Phosphorescent heterobimetallic complexes involving platinum(IV) and rhenium(VII) centers, connected by unsupported μ-oxido bridge

Heterobimetallic compounds [(CN)LMe2Pt(mu-O)ReO3] (CN = ppy, L = PPh3, 2a; CN = ppy, L = PMePh2, 2b; CN = bhq, L = PPh3, 2c; CN = bhq, L = PMePh2, 2d) containing a discrete unsupported Pt(IV)-O-Re(VII) bridge have been synthesized through a targeted synthesis route. The compounds have been prepared by a single-pot synthesis in which the Pt(IV) precursor [PtMe2I(CN)L] complexes are allowed to react easily with AgReO4 in which the iodide ligand of the starting Pt(IV) complex is replaced by an ReO4- anion. In these Pt-O-Re complexes, the Pt(IV) centers have an octahedral geometry, completed by a cyclometalated bidentate ligand (CN), two methyl groups and a phosphine ligand, while the Re(VII) centers have a tetrahedral geometry. Elemental analysis, single crystal X-ray diffraction analysis and multinuclear NMR spectroscopy are used to establish their identities. The new complexes exhibit phosphorescence emission in the solid and solution states at 298 and 77 K, which is an uncommon property of platinum complexes with an oxidation state of +4. According to DFT calculations, we found that this emission behavior in the new complexes originates from ligand centered (LC)-L-3 (CN) character with a slight amount of metal to ligand charge transfer ((MLCT)-M-3). The solid-state emission data of the corresponding cycloplatinated(IV) precursor complexes [PtMe2I(CN)L], 1a-1d, pointed out that the replacement of I- by an ReO4- anion helps enhancing the emission efficiency besides shifting the emission wavelengths

A systematic review and meta-analysis to determine the contribution of mr imaging to the diagnosis of foetal brain abnormalities In Utero.

OBJECTIVES: This systematic review was undertaken to define the diagnostic performance of in utero MR (iuMR) imaging when attempting to confirm, exclude or provide additional information compared with the information provided by prenatal ultrasound scans (USS) when there is a suspicion of foetal brain abnormality. METHODS: Electronic databases were searched as well as relevant journals and conference proceedings. Reference lists of applicable studies were also explored. Data extraction was conducted by two reviewers independently to identify relevant studies for inclusion in the review. Inclusion criteria were original research that reported the findings of prenatal USS and iuMR imaging and findings in terms of accuracy as judged by an outcome reference diagnosis for foetal brain abnormalities. RESULTS: 34 studies met the inclusion criteria which allowed diagnostic accuracy to be calculated in 959 cases, all of which had an outcome reference diagnosis determined by postnatal imaging, surgery or autopsy. iuMR imaging gave the correct diagnosis in 91 % which was an increase of 16 % above that achieved by USS alone. CONCLUSION: iuMR imaging makes a significant contribution to the diagnosis of foetal brain abnormalities, increasing the diagnostic accuracy achievable by USS alone. KEY POINTS: • Ultrasound is the primary modality for monitoring foetal brain development during pregnancy • iuMRI used together with ultrasound is more accurate for detecting foetal brain abnormalities • iuMR imaging is most helpful for detecting midline brain abnormalities • The moderate heterogeneity of reviewed studies may compromise findings

Generating Bessel beams with broad depth-of-field by using phase-only acoustic holograms

[EN] We report zero-th and high-order acoustic Bessel beams with broad depth-of-field generated using acoustic holograms. While the transverse field distribution of Bessel beams generated using traditional passive methods is correctly described by a Bessel function, these methods present a common drawback: the axial distribution of the field is not constant, as required for ideal Bessel beams. In this work, we experimentally, numerically and theoretically report acoustic truncated Bessel beams of flat-intensity along their axis in the ultrasound regime using phase-only holograms. In particular, the beams present a uniform field distribution showing an elongated focal length of about 40 wavelengths, while the transverse width of the beam remains smaller than 0.7 wavelengths. The proposed acoustic holograms were compared with 3D-printed fraxicons, a blazed version of axicons. The performance of both phase-only holograms and fraxicons is studied and we found that both lenses produce Bessel beams in a wide range of frequencies. In addition, high-order Bessel beam were generated. We report first order Bessel beams that show a clear phase dislocation along their axis and a vortex with single topological charge. The proposed method may have potential applications in ultrasonic imaging, biomedical ultrasound and particle manipulation applications using passive lenses.This work was supported by the Spanish Ministry of Economy and Innovation (MINECO) through Project TEC2016-80976-R. NJ and SJ acknowledge financial support from Generalitat Valenciana through grants APOSTD/2017/042, ACIF/2017/045 and GV/2018/11. FC acknowledges financial support from Agencia Valenciana de la Innovacio through grant INNCON00/18/9 and European Regional Development Fund (IDIFEDER/2018/022).Jiménez-Gambín, S.; Jimenez, N.; Benlloch Baviera, JM.; Camarena Femenia, F. (2019). Generating Bessel beams with broad depth-of-field by using phase-only acoustic holograms. Scientific Reports. 9:1-13. https://doi.org/10.1038/s41598-019-56369-zS1139Durnin, J. Exact solutions for nondiffracting beams. i. the scalar theory. J. Opt. Soc. Am. A 4, 651 (1987).Durnin, J., Miceli, J. Jr & Eberly, J. Diffraction-free beams. Physical review letters 58, 1499 (1987).Chu, X. Analytical study on the self-healing property of Bessel beam. Eur. Phys. J. D 66, 259 (2012).McLeod, E., Hopkins, A. B. & Arnold, C. B. Multiscale Bessel beams generated by a tunable acoustic gradient index of refraction lens. Opt. Lett. 31, 3155 (2006).Li, Z., Alici, K. B., Caglayan, H. & Ozbay, E. Generation of an axially asymmetric Bessel-like beam from a metallic subwavelength aperture. Phys. Rev. Lett. 102, 143901 (2009).Fahrbach, F. & Rohrbach, A. Propagation stability of self-reconstructing Bessel beams enables contrast-enhanced imaging in thick media. Nat. Commun. 3, 632 (2011).Lu, J.-y, Zou, H. & Greenleaf, J. F. Biomedical ultrasound beam forming. Ultrasound in medicine & biology 20, 403–428 (1994).Marston, P. L. Scattering of a Bessel beam by a sphere. J. Acous. Soc. Am. 121, 753 (2007).Marston, P. L. Scattering of a Bessel beam by a sphere: Ii. helicoidal case and spherical shell example. The Journal of the Acoustical Society of America 124, 2905–2910 (2008).Lu, J. & Greenleaf, F. Ultrasonic nondiffracting transducer for medical imaging. IEEE Trans. Ultrason. Ferroelec. Freq. Contr. 37, 438 (1990).Lu, J.-Y. & Greenleaf, J. F. Pulse-echo imaging using a nondiffracting beam transducer. Ultrasound in medicine & biology 17, 265–281 (1991).Lu, J.-y, Song, T.-K., Kinnick, R. R. & Greenleaf, J. F. In vitro and in vivo real-time imaging with ultrasonic limited diffraction beams. IEEE transactions on medical imaging 12, 819–829 (1993).Lu, J.-y, Xu, X.-L., Zou, H. & Greenleaf, J. F. Application of Bessel beam for doppler velocity estimation. IEEE transactions on ultrasonics, ferroelectrics, and frequency control 42, 649–662 (1995).Nabavizadeh, A., Greenleaf, J. F., Fatemi, M. & Urban, M. W. Optimized shear wave generation using hybrid beamforming methods. Ultrasound in medicine & biology 40, 188–199 (2014).Marston, P. L. Axial radiation force of a Bessel beam on a sphere and direction reversal of the force. The Journal of the Acoustical Society of America 120, 3518–3524 (2006).Marston, P. L. Negative axial radiation forces on solid spheres and shells in a Bessel beam. The Journal of the Acoustical Society of America 122, 3162–3165 (2007).Marston, P. L. Radiation force of a helicoidal Bessel beam on a sphere. The Journal of the Acoustical Society of America 125, 3539–3547 (2009).Thomas, J.-L. & Marchiano, R. Pseudo angular momentum and topological charge conservation for nonlinear acoustical vortices. Physical review letters 91, 244302 (2003).Volke-Sepúlveda, K., Santillán, A. O. & Boullosa, R. R. Transfer of angular momentum to matter from acoustical vortices in free space. Phys. Rev. Lett. 100, 024302 (2008).Zhang, L. & Marston, P. L. Geometrical interpretation of negative radiation forces of acoustical Bessel beams on spheres. Physical Review E 84, 035601 (2011).Courtney, C. R. et al. Dexterous manipulation of microparticles using Bessel-function acoustic pressure fields. Applied Physics Letters 102, 123508 (2013).Hong, Z., Zhang, J. & Drinkwater, B. W. Observation of orbital angular momentum transfer from Bessel-shaped acoustic vortices to diphasic liquid-microparticle mixtures. Phys. Rev. Lett. 114, 214301 (2015).Baresch, D., Thomas, J.-L. &Marchiano, R. Observation of a single-beam gradient force acoustical trap for elastic particles: Acoustical tweezers. Phys. Rev. Lett. 116 (2016).Marzo, A., Caleap, M. & Drinkwater, B. W. Acoustic virtual vortices with tunable orbital angular momentum for trapping of mie particles. Phys. Rev. Lett. 120, 044301 (2018).Li, Y. et al. Acoustic radiation torque of an acoustic-vortex spanner exerted on axisymmetric objects. Applied Physics Letters 112, 254101 (2018).Riaud, A., Baudoin, M., Thomas, J.-L. & Matar, O. B. Cyclones and attractive streaming generated by acoustical vortices. Physical Review E 90, 013008 (2014).Shi, C., Dubois, M., Wang, Y. & Zhang, X. High-speed acoustic communication by multiplexing orbital angular momentum. Proceedings of the National Academy of Sciences 114, 7250–7253 (2017).Jiang, X., Liang, B., Cheng, J.-C. & Qiu, C.-W. Twisted acoustics: metasurface-enabled multiplexing and demultiplexing. Advanced Materials 30, 1800257 (2018).Hsu, D., Margetan, F. & Thompson, D. O. Bessel beam ultrasonic transducer: fabrication method and experimental results. Appl. Phys. Lett. 55, 2066 (1989).Campbell, J. A. & Soloway, S. Generation of a nondiffracting beam with frequency-independent beamwidth. The Journal of the Acoustical Society of America 88, 2467–2477 (1990).Masuyama, H., Yokoyama, T., Nagai, K. & Mizutani, K. Generation of Bessel beam from equiamplitude-driven annular transducer array consisting of a few elements. Jpn. J. Appl. Phys. 38, 3080 (1999).Fjield, T., Fan, X. & Hynynen, K. A parametric study of the concentric-ring transducer design for mri guided ultrasound surgery. J. Acoust. Soc. Am. 100, 1220 (1996).Chillara, V. K., Pantea, C. & Sinha, D. N. Low-frequency ultrasonic Bessel-like collimated beam generation from radial modes of piezoelectric transducers. Applied Physics Letters 110, 064101 (2017).Burckhardt, C., Hoffmann, H. & Grandchamp, P.-A. Ultrasound axicon: A device for focusing over a large depth. The Journal of the Acoustical Society of America 54, 1628–1630 (1973).Foster, F., Patterson, M., Arditi, M. & Hunt, J. The conical scanner: a two transducer ultrasound scatter imaging technique. Ultrasonic imaging 3, 62–82 (1981).McLeod, J. H. The axicon: A new type of optical element. J. Opt. Soc. Am. 44, 592 (1954).Arlt, J. & Dholakia, K. Generation of high-order Bessel beams by use of an axicon. Optics Communications 177, 297–301 (2000).Golub, I. Fresnel axicon. Optics letters 31, 1890–1892 (2006).Lirette, R. & Mobley, J. Broadband wave packet dynamics of minimally diffractive ultrasonic fields from axicon and stepped fraxicon lenses. The Journal of the Acoustical Society of America 146, 103–108 (2019).Jiménez, N. et al. Acoustic Bessel-like beam formation by an axisymmetric grating. Europhys. Lett. 106, 24005 (2014).Xu, Z., Xu, W., Qian, M., Cheng, Q. & Liu, X. A flat acoustic lens to generate a Bessel-like beam. Ultrasonics 80, 66–71 (2017).Li, Y., Liang, B., Gu, Z.-M., Zou, X.-Y. & Cheng, J.-C. Reflected wavefront manipulation based on ultrathin planar acoustic metasurfaces. Scientific Reports 3, 2546 (2013).Nye, J. & Berry, M. Dislocations in wave trains. Proc. R. Soc. London, Ser. A 336, 165–190 (1974).Jiménez, N. et al. Formation of high-order acoustic Bessel beams by spiral diffraction gratings. Physical Review E 94, 053004 (2016).Wang, T. et al. Particle manipulation with acoustic vortex beam induced by a brass plate with spiral shape structure. Applied Physics Letters 109, 123506 (2016).Jia, Y.-R., Wei, Q., Wu, D.-J., Xu, Z. & Liu, X.-J. Generation of fractional acoustic vortex with a discrete archimedean spiral structure plate. Applied Physics Letters 112, 173501 (2018).Jiménez, N., Romero-Garca, V., Garca-Raffi, L. M., Camarena, F. & Staliunas, K. Sharp acoustic vortex focusing by fresnel-spiral zone plates. Applied Physics Letters 112, 204101 (2018).Baudoin, M. et al. Folding a focalized acoustical vortex on a flat holographic transducer: miniaturized selective acoustical tweezers. Science advances 5, eaav1967 (2019).Muelas-Hurtado, R. D., Ealo, J. L., Pazos-Ospina, J. F. & Volke-Sepúlveda, K. Acoustic analysis of a broadband spiral source for the simultaneous generation of multiple Bessel vortices in air. The Journal of the Acoustical Society of America 144, 3252–3261 (2018).Muelas-Hurtado, R. D., Ealo, J. L., Pazos-Ospina, J. F. & Volke-Sepúlveda, K. Generation of multiple vortex beam by means of active diffraction gratings. Applied Physics Letters 112, 084101 (2018).Wunenburger, R., Lozano, J. I. V. & Brasselet, E. Acoustic orbital angular momentum transfer to matter by chiral scattering. New Journal of Physics 17, 103022 (2015).Terzi, M., Tsysar, S., Yuldashev, P., Karzova, M. & Sapozhnikov, O. Generation of a vortex ultrasonic beam with a phase plate with an angular dependence of the thickness. Moscow University Physics Bulletin 72, 61–67 (2017).Hefner, B. T. & Marston, P. L. An acoustical helicoidal wave transducer with applications for the alignment of ultrasonic and underwater systems. Jour. Acous. Soc. Am. 106, 3313–3316 (1999).Ealo, J. L., Prieto, J. C. & Seco, F. Airborne ultrasonic vortex generation using flexible ferroelectrets. IEEE transactions on ultrasonics, ferroelectrics, and frequency control 58, 1651–1657 (2011).Naify, C. J. et al. Generation of topologically diverse acoustic vortex beams using a compact metamaterial aperture. Applied Physics Letters 108, 223503 (2016).Ye, L. et al. Making sound vortices by metasurfaces. AIP Advances 6, 085007 (2016).Jiang, X., Li, Y., Liang, B., Cheng, J.-C. & Zhang, L. Convert acoustic resonances to orbital angular momentum. Physical review letters 117, 034301 (2016).Esfahlani, H., Lissek, H. & Mosig, J. R. Generation of acoustic helical wavefronts using metasurfaces. Physical Review B 95, 024312 (2017).Jiménez-Gambn, S., Jiménez, N., Benlloch, J. M. & Camarena, F. Holograms to focus arbitrary ultrasonic fields through the skull. Physical Review Applied 12, 014016 (2019).Maimbourg, G., Houdouin, A., Deffieux, T., Tanter, M. & Aubry, J.-F. 3d-printed adaptive acoustic lens as a disruptive technology for transcranial ultrasound therapy using single-element transducers. Physics in Medicine & Biology 63, 025026 (2018).Ferri, M. et al. On the evaluation of the suitability of the materials used to 3d print holographic acoustic lenses to correct transcranial focused ultrasound aberrations. Polymers 11, 1521 (2019).Melde, K., Mark, A. G., Qiu, T. & Fischer, P. Holograms for acoustics. Nature 537, 518 (2016).Brown, M. D., Cox, B. T. & Treeby, B. E. Design of multi-frequency acoustic kinoforms. Applied Physics Letters 111, 244101 (2017).Brown, M., Nikitichev, D., Treeby, B. & Cox, B. Generating arbitrary ultrasound fields with tailored optoacoustic surface profiles. Applied Physics Letters 110, 094102 (2017).Zhu, Y. et al. Fine manipulation of sound via lossy metamaterials with independent and arbitrary reflection amplitude and phase. Nature communications 9, 1632 (2018).Brown, M. D. Phase and amplitude modulation with acoustic holograms. Applied Physics Letters 115, 053701 (2019).Jiménez, N., Romero-Garca, V., Pagneux, V. & Groby, J.-P. Quasiperfect absorption by subwavelength acoustic panels in transmission using accumulation of resonances due to slow sound. Physical Review B 95, 014205 (2017).Tsang, P. W. M. & Poon, T.-C. Novel method for converting digital fresnel hologram to phase-only hologram based on bidirectional error diffusion. Optics Express 21, 23680–23686 (2013).Soret, J. Ueber die durch kreisgitter erzeugten diffractionsphänomene. Annalen der Physik 232, 99–113 (1875).Turunen, J., Vasara, A. & Friberg, A. T. Holographic generation of diffraction-free beams. Applied Optics 27, 3959–3962 (1988).Vasara, A., Turunen, J. & Friberg, A. T. Realization of general nondiffracting beams with computer-generated holograms. JOSA A 6, 1748–1754 (1989).Cunningham, K. B. & Hamilton, M. F. Bessel beams of finite amplitude in absorbing fluids. J. Acous. Soc. Am. 108, 519 (2000).Ding, D. & Y. Lu, J. Higher-order harmonics of limited diffraction Bessel beams. J. Acous. Soc. Am. 107, 1212 (2000).Skeldon, K., Wilson, C., Edgar, M. & Padgett, M. An acoustic spanner and its associated rotational Doppler shift. New J. Phys. 10, 013018 (2008).Wu, J. Acoustical tweezers. J. Acoust. Soc. Am. 89, 2140–2143 (1991).Zhang, L. & Marston, P. L. Angular momentum flux of nonparaxial acoustic vortex beams and torques on axisymmetric objects. Physical Review E 84, 065601 (2011).Yoon, C., Kang, B. J., Lee, C., Kim, H. H. & Shung, K. K. Multi-particle trapping and manipulation by a high-frequency array transducer. Appl. Phys. Lett. 105, 214103 (2014).Marzo, A. et al. Holographic acoustic elements for manipulation of levitated objects. Nat. Commun. 6 (2015).Blackstock, D. T. Fundamentals of physical acoustics (John Wiley & Sons, 2000).Treeby, B. E. & Cox, B. Modeling power law absorption and dispersion for acoustic propagation using the fractional laplacian. The Journal of the Acoustical Society of America 127, 2741–2748 (2010).Treeby, B. E., Jaros, J., Rendell, A. P. & Cox, B. Modeling nonlinear ultrasound propagation in heterogeneous media with power law absorption using a k-space pseudospectral method. The Journal of the Acoustical Society of America 131, 4324–4336 (2012).Jiménez, N. et al. Time-domain simulation of ultrasound propagation in a tissue-like medium based on the resolution of the nonlinear acoustic constitutive relations. Acta Acustica united with Acustica 102, 876–892 (2016)

Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950-2019 : a comprehensive demographic analysis for the Global Burden of Disease Study 2019

Background Accurate and up-to-date assessment of demographic metrics is crucial for understanding a wide range of social, economic, and public health issues that affect populations worldwide. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 produced updated and comprehensive demographic assessments of the key indicators of fertility, mortality, migration, and population for 204 countries and territories and selected subnational locations from 1950 to 2019. Methods 8078 country-years of vital registration and sample registration data, 938 surveys, 349 censuses, and 238 other sources were identified and used to estimate age-specific fertility. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate age-specific fertility rates for 5-year age groups between ages 15 and 49 years. With extensions to age groups 10-14 and 50-54 years, the total fertility rate (TFR) was then aggregated using the estimated age-specific fertility between ages 10 and 54 years. 7417 sources were used for under-5 mortality estimation and 7355 for adult mortality. ST-GPR was used to synthesise data sources after correction for known biases. Adult mortality was measured as the probability of death between ages 15 and 60 years based on vital registration, sample registration, and sibling histories, and was also estimated using ST-GPR. HIV-free life tables were then estimated using estimates of under-5 and adult mortality rates using a relational model life table system created for GBD, which closely tracks observed age-specific mortality rates from complete vital registration when available. Independent estimates of HIV-specific mortality generated by an epidemiological analysis of HIV prevalence surveys and antenatal clinic serosurveillance and other sources were incorporated into the estimates in countries with large epidemics. Annual and single-year age estimates of net migration and population for each country and territory were generated using a Bayesian hierarchical cohort component model that analysed estimated age-specific fertility and mortality rates along with 1250 censuses and 747 population registry years. We classified location-years into seven categories on the basis of the natural rate of increase in population (calculated by subtracting the crude death rate from the crude birth rate) and the net migration rate. We computed healthy life expectancy (HALE) using years lived with disability (YLDs) per capita, life tables, and standard demographic methods. Uncertainty was propagated throughout the demographic estimation process, including fertility, mortality, and population, with 1000 draw-level estimates produced for each metric. Findings The global TFR decreased from 2.72 (95% uncertainty interval [UI] 2.66-2.79) in 2000 to 2.31 (2.17-2.46) in 2019. Global annual livebirths increased from 134.5 million (131.5-137.8) in 2000 to a peak of 139.6 million (133.0-146.9) in 2016. Global livebirths then declined to 135.3 million (127.2-144.1) in 2019. Of the 204 countries and territories included in this study, in 2019, 102 had a TFR lower than 2.1, which is considered a good approximation of replacement-level fertility. All countries in sub-Saharan Africa had TFRs above replacement level in 2019 and accounted for 27.1% (95% UI 26.4-27.8) of global livebirths. Global life expectancy at birth increased from 67.2 years (95% UI 66.8-67.6) in 2000 to 73.5 years (72.8-74.3) in 2019. The total number of deaths increased from 50.7 million (49.5-51.9) in 2000 to 56.5 million (53.7-59.2) in 2019. Under-5 deaths declined from 9.6 million (9.1-10.3) in 2000 to 5.0 million (4.3-6.0) in 2019. Global population increased by 25.7%, from 6.2 billion (6.0-6.3) in 2000 to 7.7 billion (7.5-8.0) in 2019. In 2019, 34 countries had negative natural rates of increase; in 17 of these, the population declined because immigration was not sufficient to counteract the negative rate of decline. Globally, HALE increased from 58.6 years (56.1-60.8) in 2000 to 63.5 years (60.8-66.1) in 2019. HALE increased in 202 of 204 countries and territories between 2000 and 2019. Interpretation Over the past 20 years, fertility rates have been dropping steadily and life expectancy has been increasing, with few exceptions. Much of this change follows historical patterns linking social and economic determinants, such as those captured by the GBD Socio-demographic Index, with demographic outcomes. More recently, several countries have experienced a combination of low fertility and stagnating improvement in mortality rates, pushing more populations into the late stages of the demographic transition. Tracking demographic change and the emergence of new patterns will be essential for global health monitoring. Copyright (C) 2020 The Author(s). Published by Elsevier Ltd.Peer reviewe

Five insights from the Global Burden of Disease Study 2019

The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a rules-based synthesis of the available evidence on levels and trends in health outcomes, a diverse set of risk factors, and health system responses. GBD 2019 covered 204 countries and territories, as well as first administrative level disaggregations for 22 countries, from 1990 to 2019. Because GBD is highly standardised and comprehensive, spanning both fatal and non-fatal outcomes, and uses a mutually exclusive and collectively exhaustive list of hierarchical disease and injury causes, the study provides a powerful basis for detailed and broad insights on global health trends and emerging challenges. GBD 2019 incorporates data from 281 586 sources and provides more than 3.5 billion estimates of health outcome and health system measures of interest for global, national, and subnational policy dialogue. All GBD estimates are publicly available and adhere to the Guidelines on Accurate and Transparent Health Estimate Reporting. From this vast amount of information, five key insights that are important for health, social, and economic development strategies have been distilled. These insights are subject to the many limitations outlined in each of the component GBD capstone papers.Peer reviewe

Global, regional and national burden of bladder cancer and its attributable risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease study 2019

Introduction The current study determined the level and trends associated with the incidence, death and disability rates for bladder cancer and its attributable risk factors in 204 countries and territories, from 1990 to 2019, by age, sex and sociodemographic index (SDI; a composite measure of sociodemographic factors). Methods Various data sources from different countries, including vital registration and cancer registries were used to generate estimates. Mortality data and incidence data transformed to mortality estimates using the mortality to incidence ratio (MIR) were used in a cause of death ensemble model to estimate mortality. Mortality estimates were divided by the MIR to produce incidence estimates. Prevalence was calculated using incidence and MIR-based survival estimates. Age-specific mortality and standardised life expectancy were used to estimate years of life lost (YLLs). Prevalence was multiplied by disability weights to estimate years lived with disability (YLDs), while disability-adjusted life years (DALYs) are the sum of the YLLs and YLDs. All estimates were presented as counts and age-standardised rates per 100 000 population. Results Globally, there were 524 000 bladder cancer incident cases (95% uncertainty interval 476 000 to 569 000) and 229 000 bladder cancer deaths (211 000 to 243 000) in 2019. Age-standardised death rate decreased by 15.7% (8.6 to 21.0), during the period 1990–2019. Bladder cancer accounted for 4.39 million (4.09 to 4.70) DALYs in 2019, and the age-standardised DALY rate decreased significantly by 18.6% (11.2 to 24.3) during the period 1990–2019. In 2019, Monaco had the highest age-standardised incidence rate (31.9 cases (23.3 to 56.9) per 100 000), while Lebanon had the highest age-standardised death rate (10.4 (8.1 to 13.7)). Cabo Verde had the highest increase in age-standardised incidence (284.2% (214.1 to 362.8)) and death rates (190.3% (139.3 to 251.1)) between 1990 and 2019. In 2019, the global age-standardised incidence and death rates were higher among males than females, across all age groups and peaked in the 95+ age group. Globally, 36.8% (28.5 to 44.0) of bladder cancer DALYs were attributable to smoking, more so in males than females (43.7% (34.0 to 51.8) vs 15.2% (10.9 to 19.4)). In addition, 9.1% (1.9 to 19.6) of the DALYs were attributable to elevated fasting plasma glucose (FPG) (males 9.3% (1.6 to 20.9); females 8.4% (1.6 to 19.1)). Conclusions There was considerable variation in the burden of bladder cancer between countries during the period 1990–2019. Although there was a clear global decrease in the age-standardised death, and DALY rates, some countries experienced an increase in these rates. National policy makers should learn from these differences, and allocate resources for preventative measures, based on their country-specific estimates. In addition, smoking and elevated FPG play an important role in the burden of bladder cancer and need to be addressed with prevention programmes.publishedVersio

Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950-2019 : a comprehensive demographic analysis for the Global Burden of Disease Study 2019

Background: Accurate and up-to-date assessment of demographic metrics is crucial for understanding a wide range of social, economic, and public health issues that affect populations worldwide. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 produced updated and comprehensive demographic assessments of the key indicators of fertility, mortality, migration, and population for 204 countries and territories and selected subnational locations from 1950 to 2019. Methods: 8078 country-years of vital registration and sample registration data, 938 surveys, 349 censuses, and 238 other sources were identified and used to estimate age-specific fertility. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate age-specific fertility rates for 5-year age groups between ages 15 and 49 years. With extensions to age groups 10–14 and 50–54 years, the total fertility rate (TFR) was then aggregated using the estimated age-specific fertility between ages 10 and 54 years. 7417 sources were used for under-5 mortality estimation and 7355 for adult mortality. ST-GPR was used to synthesise data sources after correction for known biases. Adult mortality was measured as the probability of death between ages 15 and 60 years based on vital registration, sample registration, and sibling histories, and was also estimated using ST-GPR. HIV-free life tables were then estimated using estimates of under-5 and adult mortality rates using a relational model life table system created for GBD, which closely tracks observed age-specific mortality rates from complete vital registration when available. Independent estimates of HIV-specific mortality generated by an epidemiological analysis of HIV prevalence surveys and antenatal clinic serosurveillance and other sources were incorporated into the estimates in countries with large epidemics. Annual and single-year age estimates of net migration and population for each country and territory were generated using a Bayesian hierarchical cohort component model that analysed estimated age-specific fertility and mortality rates along with 1250 censuses and 747 population registry years. We classified location-years into seven categories on the basis of the natural rate of increase in population (calculated by subtracting the crude death rate from the crude birth rate) and the net migration rate. We computed healthy life expectancy (HALE) using years lived with disability (YLDs) per capita, life tables, and standard demographic methods. Uncertainty was propagated throughout the demographic estimation process, including fertility, mortality, and population, with 1000 draw-level estimates produced for each metric. Findings: The global TFR decreased from 2·72 (95% uncertainty interval [UI] 2·66–2·79) in 2000 to 2·31 (2·17–2·46) in 2019. Global annual livebirths increased from 134·5 million (131·5–137·8) in 2000 to a peak of 139·6 million (133·0–146·9) in 2016. Global livebirths then declined to 135·3 million (127·2–144·1) in 2019. Of the 204 countries and territories included in this study, in 2019, 102 had a TFR lower than 2·1, which is considered a good approximation of replacement-level fertility. All countries in sub-Saharan Africa had TFRs above replacement level in 2019 and accounted for 27·1% (95% UI 26·4–27·8) of global livebirths. Global life expectancy at birth increased from 67·2 years (95% UI 66·8–67·6) in 2000 to 73·5 years (72·8–74·3) in 2019. The total number of deaths increased from 50·7 million (49·5–51·9) in 2000 to 56·5 million (53·7–59·2) in 2019. Under-5 deaths declined from 9·6 million (9·1–10·3) in 2000 to 5·0 million (4·3–6·0) in 2019. Global population increased by 25·7%, from 6·2 billion (6·0–6·3) in 2000 to 7·7 billion (7·5–8·0) in 2019. In 2019, 34 countries had negative natural rates of increase; in 17 of these, the population declined because immigration was not sufficient to counteract the negative rate of decline. Globally, HALE increased from 58·6 years (56·1–60·8) in 2000 to 63·5 years (60·8–66·1) in 2019. HALE increased in 202 of 204 countries and territories between 2000 and 2019

Mapping 123 million neonatal, infant and child deaths between 2000 and 2017

Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2—to end preventable child deaths by 2030—we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000–2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations

Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation: As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and developm nt investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens