Global fertility in 204 countries and territories, 1950–2021, with forecasts to 2100: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

Background Accurate assessments of current and future fertility—including overall trends and changing population age structures across countries and regions—are essential to help plan for the profound social, economic, environmental, and geopolitical challenges that these changes will bring. Estimates and projections of fertility are necessary to inform policies involving resource and health-care needs, labour supply, education, gender equality, and family planning and support. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 produced up-to-date and comprehensive demographic assessments of key fertility indicators at global, regional, and national levels from 1950 to 2021 and forecast fertility metrics to 2100 based on a reference scenario and key policy-dependent alternative scenarios. Methods To estimate fertility indicators from 1950 to 2021, mixed-effects regression models and spatiotemporal Gaussian process regression were used to synthesise data from 8709 country-years of vital and sample registrations, 1455 surveys and censuses, and 150 other sources, and to generate age-specific fertility rates (ASFRs) for 5-year age groups from age 10 years to 54 years. ASFRs were summed across age groups to produce estimates of total fertility rate (TFR). Livebirths were calculated by multiplying ASFR and age-specific female population, then summing across ages 10–54 years. To forecast future fertility up to 2100, our Institute for Health Metrics and Evaluation (IHME) forecasting model was based on projections of completed cohort fertility at age 50 years (CCF50; the average number of children born over time to females from a specified birth cohort), which yields more stable and accurate measures of fertility than directly modelling TFR. CCF50 was modelled using an ensemble approach in which three sub-models (with two, three, and four covariates variously consisting of female educational attainment, contraceptive met need, population density in habitable areas, and under-5 mortality) were given equal weights, and analyses were conducted utilising the MR-BRT (meta-regression—Bayesian, regularised, trimmed) tool. To capture time-series trends in CCF50 not explained by these covariates, we used a first-order autoregressive model on the residual term. CCF50 as a proportion of each 5-year ASFR was predicted using a linear mixed-effects model with fixed-effects covariates (female educational attainment and contraceptive met need) and random intercepts for geographical regions. Projected TFRs were then computed for each calendar year as the sum of single-year ASFRs across age groups. The reference forecast is our estimate of the most likely fertility future given the model, past fertility, forecasts of covariates, and historical relationships between covariates and fertility. We additionally produced forecasts for multiple alternative scenarios in each location: the UN Sustainable Development Goal (SDG) for education is achieved by 2030; the contraceptive met need SDG is achieved by 2030; pro-natal policies are enacted to create supportive environments for those who give birth; and the previous three scenarios combined. Uncertainty from past data inputs and model estimation was propagated throughout analyses by taking 1000 draws for past and present fertility estimates and 500 draws for future forecasts from the estimated distribution for each metric, with 95% uncertainty intervals (UIs) given as the 2·5 and 97·5 percentiles of the draws. To evaluate the forecasting performance of our model and others, we computed skill values—a metric assessing gain in forecasting accuracy—by comparing predicted versus observed ASFRs from the past 15 years (2007–21). A positive skill metric indicates that the model being evaluated performs better than the baseline model (here, a simplified model holding 2007 values constant in the future), and a negative metric indicates that the evaluated model performs worse than baseline. Findings During the period from 1950 to 2021, global TFR more than halved, from 4·84 (95% UI 4·63–5·06) to 2·23 (2·09–2·38). Global annual livebirths peaked in 2016 at 142 million (95% UI 137–147), declining to 129 million (121–138) in 2021. Fertility rates declined in all countries and territories since 1950, with TFR remaining above 2·1—canonically considered replacement-level fertility—in 94 (46·1%) countries and territories in 2021. This included 44 of 46 countries in sub-Saharan Africa, which was the super-region with the largest share of livebirths in 2021 (29·2% [28·7–29·6]). 47 countries and territories in which lowest estimated fertility between 1950 and 2021 was below replacement experienced one or more subsequent years with higher fertility; only three of these locations rebounded above replacement levels. Future fertility rates were projected to continue to decline worldwide, reaching a global TFR of 1·83 (1·59–2·08) in 2050 and 1·59 (1·25–1·96) in 2100 under the reference scenario. The number of countries and territories with fertility rates remaining above replacement was forecast to be 49 (24·0%) in 2050 and only six (2·9%) in 2100, with three of these six countries included in the 2021 World Bank-defined low-income group, all located in the GBD super-region of sub-Saharan Africa. The proportion of livebirths occurring in sub-Saharan Africa was forecast to increase to more than half of the world's livebirths in 2100, to 41·3% (39·6–43·1) in 2050 and 54·3% (47·1–59·5) in 2100. The share of livebirths was projected to decline between 2021 and 2100 in most of the six other super-regions—decreasing, for example, in south Asia from 24·8% (23·7–25·8) in 2021 to 16·7% (14·3–19·1) in 2050 and 7·1% (4·4–10·1) in 2100—but was forecast to increase modestly in the north Africa and Middle East and high-income super-regions. Forecast estimates for the alternative combined scenario suggest that meeting SDG targets for education and contraceptive met need, as well as implementing pro-natal policies, would result in global TFRs of 1·65 (1·40–1·92) in 2050 and 1·62 (1·35–1·95) in 2100. The forecasting skill metric values for the IHME model were positive across all age groups, indicating that the model is better than the constant prediction. Interpretation Fertility is declining globally, with rates in more than half of all countries and territories in 2021 below replacement level. Trends since 2000 show considerable heterogeneity in the steepness of declines, and only a small number of countries experienced even a slight fertility rebound after their lowest observed rate, with none reaching replacement level. Additionally, the distribution of livebirths across the globe is shifting, with a greater proportion occurring in the lowest-income countries. Future fertility rates will continue to decline worldwide and will remain low even under successful implementation of pro-natal policies. These changes will have far-reaching economic and societal consequences due to ageing populations and declining workforces in higher-income countries, combined with an increasing share of livebirths among the already poorest regions of the world

Multiscale gradient computation for flow in heterogeneous porous media

An efficient multiscale (MS) gradient computation method for subsurface flow management and optimization is introduced. The general, algebraic framework allows for the calculation of gradients using both the Direct and Adjoint derivative methods. The framework also allows for the utilization of any MS formulation that can be algebraically expressed in terms of a restriction and a prolongation operator. This is achieved via an implicit differentiation formulation. The approach favors algorithms for multiplying the sensitivity matrix and its transpose with arbitrary vectors. This provides a flexible way of computing gradients in a form suitable for any given gradient-based optimization algorithm. No assumption w.r.t. the nature of the problem or specific optimization parameters is made. Therefore, the framework can be applied to any gradient-based study. In the implementation, extra partial derivative information required by the gradient computation is computed via automatic differentiation. A detailed utilization of the framework using the MS Finite Volume (MSFV) simulation technique is presented. Numerical experiments are performed to demonstrate the accuracy of the method compared to a fine-scale simulator. In addition, an asymptotic analysis is presented to provide an estimate of its computational complexity. The investigations show that the presented method casts an accurate and efficient MS gradient computation strategy that can be successfully utilized in next-generation reservoir management studies.</p

A Multiscale Method For Data Assimilation

In data assimilation problems, various types of data are naturally linked to different spatial resolutions (e.g. seismic and electromagnetic data), and these scales are usually not coincident to the subsurface simulation model scale. Alternatives like down/upscaling of the data and/or the simulation model can be used, but with potential loss of important information. To address this issue, a novel Multiscale (MS) data assimilation method is introduced. The overall idea of the method is to keep uncertain parameters and observed data at their original representation scale, avoiding down/upscaling of any quantity. The method relies on a recently developed mathematical framework to compute adjoint gradients via a MS strategy. The fine-scale uncertain parameters are directly updated and the MS grid is constructed in a resolution that meets the observed data resolution. The advantages of the technique are demonstrated in the assimilation of data represented at a coarser scale than the simulation model. The misfit objective function is constructed to keep the MS nature of the problem. The regularization term is represented at the simulation model (fine) scale, whereas the data misfit term is represented at the observed data (coarse) scale. The performance of the method is demonstrated in synthetic models and compared to down/upscaling strategies. The experiments show that the MS strategy provides advantages 1) on the computational side – expensive operations are only performed at the coarse scale; 2) with respect to accuracy – the matched uncertain parameter distribution is closer to the “truth”; and 3) in the optimization performance – faster convergence behaviour due to faster gradient computation. In conclusion, the newly developed method is capable of providing superior results when compared to strategies that rely on the up/downscaling of the response/observed data, addressing the scale dissimilarity via a robust, consistent MS strategy.Green Open Access added to TU Delft Institutional Repository ‘You share, we take care!’ – Taverne project https://www.openaccess.nl/en/you-share-we-take-care Otherwise as indicated in the copyright section: the publisher is the copyright holder of this work and the author uses the Dutch legislation to make this work public.Petroleum EngineeringCivil Engineering and GeosciencesGeoscience and Engineerin

A multiscale method for data assimilation

In data assimilation problems, various types of data are naturally linked to different spatial resolutions (e.g., seismic and electromagnetic data), and these scales are usually not coincident to the subsurface simulation model scale. Alternatives like upscaling/downscaling of the data and/or the simulation model can be used, but with potential loss of important information. Such alternatives introduce additional uncertainties which are not in the nature of the problem description, but the result of the post processing of the data or the geo-model. To address this issue, a novel multiscale (MS) data assimilation method is introduced. The overall idea of the method is to keep uncertain parameters and observed data at their original representation scale, avoiding upscaling/downscaling of any quantity. The method relies on a recently developed mathematical framework to compute adjoint gradients via a MS strategy in an algebraic framework. The fine-scale uncertain parameters are directly updated and the MS grid is constructed in a resolution that meets the observed data resolution. This formulation therefore enables a consistent assimilation of data represented at a coarser scale than the simulation model. The misfit objective function is constructed to keep the MS nature of the problem. The regularization term is represented at the simulation model (fine) scale, whereas the data misfit term is represented at the observed data (coarse) scale. The computational aspects of the method are investigated in a simple synthetic model, including an elaborate uncertainty quantification step, and compared to upscaling/downscaling strategies. The experiment shows that the MS strategy provides several potential advantages compared to more traditional scale conciliation strategies: (1) expensive operations are only performed at the coarse scale; (2) the matched uncertain parameter distribution is closer to the “truth”; (3) faster convergence behavior occurs due to faster gradient computation; and (4) better uncertainty quantification results are obtained. The proof-of-concept example considered in this paper sheds new lights on how one can reduce uncertainty within fine-scale geo-model parameters with coarse-scale data, without the necessity of upscaling/downscaling the data nor the geo-model. The developments demonstrate how to consistently formulate such a gradient-based MS data assimilation strategy in an algebraic framework which allows for implementation in available computational platforms.Petroleum EngineeringCivil Engineering and Geoscience

Contact angle measurement for hydrogen/brine/sandstone system using captive-bubble method relevant for underground hydrogen storage

Subsurface porous formations provide large capacities for underground hydrogen storage (UHS). Successful utilization of these porous reservoirs for UHS depends on accurate quantification of the hydrogen transport characteristics at continuum (macro) scale, specially in contact with other reservoir fluids. Relative-permeability and capillary-pressure curves are among the macro-scale transport characteristics which play crucial roles in quantification of the storage capacity and efficiency. For a given rock sample, these functions can be determined if pore-scale (micro-scale) surface properties, specially contact angles, are known. For hydrogen/brine/rock system, these properties are yet to a large extent unknown. In this study, we characterize the contact angles of hydrogen in contact with brine and Bentheimer and Berea sandstones at various pressure, temperature, and brine salinity using captive-bubble method. The experiments are conducted close to the in-situ conditions, which resulted in water-wet intrinsic contact angles, about 25 to 45 degrees. Moreover, no meaningful correlation was found with changing tested parameters. We monitor the bubbles over time and report the average contact angles with their minimum and maximum variations. Given rock pore structures, using the contact angles reported in this study, one can define relative-permeability and capillary-pressure functions for reservoir-scale simulations and storage optimization.Petroleum Engineerin

Iterative multiscale gradient computation for heterogeneous subsurface flow

We introduce a semi-analytical iterative multiscale derivative computation methodology that allows for error control and reduction to any desired accuracy, up to fine-scale precision. The model responses are computed by the multiscale forward simulation of flow in heterogeneous porous media. The derivative computation method is based on the augmentation of the model equation and state vectors with the smoothing stage defined by the iterative multiscale method. In the formulation, we avoid additional complexity involved in computing partial derivatives associated to the smoothing step. We account for it as an approximate derivative computation stage. The numerical experiments illustrate how the newly introduced derivative method computes misfit objective function gradients that converge to fine-scale one as the iterative multiscale residual converges. The robustness of the methodology is investigated for test cases with high contrast permeability fields. The iterative multiscale gradient method casts a promising approach, with minimal accuracy-efficiency tradeoff, for large-scale heterogeneous porous media optimization problems.</p

Novel Information Regarding the Treatment of Helicobacter pylori Infection: A Systematic Review and Meta-analysis of Randomized Clinical Trials

OBJECTIVE: Helicobacter pylori infects at least 50 of the world's human population. The current study aimed to assess and compare the efficacy of triple versus quadruple therapy. METHODS: Randomized clinical trials (RCTs) consisting of triple and quadruple therapy were identified through electronic and manual searches in the national and international online databases (IsI, Magiran, Embase, PubMed, and Scopus). The random-effects model was applied to pool analysis. Funnel plots and the Egger test were used to examine publication bias. RESULTS: After a detailed review of the selected articles, 79 RCTs were included in the meta-analysis; it was based on using triple and quadruple therapy as the first and second-line treatment. The results showed that quadruple therapy in the first-line treatment had a higher eradication rate than triple therapy. Overall, the eradication rate with triple therapy was 74 (95 CI, 71-77) for intention-to-treat (ITT) analysis and 80 (95 CI, 77-82) for per-protocol (PP) analysis. Generally, the eradication rate with quadruple therapy was 82 (95 CI, 78.0-86.0) for ITT analysis and 85 (95 CI, 82.0-89.0) for PP analysis. The analysis also revealed that quadruple therapy was more effective for 7 or 10 days. CONCLUSION: The current study results demonstrated that quadruple therapy has better effectiveness than triple therapy as the first-line treatment; however, in the second-line treatment, the effectiveness of quadruple and triple regimens is almost similar. The effectiveness of quadruple therapy in the Asian population was found to be slightly higher than that of triple therapy, while this difference was considerably higher in the European population

Multiscale gradient computation for multiphase flow in porous media

A multiscale gradient computation method for multiphase flow in heterogeneous porous media is developed. The method constructs multiscale primal and dual coarse grids, imposed on the given fine-scale computational grid. Local multiscale basis functions are computed on (dual-) coarse blocks, constructing an accurate map (prolongation operator) between coarse- and fine-scale systems. While the expensive operations involved in computing the gradients are performed at the coarse scale, sensitivities with respect to uncertain parameters (e.g., grid block permeabilities) are expressed in the fine scale via the partial derivatives of the prolongation operator. Hence, the method allows for updating of the geological model, rather than the dynamic model only, avoiding upscaling and the inevitable loss of information. The formulation and implementation are based on automatic differentiation (AD), allowing for convenient extensions to complex physics. An IMPES coupling strategy for flow and transport is followed, in the forward simulation. The flow equation is computed using a multiscale finite volume (MSFV) formulation and the transport equation is computed at the fine scale, after reconstruction of mass conservative velocity field. To assess the performance of the method, a synthetic multiphase flow test case is considered. The multiscale gradients are compared against those obtained from a fine-scale reference strategy. Apart from its computational efficiency, the benefits of the method include flexibility to accommodate variables expressed at different scales, specially in multiscale data assimilation and reservoir management studies.Green Open Access added to TU Delft Institutional Repository ‘You share, we take care!’ – Taverne project https://www.openaccess.nl/en/you-share-we-take-care Otherwise as indicated in the copyright section: the publisher is the copyright holder of this work and the author uses the Dutch legislation to make this work public.Petroleum EngineeringCivil Engineering and GeosciencesGeoscience and Engineerin

Multiscale gradient computation for flow in heterogeneous porous media

An efficient multiscale (MS) gradient computation method for subsurface flow management and optimization is introduced. The general, algebraic framework allows for the calculation of gradients using both the Direct and Adjoint derivative methods. The framework also allows for the utilization of any MS formulation that can be algebraically expressed in terms of a restriction and a prolongation operator. This is achieved via an implicit differentiation formulation. The approach favors algorithms for multiplying the sensitivity matrix and its transpose with arbitrary vectors. This provides a flexible way of computing gradients in a form suitable for any given gradient-based optimization algorithm. No assumption w.r.t. the nature of the problem or specific optimization parameters is made. Therefore, the framework can be applied to any gradient-based study. In the implementation, extra partial derivative information required by the gradient computation is computed via automatic differentiation. A detailed utilization of the framework using the MS Finite Volume (MSFV) simulation technique is presented. Numerical experiments are performed to demonstrate the accuracy of the method compared to a fine-scale simulator. In addition, an asymptotic analysis is presented to provide an estimate of its computational complexity. The investigations show that the presented method casts an accurate and efficient MS gradient computation strategy that can be successfully utilized in next-generation reservoir management studies.Green Open Access added to TU Delft Institutional Repository ‘You share, we take care!’ – Taverne project https://www.openaccess.nl/en/you-share-we-take-care Otherwise as indicated in the copyright section: the publisher is the copyright holder of this work and the author uses the Dutch legislation to make this work public.Petroleum EngineeringCivil Engineering and GeosciencesGeoscience and Engineerin

Multiscale Gradient Computation for Subsurface Flow Models

We present an efficient multiscale (MS) gradient computation that is suitable for reservoir management studies involving optimization techniques for, e.g., computer-assisted history matching or life-cycle production optimization. The general, algebraic framework allows for the calculation of gradients using both the Direct and Adjoint derivative methods. The framework also allows for the utilization of any MS formulation in the forward reservoir simulation that can be algebraically expressed in terms of a restriction and a prolongation operator. In the implementation, extra partial derivative information required by the gradient methods is computed via automatic differentiation. Numerical experiments demonstrate the accuracy of the method compared against those based on fine-scale simulation (industry standard).Green Open Access added to TU Delft Institutional Repository ‘You share, we take care!’ – Taverne project https://www.openaccess.nl/en/you-share-we-take-care Otherwise as indicated in the copyright section: the publisher is the copyright holder of this work and the author uses the Dutch legislation to make this work public.Petroleum EngineeringCivil Engineering and GeosciencesGeoscience and Engineerin