Análisis de los factores internos de las exportaciones de cacao en grano de la Región San Martín durante el período 2016 – 2019

El presente estudio tiene como objetivo identificar los factores internos que influenciaron en las exportaciones de cacao en grano de las cooperativas y asociaciones de la región San Martín durante el período 2016 – 2019. A través de la revisión bibliográfica, se identificó que la asociatividad empresarial, los sistemas de información, la tecnología e infraestructura, y la capacidad gerencial como factores internos que podrían influenciar a las cooperativas y asociaciones en estudio. Cabe mencionar que, estos factores fueron validados por especialistas de la región. Al iniciar la investigación se tenía como hipótesis principal de que existen factores internos que influyen significativamente en las exportaciones de cacao en grano y como objetivo, analizar los principales factores internos del sector en estudio para la región San Martín. Se empleó la metodología CEPAL para demostrar el grado de las exportaciones de cacao en grano de la región, al analizar el período de estudio se identificó que las exportaciones de cacao en grano se encontraban estancadas, reforzando la relevancia del estudio. Para comprobar las hipótesis y objetivos planteados, se aplicó el modelo del análisis factorial, donde se pudo comprobar que la asociatividad empresarial y sistemas de información, como variables que no cumplían con el modelo. Por su lado, la infraestructura y tecnología, y capacidad gerencial demostraron alinearse con los objetivos e hipótesis planteados. Finalmente, se detalla que la asociatividad empresarial y sistemas de información son factores que no se han aplicado correctamente por parte de la asociaciones o cooperativas.The present study aims to identify the internal factors that influenced the exports of cocoa beans from cooperatives and associations in the San Martín region during the period 2016 - 2019. Through the bibliographic review, it was identified that business associativity, information systems, technology and infrastructure, and managerial capacity as internal factors that could influence the cooperatives and associations on this study. It is worth mentioning that these factors were validated by specialists in the region. At the beginning of the investigation, the main hypothesis was that there are internal factors that significantly influence exports of cocoa beans and as an objective, to analyze the main internal factors of the sector under study for the San Martín region. The CEPAL methodology was used to demonstrate the degree of cocoa bean exports from the region. When analyzing the study period, it was identified that cocoa bean exports were stagnant, reinforcing the relevance of the study. ´ To check the hypotheses and objectives, the factor analysis model was applied, where it was possible to verify that the business associativity and information systems, as variables that did not comply with the model. On the other hand, the infrastructure and technology, and managerial capacity demonstrated to be aligned with the objectives and hypotheses raised. Finally, it is detailed that business associativity and information systems are factors that have not been applied correctly by associations or cooperatives.Tesi

The Establishment of Charter Schools: A Guide to Legal Issues for Legislatures

El ritmo de vida de las personas en la actualidad se ha acelerado a tal punto que no cuentan con el tiempo necesario para realizar actividades esenciales. Destacando principalmente la función de cocinar, la cual resulta extenuante debido al engorroso proceso que implica llevarla a cabo. El proceso comprende el traslado al lugar de compra, la búsqueda de los insumos, la selección de los insumos, las largas colas para pagar, el lavado de los insumos así como el picado de los mismos, entre otras. Por ende, se propone una solución alternativa a este problema, la cual consiste en el delivery a través de la venta online de boxes con insumos frescos sin cocinar picados y en las cantidades exactas de diversos platillos criollos.The rhythm of life of the persons at present has hastened to such a point that they do not count with the necessary time to realize essential activities. Emphasizing principally the function to cook, which turns out to be exhausting due to the bothersome process that implies carrying out it. The process comprises the transfer to the place of buy, the search of the inputs, the selection of the inputs, the long tails to pay, the wash of the inputs as well as stung of the same ones, between others. Therefore, an alternative solution to this problem is proposed, which consists of the delivery through the online sale of boxes with fresh uncooked inputs chopped and the exact quantities of various Creole dishes. This paper seeks to determine the financial viability of the project in question in order to validate the possibility of implementing it in a real-world scenario.Trabajo de investigació

Rest-Frame UV-Optical Selected Galaxies at 2.3 ≾ z ≾ 3.5: Searching for Dusty Star-forming and Passively Evolving Galaxies

A new set of color selection criteria (VJL) analogous with the BzK method is designed to select both star-forming galaxies (SFGs) and passively evolving galaxies (PEGs) at 2.3 ≾ z ≾ 3.5 by using rest-frame UV-optical (V – J versus J – L) colors. The criteria are thoroughly tested with theoretical stellar population synthesis models and real galaxies with spectroscopic redshifts to evaluate their efficiency and contamination. We apply the well-tested VJL criteria to the HST/WFC3 Early Release Science field and study the physical properties of selected galaxies. The redshift distribution of selected SFGs peaks at z ~ 2.7, slightly lower than that of Lyman break galaxies at z ~ 3. Comparing the observed mid-infrared fluxes of selected galaxies with the prediction of pure stellar emission, we find that our VJL method is effective at selecting massive dusty SFGs that are missed by the Lyman break technique. About half of the star formation in massive (M_(star) > 10^(10) M_☉) galaxies at 2.3 ≾ z ≾ 3.5 is contributed by dusty (extinction E(B – V) > 0.4) SFGs, which, however, only account for ~20% of the number density of massive SFGs. We also use the mid-infrared fluxes to clean our PEG sample and find that galaxy size can be used as a secondary criterion to effectively eliminate the contamination of dusty SFGs. The redshift distribution of the cleaned PEG sample peaks at z ~ 2.5. We find six PEG candidates at z > 3 and discuss possible methods to distinguish them from dusty contamination. We conclude that at least part of our candidates are real PEGs at z ~ 3, implying that these types of galaxies began to form their stars at z ≳ 5. We measure the integrated stellar mass density (ISMD) of PEGs at z ~ 2.5 and set constraints on it at z > 3. We find that the ISMD grows by at least about a factor of 10 in 1 Gyr at 3 < z <5 and by another factor of 10 in the next 3.5 Gyr (1 < z < 3)

Plan de negocios para determinar la viabilidad econ?mica-financiera del lanzamiento de un instituto dedicado a la educaci?n en especializaci?n de gastronom?a peruana

La determinaci?n de la viabilidad econ?mica y financiera de un instituto gastron?mico permite identificar la posibilidad de establecer una nueva metodolog?a de ense?anza basado en lo vivencial para obtener nuevos conocimientos los cuales permitan el ingreso de nuevos profesionales con pr?cticas e innovaciones ?nicas y as? de esta manera apoyar al incremento del apogeo de la gastronom?a peruana al mercado internacional. La principal caracter?stica del instituto que se busca implementar, es aprovechar los recursos naturales del Per? para ser generador de una fuente de conocimientos gastron?micos los cuales dif?cilmente fueron estudiados. Sumado a ello, esta tesis busca generar una entidad la cual sea portadora de un objetivo clave, y se describe como impulsadora de una identidad del pa?s hacia sus habitantes en el rubro gastron?mico. El instituto tendr? como principal p?blico objetivo la ciudad de Lima, y la ciudad de Ayacucho a primera instancia como el lugar de desarrollo de sus operaciones educativas

Mejora del proceso de disposici?n de productos observados en el ?rea de Aseguramiento de Calidad de una empresa PET usando t?cnicas de machine learning

La industria de empaques r?gidos es un sector altamente competitivo en temas de calidad y precio en el Per? y el mundo. Es por ello, que se requiere que las empresas optimicen el uso de sus recursos para poder ofrecer lo que el mercado demanda. El presente trabajo plantea mejorar el proceso de disposici?n de productos observados en el ?rea de Aseguramiento de Calidad a trav?s de un modelo predictivo, resultante de la aplicaci?n de t?cnicas de machine learning y as? disminuir los tiempos que actualmente se emplean en este proceso. Estas t?cnicas son K-NN (k-Nearest Neighbors), M?quinas de soporte vectorial (SVM), Naive Bayes y ?rbol de decisiones. Para su entrenamiento se us? data hist?rica de los a?os 2021 y 2022 la cual fue tratada y definida en conjunto con los especialistas. Como resultado de la evaluaci?n del Accuracy de cada modelo, se pudo concluir que el m?s preciso es el ?rbol de decisiones, la cual podr? ser aplicada a futuro en la empresa para contribuir con la mejora del proceso

A Meta-Analysis of Array-CGH Studies Implicates Antiviral Immunity Pathways in the Development of Hepatocellular Carcinoma

BACKGROUND: The development and progression of hepatocellular carcinoma (HCC) is significantly correlated to the accumulation of genomic alterations. Array-based comparative genomic hybridization (array CGH) has been applied to a wide range of tumors including HCCs for the genome-wide high resolution screening of DNA copy number changes. However, the relevant chromosomal variations that play a central role in the development of HCC still are not fully elucidated. METHODS: In present study, in order to further characterize the copy number alterations (CNAs) important to HCC development, we conducted a meta-analysis of four published independent array-CGH datasets including total 159 samples. RESULTS: Eighty five significant gains (frequency ≥ 25%) were mostly mapped to five broad chromosomal regions including 1q, 6p, 8q, 17q and 20p, as well as two narrow regions 5p15.33 and 9q34.2-34.3. Eighty eight significant losses (frequency ≥ 25%) were most frequently present in 4q, 6q, 8p, 9p, 13q, 14q, 16q, and 17p. Significant correlations existed between chromosomal aberrations either located on the same chromosome or the different chromosomes. HCCs with different etiologies largely exhibited surprisingly similar profiles of chromosomal aberrations with only a few exceptions. Furthermore, the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis indicated that the genes affected by these chromosomal aberrations were significantly enriched in 31 canonical pathways with the highest enrichment observed for antiviral immunity pathways. CONCLUSIONS: Taken together, our findings provide novel and important clues for the implications of antiviral immunity-related gene pathways in the pathogenesis and progression of HCC

Recapitulating the tumor ecosystem along the metastatic cascade using 3D culture models

Advances in cancer research have shown that a tumor can be likened to a foreign species that disrupts delicately balanced ecological interactions, compromising the survival of normal tissue ecosystems. In efforts to mitigate tumor expansion and metastasis, experimental approaches from ecology are becoming more frequently and successfully applied by researchers from diverse disciplines to reverse engineer and re-engineer biological systems in order to normalize the tumor ecosystem. We present a review on the use of 3D biomimetic platforms to recapitulate biotic and abiotic components of the tumor ecosystem, in efforts to delineate the underlying mechanisms that drive evolution of tumor heterogeneity, tumor dissemination, and acquisition of drug resistance.ope

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

Background: Estimates 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. Methods: 22 223 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. Findings: Global 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. Interpretation: Global 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

Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background: Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021. Methods: The GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 risk–outcome pairs. Pairs were included on the basis of data-driven determination of a risk–outcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each risk–outcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attributable fraction (PAF; ie, the proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL). The product of PAFs and disease burden associated with a given outcome, measured in disability-adjusted life-years (DALYs), yielded measures of attributable burden (ie, the proportion of total disease burden attributable to a particular risk factor or combination of risk factors). Adjustments for mediation were applied to account for relationships involving risk factors that act indirectly on outcomes via intermediate risks. Attributable burden estimates were stratified by Socio-demographic Index (SDI) quintile and presented as counts, age-standardised rates, and rankings. To complement estimates of RR and attributable burden, newly developed burden of proof risk function (BPRF) methods were applied to yield supplementary, conservative interpretations of risk–outcome associations based on the consistency of underlying evidence, accounting for unexplained heterogeneity between input data from different studies. Estimates reported represent the mean value across 500 draws from the estimate's distribution, with 95% uncertainty intervals (UIs) calculated as the 2·5th and 97·5th percentile values across the draws. Findings: Among the specific risk factors analysed for this study, particulate matter air pollution was the leading contributor to the global disease burden in 2021, contributing 8·0% (95% UI 6·7–9·4) of total DALYs, followed by high systolic blood pressure (SBP; 7·8% [6·4–9·2]), smoking (5·7% [4·7–6·8]), low birthweight and short gestation (5·6% [4·8–6·3]), and high fasting plasma glucose (FPG; 5·4% [4·8–6·0]). For younger demographics (ie, those aged 0–4 years and 5–14 years), risks such as low birthweight and short gestation and unsafe water, sanitation, and handwashing (WaSH) were among the leading risk factors, while for older age groups, metabolic risks such as high SBP, high body-mass index (BMI), high FPG, and high LDL cholesterol had a greater impact. From 2000 to 2021, there was an observable shift in global health challenges, marked by a decline in the number of all-age DALYs broadly attributable to behavioural risks (decrease of 20·7% [13·9–27·7]) and environmental and occupational risks (decrease of 22·0% [15·5–28·8]), coupled with a 49·4% (42·3–56·9) increase in DALYs attributable to metabolic risks, all reflecting ageing populations and changing lifestyles on a global scale. Age-standardised global DALY rates attributable to high BMI and high FPG rose considerably (15·7% [9·9–21·7] for high BMI and 7·9% [3·3–12·9] for high FPG) over this period, with exposure to these risks increasing annually at rates of 1·8% (1·6–1·9) for high BMI and 1·3% (1·1–1·5) for high FPG. By contrast, the global risk-attributable burden and exposure to many other risk factors declined, notably for risks such as child growth failure and unsafe water source, with age-standardised attributable DALYs decreasing by 71·5% (64·4–78·8) for child growth failure and 66·3% (60·2–72·0) for unsafe water source. We separated risk factors into three groups according to trajectory over time: those with a decreasing attributable burden, due largely to declining risk exposure (eg, diet high in trans-fat and household air pollution) but also to proportionally smaller child and youth populations (eg, child and maternal malnutrition); those for which the burden increased moderately in spite of declining risk exposure, due largely to population ageing (eg, smoking); and those for which the burden increased considerably due to both increasing risk exposure and population ageing (eg, ambient particulate matter air pollution, high BMI, high FPG, and high SBP). Interpretation: Substantial progress has been made in reducing the global disease burden attributable to a range of risk factors, particularly those related to maternal and child health, WaSH, and household air pollution. Maintaining efforts to minimise the impact of these risk factors, especially in low SDI locations, is necessary to sustain progress. Successes in moderating the smoking-related burden by reducing risk exposure highlight the need to advance policies that reduce exposure to other leading risk factors such as ambient particulate matter air pollution and high SBP. Troubling increases in high FPG, high BMI, and other risk factors related to obesity and metabolic syndrome indicate an urgent need to identify and implement interventions

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

BACKGROUND: Estimates 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. METHODS: 22 223 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. FINDINGS: Global 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. INTERPRETATION: Global 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. FUNDING: Bill & Melinda Gates Foundation