Browsing by Author "Douwes-Schultz, Dirk (57196081398)"

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    Publication
    Erratum: Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017 (The Lancet (2018) 392(10159) (1736–1788)(S0140673618322037)(10.1016/S0140-6736(18)32203-7))
    (2018)
    Roth, Gregory A. (55074747400)
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    Abate, Degu (57204237665)
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    Abate, Kalkidan Hassen (57207943858)
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    Abay, Solomon M. (35306466900)
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    Abbafati, Cristiana (54917122400)
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    Abbasi, Nooshin (57212442022)
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    Abbastabar, Hedayat (57212441848)
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    Abd-Allah, Foad (36503428900)
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    Abdela, Jemal (57200613000)
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    Abdelalim, Ahmed (7801307783)
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    Abdollahpour, Ibrahim (36997151900)
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    Abdulkader, Rizwan Suliankatchi (57195295816)
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    Abebe, Haftom Temesgen (55950002100)
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    Abebe, Molla (57211131124)
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    Abebe, Zegeye (57193002719)
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    Abejie, Ayenew Negesse (57203015573)
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    Abera, Semaw F. (57205180598)
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    Abil, Olifan Zewdie (57204558002)
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    Abraha, Haftom Niguse (57195289877)
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    Abrham, Aklilu Roba (57202704637)
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    Abu-Raddad, Laith Jamal (14032724700)
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    Accrombessi, Manfred Mario Kokou (55353650500)
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    Acharya, Dilaram (56770895600)
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    Adamu, Abdu A. (57202024381)
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    Adebayo, Oladimeji M. (57194329853)
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    Adedoyin, Rufus Adesoji (55947572800)
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    Adekanmbi, Victor (53463192900)
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    Adetokunboh, Olatunji O. (56598104300)
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    Adhena, Beyene Meressa (57322512000)
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    Adib, Mina G. (57204560513)
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    Admasie, Amha (56609274200)
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    Afshin, Ashkan (57217465455)
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    Agarwal, Gina (57220151944)
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    Agesa, Kareha M. (57204562362)
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    Agrawal, Anurag (35214460700)
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    Agrawal, Sutapa (57202841733)
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    Ahmadi, Alireza (56336080700)
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    Ahmadi, Mehdi (16644923000)
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    Ahmed, Muktar Beshir (57207802317)
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    Ahmed, Sayem (58601030100)
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    Aichour, Amani Nidhal (57195486768)
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    Aichour, Ibtihel (57195485980)
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    Aichour, Miloud Taki Eddine (57195488258)
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    Akbari, Mohammad Esmaeil (56666938200)
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    Akinyemi, Rufus Olusola (25633566800)
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    Akseer, Nadia (57207801968)
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    Al-Aly, Ziyad (9738161500)
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    Al-Eyadhy, Ayman (24554080400)
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    Al-Raddadi, Rajaa M. (57219673720)
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    Alahdab, Fares (55135922900)
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    Alam, Khurshid (57203681299)
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    Alam, Tahiya (57205589820)
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    Alebel, Animut (57195961302)
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    Alene, Kefyalew Addis (57202583764)
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    Alijanzadeh, Mehran (56236864700)
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    Alizadeh-Navaei, Reza (36024974700)
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    Aljunid, Syed Mohamed (6504304159)
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    Alkerwi, Ala'a (57197724313)
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    Alla, Francois (6701580827)
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    Allebeck, Peter (7005187575)
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    Alonso, Jordi (7403482329)
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    Altirkawi, Khalid (57202762923)
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    Alvis-Guzman, Nelson (57210741239)
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    Amare, Azmeraw T. (57202220009)
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    Aminde, Leopold N. (56287711300)
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    Amini, Erfan (35073393800)
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    Ammar, Walid (57208159281)
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    Amoako, Yaw Ampem (44960986700)
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    Anber, Nahla Hamed (57202351369)
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    Andrei, Catalina Liliana (36543507200)
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    Androudi, Sofia (6603286512)
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    Animut, Megbaru Debalkie (57204558749)
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    Anjomshoa, Mina (57204563282)
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    Ansari, Hossein (56919376000)
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    Ansha, Mustafa Geleto (57195329453)
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    Antonio, Carl Abelardo T. (55247644500)
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    Anwari, Palwasha (57217465526)
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    Aremu, Olatunde (57214958833)
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    Arnlov, Johan (6602512227)
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    Arora, Amit (36676951800)
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    Arora, Monika (8700408200)
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    Artaman, Al (57217223811)
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    Aryal, Krishna K. (57203859052)
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    Asayesh, Hamid (55334322800)
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    Asfaw, Ephrem Tsegay (57203306449)
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    Ataro, Zerihun (57204563849)
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    Atique, Suleman (56505419100)
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    Atre, Sachin R. (22933845900)
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    Ausloos, Marcel (7101798907)
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    Avokpaho, Euripide F.G.A. (57209842037)
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    Awasthi, Ashish (58420926700)
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    Ayala Quintanilla, Beatriz Paulina (55598298700)
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    Ayele, Yohanes (57195129631)
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    Ayer, Rakesh (56051098100)
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    Azzopardi, Peter S. (56861081000)
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    Babazadeh, Arefeh (57200079032)
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    Bacha, Umar (57200173721)
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    Badali, Hamid (15123728900)
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    Badawi, Alaa (57216776029)
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    Bali, Ayele Geleto (57204564615)
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    Ballesteros, Katherine E. (57207968050)
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    Banach, Maciej (22936699500)
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    Banerjee, Kajori (57193448932)
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    Bannick, Marlena S. (57206834518)
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    Banoub, Joseph Adel Mattar (57204568975)
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    Barboza, Miguel A. (56650777100)
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    Barker-Collo, Suzanne Lyn (57193065514)
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    Barnighausen, Till Winfried (23011726900)
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    Barquera, Simon (6601928375)
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    Barrero, Lope H. (57208560675)
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    Bassat, Quique (23024176000)
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    Basu, Sanjay (9335409500)
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    Baune, Bernhard T. (6603807336)
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    Baynes, Habtamu Wondifraw (57192710748)
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    Bazargan-Hejazi, Shahrzad (57205912040)
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    Bedi, Neeraj (57988442200)
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    Beghi, Ettore (7004809655)
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    Behzadifar, Masoud (57204671696)
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    Behzadifar, Meysam (59429991000)
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    Bejot, Yannick (14038743100)
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    Bekele, Bayu Begashaw (57196083941)
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    Belachew, Abate Bekele (57201657313)
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    Belay, Ezra (56372891800)
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    Belay, Yihalem Abebe (57202972558)
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    Bell, Michelle L. (7401466450)
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    Bello, Aminu K. (12759638700)
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    Bennett, Derrick A. (57650836400)
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    Bensenor, Isabela M. (7004830338)
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    Berman, Adam E. (7201959854)
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    Bernabe, Eduardo (57194696150)
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    Bernstein, Robert S. (56971681200)
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    Bertolacci, Gregory J. (57204558417)
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    Beuran, Mircea (25229806700)
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    Beyranvand, Tina (57203000763)
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    Bhalla, Ashish (57202555305)
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    Bhattarai, Suraj (55646532200)
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    Bhaumik, Soumyadeeep (55643126300)
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    Bhutta, Zulfiqar A. (24342648300)
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    Biadgo, Belete (55672090500)
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    Biehl, Molly H. (57196041812)
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    Bijani, Ali (23134684900)
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    Bikbov, Boris (57219957158)
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    Bilano, Ver (57189663783)
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    Bililign, Nigus (57216264444)
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    Bin Sayeed, Muhammad Shahdaat (55408904500)
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    Bisanzio, Donal (57196394991)
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    Biswas, Tuhin (59824959000)
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    Blacker, Brigette F. (57202420381)
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    Basara, Berrak Bora (23089934500)
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    Borschmann, Rohan (35091024300)
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    Bosetti, Cristina (7005452936)
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    Bozorgmehr, Kayvan (34767823500)
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    Brady, Oliver J. (57218716651)
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    Brant, Luisa C. (40160889400)
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    Brayne, Carol (57210386759)
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    Brazinova, Alexandra (57216996405)
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    Breitborde, Nicholas J.K. (6603260895)
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    Brenner, Hermann (7201832825)
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    Briant, Paul Svitil (57196152334)
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    Britton, Gabrielle (7004997832)
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    Brugha, Traolach (35370057100)
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    Busse, Reinhard (35589070800)
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    Butt, Zahid A. (57202522739)
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    Callender, Charlton S.K.H. (57195560691)
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    Campos-Nonato, Ismael R. (57203424784)
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    Campuzano Rincon, Julio Cesar (6505846919)
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    Cano, Jorge (7201865982)
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    Car, Mate (57113377700)
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    Cardenas, Rosario (57216482927)
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    Carreras, Giulia (57221176357)
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    Carrero, Juan J. (16834646800)
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    Carter, Austin (57201756395)
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    Carvalho, Felix (7103070417)
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    Castaneda-Orjuela, Carlos A. (35769124700)
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    Castillo Rivas, Jacqueline (57197814657)
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    Castle, Chris D. (57196079840)
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    Castro, Clara (54787333700)
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    Castro, Franz (57204567353)
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    Catala-Lopez, Ferran (57202553733)
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    Cerin, Ester (14522064200)
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    Chaiah, Yazan (57204565480)
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    Chang, Jung-Chen (57202568248)
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    Charlson, Fiona J. (57191632086)
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    Chaturvedi, Pankaj (35547314900)
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    Chiang, Peggy Pei-Chia (59846886500)
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    Chimed-Ochir, Odgerel (57217262222)
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    Chisumpa, Vesper Hichilombwe (56761895800)
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    Chitheer, Abdulaal (57209314488)
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    Chowdhury, Rajiv (57216138475)
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    Christensen, Hanne (57202099623)
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    Christopher, Devasahayam J. (57209863533)
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    Chung, Sheng-Chia (56008137900)
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    Cicuttini, Flavia M. (7005887430)
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    Ciobanu, Liliana G. (57201603453)
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    Cirillo, Massimo (35247478400)
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    Cohen, Aaron J. (7404780942)
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    Cooper, Leslie Trumbull (15754277900)
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    Cortesi, Paolo Angelo (57200306512)
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    Cortinovis, Monica (57207893885)
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    Cousin, Ewerton (57194620705)
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    Cowie, Benjamin C. (57202566182)
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    Criqui, Michael H. (57212369327)
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    Cromwell, Elizabeth A. (15727546000)
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    Crowe, Christopher Stephen (55976347800)
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    Crump, John A. (57202595111)
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    Cunningham, Matthew (57204558787)
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    Daba, Alemneh Kabeta (57203300408)
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    Dadi, Abel Fekadu (57031690900)
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    Dandona, Lalit (7007017243)
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    Dang, Anh Kim (57195728465)
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    Dargan, Paul I. (57212154356)
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    Daryani, Ahmad (16021522200)
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    Das, Siddharth K. (55362129800)
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    Gupta, Rajat Das (57215122060)
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    Neves, Jose Das (57208073193)
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    Davis, Adrian C. (7404296836)
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    Davis Weaver, Nicole (57203300193)
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    Davitoiu, Dragos Virgil (57202555163)
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    Davletov, Kairat (6602803024)
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    De La Hoz, Fernando Pio (23134262800)
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    De Neve, Jan-Walter (57039962400)
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    Degefa, Meaza Girma (57204559873)
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    Degenhardt, Louisa (7004040033)
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    Degfie, Tizta T. (57194129130)
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    Deiparine, Selina (57205252200)
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    Demoz, Gebre Teklemariam (57202214514)
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    Denova-Gutierrez, Edgar (25228198700)
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    Deribe, Kebede (57193912587)
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    Dervenis, Nikolaos (35368148900)
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    Des Jarlais, Don C. (56990451200)
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    Dessie, Getenet Ayalew (57202055866)
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    Dharmaratne, Samath D. (57216324802)
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    Dicker, Daniel (57196026676)
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    Ding, Eric L. (54413849800)
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    Dirac, M. Ashworth (57193092988)
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    Djalalinia, Shirin (37113718000)
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    Dokova, Klara (57201523771)
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    Doku, David Teye (36015210300)
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    Donnelly, Christl A. (35468127900)
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    Dorsey, E. Ray (23102496300)
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    Doshi, Pratik P. (57202595536)
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    Douwes-Schultz, Dirk (57196081398)
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    Doyle, Kerrie E. (55693710800)
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    Driscoll, Tim R. (7005928308)
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    Dubey, Manisha (57219898654)
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    Duken, Eyasu Ejeta (57204560558)
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    Duncan, Bruce B. (35476478500)
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    Duraes, Andre R. (30867558600)
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    Ebrahimi, Hedyeh (57195329214)
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    Edessa, Dumessa (56922334200)
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    Edvardsson, David (35229255500)
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    Eggen, Anne Elise (7007019553)
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    El Bcheraoui, Charbel (25027689700)
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    El Sayed Zaki, Maysaa (57203666922)
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    El-Khatib, Ziad (54908919000)
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    Elkout, Hajer (36102315300)
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    Ellingsen, Christian Lycke (7801360950)
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    Endres, Matthias (7005056946)
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    Endries, Aman Yesuf (57216324852)
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    Er, Benjamin (57204568328)
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    Eshrati, Babak (16030619200)
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    Eskandarieh, Sharareh (57211720158)
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    Fakhar, Mahdi (24168542800)
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    Fakhim, Hamed (56532027000)
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    Fareed, Mohammad (24491815600)
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    Farhadi, Farzaneh (55869726400)
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    Faro, Andre (36770969600)
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    Farvid, Maryam S. (57216534761)
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    Farzadfar, Farshad (57195049611)
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    Farzaei, Mohammad Hosein (36458335600)
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    Feigin, Valery L. (57203677957)
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    Fentahun, Netsanet (56394665400)
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    Fereshtehnejad, Seyed-Mohammad (57202557520)
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    Ferrari, Alize J. (57195348907)
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    Feyissa, Garumma Tolu (55504728900)
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    Filip, Irina (55570061400)
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    Finegold, Samuel (57195558156)
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    Fischer, Florian (55508208800)
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    Foreman, Kyle J. (57209064414)
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    Fornari, Carla (15022250200)
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    Frank, Tahvi D. (57203197110)
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    Fukumoto, Takeshi (26531100300)
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    Fuller, John E. (57204565664)
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    Fullman, Nancy (57211064970)
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    Furtado, Joao M. (36801755000)
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    Gallus, Silvano (7005387365)
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    Garcia-Gordillo, Miguel A. (55930749500)
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    Gebrehiwot, Tsegaye Tewelde (57216482917)
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    Gibney, Katherine B. (57202564104)
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    Gnedovskaya, Elena V. (56806916500)
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    Grada, Ayman (55797741000)
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    Grosso, Giuseppe (57196998256)
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    Gugnani, Harish Chander (7005567008)
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    Guimaraes, Andre Luiz Sena (7102920800)
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    Guo, Yuming (55712472800)
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    Gupta, Prakash C. (58767181900)
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    Gupta, Rahul (57204120071)
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    Gupta, Rajeev (55705295300)
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    Gupta, Tanush (57219956402)
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    Gutierrez, Reyna Alma (57200298415)
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    Gyawali, Bishal (56237046200)
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    Haagsma, Juanita A. (57202571125)
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    Hafezi-Nejad, Nima (57216814261)
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    Hagos, Tekleberhan B. (57204236893)
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    Hailegiyorgis, Tewodros Tesfa (57202206322)
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    Hailu, Gessessew Bugssa (57219637263)
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    Haj-Mirzaian, Arvin (57210768364)
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    Haj-Mirzaian, Arya (57226201352)
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    Hamadeh, Randah R. (57202769526)
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    Hamidi, Samer (24366336000)
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    Handal, Alexis J. (57208977398)
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    Hankey, Graeme J. (7102816661)
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    Harb, Hilda L. (57221443122)
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    Harikrishnan, Sivadasanpillai (57202524069)
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    Haro, Josep Maria (57215877903)
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    Hasan, Mehedi (57908537100)
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    Hassankhani, Hadi (26436359700)
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    Hassen, Hamid Yimam (57188660707)
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    Havmoeller, Rasmus (57212075728)
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    Hay, Roderick J. (56785229200)
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    Hay, Simon I. (7101875313)
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    He, Yihua (57204561423)
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    Hedayatizadeh-Omran, Akbar (35867288600)
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    Hegazy, Mohamed I. (35110336200)
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    Heibati, Behzad (55341086000)
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    Heidari, Mohsen (56814474300)
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    Hendrie, Delia (6602071966)
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    GBD 2017 Causes of Death Collaborators. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018; 392: 1736–88—The bottom row in figure 7 was cut off. This correction has been made to the online version as of Nov 9, 2018, and has been made to the printed Article. © 2018 Elsevier Ltd
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    Global, regional, and national age-sex specific mortality for 264 causes of death, 1980–2016: a systematic analysis for the Global Burden of Disease Study 2016
    (2017)
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    Xavier, Denis (55403963100)
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    Xiao, Qingyang (59797114300)
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    Xu, Gelin (57203583113)
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    Yaghoubi, Mohsen (57212400558)
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    Yakob, Bereket (57203811497)
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    Yano, Yuichiro (57196965200)
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    Yaseri, Mehdi (23029507000)
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    Yimam, Hassen Hamid (57196325590)
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    Yonemoto, Naohiro (57204947657)
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    Yoon, Seok-Jun (24823148900)
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    Yotebieng, Marcel (26325950800)
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    Younis, Mustafa Z. (8549393000)
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    Zaidi, Zoubida (57197376721)
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    El Sayed Zaki, Maysaa (57203666922)
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    Zegeye, Elias Asfaw (57209171278)
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    Zenebe, Zerihun Menlkalew (57200737185)
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    Zerfu, Taddese Alemu (55358278900)
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    Zhang, Anthony Lin (56391112900)
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    Zhang, Xueying (56283378700)
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    Zipkin, Ben (57200737130)
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    Zodpey, Sanjay (7003415080)
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    Lopez, Alan D. (7401455668)
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    Murray, Christopher J.L. (55481130700)
    Background: Monitoring levels and trends in premature mortality is crucial to understanding how societies can address prominent sources of early death. The Global Burden of Disease 2016 Study (GBD 2016) provides a comprehensive assessment of cause-specifc mortality for 264 causes in 195 locations from 1980 to 2016. This assessment includes evaluation of the expected epidemiological transition with changes in development and where local patterns deviate from these trends. Methods: We estimated cause-specifc deaths and years of life lost (YLLs) by age, sex, geography, and year. YLLs were calculated from the sum of each death multiplied by the standard life expectancy at each age. We used the GBD cause of death database composed of: vital registration (VR) data corrected for under-registration and garbage coding; national and subnational verbal autopsy (VA) studies corrected for garbage coding; and other sources including surveys and surveillance systems for specifc causes such as maternal mortality. To facilitate assessment of quality, we reported on the fraction of deaths assigned to GBD Level 1 or Level 2 causes that cannot be underlying causes of death (major garbage codes) by location and year. Based on completeness, garbage coding, cause list detail, and time periods covered, we provided an overall data quality rating for each location with scores ranging from 0 stars (worst) to 5 stars (best). We used robust statistical methods including the Cause of Death Ensemble model (CODEm) to generate estimates for each location, year, age, and sex. We assessed observed and expected levels and trends of cause-specifc deaths in relation to the Socio-demographic Index (SDI), a summary indicator derived from measures of average income per capita, educational attainment, and total fertility, with locations grouped into quintiles by SDI. Relative to GBD 2015, we expanded the GBD cause hierarchy by 18 causes of death for GBD 2016. Findings: The quality of available data varied by location. Data quality in 25 countries rated in the highest category (5 stars), while 48, 30, 21, and 44 countries were rated at each of the succeeding data quality levels. Vital registration or verbal autopsy data were not available in 27 countries, resulting in the assignment of a zero value for data quality. Deaths from non-communicable diseases (NCDs) represented 72·3% (95% uncertainty interval [UI] 71·2-73·2) of deaths in 2016 with 19·3% (18·5-20·4) of deaths in that year occurring from communicable, maternal, neonatal, and nutritional (CMNN) diseases and a further 8·43% (8·00-8·67) from injuries. Although age-standardised rates of death from NCDs decreased globally between 2006 and 2016, total numbers of these deaths increased; both numbers and age-standardised rates of death from CMNN causes decreased in the decade 2006-16 - age-standardised rates of deaths from injuries decreased but total numbers varied little. In 2016, the three leading global causes of death in children under-5 were lower respiratory infections, neonatal preterm birth complications, and neonatal encephalopathy due to birth asphyxia and trauma, combined resulting in 1·80 million deaths (95% UI 1·59 million to 1·89 million). Between 1990 and 2016, a profound shift toward deaths at older ages occurred with a 178% (95% UI 176-181) increase in deaths in ages 90-94 years and a 210% (208-212) increase in deaths older than age 95 years. The ten leading causes by rates of age-standardised YLL signifcantly decreased from 2006 to 2016 (median annualised rate of change was a decrease of 2·89%); the median annualised rate of change for all other causes was lower (a decrease of 1·59%) during the same interval. Globally, the fve leading causes of total YLLs in 2016 were cardiovascular diseases; diarrhoea, lower respiratory infections, and other common infectious diseases; neoplasms; neonatal disorders; and HIV/AIDS and tuberculosis. At a fner level of disaggregation within cause groupings, the ten leading causes of total YLLs in 2016 were ischaemic heart disease, cerebrovascular disease, lower respiratory infections, diarrhoeal diseases, road injuries, malaria, neonatal preterm birth complications, HIV/AIDS, chronic obstructive pulmonary disease, and neonatal encephalopathy due to birth asphyxia and trauma. Ischaemic heart disease was the leading cause of total YLLs in 113 countries for men and 97 countries for women. Comparisons of observed levels of YLLs by countries, relative to the level of YLLs expected on the basis of SDI alone, highlighted distinct regional patterns including the greater than expected level of YLLs from malaria and from HIV/AIDS across sub-Saharan Africa; diabetes mellitus, especially in Oceania; interpersonal violence, notably within Latin America and the Caribbean; and cardiomyopathy and myocarditis, particularly in eastern and central Europe. The level of YLLs from ischaemic heart disease was less than expected in 117 of 195 locations. Other leading causes of YLLs for which YLLs were notably lower than expected included neonatal preterm birth complications in many locations in both south Asia and southeast Asia, and cerebrovascular disease in western Europe. Interpretation: The past 37 years have featured declining rates of communicable, maternal, neonatal, and nutritional diseases across all quintiles of SDI, with faster than expected gains for many locations relative to their SDI. A global shift towards deaths at older ages suggests success in reducing many causes of early death. YLLs have increased globally for causes such as diabetes mellitus or some neoplasms, and in some locations for causes such as drug use disorders, and confict and terrorism. Increasing levels of YLLs might refect outcomes from conditions that required high levels of care but for which efective treatments remain elusive, potentially increasing costs to health systems. Copyright © 2017 The Author(s). Published by Elsevier Ltd.
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    Publication
    Global, regional, and national age-sex-specific mortality and life expectancy, 1950-2017: A systematic analysis for the Global Burden of Disease Study 2017
    (2018)
    Dicker, Daniel (57196026676)
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    Nguyen, Grant (57191591002)
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    Schaeffner, Elke (6507021741)
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    Shamsizadeh, Morteza (57195940127)
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    Sharafi, Kiomars (57194516056)
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    Sharif, Mehdi (16022734200)
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    Sharif-Alhoseini, Mahdi (35108018000)
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    Sharma, Meenakshi (58730797800)
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    Sharma, Jayendra (57195329457)
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    Sharma, Rajesh (58228412600)
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    She, Jun (57209122131)
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    Sheikh, Aziz (7202522962)
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    Sheth, Kevin N. (57212863894)
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    Shi, Peilin (57203064901)
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    Shibuya, Kenji (8948057900)
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    Shifa, Girma Temam (57211793093)
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    Shiferaw, Mekonnen Sisay (57205232012)
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    Shigematsu, Mika (23968093000)
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    Shiri, Rahman (57200737050)
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    Shirkoohi, Reza (12776374400)
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    Shiue, Ivy (35811219800)
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    Shokraneh, Farhad (36146063000)
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    Shrime, Mark G. (57204703404)
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    Shukla, Sharvari Rahul (55760856000)
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    Si, Si (56706979500)
    Background: Assessments of age-specifc mortality and life expectancy have been done by the UN Population Division, Department of Economics and Social Afairs (UNPOP), the United States Census Bureau, WHO, and as part of previous iterations of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD). Previous iterations of the GBD used population estimates from UNPOP, which were not derived in a way that was internally consistent with the estimates of the numbers of deaths in the GBD. The present iteration of the GBD, GBD 2017, improves on previous assessments and provides timely estimates of the mortality experience of populations globally. Methods: The GBD uses all available data to produce estimates of mortality rates between 1950 and 2017 for 23 age groups, both sexes, and 918 locations, including 195 countries and territories and subnational locations for 16 countries. Data used include vital registration systems, sample registration systems, household surveys (complete birth histories, summary birth histories, sibling histories), censuses (summary birth histories, household deaths), and Demographic Surveillance Sites. In total, this analysis used 8259 data sources. Estimates of the probability of death between birth and the age of 5 years and between ages 15 and 60 years are generated and then input into a model life table system to produce complete life tables for all locations and years. Fatal discontinuities and mortality due to HIV/AIDS are analysed separately and then incorporated into the estimation. We analyse the relationship between age-specifc mortality and development status using the Socio-demographic Index, a composite measure based on fertility under the age of 25 years, education, and income. There are four main methodological improvements in GBD 2017 compared with GBD 2016: 622 additional data sources have been incorporated; new estimates of population, generated by the GBD study, are used; statistical methods used in diferent components of the analysis have been further standardised and improved; and the analysis has been extended backwards in time by two decades to start in 1950. Findings: Globally, 18·7% (95% uncertainty interval 18·4-19·0) of deaths were registered in 1950 and that proportion has been steadily increasing since, with 58·8% (58·2-59·3) of all deaths being registered in 2015. At the global level, between 1950 and 2017, life expectancy increased from 48·1 years (46·5-49·6) to 70·5 years (70·1-70·8) for men and from 52·9 years (51·7-54·0) to 75·6 years (75·3-75·9) for women. Despite this overall progress, there remains substantial variation in life expectancy at birth in 2017, which ranges from 49·1 years (46·5-51·7) for men in the Central African Republic to 87·6 years (86·9-88·1) among women in Singapore. The greatest progress across age groups was for children younger than 5 years; under-5 mortality dropped from 216·0 deaths (196·3-238·1) per 1000 livebirths in 1950 to 38·9 deaths (35·6-42·83) per 1000 livebirths in 2017, with huge reductions across countries. Nevertheless, there were still 5·4 million (5·2-5·6) deaths among children younger than 5 years in the world in 2017. Progress has been less pronounced and more variable for adults, especially for adult males, who had stagnant or increasing mortality rates in several countries. The gap between male and female life expectancy between 1950 and 2017, while relatively stable at the global level, shows distinctive patterns across super-regions and has consistently been the largest in central Europe, eastern Europe, and central Asia, and smallest in south Asia. Performance was also variable across countries and time in observed mortality rates compared with those expected on the basis of development. Interpretation: This analysis of age-sex-specifc mortality shows that there are remarkably complex patterns in population mortality across countries. The fndings of this study highlight global successes, such as the large decline in under-5 mortality, which refects signifcant local, national, and global commitment and investment over several decades. However, they also bring attention to mortality patterns that are a cause for concern, particularly among adult men and, to a lesser extent, women, whose mortality rates have stagnated in many countries over the time period of this study, and in some cases are increasing. © 2018 The Author(s).
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    Publication
    Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017
    (2018)
    Roth, Gregory A. (55074747400)
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    Abate, Degu (57204237665)
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    Abate, Kalkidan Hassen (57207943858)
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    Abbafati, Cristiana (54917122400)
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    Abbasi, Nooshin (57212442022)
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    Abbastabar, Hedayat (57212441848)
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    Abd-Allah, Foad (36503428900)
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    Abdela, Jemal (57200613000)
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    Abdelalim, Ahmed (7801307783)
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    Abdollahpour, Ibrahim (36997151900)
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    Abdulkader, Rizwan Suliankatchi (57195295816)
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    Abebe, Haftom Temesgen (55950002100)
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    Abebe, Molla (57211131124)
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    Abebe, Zegeye (57193002719)
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    Abejie, Ayenew Negesse (57203015573)
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    Abil, Olifan Zewdie (57204558002)
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    Abrham, Aklilu Roba (57202704637)
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    Abu-Raddad, Laith Jamal (14032724700)
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    Accrombessi, Manfred Mario Kokou (55353650500)
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    Alene, Kefyalew Addis (57202583764)
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    Alijanzadeh, Mehran (56236864700)
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    Alizadeh-Navaei, Reza (36024974700)
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    Aljunid, Syed Mohamed (6504304159)
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    Si, Si (56706979500)
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    Siabani, Soraya (25227131300)
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    Siddiqi, Tariq J. (57193718539)
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    Sigfusdottir, Inga Dora (57195363778)
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    Sigurvinsdottir, Rannveig (56006396200)
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    Silberberg, Donald H. (57223420256)
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    Santos Silva, Diego Augusto (36985158000)
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    Silva, Joao Pedro (7403023631)
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    Soofi, Moslem (56373891000)
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    Sorensen, Reed J.D. (57196918748)
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    Soriano, Joan B. (7101973935)
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    Soyiri, Ireneous N. (15052406400)
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    Sposato, Luciano A. (25640261000)
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    Sreeramareddy, Chandrashekhar T. (57212263335)
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    Srinivasan, Vinay (57196077031)
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    Stanaway, Jeffrey D. (57201210928)
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    Starodubov, Vladimir I. (6701820838)
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    Stathopoulou, Vasiliki (57209726581)
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    Stein, Dan J. (55769747595)
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    Steiner, Caitlyn (57205358084)
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    Stewart, Leo G. (57204565284)
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    Stokes, Mark A. (7102859000)
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    Sufiyan, Mu'Awiyyah Babale (58294633600)
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    Sur, Patrick John (57218360398)
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    Sykes, Bryan L. (57211183396)
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    Sylte, Dillon O. (57211183601)
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    Temsah, Mohamad-Hani (56115852000)
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    Temsah, Omar (57204559820)
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    Terkawi, Abdullah Sulieman (57211144258)
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    Teshale, Manaye Yihune (57204566390)
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    Tessema, Belay (20735503600)
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    Tessema, Gizachew Assefa (57196316304)
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    Thankappan, Kavumpurathu Raman (57202955435)
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    Thirunavukkarasu, Sathish (54407369300)
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    Thomas, Nihal (7401830494)
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    Tran, Bach Xuan (57209107515)
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    Tran, Khanh Bao (57201651536)
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    Tripathi, Suryakant (57225821627)
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    Troeger, Christopher E. (57195223624)
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    Truelsen, Thomas Clement (57202824565)
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    Uthman, Olalekan A. (23026328100)
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    Vladimirov, Sergey Konstantinovitch (57195959162)
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    Waheed, Yasir (35303643700)
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    Wallin, Mitchell Taylor (57201573668)
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    Walson, Judd L. (57203254111)
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    Wang, Yuan-Pang (8576812100)
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    West, T. Eoin (57756844000)
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    Whiteford, Harvey A. (55906494000)
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    Widecka, Justyna (15047205800)
    Background: Global development goals increasingly rely on country-specific estimates for benchmarking a nation's progress. To meet this need, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 estimated global, regional, national, and, for selected locations, subnational cause-specific mortality beginning in the year 1980. Here we report an update to that study, making use of newly available data and improved methods. GBD 2017 provides a comprehensive assessment of cause-specific mortality for 282 causes in 195 countries and territories from 1980 to 2017. Methods: The causes of death database is composed of vital registration (VR), verbal autopsy (VA), registry, survey, police, and surveillance data. GBD 2017 added ten VA studies, 127 country-years of VR data, 502 cancer-registry country-years, and an additional surveillance country-year. Expansions of the GBD cause of death hierarchy resulted in 18 additional causes estimated for GBD 2017. Newly available data led to subnational estimates for five additional countries—Ethiopia, Iran, New Zealand, Norway, and Russia. Deaths assigned International Classification of Diseases (ICD) codes for non-specific, implausible, or intermediate causes of death were reassigned to underlying causes by redistribution algorithms that were incorporated into uncertainty estimation. We used statistical modelling tools developed for GBD, including the Cause of Death Ensemble model (CODEm), to generate cause fractions and cause-specific death rates for each location, year, age, and sex. Instead of using UN estimates as in previous versions, GBD 2017 independently estimated population size and fertility rate for all locations. Years of life lost (YLLs) were then calculated as the sum of each death multiplied by the standard life expectancy at each age. All rates reported here are age-standardised. Findings: At the broadest grouping of causes of death (Level 1), non-communicable diseases (NCDs) comprised the greatest fraction of deaths, contributing to 73·4% (95% uncertainty interval [UI] 72·5–74·1) of total deaths in 2017, while communicable, maternal, neonatal, and nutritional (CMNN) causes accounted for 18·6% (17·9–19·6), and injuries 8·0% (7·7–8·2). Total numbers of deaths from NCD causes increased from 2007 to 2017 by 22·7% (21·5–23·9), representing an additional 7·61 million (7·20–8·01) deaths estimated in 2017 versus 2007. The death rate from NCDs decreased globally by 7·9% (7·0–8·8). The number of deaths for CMNN causes decreased by 22·2% (20·0–24·0) and the death rate by 31·8% (30·1–33·3). Total deaths from injuries increased by 2·3% (0·5–4·0) between 2007 and 2017, and the death rate from injuries decreased by 13·7% (12·2–15·1) to 57·9 deaths (55·9–59·2) per 100 000 in 2017. Deaths from substance use disorders also increased, rising from 284 000 deaths (268 000–289 000) globally in 2007 to 352 000 (334 000–363 000) in 2017. Between 2007 and 2017, total deaths from conflict and terrorism increased by 118·0% (88·8–148·6). A greater reduction in total deaths and death rates was observed for some CMNN causes among children younger than 5 years than for older adults, such as a 36·4% (32·2–40·6) reduction in deaths from lower respiratory infections for children younger than 5 years compared with a 33·6% (31·2–36·1) increase in adults older than 70 years. Globally, the number of deaths was greater for men than for women at most ages in 2017, except at ages older than 85 years. Trends in global YLLs reflect an epidemiological transition, with decreases in total YLLs from enteric infections, respiratory infections and tuberculosis, and maternal and neonatal disorders between 1990 and 2017; these were generally greater in magnitude at the lowest levels of the Socio-demographic Index (SDI). At the same time, there were large increases in YLLs from neoplasms and cardiovascular diseases. YLL rates decreased across the five leading Level 2 causes in all SDI quintiles. The leading causes of YLLs in 1990—neonatal disorders, lower respiratory infections, and diarrhoeal diseases—were ranked second, fourth, and fifth, in 2017. Meanwhile, estimated YLLs increased for ischaemic heart disease (ranked first in 2017) and stroke (ranked third), even though YLL rates decreased. Population growth contributed to increased total deaths across the 20 leading Level 2 causes of mortality between 2007 and 2017. Decreases in the cause-specific mortality rate reduced the effect of population growth for all but three causes: substance use disorders, neurological disorders, and skin and subcutaneous diseases. Interpretation: Improvements in global health have been unevenly distributed among populations. Deaths due to injuries, substance use disorders, armed conflict and terrorism, neoplasms, and cardiovascular disease are expanding threats to global health. For causes of death such as lower respiratory and enteric infections, more rapid progress occurred for children than for the oldest adults, and there is continuing disparity in mortality rates by sex across age groups. Reductions in the death rate of some common diseases are themselves slowing or have ceased, primarily for NCDs, and the death rate for selected causes has increased in the past decade. Funding: Bill & Melinda Gates Foundation. © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
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    Global, regional, and national incidence, prevalence, and mortality of HIV, 1980-2017, and forecasts to 2030, for 195 countries and territories: A systematic analysis for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017
    (2019)
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    Christopher, Devasahayam J. (57209863533)
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    Chu, Dinh-Toi (56239816300)
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    Crider, Raquel (6603551162)
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    Das Neves, José (57208073193)
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    Degenhardt, Louisa (7004040033)
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    Demeke, Feleke Mekonnen (57204717669)
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    Demis, Asmamaw Bizuneh Bizuneh (57207453281)
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    Demissie, Dereje Bayissa (6507620197)
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    Demoz, Gebre Teklemariam (57202214514)
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    Deribe, Kebede (57193912587)
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    Des Jarlais, Don (56990451200)
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    Dhungana, Govinda Prasad (24066372700)
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    Diaz, Daniel (56644152500)
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    Do, Huyen Phuc (57200737094)
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    Duber, Herbert (55522646900)
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    Eftekhari, Aziz (56829076800)
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    El Sayed Zaki, Maysaa (57203666922)
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    El-Jaafary, Shaimaa I. (34869528300)
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    El-Khatib, Ziad (54908919000)
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    Endries, Aman Yesuf (57216324852)
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    Eyawo, Oghenowede (25959550100)
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    Fatima, Batool (55510228900)
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    Fernandes, Eduarda (34770207500)
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    Filip, Irina (55570061400)
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    Fischer, Florian (55508208800)
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    Folayan, Morenike Oluwatoyin (56725310700)
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    Foroutan, Masoud (58948371300)
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    Fukumoto, Takeshi (26531100300)
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    Fullman, Nancy (57211064970)
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    Garcia-Basteiro, Alberto L. (57200187168)
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    Gayesa, Reta Tsegaye (57225049499)
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    Gebremedhin, Ketema Bizuwork (57200529247)
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    Gebremeskel, Gebreamlak Gebremedhn (57748459200)
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    Gebreyohannes, Kelali Kalaye (57212023716)
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    Gedefaw, Getnet Azeze (57204453564)
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    Gelaw, Belayneh K. (56449077900)
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    Gesesew, Hailay Abrha (56412148300)
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    Geta, Birhanu (57208190927)
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    Gezae, Kebede Embaye (57204561611)
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    Ghadiri, Keyghobad (55409170000)
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    Ghashghaee, Ahmad (57194174020)
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    Ginindza, Themba T.G. (24468039800)
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    Gugnani, Harish Chander (7005567008)
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    Guimarães, Rafael Alves (56534712800)
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    Haile, Michael Tamene (57204564050)
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    Hailu, Gessessew Bugssa (57219637263)
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    Haj-Mirzaian, Arvin (57210768364)
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    Haj-Mirzaian, Arya (57226201352)
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    Hamidi, Samer (24366336000)
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    Handanagic, Senad (55803954400)
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    Handiso, Demelash Woldeyohannes (57201501075)
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    Hasanzadeh, Amir (57193162243)
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    Hassankhani, Hadi (26436359700)
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    Hassen, Hamid Yimam (57188660707)
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    Hay, Simon I. (7101875313)
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    Kiadaliri, Aliasghar A. (57199100665)
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    Naghavi, Mohsen (57207906323)
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    Wang, Haidong (16507828100)
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    Lim, Stephen S. (57201800433)
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    Kyu, Hmwe Hmwe (57217040073)
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    Murray, Christopher J.L. (55481130700)
    Background Understanding the patterns of HIV/AIDS epidemics is crucial to tracking and monitoring the progress of prevention and control efforts in countries. We provide a comprehensive assessment of the levels and trends of HIV/AIDS incidence, prevalence, mortality, and coverage of antiretroviral therapy (ART) for 1980-2017 and forecast these estimates to 2030 for 195 countries and territories. Methods We determined a modelling strategy for each country on the basis of the availability and quality of data. For countries and territories with data from population-based seroprevalence surveys or antenatal care clinics, we estimated prevalence and incidence using an open-source version of the Estimation and Projection Package - a natural history model originally developed by the UNAIDS Reference Group on Estimates, Modelling, and Projections. For countries with cause-specific vital registration data, we corrected data for garbage coding (ie, deaths coded to an intermediate, immediate, or poorly defined cause) and HIV misclassification. We developed a process of cohort incidence bias adjustment to use information on survival and deaths recorded in vital registration to back-calculate HIV incidence. For countries without any representative data on HIV, we produced incidence estimates by pulling information from observed bias in the geographical region. We used a re-coded version of the Spectrum model (a cohort component model that uses rates of disease progression and HIV mortality on and off ART) to produce agesex- specific incidence, prevalence, and mortality, and treatment coverage results for all countries, and forecast these measures to 2030 using Spectrum with inputs that were extended on the basis of past trends in treatment scale-up and new infections. Findings Global HIV mortality peaked in 2006 with 1·95 million deaths (95% uncertainty interval 1·87-2·04) and has since decreased to 0·95 million deaths (0·91-1·01) in 2017. New cases of HIV globally peaked in 1999 (3·16 million, 2·79-3·67) and since then have gradually decreased to 1·94 million (1·63-2·29) in 2017. These trends, along with ART scale-up, have globally resulted in increased prevalence, with 36·8 million (34·8-39·2) people living with HIV in 2017. Prevalence of HIV was highest in southern sub-Saharan Africa in 2017, and countries in the region had ART coverage ranging from 65·7% in Lesotho to 85·7% in eSwatini. Our forecasts showed that 54 countries will meet the UNAIDS target of 81% ART coverage by 2020 and 12 countries are on track to meet 90% ART coverage by 2030. Forecasted results estimate that few countries will meet the UNAIDS 2020 and 2030 mortality and incidence targets. Interpretation Despite progress in reducing HIV-related mortality over the past decade, slow decreases in incidence, combined with the current context of stagnated funding for related interventions, mean that many countries are not on track to reach the 2020 and 2030 global targets for reduction in incidence and mortality. With a growing population of people living with HIV, it will continue to be a major threat to public health for years to come. The pace of progress needs to be hastened by continuing to expand access to ART and increasing investments in proven HIV prevention initiatives that can be scaled up to have population-level impact. © 2019 The Author(s).
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    Publication
    Global, regional, and national incidence, prevalence, and mortality of HIV, 1980-2017, and forecasts to 2030, for 195 countries and territories: A systematic analysis for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017
    (2019)
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    Rawaf, Salman (6602475959)
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    Merdassa Roro, Elias E.M. (57217207043)
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    Tekelemedhin, Shishay Wahdey (57204566273)
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    Tovani-Palone, Marcos Roberto (56644977900)
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    Tran, Bach Xuan (57209107515)
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    Tran, Khanh Bao (57201651536)
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    Ullah, Irfan (56992676600)
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    Unnikrishnan, Bhaskaran (12790012100)
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    Uthman, Olalekan A. (23026328100)
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    Veisani, Yousef (55370882600)
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    Vladimirov, Sergey Konstantinovitch (57195959162)
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    Wada, Fiseha Wadilo (57194049305)
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    Waheed, Yasir (35303643700)
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    Wondmagegn, Berhanu Yazew (55102740300)
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    Yeshanew, Addisu Gize (57202995662)
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    Yilma, Mekdes Tigistu (57212019529)
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    Yimer, Ebrahim M. (57204849530)
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    Yonemoto, Naohiro (57204947657)
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    Yotebieng, Marcel (26325950800)
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    Youm, Yoosik (7005933825)
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    Yu, Chuanhua (57208140344)
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    Zarghi, Afshin (7003559162)
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    Zenebe, Zerihun Menlkalew (57200737185)
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    Zewale, Taye Abuhay (57209219258)
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    Ziapour, Arash (57202571078)
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    Zodpey, Sanjay (7003415080)
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    Naghavi, Mohsen (57207906323)
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    Vollset, Stein Emil (57196315778)
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    Wang, Haidong (16507828100)
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    Lim, Stephen S. (57201800433)
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    Kyu, Hmwe Hmwe (57217040073)
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    Murray, Christopher J.L. (55481130700)
    Background Understanding the patterns of HIV/AIDS epidemics is crucial to tracking and monitoring the progress of prevention and control efforts in countries. We provide a comprehensive assessment of the levels and trends of HIV/AIDS incidence, prevalence, mortality, and coverage of antiretroviral therapy (ART) for 1980-2017 and forecast these estimates to 2030 for 195 countries and territories. Methods We determined a modelling strategy for each country on the basis of the availability and quality of data. For countries and territories with data from population-based seroprevalence surveys or antenatal care clinics, we estimated prevalence and incidence using an open-source version of the Estimation and Projection Package - a natural history model originally developed by the UNAIDS Reference Group on Estimates, Modelling, and Projections. For countries with cause-specific vital registration data, we corrected data for garbage coding (ie, deaths coded to an intermediate, immediate, or poorly defined cause) and HIV misclassification. We developed a process of cohort incidence bias adjustment to use information on survival and deaths recorded in vital registration to back-calculate HIV incidence. For countries without any representative data on HIV, we produced incidence estimates by pulling information from observed bias in the geographical region. We used a re-coded version of the Spectrum model (a cohort component model that uses rates of disease progression and HIV mortality on and off ART) to produce agesex- specific incidence, prevalence, and mortality, and treatment coverage results for all countries, and forecast these measures to 2030 using Spectrum with inputs that were extended on the basis of past trends in treatment scale-up and new infections. Findings Global HIV mortality peaked in 2006 with 1·95 million deaths (95% uncertainty interval 1·87-2·04) and has since decreased to 0·95 million deaths (0·91-1·01) in 2017. New cases of HIV globally peaked in 1999 (3·16 million, 2·79-3·67) and since then have gradually decreased to 1·94 million (1·63-2·29) in 2017. These trends, along with ART scale-up, have globally resulted in increased prevalence, with 36·8 million (34·8-39·2) people living with HIV in 2017. Prevalence of HIV was highest in southern sub-Saharan Africa in 2017, and countries in the region had ART coverage ranging from 65·7% in Lesotho to 85·7% in eSwatini. Our forecasts showed that 54 countries will meet the UNAIDS target of 81% ART coverage by 2020 and 12 countries are on track to meet 90% ART coverage by 2030. Forecasted results estimate that few countries will meet the UNAIDS 2020 and 2030 mortality and incidence targets. Interpretation Despite progress in reducing HIV-related mortality over the past decade, slow decreases in incidence, combined with the current context of stagnated funding for related interventions, mean that many countries are not on track to reach the 2020 and 2030 global targets for reduction in incidence and mortality. With a growing population of people living with HIV, it will continue to be a major threat to public health for years to come. The pace of progress needs to be hastened by continuing to expand access to ART and increasing investments in proven HIV prevention initiatives that can be scaled up to have population-level impact. © 2019 The Author(s).
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    Publication
    Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016
    (2017)
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    Shariful Islam, Sheikh Mohammed (56400111100)
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    Sharma, Jayendra (57195329457)
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    She, Jun (57209122131)
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    Shi, Peilin (57203064901)
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    Shields, Chloe (57196083232)
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    Shigematsu, Mika (23968093000)
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    Silveira, Dayane Gabriele Alves (57190284103)
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    Singh, Jasvinder A. (7404421736)
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    Singh, Narinder Pal (57211864736)
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    Smith, David L. (55574206203)
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    Sorensen, Reed J.D. (57196918748)
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    Sousa, Tatiane Cristina Moraes (57195329460)
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    Sposato, Luciano A. (25640261000)
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    Sreeramareddy, Chandrashekhar T. (57212263335)
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    Stanaway, Jeffrey D. (57201210928)
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    Stein, Dan J. (55769747595)
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    Steinke, Sabine (57203777687)
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    Stokes, Mark Andrew (7102859000)
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    Stovner, Lars Jacob (57201788390)
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    Subart, Michelle (57194140438)
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    Sufiyan, Muawiyyah Babale (58294633600)
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    Suliankatchi Abdulkader, Rizwan (57195295816)
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    Tabarés-Seisdedos, Rafael (6602981102)
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    Taffere, Getachew Redae (59807215200)
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    Takala, Jukka S. (35425471300)
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    Tandon, Nikhil (7101833756)
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    Tavakkoli, Mohammad (57202524239)
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    Tehrani-Banihashemi, Arash (57204006020)
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    Temam Shifa, Girma (57217000284)
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    Uzochukwu, Benjamin S. Chudi (57211633289)
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    Van Boven, Job F.M. (53464198500)
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    Varughese, Santosh (22942817500)
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    Venkatesh, S. (57201538443)
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    Venketasubramanian, Narayanaswamy (56804702100)
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    Vidavalur, Ramesh (57201445172)
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    Violante, Francesco S. (7003555890)
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    Vladimirov, Sergey K. (57195959162)
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    Vlassov, Vasiliy Victorovich (57211633239)
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    Wakayo, Tolassa (57205609717)
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    Wang, Yuan-Pang (8576812100)
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    Weaver, Marcia (7201548872)
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    Weichenthal, Scott (57202555239)
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    Weiderpass, Elisabete (57205018947)
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    Weintraub, Robert G. (7006079405)
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    Werdecker, Andrea (57208964895)
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    Westerman, Ronny (57218361023)
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    Whiteford, Harvey A. (55906494000)
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    Wiysonge, Charles Shey (6507441509)
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    Wolfe, Charles D.A. (57202754705)
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    Woodbrook, Rachel (57200298006)
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    Woolf, Anthony D. (7102882171)
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    Workicho, Abdulhalik (56720337100)
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    Wulf Hanson, Sarah (57212263269)
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    Xavier, Denis (55403963100)
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    Xu, Gelin (57203583113)
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    Yadgir, Simon (57192837280)
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    Yaghoubi, Mohsen (56402926900)
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    Yakob, Bereket (57203811497)
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    Yan, Lijing L. (35933756700)
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    Yano, Yuichiro (57196965200)
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    Ye, Pengpeng (57202839295)
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    Yimam, Hassen Hamid (57196325590)
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    Yip, Paul (7102503720)
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    Yonemoto, Naohiro (57204947657)
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    Yoon, Seok-Jun (24823148900)
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    Yotebieng, Marcel (26325950800)
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    Younis, Mustafa Z. (8549393000)
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    Zaidi, Zoubida (57197376721)
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    Zaki, Maysaa El Sayed (57203666922)
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    Zegeye, Elias Asfaw (57209171278)
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    Zenebe, Zerihun Menlkalew (57200737185)
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    Zhang, Xueying (56283378700)
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    Zhou, Maigeng (57054557200)
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    Zipkin, Ben (57200737130)
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    Zodpey, Sanjay (7003415080)
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    Zuhlke, Liesl Joanna (57209027746)
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    Murray, Christopher J.L. (55481130700)
    Background As mortality rates decline, life expectancy increases, and populations age, non-fatal outcomes of diseases and injuries are becoming a larger component of the global burden of disease. The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of prevalence, incidence, and years lived with disability (YLDs) for 328 causes in 195 countries and territories from 1990 to 2016. Methods We estimated prevalence and incidence for 328 diseases and injuries and 2982 sequelae, their non-fatal consequences. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between incidence, prevalence, remission, and cause of death rates for each condition. For some causes, we used alternative modelling strategies if incidence or prevalence needed to be derived from other data. YLDs were estimated as the product of prevalence and a disability weight for all mutually exclusive sequelae, corrected for comorbidity and aggregated to cause level. We updated the Socio-demographic Index (SDI), a summary indicator of income per capita, years of schooling, and total fertility rate. GBD 2016 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). Findings Globally, low back pain, migraine, age-related and other hearing loss, iron-deficiency anaemia, and major depressive disorder were the five leading causes of YLDs in 2016, contributing 57·6 million (95% uncertainty interval [UI] 40·8-75·9 million [7·2%, 6·0-8·3]), 45·1 million (29·0-62·8 million [5·6%, 4·0-7·2]), 36·3 million (25·3-50·9 million [4·5%, 3·8-5·3]), 34·7 million (23·0-49·6 million [4·3%, 3·5-5·2]), and 34·1 million (23·5-46·0 million [4·2%, 3·2-5·3]) of total YLDs, respectively. Age-standardised rates of YLDs for all causes combined decreased between 1990 and 2016 by 2·7% (95% UI 2·3-3·1). Despite mostly stagnant age-standardised rates, the absolute number of YLDs from non-communicable diseases has been growing rapidly across all SDI quintiles, partly because of population growth, but also the ageing of populations. The largest absolute increases in total numbers of YLDs globally were between the ages of 40 and 69 years. Age-standardised YLD rates for all conditions combined were 10·4% (95% UI 9·0-11·8) higher in women than in men. Iron-deficiency anaemia, migraine, Alzheimer's disease and other dementias, major depressive disorder, anxiety, and all musculoskeletal disorders apart from gout were the main conditions contributing to higher YLD rates in women. Men had higher age-standardised rates of substance use disorders, diabetes, cardiovascular diseases, cancers, and all injuries apart from sexual violence. Globally, we noted much less geographical variation in disability than has been documented for premature mortality. In 2016, there was a less than two times difference in age-standardised YLD rates for all causes between the location with the lowest rate (China, 9201 YLDs per 100 000, 95% UI 6862-11943) and highest rate (Yemen, 14 774 YLDs per 100 000, 11 018-19 228). Interpretation The decrease in death rates since 1990 for most causes has not been matched by a similar decline in age-standardised YLD rates. For many large causes, YLD rates have either been stagnant or have increased for some causes, such as diabetes. As populations are ageing, and the prevalence of disabling disease generally increases steeply with age, health systems will face increasing demand for services that are generally costlier than the interventions that have led to declines in mortality in childhood or for the major causes of mortality in adults. Up-todate information about the trends of disease and how this varies between countries is essential to plan for an adequate health-system response. © The Author(s). Published by Elsevier Ltd.
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    Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970-2016: A systematic analysis for the Global Burden of Disease Study 2016
    (2017)
    Wang, Haidong (16507828100)
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    Abajobir, Amanuel Alemu (57203613441)
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    Abate, Kalkidan Hassen (57207943858)
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    Abbafati, Cristiana (54917122400)
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    Abbas, Kaja M. (57190285707)
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    Abraha, Haftom Niguse (57195289877)
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    Abu-Raddad, Laith J. (14032724700)
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    Abu-Rmeileh, Niveen M.E. (57216675148)
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    Adedeji, Isaac Akinkunmi (57208456508)
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    Ali, Raghib (57196506541)
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    Alla, François (6701580827)
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    Martin, Elena Alvarez (57206867051)
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    Androudi, Sofia (6603286512)
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    Atre, Sachin R. (22933845900)
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    Avokpaho, Euripide Frinel G. Arthur (57209842037)
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    Barboza, Miguel A. (56650777100)
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    Barquera, Simon (6601928375)
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    Baune, Bernhard T. (6603807336)
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    Bazargan-Hejazi, Shahrzad (57205912040)
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    Bedi, Neeraj (57988442200)
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    Beghi, Ettore (7004809655)
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    Béjot, Yannick (14038743100)
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    Bekele, Bayu Begashaw (57196083941)
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    Bell, Michelle L. (7401466450)
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    Bello, Aminu K. (12759638700)
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    Zenebe, Zerihun Menlkalew (57200737185)
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    Zerfu, Taddese Alemu (55358278900)
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    Zhang, Anthony Lin (56391112900)
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    Zhang, Xueying (56283378700)
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    Zodpey, Sanjay (7003415080)
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    Zuhlke, Liesl Joanna (57209027746)
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    Lopez, Alan D. (7401455668)
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    Murray, Christopher J.L. (55481130700)
    Background: Detailed assessments of mortality patterns, particularly age-specific mortality, represent a crucial input that enables health systems to target interventions to specific populations. Understanding how all-cause mortality has changed with respect to development status can identify exemplars for best practice. To accomplish this, the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) estimated age-specific and sex-specific all-cause mortality between 1970 and 2016 for 195 countries and territories and at the subnational level for the five countries with a population greater than 200 million in 2016. Methods: We have evaluated how well civil registration systems captured deaths using a set of demographic methods called death distribution methods for adults and from consideration of survey and census data for children younger than 5 years. We generated an overall assessment of completeness of registration of deaths by dividing registered deaths in each location-year by our estimate of all-age deaths generated from our overall estimation process. For 163 locations, including subnational units in countries with a population greater than 200 million with complete vital registration (VR) systems, our estimates were largely driven by the observed data, with corrections for small fluctuations in numbers and estimation for recent years where there were lags in data reporting (lags were variable by location, generally between 1 year and 6 years). For other locations, we took advantage of different data sources available to measure under-5 mortality rates (U5MR) using complete birth histories, summary birth histories, and incomplete VR with adjustments; we measured adult mortality rate (the probability of death in individuals aged 15-60 years) using adjusted incomplete VR, sibling histories, and household death recall. We used the U5MR and adult mortality rate, together with crude death rate due to HIV in the GBD model life table system, to estimate age-specific and sex-specific death rates for each location-year. Using various international databases, we identified fatal discontinuities, which we defined as increases in the death rate of more than one death per million, resulting from conflict and terrorism, natural disasters, major transport or technological accidents, and a subset of epidemic infectious diseases; these were added to estimates in the relevant years. In 47 countries with an identified peak adult prevalence for HIV/AIDS of more than 0.5% and where VR systems were less than 65% complete, we informed our estimates of age-sex-specific mortality using the Estimation and Projection Package (EPP)-Spectrum model fitted to national HIV/AIDS prevalence surveys and antenatal clinic serosurveillance systems. We estimated stillbirths, early neonatal, late neonatal, and childhood mortality using both survey and VR data in spatiotemporal Gaussian process regression models. We estimated abridged life tables for all location-years using age-specific death rates. We grouped locations into development quintiles based on the Socio-demographic Index (SDI) and analysed mortality trends by quintile. Using spline regression, we estimated the expected mortality rate for each age-sex group as a function of SDI. We identified countries with higher life expectancy than expected by comparing observed life expectancy to anticipated life expectancy on the basis of development status alone. Findings: Completeness in the registration of deaths increased from 28% in 1970 to a peak of 45% in 2013; completeness was lower after 2013 because of lags in reporting. Total deaths in children younger than 5 years decreased from 1970 to 2016, and slower decreases occurred at ages 5-24 years. By contrast, numbers of adult deaths increased in each 5-year age bracket above the age of 25 years. The distribution of annualised rates of change in age-specific mortality rate differed over the period 2000 to 2016 compared with earlier decades: increasing annualised rates of change were less frequent, although rising annualised rates of change still occurred in some locations, particularly for adolescent and younger adult age groups. Rates of stillbirths and under-5 mortality both decreased globally from 1970. Evidence for global convergence of death rates was mixed; although the absolute difference between age-standardised death rates narrowed between countries at the lowest and highest levels of SDI, the ratio of these death rates - a measure of relative inequality - increased slightly. There was a strong shift between 1970 and 2016 toward higher life expectancy, most noticeably at higher levels of SDI. Among countries with populations greater than 1 million in 2016, life expectancy at birth was highest for women in Japan, at 86.9 years (95% UI 86.7-87.2), and for men in Singapore, at 81.3 years (78.8-83.7) in 2016. Male life expectancy was generally lower than female life expectancy between 1970 and 2016, and the gap between male and female life expectancy increased with progression to higher levels of SDI. Some countries with exceptional health performance in 1990 in terms of the difference in observed to expected life expectancy at birth had slower progress on the same measure in 2016. Interpretation Globally, mortality rates have decreased across all age groups over the past five decades, with the largest improvements occurring among children younger than 5 years. However, at the national level, considerable heterogeneity remains in terms of both level and rate of changes in age-specific mortality; increases in mortality for certain age groups occurred in some locations. We found evidence that the absolute gap between countries in age-specific death rates has declined, although the relative gap for some age-sex groups increased. Countries that now lead in terms of having higher observed life expectancy than that expected on the basis of development alone, or locations that have either increased this advantage or rapidly decreased the deficit from expected levels, could provide insight into the means to accelerate progress in nations where progress has stalled. Copyright © The Author(s).
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    Publication
    Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017
    (2018)
    Lozano, Rafael (7102198442)
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    Fullman, Nancy (57211064970)
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    Abate, Degu (57204237665)
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    Abdel-Rahman, Omar (55777635800)
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    Abdi, Alireza (56845014200)
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    Abdollahpour, Ibrahim (36997151900)
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    Abdulkader, Rizwan Suliankatchi (57195295816)
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    Abebe, Nebiyu Dereje (57192680787)
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    Adhikari, Tara Ballav (57209325586)
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    Adib, Mina G. (57204560513)
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    Background: Efforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of “leaving no one behind”, it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health-related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990–2017, projected indicators to 2030, and analysed global attainment. Methods: We measured progress on 41 health-related SDG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the health-related SDG index, we transformed the value for each indicator on a scale of 0–100, with 0 as the 2·5th percentile and 100 as the 97·5th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the probability of attainment in 2030 calculated from 1000 draws. We also did a global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends. Using 2015 global averages of indicators with defined SDG targets, we calculated the global annualised rates of change required from 2015 to 2030 to meet these targets, and then identified in what percentiles the required global annualised rates of change fell in the distribution of country-level rates of change from 1990 to 2015. We took the mean of these global percentile values across indicators and applied the past rate of change at this mean global percentile to all health-related SDG indicators, irrespective of target definition, to estimate the equivalent 2030 global average value and percentage change from 2015 to 2030 for each indicator. Findings: The global median health-related SDG index in 2017 was 59·4 (IQR 35·4–67·3), ranging from a low of 11·6 (95% uncertainty interval 9·6–14·0) to a high of 84·9 (83·1–86·7). SDG index values in countries assessed at the subnational level varied substantially, particularly in China and India, although scores in Japan and the UK were more homogeneous. Indicators also varied by SDI quintile and sex, with males having worse outcomes than females for non-communicable disease (NCD) mortality, alcohol use, and smoking, among others. Most countries were projected to have a higher health-related SDG index in 2030 than in 2017, while country-level probabilities of attainment by 2030 varied widely by indicator. Under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria indicators had the most countries with at least 95% probability of target attainment. Other indicators, including NCD mortality and suicide mortality, had no countries projected to meet corresponding SDG targets on the basis of projected mean values for 2030 but showed some probability of attainment by 2030. For some indicators, including child malnutrition, several infectious diseases, and most violence measures, the annualised rates of change required to meet SDG targets far exceeded the pace of progress achieved by any country in the recent past. We found that applying the mean global annualised rate of change to indicators without defined targets would equate to about 19% and 22% reductions in global smoking and alcohol consumption, respectively; a 47% decline in adolescent birth rates; and a more than 85% increase in health worker density per 1000 population by 2030. Interpretation: The GBD study offers a unique, robust platform for monitoring the health-related SDGs across demographic and geographic dimensions. Our findings underscore the importance of increased collection and analysis of disaggregated data and highlight where more deliberate design or targeting of interventions could accelerate progress in attaining the SDGs. Current projections show that many health-related SDG indicators, NCDs, NCD-related risks, and violence-related indicators will require a concerted shift away from what might have driven past gains—curative interventions in the case of NCDs—towards multisectoral, prevention-oriented policy action and investments to achieve SDG aims. Notably, several targets, if they are to be met by 2030, demand a pace of progress that no country has achieved in the recent past. The future is fundamentally uncertain, and no model can fully predict what breakthroughs or events might alter the course of the SDGs. What is clear is that our actions—or inaction—today will ultimately dictate how close the world, collectively, can get to leaving no one behind by 2030. Funding: Bill & Melinda Gates Foundation. © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license