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Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980-2015: the Global Burden of Disease Study 2015
Wang, Haidong; Wolock, Tim M; Carter, Austin; Nguyen, Grant; Kyu, Hmwe Hmwe; Gakidou, Emmanuela; Hay, Simon I; Mills, Edward J; Trickey, Adam; Msemburi, William; Coates, Matthew M; Mooney, Meghan D; Fraser, Maya S; Sligar, Amber; Salomon, Joshua; Larson, Heidi J; Friedman, Joseph; Abajobir, Amanuel Alemu; Abate, Kalkidan Hassen; Abbas, Kaja M; Razek, Mohamed Magdy Abd El; Abd-Allah, Foad; Abdulle, Abdishakur M; Abera, Semaw Ferede; Abubakar, Ibrahim; Abu-Raddad, Laith J; Abu-Rmeileh, Niveen M E; Abyu, Gebre Yitayih; Adebiyi, Akindele Olupelumi; Adedeji, Isaac Akinkunmi; Adelekan, Ademola Lukman; Adofo, Koranteng; Adou, Arsene Kouablan; Ajala, Oluremi N; Akinyemiju, Tomi F; Akseer, Nadia; Lami, Faris Hasan Al; Al-Aly, Ziyad; Alam, Khurshid; Alam, Noore K M; Alasfoor, Deena; Aldhahri, Saleh Fahed S; Aldridge, Robert William; Alegretti, Miguel Angel; Aleman, Alicia V; Alemu, Zewdie Aderaw; Alfonso-Cristancho, Rafael; Ali, Raghib; Alkerwi, Ala'a; Alla, Francois; Mohammad, Rajaa; Al-Raddadi, Salem; Alsharif, Ubai; Alvarez, Elena; Alvis-Guzman, Nelson; Amare, Azmeraw T; Amberbir, Alemayehu; Amegah, Adeladza Kofi; Ammar, Walid; Amrock, Stephen Marc; Antonio, Carl Abelardo T; Anwari, Palwasha; Arnlov, Johan; Artaman, Al; Asayesh, Hamid; Asghar, Rana Jawad; Assadi, Reza; Atique, Suleman; Atkins, Lydia S; Avokpaho, Euripide Frinel G Arthur; Awasthi, Ashish; Quintanilla, Beatriz Paulina Ayala; Bacha, Umar; Badawi, Alaa; Barac, Aleksandra; Barnighausen, Till; Basu, Arindam; Bayou, Tigist Assefa; Bayou, Yibeltal Tebekaw; Bazargan-Hejazi, Shahrzad; Beardsley, Justin; Bedi, Neeraj; Bennett, Derrick A; Bensenor, Isabela M; Betsu, Balem Demtsu; Beyene, Addisu Shunu; Bhatia, Eesh; Bhutta, Zulfiqar A; Biadgilign, Sibhatu; Bikbov, Boris; Birlik, Sait Mentes; Bisanzio, Donal; Brainin, Michael; Brazinova, Alexandra; Breitborde, Nicholas J K; Brown, Alexandria; Burch, Michael; Butt, Zahid A; Campuzano, Julio Cesar; Cardenas, Rosario; Carrero, Juan Jesus; Castaneda-Orjuela, Carlos A; Rivas, Jacqueline Castillo; Catala-Lopez, Ferran; Chang, Hsing-Yi; Chang, Jung-Chen; Chavan, Laxmikant; Chen, Wanqing; Chiang, Peggy Pei-Chia; Chibalabala, Mirriam; Chisumpa, Vesper Hichilombwe; Choi, Jee-Young Jasmine; Christopher, Devasahayam Jesudas; Ciobanu, Liliana G; Cooper, Cyrus; Dahiru, Tukur; Damtew, Solomon Abreha; Dandona, Lalit; Dandona, Rakhi; das Neves, Jose; de Jager, Pieter; De Leo, Diego; Degenhardt, Louisa; Dellavalle, Robert P; Deribe, Kebede; Deribew, Amare; Des Jarlais, Don C; Dharmaratne, Samath D; Ding, Eric L; Doshi, Pratik Pinal; Driscoll, Tim R; Dubey, Manisha; Elshrek, Yousef Mohamed; Elyazar, Iqbal; Endries, Aman Yesuf; Ermakov, Sergey Petrovich; Eshrati, Babak; Esteghamati, Alireza; Faghmous, Imad D A; Farinha, Carla Sofia E Sa; Faro, Andre; Farvid, Maryam S; Farzadfar, Farshad; Fereshtehnejad, Seyed-Mohammad; Fernandes, Joao C; Fischer, Florian; Fitchett, Joseph Robert Ander; Foigt, Nataliya; Fullman, Nancy; Furst, Thomas; Gankpe, Fortune Gbetoho; Gebre, Teshome; Gebremedhin, Amanuel Tesfay; Gebru, Alemseged Aregay; Geleijnse, Johanna M; Gessner, Bradford D; Gething, Peter W; Ghiwot, Tsegaye Tewelde; Giroud, Maurice; Gishu, Melkamu Dedefo; Glaser, Elizabeth; Goenka, Shifalika; Goodridge, Amador; Gopalani, Sameer Vali; Goto, Atsushi; Gugnani, Harish Chander; Guimaraes, Mark D C; Gupta, Rahul; Gupta, Rajeev; Gupta, Vipin; Haagsma, Juanita; Hafezi-Nejad, Nima; Hagan, Holly; Hailu, Gessessew Bugssa; Hamadeh, Randah Ribhi; Hamidi, Samer; Hammami, Mouhanad; Hankey, Graeme J; Hao, Yuantao; Harb, Hilda L; Harikrishnan, Sivadasanpillai; Haro, Josep Maria; Harun, Kimani M; Havmoeller, Rasmus; Hedayati, Mohammad T; Heredia-Pi, Ileana Beatriz; Hoek, Hans W; Horino, Masako; Horita, Nobuyuki; Hosgood, H Dean; Hoy, Damian G; Hsairi, Mohamed; Hu, Guoqing; Huang, Hsiang; Huang, John J; Iburg, Kim Moesgaard; Idrisov, Bulat T; Innos, Kaire; Iyer, Veena J; Jacobsen, Kathryn H; Jahanmehr, Nader; Jakovljevic, Mihajlo B; Javanbakht, Mehdi; Jayatilleke, Achala Upendra; Jeemon, Panniyammakal; Jha, Vivekanand; Jiang, Guohong; Jiang, Ying; Jibat, Tariku; Jonas, Jost B; Kabir, Zubair; Kamal, Ritul; Kan, Haidong; Karch, Andre; Karema, Corine Kakizi; Karletsos, Dimitris; Kasaeian, Amir; Kaul, Anil; Kawakami, Norito; Kayibanda, Jeanne Francoise; Keiyoro, Peter Njenga; Kemp, Andrew Haddon; Kengne, Andre Pascal; Kesavachandran, Chandrasekharan Nair; Khader, Yousef Saleh; Khalil, Ibrahim; Khan, Abdur Rahman; Khan, Ejaz Ahmad; Khang, Young-Ho; Khubchandani, Jagdish; Kim, Yun Jin; Kinfu, Yohannes; Kivipelto, Miia; Kokubo, Yoshihiro; Kosen, Soewarta; Koul, Parvaiz A; Koyanagi, Ai; Defo, Barthelemy Kuate; Bicer, Burcu Kucuk; Kulkarni, Veena S; Kumar, G Anil; Lal, Dharmesh Kumar; Lam, Hilton; Lam, Jennifer O; Langan, Sinead M; Lansingh, Van C; Larsson, Anders; Leigh, James; Leung, Ricky; Li, Yongmei; Lim, Stephen S; Lipshultz, Steven E; Liu, Shiwei; Lloyd, Belinda K; Logroscino, Giancarlo; Lotufo, Paulo A; Lunevicius, Raimundas; Razek, Hassan Magdy Abd El; Mahdavi, Mahdi; Majdan, Marek; Majeed, Azeem; Makhlouf, Carla; Malekzadeh, Reza; Mapoma, Chabila C; Marcenes, Wagner; Martinez-Raga, Jose; Marzan, Melvin Barrientos; Masiye, Felix; Mason-Jones, Amanda J; Mayosi, Bongani M; McKee, Martin; Meaney, Peter A; Mehndiratta, Man Mohan; Mekonnen, Alemayehu B; Melaku, Yohannes Adama; Memiah, Peter; Memish, Ziad A; Mendoza, Walter; Meretoja, Atte; Meretoja, Tuomo J; Mhimbira, Francis Apolinary; Miller, Ted R; Mikesell, Joseph; Mirarefin, Mojde; Mohammad, Karzan Abdulmuhsin; Mohammed, Shafiu; Mokdad, Ali H; Monasta, Lorenzo; Moradi-Lakeh, Maziar; Mori, Rintaro; Mueller, Ulrich O; Murimira, Brighton; Murthy, Gudlavalleti Venkata Satyanarayana; Naheed, Aliya; Naldi, Luigi; Nangia, Vinay; Nash, Denis; Nawaz, Haseeb; Nejjari, Chakib; Ngalesoni, Frida Namnyak; de Dieu Ngirabega, Jean; Nguyen, Quyen Le; Nisar, Muhammad Imran; Norheim, Ole F; Norman, Rosana E; Nyakarahuka, Luke; Ogbo, Felix Akpojene; Oh, In-Hwan; Ojelabi, Foluke Adetola; Olusanya, Bolajoko Olubukunola; Olusanya, Jacob Olusegun; Opio, John Nelson; Oren, Eyal; Ota, Erika; Padukudru, Mahesh Anand; Park, Hye-Youn; Park, Jae-Hyun; Patil, Snehal T; Patten, Scott B; Paul, Vinod K; Pearson, Katherine; Peprah, Emmanuel Kwame; Pereira, Claudia C; Perico, Norberto; Pesudovs, Konrad; Petzold, Max; Phillips, Michael Robert; Pillay, Julian David; Plass, Dietrich; Polinder, Suzanne; Pourmalek, Farshad; Prokop, David M; Qorbani, Mostafa; Rafay, Anwar; Rahimi, Kazem; Rahimi-Movaghar, Vafa; Rahman, Mahfuzar; Rahman, Mohammad Hifz Ur; Rahman, Sajjad Ur; Rai, Rajesh Kumar; Rajsic, Sasa; Ram, Usha; Rana, Saleem M; Rao, Paturi Vishnupriya; Remuzzi, Giuseppe; Rojas-Rueda, David; Ronfani, Luca; Roshandel, Gholamreza; Roy, Ambuj; Ruhago, George Mugambage; Saeedi, Mohammad Yahya; Sagar, Rajesh; Saleh, Muhammad Muhammad; Sanabria, Juan R; Santos, Itamar S; Sarmiento-Suarez, Rodrigo; Sartorius, Benn; Sawhney, Monika; Schutte, Aletta E; Schwebel, David C; Seedat, Soraya; Sepanlou, Sadaf G; Servan-Mori, Edson E; Shaikh, Masood Ali; Sharma, Rajesh; She, Jun; Sheikhbahaei, Sara; Shen, Jiabin; Shibuya, Kenji; Shin, Hwashin Hyun; Sigfusdottir, Inga Dora; Silpakit, Naris; Silva, Diego Augusto Santos; Silveira, Dayane Gabriele Alves; Simard, Edgar P; Sindi, Shireen; Singh, Jasvinder A; Singh, Om Prakash; Singh, Prashant Kumar; Skirbekk, Vegard; Sliwa, Karen; Soneji, Samir; Sorensen, Reed J D; Soriano, Joan B; Soti, David O; Sreeramareddy, Chandrashekhar T; Stathopoulou, Vasiliki; Steel, Nicholas; Sunguya, Bruno F; Swaminathan, Soumya; Sykes, Bryan L; Tabares-Seisdedos, Rafael; Talongwa, Roberto Tchio; Tavakkoli, Mohammad; Taye, Bineyam; Tedla, Bemnet Amare; Tekle, Tesfaye; Shifa, Girma Temam; Temesgen, Awoke Misganaw; Terkawi, Abdullah Sulieman; Tesfay, Fisaha Haile; Tessema, Gizachew Assefa; Thapa, Kiran; Thomson, Alan J; Thorne-Lyman, Andrew L; Tobe-Gai, Ruoyan; Topor-Madry, Roman; Towbin, Jeffrey Allen; Tran, Bach Xuan; Dimbuene, Zacharie Tsala; Tsilimparis, Nikolaos; Tura, Abera Kenay; Ukwaja, Kingsley Nnanna; Uneke, Chigozie Jesse; Uthman, Olalekan A; Venketasubramanian, N; Vladimirov, Sergey K; Vlassov, Vasiliy Victorovich; Vollset, Stein Emil; Wang, Linhong; Weiderpass, Elisabete; Weintraub, Robert G; Werdecker, Andrea; Westerman, Ronny; Wijeratne, Tissa; Wilkinson, James D; Wiysonge, Charles Shey; Wolfe, Charles D A; Won, Sungho; Wong, John Q; Xu, Gelin; Yadav, Ajit Kumar; Yakob, Bereket; Yalew, Ayalnesh Zemene; Yano, Yuichiro; Yaseri, Mehdi; Yebyo, Henock Gebremedhin; Yip, Paul; Yonemoto, Naohiro; Yoon, Seok-Jun; Younis, Mustafa Z; Yu, Chuanhua; Yu, Shicheng; Zaidi, Zoubida; Zaki, Maysaa El Sayed; Zeeb, Hajo; Zhang, Hao; Zhao, Yong; Zodpey, Sanjay; Zoeckler, Leo; Zuhlke, Liesl Joanna; Lopez, Alan D; Murray, Christopher J L
BACKGROUND: Timely assessment of the burden of HIV/AIDS is essential for policy setting and programme evaluation. In this report from the Global Burden of Disease Study 2015 (GBD 2015), we provide national estimates of levels and trends of HIV/AIDS incidence, prevalence, coverage of antiretroviral therapy (ART), and mortality for 195 countries and territories from 1980 to 2015. METHODS: For countries without high-quality vital registration data, we estimated prevalence and incidence with data from antenatal care clinics and population-based seroprevalence surveys, and with assumptions by age and sex on initial CD4 distribution at infection, CD4 progression rates (probability of progression from higher to lower CD4 cell-count category), on and off antiretroviral therapy (ART) mortality, and mortality from all other causes. Our estimation strategy links the GBD 2015 assessment of all-cause mortality and estimation of incidence and prevalence so that for each draw from the uncertainty distribution all assumptions used in each step are internally consistent. We estimated incidence, prevalence, and death with GBD versions of the Estimation and Projection Package (EPP) and Spectrum software originally developed by the Joint United Nations Programme on HIV/AIDS (UNAIDS). We used an open-source version of EPP and recoded Spectrum for speed, and used updated assumptions from systematic reviews of the literature and GBD demographic data. For countries with high-quality vital registration data, we developed the cohort incidence bias adjustment model to estimate HIV incidence and prevalence largely from the number of deaths caused by HIV recorded in cause-of-death statistics. We corrected these statistics for garbage coding and HIV misclassification. FINDINGS: Global HIV incidence reached its peak in 1997, at 3.3 million new infections (95% uncertainty interval [UI] 3.1-3.4 million). Annual incidence has stayed relatively constant at about 2.6 million per year (range 2.5-2.8 million) since 2005, after a period of fast decline between 1997 and 2005. The number of people living with HIV/AIDS has been steadily increasing and reached 38.8 million (95% UI 37.6-40.4 million) in 2015. At the same time, HIV/AIDS mortality has been declining at a steady pace, from a peak of 1.8 million deaths (95% UI 1.7-1.9 million) in 2005, to 1.2 million deaths (1.1-1.3 million) in 2015. We recorded substantial heterogeneity in the levels and trends of HIV/AIDS across countries. Although many countries have experienced decreases in HIV/AIDS mortality and in annual new infections, other countries have had slowdowns or increases in rates of change in annual new infections. INTERPRETATION: Scale-up of ART and prevention of mother-to-child transmission has been one of the great successes of global health in the past two decades. However, in the past decade, progress in reducing new infections has been slow, development assistance for health devoted to HIV has stagnated, and resources for health in low-income countries have grown slowly. Achievement of the new ambitious goals for HIV enshrined in Sustainable Development Goal 3 and the 90-90-90 UNAIDS targets will be challenging, and will need continued efforts from governments and international agencies in the next 15 years to end AIDS by 2030. FUNDING: Bill & Melinda Gates Foundation, and National Institute of Mental Health and National Institute on Aging, National Institutes of Health.
PMCID:5056319
PMID: 27470028
ISSN: 2352-3018
CID: 2281442
Trends in UK regional cancer mortality 1991-2007
Marshall, Dominic C; Webb, Thomas E; Hall, Richard A; Salciccioli, Justin D; Ali, Raghib; Maruthappu, Mahiben
BACKGROUND: Until 1990, there was an upward trend in mortality from breast, lung, prostate, and colon cancers in the United Kingdom. With improvements in cancer treatment there has, in general, been a fall in mortality over the last 20 years. We evaluate regional cancer mortality trends in the United Kingdom between 1991 and 2007. METHODS: We analysed mortality trends for breast, lung, prostate, and colon cancers using data obtained from the EUREG cancer database. We have described changes in age-standardised rates (using European standard population) per 100,000 for cancer mortality and generated trends in mortality for the 11 regions using Joinpoint regression. RESULTS: Across all regions in the United Kingdom there was a downward trend in mortality for the four most common cancers in males and females. Overall, deaths from colon cancer decreased most rapidly and deaths from prostate cancer decreased at the slowest rate. Similar downward trends in mortality were observed across all regions of the United Kingdom with the data for lung cancer exhibiting the greatest variation. CONCLUSIONS: Mortality from the four most common cancers decreased across all regions of the United Kingdom; however, the rate of decline varied between cancer type and in some instances by region.
PMCID:4742578
PMID: 26766741
ISSN: 1532-1827
CID: 2281472
Unemployment, public-sector healthcare expenditure and colorectal cancer mortality in the European Union: 1990-2009
Maruthappu, Mahiben; Watson, Robert A; Watkins, Johnathan; Williams, Callum; Zeltner, Thomas; Faiz, Omar; Ali, Raghib; Atun, Rifat
OBJECTIVES: We examined the association between unemployment and government spending on healthcare with colorectal cancer mortality. METHODS: Retrospective observational study using data from the World Bank and WHO. Multivariate regression analysis was used, controlling for country-specific differences in infrastructure and demographics. RESULTS: A 1 % increase in unemployment was associated with a significant increase in colorectal cancer mortality in both men and women [men: coefficient (R) = 0.0995, 95 % confidence interval (CI) 0.0132-0.1858, P = 0.024; women: R = 0.0742, 95 % CI 0.0160-0.1324, P = 0.013]. A 1 % increase in government spending on healthcare was associated with a statistically significant decrease in colorectal cancer mortality across both sexes (men: R = -0.4307, 95 % CI -0.6057 to -0.2557, P < 0.001; women: R = -0.2162, 95 % CI -0.3407 to -0.0917, P = 0.001). The largest changes in mortality occurred 3-4 years following changes in either economic variable. CONCLUSIONS: Unemployment rises are associated with a significant increase in colorectal cancer mortality, whilst government healthcare spending rises are associated with falling mortality. This is likely due, in part, to reduced access to healthcare services and has major implications for clinicians and policy makers alike.
PMID: 26303073
ISSN: 1661-8564
CID: 2281502
Perceptions and Attitudes towards Medical Research in the United Arab Emirates: Results from the Abu Dhabi Cohort Study (ADCS) Focus Group Discussions
El Obaid, Yusra; Al Hamiz, Aisha; Abdulle, Abdishakur; Hayes, Richard B; Sherman, Scott; Ali, Raghib
BACKGROUND: In developing medical research, particularly in regions where medical research is largely unfamiliar, it is important to understand public perceptions and attitudes towards medical research. In preparation for starting the first cohort study in the United Arab Emirates, the Abu Dhabi Cohort Study (ADCS), we sought to understand how we could improve the quality of the research process for participants and increase public trust and awareness of research. METHODS: We conducted six focus groups (FG), consisting of Emirati men and women aged above 18 years to resemble the target population for the ADCS. Sampling was purposive and convenient. Data collection was an iterative process until saturation was reached with no new themes identified. Text from each FG was analyzed separately by identifying emerging issues and organizing related concepts into categories or themes. A coding tree was developed, consisting of the main concepts, themes, subthemes and corresponding quotes. Both themes and main ideas were identified using inductive analysis. RESULTS: Forty-two participants enrolled at 3 academic centers (New York University Abu Dhabi, UAE University, Zayed University) and the Abu Dhabi blood bank. Focus group participants described lack of awareness of research as a challenge to participation in clinical research studies. Altruism, personal relevance of the research, and the use of role models were commonly identified motivators. Participants were generally satisfied with the informed consent process for the ADCS, but would be disappointed if not provided test results or study outcomes. Fear of a breach in confidentiality was a frequently expressed concern. CONCLUSIONS: Participants join research studies for varied, complex reasons, notably altruism and personal relevance. Based on these insights, we propose specific actions to enhance participant recruitment, retention and satisfaction in the ADCS. We identified opportunities to improve the research experience through improved study materials and communication to participants and the broader community.
PMCID:4778844
PMID: 26943636
ISSN: 1932-6203
CID: 2009482
Nervous System and Intracranial Tumour Incidence by Ethnicity in England, 2001-2007: A Descriptive Epidemiological Study
Maile, Edward J; Barnes, Isobel; Finlayson, Alexander E; Sayeed, Shameq; Ali, Raghib
BACKGROUND: There is substantial variation in nervous system and intracranial tumour incidence worldwide. UK incidence data have limited utility because they group these diverse tumours together and do not provide data for individual ethnic groups within Blacks and South Asians. Our objective was to determine the incidence of individual tumour types for seven individual ethnic groups. METHODS: We used data from the National Cancer Intelligence Network on tumour site, age, sex and deprivation to identify 42,207 tumour cases. Self-reported ethnicity was obtained from the Hospital Episode Statistics database. We used mid-year population estimates from the Office for National Statistics. We analysed tumours by site using Poisson regression to estimate incidence rate ratios comparing non-White ethnicities to Whites after adjustment for sex, age and deprivation. RESULTS: Our study showed differences in tumour incidence by ethnicity for gliomas, meningiomas, pituitary tumours and cranial and paraspinal nerve tumours. Relative to Whites; South Asians, Blacks and Chinese have a lower incidence of gliomas (p<0.01), with respective incidence rate ratios of 0.68 (confidence interval: 0.60-0.77), 0.62 (0.52-0.73) and 0.58 (0.41-0.83). Blacks have a higher incidence of meningioma (p<0.01) with an incidence rate ratio of 1.29 (1.05-1.59) and there is heterogeneity in meningioma incidence between individual South Asian ethnicities. Blacks have a higher incidence of pituitary tumours relative to Whites (p<0.01) with an incidence rate ratio of 2.95 (2.37-3.67). There is heterogeneity in pituitary tumour incidence between individual South Asian ethnicities. CONCLUSIONS: We present incidence data of individual tumour types for seven ethnic groups. Current understanding of the aetiology of these tumours cannot explain our results. These findings suggest avenues for further work.
PMCID:4852951
PMID: 27135830
ISSN: 1932-6203
CID: 2281462
Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013
Forouzanfar, Mohammad H; Alexander, Lily; Anderson, H Ross; Bachman, Victoria F; Biryukov, Stan; Brauer, Michael; Burnett, Richard; Casey, Daniel; Coates, Matthew M; Cohen, Aaron; Delwiche, Kristen; Estep, Kara; Frostad, Joseph J; Astha, K C; Kyu, Hmwe H; Moradi-Lakeh, Maziar; Ng, Marie; Slepak, Erica Leigh; Thomas, Bernadette A; Wagner, Joseph; Aasvang, Gunn Marit; Abbafati, Cristiana; Abbasoglu Ozgoren, Ayse; Abd-Allah, Foad; Abera, Semaw F; Aboyans, Victor; Abraham, Biju; Abraham, Jerry Puthenpurakal; Abubakar, Ibrahim; Abu-Rmeileh, Niveen M E; Aburto, Tania C; Achoki, Tom; Adelekan, Ademola; Adofo, Koranteng; Adou, Arsene K; Adsuar, Jose C; Afshin, Ashkan; Agardh, Emilie E; Al Khabouri, Mazin J; Al Lami, Faris H; Alam, Sayed Saidul; Alasfoor, Deena; Albittar, Mohammed I; Alegretti, Miguel A; Aleman, Alicia V; Alemu, Zewdie A; Alfonso-Cristancho, Rafael; Alhabib, Samia; Ali, Raghib; Ali, Mohammed K; Alla, Francois; Allebeck, Peter; Allen, Peter J; Alsharif, Ubai; Alvarez, Elena; Alvis-Guzman, Nelson; Amankwaa, Adansi A; Amare, Azmeraw T; Ameh, Emmanuel A; Ameli, Omid; Amini, Heresh; Ammar, Walid; Anderson, Benjamin O; Antonio, Carl Abelardo T; Anwari, Palwasha; Argeseanu Cunningham, Solveig; Arnlov, Johan; Arsenijevic, Valentina S Arsic; Artaman, Al; Asghar, Rana J; Assadi, Reza; Atkins, Lydia S; Atkinson, Charles; Avila, Marco A; Awuah, Baffour; Badawi, Alaa; Bahit, Maria C; Bakfalouni, Talal; Balakrishnan, Kalpana; Balalla, Shivanthi; Balu, Ravi Kumar; Banerjee, Amitava; Barber, Ryan M; Barker-Collo, Suzanne L; Barquera, Simon; Barregard, Lars; Barrero, Lope H; Barrientos-Gutierrez, Tonatiuh; Basto-Abreu, Ana C; Basu, Arindam; Basu, Sanjay; Basulaiman, Mohammed O; Batis Ruvalcaba, Carolina; Beardsley, Justin; Bedi, Neeraj; Bekele, Tolesa; Bell, Michelle L; Benjet, Corina; Bennett, Derrick A; Benzian, Habib; Bernabe, Eduardo; Beyene, Tariku J; Bhala, Neeraj; Bhalla, Ashish; Bhutta, Zulfiqar A; Bikbov, Boris; Bin Abdulhak, Aref A; Blore, Jed D; Blyth, Fiona M; Bohensky, Megan A; Bora Basara, Berrak; Borges, Guilherme; Bornstein, Natan M; Bose, Dipan; Boufous, Soufiane; Bourne, Rupert R; Brainin, Michael; Brazinova, Alexandra; Breitborde, Nicholas J; Brenner, Hermann; Briggs, Adam D M; Broday, David M; Brooks, Peter M; Bruce, Nigel G; Brugha, Traolach S; Brunekreef, Bert; Buchbinder, Rachelle; Bui, Linh N; Bukhman, Gene; Bulloch, Andrew G; Burch, Michael; Burney, Peter G J; Campos-Nonato, Ismael R; Campuzano, Julio C; Cantoral, Alejandra J; Caravanos, Jack; Cardenas, Rosario; Cardis, Elisabeth; Carpenter, David O; Caso, Valeria; Castaneda-Orjuela, Carlos A; Castro, Ruben E; Catala-Lopez, Ferran; Cavalleri, Fiorella; Cavlin, Alanur; Chadha, Vineet K; Chang, Jung-Chen; Charlson, Fiona J; Chen, Honglei; Chen, Wanqing; Chen, Zhengming; Chiang, Peggy P; Chimed-Ochir, Odgerel; Chowdhury, Rajiv; Christophi, Costas A; Chuang, Ting-Wu; Chugh, Sumeet S; Cirillo, Massimo; Classen, Thomas K D; Colistro, Valentina; Colomar, Mercedes; Colquhoun, Samantha M; Contreras, Alejandra G; Cooper, Cyrus; Cooperrider, Kimberly; Cooper, Leslie T; Coresh, Josef; Courville, Karen J; Criqui, Michael H; Cuevas-Nasu, Lucia; Damsere-Derry, James; Danawi, Hadi; Dandona, Lalit; Dandona, Rakhi; Dargan, Paul I; Davis, Adrian; Davitoiu, Dragos V; Dayama, Anand; de Castro, E Filipa; De la Cruz-Gongora, Vanessa; De Leo, Diego; de Lima, Graca; Degenhardt, Louisa; del Pozo-Cruz, Borja; Dellavalle, Robert P; Deribe, Kebede; Derrett, Sarah; Des Jarlais, Don C; Dessalegn, Muluken; deVeber, Gabrielle A; Devries, Karen M; Dharmaratne, Samath D; Dherani, Mukesh K; Dicker, Daniel; Ding, Eric L; Dokova, Klara; Dorsey, E Ray; Driscoll, Tim R; Duan, Leilei; Durrani, Adnan M; Ebel, Beth E; Ellenbogen, Richard G; Elshrek, Yousef M; Endres, Matthias; Ermakov, Sergey P; Erskine, Holly E; Eshrati, Babak; Esteghamati, Alireza; Fahimi, Saman; Faraon, Emerito Jose A; Farzadfar, Farshad; Fay, Derek F J; Feigin, Valery L; Feigl, Andrea B; Fereshtehnejad, Seyed-Mohammad; Ferrari, Alize J; Ferri, Cleusa P; Flaxman, Abraham D; Fleming, Thomas D; Foigt, Nataliya; Foreman, Kyle J; Paleo, Urbano Fra; Franklin, Richard C; Gabbe, Belinda; Gaffikin, Lynne; Gakidou, Emmanuela; Gamkrelidze, Amiran; Gankpe, Fortune G; Gansevoort, Ron T; Garcia-Guerra, Francisco A; Gasana, Evariste; Geleijnse, Johanna M; Gessner, Bradford D; Gething, Pete; Gibney, Katherine B; Gillum, Richard F; Ginawi, Ibrahim A M; Giroud, Maurice; Giussani, Giorgia; Goenka, Shifalika; Goginashvili, Ketevan; Gomez Dantes, Hector; Gona, Philimon; Gonzalez de Cosio, Teresita; Gonzalez-Castell, Dinorah; Gotay, Carolyn C; Goto, Atsushi; Gouda, Hebe N; Guerrant, Richard L; Gugnani, Harish C; Guillemin, Francis; Gunnell, David; Gupta, Rahul; Gupta, Rajeev; Gutierrez, Reyna A; Hafezi-Nejad, Nima; Hagan, Holly; Hagstromer, Maria; Halasa, Yara A; Hamadeh, Randah R; Hammami, Mouhanad; Hankey, Graeme J; Hao, Yuantao; Harb, Hilda L; Haregu, Tilahun Nigatu; Haro, Josep Maria; Havmoeller, Rasmus; Hay, Simon I; Hedayati, Mohammad T; Heredia-Pi, Ileana B; Hernandez, Lucia; Heuton, Kyle R; Heydarpour, Pouria; Hijar, Martha; Hoek, Hans W; Hoffman, Howard J; Hornberger, John C; Hosgood, H Dean; Hoy, Damian G; Hsairi, Mohamed; Hu, Guoqing; Hu, Howard; Huang, Cheng; Huang, John J; Hubbell, Bryan J; Huiart, Laetitia; Husseini, Abdullatif; Iannarone, Marissa L; Iburg, Kim M; Idrisov, Bulat T; Ikeda, Nayu; Innos, Kaire; Inoue, Manami; Islami, Farhad; Ismayilova, Samaya; Jacobsen, Kathryn H; Jansen, Henrica A; Jarvis, Deborah L; Jassal, Simerjot K; Jauregui, Alejandra; Jayaraman, Sudha; Jeemon, Panniyammakal; Jensen, Paul N; Jha, Vivekanand; Jiang, Fan; Jiang, Guohong; Jiang, Ying; Jonas, Jost B; Juel, Knud; Kan, Haidong; Kany Roseline, Sidibe S; Karam, Nadim E; Karch, Andre; Karema, Corine K; Karthikeyan, Ganesan; Kaul, Anil; Kawakami, Norito; Kazi, Dhruv S; Kemp, Andrew H; Kengne, Andre P; Keren, Andre; Khader, Yousef S; Khalifa, Shams Eldin Ali Hassan; Khan, Ejaz A; Khang, Young-Ho; Khatibzadeh, Shahab; Khonelidze, Irma; Kieling, Christian; Kim, Daniel; Kim, Sungroul; Kim, Yunjin; Kimokoti, Ruth W; Kinfu, Yohannes; Kinge, Jonas M; Kissela, Brett M; Kivipelto, Miia; Knibbs, Luke D; Knudsen, Ann Kristin; Kokubo, Yoshihiro; Kose, M Rifat; Kosen, Soewarta; Kraemer, Alexander; Kravchenko, Michael; Krishnaswami, Sanjay; Kromhout, Hans; Ku, Tiffany; Kuate Defo, Barthelemy; Kucuk Bicer, Burcu; Kuipers, Ernst J; Kulkarni, Chanda; Kulkarni, Veena S; Kumar, G Anil; Kwan, Gene F; Lai, Taavi; Lakshmana Balaji, Arjun; Lalloo, Ratilal; Lallukka, Tea; Lam, Hilton; Lan, Qing; Lansingh, Van C; Larson, Heidi J; Larsson, Anders; Laryea, Dennis O; Lavados, Pablo M; Lawrynowicz, Alicia E; Leasher, Janet L; Lee, Jong-Tae; Leigh, James; Leung, Ricky; Levi, Miriam; Li, Yichong; Li, Yongmei; Liang, Juan; Liang, Xiaofeng; Lim, Stephen S; Lindsay, M Patrice; Lipshultz, Steven E; Liu, Shiwei; Liu, Yang; Lloyd, Belinda K; Logroscino, Giancarlo; London, Stephanie J; Lopez, Nancy; Lortet-Tieulent, Joannie; Lotufo, Paulo A; Lozano, Rafael; Lunevicius, Raimundas; Ma, Jixiang; Ma, Stefan; Machado, Vasco M P; MacIntyre, Michael F; Magis-Rodriguez, Carlos; Mahdi, Abbas A; Majdan, Marek; Malekzadeh, Reza; Mangalam, Srikanth; Mapoma, Christopher C; Marape, Marape; Marcenes, Wagner; Margolis, David J; Margono, Christopher; Marks, Guy B; Martin, Randall V; Marzan, Melvin B; Mashal, Mohammad T; Masiye, Felix; Mason-Jones, Amanda J; Matsushita, Kunihiro; Matzopoulos, Richard; Mayosi, Bongani M; Mazorodze, Tasara T; McKay, Abigail C; McKee, Martin; McLain, Abigail; Meaney, Peter A; Medina, Catalina; Mehndiratta, Man Mohan; Mejia-Rodriguez, Fabiola; Mekonnen, Wubegzier; Melaku, Yohannes A; Meltzer, Michele; Memish, Ziad A; Mendoza, Walter; Mensah, George A; Meretoja, Atte; Mhimbira, Francis Apolinary; Micha, Renata; Miller, Ted R; Mills, Edward J; Misganaw, Awoke; Mishra, Santosh; Mohamed Ibrahim, Norlinah; Mohammad, Karzan A; Mokdad, Ali H; Mola, Glen L; Monasta, Lorenzo; Montanez Hernandez, Julio C; Montico, Marcella; Moore, Ami R; Morawska, Lidia; Mori, Rintaro; Moschandreas, Joanna; Moturi, Wilkister N; Mozaffarian, Dariush; Mueller, Ulrich O; Mukaigawara, Mitsuru; Mullany, Erin C; Murthy, Kinnari S; Naghavi, Mohsen; Nahas, Ziad; Naheed, Aliya; Naidoo, Kovin S; Naldi, Luigi; Nand, Devina; Nangia, Vinay; Narayan, K M Venkat; Nash, Denis; Neal, Bruce; Nejjari, Chakib; Neupane, Sudan P; Newton, Charles R; Ngalesoni, Frida N; Ngirabega, Jean de Dieu; Nguyen, Grant; Nguyen, Nhung T; Nieuwenhuijsen, Mark J; Nisar, Muhammad I; Nogueira, Jose R; Nolla, Joan M; Nolte, Sandra; Norheim, Ole F; Norman, Rosana E; Norrving, Bo; Nyakarahuka, Luke; Oh, In-Hwan; Ohkubo, Takayoshi; Olusanya, Bolajoko O; Omer, Saad B; Opio, John Nelson; Orozco, Ricardo; Pagcatipunan, Rodolfo S Jr; Pain, Amanda W; Pandian, Jeyaraj D; Panelo, Carlo Irwin A; Papachristou, Christina; Park, Eun-Kee; Parry, Charles D; Paternina Caicedo, Angel J; Patten, Scott B; Paul, Vinod K; Pavlin, Boris I; Pearce, Neil; Pedraza, Lilia S; Pedroza, Andrea; Pejin Stokic, Ljiljana; Pekericli, Ayfer; Pereira, David M; Perez-Padilla, Rogelio; Perez-Ruiz, Fernando; Perico, Norberto; Perry, Samuel A L; Pervaiz, Aslam; Pesudovs, Konrad; Peterson, Carrie B; Petzold, Max; Phillips, Michael R; Phua, Hwee Pin; Plass, Dietrich; Poenaru, Dan; Polanczyk, Guilherme V; Polinder, Suzanne; Pond, Constance D; Pope, C Arden; Pope, Daniel; Popova, Svetlana; Pourmalek, Farshad; Powles, John; Prabhakaran, Dorairaj; Prasad, Noela M; Qato, Dima M; Quezada, Amado D; Quistberg, D Alex A; Racape, Lionel; Rafay, Anwar; Rahimi, Kazem; Rahimi-Movaghar, Vafa; Rahman, Sajjad Ur; Raju, Murugesan; Rakovac, Ivo; Rana, Saleem M; Rao, Mayuree; Razavi, Homie; Reddy, K Srinath; Refaat, Amany H; Rehm, Jurgen; Remuzzi, Giuseppe; Ribeiro, Antonio L; Riccio, Patricia M; Richardson, Lee; Riederer, Anne; Robinson, Margaret; Roca, Anna; Rodriguez, Alina; Rojas-Rueda, David; Romieu, Isabelle; Ronfani, Luca; Room, Robin; Roy, Nobhojit; Ruhago, George M; Rushton, Lesley; Sabin, Nsanzimana; Sacco, Ralph L; Saha, Sukanta; Sahathevan, Ramesh; Sahraian, Mohammad Ali; Salomon, Joshua A; 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BACKGROUND: The Global Burden of Disease, Injuries, and Risk Factor study 2013 (GBD 2013) is the first of a series of annual updates of the GBD. Risk factor quantification, particularly of modifiable risk factors, can help to identify emerging threats to population health and opportunities for prevention. The GBD 2013 provides a timely opportunity to update the comparative risk assessment with new data for exposure, relative risks, and evidence on the appropriate counterfactual risk distribution. METHODS: Attributable deaths, years of life lost, years lived with disability, and disability-adjusted life-years (DALYs) have been estimated for 79 risks or clusters of risks using the GBD 2010 methods. Risk-outcome pairs meeting explicit evidence criteria were assessed for 188 countries for the period 1990-2013 by age and sex using three inputs: risk exposure, relative risks, and the theoretical minimum risk exposure level (TMREL). Risks are organised into a hierarchy with blocks of behavioural, environmental and occupational, and metabolic risks at the first level of the hierarchy. The next level in the hierarchy includes nine clusters of related risks and two individual risks, with more detail provided at levels 3 and 4 of the hierarchy. Compared with GBD 2010, six new risk factors have been added: handwashing practices, occupational exposure to trichloroethylene, childhood wasting, childhood stunting, unsafe sex, and low glomerular filtration rate. For most risks, data for exposure were synthesised with a Bayesian meta-regression method, DisMod-MR 2.0, or spatial-temporal Gaussian process regression. Relative risks were based on meta-regressions of published cohort and intervention studies. Attributable burden for clusters of risks and all risks combined took into account evidence on the mediation of some risks such as high body-mass index (BMI) through other risks such as high systolic blood pressure and high cholesterol. FINDINGS: All risks combined account for 57.2% (95% uncertainty interval [UI] 55.8-58.5) of deaths and 41.6% (40.1-43.0) of DALYs. Risks quantified account for 87.9% (86.5-89.3) of cardiovascular disease DALYs, ranging to a low of 0% for neonatal disorders and neglected tropical diseases and malaria. In terms of global DALYs in 2013, six risks or clusters of risks each caused more than 5% of DALYs: dietary risks accounting for 11.3 million deaths and 241.4 million DALYs, high systolic blood pressure for 10.4 million deaths and 208.1 million DALYs, child and maternal malnutrition for 1.7 million deaths and 176.9 million DALYs, tobacco smoke for 6.1 million deaths and 143.5 million DALYs, air pollution for 5.5 million deaths and 141.5 million DALYs, and high BMI for 4.4 million deaths and 134.0 million DALYs. Risk factor patterns vary across regions and countries and with time. In sub-Saharan Africa, the leading risk factors are child and maternal malnutrition, unsafe sex, and unsafe water, sanitation, and handwashing. In women, in nearly all countries in the Americas, north Africa, and the Middle East, and in many other high-income countries, high BMI is the leading risk factor, with high systolic blood pressure as the leading risk in most of Central and Eastern Europe and south and east Asia. For men, high systolic blood pressure or tobacco use are the leading risks in nearly all high-income countries, in north Africa and the Middle East, Europe, and Asia. For men and women, unsafe sex is the leading risk in a corridor from Kenya to South Africa. INTERPRETATION: Behavioural, environmental and occupational, and metabolic risks can explain half of global mortality and more than one-third of global DALYs providing many opportunities for prevention. Of the larger risks, the attributable burden of high BMI has increased in the past 23 years. In view of the prominence of behavioural risk factors, behavioural and social science research on interventions for these risks should be strengthened. Many prevention and primary care policy options are available now to act on key risks. FUNDING: Bill & Melinda Gates Foundation.
PMCID:4685753
PMID: 26364544
ISSN: 1474-547x
CID: 2033272
Changes in health in England, with analysis by English regions and areas of deprivation, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013
Newton, John N; Briggs, Adam D M; Murray, Christopher J L; Dicker, Daniel; Foreman, Kyle J; Wang, Haidong; Naghavi, Mohsen; Forouzanfar, Mohammad H; Ohno, Summer Lockett; Barber, Ryan M; Vos, Theo; Stanaway, Jeffrey D; Schmidt, Jurgen C; Hughes, Andrew J; Fay, Derek F J; Ecob, Russell; Gresser, Charis; McKee, Martin; Rutter, Harry; Abubakar, Ibrahim; Ali, Raghib; Anderson, H Ross; Banerjee, Amitava; Bennett, Derrick A; Bernabe, Eduardo; Bhui, Kamaldeep S; Biryukov, Stanley M; Bourne, Rupert R; Brayne, Carol E G; Bruce, Nigel G; Brugha, Traolach S; Burch, Michael; Capewell, Simon; Casey, Daniel; Chowdhury, Rajiv; Coates, Matthew M; Cooper, Cyrus; Critchley, Julia A; Dargan, Paul I; Dherani, Mukesh K; Elliott, Paul; Ezzati, Majid; Fenton, Kevin A; Fraser, Maya S; Furst, Thomas; Greaves, Felix; Green, Mark A; Gunnell, David J; Hannigan, Bernadette M; Hay, Roderick J; Hay, Simon I; Hemingway, Harry; Larson, Heidi J; Looker, Katharine J; Lunevicius, Raimundas; Lyons, Ronan A; Marcenes, Wagner; Mason-Jones, Amanda J; Matthews, Fiona E; Moller, Henrik; Murdoch, Michele E; Newton, Charles R; Pearce, Neil; Piel, Frederic B; Pope, Daniel; Rahimi, Kazem; Rodriguez, Alina; Scarborough, Peter; Schumacher, Austin E; Shiue, Ivy; Smeeth, Liam; Tedstone, Alison; Valabhji, Jonathan; Williams, Hywel C; Wolfe, Charles D A; Woolf, Anthony D; Davis, Adrian C J
BACKGROUND: In the Global Burden of Disease Study 2013 (GBD 2013), knowledge about health and its determinants has been integrated into a comparable framework to inform health policy. Outputs of this analysis are relevant to current policy questions in England and elsewhere, particularly on health inequalities. We use GBD 2013 data on mortality and causes of death, and disease and injury incidence and prevalence to analyse the burden of disease and injury in England as a whole, in English regions, and within each English region by deprivation quintile. We also assess disease and injury burden in England attributable to potentially preventable risk factors. England and the English regions are compared with the remaining constituent countries of the UK and with comparable countries in the European Union (EU) and beyond. METHODS: We extracted data from the GBD 2013 to compare mortality, causes of death, years of life lost (YLLs), years lived with a disability (YLDs), and disability-adjusted life-years (DALYs) in England, the UK, and 18 other countries (the first 15 EU members [apart from the UK] and Australia, Canada, Norway, and the USA [EU15+]). We extended elements of the analysis to English regions, and subregional areas defined by deprivation quintile (deprivation areas). We used data split by the nine English regions (corresponding to the European boundaries of the Nomenclature for Territorial Statistics level 1 [NUTS 1] regions), and by quintile groups within each English region according to deprivation, thereby making 45 regional deprivation areas. Deprivation quintiles were defined by area of residence ranked at national level by Index of Multiple Deprivation score, 2010. Burden due to various risk factors is described for England using new GBD methodology to estimate independent and overlapping attributable risk for five tiers of behavioural, metabolic, and environmental risk factors. We present results for 306 causes and 2337 sequelae, and 79 risks or risk clusters. FINDINGS: Between 1990 and 2013, life expectancy from birth in England increased by 5.4 years (95% uncertainty interval 5.0-5.8) from 75.9 years (75.9-76.0) to 81.3 years (80.9-81.7); gains were greater for men than for women. Rates of age-standardised YLLs reduced by 41.1% (38.3-43.6), whereas DALYs were reduced by 23.8% (20.9-27.1), and YLDs by 1.4% (0.1-2.8). For these measures, England ranked better than the UK and the EU15+ means. Between 1990 and 2013, the range in life expectancy among 45 regional deprivation areas remained 8.2 years for men and decreased from 7.2 years in 1990 to 6.9 years in 2013 for women. In 2013, the leading cause of YLLs was ischaemic heart disease, and the leading cause of DALYs was low back and neck pain. Known risk factors accounted for 39.6% (37.7-41.7) of DALYs; leading behavioural risk factors were suboptimal diet (10.8% [9.1-12.7]) and tobacco (10.7% [9.4-12.0]). INTERPRETATION: Health in England is improving although substantial opportunities exist for further reductions in the burden of preventable disease. The gap in mortality rates between men and women has reduced, but marked health inequalities between the least deprived and most deprived areas remain. Declines in mortality have not been matched by similar declines in morbidity, resulting in people living longer with diseases. Health policies must therefore address the causes of ill health as well as those of premature mortality. Systematic action locally and nationally is needed to reduce risk exposures, support healthy behaviours, alleviate the severity of chronic disabling disorders, and mitigate the effects of socioeconomic deprivation. FUNDING: Bill & Melinda Gates Foundation and Public Health England.
PMCID:4672153
PMID: 26382241
ISSN: 1474-547x
CID: 2281492
Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990-2013: quantifying the epidemiological transition
Murray, Christopher J L; Barber, Ryan M; Foreman, Kyle J; Abbasoglu Ozgoren, Ayse; Abd-Allah, Foad; Abera, Semaw F; Aboyans, Victor; Abraham, Jerry P; Abubakar, Ibrahim; Abu-Raddad, Laith J; Abu-Rmeileh, Niveen M; Achoki, Tom; Ackerman, Ilana N; Ademi, Zanfina; Adou, Arsene K; Adsuar, Jose C; Afshin, Ashkan; Agardh, Emilie E; Alam, Sayed Saidul; Alasfoor, Deena; Albittar, Mohammed I; Alegretti, Miguel A; Alemu, Zewdie A; Alfonso-Cristancho, Rafael; Alhabib, Samia; Ali, Raghib; Alla, Francois; Allebeck, Peter; Almazroa, Mohammad A; Alsharif, Ubai; Alvarez, Elena; Alvis-Guzman, Nelson; Amare, Azmeraw T; Ameh, Emmanuel A; Amini, Heresh; Ammar, Walid; Anderson, H Ross; Anderson, Benjamin O; Antonio, Carl Abelardo T; Anwari, Palwasha; Arnlov, Johan; Arsic Arsenijevic, Valentina S; Artaman, Al; Asghar, Rana J; Assadi, Reza; Atkins, Lydia S; Avila, Marco A; Awuah, Baffour; Bachman, Victoria F; Badawi, Alaa; Bahit, Maria C; Balakrishnan, Kalpana; Banerjee, Amitava; Barker-Collo, Suzanne L; Barquera, Simon; Barregard, Lars; Barrero, Lope H; Basu, Arindam; Basu, Sanjay; Basulaiman, Mohammed O; Beardsley, Justin; Bedi, Neeraj; Beghi, Ettore; Bekele, Tolesa; Bell, Michelle L; Benjet, Corina; Bennett, Derrick A; Bensenor, Isabela M; Benzian, Habib; Bernabe, Eduardo; Bertozzi-Villa, Amelia; Beyene, Tariku J; Bhala, Neeraj; Bhalla, Ashish; Bhutta, Zulfiqar A; Bienhoff, Kelly; Bikbov, Boris; Biryukov, Stan; Blore, Jed D; Blosser, Christopher D; Blyth, Fiona M; Bohensky, Megan A; Bolliger, Ian W; Bora Basara, Berrak; Bornstein, Natan M; Bose, Dipan; Boufous, Soufiane; Bourne, Rupert R A; Boyers, Lindsay N; Brainin, Michael; Brayne, Carol E; Brazinova, Alexandra; Breitborde, Nicholas J K; Brenner, Hermann; Briggs, Adam D; Brooks, Peter M; Brown, Jonathan C; Brugha, Traolach S; Buchbinder, Rachelle; Buckle, Geoffrey C; Budke, Christine M; Bulchis, Anne; Bulloch, Andrew G; Campos-Nonato, Ismael R; Carabin, Helene; Carapetis, Jonathan R; Cardenas, Rosario; Carpenter, David O; Caso, Valeria; Castaneda-Orjuela, Carlos A; Castro, Ruben E; Catala-Lopez, Ferran; Cavalleri, Fiorella; Cavlin, Alanur; Chadha, Vineet K; Chang, Jung-Chen; Charlson, Fiona J; Chen, Honglei; Chen, Wanqing; Chiang, Peggy P; Chimed-Ochir, Odgerel; Chowdhury, Rajiv; Christensen, Hanne; Christophi, Costas A; Cirillo, Massimo; Coates, Matthew M; Coffeng, Luc E; Coggeshall, Megan S; Colistro, Valentina; Colquhoun, Samantha M; Cooke, Graham S; Cooper, Cyrus; Cooper, Leslie T; Coppola, Luis M; Cortinovis, Monica; Criqui, Michael H; Crump, John A; Cuevas-Nasu, Lucia; Danawi, Hadi; Dandona, Lalit; Dandona, Rakhi; Dansereau, Emily; Dargan, Paul I; Davey, Gail; Davis, Adrian; Davitoiu, Dragos V; Dayama, Anand; De Leo, Diego; Degenhardt, Louisa; Del Pozo-Cruz, Borja; Dellavalle, Robert P; Deribe, Kebede; Derrett, Sarah; Des Jarlais, Don C; Dessalegn, Muluken; Dharmaratne, Samath D; Dherani, Mukesh K; Diaz-Torne, Cesar; Dicker, Daniel; Ding, Eric L; Dokova, Klara; Dorsey, E Ray; Driscoll, Tim R; Duan, Leilei; Duber, Herbert C; Ebel, Beth E; Edmond, Karen M; Elshrek, Yousef M; Endres, Matthias; Ermakov, Sergey P; Erskine, Holly E; Eshrati, Babak; Esteghamati, Alireza; Estep, Kara; Faraon, Emerito Jose A; Farzadfar, Farshad; Fay, Derek F; Feigin, Valery L; Felson, David T; Fereshtehnejad, Seyed-Mohammad; Fernandes, Jefferson G; Ferrari, Alize J; Fitzmaurice, Christina; Flaxman, Abraham D; Fleming, Thomas D; Foigt, Nataliya; Forouzanfar, Mohammad H; Fowkes, F Gerry R; Paleo, Urbano Fra; Franklin, Richard C; Furst, Thomas; Gabbe, Belinda; Gaffikin, Lynne; Gankpe, Fortune G; Geleijnse, Johanna M; Gessner, Bradford D; Gething, Peter; Gibney, Katherine B; Giroud, Maurice; Giussani, Giorgia; Gomez Dantes, Hector; Gona, Philimon; Gonzalez-Medina, Diego; Gosselin, Richard A; Gotay, Carolyn C; Goto, Atsushi; Gouda, Hebe N; Graetz, Nicholas; Gugnani, Harish C; Gupta, Rahul; Gupta, Rajeev; Gutierrez, Reyna A; Haagsma, Juanita; Hafezi-Nejad, Nima; Hagan, Holly; Halasa, Yara A; Hamadeh, Randah R; Hamavid, Hannah; Hammami, Mouhanad; Hancock, Jamie; Hankey, Graeme J; Hansen, Gillian M; Hao, Yuantao; Harb, Hilda L; Haro, Josep Maria; Havmoeller, Rasmus; Hay, Simon I; Hay, Roderick J; Heredia-Pi, Ileana B; Heuton, Kyle R; Heydarpour, Pouria; Higashi, Hideki; Hijar, Martha; Hoek, Hans W; Hoffman, Howard J; Hosgood, H Dean; Hossain, Mazeda; Hotez, Peter J; Hoy, Damian G; Hsairi, Mohamed; Hu, Guoqing; Huang, Cheng; Huang, John J; Husseini, Abdullatif; Huynh, Chantal; Iannarone, Marissa L; Iburg, Kim M; Innos, Kaire; Inoue, Manami; Islami, Farhad; Jacobsen, Kathryn H; Jarvis, Deborah L; Jassal, Simerjot K; Jee, Sun Ha; Jeemon, Panniyammakal; Jensen, Paul N; Jha, Vivekanand; Jiang, Guohong; Jiang, Ying; Jonas, Jost B; Juel, Knud; Kan, Haidong; Karch, Andre; Karema, Corine K; Karimkhani, Chante; Karthikeyan, Ganesan; Kassebaum, Nicholas J; Kaul, Anil; Kawakami, Norito; Kazanjan, Konstantin; Kemp, Andrew H; Kengne, Andre P; Keren, Andre; Khader, Yousef S; Khalifa, Shams Eldin A; Khan, Ejaz A; Khan, Gulfaraz; Khang, Young-Ho; Kieling, Christian; Kim, Daniel; Kim, Sungroul; Kim, Yunjin; Kinfu, Yohannes; Kinge, Jonas M; Kivipelto, Miia; Knibbs, Luke D; Knudsen, Ann Kristin; Kokubo, Yoshihiro; Kosen, Soewarta; Krishnaswami, Sanjay; Kuate Defo, Barthelemy; Kucuk Bicer, Burcu; Kuipers, Ernst J; Kulkarni, Chanda; Kulkarni, Veena S; Kumar, G Anil; Kyu, Hmwe H; Lai, Taavi; Lalloo, Ratilal; Lallukka, Tea; Lam, Hilton; Lan, Qing; Lansingh, Van C; Larsson, Anders; Lawrynowicz, Alicia E B; Leasher, Janet L; Leigh, James; Leung, Ricky; Levitz, Carly E; Li, Bin; Li, Yichong; Li, Yongmei; Lim, Stephen S; Lind, Maggie; Lipshultz, Steven E; Liu, Shiwei; Liu, Yang; Lloyd, Belinda K; Lofgren, Katherine T; Logroscino, Giancarlo; Looker, Katharine J; Lortet-Tieulent, Joannie; Lotufo, Paulo A; Lozano, Rafael; Lucas, Robyn M; Lunevicius, Raimundas; Lyons, Ronan A; Ma, Stefan; Macintyre, Michael F; Mackay, Mark T; Majdan, Marek; Malekzadeh, Reza; Marcenes, Wagner; Margolis, David J; Margono, Christopher; Marzan, Melvin B; Masci, Joseph R; Mashal, Mohammad T; Matzopoulos, Richard; Mayosi, Bongani M; Mazorodze, Tasara T; Mcgill, Neil W; Mcgrath, John J; Mckee, Martin; Mclain, Abigail; Meaney, Peter A; Medina, Catalina; Mehndiratta, Man Mohan; Mekonnen, Wubegzier; Melaku, Yohannes A; Meltzer, Michele; Memish, Ziad A; Mensah, George A; Meretoja, Atte; Mhimbira, Francis A; Micha, Renata; Miller, Ted R; Mills, Edward J; Mitchell, Philip B; Mock, Charles N; Mohamed Ibrahim, Norlinah; Mohammad, Karzan A; Mokdad, Ali H; Mola, Glen L D; Monasta, Lorenzo; Montanez Hernandez, Julio C; Montico, Marcella; Montine, Thomas J; Mooney, Meghan D; Moore, Ami R; Moradi-Lakeh, Maziar; Moran, Andrew E; Mori, Rintaro; Moschandreas, Joanna; Moturi, Wilkister N; Moyer, Madeline L; Mozaffarian, Dariush; Msemburi, William T; Mueller, Ulrich O; Mukaigawara, Mitsuru; Mullany, Erin C; Murdoch, Michele E; Murray, Joseph; Murthy, Kinnari S; Naghavi, Mohsen; Naheed, Aliya; Naidoo, Kovin S; Naldi, Luigi; Nand, Devina; Nangia, Vinay; Narayan, K M Venkat; Nejjari, Chakib; Neupane, Sudan P; Newton, Charles R; Ng, Marie; Ngalesoni, Frida N; Nguyen, Grant; Nisar, Muhammad I; Nolte, Sandra; Norheim, Ole F; Norman, Rosana E; Norrving, Bo; Nyakarahuka, Luke; Oh, In-Hwan; Ohkubo, Takayoshi; Ohno, Summer L; Olusanya, Bolajoko O; Opio, John Nelson; Ortblad, Katrina; Ortiz, Alberto; Pain, Amanda W; Pandian, Jeyaraj D; Panelo, Carlo Irwin A; Papachristou, Christina; Park, Eun-Kee; Park, Jae-Hyun; Patten, Scott B; Patton, George C; Paul, Vinod K; Pavlin, Boris I; Pearce, Neil; Pereira, David M; Perez-Padilla, Rogelio; Perez-Ruiz, Fernando; Perico, Norberto; Pervaiz, Aslam; Pesudovs, Konrad; Peterson, Carrie B; Petzold, Max; Phillips, Michael R; Phillips, Bryan K; Phillips, David E; Piel, Frederic B; Plass, Dietrich; Poenaru, Dan; Polinder, Suzanne; Pope, Daniel; Popova, Svetlana; Poulton, Richie G; Pourmalek, Farshad; Prabhakaran, Dorairaj; Prasad, Noela M; Pullan, Rachel L; Qato, Dima M; Quistberg, D Alex; Rafay, Anwar; Rahimi, Kazem; Rahman, Sajjad U; Raju, Murugesan; Rana, Saleem M; Razavi, Homie; 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Skirbekk, Vegard; Slepak, Erica Leigh; Sliwa, Karen; Soneji, Samir; Soreide, Kjetil; Soshnikov, Sergey; Sposato, Luciano A; Sreeramareddy, Chandrashekhar T; Stanaway, Jeffrey D; Stathopoulou, Vasiliki; Stein, Dan J; Stein, Murray B; Steiner, Caitlyn; Steiner, Timothy J; Stevens, Antony; Stewart, Andrea; Stovner, Lars J; Stroumpoulis, Konstantinos; Sunguya, Bruno F; Swaminathan, Soumya; Swaroop, Mamta; Sykes, Bryan L; Tabb, Karen M; Takahashi, Ken; Tandon, Nikhil; Tanne, David; Tanner, Marcel; Tavakkoli, Mohammad; Taylor, Hugh R; Te Ao, Braden J; Tediosi, Fabrizio; Temesgen, Awoke M; Templin, Tara; Ten Have, Margreet; Tenkorang, Eric Y; Terkawi, Abdullah S; Thomson, Blake; Thorne-Lyman, Andrew L; Thrift, Amanda G; Thurston, George D; Tillmann, Taavi; Tonelli, Marcello; Topouzis, Fotis; Toyoshima, Hideaki; Traebert, Jefferson; Tran, Bach X; Trillini, Matias; Truelsen, Thomas; Tsilimbaris, Miltiadis; Tuzcu, Emin M; Uchendu, Uche S; Ukwaja, Kingsley N; Undurraga, Eduardo A; Uzun, Selen B; Van Brakel, Wim H; Van De Vijver, Steven; van Gool, Coen H; Van Os, Jim; Vasankari, Tommi J; Venketasubramanian, N; Violante, Francesco S; Vlassov, Vasiliy V; Vollset, Stein Emil; Wagner, Gregory R; Wagner, Joseph; Waller, Stephen G; Wan, Xia; Wang, Haidong; Wang, Jianli; Wang, Linhong; Warouw, Tati S; Weichenthal, Scott; Weiderpass, Elisabete; Weintraub, Robert G; Wenzhi, Wang; Werdecker, Andrea; Westerman, Ronny; Whiteford, Harvey A; Wilkinson, James D; Williams, Thomas N; Wolfe, Charles D; Wolock, Timothy M; Woolf, Anthony D; Wulf, Sarah; Wurtz, Brittany; Xu, Gelin; Yan, Lijing L; Yano, Yuichiro; Ye, Pengpeng; Yentur, Gokalp K; Yip, Paul; Yonemoto, Naohiro; Yoon, Seok-Jun; Younis, Mustafa Z; Yu, Chuanhua; Zaki, Maysaa E; Zhao, Yong; Zheng, Yingfeng; Zonies, David; Zou, Xiaonong; Salomon, Joshua A; Lopez, Alan D; Vos, Theo
BACKGROUND: The Global Burden of Disease Study 2013 (GBD 2013) aims to bring together all available epidemiological data using a coherent measurement framework, standardised estimation methods, and transparent data sources to enable comparisons of health loss over time and across causes, age-sex groups, and countries. The GBD can be used to generate summary measures such as disability-adjusted life-years (DALYs) and healthy life expectancy (HALE) that make possible comparative assessments of broad epidemiological patterns across countries and time. These summary measures can also be used to quantify the component of variation in epidemiology that is related to sociodemographic development. METHODS: We used the published GBD 2013 data for age-specific mortality, years of life lost due to premature mortality (YLLs), and years lived with disability (YLDs) to calculate DALYs and HALE for 1990, 1995, 2000, 2005, 2010, and 2013 for 188 countries. We calculated HALE using the Sullivan method; 95% uncertainty intervals (UIs) represent uncertainty in age-specific death rates and YLDs per person for each country, age, sex, and year. We estimated DALYs for 306 causes for each country as the sum of YLLs and YLDs; 95% UIs represent uncertainty in YLL and YLD rates. We quantified patterns of the epidemiological transition with a composite indicator of sociodemographic status, which we constructed from income per person, average years of schooling after age 15 years, and the total fertility rate and mean age of the population. We applied hierarchical regression to DALY rates by cause across countries to decompose variance related to the sociodemographic status variable, country, and time. FINDINGS: Worldwide, from 1990 to 2013, life expectancy at birth rose by 6.2 years (95% UI 5.6-6.6), from 65.3 years (65.0-65.6) in 1990 to 71.5 years (71.0-71.9) in 2013, HALE at birth rose by 5.4 years (4.9-5.8), from 56.9 years (54.5-59.1) to 62.3 years (59.7-64.8), total DALYs fell by 3.6% (0.3-7.4), and age-standardised DALY rates per 100 000 people fell by 26.7% (24.6-29.1). For communicable, maternal, neonatal, and nutritional disorders, global DALY numbers, crude rates, and age-standardised rates have all declined between 1990 and 2013, whereas for non-communicable diseases, global DALYs have been increasing, DALY rates have remained nearly constant, and age-standardised DALY rates declined during the same period. From 2005 to 2013, the number of DALYs increased for most specific non-communicable diseases, including cardiovascular diseases and neoplasms, in addition to dengue, food-borne trematodes, and leishmaniasis; DALYs decreased for nearly all other causes. By 2013, the five leading causes of DALYs were ischaemic heart disease, lower respiratory infections, cerebrovascular disease, low back and neck pain, and road injuries. Sociodemographic status explained more than 50% of the variance between countries and over time for diarrhoea, lower respiratory infections, and other common infectious diseases; maternal disorders; neonatal disorders; nutritional deficiencies; other communicable, maternal, neonatal, and nutritional diseases; musculoskeletal disorders; and other non-communicable diseases. However, sociodemographic status explained less than 10% of the variance in DALY rates for cardiovascular diseases; chronic respiratory diseases; cirrhosis; diabetes, urogenital, blood, and endocrine diseases; unintentional injuries; and self-harm and interpersonal violence. Predictably, increased sociodemographic status was associated with a shift in burden from YLLs to YLDs, driven by declines in YLLs and increases in YLDs from musculoskeletal disorders, neurological disorders, and mental and substance use disorders. In most country-specific estimates, the increase in life expectancy was greater than that in HALE. Leading causes of DALYs are highly variable across countries. INTERPRETATION: Global health is improving. Population growth and ageing have driven up numbers of DALYs, but crude rates have remained relatively constant, showing that progress in health does not mean fewer demands on health systems. The notion of an epidemiological transition--in which increasing sociodemographic status brings structured change in disease burden--is useful, but there is tremendous variation in burden of disease that is not associated with sociodemographic status. This further underscores the need for country-specific assessments of DALYs and HALE to appropriately inform health policy decisions and attendant actions. FUNDING: Bill & Melinda Gates Foundation.
PMCID:4673910
PMID: 26321261
ISSN: 1474-547x
CID: 2033262
Incidence of prostate and urological cancers in England by ethnic group, 2001-2007: a descriptive study [Historical Article]
Maruthappu, Mahiben; Barnes, Isobel; Sayeed, Shameq; Ali, Raghib
BACKGROUND: The aetiology of urological cancers is poorly understood and variations in incidence by ethnic group may provide insights into the relative importance of genetic and environmental risk factors. Our objective was to compare the incidence of four urological cancers (kidney, bladder, prostate and testicular) among six 'non-White' ethnic groups in England (Indian, Pakistani, Bangladeshi, Black African, Black Caribbean and Chinese) to each other and to Whites. METHODS: We obtained Information on ethnicity for all urological cancer registrations from 2001 to 2007 (n = 329,524) by linkage to the Hospital Episodes Statistics database. We calculated incidence rate ratios adjusted for age, sex and income, comparing the six ethnic groups (and combined 'South Asian' and 'Black' groups) to Whites and to each other. RESULTS: There were significant differences in the incidence of all four cancers between the ethnic groups (all p < 0.001). In general, 'non-White' groups had a lower incidence of urological cancers compared to Whites, except prostate cancer, which displayed a higher incidence in Blacks. (IRR 2.55) There was strong evidence of differences in risk between Indians, Pakistanis and Bangladeshis for kidney, bladder and prostate cancer (p < 0.001), and between Black Africans and Black Caribbeans for all four cancers (p < 0.001). CONCLUSIONS: The risk of urological cancers in England varies greatly by ethnicity, including within groups that have traditionally been analysed together (South Asians and Blacks). In general, these differences are not readily explained by known risk factors, although the very high incidence of prostate cancer in both black Africans and Caribbeans suggests increased genetic susceptibility. g.
PMCID:4618465
PMID: 26486598
ISSN: 1471-2407
CID: 2281482
Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013
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Chen, Honglei; Chen, Wanqing; Chiang, Peggy P; Chimed-Ochir, Odgerel; Chowdhury, Rajiv; Christensen, Hanne; Christophi, Costas A; Chugh, Sumeet S; Cirillo, Massimo; Coggeshall, Megan; Cohen, Aaron; Colistro, Valentina; Colquhoun, Samantha M; Contreras, Alejandra G; Cooper, Leslie T; Cooper, Cyrus; Cooperrider, Kimberly; Coresh, Josef; Cortinovis, Monica; Criqui, Michael H; Crump, John A; Cuevas-Nasu, Lucia; Dandona, Rakhi; Dandona, Lalit; Dansereau, Emily; Dantes, Hector G; Dargan, Paul I; Davey, Gail; Davitoiu, Dragos V; Dayama, Anand; De la Cruz-Gongora, Vanessa; de la Vega, Shelley F; De Leo, Diego; del Pozo-Cruz, Borja; Dellavalle, Robert P; Deribe, Kebede; Derrett, Sarah; Des Jarlais, Don C; Dessalegn, Muluken; de Veber, Gabrielle A; Dharmaratne, Samath D; Diaz-Torne, Cesar; Ding, Eric L; Dokova, Klara; Dorsey, ER; Driscoll, Tim R; Duber, Herbert; Durrani, Adnan M; Edmond, Karen M; Ellenbogen, Richard G; Endres, Matthias; Ermakov, Sergey P; Eshrati, Babak; Esteghamati, Alireza; Estep, Kara; Fahimi, Saman; Farzadfar, Farshad; Fay, Derek FJ; Felson, David T; Fereshtehnejad, Seyed-Mohammad; Fernandes, Jefferson G; Ferri, Cluesa P; Flaxman, Abraham; Foigt, Nataliya; Foreman, Kyle J; Fowkes, FGerry R; Franklin, Richard C; Furst, Thomas; Futran, Neal D; Gabbe, Belinda J; Gankpe, Fortune G; Garcia-Guerra, Francisco A; Geleijnse, Johanna M; Gessner, Bradford D; Gibney, Katherine B; Gillum, Richard F; Ginawi, Ibrahim A; Giroud, Maurice; Giussani, Giorgia; Goenka, Shifalika; Goginashvili, Ketevan; Gona, Philimon; de Cosio, Teresita Gonzalez; Gosselin, Richard A; Gotay, Carolyn C; Goto, Atsushi; Gouda, Hebe N; Guerrant, Richard L; Gugnani, Harish C; Gunnell, David; Gupta, Rajeev; Gupta, Rahul; Gutierrez, Reyna A; Hafezi-Nejad, Nima; Hagan, Holly; Halasa, Yara; Hamadeh, Randah R; Hamavid, Hannah; Hammami, Mouhanad; Hankey, Graeme J; Hao, Yuantao; Harb, Hilda L; Haro, Josep Maria; Havmoeller, Rasmus; Hay, Roderick J; Hay, Simon; Hedayati, Mohammad T; Pi, Ileana BHeredia; Heydarpour, Pouria; 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Zhao, Yong; Zhu, Jun; Zonies, David; Zunt, Joseph R; Salomon, Joshua A; Murray, Christopher JL; Global Burden Dis Study
BACKGROUND:Up-to-date evidence about levels and trends in disease and injury incidence, prevalence, and years lived with disability (YLDs) is an essential input into global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013), we estimated these quantities for acute and chronic diseases and injuries for 188 countries between 1990 and 2013. METHODS:Estimates were calculated for disease and injury incidence, prevalence, and YLDs using GBD 2010 methods with some important refinements. Results for incidence of acute disorders and prevalence of chronic disorders are new additions to the analysis. Key improvements include expansion to the cause and sequelae list, updated systematic reviews, use of detailed injury codes, improvements to the Bayesian meta-regression method (DisMod-MR), and use of severity splits for various causes. An index of data representativeness, showing data availability, was calculated for each cause and impairment during three periods globally and at the country level for 2013. In total, 35 620 distinct sources of data were used and documented to calculated estimates for 301 diseases and injuries and 2337 sequelae. The comorbidity simulation provides estimates for the number of sequelae, concurrently, by individuals by country, year, age, and sex. Disability weights were updated with the addition of new population-based survey data from four countries. FINDINGS/RESULTS:Disease and injury were highly prevalent; only a small fraction of individuals had no sequelae. Comorbidity rose substantially with age and in absolute terms from 1990 to 2013. Incidence of acute sequelae were predominantly infectious diseases and short-term injuries, with over 2 billion cases of upper respiratory infections and diarrhoeal disease episodes in 2013, with the notable exception of tooth pain due to permanent caries with more than 200 million incident cases in 2013. Conversely, leading chronic sequelae were largely attributable to non-communicable diseases, with prevalence estimates for asymptomatic permanent caries and tension-type headache of 2·4 billion and 1·6 billion, respectively. The distribution of the number of sequelae in populations varied widely across regions, with an expected relation between age and disease prevalence. YLDs for both sexes increased from 537·6 million in 1990 to 764·8 million in 2013 due to population growth and ageing, whereas the age-standardised rate decreased little from 114·87 per 1000 people to 110·31 per 1000 people between 1990 and 2013. Leading causes of YLDs included low back pain and major depressive disorder among the top ten causes of YLDs in every country. YLD rates per person, by major cause groups, indicated the main drivers of increases were due to musculoskeletal, mental, and substance use disorders, neurological disorders, and chronic respiratory diseases; however HIV/AIDS was a notable driver of increasing YLDs in sub-Saharan Africa. Also, the proportion of disability-adjusted life years due to YLDs increased globally from 21·1% in 1990 to 31·2% in 2013. INTERPRETATION/CONCLUSIONS:Ageing of the world's population is leading to a substantial increase in the numbers of individuals with sequelae of diseases and injuries. Rates of YLDs are declining much more slowly than mortality rates. The non-fatal dimensions of disease and injury will require more and more attention from health systems. The transition to non-fatal outcomes as the dominant source of burden of disease is occurring rapidly outside of sub-Saharan Africa. Our results can guide future health initiatives through examination of epidemiological trends and a better understanding of variation across countries. FUNDING/BACKGROUND:Bill & Melinda Gates Foundation.
PMCID:4561509
PMID: 26063472
ISSN: 1474-547x
CID: 3048832
