Stock assessment of juvenile sturgeons in the Iranian water of the Caspian Sea by bottom trawl survey

The sturgeon stock assessment was performed to aim at estimation of absolute and relative abundance and determination of species composition at lower 10 m depths using the Si-Sara2 RV vessel in the Iranian coasts of the Caspian Sea in Guilan, Mazandaran and Golestan provinces during 6-30 September 2011-2012. In this study, 40 stations were selected on the basis of stratified random sampling design and then the stock estimation was performed using the swept area method. The study was carried out using bottom trawling with 9 m head rope. The time and speed of trawling in each station were 30 minutes and 2.5 knots respectively. The Catch per Unit of Effort (CPUE) in 2011–2012 were 7.03 and 6.96 individuals per trawling, respectively. The catch per unit of area in these years were found to be 1662 and 1644 fish in nm2, respectively.Total abundance of sturgeon juveniles was 13,327,164 individuals in 2011. So, the species composition included A. persicus (87.8%) and A. stellatus (12.2%). Total abundance of sturgeon juveniles was found to be 14,364,882 individuals in 2012 and the species composition comprised A. persicus (61.4%) and A. stellatus (38.6%). In 2011 the biomass of sturgeons in Iranian coastal water of the Caspian Sea was 295 tons and the composition of biomass included A. persicus (81.5%) and A. stellatus (18.5%), respectively. In the cruises conducted in 2011, this amount was estimated to be 217 tons comprising A. persicus (54.2%) and A. stellatus (45.8%), respectively. The results of this study in 2011–2012 showed remarkable abundance of juvenile sturgeons in Iranian coastal waters of the Caspian Sea in late summer and early autumn. So, by conserving these valuable stocks, the number of spawners will be increased in the future

Stock assessment of Acipenser persicus in the southern Caspian Sea, 2008-2009

Species composition, relative abundance, absolute abundance and biomass of sturgeon species were studied during the years 2008-2009. Eighty five stations were covered in the stratified random sampling design in depths less than 10m using 9m bottom trawl (head line) and in depths more than 10m using 24.7m bottom trawl (head line). More than 70 specimens of Acipenser persicus were caught during the effort. CPUE decreased from 0.4 to 0.24 specimens per trawl in 2009. The mean total length of the A. persicus was 47.3 ±29.1cm and 61.9 ±28.7cm in 2008 to 2009, respectively. The smallest size of A. persicus was 9cm in 2008 and 24.5cm in 2009, while the maximum size was 102.5cm in 2008 and 126.5 ±29cm in 2009. The mean total weight in 2009 in comparison with 2008 increased from 989(3-5000g) to 1569(42-7100g). Absolute abundance of A. persicus decreased from 2006000 specimens in 2008 to 1192000 specimens in 2009. The estimated biomass was 2010 and 1878 tons in 2008 and 2009, respectively. According to the results of study, the stock status of A. persicus is highly critical in the Caspian Sea and a timely decision has to be taken for conservation of the species

Efficiency of gillnets with 170mm mesh size in reduction of immature Persian sturgeon, Acipenser persicus, catch

This study was carried out in Turkmen fishing station to examine suitable mesh size of gill nets for Persian sturgeon, Acipenser persicus, to decrease possibility of catching immature specimens and increase catch likelihood for larger fish. The Holt model was used to determine suitable length for catch and selection of mature Persian sturgeon females. Following preliminary studies some 920 experimental gill nets (mesh size 170mm) similar to those generally used by Iranian Fisheries except for mesh size (150mm) were set up in the Caspian Sea. During the experimental period, 128 and 110 sturgeons were caught in control and experimental nets, respectively. Out of those caught in control nets, 63 specimens were Persian sturgeon (49.2%), 57 were Stellate sturgeon, Acipenser stellatus (44.5%) while in the experimental nets, 95 specimens (86.4%) were Persian sturgeon and 7 specimens (6.4%) were Stellate sturgeon. Regarding maturity status of fishes, 42 Persian sturgeon caught in control nets were mature females while this figure was 83 (87.4%) in experimental nets. Mean fork length of the Persian sturgeon was 152.9±13.8cm and 162.4±13.6cm in control and experimental nets, respectively. The mean caviar yield of the Persian sturgeon in control nets was 6.4±1.7 kg and in experimental nets was 7.4±1.9kg. One way ANOVA and Tukey’s test showed significant differences between factors like age, mean caviar yield and fork length of the Persian sturgeon caught in control and experimental nets. The results showed increasing mesh size of gill nets to 170mm for the Persian sturgeon may help achieving objectives of stock managements including decrease in catch of immature fish and increase in catch of mature and larger sturgeons which can secure optimum and sustainable stock yield

Study on biology (age, feeding and, reproductive) of (Cyprinus carpio, Linnaeus 1758) in south coastal line Caspian Sea (Iranian waters)

The Caspian Sea is the biggest lacustrine water source. Common carp is very important commercially in south coastal line of Iranian Caspian Sea waters, especially in east coastal line, because eighty percent annual catch of this species has been caught in this area in particular. Despite the common carp importance and value in Iran, but there is a little information about its biology in natural system. This study is comprehensive research on reproduction, growth and feeding. The specimens were caught by beach seine net in coastal line of Iranian waters. The fork length ranged between 5.6 and 2866.2 g. The b value of the length-weight relationship ranged from 2.843 to 2.924 for female and male, respectively. The age composition of the specimens was from 1 to 11 year. The Gonadosomatic ratio (GSR) changed from 2 to 12. There were two peaks of GSR in April and December, so that the latter peak was much shorter than the first that. Fecundity variations were high and ranged 77448 to 430745 eggs. It observed linear significant correlation in fecundity- weight (r=0.98) and fecundity-length (r=0.88) relationships. Average growth in length was described with the Von Bertalanffy growth model: L (t) = 60.5(1-exp (0.19(t-0.65). The percent of empty stomach and prey dominant evaluated during different seasons by specific formula result showed that in Cyprinus carpio prey Molluscs was dominated and specific food items. Empty stomachs in winter and spring were higher and lower, respectively

Investigation of CTNNB1 gene mutations and expression in hepatocellular carcinoma and cirrhosis in association with hepatitis B virus infection

Hepatitis B virus (HBV), along with Hepatitis C virus chronic infection, represents a major risk factor for hepatocellular carcinoma (HCC) development. However, molecular mechanisms involved in the development of HCC are not yet completely understood. Recent studies have indicated that mutations in CTNNB1 gene encoding for β-catenin protein lead to aberrant activation of the Wnt/ β-catenin pathway. The mutations in turn activate several downstream genes, including c-Myc, promoting the neoplastic process. The present study evaluated the mutational profile of the CTNNB1 gene and expression levels of CTNNB1 and c-Myc genes in HBV-related HCC, as well as in cirrhotic and control tissues. Mutational analysis of the β-catenin gene and HBV genotyping were conducted by direct sequencing. Expression of β-catenin and c-Myc genes was assessed using real-time PCR. Among the HCC cases, 18.1 showed missense point mutation in exon 3 of CTNNB1, more frequently in codons 32, 33, 38 and 45. The frequency of mutation in the hotspots of exon 3 was significantly higher in non-viral HCCs (29.4) rather than HBV-related cases (12.7, P = 0.021). The expression of β-catenin and c-Myc genes was found upregulated in cirrhotic tissues in association with HBV infection. Mutations at both phosphorylation and neighboring sites were associated with increased activity of the Wnt pathway. The results demonstrated that mutated β-catenin caused activation of the Wnt pathway, but the rate of CTNNB1 gene mutations was not related to HBV infection. HBV factors may deregulate the Wnt pathway by causing epigenetic alterations in the HBV-related HCC. © 2020 The Author(s)

Stock assessment of sturgeon fishes in the southern part of Caspian Sea (Iranian water)

The marine survey for sturgeon stock assessment was conducted in summer, winter and spring in the years 2006 and 2009 to estimate the relative and absolute abundance and percentage composition of each species in the Guilan, Mazandaran and Golestan Provinces. This survey was carried out in the Iranian waters of the Caspian Sea on board the Sisara2 and Guilan vessels using trawl nets at 2-100 m depths. Trawling was carried out in 85 stations that were selected using a stratified random design. The number of stations in each scope was based on the area of the scope in terms of the total area. Trawling and sampling in shallow water up to 10 m were carried out using 9 m trawl nets whereas 24.7 m trawl nets were used for depths more than 10 m. Trawl surveys were carried out in the daytime. Trawling velocity was kept at 2.5-3 kts and trawls lasted half an hour in order to calculate abundance, and biomass of sturgeons using the swept area method. Catch per unit area (CPUA) in the winter 2006 survey was 3853 specimens nm^2 , in the summer and winter 2007 survey was 1854 , 2912 specimens nm^2 at depths less than 10 m respectively . CPUA for sturgeons in spring 2008 survey was 2103 specimens nm2 at depths less than 10 m and 393 specimens nm2 at depths greater than 10 m (10-100 m depth). These values in the winter 2008 survey dropped to 44 specimens nm^2 at depths at depths above 10 m. CPUA for sturgeons in the spring 2009 survey was 300 specimens nm^2 at depths less than 10 m and 307 specimens nm^2 at depths greater than 10 m. In all the surveys conducted CPUA for A. persicus was higher than that for the other sturgeon species. Based on the calculations carried out in the marine survey in winter 2006 the estimated absolute abundance for sturgeons was about 2977.363 thousand. The total biomass of sturgeon was estimated as 131.713 tons. In the summer 2007 survey total abundance was estimated 1432.398 thousand, and total biomass of sturgeons was estimated at about 312.161 tons. In the winter 2007 survey total abundance for sturgeons was estimated at about 2250.105 thousand, and total biomass was estimated 578.08 tons. In the spring 2008 survey total abundance was estimated at about 3002.832 thousand. The total biomass was estimated at about 2533.318 tons .In the winter 2008 survey total abundance was estimated at about 152.722 thousand, and total biomass in winter 2008 was estimated 170.540 tons. Total abundance in spring 2009 survey was 1310.232 thousand and total biomass was estimated at 2019.tons. Investigation of stomach content of sturgeon Acipenser persicus caught under 10m depth in 2006 to 2007 surveys showed that there is significant difference in the consumed food. Polychaeta is the major food consumed and crustacean an the minor one(P>0.05).Also no new types of food( such as bony fishes or benthic) have been observed in food chain of Acipenser persicus only the food consumption rate has been related to the season of year and increases or decreases in warm or cold seasons, respectively For physiological study and determination of sexual maturation stages in sturgeon,119 gonad sampling prepared. The results showed that 63 % of fishes were females and 37 % of them were males. Gill microscopic study shows complications such as hyperplasia, curvature, adhesion, embowed, shorting and lengthen of secondary filaments and fraught bloody. Microscopic study on liver indicates signs of cloudy inflammation, fatty degeneration, dispersion of billed secretions and cell atrophy. The population genetic structure of Persian sturgeon (Acipenser persicus) in Sefidrood and Gorganrood rivers watershed analyzed based on microsatellite markers during sturgeons assessment in 2006-2008. Results showed that Acipenser persicus in two region of south part of Caspian Sea are two independent populations

National guidelines for cognitive assessment and rehabilitation of Iranian traumatic brain injury patients

Background: Individuals with moderate to severe traumatic brain injury (TBI) often have prolonged cognitive impairments, resulting in long-term problems with their real-life activities. Given the urgent need for evidence-based recommendations for neuropsychological management of Iranian TBI patients, the current work aimed to adapt eligible international guidelines for cognitive assessment and rehabilitation of the TBI patients in Iran. Methods: The project was led by an executive committee, under the supervision of the Iranian Ministry of Health and Medical Education (MOHME). Following a systematic literature search and selection process, four guidelines were included for adaptation. Clinical recommendations of the source guidelines were tabulated as possible clinical scenarios for 90 PICO clinical questions covering all relevant phases of care. After summing up the scenarios, our initial list of recommendations was drafted according to the Iranian patients� conditions. The final decision-making, with the contribution of a national interdisciplinary panel of 37 experts from across the country, was conducted in two rounds using online and offline survey forms (Round 1), and face-to-face and telephone meetings (Round 2). Results: A total of 63 recommendations in six sections were included in the final list of recommendations, among which 24 were considered as key recommendations. In addition, some of the recommendations were identified as fundamental, meaning that proper implementation of the other recommendations is largely dependent on their implementation. Conclusion: Iranian health policy makers and rehabilitation program managers are recommended to address some fundamental issues to provide the necessary infrastructure to set up an efficient cognitive rehabilitation service system. © 2020 Academy of Medical Sciences of I.R. Iran. All rights reserved

The global burden of cancer attributable to risk factors, 2010–19: a systematic analysis for the Global Burden of Disease Study 2019

BACKGROUND: Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. METHODS: The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk–outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. FINDINGS: Globally, in 2019, the risk factors included in this analysis accounted for 4·45 million (95% uncertainty interval 4·01–4·94) deaths and 105 million (95·0–116) DALYs for both sexes combined, representing 44·4% (41·3–48·4) of all cancer deaths and 42·0% (39·1–45·6) of all DALYs. There were 2·88 million (2·60–3·18) risk-attributable cancer deaths in males (50·6% [47·8–54·1] of all male cancer deaths) and 1·58 million (1·36–1·84) risk-attributable cancer deaths in females (36·3% [32·5–41·3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20·4% (12·6–28·4) and DALYs by 16·8% (8·8–25·0), with the greatest percentage increase in metabolic risks (34·7% [27·9–42·8] and 33·3% [25·8–42·0]). INTERPRETATION: The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden

Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background: Detailed, comprehensive, and timely reporting on population health by underlying causes of disability and premature death is crucial to understanding and responding to complex patterns of disease and injury burden over time and across age groups, sexes, and locations. The availability of disease burden estimates can promote evidence-based interventions that enable public health researchers, policy makers, and other professionals to implement strategies that can mitigate diseases. It can also facilitate more rigorous monitoring of progress towards national and international health targets, such as the Sustainable Development Goals. For three decades, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) has filled that need. A global network of collaborators contributed to the production of GBD 2021 by providing, reviewing, and analysing all available data. GBD estimates are updated routinely with additional data and refined analytical methods. GBD 2021 presents, for the first time, estimates of health loss due to the COVID-19 pandemic. Methods: The GBD 2021 disease and injury burden analysis estimated years lived with disability (YLDs), years of life lost (YLLs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries using 100 983 data sources. Data were extracted from vital registration systems, verbal autopsies, censuses, household surveys, disease-specific registries, health service contact data, and other sources. YLDs were calculated by multiplying cause-age-sex-location-year-specific prevalence of sequelae by their respective disability weights, for each disease and injury. YLLs were calculated by multiplying cause-age-sex-location-year-specific deaths by the standard life expectancy at the age that death occurred. DALYs were calculated by summing YLDs and YLLs. HALE estimates were produced using YLDs per capita and age-specific mortality rates by location, age, sex, year, and cause. 95% uncertainty intervals (UIs) were generated for all final estimates as the 2·5th and 97·5th percentiles values of 500 draws. Uncertainty was propagated at each step of the estimation process. Counts and age-standardised rates were calculated globally, for seven super-regions, 21 regions, 204 countries and territories (including 21 countries with subnational locations), and 811 subnational locations, from 1990 to 2021. Here we report data for 2010 to 2021 to highlight trends in disease burden over the past decade and through the first 2 years of the COVID-19 pandemic. Findings: Global DALYs increased from 2·63 billion (95% UI 2·44–2·85) in 2010 to 2·88 billion (2·64–3·15) in 2021 for all causes combined. Much of this increase in the number of DALYs was due to population growth and ageing, as indicated by a decrease in global age-standardised all-cause DALY rates of 14·2% (95% UI 10·7–17·3) between 2010 and 2019. Notably, however, this decrease in rates reversed during the first 2 years of the COVID-19 pandemic, with increases in global age-standardised all-cause DALY rates since 2019 of 4·1% (1·8–6·3) in 2020 and 7·2% (4·7–10·0) in 2021. In 2021, COVID-19 was the leading cause of DALYs globally (212·0 million [198·0–234·5] DALYs), followed by ischaemic heart disease (188·3 million [176·7–198·3]), neonatal disorders (186·3 million [162·3–214·9]), and stroke (160·4 million [148·0–171·7]). However, notable health gains were seen among other leading communicable, maternal, neonatal, and nutritional (CMNN) diseases. Globally between 2010 and 2021, the age-standardised DALY rates for HIV/AIDS decreased by 47·8% (43·3–51·7) and for diarrhoeal diseases decreased by 47·0% (39·9–52·9). Non-communicable diseases contributed 1·73 billion (95% UI 1·54–1·94) DALYs in 2021, with a decrease in age-standardised DALY rates since 2010 of 6·4% (95% UI 3·5–9·5). Between 2010 and 2021, among the 25 leading Level 3 causes, age-standardised DALY rates increased most substantially for anxiety disorders (16·7% [14·0–19·8]), depressive disorders (16·4% [11·9–21·3]), and diabetes (14·0% [10·0–17·4]). Age-standardised DALY rates due to injuries decreased globally by 24·0% (20·7–27·2) between 2010 and 2021, although improvements were not uniform across locations, ages, and sexes. Globally, HALE at birth improved slightly, from 61·3 years (58·6–63·6) in 2010 to 62·2 years (59·4–64·7) in 2021. However, despite this overall increase, HALE decreased by 2·2% (1·6–2·9) between 2019 and 2021. Interpretation: Putting the COVID-19 pandemic in the context of a mutually exclusive and collectively exhaustive list of causes of health loss is crucial to understanding its impact and ensuring that health funding and policy address needs at both local and global levels through cost-effective and evidence-based interventions. A global epidemiological transition remains underway. Our findings suggest that prioritising non-communicable disease prevention and treatment policies, as well as strengthening health systems, continues to be crucially important. The progress on reducing the burden of CMNN diseases must not stall; although global trends are improving, the burden of CMNN diseases remains unacceptably high. Evidence-based interventions will help save the lives of young children and mothers and improve the overall health and economic conditions of societies across the world. Governments and multilateral organisations should prioritise pandemic preparedness planning alongside efforts to reduce the burden of diseases and injuries that will strain resources in the coming decades. Funding: Bill & Melinda Gates Foundation

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