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1,167 results on '"Naik N."'

156. A Dual control strategy for improved power quality in grid-tied off-board bidirectional electric vehicle charger.

Author

Behera, Satyabrata, Naik N, Venkata Ramana, Panda, Anup Kumar, and Behera, Sameer Kumar

Subjects
*ELECTRIC vehicle charging stations, *BRIDGE circuits, *COST functions, *DC-to-DC converters, *POWER resources
Abstract

• The paper presents a novel dual control strategy combining Adaptive Model Predictive Direct Power Control (AMP-DPC) for the grid-side converter (GSC) and Adaptive Direct Power Control (ADPC) for the Dual Active Bridge (DAB) converter. • The proposed control strategy significantly improves power quality, ensuring a near-unity power factor (0.9897 during charging and 0.9898 during discharging) and reducing Total Harmonic Distortion (THD) from 29.301 % to 2.008 %. • Comparative analysis with conventional VDPC strategy shows that the proposed ADPC strategy converges faster (8 ms vs. 12 ms for load decrease and 7 ms vs. 10 ms for load increase) with lower voltage peaks and dips, demonstrating its superior stability and efficiency. • The control strategy effectively manages various operating modes, including Grid-to-Vehicle (G2V), Vehicle-to-Grid (V2G), and Vehicle-to-Load (V2L), ensuring continuous power exchange and maintaining uninterrupted power supply (UPS) to connected loads. • The effectiveness of the proposed control strategy is validated through experimental testing on a 0.5 kW off-board EVC prototype, demonstrating practical feasibility and robustness in various conditions. Electric vehicle (EV) chargers face significant challenges in maintaining grid power quality (PQ) and ensuring efficient power management during grid-to-vehicle (G2V) and vehicle-to-grid (V2G) operations. Additionally, they must seamlessly switch to vehicle-to-load (V2L) mode during grid disturbances to provide uninterrupted power supply (UPS) for domestic loads. This article explores a dual control approach incorporating adaptive model predictive direct power control (AMP-DPC) on the rectifier side and adaptive direct power control (ADPC) on the dual active bridge (DAB) side to address these challenges. The AMP-DPC employs a control strategy referred to the second-order generalized integrator (SOGI) which estimate synchronizing voltage templates specifically designed for single-phase systems. The proposed optimization control aims to mitigate the cost function value by selecting appropriate switching modes. The optimized function is independent of the weighting factor, expressing the optimal modulation function across various weighting factors without additional design or selection. The current reference used by the charger is designed to ensure that the power factor remains at closer unity throughout G2V and V2G modes. The proposed control algorithm ensures the grid current remains low in harmonics during G2V, V2G, and V2L modes of operation. The experimental validation of the proposed control strategy is performed in the laboratory on a 0.5 kW off-board electric vehicle charger (EVC) prototype under various conditions to demonstrate its effectiveness in compliance with the IEEE 519–2022 standard. [ABSTRACT FROM AUTHOR]

Published
2024
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158. Properties of B and Bs meson states in a nonrelativistic quark model with the inclusion of coupled channel effects.

Author

D'Souza, Praveen P., Monteiro, Antony Prakash, Naik, N. S. Vipin, and Kumar, K. B. Vijaya

Subjects
MASS spectrometry, MESONS, SPIN-orbit interactions, WAVE functions, QUARK models, DECAY constants
Abstract

The mass spectra and decay properties of B and B s mesons are obtained using the nonrelativistic potential model by applying the variational approach. The quark–anti-quark potential used in our model consists of a Hulthen potential and a confining linear potential. The hyper-fine interaction is introduced to obtain the splittings of the spin-singlet and triplet states, while the spin–orbit and tensor interactions provide the fine structure splittings. The model parameters and the wave functions that reproduce the mass spectra are used to investigate the decay properties of B and B s mesons. The mass spectra of B and B s mesons have been enhanced using coupled channel effects. [ABSTRACT FROM AUTHOR]

Published
2022
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168. Intraoral Lipoma: A Rare Case Report and Review of Literature

Author

Ravi Kiran A., Purnachandrarao Naik N., Samatha Y., Vijay Kumar A., and Kalyan Kumar D.

Subjects
lipoma, neoplasm, oral cavity, Medicine
Abstract

Benign soft tissue neoplasms commonly occur in oral cavity. Lipoma is one such benign tumour which rarely occurs in the oral mucosa. About 20% of lipomas occur in the head and neck region among which oral lipomas comprise only 1-4% of all lipomas. They slowly enlarge and they are known to grow to large sizes, thus causing mastication and speech difficulties. Usually, the lesion consists of a well circumscribed, lobulated mass of mature fat cells. Oral lipomas are usually asymptomatic, but in some situations, the covering mucosa becomes ulcerated and it presents difficulties in diagnosis. Here with, the present paper reports a rare case of intaoral lipoma in a 53-year-old female patient.

Published
2013
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169. List of contributors

Author

Ackom, Emmanuel, Alizadeh Bidgoli, Mohsen, Amin, Ruhul, Amrr, Syed Muhammad, Asghar, M.S. Jamil, Ashiq, Mohammad, Assagra, Y.A.O., Atif, Ammar, Atiz, Ayhan, Aziz, Muhammad, Belharouak, Ilias, Bhar, Madhushri, Bharadwaj, A., Bhattacharjee, Udita, Budiman, Bentang Arief, Carmo, J.P., Chauhan, Viplov, Chen, Bowen, Deihimi, Mohammadhossein, Dixit, Marm, Dong, Z.Y., El Haj Assad, Mamdouh, Erden, Mustafa, Essehli, Rachid, Gholami, Mehrdad, Ghosh, Shuvajit, Gonçalves, L.M., Goswami, Manoj, Gounella, R.H., Hajizadeh, Amin, Hoseinzadeh, Siamak, Islameka, Metha, Jain, Trapti, Jena, Satyaranjan, Juangsa, Firman Bagja, Karakilcik, Hatice, Karakilcik, Mehmet, Khalid, Muhammad, Khan, Khalid Abdullah, Kumar, Nayan, Kumar, Satendra, Kumar, Surender, Lai, Chun Sing, Locatelli, Giorgio, Maiti, S., Martha, Surendra Kumar, Muralidharan, Nitin, Naik N, Venkataramana, Narendra, Ankireddy, Panda, Anup Kumar, Parejiya, Anand, Prabhansu, Raju P, E.S.N., Rezaei, Navid, Sahu, Madan Mohan, Sahu, Pradeep Kumar, Saidi, Abdelaziz Salah, San, Saygin, Sathish, N., Shahverdian, Mohammad Hassan, Siddiqui, Hafsa, Singh, Netrapal, Singh, Rahul, Sohani, Ali, Tarimoradi, Hadi, Xiang, Sheng, Xu, Y., Xu, Yan, Yang, Hongming, Yin, Bangzhe, Zhang, Shijie, and Zhang, Yongxi

Published
2023
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170. Consortium Blockchain for Security and Privacy-Preserving in E-government Systems

Author

Elisa, N., Longzhi Yang, Li, H., Chao, F., and Naik, N.

Subjects
FOS: Computer and information sciences, Computer Science - Cryptography and Security, Cryptography and Security (cs.CR)
Abstract

Since its inception as a solution for secure cryptocurrencies sharing in 2008, the blockchain technology has now become one of the core technologies for secure data sharing and storage over trustless and decentralised peer-to-peer systems. E-government is amongst the systems that stores sensitive information about citizens, businesses and other affiliates, and therefore becomes the target of cyber attackers. The existing e-government systems are centralised and thus subject to single point of failure. This paper proposes a secure and decentralised e-government system based on the consortium blockchain technology, which is a semi-public and decentralised blockchain system consisting of a group of pre-selected entities or organisations in charge of consensus and decisions making for the benefit of the whole network of peers. In addition, a number of e-government nodes are pre-selected to perform the tasks of user and transaction validation before being added to the blockchain network. Accordingly, e-government users of the consortium blockchain network are given the rights to create, submit, access, and review transactions. Performance evaluation on single transaction time and transactions processed per second demonstrate the practicability of the proposed consortium blockchain-based e-government system for secure information sharing amongst all stakeholders., Comment: 9 pages

Published
2020
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172. Direct Power Control of Dual Active Bridge Bidirectional DC-DC Converter

Author

A Narendra, Nishit Tiwary, Naik N Venkataramana, and Anup Kumar Panda

Subjects
Materials science, Robustness (computer science), Control theory, Current (fluid), Bridge (nautical), Voltage reference, Dual (category theory), Power (physics), Power control, Voltage
Abstract

This paper presents a DC-DC bi-directional dual active bridge (DAB) power converter, and simulating direct power control (DPC) control for the power converter. The DPC control enables it to have an enhanced dynamic response with improved dc-link voltage stability while controlling the power flow. The output voltage is controlled by the amount of power flow while the power flow depends on the phase shift ratio between primary and secondary bridge. With the DPC control presented here, the control reference is calculated from output voltage and load current, and subsequently phase shift ratio is computed, thereby controlling the power flow. The fast control over the amount power flow provides an overall enhanced performance with improved reference voltage tracking as well as robustness against input voltage fluctuation and load variation. The proposed control scheme is simulated in Matlab Simulink environment.

Published
2019
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175. Biomechanical Behavior of Bioactive Material in Dental Implant : A Three-Dimensional Finite Element Analysis

Author

Patil, V, Naik, N, Gadicherla, S, Smriti, K, Raju, Adithya, Rathee, U, Patil, V, Naik, N, Gadicherla, S, Smriti, K, Raju, Adithya, and Rathee, U

Abstract

Dental implants are widely accepted for the rehabilitation of missing teeth due to their aesthetic compliance, functional ability, and great survival rate. The various components in implant design like thread design, thread angle, pitch, and material used for manufacturing play a critical role in its success. Understanding these influencing factors and implementing them properly in implant design can reduce cases of potential implant failure. Recently, finite element analysis (FEA) is being widely used in the field of health sciences to solve problems in designing medical devices. It provides valid and accurate assessment in the clinical and in vitro analysis. Hence, this study was conducted to evaluate the impact of thread design of the implant and 3 different bioactive materials, titanium alloy, graphene, and reduced graphene oxide (rGO) on stress, strain, and deformation in the implant system using FEA. In this study, the FEA model of the bones and the tissues are modeled as homogeneous, isotropic, and linearly elastic material with a titanium implant system with an assumption of it 100% osseointegrated into the bone. The titanium was functionalized with graphene and graphene oxide. A modeling software tool Catia¯ and Ansys Workbench¯ is used to perform the analysis and evaluate the von Mises stress distribution, strain, and deformation at the implant and implant-cortical bone interface. The results showed that the titanium implant with a surface coating of graphene oxide exhibited better mechanical behavior than graphene, with mean von Mises stress of 39.64 MPa in pitch 1, 23.65 MPa in pitch 2, and 37.23 MPa in pitch 3. It also revealed that functionalizing the titanium implant will help in reducing the stress at the implant system. Overall, the study emphasizes the use of FEA analysis methods in solving various biomechanical issues about medical and dental devices, which can further open up for invivo study and their practical uses., QC 20201216

Published
2020
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176. 021 Effects of Low-dose Triple Combination Therapy on Therapeutic Inertia and Prescribing Patterns in Hypertension – Results from the TRIUMPH Trial

Author

Wang, N ; https://orcid.org/0000-0002-8197-5090, Salam, A, Webster, R ; https://orcid.org/0000-0002-5136-1098, De Silva, A, Guggilla, R, Stepien, S, Mysore, J, Billot, L ; https://orcid.org/0000-0002-4975-9793, Jan, S ; https://orcid.org/0000-0003-2839-1405, Maulik, P ; https://orcid.org/0000-0001-6835-6175, Naik, N, Selak, V, Thom, S, Prabhakaran, D, Patel, A ; https://orcid.org/0000-0003-3825-4092, Rodgers, A ; https://orcid.org/0000-0003-1282-1896, Wang, N ; https://orcid.org/0000-0002-8197-5090, Salam, A, Webster, R ; https://orcid.org/0000-0002-5136-1098, De Silva, A, Guggilla, R, Stepien, S, Mysore, J, Billot, L ; https://orcid.org/0000-0002-4975-9793, Jan, S ; https://orcid.org/0000-0003-2839-1405, Maulik, P ; https://orcid.org/0000-0001-6835-6175, Naik, N, Selak, V, Thom, S, Prabhakaran, D, Patel, A ; https://orcid.org/0000-0003-3825-4092, and Rodgers, A ; https://orcid.org/0000-0003-1282-1896

Published
2020

177. Association of Low-Dose Triple Combination Therapy with Therapeutic Inertia and Prescribing Patterns in Patients with Hypertension: A Secondary Analysis of the TRIUMPH Trial

Author

Wang, N ; https://orcid.org/0000-0002-8197-5090, Salam, A, Webster, R ; https://orcid.org/0000-0002-5136-1098, De Silva, A, Guggilla, R, Stepien, S, Mysore, J, Billot, L ; https://orcid.org/0000-0002-4975-9793, Jan, S ; https://orcid.org/0000-0003-2839-1405, Maulik, PK ; https://orcid.org/0000-0001-6835-6175, Naik, N, Selak, V, Thom, S, Prabhakaran, D, Patel, A ; https://orcid.org/0000-0003-3825-4092, Rodgers, A ; https://orcid.org/0000-0003-1282-1896, Mohammad, Mohammad ; https://orcid.org/0000-0002-5870-7936, Wang, N ; https://orcid.org/0000-0002-8197-5090, Salam, A, Webster, R ; https://orcid.org/0000-0002-5136-1098, De Silva, A, Guggilla, R, Stepien, S, Mysore, J, Billot, L ; https://orcid.org/0000-0002-4975-9793, Jan, S ; https://orcid.org/0000-0003-2839-1405, Maulik, PK ; https://orcid.org/0000-0001-6835-6175, Naik, N, Selak, V, Thom, S, Prabhakaran, D, Patel, A ; https://orcid.org/0000-0003-3825-4092, Rodgers, A ; https://orcid.org/0000-0003-1282-1896, and Mohammad, Mohammad ; https://orcid.org/0000-0002-5870-7936

Abstract

Importance: Fixed-dose combination (FDC) therapies are being increasingly recommended for initial or early management of patients with hypertension, as they reduce treatment complexity and potentially reduce therapeutic inertia. Objective: To investigate the association of antihypertensive triple drug FDC therapy with therapeutic inertia and prescribing patterns compared with usual care. Design, Setting, and Participants: A post hoc analysis of the Triple Pill vs Usual Care Management for Patients With Mild-to-Moderate Hypertension (TRIUMPH) study, a randomized clinical trial of 700 patients with hypertension, was conducted. Patients were enrolled from 11 urban hospital clinics in Sri Lanka from February 2016 to May 2017; follow-up ended in October 2017. Data were analyzed from September to November 2019. Interventions: Once-daily FDC antihypertensive pill (telmisartan, 20 mg; amlodipine, 2.5 mg; and chlorthalidone, 12.5 mg) or usual care. Main Outcomes and Measures: Therapeutic inertia, defined as not intensifying therapy in those with blood pressure (BP) above target, was assessed at baseline and during follow-up visits. Prescribing patterns were characterized by BP-lowering drug class and treatment regimen potency. Predictors of therapeutic inertia were assessed with binomial logistic regression. Results: Of the 700 included patients, 403 (57.6%) were female, and the mean (SD) age was 56 (11) years. Among patients who did not reach the BP target, therapeutic inertia was more common in the triple pill group compared with the usual care group at the week 6 visit (92 of 106 [86.8%] vs 124 of 194 [63.9%]; P <.001) and week 12 visit (81 of 90 [90%] vs 116 of 179 [64.8%]; P <.001). At the end of the study, 221 of 318 patients in the triple pill group (69.5%) and 182 of 329 patients in the usual care group (55.3%) reached BP targets. Among those who received treatment intensification, the increase in estimated regimen potency was greater in the triple pill group compare

Published
2020

179. A Three-Level Fuzzy-2 DTC of Induction Motor Drive Using SVPWM

Author

Aurobinda Panda, S. P. Singh, and Venkataramana Naik N

Subjects
Total harmonic distortion, Vector control, Computer science, 020209 energy, 020208 electrical & electronic engineering, Flux, 02 engineering and technology, law.invention, Capacitor, Direct torque control, Control and Systems Engineering, Control theory, law, Capacitor voltage, 0202 electrical engineering, electronic engineering, information engineering, Inverter, Torque, Electrical and Electronic Engineering, Pulse-width modulation, Induction motor, Voltage
Abstract

This paper presents proportional integral direct torque control (PIDTC) and fuzzy-2 DTC (F2DTC) of the induction motor (IM) drive using space vector pulse width modulation (SVPWM) for three-level diode-clamped inverter (TDCI). The above control schemes have been implemented in the laboratory using 2 HP IM through a DSPACE DS-1104 controller. The control schemes are capable to balance the dc-link capacitor voltages of TDCI by selecting an optimum voltage vector without using an extra controller. However, the three-level PIDTC of an IM gives poor transient performance during starting, loading, and speed reversal with considerable current and voltage total harmonic distortion (THD). In addition, it takes more time to reach the steady state with large spikes on capacitor voltages during the load or speed variation. This is due to poor performance of the PI controllers (speed and torque). In F2DTC, the conventional PI controllers are replaced by Mamdani-type fuzzy-2 controllers using a centroid method with simple logical rules. The simulated and experimental performance show that F2DTC for the three-level inverter-fed IM drive provides a fast dynamic response, less current and voltage THDs, considerable less distortion in flux and torque, and fewer spikes on capacitor voltages as compared to PIDTC.

Published
2016
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181. Erratum: Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017 (The Lancet (2018) 392(10159) (1923–1994), (S0140673618322256), (10.1016/S0140-6736(18)32225-6))

Author

Stanaway, J.D. Afshin, A. Gakidou, E. Lim, S.S. Abate, D. Abate, K.H. Abbafati, C. Abbasi, N. Abbastabar, H. Abd-Allah, F. Abdela, J. Abdelalim, A. Abdollahpour, I. Abdulkader, R.S. Abebe, M. Abebe, Z. Abera, S.F. Abil, O.Z. Abraha, H.N. Abrham, A.R. Abu-Raddad, L.J. Abu-Rmeileh, N.M.E. Accrombessi, M.M.K. Acharya, D. Acharya, P. Adamu, A.A. Adane, A.A. Adebayo, O.M. Adedoyin, R.A. Adekanmbi, V. Ademi, Z. Adetokunboh, O.O. Adib, M.G. Admasie, A. Adsuar, J.C. Afanvi, K.A. Afarideh, M. Agarwal, G. Aggarwal, A. Aghayan, S.A. Agrawal, A. Agrawal, S. Ahmadi, A. Ahmadi, M. Ahmadieh, H. Ahmed, M.B. Aichour, A.N. Aichour, I. Aichour, M.T.E. Akbari, M.E. Akinyemiju, T. Akseer, N. Al-Aly, Z. Al-Eyadhy, A. Al-Mekhlafi, H.M. Alahdab, F. Alam, K. Alam, S. Alam, T. Alashi, A. Alavian, S.M. Alene, K.A. Ali, K. Ali, S.M. Alijanzadeh, M. Alizadeh-Navaei, R. Aljunid, S.M. Alkerwi, A. Alla, F. Alsharif, U. Altirkawi, K. Alvis-Guzman, N. Amare, A.T. Ammar, W. Anber, N.H. Anderson, J.A. Andrei, C.L. Androudi, S. Animut, M.D. Anjomshoa, M. Ansha, M.G. Antó, J.M. Antonio, C.A.T. Anwari, P. Appiah, L.T. Appiah, S.C.Y. Arabloo, J. Aremu, O. Ärnlöv, J. Artaman, A. Aryal, K.K. Asayesh, H. Ataro, Z. Ausloos, M. Avokpaho, E.F.G.A. Awasthi, A. Ayala Quintanilla, B.P. Ayer, R. Ayuk, T.B. Azzopardi, P.S. Babazadeh, A. Badali, H. Badawi, A. Balakrishnan, K. Bali, A.G. Ball, K. Ballew, S.H. Banach, M. Banoub, J.A.M. Barac, A. Barker-Collo, S.L. Bärnighausen, T.W. Barrero, L.H. Basu, S. Baune, B.T. Bazargan-Hejazi, S. Bedi, N. Beghi, E. Behzadifar, M. Behzadifar, M. Béjot, Y. Bekele, B.B. Bekru, E.T. Belay, E. Belay, Y.A. Bell, M.L. Bello, A.K. Bennett, D.A. Bensenor, I.M. Bergeron, G. Berhane, A. Bernabe, E. Bernstein, R.S. Beuran, M. Beyranvand, T. Bhala, N. Bhalla, A. Bhattarai, S. Bhutta, Z.A. Biadgo, B. Bijani, A. Bikbov, B. Bilano, V. Bililign, N. Bin Sayeed, M.S. Bisanzio, D. Biswas, T. Bjørge, T. Blacker, B.F. Bleyer, A. Borschmann, R. Bou-Orm, I.R. Boufous, S. Bourne, R. Brady, O.J. Brauer, M. Brazinova, A. Breitborde, N.J.K. Brenner, H. Briko, A.N. Britton, G. Brugha, T. Buchbinder, R. Burnett, R.T. Busse, R. Butt, Z.A. Cahill, L.E. Cahuana-Hurtado, L. Campos-Nonato, I.R. Cárdenas, R. Carreras, G. Carrero, J.J. Carvalho, F. Castañeda-Orjuela, C.A. Castillo Rivas, J. Castro, F. Catalá-López, F. Causey, K. Cercy, K.M. Cerin, E. Chaiah, Y. Chang, H.-Y. Chang, J.-C. Chang, K.-L. Charlson, F.J. Chattopadhyay, A. Chattu, V.K. Chee, M.L. Cheng, C.-Y. Chew, A. Chiang, P.P.-C. Chimed-Ochir, O. Chin, K.L. Chitheer, A. Choi, J.-Y.J. Chowdhury, R. Christensen, H. Christopher, D.J. Chung, S.-C. Cicuttini, F.M. Cirillo, M. Cohen, A.J. Collado-Mateo, D. Cooper, C. Cooper, O.R. Coresh, J. Cornaby, L. Cortesi, P.A. Cortinovis, M. Costa, M. Cousin, E. Criqui, M.H. Cromwell, E.A. Cundiff, D.K. Daba, A.K. Dachew, B.A. Dadi, A.F. Damasceno, A.A.M. Dandona, L. Dandona, R. Darby, S.C. Dargan, P.I. Daryani, A. Das Gupta, R. Das Neves, J. Dasa, T.T. Dash, A.P. Davitoiu, D.V. Davletov, K. De la Cruz-Góngora, V. De La Hoz, F.P. De Leo, D. De Neve, J.-W. Degenhardt, L. Deiparine, S. Dellavalle, R.P. Demoz, G.T. Denova-Gutiérrez, E. Deribe, K. Dervenis, N. Deshpande, A. Des Jarlais, D.C. Dessie, G.A. Deveber, G.A. Dey, S. Dharmaratne, S.D. Dhimal, M. Dinberu, M.T. Ding, E.L. Diro, H.D. Djalalinia, S. Do, H.P. Dokova, K. Doku, D.T. Doyle, K.E. Driscoll, T.R. Dubey, M. Dubljanin, E. Duken, E.E. Duncan, B.B. Duraes, A.R. Ebert, N. Ebrahimi, H. Ebrahimpour, S. Edvardsson, D. Effiong, A. Eggen, A.E. El Bcheraoui, C. El-Khatib, Z. Elyazar, I.R. Enayati, A. Endries, A.Y. Er, B. Erskine, H.E. Eskandarieh, S. Esteghamati, A. Estep, K. Fakhim, H. Faramarzi, M. Fareed, M. Farid, T.A. Sá Farinha, C.S.E. Farioli, A. Faro, A. Farvid, M.S. Farzaei, M.H. Fatima, B. Fay, K.A. Fazaeli, A.A. Feigin, V.L. Feigl, A.B. Fereshtehnejad, S.-M. Fernandes, E. Fernandes, J.C. Ferrara, G. Ferrari, A.J. Ferreira, M.L. Filip, I. Finger, J.D. Fischer, F. Foigt, N.A. Foreman, K.J. Fukumoto, T. Fullman, N. Fürst, T. Furtado, J.M. Futran, N.D. Gall, S. Gallus, S. Gamkrelidze, A. Ganji, M. Garcia-Basteiro, A.L. Gardner, W.M. Gebre, A.K. Gebremedhin, A.T. Gebremichael, T.G. Gelano, T.F. Geleijnse, J.M. Geramo, Y.C.D. Gething, P.W. Gezae, K.E. Ghadimi, R. Ghadiri, K. Ghasemi Falavarjani, K.G. Ghasemi-Kasman, M. Ghimire, M. Ghosh, R. Ghoshal, A.G. Giampaoli, S. Gill, P.S. Gill, T.K. Gillum, R.F. Ginawi, I.A. Giussani, G. Gnedovskaya, E.V. Godwin, W.W. Goli, S. Gómez-Dantés, H. Gona, P.N. Gopalani, S.V. Goulart, A.C. Grada, A. Grams, M.E. Grosso, G. Gugnani, H.C. Guo, Y. Gupta, R. Gupta, R. Gupta, T. Gutiérrez, R.A. Gutiérrez-Torres, D.S. Haagsma, J.A. Habtewold, T.D. Hachinski, V. Hafezi-Nejad, N. Hagos, T.B. Hailegiyorgis, T.T. Hailu, G.B. Haj-Mirzaian, A. Haj-Mirzaian, A. Hamadeh, R.R. Hamidi, S. Handal, A.J. Hankey, G.J. Hao, Y. Harb, H.L. Harikrishnan, S. Haro, J.M. Hassankhani, H. Hassen, H.Y. Havmoeller, R. Hawley, C.N. Hay, S.I. Hedayatizadeh-Omran, A. Heibati, B. Heidari, B. Heidari, M. Hendrie, D. Henok, A. Heredia-Pi, I. Herteliu, C. Heydarpour, F. Heydarpour, S. Hibstu, D.T. Higazi, T.B. Hilawe, E.H. Hoek, H.W. Hoffman, H.J. Hole, M.K. Homaie Rad, E. Hoogar, P. Hosgood, H.D. Hosseini, S.M. Hosseinzadeh, M. Hostiuc, M. Hostiuc, S. Hoy, D.G. Hsairi, M. Hsiao, T. Hu, G. Hu, H. Huang, J.J. Hussen, M.A. Huynh, C.K. Iburg, K.M. Ikeda, N. Ilesanmi, O.S. Iqbal, U. Irvani, S.S.N. Irvine, C.M.S. Islam, S.M.S. Islami, F. Jackson, M.D. Jacobsen, K.H. Jahangiry, L. Jahanmehr, N. Jain, S.K. Jakovljevic, M. James, S.L. Jassal, S.K. Jayatilleke, A.U. Jeemon, P. Jha, R.P. Jha, V. Ji, J.S. Jonas, J.B. Jonnagaddala, J. Jorjoran Shushtari, Z.J. Joshi, A. Jozwiak, J.J. Jürisson, M. Kabir, Z. Kahsay, A. Kalani, R. Kanchan, T. Kant, S. Kar, C. Karami, M. Karami Matin, B.K. Karch, A. Karema, C. Karimi, N. Karimi, S.M. Kasaeian, A. Kassa, D.H. Kassa, G.M. Kassa, T.D. Kassebaum, N.J. Katikireddi, S.V. Kaul, A. Kawakami, N. Kazemi, Z. Kazemi Karyani, A. Kefale, A.T. Keiyoro, P.N. Kemp, G.R. Kengne, A.P. Keren, A. Kesavachandran, C.N. Khader, Y.S. Khafaei, B. Khafaie, M.A. Khajavi, A. Khalid, N. Khalil, I.A. Khan, G. Khan, M.S. Khan, M.A. Khang, Y.-H. Khater, M.M. Khazaei, M. Khazaie, H. Khoja, A.T. Khosravi, A. Khosravi, M.H. Kiadaliri, A.A. Kiirithio, D.N. Kim, C.-I. Kim, D. Kim, Y.-E. Kim, Y.J. Kimokoti, R.W. Kinfu, Y. Kisa, A. Kissimova-Skarbek, K. Kivimäki, M. Knibbs, L.D. Knudsen, A.K.S. Kochhar, S. Kokubo, Y. Kolola, T. Kopec, J.A. Kosen, S. Koul, P.A. Koyanagi, A. Kravchenko, M.A. Krishan, K. Krohn, K.J. Kromhout, H. Kuate Defo, B. Kucuk Bicer, B. Kumar, G.A. Kumar, M. Kuzin, I. Kyu, H.H. Lachat, C. Lad, D.P. Lad, S.D. Lafranconi, A. Lalloo, R. Lallukka, T. Lami, F.H. Lang, J.J. Lansingh, V.C. Larson, S.L. Latifi, A. Lazarus, J.V. Lee, P.H. Leigh, J. Leili, M. Leshargie, C.T. Leung, J. Levi, M. Lewycka, S. Li, S. Li, Y. Liang, J. Liang, X. Liao, Y. Liben, M.L. Lim, L.-L. Linn, S. Liu, S. Lodha, R. Logroscino, G. Lopez, A.D. Lorkowski, S. Lotufo, P.A. Lozano, R. Lucas, T.C.D. Lunevicius, R. Ma, S. Macarayan, E.R.K. Machado, Í.E. Madotto, F. Mai, H.T. Majdan, M. Majdzadeh, R. Majeed, A. Malekzadeh, R. Malta, D.C. Mamun, A.A. Manda, A.-L. Manguerra, H. Mansournia, M.A. Mantovani, L.G. Maravilla, J.C. Marcenes, W. Marks, A. Martin, R.V. Martins, S.C.O. Martins-Melo, F.R. März, W. Marzan, M.B. Massenburg, B.B. Mathur, M.R. Mathur, P. Matsushita, K. Maulik, P.K. Mazidi, M. McAlinden, C. McGrath, J.J. McKee, M. Mehrotra, R. Mehta, K.M. Mehta, V. Meier, T. Mekonnen, F.A. Melaku, Y.A. Melese, A. Melku, M. Memiah, P.N. Memish, Z.A. Mendoza, W. Mengistu, D.T. Mensah, G.A. Mensink, G.B.M. Mereta, S.T. Meretoja, A. Meretoja, T.J. Mestrovic, T. Mezgebe, H.B. Miazgowski, B. Miazgowski, T. Millear, A.I. Miller, T.R. Miller-Petrie, M.K. Mini, G.K. Mirarefin, M. Mirica, A. Mirrakhimov, E.M. Misganaw, A.T. Mitiku, H. Moazen, B. Mohajer, B. Mohammad, K.A. Mohammadi, M. Mohammadifard, N. Mohammadnia-Afrouzi, M. Mohammed, S. Mohebi, F. Mokdad, A.H. Molokhia, M. Momeniha, F. Monasta, L. Moodley, Y. Moradi, G. Moradi-Lakeh, M. Moradinazar, M. Moraga, P. Morawska, L. Morgado-Da-Costa, J. Morrison, S.D. Moschos, M.M. Mouodi, S. Mousavi, S.M. Mozaffarian, D. Mruts, K.B. Muche, A.A. Muchie, K.F. Mueller, U.O. Muhammed, O.S. Mukhopadhyay, S. Muller, K. Musa, K.I. Mustafa, G. Nabhan, A.F. Naghavi, M. Naheed, A. Nahvijou, A. Naik, G. Naik, N. Najafi, F. Nangia, V. Nansseu, J.R. Nascimento, B.R. Neal, B. Neamati, N. Negoi, I. Negoi, R.I. Neupane, S. Newton, C.R.J. Ngunjiri, J.W. Nguyen, A.Q. Nguyen, G. Nguyen, H.T. Nguyen, H.L.T. Nguyen, H.T. Nguyen, M. Nguyen, N.B. Nichols, E. Nie, J. Ningrum, D.N.A. Nirayo, Y.L. Nishi, N. Nixon, M.R. Nojomi, M. Nomura, S. Norheim, O.F. Noroozi, M. Norrving, B. Noubiap, J.J. Nouri, H.R. Nourollahpour Shiadeh, M. Nowroozi, M.R. Nsoesie, E.O. Nyasulu, P.S. Obermeyer, C.M. Odell, C.M. Ofori-Asenso, R. Ogbo, F.A. Oh, I.-H. Oladimeji, O. Olagunju, A.T. Olagunju, T.O. Olivares, P.R. Olsen, H.E. Olusanya, B.O. Olusanya, J.O. Ong, K.L. Ong, S.K. Oren, E. Orpana, H.M. Ortiz, A. Ota, E. Otstavnov, S.S. Øverland, S. Owolabi, M.O. Mahesh, P.A. Pacella, R. Pakhare, A.P. Pakpour, A.H. Pana, A. Panda-Jonas, S. Park, E.-K. Parry, C.D.H. Parsian, H. Patel, S. Pati, S. Patil, S.T. Patle, A. Patton, G.C. Paudel, D. Paulson, K.R. Paz Ballesteros, W.C. Pearce, N. Pereira, A. Pereira, D.M. Perico, N. Pesudovs, K. Petzold, M. Pham, H.Q. Phillips, M.R. Pillay, J.D. Piradov, M.A. Pirsaheb, M. Pischon, T. Pishgar, F. Plana-Ripoll, O. Plass, D. Polinder, S. Polkinghorne, K.R. Postma, M.J. Poulton, R. Pourshams, A. Poustchi, H. Prabhakaran, D. Prakash, S. Prasad, N. Purcell, C.A. Purwar, M.B. Qorbani, M. Radfar, A. Rafay, A. Rafiei, A. Rahim, F. Rahimi, Z. Rahimi-Movaghar, A. Rahimi-Movaghar, V. Rahman, M. Rahman, M.H.U. Rahman, M.A. Rai, R.K. Rajati, F. Rajsic, S. Raju, S.B. Ram, U. Ranabhat, C.L. Ranjan, P. Rath, G.K. Rawaf, D.L. Rawaf, S. Reddy, K.S. Rehm, C.D. Rehm, J. Reiner, R.C. Reitsma, M.B. Remuzzi, G. Renzaho, A.M.N. Resnikoff, S. Reynales-Shigematsu, L.M. Rezaei, S. Ribeiro, A.L.P. Rivera, J.A. Roba, K.T. Rodríguez-Ramírez, S. Roever, L. Román, Y. Ronfani, L. Roshandel, G. Rostami, A. Roth, G.A. Rothenbacher, D. Roy, A. Rubagotti, E. Rushton, L. Sabanayagam, C. Sachdev, P.S. Saddik, B. Sadeghi, E. Saeedi Moghaddam, S. Safari, H. Safari, Y. Safari-Faramani, R. Safdarian, M. Safi, S. Safiri, S. Sagar, R. Sahebkar, A. Sahraian, M.A. Sajadi, H.S. Salam, N. Salamati, P. Saleem, Z. Salimi, Y. Salimzadeh, H. Salomon, J.A. Salvi, D.D. Salz, I. Samy, A.M. Sanabria, J. Sanchez-Niño, M.D. Sánchez-Pimienta, T.G. Sanders, T. Sang, Y. Santomauro, D.F. Santos, I.S. Santos, J.V. Santric Milicevic, M.M. Sao Jose, B.P. Sardana, M. Sarker, A.R. Sarmiento-Suárez, R. Sarrafzadegan, N. Sartorius, B. Sarvi, S. Sathian, B. Satpathy, M. Sawant, A.R. Sawhney, M. Saylan, M. Sayyah, M. Schaeffner, E. Schmidt, M.I. Schneider, I.J.C. Schöttker, B. Schutte, A.E. Schwebel, D.C. Schwendicke, F. Scott, J.G. Seedat, S. Sekerija, M. Sepanlou, S.G. Serre, M.L. Serván-Mori, E. Seyedmousavi, S. Shabaninejad, H. Shaddick, G. Shafieesabet, A. Shahbazi, M. Shaheen, A.A. Shaikh, M.A. Shamah Levy, T. Shams-Beyranvand, M. Shamsi, M. Sharafi, H. Sharafi, K. Sharif, M. Sharif-Alhoseini, M. Sharifi, H. Sharma, J. Sharma, M. Sharma, R. She, J. Sheikh, A. Shi, P. Shibuya, K. Shiferaw, M.S. Shigematsu, M. Shin, M.-J. Shiri, R. Shirkoohi, R. Shiue, I. Shokraneh, F. Shoman, H. Shrime, M.G. Shupler, M.S. Si, S. Siabani, S. Sibai, A.M. Siddiqi, T.J. Sigfusdottir, I.D. Sigurvinsdottir, R. Silva, D.A.S. Silva, J.P. Silveira, D.G.A. Singh, J.A. Singh, N.P. Singh, V. Sinha, D.N. Skiadaresi, E. Skirbekk, V. Smith, D.L. Smith, M. Sobaih, B.H. Sobhani, S. Somayaji, R. Soofi, M. Sorensen, R.J.D. Soriano, J.B. Soyiri, I.N. Spinelli, A. Sposato, L.A. Sreeramareddy, C.T. Srinivasan, V. Starodubov, V.I. Steckling, N. Stein, D.J. Stein, M.B. Stevanovic, G. Stockfelt, L. Stokes, M.A. Sturua, L. Subart, M.L. Sudaryanto, A. Sufiyan, M.B. Sulo, G. Sunguya, B.F. Sur, P.J. Sykes, B.L. Szoeke, C.E.I. Tabarés-Seisdedos, R. Tabuchi, T. Tadakamadla, S.K. Takahashi, K. Tandon, N. Tassew, S.G. Tavakkoli, M. Taveira, N. Tehrani-Banihashemi, A. Tekalign, T.G. Tekelemedhin, S.W. Tekle, M.G. Temesgen, H. Temsah, M.-H. Temsah, O. Terkawi, A.S. Tessema, B. Teweldemedhin, M. Thankappan, K.R. Theis, A. Thirunavukkarasu, S. Thomas, H.J. Thomas, M.L. Thomas, N. Thurston, G.D. Tilahun, B. Tillmann, T. To, Q.G. Tobollik, M. Tonelli, M. Topor-Madry, R. Torre, A.E. Tortajada-Girbés, M. Touvier, M. Tovani-Palone, M.R. Towbin, J.A. Tran, B.X. Tran, K.B. Truelsen, T.C. Truong, N.T. Tsadik, A.G. Tudor Car, L. Tuzcu, E.M. Tymeson, H.D. Tyrovolas, S. Ukwaja, K.N. Ullah, I. Updike, R.L. Usman, M.S. Uthman, O.A. Vaduganathan, M. Vaezi, A. Valdez, P.R. Van Donkelaar, A. Varavikova, E. Varughese, S. Vasankari, T.J. Venkateswaran, V. Venketasubramanian, N. Villafaina, S. Violante, F.S. Vladimirov, S.K. Vlassov, V. Vollset, S.E. Vos, T. Vosoughi, K. Vu, G.T. Vujcic, I.S. Wagnew, F.S. Waheed, Y. Waller, S.G. Walson, J.L. Wang, Y. Wang, Y. Wang, Y.-P. Weiderpass, E. Weintraub, R.H. Weldegebreal, F. Werdecker, A. Werkneh, A.A. West, J.J. Westerman, R. Whiteford, H.A. Widecka, J. Wijeratne, T. Winkler, A.S. Wiyeh, A.B. Wiysonge, C.S. Wolfe, C.D.A. Wong, T.Y. Wu, S. Xavier, D. Xu, G. Yadgir, S. Yadollahpour, A. Yahyazadeh Jabbari, S.H. Yamada, T. Yan, L.L. Yano, Y. Yaseri, M. Yasin, Y.J. Yeshaneh, A. Yimer, E.M. Yip, P. Yisma, E. Yonemoto, N. Yoon, S.-J. Yotebieng, M. Younis, M.Z. Yousefifard, M. Yu, C. Zaidi, Z. Zaman, S.B. Zamani, M. Zavala-Arciniega, L. Zhang, A.L. Zhang, H. Zhang, K. Zhou, M. Zimsen, S.R.M. Zodpey, S. Murray, C.J.L. GBD 2017 Risk Factor Collaborators

Abstract

Background The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk–outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk–outcome pairs, and new data on risk exposure levels and risk–outcome associations. Methods We used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk–outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs by decomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risks; and (6) changes due to all other factors, approximated as the risk-deleted death and DALY rates, where the risk-deleted rate is the rate that would be observed had we reduced the exposure levels to the TMREL for all risk factors included in GBD 2017. Findings In 2017, 34·1 million (95% uncertainty interval [UI] 33·3–35·0) deaths and 1·21 billion (1·14–1·28) DALYs were attributable to GBD risk factors. Globally, 61·0% (59·6–62·4) of deaths and 48·3% (46·3–50·2) of DALYs were attributed to the GBD 2017 risk factors. When ranked by risk-attributable DALYs, high systolic blood pressure (SBP) was the leading risk factor, accounting for 10·4 million (9·39–11·5) deaths and 218 million (198–237) DALYs, followed by smoking (7·10 million [6·83–7·37] deaths and 182 million [173–193] DALYs), high fasting plasma glucose (6·53 million [5·23–8·23] deaths and 171 million [144–201] DALYs), high body-mass index (BMI; 4·72 million [2·99–6·70] deaths and 148 million [98·6–202] DALYs), and short gestation for birthweight (1·43 million [1·36–1·51] deaths and 139 million [131–147] DALYs). In total, risk-attributable DALYs declined by 4·9% (3·3–6·5) between 2007 and 2017. In the absence of demographic changes (ie, population growth and ageing), changes in risk exposure and risk-deleted DALYs would have led to a 23·5% decline in DALYs during that period. Conversely, in the absence of changes in risk exposure and risk-deleted DALYs, demographic changes would have led to an 18·6% increase in DALYs during that period. The ratios of observed risk exposure levels to exposure levels expected based on SDI (O/E ratios) increased globally for unsafe drinking water and household air pollution between 1990 and 2017. This result suggests that development is occurring more rapidly than are changes in the underlying risk structure in a population. Conversely, nearly universal declines in O/E ratios for smoking and alcohol use indicate that, for a given SDI, exposure to these risks is declining. In 2017, the leading Level 4 risk factor for age-standardised DALY rates was high SBP in four super-regions: central Europe, eastern Europe, and central Asia; north Africa and Middle East; south Asia; and southeast Asia, east Asia, and Oceania. The leading risk factor in the high-income super-region was smoking, in Latin America and Caribbean was high BMI, and in sub-Saharan Africa was unsafe sex. O/E ratios for unsafe sex in sub-Saharan Africa were notably high, and those for alcohol use in north Africa and the Middle East were notably low. Interpretation By quantifying levels and trends in exposures to risk factors and the resulting disease burden, this assessment offers insight into where past policy and programme efforts might have been successful and highlights current priorities for public health action. Decreases in behavioural, environmental, and occupational risks have largely offset the effects of population growth and ageing, in relation to trends in absolute burden. Conversely, the combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in non-communicable diseases at the global level, which presents both a public health challenge and opportunity. We see considerable spatiotemporal heterogeneity in levels of risk exposure and risk-attributable burden. Although levels of development underlie some of this heterogeneity, O/E ratios show risks for which countries are overperforming or underperforming relative to their level of development. As such, these ratios provide a benchmarking tool to help to focus local decision making. Our findings reinforce the importance of both risk exposure monitoring and epidemiological research to assess causal connections between risks and health outcomes, and they highlight the usefulness of the GBD study in synthesising data to draw comprehensive and robust conclusions that help to inform good policy and strategic health planning. Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.

Published
2019

182. 021 Effects of Low-dose Triple Combination Therapy on Therapeutic Inertia and Prescribing Patterns in Hypertension – Results from the TRIUMPH Trial

Author

Wang, N., primary, Salam, A., additional, Webster, R., additional, De Silva, A., additional, Guggilla, R., additional, Stepien, S., additional, Mysore, J., additional, Billot, L., additional, Jan, S., additional, Maulik, P., additional, Naik, N., additional, Selak, V., additional, Thom, S., additional, Prabhakaran, D., additional, Patel, A., additional, and Rodgers, A., additional

Published
2020
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183. 1D analysis of laminated composite and sandwich plates using a new fifth-order plate theory

Author

Naik,N. S. and Sayyad,A. S.

Subjects
Fifth-order, normal deformation, laminated, sandwich, shear deformation, bending
Abstract

In the present study, a new fifth-order shear and normal deformation theory (FOSNDT) is developed for the analysis of laminated composite and sandwich plates under cylindrical bending. The theory considered the effects of transverse shear and normal deformations. To account for the effect of transverse shear deformation, in-plane displacement uses polynomial shape function expanded up to fifth-order in-terms of the thickness coordinate. Transverse displacement uses derivative of shape function to account for the effect of transverse normal deformations. Therefore, the present theory involves six independent unknown variables. The theory satisfies traction free boundary conditions at top and bottom surfaces of the plate and does not require the shear correction factor. The principle of virtual work is used to obtain the variationally consistent governing differential equations and associated boundary conditions. Analytical solutions for simply supported boundary conditions are obtained using Navier’s solution technique. Non-dimensional displacements and stresses obtained using the present theory are compared with existing exact elasticity solutions and lower and higher-order theories to prove the efficacy of the present theory. The comparison shows that the displacements and stresses predicted by the present theory are in good agreement with those obtained by using the exact solution.

Published
2018

195. A COMPREHENSIVE REVIEW ON ENZYMATIC REACTION CONDITIONS.

Author

NAIK, N. SUNIL and GURUMURTHY, K.

Subjects
LIPASES, PETROLEUM, TRANSESTERIFICATION, BIOMASS energy
Abstract

Biofuels have drawn much attention of researchers in the last few decades due to the escalating cost of crude oils and its upcoming crisis in future. However, based upon the current situation much of research witnessed towards enzymatic transesterification has shown better outcome in terms of yield rate compared with that of the conventional transesterification process. Lipases are more attractive and can be extracted from any living organisms. The present work reviews the literature regarding the usage of different enzymes for transesterification and its optimum reaction conditions. This review is bound to investigate the performance of several lipases concerning varied reaction conditions which are obtained from various sources for biodiesel synthesis. [ABSTRACT FROM AUTHOR]

Published
2021
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196. Fixed-combination, low-dose, triple-pill antihypertensive medication versus usual care in patients with mild-to-moderate hypertension in Sri Lanka: a within-trial and modelled economic evaluation of the TRIUMPH trial

Author

Lung, T ; https://orcid.org/0000-0001-9978-6311, Jan, S ; https://orcid.org/0000-0003-2839-1405, de Silva, HA, Guggilla, R, Maulik, PK ; https://orcid.org/0000-0001-6835-6175, Naik, N, Patel, A ; https://orcid.org/0000-0003-3825-4092, de Silva, AP, Rajapakse, S, Ranasinghe, G, Prabhakaran, D, Rodgers, A ; https://orcid.org/0000-0003-1282-1896, Salam, A, Selak, V, Stepien, S, Thom, S, Webster, R ; https://orcid.org/0000-0002-5136-1098, Lea-Laba, T, Mohammad, Mohammad ; https://orcid.org/0000-0002-5870-7936, Lung, T ; https://orcid.org/0000-0001-9978-6311, Jan, S ; https://orcid.org/0000-0003-2839-1405, de Silva, HA, Guggilla, R, Maulik, PK ; https://orcid.org/0000-0001-6835-6175, Naik, N, Patel, A ; https://orcid.org/0000-0003-3825-4092, de Silva, AP, Rajapakse, S, Ranasinghe, G, Prabhakaran, D, Rodgers, A ; https://orcid.org/0000-0003-1282-1896, Salam, A, Selak, V, Stepien, S, Thom, S, Webster, R ; https://orcid.org/0000-0002-5136-1098, Lea-Laba, T, and Mohammad, Mohammad ; https://orcid.org/0000-0002-5870-7936

Abstract

Background: Elevated blood pressure incurs a major health and economic burden, particularly in low-income and middle-income countries. The Triple Pill versus Usual Care Management for Patients with Mild-to-Moderate Hypertension (TRIUMPH) trial showed a greater reduction in blood pressure in patients using fixed-combination, low-dose, triple-pill antihypertensive therapy (consisting of amlodipine, telmisartan, and chlorthalidone) than in those receiving usual care in Sri Lanka. We aimed to assess the cost-effectiveness of the triple-pill strategy. Methods: We did a within-trial (6-month) and modelled (10-year) economic evaluation of the TRIUMPH trial, using the health system perspective. Health-care costs, reported in 2017 US dollars, were determined from trial records and published literature. A discrete-time simulation model was developed, extrapolating trial findings of reduced systolic blood pressure to 10-year health-care costs, cardiovascular disease events, and mortality. The primary outcomes were the proportion of people reaching blood pressure targets (at 6 months from baseline) and disability-adjusted life-years (DALYs) averted (at 10 years from baseline). Incremental cost-effectiveness ratios were calculated to estimate the cost per additional participant achieving target blood pressure at 6 months and cost per DALY averted over 10 years. Findings: The triple-pill strategy, compared with usual care, cost an additional US$9·63 (95% CI 5·29 to 13·97) per person in the within-trial analysis and $347·75 (285·55 to 412·54) per person in the modelled analysis. Incremental cost-effectiveness ratios were estimated at $7·93 (95% CI 6·59 to 11·84) per participant reaching blood pressure targets at 6 months and $2842·79 (−28·67 to 5714·24) per DALY averted over a 10-year period. Interpretation: Compared with usual care, the triple-pill strategy is cost-effective for patients with mild-to-moderate hypertension. Scaled up investment in the triple pill for hypertension

Published
2019

197. Fixed-combination, low-dose, triple-pill antihypertensive medication versus usual care in patients with mild-to-moderate hypertension in Sri Lanka: a within-trial and modelled economic evaluation of the TRIUMPH trial

Author

Lung, T, Jan, S, de Silva, HA, Guggilla, R, Maulik, PK, Naik, N, Patel, A, de Silva, AP, Rajapakse, S, Ranasinghe, G, Prabhakaran, D, Rodgers, A, Salam, A, Selak, V, Stepien, S, Thom, S, Webster, R, Lea-Laba, T, Lung, T, Jan, S, de Silva, HA, Guggilla, R, Maulik, PK, Naik, N, Patel, A, de Silva, AP, Rajapakse, S, Ranasinghe, G, Prabhakaran, D, Rodgers, A, Salam, A, Selak, V, Stepien, S, Thom, S, Webster, R, and Lea-Laba, T

Abstract

© 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license Background: Elevated blood pressure incurs a major health and economic burden, particularly in low-income and middle-income countries. The Triple Pill versus Usual Care Management for Patients with Mild-to-Moderate Hypertension (TRIUMPH) trial showed a greater reduction in blood pressure in patients using fixed-combination, low-dose, triple-pill antihypertensive therapy (consisting of amlodipine, telmisartan, and chlorthalidone) than in those receiving usual care in Sri Lanka. We aimed to assess the cost-effectiveness of the triple-pill strategy. Methods: We did a within-trial (6-month) and modelled (10-year) economic evaluation of the TRIUMPH trial, using the health system perspective. Health-care costs, reported in 2017 US dollars, were determined from trial records and published literature. A discrete-time simulation model was developed, extrapolating trial findings of reduced systolic blood pressure to 10-year health-care costs, cardiovascular disease events, and mortality. The primary outcomes were the proportion of people reaching blood pressure targets (at 6 months from baseline) and disability-adjusted life-years (DALYs) averted (at 10 years from baseline). Incremental cost-effectiveness ratios were calculated to estimate the cost per additional participant achieving target blood pressure at 6 months and cost per DALY averted over 10 years. Findings: The triple-pill strategy, compared with usual care, cost an additional US$9·63 (95% CI 5·29 to 13·97) per person in the within-trial analysis and $347·75 (285·55 to 412·54) per person in the modelled analysis. Incremental cost-effectiveness ratios were estimated at $7·93 (95% CI 6·59 to 11·84) per participant reaching blood pressure targets at 6 months and $2842·79 (−28·67 to 5714·24) per DALY averted over a 10-year period. Interpretation: Compared with usual care, the triple-pill strategy is cost-ef

Published
2019

198. STUDIES ON PHYSICAL PROPERTIES AND CHEMICAL MAKE-UP OF HYBRID AND NATIVE VARIETIES OF FLAXSEEDS

Author

Bhat, Vanita S., Jayarama Naik N, and Basavaraj Madhusudhan.

Subjects
Flaxseeds, NL-115 and LM-001 cultivars, physico-chemical properties sensors
Abstract

The present work reports the physical properties and chemical make-up of two flaxseeds cultivars NL-115 (hybrid) and LM-001 (native) of Indian origin. The flaxseeds cultivars exhibited variations in dimensions include length, width, thickness and diameter increase linearly with increase in moisture content. The retention of moisture by the seeds depends on their chemical constituents.The geometric properties increased as the moisture content increased. The bulk density, rupture force, deformation and energy absorbed decreased linearly while true density, porosity, thousand seed mass, angle of repose and static coefficient of friction increased linearly with increasing moisture content. The dimensional parameters such as length, width and thickness varied from 4.74 to 4.79 mm, 2.41 to 2.47 mm, and 0.98 to 1.10 mm, respectively. While, bulk density, true density, porosity and thousand kernel weight found to vary in the range of 630.03 to 640.66 kg/m3, 866.50to 868.50 kg/m3, 26.23to 27.29% and 7.56to 6.59 g, respectively. The static coefficient of friction found to vary from 0.43 to 0.59 and angle of repose from 270.001to 270. 551. The flaxseed variety NL-115 was found to be slightly larger and cream colored than dark colored LM-001 in appearance.

Published
2018
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199. Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017

Author

Lozano, R. Fullman, N. Abate, D. Abay, S.M. Abbafati, C. Abbasi, N. Abbastabar, H. Abd-Allah, F. Abdela, J. Abdelalim, A. Abdel-Rahman, O. Abdi, A. Abdollahpour, I. Abdulkader, R.S. Abebe, N.D. Abebe, Z. Abejie, A.N. Abera, S.F. Abil, O.Z. Aboyans, V. Abraha, H.N. Abrham, A.R. Abu-Raddad, L.J. Abu-Rmeileh, N.M. Abyu, G.Y. Accrombessi, M.M.K. Acharya, D. Acharya, P. Adamu, A.A. Adebayo, O.M. Adedeji, I.A. Adedoyin, R.A. Adekanmbi, V. Adetokunboh, O.O. Adhena, B.M. Adhikari, T.B. Adib, M.G. Adou, A.K. Adsuar, J.C. Afarideh, M. Afshari, M. Afshin, A. Agarwal, G. Aghayan, S.A. Agius, D. Agrawal, A. Agrawal, S. Ahmadi, A. Ahmadi, M. Ahmadieh, H. Ahmed, M.B. Ahmed, S. Akalu, T.Y. Akanda, A.S. Akbari, M.E. Akibu, M. Akinyemi, R.O. Akinyemiju, T. Akseer, N. Alahdab, F. Al-Aly, Z. Alam, K. Alam, T. Albujeer, A. Alebel, A. Alene, K.A. Al-Eyadhy, A. Alhabib, S. Ali, R. Alijanzadeh, M. Alizadeh-Navaei, R. Aljunid, S.M. Alkerwi, A. Alla, F. Allebeck, P. Allen, C.A. Almasi, A. Al-Maskari, F. Al-Mekhlafi, H.M. Alonso, J. Al-Raddadi, R.M. Alsharif, U. Altirkawi, K. Alvis-Guzman, N. Amare, A.T. Amenu, K. Amini, E. Ammar, W. Anber, N.H. Anderson, J.A. Andrei, C.L. Androudi, S. Animut, M.D. Anjomshoa, M. Ansari, H. Ansariadi, A. Ansha, M.G. Antonio, C.A.T. Anwari, P. Appiah, L.T. Aremu, O. Areri, H.A. Ärnlöv, J. Arora, M. Aryal, K.K. Asayesh, H. Asfaw, E.T. Asgedom, S.W. Asghar, R.J. Assadi, R. Ataro, Z. Atique, S. Atre, S.R. Atteraya, M.S. Ausloos, M. Avila-Burgos, L. Avokpaho, E.F.G.A. Awasthi, A. Quintanilla, B.P.A. Ayele, H.T. Ayele, Y. Ayer, R. Azarpazhooh, M.R. Azzopardi, P.S. Azzopardi-Muscat, N. Babalola, T.K. Babazadeh, A. Badali, H. Badawi, A. Balakrishnan, K. Bali, A.G. Banach, M. Banerjee, A. Banoub, J.A.M. Banstola, A. Barac, A. Barboza, M.A. Barker-Collo, S.L. Bärnighausen, T.W. Barrero, L.H. Barthelemy, C.M. Bassat, Q. Basu, A. Basu, S. Battista, R.J. Baune, B.T. Baynes, H.W. Bazargan-Hejazi, S. Bedi, N. Beghi, E. Behzadifar, M. Behzadifar, M. Béjot, Y. Bekele, B.B. Belachew, A.B. Belay, A.G. Belay, S.A. Belay, Y.A. Bell, M.L. Bello, A.K. Bennett, D.A. Bensenor, I.M. Benzian, H. Berhane, A. Berhe, A.K. Berman, A.E. Bernabe, E. Bernstein, R.S. Bertolacci, G.J. Beuran, M. Beyranvand, T. Bhala, N. Bhalla, A. Bhansali, A. Bhattarai, S. Bhaumik, S. Bhutta, Z.A. Biadgo, B. Biehl, M.H. Bijani, A. Bikbov, B. Bililign, N. Sayeed, M.S.B. Birlik, S.M. Birungi, C. Bisanzio, D. Biswas, T. Bitew, H. Bizuneh, H. Bjertness, E. Bobasa, E.M. Boufous, S. Bourne, R. Bozorgmehr, K. Bragazzi, N.L. Brainin, M. Brant, L.C. Brauer, M. Brazinova, A. Breitborde, N.J.K. Briant, P.S. Britton, G. Brugha, T. Bukhman, G. Busse, R. Butt, Z.A. Cahuana-Hurtado, L. Callender, C.S.K.H. Campos-Nonato, I.R. Rincon, J.C.C. Cano, J. Car, J. Car, M. Cárdenas, R. Carrero, J.J. Carter, A. Carvalho, F. Castañeda-Orjuela, C.A. Rivas, J.C. Castro, F. Causey, K. Çavlin, A. Cercy, K.M. Cerin, E. Chaiah, Y. Chalek, J. Chang, H.-Y. Chang, J.-C. Chattopadhyay, A. Chattu, V.K. Chaturvedi, P. Chiang, P.P.-C. Chin, K.L. Chisumpa, V.H. Chitheer, A. Choi, J.-Y.J. Chowdhury, R. Christensen, H. Christopher, D.J. Chung, S.-C. Cicuttini, F.M. Ciobanu, L.G. Cirillo, M. Claro, R.M. Claßen, T.K.D. Cohen, A.J. Collado-Mateo, D. Cooper, C. Cooper, L.T. Cornaby, L. Cortinovis, M. Costa, M. Cousin, E. Cromwell, E.A. Crowe, C.S. Cunningham, M. Daba, A.K. Dadi, A.F. Dandona, L. Dandona, R. Dang, A.K. Dargan, P.I. Daryani, A. Das, S.K. Das Gupta, R. Das Neves, J. Dasa, T.T. Dash, A.P. Davis, A.C. Davitoiu, D.V. Davletov, K. Dayama, A. De Courten, B. De Leo, D. Neve, J.W.D. De Steur, H. Degefa, M.G. Degenhardt, L. Degfie, T.T. Deiparine, S. Dellavalle, R.P. Demoz, G.T. Demtsu, B. Denova-Gutiérrez, E. Deribe, K. Dervenis, N. Dessie, G.A. Dey, S. Dharmaratne, S.D. Dhimal, M. Dicker, D. Dinberu, M.T. Ding, E.L. Djalalinia, S. Do, H.P. Dokova, K. Doku, D.T. Douwes-Schultz, D. Driscoll, T.R. Duan, L. Dubey, M. Dubljanin, E. Duken, E.E. Duncan, B.B. Duraes, A.R. Ebrahimpour, S. Edvardsson, D. El Bcheraoui, C. Eldrenkamp, E. El-Khatib, Z. Elyazar, I.R.F. Enayati, A. Endries, A.Y. Eshrati, B. Eskandarieh, S. Esteghamati, A. Esteghamati, S. Estep, K. Fakhar, M. Fakhim, H. Fanzo, J. Faramarzi, M. Fareed, M. Farhadi, F. Farid, T.A. Farinha, C.S.E.S. Farioli, A. Faro, A. Farvid, M.S. Farzadfar, F. Farzaei, M.H. Farzam, H. Fazaeli, A.A. Fazeli, M.S. Feigin, V.L. Feigl, A.B. Fekadu, W. Feldman, R. Fentahun, N. Fereshtehnejad, S.-M. Fernandes, E. Fernandes, J.C. Feyissa, G.T. Fijabi, D.O. Filip, I. Finegold, S. Finger, J.D. Fischer, F. Fitzmaurice, C. Flor, L.S. Foigt, N.A. Foreman, K.J. Frank, T.D. Franklin, R.C. Fukumoto, T. Fukutaki, K. Fuller, J.E. Fürst, T. Furtado, J.M. Gakidou, E. Gallus, S. Gankpe, F.G. Gansevoort, R.T. Garcia, A.C. Garcia-Basteiro, A.L. Garcia-Gordillo, M.A. Gardner, W.M. Gebre, A.K. Gebre, T. Gebregergs, G.B. Gebrehiwot, T.T. Gebremedhin, A.T. Gebremichael, B. Gebremichael, T.G. Gelano, T.F. Geleijnse, J.M. Geramo, Y.C.D. Getachew, S. Gething, P.W. Gezae, K.E. Ghadami, M.R. Ghadimi, R. Ghadiri, K. Ghasemi-Kasman, M. Ghiasvand, H. Ghimire, M. Ghoshal, A.G. Giampaoli, S. Gill, P.S. Gill, T.K. Giussani, G. Gnedovskaya, E.V. Goldberg, E.M. Goli, S. Gona, P.N. Goodridge, A. Gopalani, S.V. Gorman, T.M. Goto, A. Goulart, A.C. Goulart, B.N.G. Grada, A. Griswold, M.G. Grosso, G. Gugnani, H.C.C. Guillemin, F. Guimaraes, A.L.S. Guo, Y. Gupta, P.C. Gupta, R. Gupta, R. Gupta, T. Ha, G.H. Haagsma, J.A. Hachinski, V. Hafezi-Nejad, N. Bidgoli, H.H. Hagos, T.B. Haile, M.T. Hailegiyorgis, T.T. Hailu, G.B. Haj-Mirzaian, A. Haj-Mirzaian, A. Hamadeh, R.R. Hamidi, S. Hankey, G.J. Harb, H.L. Harikrishnan, S. Haririan, H. Haro, J.M. Hasan, M. Hassankhani, H. Hassen, H.Y. Havmoeller, R. Hawley, C.N. Hay, S.I. He, Y. Hedayatizadeh-Omran, A. Hegazy, M.I. Heibati, B. Heidari, B. Heidari, M. Hendrie, D. Henok, A. Heredia-Pi, I. Herteliu, C. Heydarpour, B. Heydarpour, F. Heydarpour, S. Hibstu, D.T. Híjar, M. Hoek, H.W. Hoffman, D.J. Hole, M.K. Homaie Rad, E. Hoogar, P. Horita, N. Hosgood, H.D. Hosseini, S.M. Hosseinzadeh, M. Hostiuc, M. Hostiuc, S. Hotez, P.J. Hoy, D.G. Hsairi, M. Hsiao, T. Hu, G. Huang, J.J. Hughes, C. Huynh, C.K. Igumbor, E.U. Ikeda, C.T. Ilesanmi, O.S. Iqbal, U. Irvani, S.S.N. Irvine, C.M.S. Islam, S.M.S. Islami, F. Ivers, R.Q. Izadi, N. Jacobsen, K.H. Jahangiry, L. Jahanmehr, N. Jain, S.K. Jakovljevic, M. Jalu, M.T. Jamal, A.A. James, S.L. Jassal, S.K. Javanbakht, M. Jayatilleke, A.U. Jeemon, P. Jha, R.P. Jha, V. Ji, J.S. Johnson, C.O. Johnson, S.C. Jonas, J.B. Jonnagaddala, J. Shushtari, Z.J. Joshi, A. Jozwiak, J.J. Jungari, S.B. Jürisson, M. Madhanraj, K. Kabir, Z. Kadel, R. Kahsay, A. Kahssay, M. Kalani, R. Kapil, U. Karami, M. Matin, B.K. Karanikolos, M. Karimi, N. Karimi, S.M. Karimi-Sari, H. Kasaeian, A. Kassa, D.H. Kassa, G.M. Kassa, T.D. Kassa, Z.Y. Kassebaum, N.J. Katikireddi, S.V. Kaul, A. Kawakami, N. Kazemi, Z. Karyani, A.K. Kazi, D.S. Prakash, K.C. Kebede, S. Keiyoro, P.N. Kemmer, L. Kemp, G.R. Kengne, A.P. Keren, A. Kesavachandran, C.N. Khader, Y.S. Khafaei, B. Khafaie, M.A. Khajavi, A. Khalid, N. Khalil, I.A. Khan, E.A. Khan, M.S. Khan, M.A. Khang, Y.-H. Khanna, T. Khater, M.M. Khatony, A. Khazaeipour, Z. Khazaie, H. Khoja, A.T. Khosravi, A. Khosravi, M.H. Khubchandani, J. Kiadaliri, A.A. Kiarie, H.W. Kibret, G.D. Kiirithio, D.N. Kim, D. Kim, J.Y. Kim, Y.-E. Kim, Y.J. Kimokoti, R.W. Kinfu, Y. Kinra, S. Kisa, A. Kissimova-Skarbek, K. Kissoon, N. Kivimäki, M. Kocarnik, J.M. Kochhar, S. Kokubo, Y. Kolola, T. Kopec, J.A. Kosek, M.N. Kosen, S. Koul, P.A. Koyanagi, A. Kravchenko, M.A. Krishan, K. Krohn, K.J. Defo, B.K. Kucuk Bicer, B. Kudom, A.A. Kulikoff, X.R. Kumar, G.A. Kumar, M. Kumar, P. Kutz, M.J. Kyu, H.H. Lachat, C. Lad, D.P. Lad, S.D. Lafranconi, A. Lagat, A.K. Lal, D.K. Lalloo, R. Lam, H. Lami, F.H. Lamichhane, P. Lan, Q. Lang, J.J. Lansingh, V.C. Lansky, S. Larson, H.J. Larsson, A.O. Laryea, D.O. Lassi, Z.S. Latifi, A. Lau, K.M.-M. Laxmaiah, A. Lazarus, J.V. Leasher, J.L. Lebedev, G. Ledesma, J.R. Lee, J.B. Lee, P.H. Leever, A.T. Leigh, J. Leinsalu, M. Leshargie, C.T. Leung, J. Lewycka, S. Li, S. Li, X. Li, Y. Liang, J. Liang, X. Liben, M.L. Lim, L.-L. Limenih, M.A. Linn, S. Liu, S. Liu, Y. Lodha, R. Logroscino, G. Lopez, A.D. Lorkowski, S. Lotufo, P.A. Lucchesi, L.R. Lyons, R.A. Macarayan, E.R.K. Mackay, M.T. Maddison, E.R. Madotto, F. Maghavani, D.P. Magis-Rodriguez, C. Mahotra, N.B. Majdan, M. Majdzadeh, R. Majeed, A. Malekzadeh, R. Malta, D.C. Mamun, A.A. Manda, A.-L. Mandarano-Filho, L.G. Mangalam, S. Manguerra, H. Mansournia, M.A. Mapoma, C.C. Maravilla, J.C. Marcenes, W. Marks, A. Martin, R.V. Martins, S.C.O. Martins-Melo, F.R. Martopullo, I. Mashamba-Thompson, T.P. Massenburg, B.B. Mathur, M.R. Maulik, P.K. Mazidi, M. McAlinden, C. McGrath, J.J. McKee, M. McMahon, B.J. Mehata, S. Mehndiratta, M.M. Mehrotra, R. Mehta, K.M. Mehta, V. Mejia-Rodriguez, F. Mekonen, T. Mekonnen, T.C.C. Meles, H.G. Melese, A. Melku, M. Memiah, P.T.N. Memish, Z.A. Mendoza, W. Mengistu, D.T. Mengistu, G. Mensah, G.A. Mensink, G.B.M. Mereta, S.T. Meretoja, A. Meretoja, T.J. Mestrovic, T. Mezgebe, H.B. Miazgowski, B. Miazgowski, T. Millear, A.I. Miller, T.R. Miller-Petrie, M.K. Milne, G.J. Mini, G.K. Minnig, S.P. Mirabi, P. Mirarefin, M. Mirrakhimov, E.M. Misganaw, A.T. Mitchell, P.B. Moazen, B. Moghadamnia, A.A. Mohajer, B. Mohammad, K.A. Mohammadi, M. Mohammadifard, N. Mohammadnia-Afrouzi, M. Mohammed, M.A. Mohammed, S. Mohan, M.B.V. Mohan, V. Mohebi, F. Moitra, M. Mokdad, A.H. Molokhia, M. Monasta, L. Montañez, J.C. Moosazadeh, M. Moradi, G. Moradi, M. Moradi-Lakeh, M. Moradinazar, M. Moraga, P. Morawska, L. Morgado-da-Costa, J. Morisaki, N. Morrison, S.D. Mosapour, A. Moschos, M.M. Mountjoy-Venning, W.C. Mouodi, S. Mousavi, S.M. Muche, A.A. Muchie, K.F. Mueller, U.O. Muhammed, O.S.S. Mukhopadhyay, S. Mullany, E.C. Muller, K. Mumford, J.E. Murhekar, M. Murthy, G.V.S. Murthy, S. Musa, J. Musa, K.I. Mustafa, G. 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Roberts, N.L.S. Roever, L. Ronfani, L. Roshandel, G. Rostami, A. Roth, G.A. Roy, A. Rubagotti, E. Ruhago, G.M. Sabde, Y.D. Sachdev, P.S. Saddik, B. Sadeghi, E. Safari, H. Safari, Y. Safari-Faramani, R. Safdarian, M. Safi, S. Safiri, S. Sagar, R. Sahebkar, A. Sahraian, M.A. Sajadi, H.S. Salam, N. Salama, J.S. Salamati, P. De Freitas Saldanha, R. Saleem, Z. Salimi, Y. Salimzadeh, H. Salomon, J.A. Salvi, S.S. Salz, I. Sambala, E.Z. Samy, A.M. Sanabria, J. Sanchez-Niño, M.D. Santos, I.S. Milicevic, M.M.S. Jose, B.P.S. Sardana, M. Sarker, A.R. Sarrafzadegan, N. Sartorius, B. Sarvi, S. Sathian, B. Satpathy, M. Savic, M. Sawant, A.R. Sawhney, M. Saxena, S. Saylan, M. Sayyah, M. Schaeffner, E. Schmidt, M.I. Schneider, I.J.C. Schöttker, B. Schutte, A.E. Schwebel, D.C. Schwendicke, F. Seedat, S. Sekerija, M. Sepanlou, S.G. Serván-Mori, E. Seyedmousavi, S. Shabaninejad, H. Shackelford, K.A. Shafieesabet, A. Shaheen, A.A. Shaikh, M.A. Shams-Beyranvand, M. Shamsi, M.B. Shamsizadeh, M. Sharafi, H. 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Abstract

Background: Efforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of “leaving no one behind”, it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health-related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990–2017, projected indicators to 2030, and analysed global attainment. Methods: We measured progress on 41 health-related SDG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the health-related SDG index, we transformed the value for each indicator on a scale of 0–100, with 0 as the 2·5th percentile and 100 as the 97·5th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the probability of attainment in 2030 calculated from 1000 draws. We also did a global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends. Using 2015 global averages of indicators with defined SDG targets, we calculated the global annualised rates of change required from 2015 to 2030 to meet these targets, and then identified in what percentiles the required global annualised rates of change fell in the distribution of country-level rates of change from 1990 to 2015. We took the mean of these global percentile values across indicators and applied the past rate of change at this mean global percentile to all health-related SDG indicators, irrespective of target definition, to estimate the equivalent 2030 global average value and percentage change from 2015 to 2030 for each indicator. Findings: The global median health-related SDG index in 2017 was 59·4 (IQR 35·4–67·3), ranging from a low of 11·6 (95% uncertainty interval 9·6–14·0) to a high of 84·9 (83·1–86·7). SDG index values in countries assessed at the subnational level varied substantially, particularly in China and India, although scores in Japan and the UK were more homogeneous. Indicators also varied by SDI quintile and sex, with males having worse outcomes than females for non-communicable disease (NCD) mortality, alcohol use, and smoking, among others. Most countries were projected to have a higher health-related SDG index in 2030 than in 2017, while country-level probabilities of attainment by 2030 varied widely by indicator. Under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria indicators had the most countries with at least 95% probability of target attainment. Other indicators, including NCD mortality and suicide mortality, had no countries projected to meet corresponding SDG targets on the basis of projected mean values for 2030 but showed some probability of attainment by 2030. For some indicators, including child malnutrition, several infectious diseases, and most violence measures, the annualised rates of change required to meet SDG targets far exceeded the pace of progress achieved by any country in the recent past. We found that applying the mean global annualised rate of change to indicators without defined targets would equate to about 19% and 22% reductions in global smoking and alcohol consumption, respectively; a 47% decline in adolescent birth rates; and a more than 85% increase in health worker density per 1000 population by 2030. Interpretation: The GBD study offers a unique, robust platform for monitoring the health-related SDGs across demographic and geographic dimensions. Our findings underscore the importance of increased collection and analysis of disaggregated data and highlight where more deliberate design or targeting of interventions could accelerate progress in attaining the SDGs. Current projections show that many health-related SDG indicators, NCDs, NCD-related risks, and violence-related indicators will require a concerted shift away from what might have driven past gains—curative interventions in the case of NCDs—towards multisectoral, prevention-oriented policy action and investments to achieve SDG aims. Notably, several targets, if they are to be met by 2030, demand a pace of progress that no country has achieved in the recent past. The future is fundamentally uncertain, and no model can fully predict what breakthroughs or events might alter the course of the SDGs. What is clear is that our actions—or inaction—today will ultimately dictate how close the world, collectively, can get to leaving no one behind by 2030. Funding: Bill & Melinda Gates Foundation. © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license

Published
2018

200. Global, regional, and national incidence, prevalence, and years lived with disability for 354 Diseases and Injuries for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017

Author

James, S.L. Abate, D. Abate, K.H. Abay, S.M. Abbafati, C. Abbasi, N. Abbastabar, H. Abd-Allah, F. Abdela, J. Abdelalim, A. Abdollahpour, I. Abdulkader, R.S. Abebe, Z. Abera, S.F. Abil, O.Z. Abraha, H.N. Abu-Raddad, L.J. Abu-Rmeileh, N.M.E. Accrombessi, M.M.K. Acharya, D. Acharya, P. Ackerman, I.N. Adamu, A.A. Adebayo, O.M. Adekanmbi, V. Adetokunboh, O.O. Adib, M.G. Adsuar, J.C. Afanvi, K.A. Afarideh, M. Afshin, A. Agarwal, G. Agesa, K.M. Aggarwal, R. Aghayan, S.A. Agrawal, S. Ahmadi, A. Ahmadi, M. Ahmadieh, H. Ahmed, M.B. Aichour, A.N. Aichour, I. Aichour, M.T.E. Akinyemiju, T. Akseer, N. Al-Aly, Z. Al-Eyadhy, A. Al-Mekhlafi, H.M. Al-Raddadi, R.M. Alahdab, F. Alam, K. Alam, T. Alashi, A. Alavian, S.M. Alene, K.A. Alijanzadeh, M. Alizadeh-Navaei, R. Aljunid, S.M. Alkerwi, A. Alla, F. Allebeck, P. Alouani, M.M.L. Altirkawi, K. Alvis-Guzman, N. Amare, A.T. Aminde, L.N. Ammar, W. Amoako, Y.A. Anber, N.H. Andrei, C.L. Androudi, S. Animut, M.D. Anjomshoa, M. Ansha, M.G. Antonio, C.A.T. 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Zenebe, Z.M. Zhang, K. Zhao, Z. Zhou, M. Zodpey, S. Zucker, I. Vos, T. Murray, C.J.L. GBD 2017 Disease Injury Incidence Prevalence Collaborators

Abstract

Background: The Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) includes a comprehensive assessment of incidence, prevalence, and years lived with disability (YLDs) for 354 causes in 195 countries and territories from 1990 to 2017. Previous GBD studies have shown how the decline of mortality rates from 1990 to 2016 has led to an increase in life expectancy, an ageing global population, and an expansion of the non-fatal burden of disease and injury. These studies have also shown how a substantial portion of the world's population experiences non-fatal health loss with considerable heterogeneity among different causes, locations, ages, and sexes. Ongoing objectives of the GBD study include increasing the level of estimation detail, improving analytical strategies, and increasing the amount of high-quality data. Methods: We estimated incidence and prevalence for 354 diseases and injuries and 3484 sequelae. We used an updated and extensive body of literature studies, survey data, surveillance data, inpatient admission records, outpatient visit records, and health insurance claims, and additionally used results from cause of death models to inform estimates using a total of 68 781 data sources. Newly available clinical data from India, Iran, Japan, Jordan, Nepal, China, Brazil, Norway, and Italy were incorporated, as well as updated claims data from the USA and new claims data from Taiwan (province of China) and Singapore. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between rates of incidence, prevalence, remission, and cause of death for each condition. YLDs were estimated as the product of a prevalence estimate and a disability weight for health states of each mutually exclusive sequela, adjusted for comorbidity. We updated the Socio-demographic Index (SDI), a summary development indicator of income per capita, years of schooling, and total fertility rate. Additionally, we calculated differences between male and female YLDs to identify divergent trends across sexes. GBD 2017 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting. Findings: Globally, for females, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and haemoglobinopathies and haemolytic anaemias in both 1990 and 2017. For males, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and tuberculosis including latent tuberculosis infection in both 1990 and 2017. In terms of YLDs, low back pain, headache disorders, and dietary iron deficiency were the leading Level 3 causes of YLD counts in 1990, whereas low back pain, headache disorders, and depressive disorders were the leading causes in 2017 for both sexes combined. All-cause age-standardised YLD rates decreased by 3·9% (95% uncertainty interval [UI] 3·1-4·6) from 1990 to 2017; however, the all-age YLD rate increased by 7·2% (6·0-8·4) while the total sum of global YLDs increased from 562 million (421-723) to 853 million (642-1100). The increases for males and females were similar, with increases in all-age YLD rates of 7·9% (6·6-9·2) for males and 6·5% (5·4-7·7) for females. We found significant differences between males and females in terms of age-standardised prevalence estimates for multiple causes. The causes with the greatest relative differences between sexes in 2017 included substance use disorders (3018 cases [95% UI 2782-3252] per 100 000 in males vs 1400 [1279-1524] per 100 000 in females), transport injuries (3322 [3082-3583] vs 2336 [2154-2535]), and self-harm and interpersonal violence (3265 [2943-3630] vs 5643 [5057-6302]). Interpretation: Global all-cause age-standardised YLD rates have improved only slightly over a period spanning nearly three decades. However, the magnitude of the non-fatal disease burden has expanded globally, with increasing numbers of people who have a wide spectrum of conditions. A subset of conditions has remained globally pervasive since 1990, whereas other conditions have displayed more dynamic trends, with different ages, sexes, and geographies across the globe experiencing varying burdens and trends of health loss. This study emphasises how global improvements in premature mortality for select conditions have led to older populations with complex and potentially expensive diseases, yet also highlights global achievements in certain domains of disease and injury. Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.

Published
2018

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