The global burden of adolescent and young adult cancer in 2019 : a systematic analysis for the Global Burden of Disease Study 2019

Background In estimating the global burden of cancer, adolescents and young adults with cancer are often overlooked, despite being a distinct subgroup with unique epidemiology, clinical care needs, and societal impact. Comprehensive estimates of the global cancer burden in adolescents and young adults (aged 15-39 years) are lacking. To address this gap, we analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, with a focus on the outcome of disability-adjusted life-years (DALYs), to inform global cancer control measures in adolescents and young adults. Methods Using the GBD 2019 methodology, international mortality data were collected from vital registration systems, verbal autopsies, and population-based cancer registry inputs modelled with mortality-to-incidence ratios (MIRs). Incidence was computed with mortality estimates and corresponding MIRs. Prevalence estimates were calculated using modelled survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated as age-specific cancer deaths multiplied by the standard life expectancy at the age of death. The main outcome was DALYs (the sum of YLLs and YLDs). Estimates were presented globally and by Socio-demographic Index (SDI) quintiles (countries ranked and divided into five equal SDI groups), and all estimates were presented with corresponding 95% uncertainty intervals (UIs). For this analysis, we used the age range of 15-39 years to define adolescents and young adults. Findings There were 1.19 million (95% UI 1.11-1.28) incident cancer cases and 396 000 (370 000-425 000) deaths due to cancer among people aged 15-39 years worldwide in 2019. The highest age-standardised incidence rates occurred in high SDI (59.6 [54.5-65.7] per 100 000 person-years) and high-middle SDI countries (53.2 [48.8-57.9] per 100 000 person-years), while the highest age-standardised mortality rates were in low-middle SDI (14.2 [12.9-15.6] per 100 000 person-years) and middle SDI (13.6 [12.6-14.8] per 100 000 person-years) countries. In 2019, adolescent and young adult cancers contributed 23.5 million (21.9-25.2) DALYs to the global burden of disease, of which 2.7% (1.9-3.6) came from YLDs and 97.3% (96.4-98.1) from YLLs. Cancer was the fourth leading cause of death and tenth leading cause of DALYs in adolescents and young adults globally. Interpretation Adolescent and young adult cancers contributed substantially to the overall adolescent and young adult disease burden globally in 2019. These results provide new insights into the distribution and magnitude of the adolescent and young adult cancer burden around the world. With notable differences observed across SDI settings, these estimates can inform global and country-level cancer control efforts. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Peer reviewe

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Thermodynamic Insight in Design of Methanation Reactor with Water Removal Considering Nexus between CO2 Conversion and Irreversibilities

The inevitable nexus between energy use and CO2 emission necessitates the development of sustainable energy systems. The conversion of CO2 to CH4 using green H2 in power-to-gas applications in such energy systems has attracted much interest. In this context, the present study provides a thermodynamic insight into the effect of water removal on CO2 conversion and irreversibility within a CO2 methanation reactor. A fixed-bed reactor with one intermediate water removal point, representing two reactors in series, was modeled by a one-dimensional pseudo-homogeneous model. Pure CO2 or a mixture of CO2 and methane, representing a typical biogas mixture, were used as feed. For short reactors, both the maximum conversion and the largest irreversibilities were observed when the water removal point was located in the middle of the reactor. However, as the length of the reactor increased, the water removal point with the highest conversion was shifted towards the end of the reactor, accompanied by a smaller thermodynamic penalty. The largest irreversibilities in long reactors were obtained when water removal took place closer to the inlet of the reactor. The study discusses the potential benefit of partial water removal and reactant feeding for energy-efficient reactor design

Development and Optimization of Processes for Liquefied Biomethane Production

The contribution of renewable energies to the globally fast-expanding transport sector is the lowest among the other sectors like power generation. Many alternative fuels have been suggested to boost the green transition towards sustainable transportation. Liquified biomethane (LBM) has recently gained much attention within this context. LBM has similar characteristics as liquefied natural gas. Moreover, the abundance and origin of LBM from biogas make it an exciting energy source in the transport sector. LBM production involves multiple energy-intensive processes. Biogas upgrading to remove CO2 and low-temperature refrigeration to liquefy the final product are the most critical parts of an LBM production plant. For a long time, the development of processes regarding biogas upgrading focused on applications such as compressed gaseous fuel and gas grid injection, where a purity of 90-97 mol% of CH4 is required. Hence, the design of the biogas upgrading process complied with such purity requirements. The emergence of LBM as an alternative transportation fuel has imposed an even more restrictive purity requirement (i.e., CO2 content below 50 ppm in upgraded biogas known as biomethane). The liquefaction process after the biogas upgrading process is the main reason for considering such stringent CO2 requirements; exceeding the CO2 concentration limit in the biomethane can damage low-temperature heat exchangers due to CO2 ice-formation. Developing processes for LBM production that are energy-efficient and cost-efficient requires further considerations for the highly restrictive CO2 content in biomethane. Hence, the focus of this thesis has been to develop and optimize the design of LBM production plants through thermodynamic and cost analyses. Further, a novel process concept has been developed to convert CO2 available in the biogas mixture to additional LBM using the CO2 methanation process fed by renewable hydrogen. In this thesis, detailed process models of state-of-the-art technologies for biogas upgrading, CO2 methanation, and biomethane liquefaction have been simulated with a commercial process simulation tool. Amine-based absorption and cryogenic gas separation have been considered for the upgrading process. Different refrigeration cycles, including N2 expander cycles and single mixed refrigerant cycles, have been used for liquefaction. The CO2 methanation process model has been developed so that it can to be integrated in the LBM production plant. The processes have been optimized using a sequential quadratic programming (SQP) algorithm. Determination of potential synergies and overall energy efficiency improvements of LBM production plants due to integration of the upgrading and liquefaction processes has been performed by comparing LBM production using amine-based biogas upgrading and cryogenic biogas upgrading. The results indicated that integrating biogas upgrading with the liquefaction process using the cryogenic gas separation would reduce the specific energy requirement of the LBM production plant. However, cryogenic gas separation for biogas upgrading was associated with challenges regarding CO2 ice-formation that limit its application in practice, even with a better thermodynamic performance. Optimization studies have aimed to propose alternative approaches to improve the performance of the conventional LBM production plant using amine-based biogas upgrading. The results illustrated that the interaction between the upgrading and liquefaction processes within the conventional LBM production plant was limited to only the pressure level of the biomethane produced from the upgrading process. Hence, a sequential optimization approach was adequate to determine the optimal operating conditions for minimum exergy demand within the plant. Further, the results revealed that the thermodynamic optima obtained from minimizing the exergy supply and the total annualized cost for the upgrading process would be similar since operating at high pressure was required to satisfy the restrictive CO2 content specification. Concerning the total exergy demand within the overall plant, the difference between solutions obtained from different objective function formulations for the upgrading process would be insignificant. In this thesis, a comprehensive investigation has been carried out to design a CO2 methanation reactor considering the improvement of CO2 conversion and irreversibility rate within the reactor. It was observed that a series of methanation reactors with intermediate water removal operating under non-isothermal conditions could provide maximum CO2 conversion with an improved irreversibility rate within the reactor. Further, the required reactor length to perform CO2 methanation was determined. The results indicated that the CO2 methanation reaction could be run in a shorter reactor when the intermediate water removal was considered as the gaining for additional CO2 conversion due to extra length was not significant. Finally, a conceptual process design has been proposed to combine the conventional LBM production plant with the methanation process. Here, the feasibility of such a process concept has been thoroughly studied. The results illustrated that the methanation process could be partly responsible for upgrading; however, an additional polishing step was required to meet the CO2 content specification. The feasibility study concluded that the applicability of the proposed process design was highly dependant on the price of H2. Further, the overall exergy efficiency of the proposed concept could outweigh the exergy efficiency of the conventional LBM production plant if the available exergy of heat was utilized

Objective Function Evaluation for Optimization of an Amine-Based Biogas Upgrading and Liquefaction Process

Conventionally, liquefied biomethane (LBM) is produced through biogas upgrading followed by a liquefaction process. In the present study, a detailed model for an LBM production plant including amine-based biogas upgrading and liquefaction was provided to compare thermodynamic and economic optimization for the biogas upgrading. In this context, multiple objective function formulations based on energy, exergy, and economy were examined. Furthermore, their impact on the exergy demand in the liquefaction process and the overall LBM production plant was investigated. The results indicated that optimization of the upgrading process based on exergy and total annualized cost would result in similar solutions, providing both the highest thermodynamic and economic performances, because the operating pressure was forced to be high to meet the strict CO2 limitations for LBM. However, the results also indicated that the exergy demand for the overall LBM production plant would be approximately the same regardless of the objective function formulation used for the upgrading process, as exergy savings in the liquefaction process would compensate higher exergy demand in the upgrading process. Overall, thermodynamic and economic optima of the LBM production plant would be similar if the LBM production plant was optimized based on exergy supply or total annualized cost. It was also illustrated that the selection of a suitable refrigeration cycle would have more impact on the overall performance of the LBM plant than the formulation of the objective function for the optimization. © 2021 American Chemical Society. All rights reserved.Objective Function Evaluation for Optimization of an Amine-Based Biogas Upgrading and Liquefaction ProcesspublishedVersio

Objective Function Evaluation for Optimization of an Amine-Based Biogas Upgrading and Liquefaction Process

Conventionally, liquefied biomethane (LBM) is produced through biogas upgrading followed by a liquefaction process. In the present study, a detailed model for an LBM production plant including amine-based biogas upgrading and liquefaction was provided to compare thermodynamic and economic optimization for the biogas upgrading. In this context, multiple objective function formulations based on energy, exergy, and economy were examined. Furthermore, their impact on the exergy demand in the liquefaction process and the overall LBM production plant was investigated. The results indicated that optimization of the upgrading process based on exergy and total annualized cost would result in similar solutions, providing both the highest thermodynamic and economic performances, because the operating pressure was forced to be high to meet the strict CO2 limitations for LBM. However, the results also indicated that the exergy demand for the overall LBM production plant would be approximately the same regardless of the objective function formulation used for the upgrading process, as exergy savings in the liquefaction process would compensate higher exergy demand in the upgrading process. Overall, thermodynamic and economic optima of the LBM production plant would be similar if the LBM production plant was optimized based on exergy supply or total annualized cost. It was also illustrated that the selection of a suitable refrigeration cycle would have more impact on the overall performance of the LBM plant than the formulation of the objective function for the optimization. © 2021 American Chemical Society. All rights reserved

Molecular Microbial Community Analysis as an Analysis Tool for Optimal Biogas Production

The microbial diversity in anaerobic digestion (AD) is important because it affects process robustness. High-throughput sequencing offers high-resolution data regarding the microbial diversity and robustness of biological systems including AD; however, to understand the dynamics of microbial processes, knowing the microbial diversity is not adequate alone. Advanced meta-omic techniques have been established to determine the activity and interactions among organisms in biological processes like AD. Results of these methods can be used to identify biomarkers for AD states. This can aid a better understanding of system dynamics and be applied to producing comprehensive models for AD. The paper provides valuable knowledge regarding the possibility of integration of molecular methods in AD. Although meta-genomic methods are not suitable for on-line use due to long operating time and high costs, they provide extensive insight into the microbial phylogeny in AD. Meta-proteomics can also be explored in the demonstration projects for failure prediction. However, for these methods to be fully realised in AD, a biomarker database needs to be developed

Optimization of an Absorption-Based Biogas Upgrading and Liquefaction Process

The present work proposes a methodology for optimization of a liquefied biomethane (LBM) production plant. The LBM production plant comprises amine-based absorption upgrading followed by a single expander refrigeration cycle. The processes were modeled using Aspen HYSYS® and optimized through a Sequential Quadratic Programming algorithm. Any changes in the operating conditions of the upgrading process will affect the cooling demand in the liquefaction, while the opposite is not true. Based on this, a sequential optimization approach starting with the upgrading process is proposed. In order to accommodate the connection between the processes, different objective functions were formulated for the sequential optimization approach. The results from the sequential approach were compared with an overall optimization approach, where the entire LBM plant was optimized simultaneously. The results indicate that the same solution was obtained both for the sequential approach and the simultaneous approach. For the sequential approach, however, the best result was observed when the interaction between the upgrading and liquefaction processes was accounted for by considering the effect of the upgrading process on the exergy requirement in the liquefaction process

Cryogenic vs. absorption biogas upgrading in liquefied biomethane production – An energy efficiency analysis

Production of liquefied biomethane (LBM) from biogas comprises two major energy intensive processes; upgrading to increase the methane concentration and refrigeration to liquefy the upgraded biogas. Amine-based absorption has been considered an attractive option for biogas upgrading in industrial applications. The temperature increase associated with amine regeneration is, however, in conflict with the cooling requirement of the subsequent liquefaction process. Hence, cryogenic biogas upgrading, integrated with liquefaction, has emerged as an interesting alternative. In this paper, a rigorous energy analysis was performed for comprehensive models of the two aforementioned LBM production alternatives. Both processes were modeled using Aspen HYSYS® and optimized to minimize the energy use. The results indicate that the integrated cryogenic upgrading process is favorable in terms of both overall energy efficiency and methane utilization. Moreover, the energy analysis implies that the liquefaction process accounts for the major part of the energy input to an LBM plant, demonstrating the significance of improving the energy efficiency of the liquefaction process in order to improve the overall performance of the LBM process

Thermodynamic Insight in Design of Methanation Reactor with Water Removal Considering Nexus between CO2 Conversion and Irreversibilities

The inevitable nexus between energy use and CO2 emission necessitates the development of sustainable energy systems. The conversion of CO2 to CH4 using green H2 in power-to-gas applications in such energy systems has attracted much interest. In this context, the present study provides a thermodynamic insight into the effect of water removal on CO2 conversion and irreversibility within a CO2 methanation reactor. A fixed-bed reactor with one intermediate water removal point, representing two reactors in series, was modeled by a one-dimensional pseudo-homogeneous model. Pure CO2 or a mixture of CO2 and methane, representing a typical biogas mixture, were used as feed. For short reactors, both the maximum conversion and the largest irreversibilities were observed when the water removal point was located in the middle of the reactor. However, as the length of the reactor increased, the water removal point with the highest conversion was shifted towards the end of the reactor, accompanied by a smaller thermodynamic penalty. The largest irreversibilities in long reactors were obtained when water removal took place closer to the inlet of the reactor. The study discusses the potential benefit of partial water removal and reactant feeding for energy-efficient reactor design