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

New physics searches at the high luminosity LHC

This thesis studies the x˜₁± x˜₁∓ [± and ∓ are superscript] and ℓ˜± ℓ˜∓ [± and ∓ are superscript] production processes in an upgraded LHC environment at √ŝ = 14 TeV. The Super Razor variables will be employed to obtain kinematic information and separate these Supersymmetric production processes from Standard Model background with identical final state topology. The analysis will be done using Monte Carlo generated data of events where truth-level information will be smeared to simulate the Phase-I and Phase-II ATLAS detector.Thesis (M.Phil..) -- University of Adelaide, School of Physical Science, 201

Suresh Amonkar. Globalization of Goa in the Light of Fr. Thomas Stephens’ Christa Purana. Panjim: Directorate of Art and Culture, Government of Goa, 2017

Book Revie

A Strategic Review on Carbon Quantum Dots for Cancer-Diagnostics and Treatment

The understanding of the genesis of life-threatening cancer and its invasion calls for urgent development of novel technologies for real-time observations, early diagnosis, and treatment. Quantum dots (QDs) grabbed the spotlight in oncology owing to their excellent photostability, bright fluorescence, high biocompatibility, good electrical and chemical stability with minimum invasiveness. Recently, carbon QDs (CQDs) have become popular over toxic inorganic QDs in the area of bioimaging, biosensing, and drug delivery. Further, CQDs derived from natural sources like biomolecules and medicinal plants have drawn attention because of their one-pot, low-cost and ease of synthesis, along with remarkable tunable optical properties and biocompatibility. This review introduces the synthesis and properties of CQDs derived from natural sources, focusing on the applicability of CQD-based technologies as nano-theranostics for the diagnosis and treatment of cancer. Furthermore, the current issues and future directions for the transformation of CQDs-based nanotechnologies to clinical applications are highlighted

Solid Electrolyte–Cathode Interface Dictates Reaction Heterogeneity and Anode Stability

Solid-state batteries (SSBs) employing a lithium metal anode are a promising candidate for next-generation energy storage systems, delivering higher power and energy densities. Interfacial instabilities due to non-uniform electrodeposition at the anode–solid electrolyte (SE) interface pose major constraints on the safety and endurance of SSBs. In this regard, non-uniform kinetic interactions at the anode–SE interface which are derived from cathode microstructural heterogeneity can have significant impact on anode stability. In this work, we present a comprehensive insight into microstructural heterogeneity-driven cathode–anode cross-talk and delineate the role of cathode architecture and SE separator design in dictating reaction heterogeneity at the anode–SE interface. We show that intrinsic and extrinsic parameters, such as cathode loading, separator thickness, particle morphologies of active material and SE, and temperature can have significant impact on reaction heterogeneity at the anode–SE interface and thus govern anode stability. Tradeoff between energy density and anode stability while achieving higher cathode loading and thinner SE separators is highlighted, and potential strategies to mitigate this problem are discussed. This work provides fundamental insights into cathode–anode cross-talk involving interfacial heterogeneities and enhancement in energy densities of SSBs via electrode engineering

A REVIEW ON - SOLAR CONCENTRATORS, PERFORMANCE OF SOLAR COLLECTORS & ENERGY STORAGE

Parabolic trough concentrators are one type of concentrators which reflects the sunlight on the receiver (Line type) and gives us wet steam for water. It can be tried with any type of fluid. Presently solar collectors are used for residential and commercial use. These solar collectors require high maintenance and high installation cost, solar concentrators help us in these disadvantages. This review paper concentrates on solar concentrators and various fluids that can be used in receiver. It also focuses on surface shape measurement of solar concentrator in solar thermal power application. In order to capture maximum amount of solar energy it is required to orient the concentrator as per the position of the sun i.e. tracking is required .However some of the concentrators do not track and are referred as fixed concentrators. The objective of the project is to track the receiver instead of solar concentrator

A Review on - Solar Concentrators, Performance of Solar Collectors & Energy Storage

Parabolic trough concentrators are one type of concentrators which reflects the sunlight on the receiver (Line type) and gives us wet steam for water. It can be tried with any type of fluid. Presently solar collectors are used for residential and commercial use. These solar collectors require high maintenance and high installation cost, solar concentrators help us in these disadvantages. This review paper concentrates on solar concentrators and various fluids that can be used in receiver. It also focuses on surface shape measurement of solar concentrator in solar thermal power application. In order to capture maximum amount of solar energy it is required to orient the concentrator as per the position of the sun i.e. tracking is required .However some of the concentrators do not track and are referred as fixed concentrators. The objective of the project is to track the receiver instead of solar concentrator

Indian Monsoon Rainfall

International Ocean Discovery Program (IODP) Expedition 353 (29 November 2014–29 January 2015) drilled six sites in the Bay of Bengal, recovering 4280 m of sediments during 32.9 days of on-site drilling. Recovery averaged 97%, including coring with the advanced piston corer, half-length advanced piston corer, and extended core barrel systems. The primary objective of Expedition 353 is to reconstruct changes in Indian monsoon circulation since the Miocene at tectonic to centennial timescales. Analysis of the sediment sections recovered will improve our understanding of how monsoonal climates respond to changes in forcing external to the Earth’s climate system (i.e., insolation) and changes in forcing internal to the Earth’s climate system, including changes in continental ice volume, greenhouse gases, sea level, and the ocean-atmosphere exchange of energy and moisture. All of these mechanisms play critical roles in current and future climate change in monsoonal regions. The primary signal targeted is the exceptionally low salinity surface waters that result, in roughly equal measure, from both direct summer monsoon precipitation to the Bay of Bengal and runoff from the numerous large river basins that drain into the Bay of Bengal. Changes in rainfall and surface ocean salinity are captured and preserved in a number of chemical, physical, isotopic, and biological components of sediments deposited in the Bay of Bengal. Expedition 353 sites are strategically located in key regions where these signals are the strongest and best preserved. Salinity changes at IODP Sites U1445 and U1446 (northeast Indian margin) result from direct precipitation as well as runoff from the Ganges-Brahmaputra river complex and the many river basins of peninsular India. Salinity changes at IODP Sites U1447 and U1448 (Andaman Sea) result from direct precipitation and runoff from the Irrawaddy and Salween river basins. IODP Site U1443 (Ninetyeast Ridge) is an open-ocean site with a modern surface water salinity very near the global mean but is documented to have recorded changes in monsoonal circulation over orbital to tectonic timescales. This site serves as an anchor for establishing the extent to which the north to south (19°N to 5°N) salinity gradient changes over time

International ocean discovery program expedition 353 preliminary report Indian Monsoon Rainfall

International Ocean Discovery Program (IODP) Expedition 353 (29 November 2014-29 January 2015) drilled six sites in the Bay of Bengal, recovering 4280 m of sediments during 32.9 days of on-site drilling. Recovery averaged 97%, including coring with the advanced piston corer, half-length advanced piston corer, and extended core barrel systems. The primary objective of Expedition 353 is to reconstruct changes in Indian monsoon circulation since the Miocene at tectonic to centennial timescales. Analysis of the sediment sections recovered will improve our understanding of how monsoonal climates respond to changes in forcing external to the Earth's climate system (i.e., insolation) and changes in forcing internal to the Earth's climate system, including changes in continental ice volume, greenhouse gases, sea level, and the ocean-atmosphere exchange of energy and moisture. All of these mechanisms play critical roles in current and future climate change in monsoonal regions. The primary signal targeted is the exceptionally low salinity surface waters that result, in roughly equal measure, from both direct summer monsoon precipitation to the Bay of Bengal and runoff from the numerous large river basins that drain into the Bay of Bengal. Changes in rainfall and surface ocean salinity are captured and preserved in a number of chemical, physical, isotopic, and biological components of sediments deposited in the Bay of Bengal. Expedition 353 sites are strategically located in key regions where these signals are the strongest and best preserved. Salinity changes at IODP Sites U1445 and U1446 (northeast Indian margin) result from direct precipitation as well as runoff from the Ganges-Brahmaputra river complex and the many river basins of peninsular India. Salinity changes at IODP Sites U1447 and U1448 (Andaman Sea) result from direct precipitation and runoff from the Irrawaddy and Sal-ween river basins. IODP Site U1443 (Ninetyeast Ridge) is an open-ocean site with a modern surface water salinity very near the global mean but is documented to have recorded changes in monsoonal circulation over orbital to tectonic timescales. This site serves as an anchor for establishing the extent to which the north to south (19°N to 5°N) salinity gradient changes over time

Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

BackgroundEstimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period.Methods22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution.FindingsGlobal all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations.InterpretationGlobal adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic