, CA, USA (M Lipnick MD); University of Miami Miller School of Medicine, Miami, FL, USA (Prof S E Lipshultz MD, Prof R L Sacco MD, Prof J D Wilkinson MD); Mulago Hospital, Kampala, Uganda (J Mabweijano MMed); Centre for International Child Health (A Steer MBBS), Department of Paediatrics, Royal Children’s Hospital (R Weintraub MBBS), University of Melbourne, Melbourne, VIC, Australia (Prof R Marks MBBS); Asian Pacific Society of Cardiology, Kyoto, Japan (A Matsumori MD); Medical Research Council, Tygerberg, South Africa (R Matzopoulos MPhil); Hatter Institute (Prof K Sliwa MD), Department of Medicine (Prof G A Mensah MD), University of Cape Town, Cape Town, South Africa (R Matzopoulos, Prof B M Mayosi DPhil); Legacy Health System, Portland, OR, USA (J H McAnulty MD); Northwestern University Feinberg School of Medicine, Evanston, IL, USA (Prof M M McDermott MD); College of Medicine, Alfaisal University, Riyadh, Saudi Arabia (Prof Z A Memish); University of Otago, Dunedin, New Zealand (T R Merriman PhD); China Medical Board, Boston, MA, USA (C Michaud MD); Pacific Institute for Research and Evaluation, Calverton, MD, USA (T R Miller PhD); National Institute of Health, Maputo, Mozambique (Prof A O Mocumbi MD); University Eduardo Mondlane, Maputo, Mozambique (Prof A O Mocumbi); Columbia University, New York City, NY, USA (A Moran MD); London School of Hygiene and Tropical Medicine, London, UK (Prof K Mulholland MD); Centro Studi GISED, Bergamo, Italy (L Naldi MD); School of Public Health, University of Liverpool, Liverpool, UK (Prof K Nasseri DVM); HRB-Clinical Research Facility, National University of Ireland Galway, Galway, Ireland, UK (M O’Donnell PhD); Deakin University, Melbourne, VIC, Australia (Prof R Osborne PhD); B P Koirala Institute of Health Sciences, Dharan, Nepal (B Pahari MD); Betty Cowan Research and Innovation Center, Ludhiana, India (J D Pandian MD); Hospital Juan XXIII, La Paz, Bolivia (A Panozo Rivero MD); Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico (R Perez Padilla MD); Hospital Universitario Cruces, Barakaldo, Spain (F Perez-Ruiz MD); Brigham Young University, Provo, UT, USA (Prof C A Pope III PhD); Hospital Universitario de Canarias, Tenerife, Spain (E Porrini MD); Faculty of Medicine, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada (F Pourmalek MD); Mason Eye Institute, University of Missouri, Columbia, MO, USA (M Raju PhD); Centre for Addiction and Mental Health, Toronto, ON, Canada (Prof J T Rehm PhD); National Opinion Research Center, University of Chicago, Chicago, IL, USA (D B Rein PhD); Complejo Hospitalario Caja De Seguro Social, Panama City, Panama (F Rodriguez de León MD); Vanderbilt University, Nashville, TN, USA (Prof U Sampson MD); University of Alabama at Birmingham, Birmingham, AL, USA (Prof D C Schwebel PhD); Ministry of Interior, Madrid, Spain (M Segui-Gomez MD); Queens Medical Center, Honolulu, HI, USA (D Singh MD); Drexel University School of Public Health, Philadelphia, PA, USA (J A Taylor PhD); Cincinnati Children’s Hospital, Cincinnati, OH, USA (Prof J A Towbin MD); Department of Neurology, Copenhagen University Hospital, Herlev, Denmark (T Truelsen MD); National University of Singapore, Singapore, (N Venketasubramanian FRCP); Voluntary Health Services, Sneha, Chennai, India (Prof L Vijayakumar MBBS); National Institute for Occupational Safety and Health, Baltimore, MD, USA (G R Wagner MD); Beijing Neurosurgical Institute, Capital Medical University, Beijing, China (Prof W Wang MD); Brown University, Providence, RI, USA (Prof M A Weinstock MD); Royal Cornwall Hospital, Truro, UK (Prof A D Woolf MBBS); London School of Economics, London, UK (P-H Yeh MS); Centre for Suicide Research and Prevention, University of Hong Kong, Hong Kong, China (Prof P Yip PhD); and School of Public Health, Shanghai Jiao Tong University, Shanghai, China (Prof Z-J Zheng MD
| | - Mohsen Naghavi
- Institute for Health Metrics and Evaluation (Prof R Lozano MD, M Naghavi PhD, S S Lim PhD, S Y Ahn MPH, M Alvarado BA, K G Andrews MPH, C Atkinson BS, I Bolliger AB, D Chou BA, K E Colson BA, A Delossantos BS, Prof S D Dharmaratne MBBS, A D Flaxman PhD, M H Forouzanfar MD, M K Freeman BA, E Gakidou PhD, D Gonzalez-Medina BA, D Haring BS, S L James MPH, R Jasrasaria BA, N Johns BA, S Lockett Ohno BA, M F MacIntyre EdM, L Mallinger MPH, A A Mokdad MD, M N Nair MD, K Ortblad BA, D Phillips BS, K Pierce BA, D Ranganathan BS, T Roberts BA, L C Rosenfeld MPH, E Sanman BS, M Wang MPH, S Wulf MPH, Prof C J L Murray MD), Department of Anesthesiology and Pain Medicine (N Kassebaum MD), Department of Epidemiology, School of Public Health (L M Anderson PhD), University of Washington, Seattle, WA, USA (Prof W Couser MD, H Duber MD, B Ebel MD, Prof C Mock MD, Prof F P Rivara MD, B Thomas MD); School of Public Health (Prof M Ezzati PhD), Imperial College London, London, UK (K Foreman MPH, Prof P Burney MD, L Rushton PhD); Department of Global Health, University of Tokyo, Tokyo, Japan (Prof K Shibuya MD); Department of Cardiology, Dupuytren University Hospital, Limoges, France (Prof V Aboyans MD); School of Medicine, University of Texas, San Antonio, TX, USA (J Abraham MPH); School of Population Health (T Adair PhD, Prof A D Lopez PhD, Prof T Vos PhD), Queensland Centre for Mental Health Research (J-P Khoo MBBS), Queensland Brain Institute, University of Queensland, Brisbane, QLD, Australia (Prof J McGrath MD); Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India (Prof R Aggarwal MD); Ministry of Health, Riyadh, Saudi Arabia (M A AlMazroa MD, Prof Z A Memish MD); St George’s, University of London, London, UK (Prof H R Anderson MD); Mayo Clinic, Rochester, MN, USA (Prof L M Baddour MD, P J Erwin MLS, Prof S E Gabriel MD); University of Auckland, Auckland, New Zealand (S Barker-Collo PhD); Brigham and Women’s Hospital (S Jayaraman MD), Harvard Medical School (D H Bartels BA, Prof S D Colan MD), Harvard Humanitarian Initiative (L M Knowlton MD), School of Public Health (M Miller MD, Prof J A Salomon PhD), Harvard University, Boston, MA, USA (K Bhalla PhD); Global Partners in Anesthesia and Surgery (D Ozgediz MD), Yale University, New Haven, CT, USA (Prof M L Bell PhD); Boston University, Boston, MA, USA (Prof E J Benjamin MD); Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, UK (D Bennett PhD); Research Institute of Transplantology and Artificial Organs, Moscow State University of Medicine and Dentistry, Moscow, Russia (B Bikbov MD); King Fahad Medical City, Riyadh, Saudi Arabia (A Bin Abdulhak MD, I M Tleyjeh MD); Michigan State University, East Lansing, MI, USA (Prof G Birbeck MD); School of Public Health (T Driscoll PhD), Faculty of Health Sciences (M Fransen PhD), Department of Rheumatology, Northern Clinical School (E Smith PhD), Institute of Bone and Joint Research (Prof L March MD), University of Sydney, Sydney, NSW, Australia (F Blyth PhD, Prof G B Marks PhD, M Cross PhD); Transport and Road Safety Research (S Boufous PhD), National Drug and Alcohol Research Centre (J Singleton MIPH, Prof L Degenhardt PhD), University of New South Wales, Sydney, NSW, Australia (C Bucello BPsych); Great Ormond Street Hospital, London, UK (M Burch MD); Telethon Institute for Child Health Research, Centre for Child Health Research (Prof J Carapetis MBBS), University of Western Australia, Perth, WA, Australia (Prof P Norman MD); National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA (H Chen PhD); Cedars-Sinai Medical Center, Los Angeles, CA, USA (Prof S S Chugh MD, R Havmoeller MD); Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands (L E Coffeng MD); Menzies School of Health Research, Darwin, NT, Australia (S Colquhoun MPH, J Condon PhD); National Health Services, Fife, Edinburgh, UK (M D Connor PhD); University of Edinburgh, Edinburgh, UK (M D Connor, Prof F G R Fowkes FRCPE); University of the Witwatersrand, Johannesburg, South Africa (M D Connor); Loyola University Medical School, Chicago, IL, USA (Prof L T Cooper MD); Department of Epidemiology, School of Public Health Sciences, Wake Forest University, Winston-Salem, NC, USA (M Corriere MD); Mario Negri Institute for Pharmacological Research, Bergamo, Italy (M Cortinovis BiotechD, F Gaspari ChemD, N Perico MD, Prof G Remuzzi MD); Hospital Dr Gustavo N Collado, Puerto Chitre, Panama (K Courville de Vaccaro MD); Victorian Infectious Diseases Reference Laboratory, Melbourne, VIC, Australia (B C Cowie MBBS); University of California, San Diego, San Diego, CA, USA (Prof M H Criqui MD, J Denenberg MA); Schools of Public Health and Medicine (S B Omer MBBS), Emory University, Atlanta, GA, USA (K C Dabhadkar MBBS, A Zabetian MD, K M V Narayan MD); University of Pennsylvania, Philadelphia, PA, USA (N Dahodwala MD); Griffith University, Brisbane, QLD, Australia (Prof D De Leo DSc); Beth Israel Medical Center, New York City, NY, USA (D C Des Jarlais PhD); University of Peradeniya, Peradeniya, Sri Lanka (Prof S D Dharmaratne); Johns Hopkins University, Baltimore, MD, USA (E R Dorsey MD); Hospital Maciel, Montevideo, Uruguay (P Espindola MD); MRC-HPA Centre for Environment and Health, London, UK (Prof M Ezzati PhD); National Institute for Stroke and Applied Neurosciences, Auckland Technical University, Auckland, New Zealand (Prof V Feigin MD, R Krishnamurthi PhD); Royal Life Saving Society, Sydney, NSW, Australia (R Franklin PhD); James Cook University, Townsville, QLD, Australia (K Watt PhD, R Franklin PhD); Howard University College of Medicine, Washington, DC, USA (Prof R F Gillum MD); Brandeis University, Waltham, MA, USA (Y A Halasa DDS, Prof D S Shepard PhD, E A Undurraga PhD); Flinders University, Adelaide, SA, Australia (Prof J E Harrison MBBS); Karolinska University Hospital, Stockholm, Sweden (R Havmoeller MD); King’s College Hospital NHS Trust, King’s College, London, UK (Prof R J Hay DM); Université de Franche-Comté, Besançon, France (Prof B Hoen MD); Centre Hospitalier Régional Universitaire de Basençon, Besançon, France (Prof B Hoen); National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, USA (Prof P J Hotez MD); Monash University, Melbourne, VIC, Australia (D Hoy PhD); George Mason University, Fairfax, VA, USA (K H Jacobsen PhD); All India Institute of Medical Sciences, New Delhi, India (G Karthikeyan MD); Department of Cardiology, Hebrew University Hadassah Medical School, Jerusalem, Israel (Prof A Keren MD); School of Public Health (O Kobusingye MMed), Makerere University, Kampala, Uganda (J Mabweijano MMed); University of South Africa, Johannesburg, South Africa (O Kobusingye MMed); Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (A Koranteng MSc); University of California, San Francisco, San Francisco, CA, USA (M Lipnick MD); University of Miami Miller School of Medicine, Miami, FL, USA (Prof S E Lipshultz MD, Prof R L Sacco MD, Prof J D Wilkinson MD); Mulago Hospital, Kampala, Uganda (J Mabweijano MMed); Centre for International Child Health (A Steer MBBS), Department of Paediatrics, Royal Children’s Hospital (R Weintraub MBBS), University of Melbourne, Melbourne, VIC, Australia (Prof R Marks MBBS); Asian Pacific Society of Cardiology, Kyoto, Japan (A Matsumori MD); Medical Research Council, Tygerberg, South Africa (R Matzopoulos MPhil); Hatter Institute (Prof K Sliwa MD), Department of Medicine (Prof G A Mensah MD), University of Cape Town, Cape Town, South Africa (R Matzopoulos, Prof B M Mayosi DPhil); Legacy Health System, Portland, OR, USA (J H McAnulty MD); Northwestern University Feinberg School of Medicine, Evanston, IL, USA (Prof M M McDermott MD); College of Medicine, Alfaisal University, Riyadh, Saudi Arabia (Prof Z A Memish); University of Otago, Dunedin, New Zealand (T R Merriman PhD); China Medical Board, Boston, MA, USA (C Michaud MD); Pacific Institute for Research and Evaluation, Calverton, MD, USA (T R Miller PhD); National Institute of Health, Maputo, Mozambique (Prof A O Mocumbi MD); University Eduardo Mondlane, Maputo, Mozambique (Prof A O Mocumbi); Columbia University, New York City, NY, USA (A Moran MD); London School of Hygiene and Tropical Medicine, London, UK (Prof K Mulholland MD); Centro Studi GISED, Bergamo, Italy (L Naldi MD); School of Public Health, University of Liverpool, Liverpool, UK (Prof K Nasseri DVM); HRB-Clinical Research Facility, National University of Ireland Galway, Galway, Ireland, UK (M O’Donnell PhD); Deakin University, Melbourne, VIC, Australia (Prof R Osborne PhD); B P Koirala Institute of Health Sciences, Dharan, Nepal (B Pahari MD); Betty Cowan Research and Innovation Center, Ludhiana, India (J D Pandian MD); Hospital Juan XXIII, La Paz, Bolivia (A Panozo Rivero MD); Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico (R Perez Padilla MD); Hospital Universitario Cruces, Barakaldo, Spain (F Perez-Ruiz MD); Brigham Young University, Provo, UT, USA (Prof C A Pope III PhD); Hospital Universitario de Canarias, Tenerife, Spain (E Porrini MD); Faculty of Medicine, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada (F Pourmalek MD); Mason Eye Institute, University of Missouri, Columbia, MO, USA (M Raju PhD); Centre for Addiction and Mental Health, Toronto, ON, Canada (Prof J T Rehm PhD); National Opinion Research Center, University of Chicago, Chicago, IL, USA (D B Rein PhD); Complejo Hospitalario Caja De Seguro Social, Panama City, Panama (F Rodriguez de León MD); Vanderbilt University, Nashville, TN, USA (Prof U Sampson MD); University of Alabama at Birmingham, Birmingham, AL, USA (Prof D C Schwebel PhD); Ministry of Interior, Madrid, Spain (M Segui-Gomez MD); Queens Medical Center, Honolulu, HI, USA (D Singh MD); Drexel University School of Public Health, Philadelphia, PA, USA (J A Taylor PhD); Cincinnati Children’s Hospital, Cincinnati, OH, USA (Prof J A Towbin MD); Department of Neurology, Copenhagen University Hospital, Herlev, Denmark (T Truelsen MD); National University of Singapore, Singapore, (N Venketasubramanian FRCP); Voluntary Health Services, Sneha, Chennai, India (Prof L Vijayakumar MBBS); National Institute for Occupational Safety and Health, Baltimore, MD, USA (G R Wagner MD); Beijing Neurosurgical Institute, Capital Medical University, Beijing, China (Prof W Wang MD); Brown University, Providence, RI, USA (Prof M A Weinstock MD); Royal Cornwall Hospital, Truro, UK (Prof A D Woolf MBBS); London School of Economics, London, UK (P-H Yeh MS); Centre for Suicide Research and Prevention, University of Hong Kong, Hong Kong, China (Prof P Yip PhD); and School of Public Health, Shanghai Jiao Tong University, Shanghai, China (Prof Z-J Zheng MD
| | - Kyle Foreman
- Institute for Health Metrics and Evaluation (Prof R Lozano MD, M Naghavi PhD, S S Lim PhD, S Y Ahn MPH, M Alvarado BA, K G Andrews MPH, C Atkinson BS, I Bolliger AB, D Chou BA, K E Colson BA, A Delossantos BS, Prof S D Dharmaratne MBBS, A D Flaxman PhD, M H Forouzanfar MD, M K Freeman BA, E Gakidou PhD, D Gonzalez-Medina BA, D Haring BS, S L James MPH, R Jasrasaria BA, N Johns BA, S Lockett Ohno BA, M F MacIntyre EdM, L Mallinger MPH, A A Mokdad MD, M N Nair MD, K Ortblad BA, D Phillips BS, K Pierce BA, D Ranganathan BS, T Roberts BA, L C Rosenfeld MPH, E Sanman BS, M Wang MPH, S Wulf MPH, Prof C J L Murray MD), Department of Anesthesiology and Pain Medicine (N Kassebaum MD), Department of Epidemiology, School of Public Health (L M Anderson PhD), University of Washington, Seattle, WA, USA (Prof W Couser MD, H Duber MD, B Ebel MD, Prof C Mock MD, Prof F P Rivara MD, B Thomas MD); School of Public Health (Prof M Ezzati PhD), Imperial College London, London, UK (K Foreman MPH, Prof P Burney MD, L Rushton PhD); Department of Global Health, University of Tokyo, Tokyo, Japan (Prof K Shibuya MD); Department of Cardiology, Dupuytren University Hospital, Limoges, France (Prof V Aboyans MD); School of Medicine, University of Texas, San Antonio, TX, USA (J Abraham MPH); School of Population Health (T Adair PhD, Prof A D Lopez PhD, Prof T Vos PhD), Queensland Centre for Mental Health Research (J-P Khoo MBBS), Queensland Brain Institute, University of Queensland, Brisbane, QLD, Australia (Prof J McGrath MD); Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India (Prof R Aggarwal MD); Ministry of Health, Riyadh, Saudi Arabia (M A AlMazroa MD, Prof Z A Memish MD); St George’s, University of London, London, UK (Prof H R Anderson MD); Mayo Clinic, Rochester, MN, USA (Prof L M Baddour MD, P J Erwin MLS, Prof S E Gabriel MD); University of Auckland, Auckland, New Zealand (S Barker-Collo PhD); Brigham and Women’s Hospital (S Jayaraman MD), Harvard Medical School (D H Bartels BA, Prof S D Colan MD), Harvard Humanitarian Initiative (L M Knowlton MD), School of Public Health (M Miller MD, Prof J A Salomon PhD), Harvard University, Boston, MA, USA (K Bhalla PhD); Global Partners in Anesthesia and Surgery (D Ozgediz MD), Yale University, New Haven, CT, USA (Prof M L Bell PhD); Boston University, Boston, MA, USA (Prof E J Benjamin MD); Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, UK (D Bennett PhD); Research Institute of Transplantology and Artificial Organs, Moscow State University of Medicine and Dentistry, Moscow, Russia (B Bikbov MD); King Fahad Medical City, Riyadh, Saudi Arabia (A Bin Abdulhak MD, I M Tleyjeh MD); Michigan State University, East Lansing, MI, USA (Prof G Birbeck MD); School of Public Health (T Driscoll PhD), Faculty of Health Sciences (M Fransen PhD), Department of Rheumatology, Northern Clinical School (E Smith PhD), Institute of Bone and Joint Research (Prof L March MD), University of Sydney, Sydney, NSW, Australia (F Blyth PhD, Prof G B Marks PhD, M Cross PhD); Transport and Road Safety Research (S Boufous PhD), National Drug and Alcohol Research Centre (J Singleton MIPH, Prof L Degenhardt PhD), University of New South Wales, Sydney, NSW, Australia (C Bucello BPsych); Great Ormond Street Hospital, London, UK (M Burch MD); Telethon Institute for Child Health Research, Centre for Child Health Research (Prof J Carapetis MBBS), University of Western Australia, Perth, WA, Australia (Prof P Norman MD); National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA (H Chen PhD); Cedars-Sinai Medical Center, Los Angeles, CA, USA (Prof S S Chugh MD, R Havmoeller MD); Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands (L E Coffeng MD); Menzies School of Health Research, Darwin, NT, Australia (S Colquhoun MPH, J Condon PhD); National Health Services, Fife, Edinburgh, UK (M D Connor PhD); University of Edinburgh, Edinburgh, UK (M D Connor, Prof F G R Fowkes FRCPE); University of the Witwatersrand, Johannesburg, South Africa (M D Connor); Loyola University Medical School, Chicago, IL, USA (Prof L T Cooper MD); Department of Epidemiology, School of Public Health Sciences, Wake Forest University, Winston-Salem, NC, USA (M Corriere MD); Mario Negri Institute for Pharmacological Research, Bergamo, Italy (M Cortinovis BiotechD, F Gaspari ChemD, N Perico MD, Prof G Remuzzi MD); Hospital Dr Gustavo N Collado, Puerto Chitre, Panama (K Courville de Vaccaro MD); Victorian Infectious Diseases Reference Laboratory, Melbourne, VIC, Australia (B C Cowie MBBS); University of California, San Diego, San Diego, CA, USA (Prof M H Criqui MD, J Denenberg MA); Schools of Public Health and Medicine (S B Omer MBBS), Emory University, Atlanta, GA, USA (K C Dabhadkar MBBS, A Zabetian MD, K M V Narayan MD); University of Pennsylvania, Philadelphia, PA, USA (N Dahodwala MD); Griffith University, Brisbane, QLD, Australia (Prof D De Leo DSc); Beth Israel Medical Center, New York City, NY, USA (D C Des Jarlais PhD); University of Peradeniya, Peradeniya, Sri Lanka (Prof S D Dharmaratne); Johns Hopkins University, Baltimore, MD, USA (E R Dorsey MD); Hospital Maciel, Montevideo, Uruguay (P Espindola MD); MRC-HPA Centre for Environment and Health, London, UK (Prof M Ezzati PhD); National Institute for Stroke and Applied Neurosciences, Auckland Technical University, Auckland, New Zealand (Prof V Feigin MD, R Krishnamurthi PhD); Royal Life Saving Society, Sydney, NSW, Australia (R Franklin PhD); James Cook University, Townsville, QLD, Australia (K Watt PhD, R Franklin PhD); Howard University College of Medicine, Washington, DC, USA (Prof R F Gillum MD); Brandeis University, Waltham, MA, USA (Y A Halasa DDS, Prof D S Shepard PhD, E A Undurraga PhD); Flinders University, Adelaide, SA, Australia (Prof J E Harrison MBBS); Karolinska University Hospital, Stockholm, Sweden (R Havmoeller MD); King’s College Hospital NHS Trust, King’s College, London, UK (Prof R J Hay DM); Université de Franche-Comté, Besançon, France (Prof B Hoen MD); Centre Hospitalier Régional Universitaire de Basençon, Besançon, France (Prof B Hoen); National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, USA (Prof P J Hotez MD); Monash University, Melbourne, VIC, Australia (D Hoy PhD); George Mason University, Fairfax, VA, USA (K H Jacobsen PhD); All India Institute of Medical Sciences, New Delhi, India (G Karthikeyan MD); Department of Cardiology, Hebrew University Hadassah Medical School, Jerusalem, Israel (Prof A Keren MD); School of Public Health (O Kobusingye MMed), Makerere University, Kampala, Uganda (J Mabweijano MMed); University of South Africa, Johannesburg, South Africa (O Kobusingye MMed); Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (A Koranteng MSc); University of California, San Francisco, San Francisco, CA, USA (M Lipnick MD); University of Miami Miller School of Medicine, Miami, FL, USA (Prof S E Lipshultz MD, Prof R L Sacco MD, Prof J D Wilkinson MD); Mulago Hospital, Kampala, Uganda (J Mabweijano MMed); Centre for International Child Health (A Steer MBBS), Department of Paediatrics, Royal Children’s Hospital (R Weintraub MBBS), University of Melbourne, Melbourne, VIC, Australia (Prof R Marks MBBS); Asian Pacific Society of Cardiology, Kyoto, Japan (A Matsumori MD); Medical Research Council, Tygerberg, South Africa (R Matzopoulos MPhil); Hatter Institute (Prof K Sliwa MD), Department of Medicine (Prof G A Mensah MD), University of Cape Town, Cape Town, South Africa (R Matzopoulos, Prof B M Mayosi DPhil); Legacy Health System, Portland, OR, USA (J H McAnulty MD); Northwestern University Feinberg School of Medicine, Evanston, IL, USA (Prof M M McDermott MD); College of Medicine, Alfaisal University, Riyadh, Saudi Arabia (Prof Z A Memish); University of Otago, Dunedin, New Zealand (T R Merriman PhD); China Medical Board, Boston, MA, USA (C Michaud MD); Pacific Institute for Research and Evaluation, Calverton, MD, USA (T R Miller PhD); National Institute of Health, Maputo, Mozambique (Prof A O Mocumbi MD); University Eduardo Mondlane, Maputo, Mozambique (Prof A O Mocumbi); Columbia University, New York City, NY, USA (A Moran MD); London School of Hygiene and Tropical Medicine, London, UK (Prof K Mulholland MD); Centro Studi GISED, Bergamo, Italy (L Naldi MD); School of Public Health, University of Liverpool, Liverpool, UK (Prof K Nasseri DVM); HRB-Clinical Research Facility, National University of Ireland Galway, Galway, Ireland, UK (M O’Donnell PhD); Deakin University, Melbourne, VIC, Australia (Prof R Osborne PhD); B P Koirala Institute of Health Sciences, Dharan, Nepal (B Pahari MD); Betty Cowan Research and Innovation Center, Ludhiana, India (J D Pandian MD); Hospital Juan XXIII, La Paz, Bolivia (A Panozo Rivero MD); Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico (R Perez Padilla MD); Hospital Universitario Cruces, Barakaldo, Spain (F Perez-Ruiz MD); Brigham Young University, Provo, UT, USA (Prof C A Pope III PhD); Hospital Universitario de Canarias, Tenerife, Spain (E Porrini MD); Faculty of Medicine, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada (F Pourmalek MD); Mason Eye Institute, University of Missouri, Columbia, MO, USA (M Raju PhD); Centre for Addiction and Mental Health, Toronto, ON, Canada (Prof J T Rehm PhD); National Opinion Research Center, University of Chicago, Chicago, IL, USA (D B Rein PhD); Complejo Hospitalario Caja De Seguro Social, Panama City, Panama (F Rodriguez de León MD); Vanderbilt University, Nashville, TN, USA (Prof U Sampson MD); University of Alabama at Birmingham, Birmingham, AL, USA (Prof D C Schwebel PhD); Ministry of Interior, Madrid, Spain (M Segui-Gomez MD); Queens Medical Center, Honolulu, HI, USA (D Singh MD); Drexel University School of Public Health, Philadelphia, PA, USA (J A Taylor PhD); Cincinnati Children’s Hospital, Cincinnati, OH, USA (Prof J A Towbin MD); Department of Neurology, Copenhagen University Hospital, Herlev, Denmark (T Truelsen MD); National University of Singapore, Singapore, (N Venketasubramanian FRCP); Voluntary Health Services, Sneha, Chennai, India (Prof L Vijayakumar MBBS); National Institute for Occupational Safety and Health, Baltimore, MD, USA (G R Wagner MD); Beijing Neurosurgical Institute, Capital Medical University, Beijing, China (Prof W Wang MD); Brown University, Providence, RI, USA (Prof M A Weinstock MD); Royal Cornwall Hospital, Truro, UK (Prof A D Woolf MBBS); London School of Economics, London, UK (P-H Yeh MS); Centre for Suicide Research and Prevention, University of Hong Kong, Hong Kong, China (Prof P Yip PhD); and School of Public Health, Shanghai Jiao Tong University, Shanghai, China (Prof Z-J Zheng MD
| | - Stephen Lim
- Institute for Health Metrics and Evaluation (Prof R Lozano MD, M Naghavi PhD, S S Lim PhD, S Y Ahn MPH, M Alvarado BA, K G Andrews MPH, C Atkinson BS, I Bolliger AB, D Chou BA, K E Colson BA, A Delossantos BS, Prof S D Dharmaratne MBBS, A D Flaxman PhD, M H Forouzanfar MD, M K Freeman BA, E Gakidou PhD, D Gonzalez-Medina BA, D Haring BS, S L James MPH, R Jasrasaria BA, N Johns BA, S Lockett Ohno BA, M F MacIntyre EdM, L Mallinger MPH, A A Mokdad MD, M N Nair MD, K Ortblad BA, D Phillips BS, K Pierce BA, D Ranganathan BS, T Roberts BA, L C Rosenfeld MPH, E Sanman BS, M Wang MPH, S Wulf MPH, Prof C J L Murray MD), Department of Anesthesiology and Pain Medicine (N Kassebaum MD), Department of Epidemiology, School of Public Health (L M Anderson PhD), University of Washington, Seattle, WA, USA (Prof W Couser MD, H Duber MD, B Ebel MD, Prof C Mock MD, Prof F P Rivara MD, B Thomas MD); School of Public Health (Prof M Ezzati PhD), Imperial College London, London, UK (K Foreman MPH, Prof P Burney MD, L Rushton PhD); Department of Global Health, University of Tokyo, Tokyo, Japan (Prof K Shibuya MD); Department of Cardiology, Dupuytren University Hospital, Limoges, France (Prof V Aboyans MD); School of Medicine, University of Texas, San Antonio, TX, USA (J Abraham MPH); School of Population Health (T Adair PhD, Prof A D Lopez PhD, Prof T Vos PhD), Queensland Centre for Mental Health Research (J-P Khoo MBBS), Queensland Brain Institute, University of Queensland, Brisbane, QLD, Australia (Prof J McGrath MD); Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India (Prof R Aggarwal MD); Ministry of Health, Riyadh, Saudi Arabia (M A AlMazroa MD, Prof Z A Memish MD); St George’s, University of London, London, UK (Prof H R Anderson MD); Mayo Clinic, Rochester, MN, USA (Prof L M Baddour MD, P J Erwin MLS, Prof S E Gabriel MD); University of Auckland, Auckland, New Zealand (S Barker-Collo PhD); Brigham and Women’s Hospital (S Jayaraman MD), Harvard Medical School (D H Bartels BA, Prof S D Colan MD), Harvard Humanitarian Initiative (L M Knowlton MD), School of Public Health (M Miller MD, Prof J A Salomon PhD), Harvard University, Boston, MA, USA (K Bhalla PhD); Global Partners in Anesthesia and Surgery (D Ozgediz MD), Yale University, New Haven, CT, USA (Prof M L Bell PhD); Boston University, Boston, MA, USA (Prof E J Benjamin MD); Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, UK (D Bennett PhD); Research Institute of Transplantology and Artificial Organs, Moscow State University of Medicine and Dentistry, Moscow, Russia (B Bikbov MD); King Fahad Medical City, Riyadh, Saudi Arabia (A Bin Abdulhak MD, I M Tleyjeh MD); Michigan State University, East Lansing, MI, USA (Prof G Birbeck MD); School of Public Health (T Driscoll PhD), Faculty of Health Sciences (M Fransen PhD), Department of Rheumatology, Northern Clinical School (E Smith PhD), Institute of Bone and Joint Research (Prof L March MD), University of Sydney, Sydney, NSW, Australia (F Blyth PhD, Prof G B Marks PhD, M Cross PhD); Transport and Road Safety Research (S Boufous PhD), National Drug and Alcohol Research Centre (J Singleton MIPH, Prof L Degenhardt PhD), University of New South Wales, Sydney, NSW, Australia (C Bucello BPsych); Great Ormond Street Hospital, London, UK (M Burch MD); Telethon Institute for Child Health Research, Centre for Child Health Research (Prof J Carapetis MBBS), University of Western Australia, Perth, WA, Australia (Prof P Norman MD); National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA (H Chen PhD); Cedars-Sinai Medical Center, Los Angeles, CA, USA (Prof S S Chugh MD, R Havmoeller MD); Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands (L E Coffeng MD); Menzies School of Health Research, Darwin, NT, Australia (S Colquhoun MPH, J Condon PhD); National Health Services, Fife, Edinburgh, UK (M D Connor PhD); University of Edinburgh, Edinburgh, UK (M D Connor, Prof F G R Fowkes FRCPE); University of the Witwatersrand, Johannesburg, South Africa (M D Connor); Loyola University Medical School, Chicago, IL, USA (Prof L T Cooper MD); Department of Epidemiology, School of Public Health Sciences, Wake Forest University, Winston-Salem, NC, USA (M Corriere MD); Mario Negri Institute for Pharmacological Research, Bergamo, Italy (M Cortinovis BiotechD, F Gaspari ChemD, N Perico MD, Prof G Remuzzi MD); Hospital Dr Gustavo N Collado, Puerto Chitre, Panama (K Courville de Vaccaro MD); Victorian Infectious Diseases Reference Laboratory, Melbourne, VIC, Australia (B C Cowie MBBS); University of California, San Diego, San Diego, CA, USA (Prof M H Criqui MD, J Denenberg MA); Schools of Public Health and Medicine (S B Omer MBBS), Emory University, Atlanta, GA, USA (K C Dabhadkar MBBS, A Zabetian MD, K M V Narayan MD); University of Pennsylvania, Philadelphia, PA, USA (N Dahodwala MD); Griffith University, Brisbane, QLD, Australia (Prof D De Leo DSc); Beth Israel Medical Center, New York City, NY, USA (D C Des Jarlais PhD); University of Peradeniya, Peradeniya, Sri Lanka (Prof S D Dharmaratne); Johns Hopkins University, Baltimore, MD, USA (E R Dorsey MD); Hospital Maciel, Montevideo, Uruguay (P Espindola MD); MRC-HPA Centre for Environment and Health, London, UK (Prof M Ezzati PhD); National Institute for Stroke and Applied Neurosciences, Auckland Technical University, Auckland, New Zealand (Prof V Feigin MD, R Krishnamurthi PhD); Royal Life Saving Society, Sydney, NSW, Australia (R Franklin PhD); James Cook University, Townsville, QLD, Australia (K Watt PhD, R Franklin PhD); Howard University College of Medicine, Washington, DC, USA (Prof R F Gillum MD); Brandeis University, Waltham, MA, USA (Y A Halasa DDS, Prof D S Shepard PhD, E A Undurraga PhD); Flinders University, Adelaide, SA, Australia (Prof J E Harrison MBBS); Karolinska University Hospital, Stockholm, Sweden (R Havmoeller MD); King’s College Hospital NHS Trust, King’s College, London, UK (Prof R J Hay DM); Université de Franche-Comté, Besançon, France (Prof B Hoen MD); Centre Hospitalier Régional Universitaire de Basençon, Besançon, France (Prof B Hoen); National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, USA (Prof P J Hotez MD); Monash University, Melbourne, VIC, Australia (D Hoy PhD); George Mason University, Fairfax, VA, USA (K H Jacobsen PhD); All India Institute of Medical Sciences, New Delhi, India (G Karthikeyan MD); Department of Cardiology, Hebrew University Hadassah Medical School, Jerusalem, Israel (Prof A Keren MD); School of Public Health (O Kobusingye MMed), Makerere University, Kampala, Uganda (J Mabweijano MMed); University of South Africa, Johannesburg, South Africa (O Kobusingye MMed); Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (A Koranteng MSc); University of California, San Francisco, San Francisco, CA, USA (M Lipnick MD); University of Miami Miller School of Medicine, Miami, FL, USA (Prof S E Lipshultz MD, Prof R L Sacco MD, Prof J D Wilkinson MD); Mulago Hospital, Kampala, Uganda (J Mabweijano MMed); Centre for International Child Health (A Steer MBBS), Department of Paediatrics, Royal Children’s Hospital (R Weintraub MBBS), University of Melbourne, Melbourne, VIC, Australia (Prof R Marks MBBS); Asian Pacific Society of Cardiology, Kyoto, Japan (A Matsumori MD); Medical Research Council, Tygerberg, South Africa (R Matzopoulos MPhil); Hatter Institute (Prof K Sliwa MD), Department of Medicine (Prof G A Mensah MD), University of Cape Town, Cape Town, South Africa (R Matzopoulos, Prof B M Mayosi DPhil); Legacy Health System, Portland, OR, USA (J H McAnulty MD); Northwestern University Feinberg School of Medicine, Evanston, IL, USA (Prof M M McDermott MD); College of Medicine, Alfaisal University, Riyadh, Saudi Arabia (Prof Z A Memish); University of Otago, Dunedin, New Zealand (T R Merriman PhD); China Medical Board, Boston, MA, USA (C Michaud MD); Pacific Institute for Research and Evaluation, Calverton, MD, USA (T R Miller PhD); National Institute of Health, Maputo, Mozambique (Prof A O Mocumbi MD); University Eduardo Mondlane, Maputo, Mozambique (Prof A O Mocumbi); Columbia University, New York City, NY, USA (A Moran MD); London School of Hygiene and Tropical Medicine, London, UK (Prof K Mulholland MD); Centro Studi GISED, Bergamo, Italy (L Naldi MD); School of Public Health, University of Liverpool, Liverpool, UK (Prof K Nasseri DVM); HRB-Clinical Research Facility, National University of Ireland Galway, Galway, Ireland, UK (M O’Donnell PhD); Deakin University, Melbourne, VIC, Australia (Prof R Osborne PhD); B P Koirala Institute of Health Sciences, Dharan, Nepal (B Pahari MD); Betty Cowan Research and Innovation Center, Ludhiana, India (J D Pandian MD); Hospital Juan XXIII, La Paz, Bolivia (A Panozo Rivero MD); Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico (R Perez Padilla MD); Hospital Universitario Cruces, Barakaldo, Spain (F Perez-Ruiz MD); Brigham Young University, Provo, UT, USA (Prof C A Pope III PhD); Hospital Universitario de Canarias, Tenerife, Spain (E Porrini MD); Faculty of Medicine, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada (F Pourmalek MD); Mason Eye Institute, University of Missouri, Columbia, MO, USA (M Raju PhD); Centre for Addiction and Mental Health, Toronto, ON, Canada (Prof J T Rehm PhD); National Opinion Research Center, University of Chicago, Chicago, IL, USA (D B Rein PhD); Complejo Hospitalario Caja De Seguro Social, Panama City, Panama (F Rodriguez de León MD); Vanderbilt University, Nashville, TN, USA (Prof U Sampson MD); University of Alabama at Birmingham, Birmingham, AL, USA (Prof D C Schwebel PhD); Ministry of Interior, Madrid, Spain (M Segui-Gomez MD); Queens Medical Center, Honolulu, HI, USA (D Singh MD); Drexel University School of Public Health, Philadelphia, PA, USA (J A Taylor PhD); Cincinnati Children’s Hospital, Cincinnati, OH, USA (Prof J A Towbin MD); Department of Neurology, Copenhagen University Hospital, Herlev, Denmark (T Truelsen MD); National University of Singapore, Singapore, (N Venketasubramanian FRCP); Voluntary Health Services, Sneha, Chennai, India (Prof L Vijayakumar MBBS); National Institute for Occupational Safety and Health, Baltimore, MD, USA (G R Wagner MD); Beijing Neurosurgical Institute, Capital Medical University, Beijing, China (Prof W Wang MD); Brown University, Providence, RI, USA (Prof M A Weinstock MD); Royal Cornwall Hospital, Truro, UK (Prof A D Woolf MBBS); London School of Economics, London, UK (P-H Yeh MS); Centre for Suicide Research and Prevention, University of Hong Kong, Hong Kong, China (Prof P Yip PhD); and School of Public Health, Shanghai Jiao Tong University, Shanghai, China (Prof Z-J Zheng MD
| | - Kenji Shibuya
- Institute for Health Metrics and Evaluation (Prof R Lozano MD, M Naghavi PhD, S S Lim PhD, S Y Ahn MPH, M Alvarado BA, K G Andrews MPH, C Atkinson BS, I Bolliger AB, D Chou BA, K E Colson BA, A Delossantos BS, Prof S D Dharmaratne MBBS, A D Flaxman PhD, M H Forouzanfar MD, M K Freeman BA, E Gakidou PhD, D Gonzalez-Medina BA, D Haring BS, S L James MPH, R Jasrasaria BA, N Johns BA, S Lockett Ohno BA, M F MacIntyre EdM, L Mallinger MPH, A A Mokdad MD, M N Nair MD, K Ortblad BA, D Phillips BS, K Pierce BA, D Ranganathan BS, T Roberts BA, L C Rosenfeld MPH, E Sanman BS, M Wang MPH, S Wulf MPH, Prof C J L Murray MD), Department of Anesthesiology and Pain Medicine (N Kassebaum MD), Department of Epidemiology, School of Public Health (L M Anderson PhD), University of Washington, Seattle, WA, USA (Prof W Couser MD, H Duber MD, B Ebel MD, Prof C Mock MD, Prof F P Rivara MD, B Thomas MD); School of Public Health (Prof M Ezzati PhD), Imperial College London, London, UK (K Foreman MPH, Prof P Burney MD, L Rushton PhD); Department of Global Health, University of Tokyo, Tokyo, Japan (Prof K Shibuya MD); Department of Cardiology, Dupuytren University Hospital, Limoges, France (Prof V Aboyans MD); School of Medicine, University of Texas, San Antonio, TX, USA (J Abraham MPH); School of Population Health (T Adair PhD, Prof A D Lopez PhD, Prof T Vos PhD), Queensland Centre for Mental Health Research (J-P Khoo MBBS), Queensland Brain Institute, University of Queensland, Brisbane, QLD, Australia (Prof J McGrath MD); Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India (Prof R Aggarwal MD); Ministry of Health, Riyadh, Saudi Arabia (M A AlMazroa MD, Prof Z A Memish MD); St George’s, University of London, London, UK (Prof H R Anderson MD); Mayo Clinic, Rochester, MN, USA (Prof L M Baddour MD, P J Erwin MLS, Prof S E Gabriel MD); University of Auckland, Auckland, New Zealand (S Barker-Collo PhD); Brigham and Women’s Hospital (S Jayaraman MD), Harvard Medical School (D H Bartels BA, Prof S D Colan MD), Harvard Humanitarian Initiative (L M Knowlton MD), School of Public Health (M Miller MD, Prof J A Salomon PhD), Harvard University, Boston, MA, USA (K Bhalla PhD); Global Partners in Anesthesia and Surgery (D Ozgediz MD), Yale University, New Haven, CT, USA (Prof M L Bell PhD); Boston University, Boston, MA, USA (Prof E J Benjamin MD); Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, UK (D Bennett PhD); Research Institute of Transplantology and Artificial Organs, Moscow State University of Medicine and Dentistry, Moscow, Russia (B Bikbov MD); King Fahad Medical City, Riyadh, Saudi Arabia (A Bin Abdulhak MD, I M Tleyjeh MD); Michigan State University, East Lansing, MI, USA (Prof G Birbeck MD); School of Public Health (T Driscoll PhD), Faculty of Health Sciences (M Fransen PhD), Department of Rheumatology, Northern Clinical School (E Smith PhD), Institute of Bone and Joint Research (Prof L March MD), University of Sydney, Sydney, NSW, Australia (F Blyth PhD, Prof G B Marks PhD, M Cross PhD); Transport and Road Safety Research (S Boufous PhD), National Drug and Alcohol Research Centre (J Singleton MIPH, Prof L Degenhardt PhD), University of New South Wales, Sydney, NSW, Australia (C Bucello BPsych); Great Ormond Street Hospital, London, UK (M Burch MD); Telethon Institute for Child Health Research, Centre for Child Health Research (Prof J Carapetis MBBS), University of Western Australia, Perth, WA, Australia (Prof P Norman MD); National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA (H Chen PhD); Cedars-Sinai Medical Center, Los Angeles, CA, USA (Prof S S Chugh MD, R Havmoeller MD); Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands (L E Coffeng MD); Menzies School of Health Research, Darwin, NT, Australia (S Colquhoun MPH, J Condon PhD); National Health Services, Fife, Edinburgh, UK (M D Connor PhD); University of Edinburgh, Edinburgh, UK (M D Connor, Prof F G R Fowkes FRCPE); University of the Witwatersrand, Johannesburg, South Africa (M D Connor); Loyola University Medical School, Chicago, IL, USA (Prof L T Cooper MD); Department of Epidemiology, School of Public Health Sciences, Wake Forest University, Winston-Salem, NC, USA (M Corriere MD); Mario Negri Institute for Pharmacological Research, Bergamo, Italy (M Cortinovis BiotechD, F Gaspari ChemD, N Perico MD, Prof G Remuzzi MD); Hospital Dr Gustavo N Collado, Puerto Chitre, Panama (K Courville de Vaccaro MD); Victorian Infectious Diseases Reference Laboratory, Melbourne, VIC, Australia (B C Cowie MBBS); University of California, San Diego, San Diego, CA, USA (Prof M H Criqui MD, J Denenberg MA); Schools of Public Health and Medicine (S B Omer MBBS), Emory University, Atlanta, GA, USA (K C Dabhadkar MBBS, A Zabetian MD, K M V Narayan MD); University of Pennsylvania, Philadelphia, PA, USA (N Dahodwala MD); Griffith University, Brisbane, QLD, Australia (Prof D De Leo DSc); Beth Israel Medical Center, New York City, NY, USA (D C Des Jarlais PhD); University of Peradeniya, Peradeniya, Sri Lanka (Prof S D Dharmaratne); Johns Hopkins University, Baltimore, MD, USA (E R Dorsey MD); Hospital Maciel, Montevideo, Uruguay (P Espindola MD); MRC-HPA Centre for Environment and Health, London, UK (Prof M Ezzati PhD); National Institute for Stroke and Applied Neurosciences, Auckland Technical University, Auckland, New Zealand (Prof V Feigin MD, R Krishnamurthi PhD); Royal Life Saving Society, Sydney, NSW, Australia (R Franklin PhD); James Cook University, Townsville, QLD, Australia (K Watt PhD, R Franklin PhD); Howard University College of Medicine, Washington, DC, USA (Prof R F Gillum MD); Brandeis University, Waltham, MA, USA (Y A Halasa DDS, Prof D S Shepard PhD, E A Undurraga PhD); Flinders University, Adelaide, SA, Australia (Prof J E Harrison MBBS); Karolinska University Hospital, Stockholm, Sweden (R Havmoeller MD); King’s College Hospital NHS Trust, King’s College, London, UK (Prof R J Hay DM); Université de Franche-Comté, Besançon, France (Prof B Hoen MD); Centre Hospitalier Régional Universitaire de Basençon, Besançon, France (Prof B Hoen); National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, USA (Prof P J Hotez MD); Monash University, Melbourne, VIC, Australia (D Hoy PhD); George Mason University, Fairfax, VA, USA (K H Jacobsen PhD); All India Institute of Medical Sciences, New Delhi, India (G Karthikeyan MD); Department of Cardiology, Hebrew University Hadassah Medical School, Jerusalem, Israel (Prof A Keren MD); School of Public Health (O Kobusingye MMed), Makerere University, Kampala, Uganda (J Mabweijano MMed); University of South Africa, Johannesburg, South Africa (O Kobusingye MMed); Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (A Koranteng MSc); University of California, San Francisco, San Francisco, CA, USA (M Lipnick MD); University of Miami Miller School of Medicine, Miami, FL, USA (Prof S E Lipshultz MD, Prof R L Sacco MD, Prof J D Wilkinson MD); Mulago Hospital, Kampala, Uganda (J Mabweijano MMed); Centre for International Child Health (A Steer MBBS), Department of Paediatrics, Royal Children’s Hospital (R Weintraub MBBS), University of Melbourne, Melbourne, VIC, Australia (Prof R Marks MBBS); Asian Pacific Society of Cardiology, Kyoto, Japan (A Matsumori MD); Medical Research Council, Tygerberg, South Africa (R Matzopoulos MPhil); Hatter Institute (Prof K Sliwa MD), Department of Medicine (Prof G A Mensah MD), University of Cape Town, Cape Town, South Africa (R Matzopoulos, Prof B M Mayosi DPhil); Legacy Health System, Portland, OR, USA (J H McAnulty MD); Northwestern University Feinberg School of Medicine, Evanston, IL, USA (Prof M M McDermott MD); College of Medicine, Alfaisal University, Riyadh, Saudi Arabia (Prof Z A Memish); University of Otago, Dunedin, New Zealand (T R Merriman PhD); China Medical Board, Boston, MA, USA (C Michaud MD); Pacific Institute for Research and Evaluation, Calverton, MD, USA (T R Miller PhD); National Institute of Health, Maputo, Mozambique (Prof A O Mocumbi MD); University Eduardo Mondlane, Maputo, Mozambique (Prof A O Mocumbi); Columbia University, New York City, NY, USA (A Moran MD); London School of Hygiene and Tropical Medicine, London, UK (Prof K Mulholland MD); Centro Studi GISED, Bergamo, Italy (L Naldi MD); School of Public Health, University of Liverpool, Liverpool, UK (Prof K Nasseri DVM); HRB-Clinical Research Facility, National University of Ireland Galway, Galway, Ireland, UK (M O’Donnell PhD); Deakin University, Melbourne, VIC, Australia (Prof R Osborne PhD); B P Koirala Institute of Health Sciences, Dharan, Nepal (B Pahari MD); Betty Cowan Research and Innovation Center, Ludhiana, India (J D Pandian MD); Hospital Juan XXIII, La Paz, Bolivia (A Panozo Rivero MD); Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico (R Perez Padilla MD); Hospital Universitario Cruces, Barakaldo, Spain (F Perez-Ruiz MD); Brigham Young University, Provo, UT, USA (Prof C A Pope III PhD); Hospital Universitario de Canarias, Tenerife, Spain (E Porrini MD); Faculty of Medicine, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada (F Pourmalek MD); Mason Eye Institute, University of Missouri, Columbia, MO, USA (M Raju PhD); Centre for Addiction and Mental Health, Toronto, ON, Canada (Prof J T Rehm PhD); National Opinion Research Center, University of Chicago, Chicago, IL, USA (D B Rein PhD); Complejo Hospitalario Caja De Seguro Social, Panama City, Panama (F Rodriguez de León MD); Vanderbilt University, Nashville, TN, USA (Prof U Sampson MD); University of Alabama at Birmingham, Birmingham, AL, USA (Prof D C Schwebel PhD); Ministry of Interior, Madrid, Spain (M Segui-Gomez MD); Queens Medical Center, Honolulu, HI, USA (D Singh MD); Drexel University School of Public Health, Philadelphia, PA, USA (J A Taylor PhD); Cincinnati Children’s Hospital, Cincinnati, OH, USA (Prof J A Towbin MD); Department of Neurology, Copenhagen University Hospital, Herlev, Denmark (T Truelsen MD); National University of Singapore, Singapore, (N Venketasubramanian FRCP); Voluntary Health Services, Sneha, Chennai, India (Prof L Vijayakumar MBBS); National Institute for Occupational Safety and Health, Baltimore, MD, USA (G R Wagner MD); Beijing Neurosurgical Institute, Capital Medical University, Beijing, China (Prof W Wang MD); Brown University, Providence, RI, USA (Prof M A Weinstock MD); Royal Cornwall Hospital, Truro, UK (Prof A D Woolf MBBS); London School of Economics, London, UK (P-H Yeh MS); Centre for Suicide Research and Prevention, University of Hong Kong, Hong Kong, China (Prof P Yip PhD); and School of Public Health, Shanghai Jiao Tong University, Shanghai, China (Prof Z-J Zheng MD
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Ali A Mokdad
- Institute for Health Metrics and Evaluation (Prof R Lozano MD, M Naghavi PhD, S S Lim PhD, S Y Ahn MPH, M Alvarado BA, K G Andrews MPH, C Atkinson BS, I Bolliger AB, D Chou BA, K E Colson BA, A Delossantos BS, Prof S D Dharmaratne MBBS, A D Flaxman PhD, M H Forouzanfar MD, M K Freeman BA, E Gakidou PhD, D Gonzalez-Medina BA, D Haring BS, S L James MPH, R Jasrasaria BA, N Johns BA, S Lockett Ohno BA, M F MacIntyre EdM, L Mallinger MPH, A A Mokdad MD, M N Nair MD, K Ortblad BA, D Phillips BS, K Pierce BA, D Ranganathan BS, T Roberts BA, L C Rosenfeld MPH, E Sanman BS, M Wang MPH, S Wulf MPH, Prof C J L Murray MD), Department of Anesthesiology and Pain Medicine (N Kassebaum MD), Department of Epidemiology, School of Public Health (L M Anderson PhD), University of Washington, Seattle, WA, USA (Prof W Couser MD, H Duber MD, B Ebel MD, Prof C Mock MD, Prof F P Rivara MD, B Thomas MD); School of Public Health (Prof M Ezzati PhD), Imperial College London, London, UK (K Foreman MPH, Prof P Burney MD, L Rushton PhD); Department of Global Health, University of Tokyo, Tokyo, Japan (Prof K Shibuya MD); Department of Cardiology, Dupuytren University Hospital, Limoges, France (Prof V Aboyans MD); School of Medicine, University of Texas, San Antonio, TX, USA (J Abraham MPH); School of Population Health (T Adair PhD, Prof A D Lopez PhD, Prof T Vos PhD), Queensland Centre for Mental Health Research (J-P Khoo MBBS), Queensland Brain Institute, University of Queensland, Brisbane, QLD, Australia (Prof J McGrath MD); Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India (Prof R Aggarwal MD); Ministry of Health, Riyadh, Saudi Arabia (M A AlMazroa MD, Prof Z A Memish MD); St George’s, University of London, London, UK (Prof H R Anderson MD); Mayo Clinic, Rochester, MN, USA (Prof L M Baddour MD, P J Erwin MLS, Prof S E Gabriel MD); University of Auckland, Auckland, New Zealand (S Barker-Collo PhD); Brigham and Women’s Hospital (S Jayaraman MD), Harvard Medical School (D H Bartels BA, Prof S D Colan MD), Harvard Humanitarian Initiative (L M Knowlton MD), School of Public Health (M Miller MD, Prof J A Salomon PhD), Harvard University, Boston, MA, USA (K Bhalla PhD); Global Partners in Anesthesia and Surgery (D Ozgediz MD), Yale University, New Haven, CT, USA (Prof M L Bell PhD); Boston University, Boston, MA, USA (Prof E J Benjamin MD); Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, UK (D Bennett PhD); Research Institute of Transplantology and Artificial Organs, Moscow State University of Medicine and Dentistry, Moscow, Russia (B Bikbov MD); King Fahad Medical City, Riyadh, Saudi Arabia (A Bin Abdulhak MD, I M Tleyjeh MD); Michigan State University, East Lansing, MI, USA (Prof G Birbeck MD); School of Public Health (T Driscoll PhD), Faculty of Health Sciences (M Fransen PhD), Department of Rheumatology, Northern Clinical School (E Smith PhD), Institute of Bone and Joint Research (Prof L March MD), University of Sydney, Sydney, NSW, Australia (F Blyth PhD, Prof G B Marks PhD, M Cross PhD); Transport and Road Safety Research (S Boufous PhD), National Drug and Alcohol Research Centre (J Singleton MIPH, Prof L Degenhardt PhD), University of New South Wales, Sydney, NSW, Australia (C Bucello BPsych); Great Ormond Street Hospital, London, UK (M Burch MD); Telethon Institute for Child Health Research, Centre for Child Health Research (Prof J Carapetis MBBS), University of Western Australia, Perth, WA, Australia (Prof P Norman MD); National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA (H Chen PhD); Cedars-Sinai Medical Center, Los Angeles, CA, USA (Prof S S Chugh MD, R Havmoeller MD); Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands (L E Coffeng MD); Menzies School of Health Research, Darwin, NT, Australia (S Colquhoun MPH, J Condon PhD); National Health Services, Fife, Edinburgh, UK (M D Connor PhD); University of Edinburgh, Edinburgh, UK (M D Connor, Prof F G R Fowkes FRCPE); University of the Witwatersrand, Johannesburg, South Africa (M D Connor); Loyola University Medical School, Chicago, IL, USA (Prof L T Cooper MD); Department of Epidemiology, School of Public Health Sciences, Wake Forest University, Winston-Salem, NC, USA (M Corriere MD); Mario Negri Institute for Pharmacological Research, Bergamo, Italy (M Cortinovis BiotechD, F Gaspari ChemD, N Perico MD, Prof G Remuzzi MD); Hospital Dr Gustavo N Collado, Puerto Chitre, Panama (K Courville de Vaccaro MD); Victorian Infectious Diseases Reference Laboratory, Melbourne, VIC, Australia (B C Cowie MBBS); University of California, San Diego, San Diego, CA, USA (Prof M H Criqui MD, J Denenberg MA); Schools of Public Health and Medicine (S B Omer MBBS), Emory University, Atlanta, GA, USA (K C Dabhadkar MBBS, A Zabetian MD, K M V Narayan MD); University of Pennsylvania, Philadelphia, PA, USA (N Dahodwala MD); Griffith University, Brisbane, QLD, Australia (Prof D De Leo DSc); Beth Israel Medical Center, New York City, NY, USA (D C Des Jarlais PhD); University of Peradeniya, Peradeniya, Sri Lanka (Prof S D Dharmaratne); Johns Hopkins University, Baltimore, MD, USA (E R Dorsey MD); Hospital Maciel, Montevideo, Uruguay (P Espindola MD); MRC-HPA Centre for Environment and Health, London, UK (Prof M Ezzati PhD); National Institute for Stroke and Applied Neurosciences, Auckland Technical University, Auckland, New Zealand (Prof V Feigin MD, R Krishnamurthi PhD); Royal Life Saving Society, Sydney, NSW, Australia (R Franklin PhD); James Cook University, Townsville, QLD, Australia (K Watt PhD, R Franklin PhD); Howard University College of Medicine, Washington, DC, USA (Prof R F Gillum MD); Brandeis University, Waltham, MA, USA (Y A Halasa DDS, Prof D S Shepard PhD, E A Undurraga PhD); Flinders University, Adelaide, SA, Australia (Prof J E Harrison MBBS); Karolinska University Hospital, Stockholm, Sweden (R Havmoeller MD); King’s College Hospital NHS Trust, King’s College, London, UK (Prof R J Hay DM); Université de Franche-Comté, Besançon, France (Prof B Hoen MD); Centre Hospitalier Régional Universitaire de Basençon, Besançon, France (Prof B Hoen); National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, USA (Prof P J Hotez MD); Monash University, Melbourne, VIC, Australia (D Hoy PhD); George Mason University, Fairfax, VA, USA (K H Jacobsen PhD); All India Institute of Medical Sciences, New Delhi, India (G Karthikeyan MD); Department of Cardiology, Hebrew University Hadassah Medical School, Jerusalem, Israel (Prof A Keren MD); School of Public Health (O Kobusingye MMed), Makerere University, Kampala, Uganda (J Mabweijano MMed); University of South Africa, Johannesburg, South Africa (O Kobusingye MMed); Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (A Koranteng MSc); University of California, San Francisco, San Francisco, CA, USA (M Lipnick MD); University of Miami Miller School of Medicine, Miami, FL, USA (Prof S E Lipshultz MD, Prof R L Sacco MD, Prof J D Wilkinson MD); Mulago Hospital, Kampala, Uganda (J Mabweijano MMed); Centre for International Child Health (A Steer MBBS), Department of Paediatrics, Royal Children’s Hospital (R Weintraub MBBS), University of Melbourne, Melbourne, VIC, Australia (Prof R Marks MBBS); Asian Pacific Society of Cardiology, Kyoto, Japan (A Matsumori MD); Medical Research Council, Tygerberg, South Africa (R Matzopoulos MPhil); Hatter Institute (Prof K Sliwa MD), Department of Medicine (Prof G A Mensah MD), University of Cape Town, Cape Town, South Africa (R Matzopoulos, Prof B M Mayosi DPhil); Legacy Health System, Portland, OR, USA (J H McAnulty MD); Northwestern University Feinberg School of Medicine, Evanston, IL, USA (Prof M M McDermott MD); College of Medicine, Alfaisal University, Riyadh, Saudi Arabia (Prof Z A Memish); University of Otago, Dunedin, New Zealand (T R Merriman PhD); China Medical Board, Boston, MA, USA (C Michaud MD); Pacific Institute for Research and Evaluation, Calverton, MD, USA (T R Miller PhD); National Institute of Health, Maputo, Mozambique (Prof A O Mocumbi MD); University Eduardo Mondlane, Maputo, Mozambique (Prof A O Mocumbi); Columbia University, New York City, NY, USA (A Moran MD); London School of Hygiene and Tropical Medicine, London, UK (Prof K Mulholland MD); Centro Studi GISED, Bergamo, Italy (L Naldi MD); School of Public Health, University of Liverpool, Liverpool, UK (Prof K Nasseri DVM); HRB-Clinical Research Facility, National University of Ireland Galway, Galway, Ireland, UK (M O’Donnell PhD); Deakin University, Melbourne, VIC, Australia (Prof R Osborne PhD); B P Koirala Institute of Health Sciences, Dharan, Nepal (B Pahari MD); Betty Cowan Research and Innovation Center, Ludhiana, India (J D Pandian MD); Hospital Juan XXIII, La Paz, Bolivia (A Panozo Rivero MD); Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico (R Perez Padilla MD); Hospital Universitario Cruces, Barakaldo, Spain (F Perez-Ruiz MD); Brigham Young University, Provo, UT, USA (Prof C A Pope III PhD); Hospital Universitario de Canarias, Tenerife, Spain (E Porrini MD); Faculty of Medicine, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada (F Pourmalek MD); Mason Eye Institute, University of Missouri, Columbia, MO, USA (M Raju PhD); Centre for Addiction and Mental Health, Toronto, ON, Canada (Prof J T Rehm PhD); National Opinion Research Center, University of Chicago, Chicago, IL, USA (D B Rein PhD); Complejo Hospitalario Caja De Seguro Social, Panama City, Panama (F Rodriguez de León MD); Vanderbilt University, Nashville, TN, USA (Prof U Sampson MD); University of Alabama at Birmingham, Birmingham, AL, USA (Prof D C Schwebel PhD); Ministry of Interior, Madrid, Spain (M Segui-Gomez MD); Queens Medical Center, Honolulu, HI, USA (D Singh MD); Drexel University School of Public Health, Philadelphia, PA, USA (J A Taylor PhD); Cincinnati Children’s Hospital, Cincinnati, OH, USA (Prof J A Towbin MD); Department of Neurology, Copenhagen University Hospital, Herlev, Denmark (T Truelsen MD); National University of Singapore, Singapore, (N Venketasubramanian FRCP); Voluntary Health Services, Sneha, Chennai, India (Prof L Vijayakumar MBBS); National Institute for Occupational Safety and Health, Baltimore, MD, USA (G R Wagner MD); Beijing Neurosurgical Institute, Capital Medical University, Beijing, China (Prof W Wang MD); Brown University, Providence, RI, USA (Prof M A Weinstock MD); Royal Cornwall Hospital, Truro, UK (Prof A D Woolf MBBS); London School of Economics, London, UK (P-H Yeh MS); Centre for Suicide Research and Prevention, University of Hong Kong, Hong Kong, China (Prof P Yip PhD); and School of Public Health, Shanghai Jiao Tong University, Shanghai, China (Prof Z-J Zheng MD
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- Corresponding author: Correspondence to: Prof Christopher J L Murray, Institute for Health Metrics and Evaluation, University of Washington, 2301 Fifth Avenue, Suite 600, Seattle, WA 98121, USA,
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Chou D, Say L. I069 ICD MM, A WORLD HEALTH ORGANIZATION TOOL TO IMPROVE AND STANDARDIZE MATERNAL CAUSE OF DEATH. Int J Gynaecol Obstet 2012. [DOI: 10.1016/s0020-7292(12)60099-x] [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: 11/29/2022]
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Norman J, Chou D, Say L. I274 ICD 11 - WHAT IT MEANS TO YOU AND HOW YOU CAN HELP GET IT RIGHT. Int J Gynaecol Obstet 2012. [DOI: 10.1016/s0020-7292(12)60304-x] [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: 11/26/2022]
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Affiliation(s)
- L Say
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
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Hsu J, Chiu H, Chou D, Huang C, Lin W, Lien T, Yen K. 1025 POSTER Suppression of Stat3 Activity Sensitizes Gefitinib-resistant Non Small Cell Lung Cancer Cells. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)70668-2] [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: 11/27/2022]
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