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Basu S, Venkataramani AS, Schillinger D. The Risk Of Perpetuating Health Disparities Through Cost-Effectiveness Analyses. Health Aff (Millwood) 2024; 43:1165-1171. [PMID: 39102593 DOI: 10.1377/hlthaff.2023.01583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/07/2024]
Abstract
Cost-effectiveness analyses are commonly used to inform health care and public health policy decisions. However, standard approaches may systematically disadvantage marginalized groups by incorporating assumptions of persisting health inequities. We examined how competing risks, baseline health care costs, and indirect costs can differentially affect cost-effectiveness analyses for racial and ethnic minority populations. We illustrate that these structural factors can reduce estimated quality-adjusted life-years and cost savings for disadvantaged groups, making interventions focused on disadvantaged populations appear less cost-effective. For example, analyses of a sugar-sweetened beverage tax may estimate higher costs per quality-adjusted life-year gained for Black versus White populations because of differences in competing risks and insurance status that manifest in higher health care cost savings from averted disease among White people. To ensure that cost-effectiveness assessments do not perpetuate inequities, alternative approaches are needed that account for the impact of structural factors on different groups and that consider scenarios in which health inequities are reduced. Sensitivity analyses focusing on health equity could help advance interventions that disproportionately benefit disadvantaged communities.
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Basu S, Patel SY, Robinson K, Baum A. Financing Thresholds for Sustainability of Community Health Worker Programs for Patients Receiving Medicaid Across the United States. J Community Health 2024; 49:606-634. [PMID: 38311699 PMCID: PMC11306546 DOI: 10.1007/s10900-023-01290-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2023] [Indexed: 02/06/2024]
Abstract
States have turned to novel Medicaid financing to pay for community health worker (CHW) programs, often through fee-for-service or capitated payments. We sought to estimate Medicaid payment rates to ensure CHW program sustainability. A microsimulation model was constructed to estimate CHW salaries, equipment, transportation, space, and benefits costs across the U.S. Fee-for-service rates per 30-min CHW visit (code 98960) and capitated rates were calculated for financial sustainability. The mean CHW hourly wage was $23.51, varying from $15.90 in Puerto Rico to $31.61 in Rhode Island. Overhead per work hour averaged $43.65 nationwide, and was highest for transportation among other overhead categories (65.1% of overhead). The minimum fee-for-service rate for a 30-min visit was $53.24 (95% CI $24.80, $91.11), varying from $40.44 in South Dakota to $70.89 in Washington D.C. The minimum capitated rate was $140.18 per member per month (95% CI $105.94, $260.90), varying from $113.55 in South Dakota to $176.58 in Washington D.C. Rates varied minimally by metro status but more by panel size. Higher Medicaid fee-for-service and capitated rates than currently used may be needed to support financial viability of CHW programs. A revised payment estimation approach may help state officials, health systems and plans discussing CHW program sustainability.
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Acharya S, Adamová D, Aglieri Rinella G, Agnello M, Agrawal N, Ahammed Z, Ahmad S, Ahn SU, Ahuja I, Akindinov A, Al-Turany M, Aleksandrov D, Alessandro B, Alfanda HM, Alfaro Molina R, Ali B, Alici A, Alizadehvandchali N, Alkin A, Alme J, Alocco G, Alt T, Altamura AR, Altsybeev I, Alvarado JR, Anaam MN, Andrei C, Andreou N, Andronic A, Anguelov V, Antinori F, Antonioli P, Apadula N, Aphecetche L, Appelshäuser H, Arata C, Arcelli S, Aresti M, Arnaldi R, Arneiro JGMCA, Arsene IC, Arslandok M, Augustinus A, Averbeck R, Azmi MD, Baba H, Badalà A, Bae J, Baek YW, Bai X, Bailhache R, Bailung Y, Balbino A, Baldisseri A, Balis B, Banerjee D, Banoo Z, Barbera R, Barile F, Barioglio L, Barlou M, Barman B, Barnaföldi GG, Barnby LS, Barret V, Barreto L, Bartels C, Barth K, Bartsch E, Bastid N, Basu S, Batigne G, Battistini D, Batyunya B, Bauri D, Bazo Alba JL, Bearden IG, Beattie C, Becht P, Behera D, Belikov I, Bell Hechavarria ADC, Bellini F, Bellwied R, Belokurova S, Beltran YAV, Bencedi G, Beole S, Berdnikov Y, Berdnikova A, Bergmann L, Besoiu MG, Betev L, Bhaduri PP, Bhasin A, Bhat MA, Bhattacharjee B, Bianchi L, Bianchi N, Bielčík J, Bielčíková J, Biernat J, Bigot AP, Bilandzic A, Biro G, Biswas S, Bize N, Blair JT, Blau D, Blidaru MB, Bluhme N, Blume C, Boca G, Bock F, Bodova T, Bogdanov A, Boi S, Bok J, Boldizsár L, Bombara M, Bond PM, Bonomi G, Borel H, Borissov A, Borquez Carcamo AG, Bossi H, Botta E, Bouziani YEM, Bratrud L, Braun-Munzinger P, Bregant M, Broz M, Bruno GE, Buckland MD, Budnikov D, Buesching H, Bufalino S, Buhler P, Burmasov N, Buthelezi Z, Bylinkin A, Bysiak SA, Cai M, Caines H, Caliva A, Calvo Villar E, Camacho JMM, Camerini P, Canedo FDM, Cantway SL, Carabas M, Carballo AA, Carnesecchi F, Caron R, Carvalho LAD, Castillo Castellanos J, Catalano F, Ceballos Sanchez C, Chakaberia I, Chakraborty P, Chandra S, Chapeland S, Chartier M, Chattopadhyay S, Chattopadhyay S, Cheng T, Cheshkov C, Cheynis B, Chibante Barroso V, Chinellato DD, Chizzali ES, Cho J, Cho S, Chochula P, Choudhury D, Christakoglou P, Christensen CH, Christiansen P, Chujo T, Ciacco M, Cicalo C, Cindolo F, Ciupek MR, Clai G, Colamaria F, Colburn JS, Colella D, Colocci M, Concas M, Conesa Balbastre G, Conesa Del Valle Z, Contin G, Contreras JG, Coquet ML, Cortese P, Cosentino MR, Costa F, Costanza S, Cot C, Crkovská J, Crochet P, Cruz-Torres R, Cui P, Dainese A, Danisch MC, Danu A, Das P, Das P, Das S, Dash AR, Dash S, De Caro A, de Cataldo G, de Cuveland J, De Falco A, De Gruttola D, De Marco N, De Martin C, De Pasquale S, Deb R, Del Grande R, Dello Stritto L, Deng W, Dhankher P, Di Bari D, Di Mauro A, Diab B, Diaz RA, Dietel T, Ding Y, Ditzel J, Divià R, Dixit DU, Djuvsland Ø, Dmitrieva U, Dobrin A, Dönigus B, Dubinski JM, Dubla A, Dudi S, Dupieux P, Durkac M, Dzalaiova N, Eder TM, Ehlers RJ, Eisenhut F, Ejima R, Elia D, Erazmus B, Ercolessi F, Espagnon B, Eulisse G, Evans D, Evdokimov S, Fabbietti L, Faggin M, Faivre J, Fan F, Fan W, Fantoni A, Fasel M, Feliciello A, Feofilov G, Fernández Téllez A, Ferrandi L, Ferrer MB, Ferrero A, Ferrero C, Ferretti A, Feuillard VJG, Filova V, Finogeev D, Fionda FM, Flatland E, Flor F, Flores AN, Foertsch S, Fokin I, Fokin S, Fragiacomo E, Frajna E, Fuchs U, Funicello N, Furget C, Furs A, Fusayasu T, Gaardhøje JJ, Gagliardi M, Gago AM, Gahlaut T, Galvan CD, Gangadharan DR, Ganoti P, Garabatos C, García Chávez T, Garcia-Solis E, Gargiulo C, Gasik P, Gautam A, Gay Ducati MB, Germain M, Ghimouz A, Ghosh C, Giacalone M, Gioachin G, Giubellino P, Giubilato P, Glaenzer AMC, Glässel P, Glimos E, Goh DJQ, Gonzalez V, Gordeev P, Gorgon M, Goswami K, Gotovac S, Grabski V, Graczykowski LK, Grecka E, Grelli A, Grigoras C, Grigoriev V, Grigoryan S, Grosa F, Grosse-Oetringhaus JF, Grosso R, Grund D, Grunwald NA, Guardiano GG, Guernane R, Guilbaud M, Gulbrandsen K, Gündem T, Gunji T, Guo W, Gupta A, Gupta R, Gupta R, Gwizdziel K, Gyulai L, Hadjidakis C, Haider FU, Haidlova S, Hamagaki H, Hamdi A, Han Y, Hanley BG, Hannigan R, Hansen J, Haque MR, Harris JW, Harton A, Hassan H, Hatzifotiadou D, Hauer P, Havener LB, Heckel ST, Hellbär E, Helstrup H, Hemmer M, Herman T, Herrera Corral G, Herrmann F, Herrmann S, Hetland KF, Heybeck B, Hillemanns H, Hippolyte B, Hoffmann FW, Hofman B, Hong GH, Horst M, Horzyk A, Hou Y, Hristov P, Hughes C, Huhn P, Huhta LM, Humanic TJ, Hutson A, Hutter D, Ilkaev R, Ilyas H, Inaba M, Innocenti GM, Ippolitov M, Isakov A, Isidori T, Islam MS, Ivanov M, Ivanov M, Ivanov V, Iversen KE, Jablonski M, Jacak B, Jacazio N, Jacobs PM, Jadlovska S, Jadlovsky J, Jaelani S, Jahnke C, Jakubowska MJ, Janik MA, Janson T, Ji S, Jia S, Jimenez AAP, Jonas F, Jones DM, Jowett JM, Jung J, Jung M, Junique A, Jusko A, Kaewjai J, Kalinak P, Kalteyer AS, Kalweit A, Kaplin V, Karasu Uysal A, Karatovic D, Karavichev O, Karavicheva T, Karczmarczyk P, Karpechev E, Karwowska MJ, Kebschull U, Keidel R, Keijdener DLD, Keil M, Ketzer B, Khade SS, Khan AM, Khan S, Khanzadeev A, Kharlov Y, Khatun A, Khuntia A, Kileng B, Kim B, Kim C, Kim DJ, Kim EJ, Kim J, Kim JS, Kim J, Kim J, Kim M, Kim S, Kim T, Kimura K, Kirsch S, Kisel I, Kiselev S, Kisiel A, Kitowski JP, Klay JL, Klein J, Klein S, Klein-Bösing C, Kleiner M, Klemenz T, Kluge A, Knospe AG, Kobdaj C, Kollegger T, Kondratyev A, Kondratyeva N, Kondratyuk E, Konig J, Konigstorfer SA, Konopka PJ, Kornakov G, Korwieser M, Koryciak SD, Kotliarov A, Kovalenko V, Kowalski M, Kozhuharov V, Králik I, Kravčáková A, Krcal L, Krivda M, Krizek F, Krizkova Gajdosova K, Kroesen M, Krüger M, Krupova DM, Kryshen E, Kučera V, Kuhn C, Kuijer PG, Kumaoka T, Kumar D, Kumar L, Kumar N, Kumar S, Kundu S, Kurashvili P, Kurepin A, Kurepin AB, Kuryakin A, Kushpil S, Kuskov V, Kweon MJ, Kwon Y, La Pointe SL, La Rocca P, Lakrathok A, Lamanna M, Landou AR, Langoy R, Larionov P, Laudi E, Lautner L, Lavicka R, Lea R, Lee H, Legrand I, Legras G, Lehrbach J, Lelek TM, Lemmon RC, León Monzón I, Lesch MM, Lesser ED, Lévai P, Li X, Lien J, Lietava R, Likmeta I, Lim B, Lim SH, Lindenstruth V, Lindner A, Lippmann C, Liu DH, Liu J, Liveraro GSS, Lofnes IM, Loizides C, Lokos S, Lömker J, Loncar P, Lopez X, López Torres E, Lu P, Lugo FV, Luhder JR, Lunardon M, Luparello G, Ma YG, Mager M, Maire A, Majerz EM, Makariev MV, Malaev M, Malfattore G, Malik NM, Malik QW, Malik SK, Malinina L, Mallick D, Mallick N, Mandaglio G, Mandal SK, Manko V, Manso F, Manzari V, Mao Y, Marcjan RW, Margagliotti GV, Margotti A, Marín A, Markert C, Martinengo P, Martínez MI, Martínez García G, Martins MPP, Masciocchi S, Masera M, Masoni A, Massacrier L, Massen O, Mastroserio A, Matonoha O, Mattiazzo S, Matyja A, Mayer C, Mazuecos AL, Mazzaschi F, Mazzilli M, Mdhluli JE, Melikyan Y, Menchaca-Rocha A, Mendez JEM, Meninno E, Menon AS, Meres M, Mhlanga S, Miake Y, Micheletti L, Mihaylov DL, Mikhaylov K, Mishra AN, Miśkowiec D, Modak A, Mohanty B, Mohisin Khan M, Molander MA, Monira S, Mordasini C, Moreira De Godoy DA, Morozov I, Morsch A, Mrnjavac T, Muccifora V, Muhuri S, Mulligan JD, Mulliri A, Munhoz MG, Munzer RH, Murakami H, Murray S, Musa L, Musinsky J, Myrcha JW, Naik B, Nambrath AI, Nandi BK, Nania R, Nappi E, Nassirpour AF, Nath A, Nattrass C, Naydenov MN, Neagu A, Negru A, Nekrasova E, Nellen L, Nepeivoda R, Nese S, Neskovic G, Nicassio N, Nielsen BS, Nielsen EG, Nikolaev S, Nikulin S, Nikulin V, Noferini F, Noh S, Nomokonov P, Norman J, Novitzky N, Nowakowski P, Nyanin A, Nystrand J, Ogino M, Oh S, Ohlson A, Okorokov VA, Oleniacz J, Oliveira Da Silva AC, Onnerstad A, Oppedisano C, Ortiz Velasquez A, Otwinowski J, Oya M, Oyama K, Pachmayer Y, Padhan S, Pagano D, Paić G, Paisano-Guzmán S, Palasciano A, Panebianco S, Park H, Park H, Park J, Parkkila JE, Patley Y, Patra RN, Paul B, Pei H, Peitzmann T, Peng X, Pennisi M, Perciballi S, Peresunko D, Perez GM, Pestov Y, Petrov V, Petrovici M, Pezzi RP, Piano S, Pikna M, Pillot P, Pinazza O, Pinsky L, Pinto C, Pisano S, Płoskoń M, Planinic M, Pliquett F, Poghosyan MG, Polichtchouk B, Politano S, Poljak N, Pop A, Porteboeuf-Houssais S, Pozdniakov V, Pozos IY, Pradhan KK, Prasad SK, Prasad S, Preghenella R, Prino F, Pruneau CA, Pshenichnov I, Puccio M, Pucillo S, Pugelova Z, Qiu S, Quaglia L, Ragoni S, Rai A, Rakotozafindrabe A, Ramello L, Rami F, Rancien TA, Rasa M, Räsänen SS, Rath R, Rauch MP, Ravasenga I, Read KF, Reckziegel C, Redelbach AR, Redlich K, Reetz CA, Regules-Medel HD, Rehman A, Reidt F, Reme-Ness HA, Rescakova Z, Reygers K, Riabov A, Riabov V, Ricci R, Richter M, Riedel AA, Riegler W, Riffero AG, Ristea C, Rodriguez MV, Rodríguez Cahuantzi M, Rodríguez Ramírez SA, Røed K, Rogalev R, Rogochaya E, Rogoschinski TS, Rohr D, Röhrich D, Rojas PF, Rojas Torres S, Rokita PS, Romanenko G, Ronchetti F, Rosano A, Rosas ED, Roslon K, Rossi A, Roy A, Roy S, Rubini N, Ruggiano D, Rui R, Russek PG, Russo R, Rustamov A, Ryabinkin E, Ryabov Y, Rybicki A, Rytkonen H, Ryu J, Rzesa W, Saarimaki OAM, Sadhu S, Sadovsky S, Saetre J, Šafařík K, Saha P, Saha SK, Saha S, Sahoo B, Sahoo B, Sahoo R, Sahoo S, Sahu D, Sahu PK, Saini J, Sajdakova K, Sakai S, Salvan MP, Sambyal S, Samitz D, Sanna I, Saramela TB, Sarma P, Sarritzu V, Sarti VM, Sas MHP, Sawan S, Schambach J, Scheid HS, Schiaua C, Schicker R, Schlepper F, Schmah A, Schmidt C, Schmidt HR, Schmidt MO, Schmidt M, Schmidt NV, Schmier AR, Schotter R, Schröter A, Schukraft J, Schweda K, Scioli G, Scomparin E, Seger JE, Sekiguchi Y, Sekihata D, Selina M, Selyuzhenkov I, Senyukov S, Seo JJ, Serebryakov D, Šerkšnytė L, Sevcenco A, Shaba TJ, Shabetai A, Shahoyan R, Shangaraev A, Sharma A, Sharma B, Sharma D, Sharma H, Sharma M, Sharma S, Sharma S, Sharma U, Shatat A, Sheibani O, Shigaki K, Shimomura M, Shin J, Shirinkin S, Shou Q, Sibiriak Y, Siddhanta S, Siemiarczuk T, Silva TF, Silvermyr D, Simantathammakul T, Simeonov R, Singh B, Singh B, Singh K, Singh R, Singh R, Singh R, Singh S, Singh VK, Singhal V, Sinha T, Sitar B, Sitta M, Skaali TB, Skorodumovs G, Slupecki M, Smirnov N, Snellings RJM, Solheim EH, Song J, Sonnabend C, Soramel F, Soto-Hernandez AB, Spijkers R, Sputowska I, Staa J, Stachel J, Stan I, Steffanic PJ, Stiefelmaier SF, Stocco D, Storehaug I, Stratmann P, Strazzi S, Sturniolo A, Stylianidis CP, Suaide AAP, Suire C, Sukhanov M, Suljic M, Sultanov R, Sumberia V, Sumowidagdo S, Swain S, Szarka I, Szymkowski M, Taghavi SF, Taillepied G, Takahashi J, Tambave GJ, Tang S, Tang Z, Tapia Takaki JD, Tapus N, Tarasovicova LA, Tarzila MG, Tassielli GF, Tauro A, Tavira García A, Tejeda Muñoz G, Telesca A, Terlizzi L, Terrevoli C, Thakur S, Thomas D, Tikhonov A, Tiltmann N, Timmins AR, Tkacik M, Tkacik T, Toia A, Tokumoto R, Tomohiro K, Topilskaya N, Toppi M, Tork T, Torres VV, Torres Ramos AG, Trifiró A, Triolo AS, Tripathy S, Tripathy T, Trogolo S, Trubnikov V, Trzaska WH, Trzcinski TP, Tumkin A, Turrisi R, Tveter TS, Ullaland K, Ulukutlu B, Uras A, Usai GL, Vala M, Valle N, van Doremalen LVR, van Leeuwen M, van Veen CA, van Weelden RJG, Vande Vyvre P, Varga D, Varga Z, Vargas Torres P, Vasileiou M, Vasiliev A, Vázquez Doce O, Vazquez Rueda O, Vechernin V, Vercellin E, Vergara Limón S, Verma R, Vermunt L, Vértesi R, Verweij M, Vickovic L, Vilakazi Z, Villalobos Baillie O, Villani A, Vinogradov A, Virgili T, Virta MMO, Vislavicius V, Vodopyanov A, Volkel B, Völkl MA, Voloshin K, Voloshin SA, Volpe G, von Haller B, Vorobyev I, Vozniuk N, Vrláková J, Wan J, Wang C, Wang D, Wang Y, Wang Y, Wegrzynek A, Weiglhofer FT, Wenzel SC, Wessels JP, Wiechula J, Wikne J, Wilk G, Wilkinson J, Willems GA, Windelband B, Winn M, Wright JR, Wu W, Wu Y, Xu R, Yadav A, Yadav AK, Yalcin S, Yamaguchi Y, Yang S, Yano S, Yin Z, Yoo IK, Yoon JH, Yu H, Yuan S, Yuncu A, Zaccolo V, Zampolli C, Zanone F, Zardoshti N, Zarochentsev A, Závada P, Zaviyalov N, Zhalov M, Zhang B, Zhang C, Zhang L, Zhang S, Zhang X, Zhang Y, Zhang Z, Zhao M, Zherebchevskii V, Zhi Y, Zhou D, Zhou Y, Zhu J, Zhu Y, Zugravel SC, Zurlo N. Observation of Medium-Induced Yield Enhancement and Acoplanarity Broadening of Low-p_{T} Jets from Measurements in pp and Central Pb-Pb Collisions at sqrt[s_{NN}]=5.02 TeV. PHYSICAL REVIEW LETTERS 2024; 133:022301. [PMID: 39073970 DOI: 10.1103/physrevlett.133.022301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 05/06/2024] [Accepted: 05/13/2024] [Indexed: 07/31/2024]
Abstract
The ALICE Collaboration reports the measurement of semi-inclusive distributions of charged-particle jets recoiling from a high transverse momentum (high p_{T}) hadron trigger in proton-proton and central Pb-Pb collisions at sqrt[s_{NN}]=5.02 TeV. A data-driven statistical method is used to mitigate the large uncorrelated background in central Pb-Pb collisions. Recoil jet distributions are reported for jet resolution parameter R=0.2, 0.4, and 0.5 in the range 7
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Naghavi M, Ong KL, Aali A, Ababneh HS, Abate YH, Abbafati C, Abbasgholizadeh R, Abbasian M, Abbasi-Kangevari M, Abbastabar H, Abd ElHafeez S, Abdelmasseh M, Abd-Elsalam S, Abdelwahab A, Abdollahi M, Abdollahifar MA, Abdoun M, Abdulah DM, Abdullahi A, Abebe M, Abebe SS, Abedi A, Abegaz KH, Abhilash ES, Abidi H, Abiodun O, Aboagye RG, Abolhassani H, Abolmaali M, Abouzid M, Aboye GB, Abreu LG, Abrha WA, Abtahi D, Abu Rumeileh S, Abualruz H, Abubakar B, Abu-Gharbieh E, Abu-Rmeileh NME, Aburuz S, Abu-Zaid A, Accrombessi MMK, Adal TG, Adamu AA, Addo IY, Addolorato G, Adebiyi AO, Adekanmbi V, Adepoju AV, Adetunji CO, Adetunji JB, Adeyeoluwa TE, Adeyinka DA, Adeyomoye OI, Admass BAA, Adnani QES, Adra S, Afolabi AA, Afzal MS, Afzal S, Agampodi SB, Agasthi P, Aggarwal M, Aghamiri S, Agide FD, Agodi A, Agrawal A, Agyemang-Duah W, Ahinkorah BO, Ahmad A, Ahmad D, Ahmad F, Ahmad MM, Ahmad S, Ahmad S, Ahmad T, Ahmadi K, Ahmadzade AM, Ahmed A, Ahmed A, Ahmed H, Ahmed LA, Ahmed MS, Ahmed MS, Ahmed MB, Ahmed SA, Ajami M, Aji B, Akara EM, Akbarialiabad H, Akinosoglou K, Akinyemiju T, Akkaif MA, Akyirem S, Al Hamad H, Al Hasan SM, Alahdab F, Alalalmeh SO, Alalwan TA, Al-Aly Z, Alam K, Alam M, Alam N, Al-amer RM, Alanezi FM, Alanzi TM, Al-Azzam S, Albakri A, Albashtawy M, AlBataineh MT, Alcalde-Rabanal JE, Aldawsari KA, Aldhaleei WA, Aldridge RW, Alema HB, Alemayohu MA, Alemi S, Alemu YM, Al-Gheethi AAS, Alhabib KF, Alhalaiqa FAN, Al-Hanawi MK, Ali A, Ali A, Ali L, Ali MU, Ali R, Ali S, Ali SSS, Alicandro G, Alif SM, Alikhani R, Alimohamadi Y, Aliyi AA, Aljasir MAM, Aljunid SM, Alla F, Allebeck P, Al-Marwani S, Al-Maweri SAA, Almazan JU, Al-Mekhlafi HM, Almidani L, Almidani O, Alomari MA, Al-Omari B, Alonso J, Alqahtani JS, Alqalyoobi S, Alqutaibi AY, Al-Sabah SK, Altaany Z, Altaf A, Al-Tawfiq JA, Altirkawi KA, Aluh DO, Alvis-Guzman N, Alwafi H, Al-Worafi YM, Aly H, Aly S, Alzoubi KH, Amani R, Amare AT, Amegbor PM, Ameyaw EK, Amin TT, Amindarolzarbi A, Amiri S, Amirzade-Iranaq MH, Amu H, Amugsi DA, Amusa GA, Ancuceanu R, Anderlini D, Anderson DB, Andrade PP, Andrei CL, Andrei T, Angus C, Anil A, Anil S, Anoushiravani A, Ansari H, Ansariadi A, Ansari-Moghaddam A, Antony CM, Antriyandarti E, Anvari D, Anvari S, Anwar S, Anwar SL, Anwer R, Anyasodor AE, Aqeel M, Arab JP, Arabloo J, Arafat M, Aravkin AY, Areda D, Aremu A, Aremu O, Ariffin H, Arkew M, Armocida B, Arndt MB, Ärnlöv J, Arooj M, Artamonov AA, Arulappan J, Aruleba RT, Arumugam A, Asaad M, Asadi-Lari M, Asgedom AA, Asghariahmadabad M, Asghari-Jafarabadi M, Ashraf M, Aslani A, Astell-Burt T, Athar M, Athari SS, Atinafu BTT, Atlaw HW, Atorkey P, Atout MMW, Atreya A, Aujayeb A, Ausloos M, Avan A, Awedew AF, Aweke AM, Ayala Quintanilla BP, Ayatollahi H, Ayuso-Mateos JL, Ayyoubzadeh SM, Azadnajafabad S, Azevedo RMS, Azzam AY, B DB, Babu AS, Badar M, Badiye AD, Baghdadi S, Bagheri N, Bagherieh S, Bah S, Bahadorikhalili S, Bahmanziari N, Bai R, Baig AA, Baker JL, Bako AT, Bakshi RK, Balakrishnan S, Balasubramanian M, Baltatu OC, Bam K, Banach M, Bandyopadhyay S, Banik PC, Bansal H, Bansal K, Barbic F, Barchitta M, Bardhan M, Bardideh E, Barker-Collo SL, Bärnighausen TW, Barone-Adesi F, Barqawi HJ, Barrero LH, Barrow A, Barteit S, Barua L, Basharat Z, Bashiri A, Basiru A, Baskaran P, Basnyat B, Bassat Q, Basso JD, Basting AVL, Basu S, Batra K, Baune BT, Bayati M, Bayileyegn NS, Beaney T, Bedi N, Beghi M, Behboudi E, Behera P, Behnoush AH, Behzadifar M, Beiranvand M, Bejarano Ramirez DF, Béjot Y, Belay SA, Belete CM, Bell ML, Bello MB, Bello OO, Belo L, Beloukas A, Bender RG, Bensenor IM, Beran A, Berezvai Z, Berhie AY, Berice BN, Bernstein RS, Bertolacci GJ, Bettencourt PJG, Beyene KA, Bhagat DS, Bhagavathula AS, Bhala N, Bhalla A, Bhandari D, Bhangdia K, Bhardwaj N, Bhardwaj P, Bhardwaj PV, Bhargava A, Bhaskar S, Bhat V, Bhatti GK, Bhatti JS, Bhatti MS, Bhatti R, Bhutta ZA, Bikbov B, Bishai JD, Bisignano C, Bisulli F, Biswas A, Biswas B, Bitaraf S, Bitew BD, Bitra VR, Bjørge T, Boachie MK, Boampong 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Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet 2024; 403:2100-2132. [PMID: 38582094 PMCID: PMC11126520 DOI: 10.1016/s0140-6736(24)00367-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 02/15/2024] [Accepted: 02/22/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation.
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Burden of disease scenarios for 204 countries and territories, 2022-2050: a forecasting analysis for the Global Burden of Disease Study 2021. Lancet 2024; 403:2204-2256. [PMID: 38762325 PMCID: PMC11121021 DOI: 10.1016/s0140-6736(24)00685-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 03/29/2024] [Accepted: 04/02/2024] [Indexed: 05/20/2024]
Abstract
BACKGROUND Future trends in disease burden and drivers of health are of great interest to policy makers and the public at large. This information can be used for policy and long-term health investment, planning, and prioritisation. We have expanded and improved upon previous forecasts produced as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) and provide a reference forecast (the most likely future), and alternative scenarios assessing disease burden trajectories if selected sets of risk factors were eliminated from current levels by 2050. METHODS Using forecasts of major drivers of health such as the Socio-demographic Index (SDI; a composite measure of lag-distributed income per capita, mean years of education, and total fertility under 25 years of age) and the full set of risk factor exposures captured by GBD, we provide cause-specific forecasts of mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) by age and sex from 2022 to 2050 for 204 countries and territories, 21 GBD regions, seven super-regions, and the world. All analyses were done at the cause-specific level so that only risk factors deemed causal by the GBD comparative risk assessment influenced future trajectories of mortality for each disease. Cause-specific mortality was modelled using mixed-effects models with SDI and time as the main covariates, and the combined impact of causal risk factors as an offset in the model. At the all-cause mortality level, we captured unexplained variation by modelling residuals with an autoregressive integrated moving average model with drift attenuation. These all-cause forecasts constrained the cause-specific forecasts at successively deeper levels of the GBD cause hierarchy using cascading mortality models, thus ensuring a robust estimate of cause-specific mortality. For non-fatal measures (eg, low back pain), incidence and prevalence were forecasted from mixed-effects models with SDI as the main covariate, and YLDs were computed from the resulting prevalence forecasts and average disability weights from GBD. Alternative future scenarios were constructed by replacing appropriate reference trajectories for risk factors with hypothetical trajectories of gradual elimination of risk factor exposure from current levels to 2050. The scenarios were constructed from various sets of risk factors: environmental risks (Safer Environment scenario), risks associated with communicable, maternal, neonatal, and nutritional diseases (CMNNs; Improved Childhood Nutrition and Vaccination scenario), risks associated with major non-communicable diseases (NCDs; Improved Behavioural and Metabolic Risks scenario), and the combined effects of these three scenarios. Using the Shared Socioeconomic Pathways climate scenarios SSP2-4.5 as reference and SSP1-1.9 as an optimistic alternative in the Safer Environment scenario, we accounted for climate change impact on health by using the most recent Intergovernmental Panel on Climate Change temperature forecasts and published trajectories of ambient air pollution for the same two scenarios. Life expectancy and healthy life expectancy were computed using standard methods. The forecasting framework includes computing the age-sex-specific future population for each location and separately for each scenario. 95% uncertainty intervals (UIs) for each individual future estimate were derived from the 2·5th and 97·5th percentiles of distributions generated from propagating 500 draws through the multistage computational pipeline. FINDINGS In the reference scenario forecast, global and super-regional life expectancy increased from 2022 to 2050, but improvement was at a slower pace than in the three decades preceding the COVID-19 pandemic (beginning in 2020). Gains in future life expectancy were forecasted to be greatest in super-regions with comparatively low life expectancies (such as sub-Saharan Africa) compared with super-regions with higher life expectancies (such as the high-income super-region), leading to a trend towards convergence in life expectancy across locations between now and 2050. At the super-region level, forecasted healthy life expectancy patterns were similar to those of life expectancies. Forecasts for the reference scenario found that health will improve in the coming decades, with all-cause age-standardised DALY rates decreasing in every GBD super-region. The total DALY burden measured in counts, however, will increase in every super-region, largely a function of population ageing and growth. We also forecasted that both DALY counts and age-standardised DALY rates will continue to shift from CMNNs to NCDs, with the most pronounced shifts occurring in sub-Saharan Africa (60·1% [95% UI 56·8-63·1] of DALYs were from CMNNs in 2022 compared with 35·8% [31·0-45·0] in 2050) and south Asia (31·7% [29·2-34·1] to 15·5% [13·7-17·5]). This shift is reflected in the leading global causes of DALYs, with the top four causes in 2050 being ischaemic heart disease, stroke, diabetes, and chronic obstructive pulmonary disease, compared with 2022, with ischaemic heart disease, neonatal disorders, stroke, and lower respiratory infections at the top. The global proportion of DALYs due to YLDs likewise increased from 33·8% (27·4-40·3) to 41·1% (33·9-48·1) from 2022 to 2050, demonstrating an important shift in overall disease burden towards morbidity and away from premature death. The largest shift of this kind was forecasted for sub-Saharan Africa, from 20·1% (15·6-25·3) of DALYs due to YLDs in 2022 to 35·6% (26·5-43·0) in 2050. In the assessment of alternative future scenarios, the combined effects of the scenarios (Safer Environment, Improved Childhood Nutrition and Vaccination, and Improved Behavioural and Metabolic Risks scenarios) demonstrated an important decrease in the global burden of DALYs in 2050 of 15·4% (13·5-17·5) compared with the reference scenario, with decreases across super-regions ranging from 10·4% (9·7-11·3) in the high-income super-region to 23·9% (20·7-27·3) in north Africa and the Middle East. The Safer Environment scenario had its largest decrease in sub-Saharan Africa (5·2% [3·5-6·8]), the Improved Behavioural and Metabolic Risks scenario in north Africa and the Middle East (23·2% [20·2-26·5]), and the Improved Nutrition and Vaccination scenario in sub-Saharan Africa (2·0% [-0·6 to 3·6]). INTERPRETATION Globally, life expectancy and age-standardised disease burden were forecasted to improve between 2022 and 2050, with the majority of the burden continuing to shift from CMNNs to NCDs. That said, continued progress on reducing the CMNN disease burden will be dependent on maintaining investment in and policy emphasis on CMNN disease prevention and treatment. Mostly due to growth and ageing of populations, the number of deaths and DALYs due to all causes combined will generally increase. By constructing alternative future scenarios wherein certain risk exposures are eliminated by 2050, we have shown that opportunities exist to substantially improve health outcomes in the future through concerted efforts to prevent exposure to well established risk factors and to expand access to key health interventions. FUNDING Bill & Melinda Gates Foundation.
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Global fertility in 204 countries and territories, 1950-2021, with forecasts to 2100: a comprehensive demographic analysis for the Global Burden of Disease Study 2021. Lancet 2024; 403:2057-2099. [PMID: 38521087 PMCID: PMC11122687 DOI: 10.1016/s0140-6736(24)00550-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/28/2023] [Accepted: 03/15/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND Accurate assessments of current and future fertility-including overall trends and changing population age structures across countries and regions-are essential to help plan for the profound social, economic, environmental, and geopolitical challenges that these changes will bring. Estimates and projections of fertility are necessary to inform policies involving resource and health-care needs, labour supply, education, gender equality, and family planning and support. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 produced up-to-date and comprehensive demographic assessments of key fertility indicators at global, regional, and national levels from 1950 to 2021 and forecast fertility metrics to 2100 based on a reference scenario and key policy-dependent alternative scenarios. METHODS To estimate fertility indicators from 1950 to 2021, mixed-effects regression models and spatiotemporal Gaussian process regression were used to synthesise data from 8709 country-years of vital and sample registrations, 1455 surveys and censuses, and 150 other sources, and to generate age-specific fertility rates (ASFRs) for 5-year age groups from age 10 years to 54 years. ASFRs were summed across age groups to produce estimates of total fertility rate (TFR). Livebirths were calculated by multiplying ASFR and age-specific female population, then summing across ages 10-54 years. To forecast future fertility up to 2100, our Institute for Health Metrics and Evaluation (IHME) forecasting model was based on projections of completed cohort fertility at age 50 years (CCF50; the average number of children born over time to females from a specified birth cohort), which yields more stable and accurate measures of fertility than directly modelling TFR. CCF50 was modelled using an ensemble approach in which three sub-models (with two, three, and four covariates variously consisting of female educational attainment, contraceptive met need, population density in habitable areas, and under-5 mortality) were given equal weights, and analyses were conducted utilising the MR-BRT (meta-regression-Bayesian, regularised, trimmed) tool. To capture time-series trends in CCF50 not explained by these covariates, we used a first-order autoregressive model on the residual term. CCF50 as a proportion of each 5-year ASFR was predicted using a linear mixed-effects model with fixed-effects covariates (female educational attainment and contraceptive met need) and random intercepts for geographical regions. Projected TFRs were then computed for each calendar year as the sum of single-year ASFRs across age groups. The reference forecast is our estimate of the most likely fertility future given the model, past fertility, forecasts of covariates, and historical relationships between covariates and fertility. We additionally produced forecasts for multiple alternative scenarios in each location: the UN Sustainable Development Goal (SDG) for education is achieved by 2030; the contraceptive met need SDG is achieved by 2030; pro-natal policies are enacted to create supportive environments for those who give birth; and the previous three scenarios combined. Uncertainty from past data inputs and model estimation was propagated throughout analyses by taking 1000 draws for past and present fertility estimates and 500 draws for future forecasts from the estimated distribution for each metric, with 95% uncertainty intervals (UIs) given as the 2·5 and 97·5 percentiles of the draws. To evaluate the forecasting performance of our model and others, we computed skill values-a metric assessing gain in forecasting accuracy-by comparing predicted versus observed ASFRs from the past 15 years (2007-21). A positive skill metric indicates that the model being evaluated performs better than the baseline model (here, a simplified model holding 2007 values constant in the future), and a negative metric indicates that the evaluated model performs worse than baseline. FINDINGS During the period from 1950 to 2021, global TFR more than halved, from 4·84 (95% UI 4·63-5·06) to 2·23 (2·09-2·38). Global annual livebirths peaked in 2016 at 142 million (95% UI 137-147), declining to 129 million (121-138) in 2021. Fertility rates declined in all countries and territories since 1950, with TFR remaining above 2·1-canonically considered replacement-level fertility-in 94 (46·1%) countries and territories in 2021. This included 44 of 46 countries in sub-Saharan Africa, which was the super-region with the largest share of livebirths in 2021 (29·2% [28·7-29·6]). 47 countries and territories in which lowest estimated fertility between 1950 and 2021 was below replacement experienced one or more subsequent years with higher fertility; only three of these locations rebounded above replacement levels. Future fertility rates were projected to continue to decline worldwide, reaching a global TFR of 1·83 (1·59-2·08) in 2050 and 1·59 (1·25-1·96) in 2100 under the reference scenario. The number of countries and territories with fertility rates remaining above replacement was forecast to be 49 (24·0%) in 2050 and only six (2·9%) in 2100, with three of these six countries included in the 2021 World Bank-defined low-income group, all located in the GBD super-region of sub-Saharan Africa. The proportion of livebirths occurring in sub-Saharan Africa was forecast to increase to more than half of the world's livebirths in 2100, to 41·3% (39·6-43·1) in 2050 and 54·3% (47·1-59·5) in 2100. The share of livebirths was projected to decline between 2021 and 2100 in most of the six other super-regions-decreasing, for example, in south Asia from 24·8% (23·7-25·8) in 2021 to 16·7% (14·3-19·1) in 2050 and 7·1% (4·4-10·1) in 2100-but was forecast to increase modestly in the north Africa and Middle East and high-income super-regions. Forecast estimates for the alternative combined scenario suggest that meeting SDG targets for education and contraceptive met need, as well as implementing pro-natal policies, would result in global TFRs of 1·65 (1·40-1·92) in 2050 and 1·62 (1·35-1·95) in 2100. The forecasting skill metric values for the IHME model were positive across all age groups, indicating that the model is better than the constant prediction. INTERPRETATION Fertility is declining globally, with rates in more than half of all countries and territories in 2021 below replacement level. Trends since 2000 show considerable heterogeneity in the steepness of declines, and only a small number of countries experienced even a slight fertility rebound after their lowest observed rate, with none reaching replacement level. Additionally, the distribution of livebirths across the globe is shifting, with a greater proportion occurring in the lowest-income countries. Future fertility rates will continue to decline worldwide and will remain low even under successful implementation of pro-natal policies. These changes will have far-reaching economic and societal consequences due to ageing populations and declining workforces in higher-income countries, combined with an increasing share of livebirths among the already poorest regions of the world. FUNDING Bill & Melinda Gates Foundation.
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Yehualashet SS, Yesuf SA, Yezli S, Yiğit A, Yiğit V, Yigzaw ZA, Yismaw Y, Yon DK, Yonemoto N, Younis MZ, Yu C, Yu Y, Yusuf H, Zahid MH, Zakham F, Zaki L, Zaki N, Zaman BA, Zamora N, Zand R, Zandieh GGZ, Zar HJ, Zarrintan A, Zastrozhin MS, Zhang H, Zhang N, Zhang Y, Zhao H, Zhong C, Zhong P, Zhou J, Zhu Z, Ziafati M, Zielińska M, Zimsen SRM, Zoladl M, Zumla A, Zyoud SH, Vos T, Murray CJL. 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. Lancet 2024; 403:2133-2161. [PMID: 38642570 PMCID: PMC11122111 DOI: 10.1016/s0140-6736(24)00757-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 03/07/2024] [Accepted: 04/12/2024] [Indexed: 04/22/2024]
Abstract
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.
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Solaimanian S, Solanki R, Solanki S, Soliman SSM, Somayaji R, Song Y, Sorensen RJD, Soriano JB, Soyiri IN, Spartalis M, Spearman S, Spencer CN, Sreeramareddy CT, Stachteas P, Stafford LK, Stanaway JD, Stanikzai MH, Stein C, Stein DJ, Steinbeis F, Steiner C, Steinke S, Steiropoulos P, Stockfelt L, Stokes MA, Straif K, Stranges S, Subedi N, Subramaniyan V, Suleman M, Suliankatchi Abdulkader R, Sundström J, Sunkersing D, Sunnerhagen KS, Suresh V, Swain CK, Szarpak L, Szeto MD, Tabaee Damavandi P, Tabarés-Seisdedos R, Tabatabaei SM, Tabatabaei Malazy O, Tabatabaeizadeh SA, Tabatabai S, Tabche C, Tabish M, Tadakamadla SK, Taheri Abkenar Y, Taheri Soodejani M, Taherkhani A, Taiba J, Takahashi K, Talaat IM, Tamuzi JL, Tan KK, Tang H, Tat NY, Taveira N, Tefera YM, Tehrani-Banihashemi A, Temesgen WA, Temsah MH, Teramoto M, Terefa DR, Teye-Kwadjo E, Thakur R, Thangaraju P, Thankappan KR, Thapar R, Thayakaran R, Thirunavukkarasu S, Thomas N, Thomas NK, Tian J, Tichopad A, Ticoalu JHV, Tiruye TY, Tobe-Gai R, Tolani MA, Tolossa T, Tonelli M, Topor-Madry R, Topouzis F, Touvier M, Tovani-Palone MR, Trabelsi K, Tran JT, Tran MTN, Tran NM, Trico D, Trihandini I, Troeger CE, Tromans SJ, Truyen TTTT, Tsatsakis A, Tsermpini EE, Tumurkhuu M, Udoakang AJ, Udoh A, Ullah A, Ullah S, Ullah S, Umair M, Umakanthan S, Unim B, Unnikrishnan B, Upadhyay E, Urso D, Usman JS, Vaithinathan AG, Vakili O, Valenti M, Valizadeh R, Van den Eynde J, van Donkelaar A, Varga O, Vart P, Varthya SB, Vasankari TJ, Vasic M, Vaziri S, Venketasubramanian N, Verghese NA, Verma M, Veroux M, Verras GI, Vervoort D, Villafañe JH, Villalobos-Daniel VE, Villani L, Villanueva GI, Vinayak M, Violante FS, Vlassov V, Vo B, Vollset SE, Volovat SR, Vos T, Vujcic IS, Waheed Y, Wang C, Wang F, Wang S, Wang Y, Wang YP, Wanjau MN, Waqas M, Ward P, Waris A, Wassie EG, Weerakoon KG, Weintraub RG, Weiss DJ, Weiss EJ, Weldetinsaa HLL, Wells KM, Wen YF, Wiangkham T, Wickramasinghe ND, Wilkerson C, Willeit P, Wilson S, Wong YJ, Wongsin U, Wozniak S, Wu C, Wu D, Wu F, Wu Z, Xia J, Xiao H, Xu S, Xu X, Xu YY, Yadav MK, Yaghoubi S, Yamagishi K, Yang L, Yano Y, Yaribeygi H, Yasufuku Y, Ye P, Yesodharan R, Yesuf SA, Yezli S, Yi S, Yiğit A, Yigzaw ZA, Yin D, Yip P, Yismaw MB, Yon DK, Yonemoto N, You Y, Younis MZ, Yousefi Z, Yu C, Yu Y, Zadey S, Zadnik V, Zakham F, Zaki N, Zakzuk J, Zamagni G, Zaman SB, Zandieh GGZ, Zanghì A, Zar HJ, Zare I, Zarimeidani F, Zastrozhin MS, Zeng Y, Zhai C, Zhang AL, Zhang H, Zhang L, Zhang M, Zhang Y, Zhang Z, Zhang ZJ, Zhao H, Zhao JT, Zhao XJG, Zhao Y, Zhao Y, Zhong C, Zhou J, Zhou J, Zhou S, Zhu B, Zhu L, Zhu Z, Ziaeian B, Ziafati M, Zielińska M, Zimsen SRM, Zoghi G, Zoller T, Zumla A, Zyoud SH, Zyoud SH, Murray CJL, Gakidou E. Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet 2024; 403:2162-2203. [PMID: 38762324 PMCID: PMC11120204 DOI: 10.1016/s0140-6736(24)00933-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 03/11/2024] [Accepted: 05/02/2024] [Indexed: 05/20/2024]
Abstract
BACKGROUND Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021. METHODS The GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 risk-outcome pairs. Pairs were included on the basis of data-driven determination of a risk-outcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each risk-outcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attributable fraction (PAF; ie, the proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL). The product of PAFs and disease burden associated with a given outcome, measured in disability-adjusted life-years (DALYs), yielded measures of attributable burden (ie, the proportion of total disease burden attributable to a particular risk factor or combination of risk factors). Adjustments for mediation were applied to account for relationships involving risk factors that act indirectly on outcomes via intermediate risks. Attributable burden estimates were stratified by Socio-demographic Index (SDI) quintile and presented as counts, age-standardised rates, and rankings. To complement estimates of RR and attributable burden, newly developed burden of proof risk function (BPRF) methods were applied to yield supplementary, conservative interpretations of risk-outcome associations based on the consistency of underlying evidence, accounting for unexplained heterogeneity between input data from different studies. Estimates reported represent the mean value across 500 draws from the estimate's distribution, with 95% uncertainty intervals (UIs) calculated as the 2·5th and 97·5th percentile values across the draws. FINDINGS Among the specific risk factors analysed for this study, particulate matter air pollution was the leading contributor to the global disease burden in 2021, contributing 8·0% (95% UI 6·7-9·4) of total DALYs, followed by high systolic blood pressure (SBP; 7·8% [6·4-9·2]), smoking (5·7% [4·7-6·8]), low birthweight and short gestation (5·6% [4·8-6·3]), and high fasting plasma glucose (FPG; 5·4% [4·8-6·0]). For younger demographics (ie, those aged 0-4 years and 5-14 years), risks such as low birthweight and short gestation and unsafe water, sanitation, and handwashing (WaSH) were among the leading risk factors, while for older age groups, metabolic risks such as high SBP, high body-mass index (BMI), high FPG, and high LDL cholesterol had a greater impact. From 2000 to 2021, there was an observable shift in global health challenges, marked by a decline in the number of all-age DALYs broadly attributable to behavioural risks (decrease of 20·7% [13·9-27·7]) and environmental and occupational risks (decrease of 22·0% [15·5-28·8]), coupled with a 49·4% (42·3-56·9) increase in DALYs attributable to metabolic risks, all reflecting ageing populations and changing lifestyles on a global scale. Age-standardised global DALY rates attributable to high BMI and high FPG rose considerably (15·7% [9·9-21·7] for high BMI and 7·9% [3·3-12·9] for high FPG) over this period, with exposure to these risks increasing annually at rates of 1·8% (1·6-1·9) for high BMI and 1·3% (1·1-1·5) for high FPG. By contrast, the global risk-attributable burden and exposure to many other risk factors declined, notably for risks such as child growth failure and unsafe water source, with age-standardised attributable DALYs decreasing by 71·5% (64·4-78·8) for child growth failure and 66·3% (60·2-72·0) for unsafe water source. We separated risk factors into three groups according to trajectory over time: those with a decreasing attributable burden, due largely to declining risk exposure (eg, diet high in trans-fat and household air pollution) but also to proportionally smaller child and youth populations (eg, child and maternal malnutrition); those for which the burden increased moderately in spite of declining risk exposure, due largely to population ageing (eg, smoking); and those for which the burden increased considerably due to both increasing risk exposure and population ageing (eg, ambient particulate matter air pollution, high BMI, high FPG, and high SBP). INTERPRETATION Substantial progress has been made in reducing the global disease burden attributable to a range of risk factors, particularly those related to maternal and child health, WaSH, and household air pollution. Maintaining efforts to minimise the impact of these risk factors, especially in low SDI locations, is necessary to sustain progress. Successes in moderating the smoking-related burden by reducing risk exposure highlight the need to advance policies that reduce exposure to other leading risk factors such as ambient particulate matter air pollution and high SBP. Troubling increases in high FPG, high BMI, and other risk factors related to obesity and metabolic syndrome indicate an urgent need to identify and implement interventions. FUNDING Bill & Melinda Gates Foundation.
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Basu S, Yudkin JS, Jawad M, Ghattas H, Hamad BA, Jamaluddine Z, Safadi G, Ragi ME, Ahmad RES, Vamos EP, Millett C. Reducing non-communicable diseases among Palestinian populations in Gaza: A participatory comparative and cost-effectiveness modeling assessment. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003168. [PMID: 38696423 PMCID: PMC11065248 DOI: 10.1371/journal.pgph.0003168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 04/02/2024] [Indexed: 05/04/2024]
Abstract
We sought to assess the effectiveness and cost-effectiveness of potential new public health and healthcare NCD risk reduction efforts among Palestinians in Gaza. We created a microsimulation model using: (i) a cross-sectional household survey of NCD risk factors among 4,576 Palestinian adults aged ≥40 years old in Gaza; (ii) a modified Delphi process among local public health experts to identify potentially feasible new interventions; and (iii) reviews of intervention cost and effectiveness, modified to the Gazan and refugee contexts. The survey revealed 28.6% tobacco smoking, a 40.4% prevalence of hypertension diagnosis (with a 95.6% medication treatment rate), a 25.6% prevalence of diabetes diagnosis (with 95.3% on treatment), a 21.9% prevalence of dyslipidemia (with 79.6% on a statin), and a 9.8% prevalence of asthma or chronic obstructive pulmonary disease (without known treatment). A calibrated model estimated a loss of 9,516 DALYs per 10,000 population over the 10-year policy horizon. The interventions having an incremental cost-effectiveness ratio (ICER) less than three times the GDP per capita of Palestine per DALY averted (<$10,992 per DALY averted)(<$10,992 per DALY averted) included bans on tobacco smoking in indoor and public places [$34 per incremental DALY averted (95% CI: $17, $50)], treatment of asthma using low dose inhaled beclometasone and short-acting beta-agonists [$140 per DALY averted (95% CI: $77, $207)], treatment of breast cancer stages I and II [$730 per DALY averted (95% CI: $372, $1,100)], implementing a mass media campaign for healthier nutrition [$737 per DALY averted (95% CI: $403, $1,100)], treatment of colorectal cancer stages I and II [$7,657 per DALY averted (95% CI: $3,721, $11,639)], and (screening with mammography [$17,054 per DALY averted (95% CI: $8,693, $25,359)]). Despite high levels of NCD risk factors among Palestinians in Gaza, we estimated that several interventions would be expected to reduce the loss of DALYs within common cost-effectiveness thresholds.
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Acharya S, Adamová D, Aglieri Rinella G, Aglietta L, Agnello M, Agrawal N, Ahammed Z, Ahmad S, Ahn SU, Ahuja I, Akindinov A, Al-Turany M, Aleksandrov D, Alessandro B, Alfanda HM, Alfaro Molina R, Ali B, Alici A, Alizadehvandchali N, Alkin A, Alme J, Alocco G, Alt T, Altamura AR, Altsybeev I, Alvarado JR, Anaam MN, Andrei C, Andreou N, Andronic A, Andronov E, Anguelov V, Antinori F, Antonioli P, Apadula N, Aphecetche L, Appelshäuser H, Arata C, Arcelli S, Aresti M, Arnaldi R, Arneiro JGMCA, Arsene IC, Arslandok M, Augustinus A, Averbeck R, Azmi MD, Baba H, Badalà A, Bae J, Baek YW, Bai X, Bailhache R, Bailung Y, Bala R, Balbino A, Baldisseri A, Balis B, Banerjee D, Banoo Z, Barile F, Barioglio L, Barlou M, Barman B, Barnaföldi GG, Barnby LS, Barreau E, Barret V, Barreto L, Bartels C, Barth K, Bartsch E, Bastid N, Basu S, Batigne G, Battistini D, Batyunya B, Bauri D, Bazo Alba JL, Bearden IG, Beattie C, Becht P, Behera D, Belikov I, Bell Hechavarria ADC, Bellini F, Bellwied R, Belokurova S, Beltran LGE, Beltran YAV, Bencedi G, Beole S, Berdnikov Y, Berdnikova A, Bergmann L, Besoiu MG, Betev L, Bhaduri PP, Bhasin A, Bhat MA, Bhattacharjee B, Bianchi L, Bianchi N, Bielčík J, Bielčíková J, Bigot AP, Bilandzic A, Biro G, Biswas S, Bize N, Blair JT, Blau D, Blidaru MB, Bluhme N, Blume C, Boca G, Bock F, Bodova T, Boi S, Bok J, Boldizsár L, Bombara M, Bond PM, Bonomi G, Borel H, Borissov A, Borquez Carcamo AG, Bossi H, Botta E, Bouziani YEM, Bratrud L, Braun-Munzinger P, Bregant M, Broz M, Bruno GE, Buckland MD, Budnikov D, Buesching H, Bufalino S, Buhler P, Burmasov N, Buthelezi Z, Bylinkin A, Bysiak SA, Cabanillas Noris JC, Cai M, Caines H, Caliva A, Calvo Villar E, Camacho JMM, Camerini P, Canedo FDM, Cantway SL, Carabas M, Carballo AA, Carnesecchi F, Caron R, Carvalho LAD, Castillo Castellanos J, Catalano F, Cattaruzzi S, Ceballos Sanchez C, Cerri R, Chakaberia I, Chakraborty P, Chandra S, Chapeland S, Chartier M, Chattopadhyay S, Chattopadhyay S, Cheng T, Cheshkov C, Chibante Barroso V, Chinellato DD, Chizzali ES, Cho J, Cho S, Chochula P, Choudhury D, Christakoglou P, Christensen CH, Christiansen P, Chujo T, Ciacco M, Cicalo C, Ciupek MR, Clai G, Colamaria F, Colburn JS, Colella D, Colocci M, Concas M, Conesa Balbastre G, Conesa Del Valle Z, Contin G, Contreras JG, Coquet ML, Cortese P, Cosentino MR, Costa F, Costanza S, Cot C, Crkovská J, Crochet P, Cruz-Torres R, Cui P, Dainese A, Danisch MC, Danu A, Das P, Das P, Das S, Dash AR, Dash S, De Caro A, de Cataldo G, de Cuveland J, De Falco A, De Gruttola D, De Marco N, De Martin C, De Pasquale S, Deb R, Del Grande R, Dello Stritto L, Deng W, Dhankher P, Di Bari D, Di Mauro A, Diab B, Diaz RA, Dietel T, Ding Y, Ditzel J, Divià R, Dixit DU, Djuvsland Ø, Dmitrieva U, Dobrin A, Dönigus B, Dubinski JM, Dubla A, Dudi S, Dupieux P, Durkac M, Dzalaiova N, Eder TM, Ehlers RJ, Eisenhut F, Ejima R, Elia D, Erazmus B, Ercolessi F, Espagnon B, Eulisse G, Evans D, Evdokimov S, Fabbietti L, Faggin M, Faivre J, Fan F, Fan W, Fantoni A, Fasel M, Feliciello A, Feofilov G, Fernández Téllez A, Ferrandi L, Ferrer MB, Ferrero A, Ferrero C, Ferretti A, Feuillard VJG, Filova V, Finogeev D, Fionda FM, Flatland E, Flor F, Flores AN, Foertsch S, Fokin I, Fokin S, Fragiacomo E, Frajna E, Fuchs U, Funicello N, Furget C, Furs A, Fusayasu T, Gaardhøje JJ, Gagliardi M, Gago AM, Gahlaut T, Galvan CD, Gangadharan DR, Ganoti P, Garabatos C, García Chávez T, Garcia-Solis E, Gargiulo C, Gasik P, Gautam A, Gay Ducati MB, Germain M, Ghimouz A, Ghosh C, Giacalone M, Gioachin G, Giubellino P, Giubilato P, Glaenzer AMC, Glässel P, Glimos E, Goh DJQ, Gonzalez V, Gordeev P, Gorgon M, Goswami K, Gotovac S, Grabski V, Graczykowski LK, Grecka E, Grelli A, Grigoras C, Grigoriev V, Grigoryan S, Grosa F, Grosse-Oetringhaus JF, Grosso R, Grund D, Grunwald NA, Guardiano GG, Guernane R, Guilbaud M, Gulbrandsen K, Gündem T, Gunji T, Guo W, Gupta A, Gupta R, Gupta R, Gwizdziel K, Gyulai L, Hadjidakis C, Haider FU, Haidlova S, Haldar M, Hamagaki H, Hamdi A, Han Y, Hanley BG, Hannigan R, Hansen J, Harris JW, Harton A, Hartung MV, Hassan H, Hatzifotiadou D, Hauer P, Havener LB, Hellbär E, Helstrup H, Hemmer M, Herman T, Herrera Corral G, Herrmann F, Herrmann S, Hetland KF, Heybeck B, Hillemanns H, Hippolyte B, Hoffmann FW, Hofman B, Hong GH, Horst M, Horzyk A, Hou Y, Hristov P, Huhn P, Huhta LM, Humanic TJ, Hutson A, Hutter D, Hwang MC, Ilkaev R, Ilyas H, Inaba M, Innocenti GM, Ippolitov M, Isakov A, Isidori T, Islam MS, Ivanov M, Ivanov M, Ivanov V, Iversen KE, Jablonski M, Jacak B, Jacazio N, Jacobs PM, Jadlovska S, Jadlovsky J, Jaelani S, Jahnke C, Jakubowska MJ, Janik MA, Janson T, Ji S, Jia S, Jimenez AAP, Jonas F, Jones DM, Jowett JM, Jung J, Jung M, Junique A, Jusko A, Kabus MJ, Kaewjai J, Kalinak P, Kalteyer AS, Kalweit A, Karatovic D, Karavichev O, Karavicheva T, Karczmarczyk P, Karpechev E, Kebschull U, Keidel R, Keijdener DLD, Keil M, Ketzer B, Khade SS, Khan AM, Khan S, Khanzadeev A, Kharlov Y, Khatun A, Khuntia A, Khuranova Z, Kileng B, Kim B, Kim C, Kim DJ, Kim EJ, Kim J, Kim J, Kim J, Kim M, Kim S, Kim T, Kimura K, Kirsch S, Kisel I, Kiselev S, Kisiel A, Kitowski JP, Klay JL, Klein J, Klein S, Klein-Bösing C, Kleiner M, Klemenz T, Kluge A, Kobdaj C, Kollegger T, Kondratyev A, Kondratyeva N, Konig J, Konigstorfer SA, Konopka PJ, Kornakov G, Korwieser M, Koryciak SD, Kotliarov A, Kovacic N, Kovalenko V, Kowalski M, Kozhuharov V, Králik I, Kravčáková A, Krcal L, Krivda M, Krizek F, Krizkova Gajdosova K, Kroesen M, Krüger M, Krupova DM, Kryshen E, Kučera V, Kuhn C, Kuijer PG, Kumaoka T, Kumar D, Kumar L, Kumar N, Kumar S, Kundu S, Kurashvili P, Kurepin A, Kurepin AB, Kuryakin A, Kushpil S, Kuskov V, Kutyla M, Kweon MJ, Kwon Y, La Pointe SL, La Rocca P, Lakrathok A, Lamanna M, Landou AR, Langoy R, Larionov P, Laudi E, Lautner L, Lavicka R, Lea R, Lee H, Legrand I, Legras G, Lehrbach J, Lelek TM, Lemmon RC, León Monzón I, Lesch MM, Lesser ED, Lévai P, Li X, Liang-Gilman BE, Lien J, Lietava R, Likmeta I, Lim B, Lim SH, Lindenstruth V, Lindner A, Lippmann C, Liu DH, Liu J, Liveraro GSS, Lofnes IM, Loizides C, Lokos S, Lömker J, Loncar P, Lopez X, López Torres E, Lu P, Lugo FV, Luhder JR, Lunardon M, Luparello G, Ma YG, Mager M, Maire A, Majerz EM, Makariev MV, Malaev M, Malfattore G, Malik NM, Malik QW, Malik SK, Malinina L, Mallick D, Mallick N, Mandaglio G, Mandal SK, Manko V, Manso F, Manzari V, Mao Y, Marcjan RW, Margagliotti GV, Margotti A, Marín A, Markert C, Martinengo P, Martínez MI, Martínez García G, Martins MPP, Masciocchi S, Masera M, Masoni A, Massacrier L, Massen O, Mastroserio A, Matonoha O, Mattiazzo S, Matyja A, Mayer C, Mazuecos AL, Mazzaschi F, Mazzilli M, Mdhluli JE, Melikyan Y, Menchaca-Rocha A, Mendez JEM, Meninno E, Menon AS, Meres M, Miake Y, Micheletti L, Mihaylov DL, Mikhaylov K, Miśkowiec D, Modak A, Mohanty B, Khan MM, Molander MA, Monira S, Mordasini C, Moreira De Godoy DA, Morozov I, Morsch A, Mrnjavac T, Muccifora V, Muhuri S, Mulligan JD, Mulliri A, Munhoz MG, Munzer RH, Murakami H, Murray S, Musa L, Musinsky J, Myrcha JW, Naik B, Nambrath AI, Nandi BK, Nania R, Nappi E, Nassirpour AF, Nath A, Nattrass C, Naydenov MN, Neagu A, Negru A, Nekrasova E, Nellen L, Nepeivoda R, Nese S, Neskovic G, Nicassio N, Nielsen BS, Nielsen EG, Nikolaev S, Nikulin S, Nikulin V, Noferini F, Noh S, Nomokonov P, Norman J, Novitzky N, Nowakowski P, Nyanin A, Nystrand J, Oh S, Ohlson A, Okorokov VA, Oleniacz J, Onnerstad A, Oppedisano C, Ortiz Velasquez A, Otwinowski J, Oya M, Oyama K, Pachmayer Y, Padhan S, Pagano D, Paić G, Paisano-Guzmán S, Palasciano A, Panebianco S, Park H, Park H, Park J, Parkkila JE, Patley Y, Paul B, Paulino MMDM, Pei H, Peitzmann T, Peng X, Pennisi M, Perciballi S, Peresunko D, Perez GM, Pestov Y, Petrov V, Petrovici M, Pezzi RP, Piano S, Pikna M, Pillot P, Pinazza O, Pinsky L, Pinto C, Pisano S, Płoskoń M, Planinic M, Pliquett F, Poghosyan MG, Polichtchouk B, Politano S, Poljak N, Pop A, Porteboeuf-Houssais S, Pozdniakov V, Pozos IY, Pradhan KK, Prasad SK, Prasad S, Preghenella R, Prino F, Pruneau CA, Pshenichnov I, Puccio M, Pucillo S, Pugelova Z, Qiu S, Quaglia L, Ragoni S, Rai A, Rakotozafindrabe A, Ramello L, Rami F, Rancien TA, Rasa M, Räsänen SS, Rath R, Rauch MP, Ravasenga I, Read KF, Reckziegel C, Redelbach AR, Redlich K, Reetz CA, Regules-Medel HD, Rehman A, Reidt F, Reme-Ness HA, Rescakova Z, Reygers K, Riabov A, Riabov V, Ricci R, Richter M, Riedel AA, Riegler W, Riffero AG, Ristea C, Rodriguez MV, Rodríguez Cahuantzi M, Rodríguez Ramírez SA, Røed K, Rogalev R, Rogochaya E, Rogoschinski TS, Rohr D, Röhrich D, Rojas PF, Rojas Torres S, Rokita PS, Romanenko G, Ronchetti F, Rosano A, Rosas ED, Roslon K, Rossi A, Roy A, Roy S, Rubini N, Ruggiano D, Rui R, Russek PG, Russo R, Rustamov A, Ryabinkin E, Ryabov Y, Rybicki A, Rytkonen H, Ryu J, Rzesa W, Saarimaki OAM, Sadhu S, Sadovsky S, Saetre J, Šafařík K, Saha P, Saha SK, Saha S, Sahoo B, Sahoo R, Sahoo S, Sahu D, Sahu PK, Saini J, Sajdakova K, Sakai S, Salvan MP, Sambyal S, Samitz D, Sanna I, Saramela TB, Sarkar D, Sarma P, Sarritzu V, Sarti VM, Sas MHP, Sawan S, Scapparone E, Schambach J, Scheid HS, Schiaua C, Schicker R, Schlepper F, Schmah A, Schmidt C, Schmidt HR, Schmidt MO, Schmidt M, Schmidt NV, Schmier AR, Schotter R, Schröter A, Schukraft J, Schweda K, Scioli G, Scomparin E, Seger JE, Sekiguchi Y, Sekihata D, Selina M, Selyuzhenkov I, Senyukov S, Seo JJ, Serebryakov D, Serkin L, Šerkšnytė L, Sevcenco A, Shaba TJ, Shabetai A, Shahoyan R, Shangaraev A, Sharma B, Sharma D, Sharma H, Sharma M, Sharma S, Sharma S, Sharma U, Shatat A, Sheibani O, Shigaki K, Shimomura M, Shin J, Shirinkin S, Shou Q, Sibiriak Y, Siddhanta S, Siemiarczuk T, Silva TF, Silvermyr D, Simantathammakul T, Simeonov R, Singh B, Singh B, Singh K, Singh R, Singh R, Singh R, Singh S, Singh VK, Singhal V, Sinha T, Sitar B, Sitta M, Skaali TB, Skorodumovs G, Slupecki M, Smirnov N, Snellings RJM, Solheim EH, Song J, Sonnabend C, Sonneveld JM, Soramel F, Soto-Hernandez AB, Spijkers R, Sputowska I, Staa J, Stachel J, Stan I, Steffanic PJ, Stiefelmaier SF, Stocco D, Storehaug I, Stratmann P, Strazzi S, Sturniolo A, Stylianidis CP, Suaide AAP, Suire C, Sukhanov M, Suljic M, Sultanov R, Sumberia V, Sumowidagdo S, Szarka I, Szymkowski M, Taghavi SF, Taillepied G, Takahashi J, Tambave GJ, Tang S, Tang Z, Tapia Takaki JD, Tapus N, Tarasovicova LA, Tarzila MG, Tassielli GF, Tauro A, Tavira García A, Tejeda Muñoz G, Telesca A, Terlizzi L, Terrevoli C, Thakur S, Thomas D, Tikhonov A, Tiltmann N, Timmins AR, Tkacik M, Tkacik T, Toia A, Tokumoto R, Tomohiro K, Topilskaya N, Toppi M, Tork T, Torres PV, Torres VV, Torres Ramos AG, Trifiró A, Triolo AS, Tripathy S, Tripathy T, Trogolo S, Trubnikov V, Trzaska WH, Trzcinski TP, Tumkin A, Turrisi R, Tveter TS, Ullaland K, Ulukutlu B, Uras A, Urioni M, Usai GL, Vala M, Valle N, van Doremalen LVR, van Leeuwen M, van Veen CA, van Weelden RJG, Vande Vyvre P, Varga D, Varga Z, Vasileiou M, Vasiliev A, Vázquez Doce O, Vazquez Rueda O, Vechernin V, Vercellin E, Vergara Limón S, Verma R, Vermunt L, Vértesi R, Verweij M, Vickovic L, Vilakazi Z, Villalobos Baillie O, Villani A, Vinogradov A, Virgili T, Virta MMO, Vislavicius V, Vodopyanov A, Volkel B, Völkl MA, Voloshin SA, Volpe G, von Haller B, Vorobyev I, Vozniuk N, Vrláková J, Wan J, Wang C, Wang D, Wang Y, Wang Y, Wegrzynek A, Weiglhofer FT, Wenzel SC, Wessels JP, Wiechula J, Wikne J, Wilk G, Wilkinson J, Willems GA, Windelband B, Winn M, Wright JR, Wu W, Wu Y, Xu R, Yadav A, Yadav AK, Yamaguchi Y, Yang S, Yano S, Yeats ER, Yin Z, Yoo IK, Yoon JH, Yu H, Yuan S, Yuncu A, Zaccolo V, Zampolli C, Zanone F, Zardoshti N, Zarochentsev A, Závada P, Zaviyalov N, Zhalov M, Zhang B, Zhang C, Zhang L, Zhang S, Zhang X, Zhang Y, Zhang Z, Zhao M, Zherebchevskii V, Zhi Y, Zhong C, Zhou D, Zhou Y, Zhu J, Zhu Y, Zugravel SC, Zurlo N. Emergence of Long-Range Angular Correlations in Low-Multiplicity Proton-Proton Collisions. PHYSICAL REVIEW LETTERS 2024; 132:172302. [PMID: 38728735 DOI: 10.1103/physrevlett.132.172302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/22/2024] [Accepted: 03/22/2024] [Indexed: 05/12/2024]
Abstract
This Letter presents the measurement of near-side associated per-trigger yields, denoted ridge yields, from the analysis of angular correlations of charged hadrons in proton-proton collisions at sqrt[s]=13 TeV. Long-range ridge yields are extracted for pairs of charged particles with a pseudorapidity difference of 1.4<|Δη|<1.8 and a transverse momentum of 1
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Acharya S, Adamová D, Adler A, Aglieri Rinella G, Agnello M, Agrawal N, Ahammed Z, Ahmad S, Ahn SU, Ahuja I, Akindinov A, Al-Turany M, Aleksandrov D, Alessandro B, Alfanda HM, Alfaro Molina R, Ali B, Alici A, Alizadehvandchali N, Alkin A, Alme J, Alocco G, Alt T, Altamura AR, Altsybeev I, Alvarado JR, Anaam MN, Andrei C, Andronic A, Anguelov V, Antinori F, Antonioli P, Apadula N, Aphecetche L, Appelshäuser H, Arata C, Arcelli S, Aresti M, Arnaldi R, Arneiro JGMCA, Arsene IC, Arslandok M, Augustinus A, Averbeck R, Azmi MD, Baba H, Badalà A, Bae J, Baek YW, Bai X, Bailhache R, Bailung Y, Balbino A, Baldisseri A, Balis B, Banerjee D, Banoo Z, Barbera R, Barile F, Barioglio L, Barlou M, Barnaföldi GG, Barnby LS, Barret V, Barreto L, Bartels C, Barth K, Bartsch E, Bastid N, Basu S, Batigne G, Battistini D, Batyunya B, Bauri D, Bazo Alba JL, Bearden IG, Beattie C, Becht P, Behera D, Belikov I, Bell Hechavarria ADC, Bellini F, Bellwied R, Belokurova S, Bencedi G, Beole S, Bercuci A, Berdnikov Y, Berdnikova A, Bergmann L, Besoiu MG, Betev L, Bhaduri PP, Bhasin A, Bhat MA, Bhattacharjee B, Bianchi L, Bianchi N, Bielčík J, Bielčíková J, Biernat J, Bigot AP, Bilandzic A, Biro G, Biswas S, Bize N, Blair JT, Blau D, Blidaru MB, Bluhme N, Blume C, Boca G, Bock F, Bodova T, Bogdanov A, Boi S, Bok J, Boldizsár L, Bombara M, Bond PM, Bonomi G, Borel H, Borissov A, Borquez Carcamo AG, Bossi H, Botta E, Bouziani YEM, Bratrud L, Braun-Munzinger P, Bregant M, Broz M, Bruno GE, Buckland MD, Budnikov D, Buesching H, Bufalino S, Buhler P, Burmasov N, Buthelezi Z, Bylinkin A, Bysiak SA, Cai M, Caines H, Caliva A, Calvo Villar E, Camacho JMM, Camerini P, Canedo FDM, Cantway SL, Carabas M, Carballo AA, Carnesecchi F, Caron R, Carvalho LAD, Castillo Castellanos J, Catalano F, Ceballos Sanchez C, Chakaberia I, Chakraborty P, Chandra S, Chapeland S, Chartier M, Chattopadhyay S, Chattopadhyay S, Cheng T, Cheshkov C, Cheynis B, Chibante Barroso V, Chinellato DD, Chizzali ES, Cho J, Cho S, Chochula P, Christakoglou P, Christensen CH, Christiansen P, Chujo T, Ciacco M, Cicalo C, Cindolo F, Ciupek MR, Clai G, Colamaria F, Colburn JS, Colella D, Colocci M, Concas M, Conesa Balbastre G, Conesa Del Valle Z, Contin G, Contreras JG, Coquet ML, Cortese P, Cosentino MR, Costa F, Costanza S, Cot C, Crkovská J, Crochet P, Cruz-Torres R, Cui P, Dainese A, Danisch MC, Danu A, Das P, Das P, Das S, Dash AR, Dash S, De Caro A, de Cataldo G, de Cuveland J, De Falco A, De Gruttola D, De Marco N, De Martin C, De Pasquale S, Deb R, Deb S, Del Grande R, Dello Stritto L, Deng W, Dhankher P, Di Bari D, Di Mauro A, Diab B, Diaz RA, Dietel T, Ding Y, Divià R, Dixit DU, Djuvsland Ø, Dmitrieva U, Dobrin A, Dönigus B, Dubinski JM, Dubla A, Dudi S, Dupieux P, Durkac M, Dzalaiova N, Eder TM, Ehlers RJ, Eisenhut F, Ejima R, Elia D, Erazmus B, Ercolessi F, Erhardt F, Ersdal MR, Espagnon B, Eulisse G, Evans D, Evdokimov S, Fabbietti L, Faggin M, Faivre J, Fan F, Fan W, Fantoni A, Fasel M, Fecchio P, Feliciello A, Feofilov G, Fernández Téllez A, Ferrandi L, Ferrer MB, Ferrero A, Ferrero C, Ferretti A, Feuillard VJG, Filova V, Finogeev D, Fionda FM, Flor F, Flores AN, Foertsch S, Fokin I, Fokin S, Fragiacomo E, Frajna E, Fuchs U, Funicello N, Furget C, Furs A, Fusayasu T, Gaardhøje JJ, Gagliardi M, Gago AM, Gahlaut T, Galvan CD, Gangadharan DR, Ganoti P, Garabatos C, Garcia AT, García Chávez T, Garcia-Solis E, Gargiulo C, Garner K, Gasik P, Gautam A, Gay Ducati MB, Germain M, Ghimouz A, Ghosh C, Giacalone M, Giubellino P, Giubilato P, Glaenzer AMC, Glässel P, Glimos E, Goh DJQ, Gonzalez V, Gorgon M, Goswami K, Gotovac S, Grabski V, Graczykowski LK, Grecka E, Grelli A, Grigoras C, Grigoriev V, Grigoryan S, Grosa F, Grosse-Oetringhaus JF, Grosso R, Grund D, Guardiano GG, Guernane R, Guilbaud M, Gulbrandsen K, Gündem T, Gunji T, Guo W, Gupta A, Gupta R, Gupta R, Gwizdziel K, Gyulai L, Habib MK, Hadjidakis C, Haider FU, Hamagaki H, Hamdi A, Hamid M, Han Y, Hanley BG, Hannigan R, Hansen J, Haque MR, Harris JW, Harton A, Hassan H, Hatzifotiadou D, Hauer P, Havener LB, Heckel ST, Hellbär E, Helstrup H, Hemmer M, Herman T, Herrera Corral G, Herrmann F, Herrmann S, Hetland KF, Heybeck B, Hillemanns H, Hippolyte B, Hoffmann FW, Hofman B, Hohlweger B, Hong GH, Horst M, Horzyk A, Hou Y, Hristov P, Hughes C, Huhn P, Huhta LM, Humanic TJ, Hutson A, Hutter D, Ilkaev R, Ilyas H, Inaba M, Innocenti GM, Ippolitov M, Isakov A, Isidori T, Islam MS, Ivanov M, Ivanov M, Ivanov V, Iversen KE, Jablonski M, Jacak B, Jacazio N, Jacobs PM, Jadlovska S, Jadlovsky J, Jaelani S, Jahnke C, Jakubowska MJ, Janik MA, Janson T, Jercic M, Ji S, Jia S, Jimenez AAP, Jonas F, Jones DM, Jowett JM, Jung J, Jung M, Junique A, Jusko A, Kabus MJ, Kaewjai J, Kalinak P, Kalteyer AS, Kalweit A, Kaplin V, Karasu Uysal A, Karatovic D, Karavichev O, Karavicheva T, Karczmarczyk P, Karpechev E, Kebschull U, Keidel R, Keijdener DLD, Keil M, Ketzer B, Khade SS, Khan AM, Khan S, Khanzadeev A, Kharlov Y, Khatun A, Khuntia A, Kidson MB, Kileng B, Kim B, Kim C, Kim DJ, Kim EJ, Kim J, Kim JS, Kim J, Kim J, Kim M, Kim S, Kim T, Kimura K, Kirsch S, Kisel I, Kiselev S, Kisiel A, Kitowski JP, Klay JL, Klein J, Klein S, Klein-Bösing C, Kleiner M, Klemenz T, Kluge A, Knospe AG, Kobdaj C, Kollegger T, Kondratyev A, Kondratyeva N, Kondratyuk E, Konig J, Konigstorfer SA, Konopka PJ, Kornakov G, Korwieser M, Koryciak SD, Kotliarov A, Kovalenko V, Kowalski M, Kozhuharov V, Králik I, Kravčáková A, Krcal L, Krivda M, Krizek F, Krizkova Gajdosova K, Kroesen M, Krüger M, Krupova DM, Kryshen E, Kučera V, Kuhn C, Kuijer PG, Kumaoka T, Kumar D, Kumar L, Kumar N, Kumar S, Kundu S, Kurashvili P, Kurepin A, Kurepin AB, Kuryakin A, Kushpil S, Kweon MJ, Kwon Y, La Pointe SL, La Rocca P, Lakrathok A, Lamanna M, Landou AR, Langoy R, Larionov P, Laudi E, Lautner L, Lavicka R, Lea R, Lee H, Legrand I, Legras G, Lehrbach J, Lelek TM, Lemmon RC, León Monzón I, Lesch MM, Lesser ED, Lévai P, Li X, Li XL, Lien J, Lietava R, Likmeta I, Lim B, Lim SH, Lindenstruth V, Lindner A, Lippmann C, Liu A, Liu DH, Liu J, Liveraro GSS, Lofnes IM, Loizides C, Lokos S, Lomker J, Loncar P, Lopez JA, Lopez X, López Torres E, Lu P, Luhder JR, Lunardon M, Luparello G, Ma YG, Mager M, Maire A, Majerz EM, Makariev MV, Malaev M, Malfattore G, Malik NM, Malik QW, Malik SK, Malinina L, Mallick D, Mallick N, Mandaglio G, Mandal SK, Manko V, Manso F, Manzari V, Mao Y, Marcjan RW, Margagliotti GV, Margotti A, Marín A, Markert C, Martinengo P, Martínez MI, Martínez García G, Martins MPP, Masciocchi S, Masera M, Masoni A, Massacrier L, Mastroserio A, Matonoha O, Mattiazzo S, Matuoka PFT, Matyja A, Mayer C, Mazuecos AL, Mazzaschi F, Mazzilli M, Mdhluli JE, Mechler AF, Melikyan Y, Menchaca-Rocha A, Meninno E, Menon AS, Meres M, Mhlanga S, Miake Y, Micheletti L, Migliorin LC, Mihaylov DL, Mikhaylov K, Mishra AN, Miśkowiec D, Modak A, Mohanty AP, Mohanty B, Mohisin Khan M, Molander MA, Monira S, Moravcova Z, Mordasini C, Moreira De Godoy DA, Morozov I, Morsch A, Mrnjavac T, Muccifora V, Muhuri S, Mulligan JD, Mulliri A, Munhoz MG, Munzer RH, Murakami H, Murray S, Musa L, Musinsky J, Myrcha JW, Naik B, Nambrath AI, Nandi BK, Nania R, Nappi E, Nassirpour AF, Nath A, Nattrass C, Naydenov MN, Neagu A, Negru A, Nellen L, Nepeivoda R, Nese S, Neskovic G, Nielsen BS, Nielsen EG, Nikolaev S, Nikulin S, Nikulin V, Noferini F, Noh S, Nomokonov P, Norman J, Novitzky N, Nowakowski P, Nyanin A, Nystrand J, Ogino M, Oh S, Ohlson A, Okorokov VA, Oleniacz J, Oliveira Da Silva AC, Oliver MH, Onnerstad A, Oppedisano C, Ortiz Velasquez A, Otwinowski J, Oya M, Oyama K, Pachmayer Y, Padhan S, Pagano D, Paić G, Paisano-Guzmán S, Palasciano A, Panebianco S, Park H, Park H, Park J, Parkkila JE, Patley Y, Patra RN, Paul B, Pei H, Peitzmann T, Peng X, Pennisi M, Peresunko D, Perez GM, Pestov Y, Petrov V, Petrovici M, Pezzi RP, Piano S, Pikna M, Pillot P, Pinazza O, Pinsky L, Pinto C, Pisano S, Płoskoń M, Planinic M, Pliquett F, Poghosyan MG, Polichtchouk B, Politano S, Poljak N, Pop A, Porteboeuf-Houssais S, Pozdniakov V, Pozos IY, Pradhan KK, Prasad SK, Prasad S, Preghenella R, Prino F, Pruneau CA, Pshenichnov I, Puccio M, Pucillo S, Pugelova Z, Qiu S, Quaglia L, Quishpe RE, Ragoni S, Rakotozafindrabe A, Ramello L, Rami F, Rancien TA, Rasa M, Räsänen SS, Rath R, Rauch MP, Ravasenga I, Read KF, Reckziegel C, Redelbach AR, Redlich K, Reetz CA, Regules-Medel HD, Rehman A, Reidt F, Reme-Ness HA, Rescakova Z, Reygers K, Riabov A, Riabov V, Ricci R, Richter M, Riedel AA, Riegler W, Ristea C, Rodriguez MV, Rodríguez Cahuantzi M, Rodríguez Ramírez SA, Røed K, Rogalev R, Rogochaya E, Rogoschinski TS, Rohr D, Röhrich D, Rojas PF, Rojas Torres S, Rokita PS, Romanenko G, Ronchetti F, Rosano A, Rosas ED, Roslon K, Rossi A, Roy A, Roy S, Rubini N, Ruggiano D, Rui R, Russek PG, Russo R, Rustamov A, Ryabinkin E, Ryabov Y, Rybicki A, Rytkonen H, Ryu J, Rzesa W, Saarimaki OAM, Sadek R, Sadhu S, Sadovsky S, Saetre J, Šafařík K, Saha P, Saha SK, Saha S, Sahoo B, Sahoo B, Sahoo R, Sahoo S, Sahu D, Sahu PK, Saini J, Sajdakova K, Sakai S, Salvan MP, Sambyal S, Sanna I, Saramela TB, Sarkar D, Sarkar N, Sarma P, Sarritzu V, Sarti VM, Sas MHP, Schambach J, Scheid HS, Schiaua C, Schicker R, Schmah A, Schmidt C, Schmidt HR, Schmidt MO, Schmidt M, Schmidt NV, Schmier AR, Schotter R, Schröter A, Schukraft J, Schweda K, Scioli G, Scomparin E, Seger JE, Sekiguchi Y, Sekihata D, Selina M, Selyuzhenkov I, Senyukov S, Seo JJ, Serebryakov D, Šerkšnytė L, Sevcenco A, Shaba TJ, Shabetai A, Shahoyan R, Shangaraev A, Sharma A, Sharma B, Sharma D, Sharma H, Sharma M, Sharma S, Sharma S, Sharma U, Shatat A, Sheibani O, Shigaki K, Shimomura M, Shin J, Shirinkin S, Shou Q, Sibiriak Y, Siddhanta S, Siemiarczuk T, Silva TF, Silvermyr D, Simantathammakul T, Simeonov R, Singh B, Singh B, Singh K, Singh R, Singh R, Singh R, Singh S, Singh VK, Singhal V, Sinha T, Sitar B, Sitta M, Skaali TB, Skorodumovs G, Slupecki M, Smirnov N, Snellings RJM, Solheim EH, Song J, Songmoolnak A, Sonnabend C, Soramel F, Soto-Hernandez AB, Spijkers R, Sputowska I, Staa J, Stachel J, Stan I, Steffanic PJ, Stiefelmaier SF, Stocco D, Storehaug I, Stratmann P, Strazzi S, Stylianidis CP, Suaide AAP, Suire C, Sukhanov M, Suljic M, Sultanov R, Sumberia V, Sumowidagdo S, Swain S, Szarka I, Szymkowski M, Taghavi SF, Taillepied G, Takahashi J, Tambave GJ, Tang S, Tang Z, Tapia Takaki JD, Tapus N, Tarasovicova LA, Tarzila MG, Tassielli GF, Tauro A, Tejeda Muñoz G, Telesca A, Terlizzi L, Terrevoli C, Thakur S, Thomas D, Tikhonov A, Timmins AR, Tkacik M, Tkacik T, Toia A, Tokumoto R, Tomohiro K, Topilskaya N, Toppi M, Tork T, Torres VV, Torres Ramos AG, Trifiró A, Triolo AS, Tripathy S, Tripathy T, Trogolo S, Trubnikov V, Trzaska WH, Trzcinski TP, Tumkin A, Turrisi R, Tveter TS, Ullaland K, Ulukutlu B, Uras A, Urioni M, Usai GL, Vala M, Valle N, van Doremalen LVR, van Leeuwen M, van Veen CA, van Weelden RJG, Vande Vyvre P, Varga D, Varga Z, Vasileiou M, Vasiliev A, Vázquez Doce O, Vazquez Rueda O, Vechernin V, Vercellin E, Vergara Limón S, Verma R, Vermunt L, Vértesi R, Verweij M, Vickovic L, Vilakazi Z, Villalobos Baillie O, Villani A, Vino G, Vinogradov A, Virgili T, Virta MMO, Vislavicius V, Vodopyanov A, Volkel B, Völkl MA, Voloshin K, Voloshin SA, Volpe G, von Haller B, Vorobyev I, Vozniuk N, Vrláková J, Wan J, Wang C, Wang D, Wang Y, Wang Y, Wegrzynek A, Weiglhofer FT, Wenzel SC, Wessels JP, Wiechula J, Wikne J, Wilk G, Wilkinson J, Willems GA, Windelband B, Winn M, Wright JR, Wu W, Wu Y, Xu R, Yadav A, Yadav AK, Yalcin S, Yamaguchi Y, Yang S, Yano S, Yin Z, Yoo IK, Yoon JH, Yu H, Yuan S, Yuncu A, Zaccolo V, Zampolli C, Zanone F, Zardoshti N, Zarochentsev A, Závada P, Zaviyalov N, Zhalov M, Zhang B, Zhang C, Zhang L, Zhang S, Zhang X, Zhang Y, Zhang Z, Zhao M, Zherebchevskii V, Zhi Y, Zhou D, Zhou Y, Zhu J, Zhu Y, Zugravel SC, Zurlo N. First Measurement of the |t| Dependence of Incoherent J/ψ Photonuclear Production. PHYSICAL REVIEW LETTERS 2024; 132:162302. [PMID: 38701458 DOI: 10.1103/physrevlett.132.162302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 11/22/2023] [Accepted: 01/23/2024] [Indexed: 05/05/2024]
Abstract
The first measurement of the cross section for incoherent photonuclear production of J/ψ vector mesons as a function of the Mandelstam |t| variable is presented. The measurement was carried out with the ALICE detector at midrapidity, |y|<0.8, using ultraperipheral collisions of Pb nuclei at a center-of-mass energy per nucleon pair of sqrt[s_{NN}]=5.02 TeV. This rapidity interval corresponds to a Bjorken-x range (0.3-1.4)×10^{-3}. Cross sections are given in five |t| intervals in the range 0.04<|t|<1 GeV^{2} and compared to the predictions by different models. Models that ignore quantum fluctuations of the gluon density in the colliding hadron predict a |t| dependence of the cross section much steeper than in data. The inclusion of such fluctuations in the same models provides a better description of the data.
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Kumar N, Das A, Dhamala I, Basu S. The Use of CECT in the Diagnosis of Intestinal Obstruction: A Case of Difficult Diagnosis in a Strangulated Left Femoral Hernia. Niger J Clin Pract 2024; 27:534-536. [PMID: 38679778 DOI: 10.4103/njcp.njcp_590_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 03/04/2024] [Indexed: 05/01/2024]
Abstract
ABSTRACT A femoral hernia is an uncommon and acquired hernia in the groin. Its incidence in adults is 2%-8% of all abdominal wall hernias, and it has a female-to-male ratio of 1.8:1. It is usually found in elderly patients and is associated with increased morbidity due to delays in diagnosis leading to a high incidence of incarceration and strangulation. Accurate preoperative diagnosis of femoral hernia is challenging, especially in obese patients in whom a small femoral hernia can be hidden under the groin fat. Unlike an inguinal hernia, it rarely reduces on its own and if asymptomatic and small, is often unnoticed by the elderly obese patient. Femoral hernia is often unsuspected and overlooked in males as it is predominant among females. Delay in diagnosis can lead to intestinal gangrene and high morbidity. We present a case of an incarcerated left femoral hernia in an elderly obese male who presented with acute intestinal obstruction. He was managed with resection of the gangrenous segment and double barrel ileostomy. Although uncommon in males, a femoral hernia has a high incidence of strangulation, and therefore should always be ruled out as a cause of acute intestinal obstruction in elderly patients. Therefore, never forget to examine the groin in case of intestinal obstruction.
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Steinmetz JD, Seeher KM, Schiess N, Nichols E, Cao B, Servili C, Cavallera V, Cousin E, Hagins H, Moberg ME, Mehlman ML, Abate YH, Abbas J, Abbasi MA, Abbasian M, Abbastabar H, Abdelmasseh M, Abdollahi M, Abdollahi M, Abdollahifar MA, Abd-Rabu R, Abdulah DM, Abdullahi A, Abedi A, Abedi V, Abeldańo Zuńiga RA, Abidi H, Abiodun O, Aboagye RG, Abolhassani H, Aboyans V, Abrha WA, Abualhasan A, Abu-Gharbieh E, Aburuz S, Adamu LH, Addo IY, Adebayo OM, Adekanmbi V, Adekiya TA, Adikusuma W, Adnani QES, Adra S, Afework T, Afolabi AA, Afraz A, Afzal S, Aghamiri S, Agodi A, Agyemang-Duah W, Ahinkorah BO, Ahmad A, Ahmad D, Ahmad S, Ahmadzade AM, Ahmed A, Ahmed A, Ahmed H, Ahmed JQ, Ahmed LA, Ahmed MB, Ahmed SA, Ajami M, Aji B, Ajumobi O, Akade SE, Akbari M, Akbarialiabad H, Akhlaghi S, Akinosoglou K, Akinyemi RO, Akonde M, Al Hasan SM, Alahdab F, AL-Ahdal TMA, Al-amer RM, Albashtawy M, AlBataineh MT, Aldawsari KA, Alemi H, Alemi S, Algammal AM, Al-Gheethi AAS, Alhalaiqa FAN, Alhassan RK, Ali A, Ali EA, Ali L, Ali MU, Ali MM, Ali R, Ali S, Ali SSS, Ali Z, Alif SM, Alimohamadi Y, Aliyi AA, Aljofan M, Aljunid SM, Alladi S, Almazan JU, Almustanyir S, Al-Omari B, Alqahtani JS, Alqasmi I, Alqutaibi AY, Al-Shahi Salman R, Altaany Z, Al-Tawfiq JA, Altirkawi KA, Alvis-Guzman N, Al-Worafi YM, Aly H, Aly S, Alzoubi KH, Amani R, Amindarolzarbi A, Amiri S, Amirzade-Iranaq MH, Amu H, Amugsi DA, Amusa GA, Amzat J, Ancuceanu R, Anderlini D, Anderson DB, Andrei CL, Androudi S, Angappan D, Angesom TW, Anil A, Ansari-Moghaddam A, Anwer R, Arafat M, Aravkin AY, Areda D, Ariffin H, Arifin H, Arkew M, Ärnlöv J, Arooj M, Artamonov AA, Artanti KD, Aruleba RT, Asadi-Pooya AA, Asena TF, Asghari-Jafarabadi M, Ashraf M, Ashraf T, Atalell KA, Athari SS, Atinafu BTT, Atorkey P, Atout MMW, Atreya A, Aujayeb A, Avan A, Ayala Quintanilla BP, Ayatollahi H, Ayinde OO, Ayyoubzadeh SM, Azadnajafabad S, Azizi Z, Azizian K, Azzam AY, Babaei M, Badar M, Badiye AD, Baghdadi S, Bagherieh S, Bai R, Baig AA, Balakrishnan S, Balalla S, Baltatu OC, Banach M, Bandyopadhyay S, Banerjee I, Baran MF, Barboza MA, Barchitta M, Bardhan M, Barker-Collo SL, Bärnighausen TW, Barrow A, Bashash D, Bashiri H, Bashiru HA, Basiru A, Basso JD, Basu S, Batiha AMM, Batra K, Baune BT, Bedi N, Begde A, Begum T, Behnam B, Behnoush AH, Beiranvand M, Béjot Y, Bekele A, Belete MA, Belgaumi UI, Bemanalizadeh M, Bender RG, Benfor B, Bennett DA, Bensenor IM, Berice B, Bettencourt PJG, Beyene KA, Bhadra A, Bhagat DS, Bhangdia K, Bhardwaj N, Bhardwaj P, Bhargava A, Bhaskar S, Bhat AN, Bhat V, Bhatti GK, Bhatti JS, Bhatti R, Bijani A, Bikbov B, Bilalaga MM, Biswas A, Bitaraf S, Bitra VR, Bjørge T, Bodolica V, Bodunrin AO, Boloor A, Braithwaite D, Brayne C, Brenner H, Briko A, Bringas Vega ML, Brown J, Budke CM, Buonsenso D, Burkart K, Burns RA, Bustanji Y, Butt MH, Butt NS, Butt ZA, Cabral LS, Caetano dos Santos FL, Calina D, Campos-Nonato IR, Cao C, Carabin H, Cárdenas R, Carreras G, Carvalho AF, Castańeda-Orjuela CA, Casulli A, Catalá-López F, Catapano AL, Caye A, Cegolon L, Cenderadewi M, Cerin E, Chacón-Uscamaita PR, Chan JSK, Chanie GS, Charan J, Chattu VK, Chekol Abebe E, Chen H, Chen J, Chi G, Chichagi F, Chidambaram SB, Chimoriya R, Ching PR, Chitheer A, Chong YY, Chopra H, Choudhari SG, Chowdhury EK, Chowdhury R, Christensen H, Chu DT, Chukwu IS, Chung E, Coberly K, Columbus A, Comachio J, Conde J, Cortesi PA, Costa VM, Couto RAS, Criqui MH, Cruz-Martins N, Dabbagh Ohadi MA, Dadana S, Dadras O, Dai X, Dai Z, D'Amico E, Danawi HA, Dandona L, Dandona R, Darwish AH, Das S, Das S, Dascalu AM, Dash NR, Dashti M, De la Hoz FP, de la Torre-Luque A, De Leo D, Dean FE, Dehghan A, Dehghan A, Dejene H, Demant D, Demetriades AK, Demissie S, Deng X, Desai HD, Devanbu VGC, Dhama K, Dharmaratne SD, Dhimal M, Dias da Silva D, Diaz D, Dibas M, Ding DD, Dinu M, Dirac MA, Diress M, Do TC, Do THP, Doan KDK, Dodangeh M, Doheim MF, Dokova KG, Dongarwar D, Dsouza HL, Dube J, Duraisamy S, Durojaiye OC, Dutta S, Dziedzic AM, 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CCD, Iyer M, Jaan A, Jacob L, Jadidi-Niaragh F, Jafari M, Jafarinia M, Jafarzadeh A, Jahankhani K, Jahanmehr N, Jahrami H, Jaiswal A, Jakovljevic M, Jamora RDG, Jana S, Javadi N, Javed S, Javeed S, Jayapal SK, Jayaram S, Jiang H, Johnson CO, Johnson WD, Jokar M, Jonas JB, Joseph A, Joseph N, Joshua CE, Jürisson M, Kabir A, Kabir Z, Kabito GG, Kadashetti V, Kafi F, Kalani R, Kalantar F, Kaliyadan F, Kamath A, Kamath S, Kanchan T, Kandel A, Kandel H, Kanmodi KK, Karajizadeh M, Karami J, Karanth SD, Karaye IM, Karch A, Karimi A, Karimi H, Karimi Behnagh A, Kasraei H, Kassebaum NJ, Kauppila JH, Kaur H, Kaur N, Kayode GA, Kazemi F, Keikavoosi-Arani L, Keller C, Keykhaei M, Khadembashiri MA, Khader YS, Khafaie MA, Khajuria H, Khalaji A, Khamesipour F, Khammarnia M, Khan M, Khan MAB, Khan YH, Khan Suheb MZ, Khanmohammadi S, Khanna T, Khatab K, Khatatbeh H, Khatatbeh MM, Khateri S, Khatib MN, Khayat Kashani HR, Khonji MS, khorashadizadeh F, Khormali M, Khubchandani J, Kian S, Kim G, Kim J, Kim MS, Kim YJ, Kimokoti RW, Kisa A, Kisa S, Kivimäki M, Kochhar S, Kolahi AA, Koly KN, Kompani F, Koroshetz WJ, Kosen S, Kourosh Arami M, Koyanagi A, Kravchenko MA, Krishan K, Krishnamoorthy V, Kuate Defo B, Kuddus MA, Kumar A, Kumar GA, Kumar M, Kumar N, Kumsa NB, Kundu S, Kurniasari MD, Kusuma D, Kuttikkattu A, Kyu HH, La Vecchia C, Ladan MA, Lahariya C, Laksono T, Lal DK, Lallukka T, Lám J, Lami FH, Landires I, Langguth B, Lasrado S, Latief K, Latifinaibin K, Lau KMM, Laurens MB, Lawal BK, Le LKD, Le TTT, Ledda C, Lee M, Lee SW, Lee SW, Lee WC, Lee YH, Leonardi M, Lerango TL, Li MC, Li W, Ligade VS, Lim SS, Linehan C, Liu C, Liu J, Liu W, Lo CH, Lo WD, Lobo SW, Logroscino G, Lopes G, Lopukhov PD, Lorenzovici L, Lorkowski S, Loureiro JA, Lubinda J, Lucchetti G, Lutzky Saute R, Ma ZF, Mabrok M, Machoy M, Madadizadeh F, Magdy Abd El Razek M, Maghazachi AA, Maghbouli N, Mahjoub S, Mahmoudi M, Majeed A, Malagón-Rojas JN, Malakan Rad E, Malhotra K, Malik AA, Malik I, Mallhi TH, Malta DC, 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R, Tabatabaei SM, Tabatabai S, Tabish M, Taheri M, Tahvildari A, Tajbakhsh A, Tampa M, Tamuzi JJLL, Tan KK, Tang H, Tareke M, Tarigan IU, Tat NY, Tat VY, Tavakoli Oliaee R, Tavangar SM, Tavasol A, Tefera YM, Tehrani-Banihashemi A, Temesgen WA, Temsah MH, Teramoto M, Tesfaye AH, Tesfaye EG, Tesler R, Thakali O, Thangaraju P, Thapa R, Thapar R, Thomas NK, Thrift AG, Ticoalu JHV, Tillawi T, Toghroli R, Tonelli M, Tovani-Palone MR, Traini E, Tran NM, Tran NH, Tran PV, Tromans SJ, Truelsen TC, Truyen TTTT, Tsatsakis A, Tsegay GM, Tsermpini EE, Tualeka AR, Tufa DG, Ubah CS, Udoakang AJ, Ulhaq I, Umair M, Umakanthan S, Umapathi KK, Unim B, Unnikrishnan B, Vaithinathan AG, Vakilian A, Valadan Tahbaz S, Valizadeh R, Van den Eynde J, Vart P, Varthya SB, Vasankari TJ, Vaziri S, Vellingiri B, Venketasubramanian N, Verras GI, Vervoort D, Villafańe JH, Villani L, Vinueza Veloz AF, Viskadourou M, Vladimirov SK, Vlassov V, Volovat SR, Vu LT, Vujcic IS, Wagaye B, Waheed Y, Wahood W, Walde MT, Wang F, Wang S, Wang Y, Wang YP, Waqas M, Waris A, Weerakoon KG, Weintraub RG, Weldemariam AH, Westerman R, Whisnant JL, Wickramasinghe DP, Wickramasinghe ND, Willekens B, Wilner LB, Winkler AS, Wolfe CDA, Wu AM, Wulf Hanson S, Xu S, Xu X, Yadollahpour A, Yaghoubi S, Yahya G, Yamagishi K, Yang L, Yano Y, Yao Y, Yehualashet SS, Yeshaneh A, Yesiltepe M, Yi S, Yiğit A, Yiğit V, Yon DK, Yonemoto N, You Y, Younis MZ, Yu C, Yusuf H, Zadey S, Zahedi M, Zakham F, Zaki N, Zali A, Zamagni G, Zand R, Zandieh GGZ, Zangiabadian M, Zarghami A, Zastrozhin MS, Zeariya MGM, Zegeye ZB, Zeukeng F, Zhai C, Zhang C, Zhang H, Zhang Y, Zhang ZJ, Zhao H, Zhao Y, Zheng P, Zhou H, Zhu B, Zhumagaliuly A, Zielińska M, Zikarg YT, Zoladl M, Murray CJL, Ong KL, Feigin VL, Vos T, Dua T. Global, regional, and national burden of disorders affecting the nervous system, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet Neurol 2024; 23:344-381. [PMID: 38493795 PMCID: PMC10949203 DOI: 10.1016/s1474-4422(24)00038-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 01/23/2024] [Accepted: 01/26/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND Disorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021. METHODS We estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined. FINDINGS Globally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378-521), affecting 3·40 billion (3·20-3·62) individuals (43·1%, 40·5-45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7-26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6-38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5-32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7-2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer. INTERPRETATION As the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed. FUNDING Bill & Melinda Gates Foundation.
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Renedo D, Acosta JN, Leasure AC, Sharma R, Krumholz HM, de Havenon A, Alahdab F, Aravkin AY, Aryan Z, Bärnighausen TW, Basu S, Burkart K, Coberly K, Criqui MH, Dai X, Desai R, Dharmaratne SD, Doshi R, Elgendy IY, Feigin VL, Filip I, Gad MM, Ghozy S, Hafezi-Nejad N, Kalani R, Karaye IM, Kisa A, Krishnamoorthy V, Lo W, Mestrovic T, Miller TR, Misganaw A, Mokdad AH, Murray CJL, Natto ZS, Radfar A, Ram P, Roth GA, Seylani A, Shah NS, Sharma P, Sheikh A, Singh JA, Song S, Sotoudeh H, Vervoort D, Wang C, Xiao H, Xu S, Zand R, Falcone GJ, Sheth KN. Burden of Ischemic and Hemorrhagic Stroke Across the US From 1990 to 2019. JAMA Neurol 2024; 81:2815830. [PMID: 38436973 PMCID: PMC10913004 DOI: 10.1001/jamaneurol.2024.0190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 01/18/2024] [Indexed: 03/05/2024]
Abstract
Importance Stroke is a leading cause of death and disability in the US. Accurate and updated measures of stroke burden are needed to guide public health policies. Objective To present burden estimates of ischemic and hemorrhagic stroke in the US in 2019 and describe trends from 1990 to 2019 by age, sex, and geographic location. Design, Setting, and Participants An in-depth cross-sectional analysis of the 2019 Global Burden of Disease study was conducted. The setting included the time period of 1990 to 2019 in the US. The study encompassed estimates for various types of strokes, including all strokes, ischemic strokes, intracerebral hemorrhages (ICHs), and subarachnoid hemorrhages (SAHs). The 2019 Global Burden of Disease results were released on October 20, 2020. Exposures In this study, no particular exposure was specifically targeted. Main Outcomes and Measures The primary focus of this analysis centered on both overall and age-standardized estimates, stroke incidence, prevalence, mortality, and DALYs per 100 000 individuals. Results In 2019, the US recorded 7.09 million prevalent strokes (4.07 million women [57.4%]; 3.02 million men [42.6%]), with 5.87 million being ischemic strokes (82.7%). Prevalence also included 0.66 million ICHs and 0.85 million SAHs. Although the absolute numbers of stroke cases, mortality, and DALYs surged from 1990 to 2019, the age-standardized rates either declined or remained steady. Notably, hemorrhagic strokes manifested a substantial increase, especially in mortality, compared with ischemic strokes (incidence of ischemic stroke increased by 13% [95% uncertainty interval (UI), 14.2%-11.9%]; incidence of ICH increased by 39.8% [95% UI, 38.9%-39.7%]; incidence of SAH increased by 50.9% [95% UI, 49.2%-52.6%]). The downturn in stroke mortality plateaued in the recent decade. There was a discernible heterogeneity in stroke burden trends, with older adults (50-74 years) experiencing a decrease in incidence in coastal areas (decreases up to 3.9% in Vermont), in contrast to an uptick observed in younger demographics (15-49 years) in the South and Midwest US (with increases up to 8.4% in Minnesota). Conclusions and Relevance In this cross-sectional study, the declining age-standardized stroke rates over the past 3 decades suggest progress in managing stroke-related outcomes. However, the increasing absolute burden of stroke, coupled with a notable rise in hemorrhagic stroke, suggests an evolving and substantial public health challenge in the US. Moreover, the significant disparities in stroke burden trends across different age groups and geographic locations underscore the necessity for region- and demography-specific interventions and policies to effectively mitigate the multifaceted and escalating burden of stroke in the country.
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Nianogo RA, Zhao F, Li S, Nishi A, Basu S. Medicaid Expansion and Racial-Ethnic and Sex Disparities in Cardiovascular Diseases Over 6 Years: A Generalized Synthetic Control Approach. Epidemiology 2024; 35:263-272. [PMID: 38290145 DOI: 10.1097/ede.0000000000001691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
BACKGROUND Studies have suggested Medicaid expansion enacted in 2014 has resulted in a reduction in overall cardiovascular disease (CVD) mortality in the United States. However, it is unknown whether Medicaid expansion has a similar effect across race-ethnicity and sex. We investigated the effect of Medicaid expansion on CVD mortality across race-ethnicity and sex. METHODS Data come from the behavioral risk factor surveillance system and the US Centers for Disease Control's Wide-ranging Online Data for Epidemiologic Research, spanning the period 2000-2019. We used the generalized synthetic control method, a quasi-experimental approach, to estimate effects. RESULTS Medicaid expansion was associated with -5.36 (mean difference [MD], 95% confidence interval [CI] = -22.63, 11.91) CVD deaths per 100,000 persons per year among Blacks; -4.28 (MD, 95% CI = -30.08, 21.52) among Hispanics; -3.18 (MD, 95% CI = -8.30, 1.94) among Whites; -5.96 (MD, 95% CI = -15.42, 3.50) among men; and -3.34 (MD, 95% CI = -8.05, 1.37) among women. The difference in mean difference (DMD) between the effect of Medicaid expansion in Blacks compared with Whites was -2.18; (DMD, 95% CI = -20.20, 15.83); between that in Hispanics compared with Whites: -1.10; (DMD, 95% CI = -27.40, 25.20) and between that in women compared with men: 2.62; (DMD, 95% CI = -7.95, 13.19). CONCLUSIONS Medicaid expansion was associated with a reduction in CVD mortality overall and in White, Black, Hispanic, male, and female subpopulations. Also, our study did not find any difference or disparity in the effect of Medicaid on CVD across race-ethnicity and sex-gender subpopulations, likely owing to imprecise estimates.
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Basu S, Shukron O, Hall D, Parutto P, Ponjavic A, Shah D, Boucher W, Lando D, Zhang W, Reynolds N, Sober LH, Jartseva A, Ragheb R, Ma X, Cramard J, Floyd R, Balmer J, Drury TA, Carr AR, Needham LM, Aubert A, Communie G, Gor K, Steindel M, Morey L, Blanco E, Bartke T, Di Croce L, Berger I, Schaffitzel C, Lee SF, Stevens TJ, Klenerman D, Hendrich BD, Holcman D, Laue ED. Publisher Correction: Live-cell three-dimensional single-molecule tracking reveals modulation of enhancer dynamics by NuRD. Nat Struct Mol Biol 2024; 31:390. [PMID: 38102414 PMCID: PMC10873192 DOI: 10.1038/s41594-023-01179-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
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Roy AS, Banerjee K, Roy P, Shil R, Ravishankar R, Datta R, Sen A, Manna S, Ghosh TK, Mukherjee G, Rana TK, Kundu S, Nayak SS, Pandey R, Paul D, Atreya K, Basu S, Mukhopadhyay S, Pandit D, Kulkarni MS, Bhattacharya C. Measurement of energy and directional distribution of neutron ambient dose equivalent for the 7Li(p,n) 7Be reaction. Appl Radiat Isot 2024; 204:111140. [PMID: 38070360 DOI: 10.1016/j.apradiso.2023.111140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 11/13/2023] [Accepted: 12/02/2023] [Indexed: 12/31/2023]
Abstract
Double differential neutron fluence distributions were measured in the 7Li(p,n)7Be reaction for proton beam energies 7, 9 and 12 MeV. Seven liquid scintillator based detectors were employed to measure neutron fluence distributions using the Time of Flight technique. Neutron ambient dose equivalents were determined from the measured fluence distribution using ICRP (International Commission on Radiological Protection) recommended fluence to dose equivalent conversion coefficients. Neutron dose equivalents were also measured using a conventional BF3 detector based REM counter. Ambient dose equivalent measured by the REM counter is found to be in agreement with that determined from the neutron fluence spectra within their uncertainties. Angular distributions of the ambient dose equivalents were also determined from the measured fluence distributions at different angles.
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Acharya S, Adamová D, Adler A, Aglieri Rinella G, Agnello M, Agrawal N, Ahammed Z, Ahmad S, Ahn SU, Ahuja I, Akindinov A, Al-Turany M, Aleksandrov D, Alessandro B, Alfanda HM, Alfaro Molina R, Ali B, Alici A, Alizadehvandchali N, Alkin A, Alme J, Alocco G, Alt T, Altsybeev I, Anaam MN, Andrei C, Andronic A, Anguelov V, Antinori F, Antonioli P, Apadula N, Aphecetche L, Appelshäuser H, Arata C, Arcelli S, Aresti M, Arnaldi R, Arsene IC, Arslandok M, Augustinus A, Averbeck R, Azmi MD, Badalà A, Bae J, Baek YW, Bai X, Bailhache R, Bailung Y, Balbino A, Baldisseri A, Balis B, Banerjee D, Banoo Z, Barbera R, Barile F, Barioglio L, Barlou M, Barnaföldi GG, Barnby LS, Barret V, Barreto L, Bartels C, Barth K, Bartsch E, Baruffaldi F, Bastid N, Basu S, Batigne G, Battistini D, Batyunya B, Bauri D, Bazo Alba JL, Bearden IG, Beattie C, Becht P, Behera D, Belikov I, Bell Hechavarria ADC, Bellini F, Bellwied R, Belokurova S, Belyaev V, Bencedi G, Beole S, Bercuci A, Berdnikov Y, Berdnikova A, Bergmann L, Besoiu MG, Betev L, Bhaduri PP, Bhasin A, Bhat MA, Bhattacharjee B, Bianchi L, Bianchi N, Bielčík J, Bielčíková J, Biernat J, Bigot AP, Bilandzic A, Biro G, Biswas S, Bize N, Blair JT, Blau D, Blidaru MB, Bluhme N, Blume C, Boca G, Bock F, Bodova T, Bogdanov A, Boi S, Bok J, Boldizsár L, Bolozdynya A, Bombara M, Bond PM, Bonomi G, Borel H, Borissov A, Borquez Carcamo AG, Bossi H, Botta E, Bouziani YEM, Bratrud L, Braun-Munzinger P, Bregant M, Broz M, Bruno GE, Budnikov D, Buesching H, Bufalino S, Bugnon O, Buhler P, Buthelezi Z, Bysiak SA, Cai M, Caines H, Caliva A, Calvo Villar E, Camacho JMM, Camerini P, Canedo FDM, Carabas M, Carballo AA, Carnesecchi F, Caron R, Castillo Castellanos J, Catalano F, Ceballos Sanchez C, Chakaberia I, Chakraborty P, Chandra S, Chapeland S, Chartier M, Chattopadhyay S, Chattopadhyay S, Chavez TG, Cheng T, Cheshkov C, Cheynis B, Chibante Barroso V, Chinellato DD, Chizzali ES, Cho J, Cho S, Chochula P, Christakoglou P, Christensen CH, Christiansen P, Chujo T, Ciacco M, Cicalo C, Cindolo F, Ciupek MR, Clai G, Colamaria F, Colburn JS, Colella D, Colocci M, Concas M, Conesa Balbastre G, Conesa Del Valle Z, Contin G, Contreras JG, Coquet ML, Cormier TM, Cortese P, Cosentino MR, Costa F, Costanza S, Crkovská J, Crochet P, Cruz-Torres R, Cuautle E, Cui P, Dainese A, Danisch MC, Danu A, Das P, Das P, Das S, Dash AR, Dash S, De Caro A, de Cataldo G, de Cuveland J, De Falco A, De Gruttola D, De Marco N, De Martin C, De Pasquale S, Deb S, Debski RJ, Deja KR, Del Grande R, Dello Stritto L, Deng W, Dhankher P, Di Bari D, Di Mauro A, Diaz RA, Dietel T, Ding Y, Divià R, Dixit DU, Djuvsland Ø, Dmitrieva U, Dobrin A, Dönigus B, Dubinski JM, Dubla A, Dudi S, Dupieux P, Durkac M, Dzalaiova N, Eder TM, Ehlers RJ, Eikeland VN, Eisenhut F, Elia D, Erazmus B, Ercolessi F, Erhardt F, Ersdal MR, Espagnon B, Eulisse G, Evans D, Evdokimov S, Fabbietti L, Faggin M, Faivre J, Fan F, Fan W, Fantoni A, Fasel M, Fecchio P, Feliciello A, Feofilov G, Fernández Téllez A, Ferrandi L, Ferrer MB, Ferrero A, Ferrero C, Ferretti A, Feuillard VJG, Filova V, Finogeev D, Fionda FM, Flor F, Flores AN, Foertsch S, Fokin I, Fokin S, Fragiacomo E, Frajna E, Fuchs U, Funicello N, Furget C, Furs A, Fusayasu T, Gaardhøje JJ, Gagliardi M, Gago AM, Galvan CD, Gangadharan DR, Ganoti P, Garabatos C, Garcia JRA, Garcia-Solis E, Garg K, Gargiulo C, Garibli A, Garner K, Gasik P, Gautam A, Gay Ducati MB, Germain M, Ghosh C, Giacalone M, Giubellino P, Giubilato P, Glaenzer AMC, Glässel P, Glimos E, Goh DJQ, Gonzalez V, González-Trueba LH, Gorgon M, Gotovac S, Grabski V, Graczykowski LK, Grecka E, Grelli A, Grigoras C, Grigoriev V, Grigoryan S, Grosa F, Grosse-Oetringhaus JF, Grosso R, Grund D, Guardiano GG, Guernane R, Guilbaud M, Gulbrandsen K, Gundem T, Gunji T, Guo W, Gupta A, Gupta R, Guzman SP, Gyulai L, Habib MK, Hadjidakis C, Haider FU, Hamagaki H, Hamdi A, Hamid M, Han Y, Hannigan R, Haque MR, Harris JW, Harton A, Hassan H, Hatzifotiadou D, Hauer P, Havener LB, Heckel ST, Hellbär E, Helstrup H, Hemmer M, Herman T, Herrera Corral G, Herrmann F, Herrmann S, Hetland KF, Heybeck B, Hillemanns H, Hills C, Hippolyte B, Hofman B, Hohlweger B, Hong GH, Horst M, Horzyk A, Hosokawa R, Hou Y, Hristov P, Hughes C, Huhn P, Huhta LM, Hulse CV, Humanic TJ, Hushnud H, Hutson A, Hutter D, Iddon JP, Ilkaev R, Ilyas H, Inaba M, Innocenti GM, Ippolitov M, Isakov A, Isidori T, Islam MS, Ivanov M, Ivanov M, Ivanov V, Jablonski M, Jacak B, Jacazio N, Jacobs PM, Jadlovska S, Jadlovsky J, Jaelani S, Jaffe L, Jahnke C, Jakubowska MJ, Janik MA, Janson T, Jercic M, Jia S, Jimenez AAP, Jonas F, Jowett JM, Jung J, Jung M, Junique A, Jusko A, Kabus MJ, Kaewjai J, Kalinak P, Kalteyer AS, Kalweit A, Kaplin V, Karasu Uysal A, Karatovic D, Karavichev O, Karavicheva T, Karczmarczyk P, Karpechev E, Kebschull U, Keidel R, Keijdener DLD, Keil M, Ketzer B, Khan AM, Khan S, Khanzadeev A, Kharlov Y, Khatun A, Khuntia A, Kidson MB, Kileng B, Kim B, Kim C, Kim DJ, Kim EJ, Kim J, Kim JS, Kim J, Kim J, Kim M, Kim S, Kim T, Kimura K, Kirsch S, Kisel I, Kiselev S, Kisiel A, Kitowski JP, Klay JL, Klein J, Klein S, Klein-Bösing C, Kleiner M, Klemenz T, Kluge A, Knospe AG, Kobdaj C, Kollegger T, Kondratyev A, Kondratyuk E, Konig J, Konigstorfer SA, Konopka PJ, Kornakov G, Koryciak SD, Kotliarov A, Kovalenko V, Kowalski M, Kozhuharov V, Králik I, Kravčáková A, Kreis L, Krivda M, Krizek F, Krizkova Gajdosova K, Kroesen M, Krüger M, Krupova DM, Kryshen E, Kučera V, Kuhn C, Kuijer PG, Kumaoka T, Kumar D, Kumar L, Kumar N, Kumar S, Kundu S, Kurashvili P, Kurepin A, Kurepin AB, Kuryakin A, Kushpil S, Kvapil J, Kweon MJ, Kwon JY, Kwon Y, La Pointe SL, La Rocca P, Lai YS, Lakrathok A, Lamanna M, Langoy R, Larionov P, Laudi E, Lautner L, Lavicka R, Lazareva T, Lea R, Lee H, Legras G, Lehrbach J, Lemmon RC, León Monzón I, Lesch MM, Lesser ED, Lettrich M, Lévai P, Li X, Li XL, Lien J, Lietava R, Lim B, Lim SH, Lindenstruth V, Lindner A, Lippmann C, Liu A, Liu DH, Liu J, Lofnes IM, Loizides C, Lokos S, Loncar P, Lopez JA, Lopez X, López Torres E, Lu P, Luhder JR, Lunardon M, Luparello G, Ma YG, Maevskaya A, Mager M, Mahmoud T, Maire A, Makariev MV, Malaev M, Malfattore G, Malik NM, Malik QW, Malik SK, Malinina L, Mal'Kevich D, Mallick D, Mallick N, Mandaglio G, Manko V, Manso F, Manzari V, Mao Y, Margagliotti GV, Margotti A, Marín A, Markert C, Martinengo P, Martinez JL, Martínez MI, Martínez García G, Masciocchi S, Masera M, Masoni A, Massacrier L, Mastroserio A, Mathis AM, Matonoha O, Matuoka PFT, Matyja A, Mayer C, Mazuecos AL, Mazzaschi F, Mazzilli M, Mdhluli JE, Mechler AF, Melikyan Y, Menchaca-Rocha A, Meninno E, Menon AS, Meres M, Mhlanga S, Miake Y, Micheletti L, Migliorin LC, Mihaylov DL, Mikhaylov K, Mishra AN, Miśkowiec D, Modak A, Mohanty AP, Mohanty B, Khan MM, Molander MA, Moravcova Z, Mordasini C, Moreira De Godoy DA, Morozov I, Morsch A, Mrnjavac T, Muccifora V, Muhuri S, Mulligan JD, Mulliri A, Munhoz MG, Munzer RH, Murakami H, Murray S, Musa L, Musinsky J, Myrcha JW, Naik B, Nambrath AI, Nandi BK, Nania R, Nappi E, Nassirpour AF, Nath A, Nattrass C, Naydenov MN, Neagu A, Negru A, Nellen L, Nesbo SV, Neskovic G, Nesterov D, Nielsen BS, Nielsen EG, Nikolaev S, Nikulin S, Nikulin V, Noferini F, Noh S, Nomokonov P, Norman J, Novitzky N, Nowakowski P, Nyanin A, Nystrand J, Ogino M, Ohlson A, Okorokov VA, Oleniacz J, Oliveira Da Silva AC, Oliver MH, Onnerstad A, Oppedisano C, Ortiz Velasquez A, Otwinowski J, Oya M, Oyama K, Pachmayer Y, Padhan S, Pagano D, Paić G, Palasciano A, Panebianco S, Park H, Park H, Park J, Parkkila JE, Patra RN, Paul B, Pei H, Peitzmann T, Peng X, Pennisi M, Pereira LG, Peresunko D, Perez GM, Perrin S, Pestov Y, Petráček V, Petrov V, Petrovici M, Pezzi RP, Piano S, Pikna M, Pillot P, Pinazza O, Pinsky L, Pinto C, Pisano S, Płoskoń M, Planinic M, Pliquett F, Poghosyan MG, Polichtchouk B, Politano S, Poljak N, Pop A, Porteboeuf-Houssais S, Pozdniakov V, Pradhan KK, Prasad SK, Prasad S, Preghenella R, Prino F, Pruneau CA, Pshenichnov I, Puccio M, Pucillo S, Pugelova Z, Qiu S, Quaglia L, Quishpe RE, Ragoni S, Rakotozafindrabe A, Ramello L, Rami F, Ramirez SAR, Rancien TA, Rasa M, Räsänen SS, Rath R, Rauch MP, Ravasenga I, Read KF, Reckziegel C, Redelbach AR, Redlich K, Rehman A, Reidt F, Reme-Ness HA, Rescakova Z, Reygers K, Riabov A, Riabov V, Ricci R, Richter M, Riedel AA, Riegler W, Ristea C, Rodríguez Cahuantzi M, Røed K, Rogalev R, Rogochaya E, Rogoschinski TS, Rohr D, Röhrich D, Rojas PF, Rojas Torres S, Rokita PS, Romanenko G, Ronchetti F, Rosano A, Rosas ED, Rossi A, Roy A, Roy S, Rubini N, Rueda OV, Ruggiano D, Rui R, Rumyantsev B, Russek PG, Russo R, Rustamov A, Ryabinkin E, Ryabov Y, Rybicki A, Rytkonen H, Rzesa W, Saarimaki OAM, Sadek R, Sadhu S, Sadovsky S, Saetre J, Šafařík K, Saha SK, Saha S, Sahoo B, Sahoo R, Sahoo S, Sahu D, Sahu PK, Saini J, Sajdakova K, Sakai S, Salvan MP, Sambyal S, Sanna I, Saramela TB, Sarkar D, Sarkar N, Sarma P, Sarritzu V, Sarti VM, Sas MHP, Schambach J, Scheid HS, Schiaua C, Schicker R, Schmah A, Schmidt C, Schmidt HR, Schmidt MO, Schmidt M, Schmidt NV, Schmier AR, Schotter R, Schröter A, Schukraft J, Schwarz K, Schweda K, Scioli G, Scomparin E, Seger JE, Sekiguchi Y, Sekihata D, Selyuzhenkov I, Senyukov S, Seo JJ, Serebryakov D, Šerkšnytė L, Sevcenco A, Shaba TJ, Shabetai A, Shahoyan R, Shangaraev A, Sharma A, Sharma D, Sharma H, Sharma M, Sharma S, Sharma S, Sharma U, Shatat A, Sheibani O, Shigaki K, Shimomura M, Shin J, Shirinkin S, Shou Q, Sibiriak Y, Siddhanta S, Siemiarczuk T, Silva TF, Silvermyr D, Simantathammakul T, Simeonov R, Singh B, Singh B, Singh R, Singh R, Singh R, Singh S, Singh VK, Singhal V, Sinha T, Sitar B, Sitta M, Skaali TB, Skorodumovs G, Slupecki M, Smirnov N, Snellings RJM, Solheim EH, Song J, Songmoolnak A, Soramel F, Spijkers R, Sputowska I, Staa J, Stachel J, Stan I, Steffanic PJ, Stiefelmaier SF, Stocco D, Storehaug I, Stratmann P, Strazzi S, Stylianidis CP, Suaide AAP, Suire C, Sukhanov M, Suljic M, Sultanov R, Sumberia V, Sumowidagdo S, Swain S, Szarka I, Taghavi SF, Taillepied G, Takahashi J, Tambave GJ, Tang S, Tang Z, Tapia Takaki JD, Tapus N, Tarasovicova LA, Tarzila MG, Tassielli GF, Tauro A, Tejeda Muñoz G, Telesca A, Terlizzi L, Terrevoli C, Tersimonov G, Thakur S, Thomas D, Tikhonov A, Timmins AR, Tkacik M, Tkacik T, Toia A, Tokumoto R, Topilskaya N, Toppi M, Torales-Acosta F, Tork T, Torres Ramos AG, Trifiró A, Triolo AS, Tripathy S, Tripathy T, Trogolo S, Trubnikov V, Trzaska WH, Trzcinski TP, Tumkin A, Turrisi R, Tveter TS, Ullaland K, Ulukutlu B, Uras A, Urioni M, Usai GL, Vala M, Valle N, van Doremalen LVR, van Leeuwen M, van Veen CA, van Weelden RJG, Vande Vyvre P, Varga D, Varga Z, Vasileiou M, Vasiliev A, Vázquez Doce O, Vechernin V, Vercellin E, Vergara Limón S, Vermunt L, Vértesi R, Verweij M, Vickovic L, Vilakazi Z, Villalobos Baillie O, Vino G, Vinogradov A, Virgili T, Vislavicius V, Vodopyanov A, Volkel B, Völkl MA, Voloshin K, Voloshin SA, Volpe G, von Haller B, Vorobyev I, Vozniuk N, Vrláková J, Wang C, Wang D, Wang Y, Wegrzynek A, Weiglhofer FT, Wenzel SC, Wessels JP, Weyhmiller SL, Wiechula J, Wikne J, Wilk G, Wilkinson J, Willems GA, Windelband B, Winn M, Wright JR, Wu W, Wu Y, Xu R, Yadav A, Yadav AK, Yalcin S, Yamaguchi Y, Yamakawa K, Yang S, Yano S, Yin Z, Yoo IK, Yoon JH, Yuan S, Yuncu A, Zaccolo V, Zampolli C, Zanone F, Zardoshti N, Zarochentsev A, Závada P, Zaviyalov N, Zhalov M, Zhang B, Zhang L, Zhang S, Zhang X, Zhang Y, Zhang Z, Zhao M, Zherebchevskii V, Zhi Y, Zhou D, Zhou Y, Zhu J, Zhu Y, Zugravel SC, Zurlo N. ψ(2S) Suppression in Pb-Pb Collisions at the LHC. PHYSICAL REVIEW LETTERS 2024; 132:042301. [PMID: 38335364 DOI: 10.1103/physrevlett.132.042301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 05/25/2023] [Accepted: 11/20/2023] [Indexed: 02/12/2024]
Abstract
The production of the ψ(2S) charmonium state was measured with ALICE in Pb-Pb collisions at sqrt[s_{NN}]=5.02 TeV, in the dimuon decay channel. A significant signal was observed for the first time at LHC energies down to zero transverse momentum, at forward rapidity (2.5
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Patel SY, Baum A, Basu S. Prediction of non emergent acute care utilization and cost among patients receiving Medicaid. Sci Rep 2024; 14:824. [PMID: 38263373 PMCID: PMC10805799 DOI: 10.1038/s41598-023-51114-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 12/30/2023] [Indexed: 01/25/2024] Open
Abstract
Patients receiving Medicaid often experience social risk factors for poor health and limited access to primary care, leading to high utilization of emergency departments and hospitals (acute care) for non-emergent conditions. As programs proactively outreach Medicaid patients to offer primary care, they rely on risk models historically limited by poor-quality data. Following initiatives to improve data quality and collect data on social risk, we tested alternative widely-debated strategies to improve Medicaid risk models. Among a sample of 10 million patients receiving Medicaid from 26 states and Washington DC, the best-performing model tripled the probability of prospectively identifying at-risk patients versus a standard model (sensitivity 11.3% [95% CI 10.5, 12.1%] vs 3.4% [95% CI 3.0, 4.0%]), without increasing "false positives" that reduce efficiency of outreach (specificity 99.8% [95% CI 99.6, 99.9%] vs 99.5% [95% CI 99.4, 99.7%]), and with a ~ tenfold improved coefficient of determination when predicting costs (R2: 0.195-0.412 among population subgroups vs 0.022-0.050). Our best-performing model also reversed the lower sensitivity of risk prediction for Black versus White patients, a bias present in the standard cost-based model. Our results demonstrate a modeling approach to substantially improve risk prediction performance and equity for patients receiving Medicaid.
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Kaplan S, White JS, Madsen KA, Basu S, Villas-Boas SB, Schillinger D. Evaluation of Changes in Prices and Purchases Following Implementation of Sugar-Sweetened Beverage Taxes Across the US. JAMA HEALTH FORUM 2024; 5:e234737. [PMID: 38180765 PMCID: PMC10770775 DOI: 10.1001/jamahealthforum.2023.4737] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 10/26/2023] [Indexed: 01/06/2024] Open
Abstract
Importance Sugar-sweetened beverage (SSB) taxes are promoted as key policies to reduce cardiometabolic diseases and other conditions, but comprehensive analyses of SSB taxes in the US have been difficult because of the absence of sufficiently large data samples and methods limitations. Objective To estimate changes in SSB prices and purchases following SSB taxes in 5 large US cities. Design, Setting, and Participants In this cross-sectional study with an augmented synthetic control analysis, changes in prices and purchases of SSBs were estimated following SSB tax implementation in Boulder, Colorado; Philadelphia, Pennsylvania; Oakland, California; Seattle, Washington; and San Francisco, California. Changes in SSB prices (in US dollars) and purchases (volume in ounces) in these cities in the 2 years following tax implementation were estimated and compared with control groups constructed from other cities. Changes in adjacent, untaxed areas were assessed to detect any increase in cross-border purchases. Data used for this analysis spanned from January 1, 2012, to February 29, 2020, and were analyzed between June 1, 2022, and September 29, 2023. Main Outcomes and Measures The main outcomes were the changes in SSB prices and volume purchased. Results Using nutritional information, 5500 unique universal product codes were classified as SSBs, according to tax designations. The sample included 26 338 stores-496 located in treated localities, 1340 in bordering localities, and 24 502 in the donor pool. Prices of SSBs increased by an average of 33.1% (95% CI, 14.0% to 52.2%; P < .001) during the 2 years following tax implementation, corresponding to an average price increase of 1.3¢ per oz and a 92% tax pass-through rate from distributors to consumers. SSB purchases declined in total volume by an average of 33.0% (95% CI, -2.2% to -63.8%; P = .04) following tax implementation, corresponding to a -1.00 price elasticity of demand. The observed price increase and corresponding volume decrease immediately followed tax implementation, and both outcomes were sustained in the months thereafter. No evidence of increased cross-border purchases following tax implementation was found. Conclusions and Relevance In this cross-sectional study, SSB taxes led to substantial, consistent declines in SSB purchases across 5 taxed cities following price increases associated with those taxes. Scaling SSB taxes nationally could yield substantial public health benefits.
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Maheshwari V, Samanta P, Basu S. The Prevalence of Frailty and Associated Factors, Including Food Security in Community Dwelling Older Adults with Multimorbidity: A Cross-Sectional Analysis from the Longitudinal Aging Study in India. JOURNAL OF FRAILTY & AGING 2024. [DOI: 10.14283/jfa.2024.36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/24/2024]
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Anderson MAE, Leftwich PT, Wilson R, Paladino LZC, Basu S, Rooney S, Adelman ZN, Alphey L. AePUb promoter length modulates gene expression in Aedes aegypti. Sci Rep 2023; 13:20352. [PMID: 37990055 PMCID: PMC10663553 DOI: 10.1038/s41598-023-47777-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 11/18/2023] [Indexed: 11/23/2023] Open
Abstract
Molecular tools for modulating transgene expression in Aedes aegypti are few. Here we demonstrate that adjustments to the AePUb promoter length can alter expression levels of two reporter proteins in Ae. aegypti cell culture and in mosquitoes. This provides a simple means for increasing or decreasing expression of a gene of interest and easy translation from cells to whole insects.
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Acharya S, Adamová D, Adler A, Aglieri Rinella G, Agnello M, Agrawal N, Ahammed Z, Ahmad S, Ahn SU, Ahuja I, Akindinov A, Al-Turany M, Aleksandrov D, Alessandro B, Alfanda HM, Alfaro Molina R, Ali B, Ali Y, Alici A, Alizadehvandchali N, Alkin A, Alme J, Alocco G, Alt T, Altsybeev I, Anaam MN, Andrei C, Andronic A, Anguelov V, Antinori F, Antonioli P, Anuj C, Apadula N, Aphecetche L, Appelshäuser H, Arata C, Arcelli S, Aresti M, Arnaldi R, Arsene IC, Arslandok M, Augustinus A, Averbeck R, Azmi MD, Badalà A, Baek YW, Bai X, Bailhache R, Bailung Y, Bala R, Balbino A, Baldisseri A, Balis B, Banerjee D, Banoo Z, Barbera R, Barile F, Barioglio L, Barlou M, Barnaföldi GG, Barnby LS, Barret V, Barreto L, Bartels C, Barth K, Bartsch E, Baruffaldi F, Bastid N, Basu S, Batigne G, Battistini D, Batyunya B, Bauri D, Bazo Alba JL, Bearden IG, Beattie C, Becht P, Behera D, Belikov I, Bell Hechavarria ADC, Bellini F, Bellwied R, Belokurova S, Belyaev V, Bencedi G, Beole S, Bercuci A, Berdnikov Y, Berdnikova A, Bergmann L, Besoiu MG, Betev L, Bhaduri PP, Bhasin A, Bhat MA, Bhattacharjee B, Bianchi L, Bianchi N, Bielčík J, Bielčíková J, Biernat J, Bigot AP, Bilandzic A, Biro G, Biswas S, Bize N, Blair JT, Blau D, Blidaru MB, Bluhme N, Blume C, Boca G, Bock F, Bodova T, Bogdanov A, Boi S, Bok J, Boldizsár L, Bolozdynya A, Bombara M, Bond PM, Bonomi G, Borel H, Borissov A, Bossi H, Botta E, Bouziani YEM, Bratrud L, Braun-Munzinger P, Bregant M, Broz M, Bruno GE, Buckland MD, Budnikov D, Buesching H, Bufalino S, Bugnon O, Buhler P, Buthelezi Z, Butt JB, Bysiak SA, Cai M, Caines H, Caliva A, Calvo Villar E, Camacho JMM, Camerini P, Canedo FDM, Carabas M, Carnesecchi F, Caron R, Castillo Castellanos J, Catalano F, Ceballos Sanchez C, Chakaberia I, Chakraborty P, Chandra S, Chapeland S, Chartier M, Chattopadhyay S, Chattopadhyay S, Chavez TG, Cheng T, Cheshkov C, Cheynis B, Chibante Barroso V, Chinellato DD, Chizzali ES, Cho J, Cho S, Chochula P, Christakoglou P, Christensen CH, Christiansen P, Chujo T, Ciacco M, Cicalo C, Cifarelli L, Cindolo F, Ciupek MR, Clai G, Colamaria F, Colburn JS, Colella D, Colocci M, Concas M, Conesa Balbastre G, Conesa Del Valle Z, Contin G, Contreras JG, Coquet ML, Cormier TM, Cortese P, Cosentino MR, Costa F, Costanza S, Crkovská J, Crochet P, Cruz-Torres R, Cuautle E, Cui P, Cunqueiro L, Dainese A, Danisch MC, Danu A, Das P, Das P, Das S, Dash AR, Dash S, David RMH, De Caro A, de Cataldo G, de Cuveland J, De Falco A, De Gruttola D, De Marco N, De Martin C, De Pasquale S, Deb S, Debski RJ, Deja KR, Del Grande R, Dello Stritto L, Deng W, Dhankher P, Di Bari D, Di Mauro A, Diaz RA, Dietel T, Ding Y, Divià R, Dixit DU, Djuvsland Ø, Dmitrieva U, Dobrin A, Dönigus B, Dubey AK, Dubinski JM, Dubla A, Dudi S, Dupieux P, Durkac M, Dzalaiova N, Eder TM, Ehlers RJ, Eikeland VN, Eisenhut F, Elia D, Erazmus B, Ercolessi F, Erhardt F, Ersdal MR, Espagnon B, Eulisse G, Evans D, Evdokimov S, Fabbietti L, Faggin M, Faivre J, Fan F, Fan W, Fantoni A, Fasel M, Fecchio P, Feliciello A, Feofilov G, Fernández Téllez A, Ferrer MB, Ferrero A, Ferrero C, Ferretti A, Feuillard VJG, Filova V, Finogeev D, Fionda FM, Flor F, Flores AN, Foertsch S, Fokin I, Fokin S, Fragiacomo E, Frajna E, Fuchs U, Funicello N, Furget C, Furs A, Fusayasu T, Gaardhøje JJ, Gagliardi M, Gago AM, Galvan CD, Gangadharan DR, Ganoti P, Garabatos C, Garcia JRA, Garcia-Solis E, Garg K, Gargiulo C, Garibli A, Garner K, Gautam A, Gay Ducati MB, Germain M, Ghosh C, Ghosh SK, Giacalone M, Gianotti P, Giubellino P, Giubilato P, Glaenzer AMC, Glässel P, Glimos E, Goh DJQ, Gonzalez V, González-Trueba LH, Gorgon M, Gotovac S, Grabski V, Graczykowski LK, Grecka E, Grelli A, Grigoras C, Grigoriev V, Grigoryan S, Grosa F, Grosse-Oetringhaus JF, Grosso R, Grund D, Guardiano GG, Guernane R, Guilbaud M, Gulbrandsen K, Gundem T, Gunji T, Guo W, Gupta A, Gupta R, Guzman SP, Gyulai L, Habib MK, Hadjidakis C, Hamagaki H, Hamid M, Han Y, Hannigan R, Haque MR, Harris JW, Harton A, Hassan H, Hatzifotiadou D, Hauer P, Havener LB, Heckel ST, Hellbär E, Helstrup H, Hemmer M, Herman T, Herrera Corral G, Herrmann F, Herrmann S, Hetland KF, Heybeck B, Hillemanns H, Hills C, Hippolyte B, Hofman B, Hohlweger B, Honermann J, Hong GH, Horzyk A, Hosokawa R, Hou Y, Hristov P, Hughes C, Huhn P, Huhta LM, Hulse CV, Humanic TJ, Hushnud H, Hutson A, Hutter D, Iddon JP, Ilkaev R, Ilyas H, Inaba M, Innocenti GM, Ippolitov M, Isakov A, Isidori T, Islam MS, Ivanov M, Ivanov M, Ivanov V, Izucheev V, Jablonski M, Jacak B, Jacazio N, Jacobs PM, Jadlovska S, Jadlovsky J, Jaelani S, Jaffe L, Jahnke C, Jakubowska MJ, Janik MA, Janson T, Jercic M, Jevons O, Jimenez AAP, Jonas F, Jones PG, Jowett JM, Jung J, Jung M, Junique A, Jusko A, Kabus MJ, Kaewjai J, Kalinak P, Kalteyer AS, Kalweit A, Kaplin V, Karasu Uysal A, Karatovic D, Karavichev O, Karavicheva T, Karczmarczyk P, Karpechev E, Kashyap V, Kebschull U, Keidel R, Keijdener DLD, Keil M, Ketzer B, Khan AM, Khan S, Khanzadeev A, Kharlov Y, Khatun A, Khuntia A, Kileng B, Kim B, Kim C, Kim DJ, Kim EJ, Kim J, Kim JS, Kim J, Kim J, Kim M, Kim S, Kim T, Kimura K, Kirsch S, Kisel I, Kiselev S, Kisiel A, Kitowski JP, Klay JL, Klein J, Klein S, Klein-Bösing C, Kleiner M, Klemenz T, Kluge A, Knospe AG, Kobdaj C, Kollegger T, Kondratyev A, Kondratyuk E, Konig J, Konigstorfer SA, Konopka PJ, Kornakov G, Koryciak SD, Kotliarov A, Kovalenko O, Kovalenko V, Kowalski M, Králik I, Kravčáková A, Kreis L, Krivda M, Krizek F, Krizkova Gajdosova K, Kroesen M, Krüger M, Krupova DM, Kryshen E, Kučera V, Kuhn C, Kuijer PG, Kumaoka T, Kumar D, Kumar L, Kumar N, Kumar S, Kundu S, Kurashvili P, Kurepin A, Kurepin AB, Kushpil S, Kvapil J, Kweon MJ, Kwon JY, Kwon Y, La Pointe SL, La Rocca P, Lai YS, Lakrathok A, Lamanna M, Langoy R, Larionov P, Laudi E, Lautner L, Lavicka R, Lazareva T, Lea R, Legras G, Lehrbach J, Lemmon RC, León Monzón I, Lesch MM, Lesser ED, Lettrich M, Lévai P, Li X, Li XL, Lien J, Lietava R, Lim B, Lim SH, Lindenstruth V, Lindner A, Lippmann C, Liu A, Liu DH, Liu J, Lofnes IM, Loizides C, Loncar P, Lopez JA, Lopez X, López Torres E, Lu P, Luhder JR, Lunardon M, Luparello G, Ma YG, Maevskaya A, Mager M, Mahmoud T, Maire A, Malaev M, Malfattore G, Malik NM, Malik QW, Malik SK, Malinina L, Mal'Kevich D, Mallick D, Mallick N, Mandaglio G, Manko V, Manso F, Manzari V, Mao Y, Margagliotti GV, Margotti A, Marín A, Markert C, Martinengo P, Martinez JL, Martínez MI, Martínez García G, Masciocchi S, Masera M, Masoni A, Massacrier L, Mastroserio A, Mathis AM, Matonoha O, Matuoka PFT, Matyja A, Mayer C, Mazuecos AL, Mazzaschi F, Mazzilli M, Mdhluli JE, Mechler AF, Melikyan Y, Menchaca-Rocha A, Meninno E, Menon AS, Meres M, Mhlanga S, Miake Y, Micheletti L, Migliorin LC, Mihaylov DL, Mikhaylov K, Mishra AN, Miśkowiec D, Modak A, Mohanty AP, Mohanty B, Khan MM, Molander MA, Moravcova Z, Mordasini C, Moreira De Godoy DA, Morozov I, Morsch A, Mrnjavac T, Muccifora V, Muhuri S, Mulligan JD, Mulliri A, Munhoz MG, Munzer RH, Murakami H, Murray S, Musa L, Musinsky J, Myrcha JW, Naik B, Nair R, Nambrath AI, Nandi BK, Nania R, Nappi E, Nassirpour AF, Nath A, Nattrass C, Neagu A, Negru A, Nellen L, Nesbo SV, Neskovic G, Nesterov D, Nielsen BS, Nielsen EG, Nikolaev S, Nikulin S, Nikulin V, Noferini F, Noh S, Nomokonov P, Norman J, Novitzky N, Nowakowski P, Nyanin A, Nystrand J, Ogino M, Ohlson A, Okorokov VA, Oleniacz J, Oliveira Da Silva AC, Oliver MH, Onnerstad A, Oppedisano C, Ortiz Velasquez A, Oskarsson A, Otwinowski J, Oya M, Oyama K, Pachmayer Y, Padhan S, Pagano D, Paić G, Palasciano A, Panebianco S, Park H, Park J, Parkkila JE, Patra RN, Paul B, Pei H, Peitzmann T, Peng X, Pennisi M, Pereira LG, Pereira Da Costa H, Peresunko D, Perez GM, Perrin S, Pestov Y, Petráček V, Petrov V, Petrovici M, Pezzi RP, Piano S, Pikna M, Pillot P, Pinazza O, Pinsky L, Pinto C, Pisano S, Płoskoń M, Planinic M, Pliquett F, Poghosyan MG, Politano S, Poljak N, Pop A, Porteboeuf-Houssais S, Porter J, Pozdniakov V, Prasad SK, Prasad S, Preghenella R, Prino F, Pruneau CA, Pshenichnov I, Puccio M, Pucillo S, Pugelova Z, Qiu S, Quaglia L, Quishpe RE, Ragoni S, Rakotozafindrabe A, Ramello L, Rami F, Ramirez SAR, Rancien TA, Raniwala R, Raniwala S, Rasa M, Räsänen SS, Rath R, Ravasenga I, Read KF, Reckziegel C, Redelbach AR, Redlich K, Rehman A, Reidt F, Reme-Ness HA, Rescakova Z, Reygers K, Riabov A, Riabov V, Ricci R, Richert T, Richter M, Riedel AA, Riegler W, Riggi F, Ristea C, Rodríguez Cahuantzi M, Røed K, Rogalev R, Rogochaya E, Rogoschinski TS, Rohr D, Röhrich D, Rojas PF, Rojas Torres S, Rokita PS, Romanenko G, Ronchetti F, Rosano A, Rosas ED, Rossi A, Roy A, Roy P, Roy S, Rubini N, Rueda OV, Ruggiano D, Rui R, Rumyantsev B, Russek PG, Russo R, Rustamov A, Ryabinkin E, Ryabov Y, Rybicki A, Rytkonen H, Rzesa W, Saarimaki OAM, Sadek R, Sadhu S, Sadovsky S, Saetre J, Šafařík K, Saha SK, Saha S, Sahoo B, Sahoo R, Sahoo S, Sahu D, Sahu PK, Saini J, Sajdakova K, Sakai S, Salvan MP, Sambyal S, Saramela TB, Sarkar D, Sarkar N, Sarma P, Sarritzu V, Sarti VM, Sas MHP, Schambach J, Scheid HS, Schiaua C, Schicker R, Schmah A, Schmidt C, Schmidt HR, Schmidt MO, Schmidt M, Schmidt NV, Schmier AR, Schotter R, Schukraft J, Schwarz K, Schweda K, Scioli G, Scomparin E, Seger JE, Sekiguchi Y, Sekihata D, Selyuzhenkov I, Senyukov S, Seo JJ, Serebryakov D, Šerkšnytė L, Sevcenco A, Shaba TJ, Shabetai A, Shahoyan R, Shangaraev A, Sharma A, Sharma D, Sharma H, Sharma M, Sharma N, Sharma S, Sharma S, Sharma U, Shatat A, Sheibani O, Shigaki K, Shimomura M, Shirinkin S, Shou Q, Sibiriak Y, Siddhanta S, Siemiarczuk T, Silva TF, Silvermyr D, Simantathammakul T, Simeonov R, Singh B, Singh B, Singh R, Singh R, Singh R, Singh S, Singh VK, Singhal V, Sinha T, Sitar B, Sitta M, Skaali TB, Skorodumovs G, Slupecki M, Smirnov N, Snellings RJM, Solheim EH, Song J, Songmoolnak A, Soramel F, Sorensen S, Spijkers R, Sputowska I, Staa J, Stachel J, Stan I, Steffanic PJ, Stiefelmaier SF, Stocco D, Storehaug I, Storetvedt MM, Stratmann P, Strazzi S, Stylianidis CP, Suaide AAP, Suire C, Sukhanov M, Suljic M, Sumberia V, Sumowidagdo S, Swain S, Szarka I, Tabassam U, Taghavi SF, Taillepied G, Takahashi J, Tambave GJ, Tang S, Tang Z, Tapia Takaki JD, Tapus N, Tarasovicova LA, Tarzila MG, Tassielli GF, Tauro A, Telesca A, Terlizzi L, Terrevoli C, Tersimonov G, Thakur S, Thomas D, Tikhonov A, Timmins AR, Tkacik M, Tkacik T, Toia A, Tokumoto R, Topilskaya N, Toppi M, Torales-Acosta F, Tork T, Torres Ramos AG, Trifiró A, Triolo AS, Tripathy S, Tripathy T, Trogolo S, Trubnikov V, Trzaska WH, Trzcinski TP, Turrisi R, Tveter TS, Ullaland K, Ulukutlu B, Uras A, Urioni M, Usai GL, Vala M, Valle N, Vallero S, van Doremalen LVR, van Leeuwen M, van Veen CA, van Weelden RJG, Vande Vyvre P, Varga D, Varga Z, Varga-Kofarago M, Vasileiou M, Vasiliev A, Vázquez Doce O, Vechernin V, Vercellin E, Vergara Limón S, Vermunt L, Vértesi R, Verweij M, Vickovic L, Vilakazi Z, Villalobos Baillie O, Vino G, Vinogradov A, Virgili T, Vislavicius V, Vodopyanov A, Volkel B, Völkl MA, Voloshin K, Voloshin SA, Volpe G, von Haller B, Vorobyev I, Vozniuk N, Vrláková J, Wagner B, Wang C, Wang D, Wegrzynek A, Weiglhofer FT, Wenzel SC, Wessels JP, Weyhmiller SL, Wiechula J, Wikne J, Wilk G, Wilkinson J, Willems GA, Windelband B, Winn M, Wright JR, Wu W, Wu Y, Xu R, Yadav A, Yadav AK, Yalcin S, Yamaguchi Y, Yamakawa K, Yang S, Yano S, Yin Z, Yoo IK, Yoon JH, Yuan S, Yuncu A, Zaccolo V, Zampolli C, Zanoli HJC, Zanone F, Zardoshti N, Zarochentsev A, Závada P, Zaviyalov N, Zhalov M, Zhang B, Zhang S, Zhang X, Zhang Y, Zhang Z, Zhao M, Zherebchevskii V, Zhi Y, Zhigareva N, Zhou D, Zhou Y, Zhu J, Zhu Y, Zinovjev G, Zurlo N. Measurements of Groomed-Jet Substructure of Charm Jets Tagged by D^{0} Mesons in Proton-Proton Collisions at sqrt[s]=13 TeV. PHYSICAL REVIEW LETTERS 2023; 131:192301. [PMID: 38000395 DOI: 10.1103/physrevlett.131.192301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 01/13/2023] [Accepted: 07/19/2023] [Indexed: 11/26/2023]
Abstract
Understanding the role of parton mass and Casimir color factors in the quantum chromodynamics parton shower represents an important step in characterizing the emission properties of heavy quarks. Recent experimental advances in jet substructure techniques have provided the opportunity to isolate and characterize gluon emissions from heavy quarks. In this Letter, the first direct experimental constraint on the charm-quark splitting function is presented, obtained via the measurement of the groomed shared momentum fraction of the first splitting in charm jets, tagged by a reconstructed D^{0} meson. The measurement is made in proton-proton collisions at sqrt[s]=13 TeV, in the low jet transverse-momentum interval of 15≤p_{T}^{jet ch}<30 GeV/c where the emission properties are sensitive to parton mass effects. In addition, the opening angle of the first perturbative emission of the charm quark, as well as the number of perturbative emissions it undergoes, is reported. Comparisons to measurements of an inclusive-jet sample show a steeper splitting function for charm quarks compared with gluons and light quarks. Charm quarks also undergo fewer perturbative emissions in the parton shower, with a reduced probability of large-angle emissions.
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Basu S, Shukron O, Hall D, Parutto P, Ponjavic A, Shah D, Boucher W, Lando D, Zhang W, Reynolds N, Sober LH, Jartseva A, Ragheb R, Ma X, Cramard J, Floyd R, Balmer J, Drury TA, Carr AR, Needham LM, Aubert A, Communie G, Gor K, Steindel M, Morey L, Blanco E, Bartke T, Di Croce L, Berger I, Schaffitzel C, Lee SF, Stevens TJ, Klenerman D, Hendrich BD, Holcman D, Laue ED. Live-cell three-dimensional single-molecule tracking reveals modulation of enhancer dynamics by NuRD. Nat Struct Mol Biol 2023; 30:1628-1639. [PMID: 37770717 PMCID: PMC10643137 DOI: 10.1038/s41594-023-01095-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 08/14/2023] [Indexed: 09/30/2023]
Abstract
To understand how the nucleosome remodeling and deacetylase (NuRD) complex regulates enhancers and enhancer-promoter interactions, we have developed an approach to segment and extract key biophysical parameters from live-cell three-dimensional single-molecule trajectories. Unexpectedly, this has revealed that NuRD binds to chromatin for minutes, decompacts chromatin structure and increases enhancer dynamics. We also uncovered a rare fast-diffusing state of enhancers and found that NuRD restricts the time spent in this state. Hi-C and Cut&Run experiments revealed that NuRD modulates enhancer-promoter interactions in active chromatin, allowing them to contact each other over longer distances. Furthermore, NuRD leads to a marked redistribution of CTCF and, in particular, cohesin. We propose that NuRD promotes a decondensed chromatin environment, where enhancers and promoters can contact each other over longer distances, and where the resetting of enhancer-promoter interactions brought about by the fast decondensed chromatin motions is reduced, leading to more stable, long-lived enhancer-promoter relationships.
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Dudreuilh C, Basu S, Shaw O, Burton H, Mamode N, Harris F, Tree T, Nedyalko P, Terranova-Barberio M, Lombardi G, Scottà C, Dorling A. Highly sensitised individuals present a distinct Treg signature compared to unsensitised individuals on haemodialysis. FRONTIERS IN TRANSPLANTATION 2023; 2:1165320. [PMID: 38993845 PMCID: PMC11235238 DOI: 10.3389/frtra.2023.1165320] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 09/20/2023] [Indexed: 07/13/2024]
Abstract
Introduction Highly sensitised (HS) patients represent up to 30% of patients on the kidney transplant waiting list. When they are transplanted, they have a high risk of acute/chronic rejection and long-term allograft loss. Regulatory T cells (Tregs) (CD4+CD25hiCD127lo) are T cells involved in the suppression of immune alloresponses. A particular subset, called T follicular regulatory T cells (Tfr, CXCR5+Bcl-6+), is involved in regulating interactions between T effectors and B cells within the germinal centre and can be found in peripheral blood. Therefore, we wanted to identify specific subsets of Tregs in the peripheral blood of HS individuals. Methods We recruited prospectively healthy volunteers (HV) (n = 9), non-sensitised patients on haemodialysis (HD) (n = 9) and HS individuals, all of whom were on haemodialysis (n = 15). Results We compared the Treg phenotypes of HV, HD and HS. HS patients had more CD161+ Tregs (p = 0.02) and more CD45RA-CCR7- T effectors (Teffs) (p = 0.04, memory Teffs able to home to the germinal centre) compared to HVs. HS patients had more Bcl-6+ Tregs (p < 0.05), fewer Th1-like Tregs, more Th2-like Tregs (p < 0.001) and more CD161+ (p < 0.05) Tregs compared to HD patients. This population has been described to be highly suppressive. HD had a deficiency in a Th17-like CD161+ effector Treg cluster (cluster iii., CCR6+CCR4+CXCR3- CD39+CD15s+ICOS-CCR7-CD161+) (p < 0.05). Discussion This is the first study presenting a deep Treg phenotype in HS patients. We confirmed that HS patients had more of a Th17-like CD161+ effector Treg from population III (CD4+CD25hiCD127loCD45RA-) compared to non-sensitised patients on HD. The clinical relevance of this highly suppressive Tregs population remains to be determined in the context of transplantation.
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