Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017

Background: The Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) includes a comprehensive assessment of incidence, prevalence, and years lived with disability (YLDs) for 354 causes in 195 countries and territories from 1990 to 2017. Previous GBD studies have shown how the decline of mortality rates from 1990 to 2016 has led to an increase in life expectancy, an ageing global population, and an expansion of the non-fatal burden of disease and injury. These studies have also shown how a substantial portion of the world's population experiences non-fatal health loss with considerable heterogeneity among different causes, locations, ages, and sexes. Ongoing objectives of the GBD study include increasing the level of estimation detail, improving analytical strategies, and increasing the amount of high-quality data. Methods: We estimated incidence and prevalence for 354 diseases and injuries and 3484 sequelae. We used an updated and extensive body of literature studies, survey data, surveillance data, inpatient admission records, outpatient visit records, and health insurance claims, and additionally used results from cause of death models to inform estimates using a total of 68 781 data sources. Newly available clinical data from India, Iran, Japan, Jordan, Nepal, China, Brazil, Norway, and Italy were incorporated, as well as updated claims data from the USA and new claims data from Taiwan (province of China) and Singapore. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between rates of incidence, prevalence, remission, and cause of death for each condition. YLDs were estimated as the product of a prevalence estimate and a disability weight for health states of each mutually exclusive sequela, adjusted for comorbidity. We updated the Socio-demographic Index (SDI), a summary development indicator of income per capita, years of schooling, and total fertility rate. Additionally, we calculated differences between male and female YLDs to identify divergent trends across sexes. GBD 2017 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting. Findings: Globally, for females, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and haemoglobinopathies and haemolytic anaemias in both 1990 and 2017. For males, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and tuberculosis including latent tuberculosis infection in both 1990 and 2017. In terms of YLDs, low back pain, headache disorders, and dietary iron deficiency were the leading Level 3 causes of YLD counts in 1990, whereas low back pain, headache disorders, and depressive disorders were the leading causes in 2017 for both sexes combined. All-cause age-standardised YLD rates decreased by 3·9% (95% uncertainty interval [UI] 3·1–4·6) from 1990 to 2017; however, the all-age YLD rate increased by 7·2% (6·0–8·4) while the total sum of global YLDs increased from 562 million (421–723) to 853 million (642–1100). The increases for males and females were similar, with increases in all-age YLD rates of 7·9% (6·6–9·2) for males and 6·5% (5·4–7·7) for females. We found significant differences between males and females in terms of age-standardised prevalence estimates for multiple causes. The causes with the greatest relative differences between sexes in 2017 included substance use disorders (3018 cases [95% UI 2782–3252] per 100 000 in males vs s1400 [1279–1524] per 100 000 in females), transport injuries (3322 [3082–3583] vs 2336 [2154–2535]), and self-harm and interpersonal violence (3265 [2943–3630] vs 5643 [5057–6302]). Interpretation: Global all-cause age-standardised YLD rates have improved only slightly over a period spanning nearly three decades. However, the magnitude of the non-fatal disease burden has expanded globally, with increasing numbers of people who have a wide spectrum of conditions. A subset of conditions has remained globally pervasive since 1990, whereas other conditions have displayed more dynamic trends, with different ages, sexes, and geographies across the globe experiencing varying burdens and trends of health loss. This study emphasises how global improvements in premature mortality for select conditions have led to older populations with complex and potentially expensive diseases, yet also highlights global achievements in certain domains of disease and injury

Overcoming obstacles to creativity in science

Worldwide, the money spent on research and the number of scientific publications have never been more important. However, the amount of money and the number of scientific papers are not necessarily good indicators of scientific creativity. In this presentation, we show that scientific education, research funding, and criteria for scientific publications and scientific recognition does not always support creativity. Instead, they often favor caution and conformity. Scientific research should not be restricted to the logical development and application of known ideas, but should promote new ideas and expand knowledge beyond the existing frontiers. Stimulating scientific creativity means not only giving a boost to creative thinking, but also taking into account the factors that put a brake on creativity. This presentation is devoted to the factors that keep scientific creativity in check and how we should address them. Obstacles to scientific creativity are identified, some being inside the researcher’s mind (epistemological obstacles, cognitive bias…) and others outside (conformity to the dominant model). As a consequence, to stimulate scientific creativity, it is essential to rethink science education from primary school to university. It is also necessary to change the criteria for funding and recognition of researchers. Scientific creativity must be a political priority for the next future. Several concrete proposals that could be easily implemented are discussed

Quickest Paths for Different Network Router Mechanisms

The quickest path problem deals with the transmission of a message of size {sigma} from a source to a destination with the minimum end-to-end delay over a network with bandwidth and delay constraints on the links. We consider four basic modes and two variations for the message delivery at the nodes reacting the mechanisms such as circuit switching, Internet protocol, and their combinations. For each of first three modes, we present O(m{sup 2} + mn log n) time algorithm to compute the quickest path for a given message size {sigma}. For the last mode, the quickest path can be computed in O(m + n log n) time

Routing scalability in multi-domain DWDM networks

This paper studies routing scalability in multi-domain DWDM networks. Although inter-domain provisioning has been well studied for packet/cell-switching networks, the wavelength dimension (along with wavelength conversion) poses many challenges in multi-domain DWDM settings. To address these concerns a detailed GMPLS-based hierarchical routing framework is proposed for multi-domain DWDM networks with wavelength conversion. This solution uses mesh topology abstraction schemes to hide domain-internal state. However related inter-domain routing loads can be significant here, growing by the square of the number of border nodes. To address these scalability limitations, improved inter-domain routing update strategies are also proposed and the associated performance of inter-domain lightpath RWA and signaling schemes studied

Inter-Domain Routing Scalability in Optical DWDM Networks

Recent studies on inter-domain DWDM networks have focused on topology abstraction for state summarization, i.e. transforming a physical topology to a virtual mesh, tree, or star network. Although these schemes give very good inter-domain blocking reduction, associated inter-domain routing overheads are significant, particularly as the number of domains and border OXC nodes increase. To address these scalability limitations, novel routing update triggering policies for multi-domain DWDM networks are developed. The performance of inter-domain lightpath RWA and signaling schemes in conjunction with these strategies is then studied in order to gauge the overall effectiveness of these approaches.© IEE

Exploration, Navigation and Self-Localization in an Autonomous Mobile Robot

In this paper the autonomous mobile vehicle MOBOT-IV is presented, which is capable of exploring an indoor-environment while building up an internal representation of its world. This internal model is used for the navigation of the vehicle during and after the exploration phase. In contrast to methods, which use a grid based or line based environment representation, in the approach presented in this paper, local sector maps are the basic data structure of the world model. This paper describes the method of the view-point-planning for map building, the use of this map for navigation and the method of external position estimation including the handling of an position error in a moving real-time system. 1 Introduction Autonomous Mobile Robots (AMRs) are systems which can move and perform useful operations without any external support or human intervention. One reason, which makes it hard to use autonomous mobile robots in changing operating environments, is the fact, that the robot's rep..