9 research outputs found
Timing of tectonic events in the AlpujƔrride Complex, Betic Cordillera, southern Spain
<p>ArāAr and fission-track dating from four low-grade sections in the AlpujĆ”rride Complex sheds light on the timing of the early
contractional history of these high-pressure metamorphic units, and their subsequent exhumation during the early Miocene extensional
collapse of the Betic orogen. White mica grains from the lowest-grade rocks yield partly reset detrital ArāAr ages; where
deformation and recrystallization are more intense, however, they yield reproducible ages as old as <em>c</em>. 48 Ma, which we interpret as the approximate timing of the main contractional event and associated high-pressure metamorphism
in these units. Rocks from slightly higher-grade sections give reproducible ArāAr ages between 30 and 40 Ma, but these younger
ages probably reflect the interplay of growth and cooling in fine-grained micas heated to between 300 Ā°C and 400 Ā°C during
prograde metamorphism. In each of the four areas studied the low-grade rocks are separated by an extensional detachment or
shear zone from medium-grade rocks below. In two areas these detachments have been folded around major overturned north-vergent
folds. ArāAr data from structurally below the detachments, and fission-track ages from all structural levels, indicate the
onset of significant cooling in the early Miocene, which corresponds to the age of the extensional event. The folds must therefore
be early Miocene or younger.
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Provenance of Oligocene Andaman sandstones (AndamanāNicobar Islands): GangaāBrahmaputra or Irrawaddy derived?
Sample location (Table A1), the complete petrographic (Table A2), heavy mineral (Table A3) and UāPb zircon-age datasets (Table A4
The unknown complications of M.F.Denton : suffering in the first 11 years after she came to Japan
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Exhumation of the Ronda peridotite and its crustal envelope: constraints from thermal modelling of a <em>P</em>ā<em>T</em>ātime array
<p>The Ronda peridotite in the Betic Cordillera of southern Spain is a relic of the sub-orogenic lithospheric mantle that was
exhumed during earliest Miocene time from about 66 km depth. Overlying crustal rocks show an apparently coherent metamorphic
zonation from high-pressure granulite-facies rocks at the contact to unmetamorphosed rocks 5 km higher in the structural sequence,
indicating drastic tectonic thinning of the whole orogenic crust during exhumation. <em>P</em>ā<em>T</em> paths from the peridotite and its crustal envelope indicate decompression with rising temperature to shallow depths. UāPb
ion microprobe dating of zircon, Ar/Ar dating of hornblende, Ar/Ar laserprobe dating of muscovite and biotite, and fission-track
analysis of zircon and apatite reveal that cooling was extremely rapid in the interval 21.2ā20.4 Ma. One-dimensional thermal
modelling of the array of <em>P</em>ā<em>T</em>ātime paths indicates that an asthenospheric heat source at an initial depth of about 67.5 km is required to explain heating
during exhumation, and that the main period of exhumation lasted 5 Ma, starting at around 25 Ma. Exhumation must therefore
have directly followed removal of most, but not all, of the lithospheric mantle beneath the Betic orogen, and was coeval with
a period of late orogenic extension that profoundly modified the crustal structure and created the present-day Alboran Sea
in the western Mediterranean.
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Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015
Background
Healthy life expectancy (HALE) and disability-adjusted life-years (DALYs) provide summary measures of health across geographies and time that can inform assessments of epidemiological patterns and health system performance, help to prioritise investments in research and development, and monitor progress toward the Sustainable Development Goals (SDGs). We aimed to provide updated HALE and DALYs for geographies worldwide and evaluate how disease burden changes with development.
Methods
We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015) for all-cause mortality, cause-specific mortality, and non-fatal disease burden to derive HALE and DALYs by sex for 195 countries and territories from 1990 to 2015. We calculated DALYs by summing years of life lost (YLLs) and years of life lived with disability (YLDs) for each geography, age group, sex, and year. We estimated HALE using the Sullivan method, which draws from age-specific death rates and YLDs per capita. We then assessed how observed levels of DALYs and HALE differed from expected trends calculated with the Socio-demographic Index (SDI), a composite indicator constructed from measures of income per capita, average years of schooling, and total fertility rate.
Findings
Total global DALYs remained largely unchanged from 1990 to 2015, with decreases in communicable, neonatal, maternal, and nutritional (Group 1) disease DALYs offset by increased DALYs due to non-communicable diseases (NCDs). Much of this epidemiological transition was caused by changes in population growth and ageing, but it was accelerated by widespread improvements in SDI that also correlated strongly with the increasing importance of NCDs. Both total DALYs and age-standardised DALY rates due to most Group 1 causes significantly decreased by 2015, and although total burden climbed for the majority of NCDs, age-standardised DALY rates due to NCDs declined. Nonetheless, age-standardised DALY rates due to several high-burden NCDs (including osteoarthritis, drug use disorders, depression, diabetes, congenital birth defects, and skin, oral, and sense organ diseases) either increased or remained unchanged, leading to increases in their relative ranking in many geographies. From 2005 to 2015, HALE at birth increased by an average of 2Ā·9 years (95% uncertainty interval 2Ā·9ā3Ā·0) for men and 3Ā·5 years (3Ā·4ā3Ā·7) for women, while HALE at age 65 years improved by 0Ā·85 years (0Ā·78ā0Ā·92) and 1Ā·2 years (1Ā·1ā1Ā·3), respectively. Rising SDI was associated with consistently higher HALE and a somewhat smaller proportion of life spent with functional health loss; however, rising SDI was related to increases in total disability. Many countries and territories in central America and eastern sub-Saharan Africa had increasingly lower rates of disease burden than expected given their SDI. At the same time, a subset of geographies recorded a growing gap between observed and expected levels of DALYs, a trend driven mainly by rising burden due to war, interpersonal violence, and various NCDs.
Interpretation
Health is improving globally, but this means more populations are spending more time with functional health loss, an absolute expansion of morbidity. The proportion of life spent in ill health decreases somewhat with increasing SDI, a relative compression of morbidity, which supports continued efforts to elevate personal income, improve education, and limit fertility. Our analysis of DALYs and HALE and their relationship to SDI represents a robust framework on which to benchmark geography-specific health performance and SDG progress. Country-specific drivers of disease burden, particularly for causes with higher-than-expected DALYs, should inform financial and research investments, prevention efforts, health policies, and health system improvement initiatives for all countries along the development continuum.
Funding
Bill & Melinda Gates Foundation
Measuring the health-related Sustainable Development Goals in 188 countries: a baseline analysis from the Global Burden of Disease Study 2015
Background
In September, 2015, the UN General Assembly established the Sustainable Development Goals (SDGs). The SDGs specify 17 universal goals, 169 targets, and 230 indicators leading up to 2030. We provide an analysis of 33 health-related SDG indicators based on the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015).
Methods
We applied statistical methods to systematically compiled data to estimate the performance of 33 health-related SDG indicators for 188 countries from 1990 to 2015. We rescaled each indicator on a scale from 0 (worst observed value between 1990 and 2015) to 100 (best observed). Indices representing all 33 health-related SDG indicators (health-related SDG index), health-related SDG indicators included in the Millennium Development Goals (MDG index), and health-related indicators not included in the MDGs (non-MDG index) were computed as the geometric mean of the rescaled indicators by SDG target. We used spline regressions to examine the relations between the Socio-demographic Index (SDI, a summary measure based on average income per person, educational attainment, and total fertility rate) and each of the health-related SDG indicators and indices.
Findings
In 2015, the median health-related SDG index was 59Ā·3 (95% uncertainty interval 56Ā·8ā61Ā·8) and varied widely by country, ranging from 85Ā·5 (84Ā·2ā86Ā·5) in Iceland to 20Ā·4 (15Ā·4ā24Ā·9) in Central African Republic. SDI was a good predictor of the health-related SDG index (r2=0Ā·88) and the MDG index (r2=0Ā·92), whereas the non-MDG index had a weaker relation with SDI (r2=0Ā·79). Between 2000 and 2015, the health-related SDG index improved by a median of 7Ā·9 (IQR 5Ā·0ā10Ā·4), and gains on the MDG index (a median change of 10Ā·0 [6Ā·7ā13Ā·1]) exceeded that of the non-MDG index (a median change of 5Ā·5 [2Ā·1ā8Ā·9]). Since 2000, pronounced progress occurred for indicators such as met need with modern contraception, under-5 mortality, and neonatal mortality, as well as the indicator for universal health coverage tracer interventions. Moderate improvements were found for indicators such as HIV and tuberculosis incidence, minimal changes for hepatitis B incidence took place, and childhood overweight considerably worsened.
Interpretation
GBD provides an independent, comparable avenue for monitoring progress towards the health-related SDGs. Our analysis not only highlights the importance of income, education, and fertility as drivers of health improvement but also emphasises that investments in these areas alone will not be sufficient. Although considerable progress on the health-related MDG indicators has been made, these gains will need to be sustained and, in many cases, accelerated to achieve the ambitious SDG targets. The minimal improvement in or worsening of health-related indicators beyond the MDGs highlight the need for additional resources to effectively address the expanded scope of the health-related SDGs
Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015
Background
Improving survival and extending the longevity of life for all populations requires timely, robust evidence on local mortality levels and trends. The Global Burden of Disease 2015 Study (GBD 2015) provides a comprehensive assessment of all-cause and cause-specific mortality for 249 causes in 195 countries and territories from 1980 to 2015. These results informed an in-depth investigation of observed and expected mortality patterns based on sociodemographic measures.
Methods
We estimated all-cause mortality by age, sex, geography, and year using an improved analytical approach originally developed for GBD 2013 and GBD 2010. Improvements included refinements to the estimation of child and adult mortality and corresponding uncertainty, parameter selection for under-5 mortality synthesis by spatiotemporal Gaussian process regression, and sibling history data processing. We also expanded the database of vital registration, survey, and census data to 14ā294 geographyāyear datapoints. For GBD 2015, eight causes, including Ebola virus disease, were added to the previous GBD cause list for mortality. We used six modelling approaches to assess cause-specific mortality, with the Cause of Death Ensemble Model (CODEm) generating estimates for most causes. We used a series of novel analyses to systematically quantify the drivers of trends in mortality across geographies. First, we assessed observed and expected levels and trends of cause-specific mortality as they relate to the Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility. Second, we examined factors affecting total mortality patterns through a series of counterfactual scenarios, testing the magnitude by which population growth, population age structures, and epidemiological changes contributed to shifts in mortality. Finally, we attributed changes in life expectancy to changes in cause of death. We documented each step of the GBD 2015 estimation processes, as well as data sources, in accordance with Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER).
Findings
Globally, life expectancy from birth increased from 61Ā·7 years (95% uncertainty interval 61Ā·4ā61Ā·9) in 1980 to 71Ā·8 years (71Ā·5ā72Ā·2) in 2015. Several countries in sub-Saharan Africa had very large gains in life expectancy from 2005 to 2015, rebounding from an era of exceedingly high loss of life due to HIV/AIDS. At the same time, many geographies saw life expectancy stagnate or decline, particularly for men and in countries with rising mortality from war or interpersonal violence. From 2005 to 2015, male life expectancy in Syria dropped by 11Ā·3 years (3Ā·7ā17Ā·4), to 62Ā·6 years (56Ā·5ā70Ā·2). Total deaths increased by 4Ā·1% (2Ā·6ā5Ā·6) from 2005 to 2015, rising to 55Ā·8 million (54Ā·9 million to 56Ā·6 million) in 2015, but age-standardised death rates fell by 17Ā·0% (15Ā·8ā18Ā·1) during this time, underscoring changes in population growth and shifts in global age structures. The result was similar for non-communicable diseases (NCDs), with total deaths from these causes increasing by 14Ā·1% (12Ā·6ā16Ā·0) to 39Ā·8 million (39Ā·2 million to 40Ā·5 million) in 2015, whereas age-standardised rates decreased by 13Ā·1% (11Ā·9ā14Ā·3). Globally, this mortality pattern emerged for several NCDs, including several types of cancer, ischaemic heart disease, cirrhosis, and Alzheimer's disease and other dementias. By contrast, both total deaths and age-standardised death rates due to communicable, maternal, neonatal, and nutritional conditions significantly declined from 2005 to 2015, gains largely attributable to decreases in mortality rates due to HIV/AIDS (42Ā·1%, 39Ā·1ā44Ā·6), malaria (43Ā·1%, 34Ā·7ā51Ā·8), neonatal preterm birth complications (29Ā·8%, 24Ā·8ā34Ā·9), and maternal disorders (29Ā·1%, 19Ā·3ā37Ā·1). Progress was slower for several causes, such as lower respiratory infections and nutritional deficiencies, whereas deaths increased for others, including dengue and drug use disorders. Age-standardised death rates due to injuries significantly declined from 2005 to 2015, yet interpersonal violence and war claimed increasingly more lives in some regions, particularly in the Middle East. In 2015, rotaviral enteritis (rotavirus) was the leading cause of under-5 deaths due to diarrhoea (146ā000 deaths, 118ā000ā183ā000) and pneumococcal pneumonia was the leading cause of under-5 deaths due to lower respiratory infections (393ā000 deaths, 228ā000ā532ā000), although pathogen-specific mortality varied by region. Globally, the effects of population growth, ageing, and changes in age-standardised death rates substantially differed by cause. Our analyses on the expected associations between cause-specific mortality and SDI show the regular shifts in cause of death composition and population age structure with rising SDI. Country patterns of premature mortality (measured as years of life lost [YLLs]) and how they differ from the level expected on the basis of SDI alone revealed distinct but highly heterogeneous patterns by region and country or territory. Ischaemic heart disease, stroke, and diabetes were among the leading causes of YLLs in most regions, but in many cases, intraregional results sharply diverged for ratios of observed and expected YLLs based on SDI. Communicable, maternal, neonatal, and nutritional diseases caused the most YLLs throughout sub-Saharan Africa, with observed YLLs far exceeding expected YLLs for countries in which malaria or HIV/AIDS remained the leading causes of early death.
Interpretation
At the global scale, age-specific mortality has steadily improved over the past 35 years; this pattern of general progress continued in the past decade. Progress has been faster in most countries than expected on the basis of development measured by the SDI. Against this background of progress, some countries have seen falls in life expectancy, and age-standardised death rates for some causes are increasing. Despite progress in reducing age-standardised death rates, population growth and ageing mean that the number of deaths from most non-communicable causes are increasing in most countries, putting increased demands on health systems.
Funding
Bill & Melinda Gates Foundation
Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970ā2016: a systematic analysis for the Global Burden of Disease Study 2016
Background: Detailed assessments of mortality patterns, particularly age-specific mortality, represent a crucial input that enables health systems to target interventions to specific populations. Understanding how all-cause mortality has changed with respect to development status can identify exemplars for best practice. To accomplish this, the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) estimated age-specific and sex-specific all-cause mortality between 1970 and 2016 for 195 countries and territories and at the subnational level for the five countries with a population greater than 200 million in 2016
Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016
Background: As mortality rates decline, life expectancy increases, and populations age, non-fatal outcomes of diseases and injuries are becoming a larger component of the global burden of disease. The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of prevalence, incidence, and years lived with disability (YLDs) for 328 causes in 195 countries and territories from 1990 to 2016