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

Depth dynamics of soil N contents and natural abundances of N-15 after 43 years of long-term fertilization and liming in sub-tropical Alfisol

The aim of this study was to understand impacts of long-term (43years) fertilization on soil aggregation, N accumulation rates and N-15 in surface and deep layers in an Alfisol. Soil samples from seven treatments were analysed for N stocks, aggregate-associated N in 0-30 cm and the changes in N-15 in 0-90 cm depths. The treatments were: unfertilized control (control); recommended N dose (N); recommended N and phosphorus doses (NP); recommended N, P and potassium doses (NPK); 150% of recommended N, P and K doses (150% NPK); NPK + 10Mg FYM ha(-1) (NPK + FYM) and NPK + 0.4Mg lime ha(-1) (NPK + L). Results revealed that plots under NPK + FYM had similar to 39% higher total N concentrations than NPK + L in 0-30 cm soil layers. In NPK + L, macro-aggregates had 35 and 11% and microaggregates had 20 and 9% lower N-15 values than NPK + FYM in 0-15 and 15-30 cm soil layers, respectively. However, plots receiving NPK + FYM had similar to 39% greater deep soil (30-90 cm) N accumulation than NPK + L. These results would help understanding N supplying capacity by long-term fertilization and assist devising N management strategies in sub-tropical acidic Alfisols

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Not AvailableAgricultural land degradation due to nutrient deficiencies is a threat to agricultural sustainability. As nutrients availability is influenced by soil heterogeneity, climatic conditions and anthropogenic activities; hence, delineation of nutrient management zones (MZs) based on spatial variability could be an effective management option at regional scale. Thus, the present study was carried out to delineate MZs in the Shiwalik Himalayan region of India by capturing spatial variability of soil properties and secondary and micronutrients status because of the emerging nutrient deficiencies. For the study, a total of 2575 geo‐referenced representative surface (0–15 cm depth) soil samples were collected from the study region covering an area of 53,483 km2. The soils were analysed for pH, electrical conductivity, soil organic carbon, available sulphur (S) and micronutrients (Zn, Fe, Cu, Mn, B and Mo) concentrations. There was a wide variation in soil properties with coefficient of variation values of 14 (for pH) to 86% for available Mo. Geostatistical analysis revealed spherical, Gaussian, exponential, stable, circular and K‐Bessel best‐fit models for soil properties. Most of the soil properties were having moderate spatial dependence except soil pH and S (strong spatial dependence) and Zn (weak spatial dependence). About 49%, 10%, 2%, 13%, 11%, 12% and 8% area of the study region were found to be deficient (including acute and marginal deficiency) in S, Zn, Fe, Cu, Mn, B and Mo, respectively. The principal component analysis and fuzzy c‐mean clustering were performed to develop the MZs. Four principal components with eigenvalues greater than 1 and accounting 65·4% of total variance were retained for further analysis. On the basis of fuzzy performance index and normalized classification entropy, four potential MZs were identified. Analysis of variance confirmed the heterogeneity in most of the studied soil properties among the MZs. The study indicated that the methodology of delineating MZs can be effectively used in site‐specific S and micronutrients management in the Shiwalik Himalayan region of India. Copyright © 2016 John Wiley & Sons, Ltd.Not Availabl

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Not AvailableEmerging micronutrient deficiencies in different soils of the world is a threat for sustainability of agriculture. As distribution of micronutrients in soil varies spatially, site‐specific management of micronutrients by delineating regional zones (RZs) is an effective strategy for precision agriculture. The current investigation was performed to delineate RZs in a Deccan Plateau Region (DPR) of India by considering spatial variability of some soil properties and available micronutrients for efficient management of micronutrients. Altogether, 4,939 representative soil samples (with geographical coordinates) from surface (0–0.15 m depth) layers were obtained from Telangana state lying in DPR of India. After processing, soil samples were analysed for pH, electrical conductivity, soil organic carbon and available zinc, copper, iron, and manganese. Soil pH, electrical conductivity, and soil organic carbon content had mean values of 7.48 ± 0.95, 0.42 ± 0.22 dS/m and 0.48 ± 0.17%, respectively. Whereas, the mean values of available zinc, iron, copper, and manganese concentrations were 0.83 ± 0.36, 8.79 ± 4.15, 0.99 ± 0.43, and 8.79 ± 4.06 mg/kg, respectively. Geostatistical analysis divulged different distribution pattern of soil properties and available micronutrients with strong to moderate spatial dependency. The four principal components (with >1 eigenvalue) responsible for 73% of total variance were considered for analysis. Six RZs from the study area were created through geostatistical, principal component, and clustering analysis. The measured soil properties and available micronutrients in the RZs varied significantly highlighting the usefulness of RZ delineation technique for precise micronutrients management in DPR of India.Not Availabl

Search for CPCP violation in D0^0→\to KS0^0_\mathrm{S}KS0^0_\mathrm{S} decays in proton-proton collisions at s\sqrt{s} = 13 TeV

International audienceA search is reported for charge-parity D$^0$$\to$ K$^0_\mathrm{S}$K$^0_\mathrm{S}$$CP$ violation in D$^0$$\to$ K$^0_\mathrm{S}$K$^0_\mathrm{S}$ decays, using data collected in proton-proton collisions at $\sqrt{s}$ = 13 TeV recorded by the CMS experiment in 2018. The analysis uses a dedicated data set that corresponds to an integrated luminosity of 41.6 fb$^{-1}$, which consists of about 10 billion events containing a pair of ẖadrons, nearly all of which decay to charm hadrons. The flavor of the neutral D meson is determined by the pion charge in the reconstructed decays D$^{*+}$$\to$ D$^0\pi^+$ and D$^{*-}$$\to$ D$^0\pi^-$. The D$^0$$\to$ K$^0_\mathrm{S}$K$^0_\mathrm{S}$$CP$ asymmetry in D$^0$$\to$ K$^0_\mathrm{S}$K$^0_\mathrm{S}$ is measured to be $A_{CP}$( K$^0_\mathrm{S}$K$^0_\mathrm{S}$) = (6.2 $\pm$ 3.0 $\pm$ 0.2 $\pm$ 0.8)%, where the three uncertainties represent the statistical uncertainty, the systematic uncertainty, and the uncertainty in the measurement of the D$^0$ $\to$ K$^0_\mathrm{S}$K$^0_\mathrm{S}$ $CP$ asymmetry in the D$^0$ $\to$ K$^0_\mathrm{S}\pi^+\pi^-$ decay. This is the first D$^0$ $\to$ K$^0_\mathrm{S}$K$^0_\mathrm{S}$ $CP$ asymmetry measurement by CMS in the charm sector as well as the first to utilize a fully hadronic final state

The CMS Statistical Analysis and Combination Tool: COMBINE

International audienceThis paper describes the COMBINE software package used for statistical analyses by the CMS Collaboration. The package, originally designed to perform searches for a Higgs boson and the combined analysis of those searches, has evolved to become the statistical analysis tool presently used in the majority of measurements and searches performed by the CMS Collaboration. It is not specific to the CMS experiment, and this paper is intended to serve as a reference for users outside of the CMS Collaboration, providing an outline of the most salient features and capabilities. Readers are provided with the possibility to run COMBINE and reproduce examples provided in this paper using a publicly available container image. Since the package is constantly evolving to meet the demands of ever-increasing data sets and analysis sophistication, this paper cannot cover all details of COMBINE. However, the online documentation referenced within this paper provides an up-to-date and complete user guide

Dark sector searches with the CMS experiment

Astrophysical observations provide compelling evidence for gravitationally interacting dark matter in the universe that cannot be explained by the standard model of particle physics. The extraordinary amount of data from the CERN LHC presents a unique opportunity to shed light on the nature of dark matter at unprecedented collision energies. This Report comprehensively reviews the most recent searches with the CMS experiment for particles and interactions belonging to a dark sector and for dark-sector mediators. Models with invisible massive particles are probed by searches for signatures of missing transverse momentum recoiling against visible standard model particles. Searches for mediators are also conducted via fully visible final states. The results of these searches are compared with those obtained from direct-detection experiments. Searches for alternative scenarios predicting more complex dark sectors with multiple new particles and new forces are also presented. Many of these models include long-lived particles, which could manifest themselves with striking unconventional signatures with relatively small amounts of background. Searches for such particles are discussed and their impact on dark-sector scenarios is evaluated. Many results and interpretations have been newly obtained for this Report.Astrophysical observations provide compelling evidence for gravitationally interacting dark matter in the universe that cannot be explained by the standard model of particle physics. The extraordinary amount of data from the CERN LHC presents a unique opportunity to shed light on the nature of dark matter at unprecedented collision energies. This Report comprehensively reviews the most recent searches with the CMS experiment for particles and interactions belonging to a dark sector and for dark-sector mediators. Models with invisible massive particles are probed by searches for signatures of missing transverse momentum recoiling against visible standard model particles. Searches for mediators are also conducted via fully visible final states. The results of these searches are compared with those obtained from direct-detection experiments. Searches for alternative scenarios predicting more complex dark sectors with multiple new particles and new forces are also presented. Many of these models include long-lived particles, which could manifest themselves with striking unconventional signatures with relatively small amounts of background. Searches for such particles are discussed and their impact on dark-sector scenarios is evaluated. Many results and interpretations have been newly obtained for this Report

Search for the Z boson decay to ττμμ\tau\tau\mu\mu in proton-proton collisions at s\sqrt{s} = 13 TeV

International audienceThe first search for the Z boson decay to $\tau\tau\mu\mu$ at the CERN LHC is presented, based on data collected by the CMS experiment at the LHC in proton-proton collisions at a center-of-mass energy of 13 TeV and corresponding to an integrated luminosity of 138 fb$^{-1}$. The data are compatible with the predicted background. For the first time, an upper limit at the 95% confidence level of 6.9 times the standard model expectation is placed on the ratio of the Z $\to$ $\tau\tau\mu\mu$ to Z $\to$ 4$\mu$ branching fractions. Limits are also placed on the six flavor-conserving four-lepton effective-field-theory operators involving two muons and two tau leptons, for the first time testing all such operators

Searches for Higgs boson production through decays of heavy resonances

The discovery of the Higgs boson has led to new possible signatures for heavy resonance searches at the LHC. Since then, search channels including at least one Higgs boson plus another particle have formed an important part of the program of new physics searches. In this report, the status of these searches by the CMS Collaboration is reviewed. Searches are discussed for resonances decaying to two Higgs bosons, a Higgs and a vector boson, or a Higgs boson and another new resonance, with proton-proton collision data collected at $\sqrt{s}=$ 13 TeV in the years 2016-2018. A combination of the results of these searches is presented together with constraints on different beyond-the-standard model scenarios, including scenarios with extended Higgs sectors, heavy vector bosons and extra dimensions. Studies are shown for the first time by CMS on the validity of the narrow-width approximation in searches for the resonant production of a pair of Higgs bosons. The potential for a discovery at the High Luminosity LHC is also discussed.The discovery of the Higgs boson has led to new possible signatures for heavy resonance searches at the LHC. Since then, search channels including at least one Higgs boson plus another particle have formed an important part of the program of new physics searches. In this report, the status of these searches by the CMS Collaboration is reviewed. Searches are discussed for resonances decaying to two Higgs bosons, a Higgs and a vector boson, or a Higgs boson and another new resonance, with proton-proton collision data collected at $\sqrt{s}$ = 13 TeV in the years 2016-2018. A combination of the results of these searches is presented together with constraints on different beyond-the-standard model scenarios, including scenarios with extended Higgs sectors, heavy vector bosons and extra dimensions. Studies are shown for the first time by CMS on the validity of the narrow-width approximation in searches for the resonant production of a pair of Higgs bosons. The potential for a discovery at the High Luminosity LHC is also discussed

Search for a resonance decaying to a W boson and a photon in proton-proton collisions at s= \sqrt{s} = 13 TeV using leptonic W boson decays

A search for a new charged particle X with mass between 0.3 and 2.0 TeV decaying to a W boson and a photon is presented, using proton-proton collision data at a center-of-mass energy of 13 TeV, collected by the CMS experiment and corresponding to an integrated luminosity of 138 fb$^{-1}$. Particle X has electric charge $\pm$1 and is assumed to have spin 0. The search is performed using the electron and muon decays of the W boson. No significant excess above the predicted background is observed. The upper limit at 95% confidence level on the product of the production cross section of the X and its branching fraction to a W boson and a photon is found to be 94 (137) fb for a 0.3 TeV resonance and 0.75 (0.81) fb for a 2.0 TeV resonance, for an X width-to-mass ratio of 0.01% (5%). This search presents the most stringent constraints to date on the existence of such resonances across the probed mass range. A statistical combination with an earlier study based on the hadronic decay mode of the W boson is also performed, and the upper limit at 95% confidence level for a 2.0 TeV resonance is reduced to 0.50 (0.63) fb for an X width-to-mass ratio of 0.01% (5%).A search for a new charged particle X with mass between 0.3 and 2.0 TeV decaying to a W boson and a photon is presented, using proton-proton collision data at a center-of-mass energy of 13 TeV, collected by the CMS experiment and corresponding to an integrated luminosity of 138 fb$^{-1}$. Particle X has electric charge $\pm$1 and is assumed to have spin 0. The search is performed using the electron and muon decays of the W boson. No significant excess above the predicted background is observed. The upper limit at 95% confidence level on the product of the production cross section of the X and its branching fraction to a W boson and a photon is found to be 94 (137) fb for a 0.3 TeV resonance and 0.75 (0.81) fb for a 2.0 TeV resonance, for an X width-to-mass ratio of 0.01% (5%). This search presents the most stringent constraints to date on the existence of such resonances across the probed mass range. A statistical combination with an earlier study based on the hadronic decay mode of the W boson is also performed, and the upper limit at 95% confidence level for a 2.0 TeV resonance is reduced to 0.50 (0.63) fb for an X width-to-mass ratio of 0.01% (5%)