Browsing by Author "Fuller, John E. (57204565664)"

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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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    Dandona, Rakhi (57203043697)
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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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    Dasa, Tamirat Tesfaye (57204268402)
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    Dash, Aditya Prasad (57205497428)
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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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    Demtsu, Balem Betsu (57204566544)
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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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    Dey, Subhojit (25958052600)
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    Dharmaratne, Samath D. (57216324802)
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    Dicker, Daniel (57196026676)
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    Dinberu, Mesfin Tadese (57201669580)
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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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    Dubljanin, Eleonora (55957442600)
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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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    Ebrahimpour, Soheil (57204558416)
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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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    Erskine, Holly E. (57202798676)
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    Eshrati, Babak (16030619200)
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    Eskandarieh, Sharareh (57211720158)
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    Esmaeili, Reza (57193352042)
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    Esteghamati, Alireza (11240321100)
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    Fakhar, Mahdi (24168542800)
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    Fakhim, Hamed (56532027000)
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    Faramarzi, Mahbobeh (8928307700)
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    Fareed, Mohammad (24491815600)
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    Farhadi, Farzaneh (55869726400)
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    Farinha, Carla Sofia Esá (57190279273)
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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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    Feigl, Andrea B. (57202461042)
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    Fentahun, Netsanet (56394665400)
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    Fereshtehnejad, Seyed-Mohammad (57202557520)
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    Fernandes, Eduarda (34770207500)
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    Fernandes, Joao C. (35274726800)
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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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    Fitzmaurice, Christina (57212628757)
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    Foigt, Nataliya A. (57216998893)
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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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    Furst, Thomas (57208431345)
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    Furtado, Joao M. (36801755000)
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    Futran, Neal D. (35554564000)
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    Gallus, Silvano (7005387365)
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    Garcia-Basteiro, Alberto L. (57200187168)
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    Garcia-Gordillo, Miguel A. (55930749500)
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    Gardner, William M. (57204566870)
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    Gebre, Abadi Kahsu (59426751000)
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    Gebrehiwot, Tsegaye Tewelde (57216482917)
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    Gebremedhin, Amanuel Tesfay (57202566187)
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    Gebremichael, Bereket (57191254167)
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    Gebremichael, Teklu Gebrehiwo (57204566728)
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    Gelano, Tilayie Feto (57200628899)
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    Geleijnse, Johanna M. (35195702500)
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    Genova-Maleras, Ricard (15070563900)
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    Geramo, Yilma Chisha Dea (57204563310)
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    Gething, Peter W. (57193559189)
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    Gezae, Kebede Embaye (57204561611)
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    Ghadami, Mohammad Rasoul (57204797800)
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    Ghadimi, Reza (57202290802)
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    Ghasemi Falavarjani, Khalil (15724975400)
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    Ghasemi-Kasman, Maryam (55371171100)
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    Ghimire, Mamata (57190385188)
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    Gibney, Katherine B. (57202564104)
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    Gill, Paramjit Singh (7202766660)
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    Gill, Tiffany K. (8545441900)
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    Gillum, Richard F. (7103181331)
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    Ginawi, Ibrahim Abdelmageed (57192378390)
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    Giroud, Maurice (7203027541)
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    Giussani, Giorgia (57200843076)
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    Goenka, Shifalika (57217111080)
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    Goldberg, Ellen M. (57191842703)
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    Goli, Srinivas (39761832500)
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    Gomez-Dantes, Hector (57202555692)
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    Gona, Philimon N. (57219703762)
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    Gopalani, Sameer Vali (57190277891)
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    Gorman, Taren M. (57204559340)
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    Goto, Atsushi (57193212299)
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    Goulart, Alessandra C. (57201181348)
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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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    Henok, Andualem (57196451824)
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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 age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021
    (2024)
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    Lioutas, Vasileios-Arsenios (36114439100)
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    Listl, Stefan (35759488300)
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    Liu, Jue (56797105100)
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    Liu, Simin (58636394800)
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    Liu, Xiaofeng (57193764777)
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    Livingstone, Katherine M. (55466317400)
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    Llanaj, Erand (57204154387)
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    Lo, Chun-Han (57216207024)
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    Loreche, Arianna Maever (58094114300)
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    Lorenzovici, László (57200941835)
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    Lotfi, Mojgan (37109768200)
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    Lotfizadeh, Masoud (55853761600)
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    Lozano, Rafael (57570224000)
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    Lubinda, Jailos (56700387300)
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    Lucchetti, Giancarlo (35790096500)
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    Lugo, Alessandra (55227636600)
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    Lunevicius, Raimundas (57216165063)
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    Ma, Jianing (58040920000)
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    Ma, Stefan (7403723389)
    Background: Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods: 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. Findings: Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. Interpretation: Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic. Funding: Bill & Melinda Gates Foundation. © 2024 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 burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021
    (2024)
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    Khanmohammadi, Shaghayegh (57216530776)
    Background: Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. Methods: The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model—a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates—with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality—which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. Findings: The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2–100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1–290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1–211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4–48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3–37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7–9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. Interpretation: Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. Funding: Bill & Melinda Gates Foundation. © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
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    Publication
    Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019
    (2020)
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    Langan, Sinéad M. (55490520500)
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    Lansingh, Van Charles (57209471470)
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    Lansky, Sonia (56038709700)
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    Larson, Heidi Jane (57223681247)
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    Larson, Samantha Leigh (57204569813)
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    Larsson, Anders O. (56381985300)
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    Lasrado, Savita (36632480900)
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    Lassi, Zohra S. (35769584500)
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    Lau, Kathryn Mei-Ming (57204566924)
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    Lauriola, Paolo (7004129174)
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    Lavados, Pablo M. (57188955599)
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    Lazarus, Jeffrey V. (55431519100)
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    Leal, Lisiane F. (57204272414)
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    Leasher, Janet L. (57197789738)
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    Ledesma, Jorge R. (57204449040)
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    Lee, Paul H. (57200302692)
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    Lee, Shaun Wen Huey (35201185800)
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    Leever, Andrew T. (57204179781)
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    LeGrand, Kate E. (57216789066)
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    Leigh, James (7202089604)
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    Leonardi, Matilde (7101854166)
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    Lescinsky, Haley (57219385330)
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    Leung, Janni (57214397752)
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    Levi, Miriam (54893035000)
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    Lewington, Sarah (6601929863)
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    Li, Bingyu (57205248886)
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    Li, Shanshan (57216631901)
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    Lim, Lee-Ling (56988527400)
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    Lin, Christine (57219861546)
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    Lin, Ro-Ting (15123000400)
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    Linehan, Christine (6603446655)
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    Linn, Shai (7102590173)
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    Listl, Stefan (35759488300)
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    Liu, Hung-Chun (57219861204)
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    Liu, Shiwei (57209574351)
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    Liu, Simin (59794164200)
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    Liu, Xuefeng (37050047900)
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    Liu, Yang (57202561981)
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    Liu, Zichen (57210830015)
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    Lo, Justin (57219861047)
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    Lodha, Rakesh (7007019609)
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    Logroscino, Giancarlo (7004888005)
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    Looker, Katharine J. (57202553673)
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    Lopez, Alan D. (57217442571)
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    Lopez, Jaifred Christian F. (57204721325)
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    Lopukhov, Platon D. (57191340780)
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    Lorkowski, Stefan (57203677656)
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    Lotufo, Paulo A. (7003331101)
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    Lozano, Rafael (57570224000)
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    Lu, Alton (57218878815)
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    Lucas, Tim C.D. (57216683591)
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    Lugo, Alessandra (55227636600)
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    Lunevicius, Raimundas (57216165063)
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    Lyons, Ronan A. (55574561400)
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    Ma, Jianing (58040920000)
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    Machado, Daiane Borges (56644244100)
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    MacLachlan, Jennifer H. (55431229800)
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    Madadin, Mohammed (55912631700)
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    Maddison, Emilie R. (57196084094)
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    Maddison, Ralph (8552158500)
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    Madotto, Fabiana (16029150500)
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    Magdy Abd El Razek, Hassan (57195948985)
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    Magdy Abd El Razek, Muhammed (57201191366)
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    Mahasha, Phetole Walter (28767805500)
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    Mahdavi, Mokhtar Mahdavi (55412693600)
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    Mahmoudi, Morteza (24071600700)
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    Mai, Hue Thi (57193029106)
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    Majeed, Azeem (57217722657)
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    Malagón-Rojas, Jeadran N. (57197819455)
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    Maled, Venkatesh (59317098500)
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    Maleki, Afshin (16402422400)
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    Maleki, Shokofeh (57200675775)
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    Malekzadeh, Reza (7005197760)
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    Malta, Deborah Carvalho (15835283500)
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    Mamun, Abdullah A. (55666602500)
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    Mantilla Herrera, Ana M. (57192713838)
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    Mapoma, Chabila Christopher (57208956832)
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    Maravilla, Joemer C. (57008289000)
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    Marks, Ashley (57204558704)
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    Martin, Randall V. (7501381728)
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    Massenburg, Benjamin Ballard (55859007400)
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    Maulik, Pallab K. (7005919685)
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    May, Erin A. (57219861462)
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    McAlinden, Colm (35325278500)
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    McGrath, John J. (57215198193)
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    McKee, Martin (7202304775)
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    Medina-Solís, Carlo Eduardo (8530789600)
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    Meharie, Birhanu Geta (57217083932)
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    Mehndiratta, Man Mohan (57202557864)
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    Mehrabi Nasab, Entezar (56062744400)
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    Mehri, Fereshteh (57211542603)
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    Mehrotra, Ravi (7203045563)
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    Mehta, Kala M. (7201939418)
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    Meitei, Wahengbam Bigyananda (57209140259)
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    Melese, Addisu (56901393600)
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    Memish, Ziad A. (7005059350)
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    Mendoza, Walter (57216905642)
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    Menezes, Ritesh G. (55517099900)
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    Mengesha, Endalkachew Worku (57216203521)
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    Mengesha, Meresa Berwo (57210570181)
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    Mensah, George A. (57196028147)
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    Mereke, Alibek (57205595662)
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    Mereta, Seid Tiku (57203628211)
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    Meretoja, Atte (12775885500)
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    Meretoja, Tuomo J. (57219008708)
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    Mestrovic, Tomislav (6507240107)
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    Miazgowski, Bartosz (56857536900)
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    Miazgowski, Tomasz (6701404689)
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    Michalek, Irmina Maria (56982945900)
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    Mihretie, Kebadnew Mulatu (57214781514)
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    Miller, Ted R. (7403948600)
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    Mills, Edward J. (57205301363)
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    Milne, George J. (9434770500)
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    Mini, G.K. (12800865800)
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    Miri, Mohammad (56938228400)
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    Mirica, Andreea (57188983765)
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    Mirrakhimov, Erkin M. (57508336100)
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    Mirzaei, Hamed (37034594600)
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    Mirzaei, Maryam (56902299800)
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    Mirzaei, Roya (55745833800)
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    Mirzaei-Alavijeh, Mehdi (57201700997)
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    Misganaw, Awoke Temesgen (57202808713)
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    Mitchell, Philip B. (35354747000)
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    Mithra, Prasanna (36018632500)
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    Moazen, Babak (57204324006)
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    Moghadaszadeh, Masoud (57200791890)
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    Mohajer, Bahram (57039225300)
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    Mohamad, Osama (36342663600)
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    Mohamadi, Efat (57202198397)
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    Mohammad, Dara K. (43161421200)
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    Mohammad, Yousef (6603403710)
    Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation: As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and development investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding: Bill & Melinda Gates Foundation. © 2020 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 burden of bacterial antimicrobial resistance 1990–2021: a systematic analysis with forecasts to 2050
    (2024)
    Naghavi, Mohsen (59116090300)
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    Vollset, Stein Emil (57196315778)
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    Ikuta, Kevin S. (57211541916)
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    Swetschinski, Lucien R. (57191617721)
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    Gray, Authia P. (57442982500)
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    Wool, Eve E. (57207302408)
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    Robles Aguilar, Gisela (57194196873)
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    Mestrovic, Tomislav (6507240107)
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    Smith, Georgia (58960344900)
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    Han, Chieh (57218882107)
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    Hsu, Rebecca L. (59282633000)
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    Chalek, Julian (57203308287)
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    Araki, Daniel T. (58565193000)
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    Chung, Erin (59617590200)
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    Raggi, Catalina (58961180400)
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    Gershberg Hayoon, Anna (57219861225)
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    Davis Weaver, Nicole (57203300193)
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    Lindstedt, Paulina A. (57211558396)
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    Smith, Amanda E. (56128141700)
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    Altay, Umut (57479049500)
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    Bhattacharjee, Natalia V. (57203791372)
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    Runghien, Tilleye (58961182700)
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    Abolhassani, Hassan (58597704600)
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    Adeyeoluwa, Temitayo Esther (57218094241)
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    Adnani, Qorinah Estiningtyas Sakilah (57211604149)
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    Afzal, Muhammad Sohail (56009310800)
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    Agodi, Antonella (36774232400)
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    Al-Gheethi, Adel Ali Saeed (57195533166)
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    Anuoluwa, Iyadunni Adesola (57266075700)
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    Anyasodor, Anayochukwu Edward (57192947419)
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    Artamonov, Anton A. (57089921800)
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    Atout, Maha Moh’d Wahbi (57195251851)
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    Bello, Olorunjuwon Omolaja (57219902458)
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    Bhagavathula, Akshaya Srikanth (56398498300)
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    Bhuyan, Soumitra S. (55212014900)
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    Briko, Nikolay Ivanovich (7004344976)
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    Brown, Colin Stewart (12809768100)
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    Bustanji, Yasser (8847282600)
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    Castañeda-Orjuela, Carlos A. (35769124700)
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    Chattu, Vijay Kumar (55743746500)
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    Chaudhary, Anis Ahmad (55419607600)
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    Ching, Patrick R. (57226415941)
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    Chopra, Hitesh (57217071283)
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    Chowdhury, Fazle Rabbi (57200940630)
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    Chu, Dinh-Toi (56239816300)
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    Chutiyami, Muhammad (57202967671)
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    Cruz-Martins, Natalia (57203415019)
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    da Silva, Alanna Gomes (57201069954)
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    Dadras, Omid (57205721978)
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    Dai, Xiaochen (58530783700)
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    Darcho, Samuel D. (58825537100)
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    Dickson, Benjamin Felix Rothschild (57204794734)
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    Doshi, Ojas Prakashbhai (59748102300)
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    Dowou, Robert Kokou (57220119787)
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    Dsouza, Haneil Larson (55058745500)
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    Dunachie, Susanna J. (57537262900)
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    Dziedzic, Arkadiusz Marian (56155198800)
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    Eckmanns, Tim (6602143805)
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    Ed-Dra, Abdelaziz (56910293500)
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    Eftekharimehrabad, Aziz (58960140400)
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    Ekundayo, Temitope Cyrus (57204841448)
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    El Sayed, Iman (7004479194)
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    Elhadi, Muhammed (57212082248)
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    El-Huneidi, Waseem (14821883000)
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    Elias, Christelle (57194788358)
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    Ellis, Sally J. (59578393800)
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    Elsheikh, Randa (57220065184)
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    Elsohaby, Ibrahim (56401825200)
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    Eltaha, Chadi (59331958600)
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    Eshrati, Babak (16030619200)
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    Eslami, Majid (57201082050)
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    Eyre, David William (36458191600)
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    Fadaka, Adewale Oluwaseun (57189054585)
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    Fagbamigbe, Adeniyi Francis (50861113000)
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    Fahim, Ayesha (56996903600)
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    Fakhri-Demeshghieh, Aliasghar (58910414400)
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    Fasina, Folorunso Oludayo (16416667800)
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    Fatehizadeh, Ali (36782045000)
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    Feasey, Nicholas A. (36479968900)
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    Feizkhah, Alireza (57226144762)
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    Fekadu, Ginenus (57207252461)
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    Fischer, Florian (55508208800)
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    Fitriana, Ida (57156637800)
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    Forrest, Karen M. (57209576234)
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    Fortuna Rodrigues, Celia (59342684000)
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    Fuller, John E. (57204565664)
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    Gadanya, Muktar A. (25957587400)
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    Gajdács, Márió (56690440800)
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    Gandhi, Aravind P. (57217858382)
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    Garcia-Gallo, Esteban E. (57221713698)
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    Garrett, Denise O. (57211415589)
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    Gautam, Rupesh K. (55216656700)
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    Gebregergis, Miglas Welay (58955738100)
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    Gebrehiwot, Mesfin (57192100745)
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    Gebremeskel, Teferi Gebru (57210337170)
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    Geffers, Christine (6603859287)
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    Georgalis, Leonidas (57190125023)
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    Ghazy, Ramy Mohamed (57212085342)
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    Golechha, Mahaveer (36006347600)
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    Golinelli, Davide (57194230279)
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    Gordon, Melita (7402800616)
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    Gulati, Snigdha (58960555500)
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    Gupta, Rajat Das (57215122060)
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    Gupta, Sapna (57217857409)
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    Gupta, Vijai Kumar (57192302258)
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    Habteyohannes, Awoke Derbie (59341858000)
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    Haller, Sebastian (55806149600)
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    Harapan, Harapan (55844857500)
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    Harrison, Michelle L. (58562161600)
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    Hasaballah, Ahmed I. (56002305300)
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    Hasan, Ikramul (57218312454)
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    Hasan, Rumina Syeda (55598041700)
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    Hasani, Hamidreza (55632123200)
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    Haselbeck, Andrea Haekyung (57195104016)
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    Hasnain, Md Saquib (36809656200)
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    Hassan, Ikrama Ibrahim (57216965519)
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    Hassan, Shoaib (57216236959)
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    Hassan Zadeh Tabatabaei, Mahgol Sadat (57551579700)
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    Hayat, Khezar (57219918947)
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    He, Jiawei (57201492225)
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    Hegazi, Omar E. (59333456400)
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    Heidari, Mohammad (56494430400)
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    Hezam, Kamal (57199187791)
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    Holla, Ramesh (55270371800)
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    Holm, Marianne (56265412800)
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    Hopkins, Heidi (35860066400)
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    Hossain, Md Mahbub (57207311791)
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    Hosseinzadeh, Mehdi (57201880569)
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    Hostiuc, Sorin (24829099800)
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    Hussein, Nawfal R. (24766000100)
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    Huy, Le Duc (57216329101)
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    Ibáñez-Prada, Elsa D. (57565176700)
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    Ikiroma, Adalia (57802826500)
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    Ilic, Irena M. (57210823522)
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    Islam, Sheikh Mohammed Shariful (57218355467)
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    Ismail, Faisal (57218801491)
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    Ismail, Nahlah Elkudssiah (57885381900)
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    Iwu, Chidozie Declan (57204657478)
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    Iwu-Jaja, Chinwe Juliana (56904084900)
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    Jafarzadeh, Abdollah (32667811600)
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    Jaiteh, Fatoumatta (59606196200)
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    Jalilzadeh Yengejeh, Reza (56105676800)
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    Jamora, Roland Dominic G. (8896661800)
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    Javidnia, Javad (59357196200)
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    Jawaid, Talha (26326847900)
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    Jenney, Adam W.J. (6701689486)
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    Jeon, Hyon Jin (57193343505)
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    Jokar, Mohammad (57221729841)
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    Jomehzadeh, Nabi (35995705400)
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    Joo, Tamas (57214777013)
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    Joseph, Nitin (35292547200)
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    Kamal, Zul (56503670100)
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    Kanmodi, Kehinde Kazeem (57193860523)
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    Kantar, Rami S. (56719718400)
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    Kapisi, James Apollo (55538290600)
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    Karaye, Ibraheem M. (55598638900)
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    Khader, Yousef Saleh (55654192600)
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    Khajuria, Himanshu (56639982500)
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    Khalid, Nauman (57204561542)
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    Khamesipour, Faham (55236513800)
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    Khan, Ajmal (35783172300)
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    Khan, Mohammad Jobair (57298003900)
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    Khan, Muhammad Tariq (59512685200)
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    Khanal, Vishnu (55151541100)
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    Khidri, Feriha Fatima (57210751376)
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    Khubchandani, Jagdish (57211720011)
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    Khusuwan, Suwimon (56166613100)
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    Kim, Min Seo (57203591936)
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    Kisa, Adnan (6603346067)
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    Korshunov, Vladimir Andreevich (57203303920)
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    Krapp, Fiorella (25225806600)
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    Krumkamp, Ralf (23501878900)
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    Kuddus, Mohammed (8596487800)
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    Kulimbet, Mukhtar (57288600700)
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    Kumar, Dewesh (56849792100)
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    Kumaran, Emmanuelle A.P. (55615843600)
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    Kuttikkattu, Ambily (57860475200)
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    Kyu, Hmwe Hmwe (57217040073)
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    Landires, Iván (15063040000)
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    Lawal, Basira Kankia (57217130752)
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    Le, Thao Thi Thu (57736182100)
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    Lederer, Ingeborg Maria (14054203400)
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    Lee, Munjae (58964400000)
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    Lee, Seung Won (57223118056)
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    Lepape, Alain (7004477657)
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    Lerango, Temesgen Leka (58124758800)
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    Ligade, Virendra S. (15769728900)
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    Lim, Cherry (56079847200)
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    Lim, Stephen S. (57201800433)
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    Limenh, Liknaw Workie (58019849100)
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    Liu, Chaojie (58758100100)
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    Liu, Xiaofeng (57193764777)
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    Liu, Xuefeng (37050047900)
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    Loftus, Michael J. (56363464100)
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    Maass, Kelsey Lynn (57211536483)
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    Maharaj, Sandeep B. (54883987800)
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    Mahmoud, Mansour Adam (55461775000)
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    Maikanti-Charalampous, Panagiota (56703410500)
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    Makram, Omar M. (57201684400)
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    Malhotra, Kashish (57224508895)
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    Malik, Ahmad Azam (57198682313)
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    Mandilara, Georgia D. (35800980500)
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    Marks, Florian (8346903600)
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    Martinez-Guerra, Bernardo Alfonso (57200441158)
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    Martorell, Miquel (59899373200)
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    Masoumi-Asl, Hossein (22938089900)
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    Mathioudakis, Alexander G. (55452222600)
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    McHugh, Theresa A. (58189613000)
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    Meiring, James (57194712990)
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    Meles, Hadush Negash (57209110507)
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    Melese, Addisu (56901393600)
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    Melese, Endalkachew Belayneh (12773823200)
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    Minervini, Giuseppe (57190170894)
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    Mohamed, Nouh Saad (57208820453)
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    Mohammed, Shafiu (57838689000)
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    Mohan, Syam (26424414900)
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    Mokdad, Ali H. (7004813962)
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    Monasta, Lorenzo (7801520497)
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    Moodi Ghalibaf, AmirAli (57226579608)
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    Moore, Catrin E. (57195934063)
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    Moradi, Yousef (55338348700)
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    Mossialos, Elias (7004354602)
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    Mougin, Vincent (58857561500)
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    Mukoro, George Duke (58627920300)
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    Mulita, Francesk (57200275021)
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    Muller-Pebody, Berit (20735229800)
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    Murillo-Zamora, Efren (55496438100)
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    Musa, Sani (57225357356)
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    Musicha, Patrick (57192175092)
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    Musila, Lillian A. (37013769600)
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    Muthupandian, Saravanan (54585668500)
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    Nagarajan, Ahamarshan Jayaraman (57204562074)
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    Naghavi, Pirouz (58857110800)
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    Nainu, Firzan (57120069200)
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    Nair, Tapas Sadasivan (59496484400)
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    Najmuldeen, Hastyar Hama Rashid (55485512800)
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    Natto, Zuhair S. (37000768500)
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    Nauman, Javaid (35334911400)
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    Nayak, Biswa Prakash (56639942500)
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    Nchanji, G. Takop (57188854163)
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    Ndishimye, Pacifique (56646467500)
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    Negoi, Ionut (57200640014)
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    Negoi, Ruxandra Irina (55566106200)
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    Nejadghaderi, Seyed Aria (57218948511)
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    Nguyen, QuynhAnh P. (57211556351)
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    Noman, Efaq Ali (59340560200)
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    Nwakanma, Davis C. (23091478500)
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    O’Brien, Seamus (57992085900)
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    Ochoa, Theresa J. (35593777700)
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    Odetokun, Ismail A. (58518431400)
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    Ogundijo, Oluwaseun Adeolu (57253773900)
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    Ojo-Akosile, Tolulope R. (58566223700)
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    Okeke, Sylvester Reuben (57200939187)
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    Okonji, Osaretin Christabel (57222864302)
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    Olagunju, Andrew T. (26029995700)
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    Olivas-Martinez, Antonio (57205108486)
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    Olorukooba, Abdulhakeem Abayomi (57211516423)
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    Olwoch, Peter (57163627000)
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    Onyedibe, Kenneth Ikenna (55443978500)
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    Ortiz-Brizuela, Edgar (57191414443)
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    Osuolale, Olayinka (56695376300)
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    Ounchanum, Pradthana (57200558813)
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    Oyeyemi, Oyetunde T. (56732871100)
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    Padukudru, P.A. Mahesh (57195664371)
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    Paredes, Jose L. (57195588237)
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    Parikh, Romil R. (57204150124)
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    Patel, Jay (59222700400)
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    Patil, Shankargouda (58278922000)
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    Pawar, Shrikant (58594958600)
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    Peleg, Anton Y. (57202571877)
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    Peprah, Prince (57200369019)
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    Perdigão, João (24723211800)
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    Perrone, Carlo (57443562000)
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    Petcu, Ionela-Roxana (59195104100)
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    Phommasone, Koukeo (55676100200)
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    Piracha, Zahra Zahid (57189084862)
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    Poddighe, Dimitri (14623163000)
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    Pollard, Andrew J. (7103193821)
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    Poluru, Ramesh (57205250311)
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    Ponce-De-Leon, Alfredo (7003924320)
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    Puvvula, Jagadeesh (57223195816)
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    Qamar, Farah Naz (37052576700)
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    Qasim, Nameer Hashim (56674669100)
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    Rafai, Clotaire Donatien (55744918000)
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    Raghav, Pankaja (57208123272)
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    Rahbarnia, Leila (57204202594)
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    Rahim, Fakher (23052247800)
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    Rahimi-Movaghar, Vafa (6507646446)
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    Rahman, Mosiur (55457953000)
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    Rahman, Muhammad Aziz (55327627600)
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    Ramadan, Hazem (55502685800)
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    Ramasamy, Shakthi Kumaran (58321724400)
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    Ramesh, Pushkal Sinduvadi (57202816228)
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    Ramteke, Pramod W. (55890063800)
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    Rana, Rishabh Kumar (57109944200)
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    Rani, Usha (57194071964)
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    Rashidi, Mohammad-Mahdi (57324471900)
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    Rathish, Devarajan (57188755730)
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    Rattanavong, Sayaphet (55401700000)
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    Rawaf, Salman (6602475959)
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    Redwan, Elrashdy Moustafa Mohamed (8519808500)
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    Reyes, Luis Felipe (56660395500)
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    Roberts, Tamalee (57195759457)
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    Robotham, Julie V. (7006629230)
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    Rosenthal, Victor Daniel (6603762543)
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    Ross, Allen Guy (36108603600)
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    Roy, Nitai (57262294700)
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    Rudd, Kristina E. (55584242800)
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    Sabet, Cameron John (57223244316)
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    Saddik, Basema Ahmad (23020079300)
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    Saeb, Mohammad Reza (24833454900)
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    Saeed, Umar (36612315100)
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    Saeedi Moghaddam, Sahar (56071020000)
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    Saengchan, Weeravoot (59342406200)
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    Safaei, Mohsen (36612136800)
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    Saghazadeh, Amene (55634259200)
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    Saheb Sharif-Askari, Narjes (56160973000)
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    Sahebkar, Amirhossein (26639699900)
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    Sahoo, Soumya Swaroop (57204573139)
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    Sahu, Maitreyi (57216341277)
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    Saki, Morteza (54382406800)
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    Salam, Nasir (23992664500)
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    Saleem, Zikria (56179814800)
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    Saleh, Mohamed A. (7201797507)
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    Samodra, Yoseph Leonardo (57363130700)
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    Samy, Abdallah M. (36973661300)
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    Saravanan, Aswini (58290959400)
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    Satpathy, Maheswar (57202563691)
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    Schumacher, Austin E. (57209276410)
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    Sedighi, Mansour (56432537400)
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    Seekaew, Samroeng (56993956100)
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    Shafie, Mahan (57221374072)
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    Shah, Pritik A. (57202065760)
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    Shahid, Samiah (57208126144)
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    Shahwan, Moyad Jamal (6601974519)
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    Shakoor, Sadia (21835020200)
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    Shalev, Noga (59740283100)
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    Shamim, Muhammad Aaqib (58030336800)
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    Shamshirgaran, Mohammad Ali (57225935906)
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    Shamsi, Anas (56255369500)
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    Sharifan, Amin (57224116591)
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    Shastry, Rajesh P. (57203570452)
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    Shetty, Mahabalesh (7005020142)
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    Shittu, Aminu (16418068900)
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    Shrestha, Sunil (56453947500)
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    Siddig, Emmanuel Edwar (55879555400)
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    Sideroglou, Theologia (36466981200)
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    Sifuentes-Osornio, Jose (7003764364)
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    Silva, Luís Manuel Lopes Rodrigues (11838952800)
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    Simões, Eric A.F. (7006265421)
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    Simpson, Andrew J.H. (24391676700)
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    Singh, Amit (57201303842)
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    Singh, Surjit (55740397100)
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    Sinto, Robert (36099377100)
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    Soliman, Sameh S.M. (54880644900)
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    Soraneh, Soroush (57377347800)
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    Stoesser, Nicole (16242353500)
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    Stoeva, Temenuga Zhekova (9436519600)
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    Swain, Chandan Kumar (58956745000)
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    Szarpak, Lukasz (55053599400)
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    Sree Sudha, T.Y. (57222998870)
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    Tabatabai, Shima (56005281800)
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    Tabche, Celine (57561023400)
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    Taha, Zanan Mohammed-Ameen (57217757616)
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    Tan, Ker-Kan (16745396700)
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    Tasak, Nidanuch (57443180500)
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    Tat, Nathan Y. (57820156400)
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    Thaiprakong, Areerat (57444139600)
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    Thangaraju, Pugazhenthan (55854329500)
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    Tigoi, Caroline Chepngeno (55022812700)
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    Tiwari, Krishna (58560409500)
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    Tovani-Palone, Marcos Roberto (56644977900)
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    Tran, Thang Huu (58158086500)
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    Tumurkhuu, Munkhtuya (59156725100)
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    Turner, Paul (7402095559)
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    Udoakang, Aniefiok John (57217492763)
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    Udoh, Arit (57201424634)
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    Ullah, Noor (59271934200)
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    Ullah, Saeed (57218515071)
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    Vaithinathan, Asokan Govindaraj (58309502900)
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    Valenti, Mario (57212270726)
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    Vos, Theo (57223885848)
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    Vu, Huong T.L. (39262770000)
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    Waheed, Yasir (35303643700)
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    Walker, Ann Sarah (59630522200)
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    Walson, Judd L. (57203254111)
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    Wangrangsimakul, Tri (57202318704)
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    Weerakoon, Kosala Gayan (36456582000)
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    Wertheim, Heiman F.L. (6602423153)
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    Williams, Phoebe C.M. (57195258843)
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    Wolde, Asrat Arja (57226497047)
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    Wozniak, Teresa M. (10540392000)
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    Wu, Felicia (55700782200)
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    Wu, Zenghong (57208700583)
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    Yadav, Mukesh Kumar Kumar (7102892913)
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    Yaghoubi, Sajad (57194285048)
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    Yahaya, Zwanden Sule (57196374777)
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    Yarahmadi, Amir (57194976053)
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    Yezli, Saber (35996197300)
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    Yismaw, Yazachew Engida (57217253497)
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    Yon, Dong Keon (57193675906)
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    Yuan, Chun-Wei (57205704701)
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    Yusuf, Hadiza (57191630259)
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    Zakham, Fathiah (37064030100)
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    Zamagni, Giulia (57303993500)
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    Zhang, Haijun (59340699800)
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    Zhang, Zhi-Jiang (56068578400)
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    Zielińska, Magdalena (58491440100)
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    Zumla, Alimuddin (7006170723)
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    Zyoud, Sa’ed H.H. (58486874500)
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    Zyoud, Samer H. (57220556938)
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    Hay, Simon I. (7101875313)
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    Stergachis, Andy (7006802396)
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    Sartorius, Benn (12788526800)
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    Cooper, Ben S. (7401623515)
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    Dolecek, Christiane (35784177100)
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    Murray, Christopher J.L. (57224556036)
    Background: Antimicrobial resistance (AMR) poses an important global health challenge in the 21st century. A previous study has quantified the global and regional burden of AMR for 2019, followed with additional publications that provided more detailed estimates for several WHO regions by country. To date, there have been no studies that produce comprehensive estimates of AMR burden across locations that encompass historical trends and future forecasts. Methods: We estimated all-age and age-specific deaths and disability-adjusted life-years (DALYs) attributable to and associated with bacterial AMR for 22 pathogens, 84 pathogen–drug combinations, and 11 infectious syndromes in 204 countries and territories from 1990 to 2021. We collected and used multiple cause of death data, hospital discharge data, microbiology data, literature studies, single drug resistance profiles, pharmaceutical sales, antibiotic use surveys, mortality surveillance, linkage data, outpatient and inpatient insurance claims data, and previously published data, covering 520 million individual records or isolates and 19 513 study-location-years. We used statistical modelling to produce estimates of AMR burden for all locations, including those with no data. Our approach leverages the estimation of five broad component quantities: the number of deaths involving sepsis; the proportion of infectious deaths attributable to a given infectious syndrome; the proportion of infectious syndrome deaths attributable to a given pathogen; the percentage of a given pathogen resistant to an antibiotic of interest; and the excess risk of death or duration of an infection associated with this resistance. Using these components, we estimated disease burden attributable to and associated with AMR, which we define based on two counterfactuals; respectively, an alternative scenario in which all drug-resistant infections are replaced by drug-susceptible infections, and an alternative scenario in which all drug-resistant infections were replaced by no infection. Additionally, we produced global and regional forecasts of AMR burden until 2050 for three scenarios: a reference scenario that is a probabilistic forecast of the most likely future; a Gram-negative drug scenario that assumes future drug development that targets Gram-negative pathogens; and a better care scenario that assumes future improvements in health-care quality and access to appropriate antimicrobials. We present final estimates aggregated to the global, super-regional, and regional level. Findings: In 2021, we estimated 4·71 million (95% UI 4·23–5·19) deaths were associated with bacterial AMR, including 1·14 million (1·00–1·28) deaths attributable to bacterial AMR. Trends in AMR mortality over the past 31 years varied substantially by age and location. From 1990 to 2021, deaths from AMR decreased by more than 50% among children younger than 5 years yet increased by over 80% for adults 70 years and older. AMR mortality decreased for children younger than 5 years in all super-regions, whereas AMR mortality in people 5 years and older increased in all super-regions. For both deaths associated with and deaths attributable to AMR, meticillin-resistant Staphylococcus aureus increased the most globally (from 261 000 associated deaths [95% UI 150 000–372 000] and 57 200 attributable deaths [34 100–80 300] in 1990, to 550 000 associated deaths [500 000–600 000] and 130 000 attributable deaths [113 000–146 000] in 2021). Among Gram-negative bacteria, resistance to carbapenems increased more than any other antibiotic class, rising from 619 000 associated deaths (405 000–834 000) in 1990, to 1·03 million associated deaths (909 000–1·16 million) in 2021, and from 127 000 attributable deaths (82 100–171 000) in 1990, to 216 000 (168 000–264 000) attributable deaths in 2021. There was a notable decrease in non-COVID-related infectious disease in 2020 and 2021. Our forecasts show that an estimated 1·91 million (1·56–2·26) deaths attributable to AMR and 8·22 million (6·85–9·65) deaths associated with AMR could occur globally in 2050. Super-regions with the highest all-age AMR mortality rate in 2050 are forecasted to be south Asia and Latin America and the Caribbean. Increases in deaths attributable to AMR will be largest among those 70 years and older (65·9% [61·2–69·8] of all-age deaths attributable to AMR in 2050). In stark contrast to the strong increase in number of deaths due to AMR of 69·6% (51·5–89·2) from 2022 to 2050, the number of DALYs showed a much smaller increase of 9·4% (–6·9 to 29·0) to 46·5 million (37·7 to 57·3) in 2050. Under the better care scenario, across all age groups, 92·0 million deaths (82·8–102·0) could be cumulatively averted between 2025 and 2050, through better care of severe infections and improved access to antibiotics, and under the Gram-negative drug scenario, 11·1 million AMR deaths (9·08–13·2) could be averted through the development of a Gram-negative drug pipeline to prevent AMR deaths. Interpretation: This study presents the first comprehensive assessment of the global burden of AMR from 1990 to 2021, with results forecasted until 2050. Evaluating changing trends in AMR mortality across time and location is necessary to understand how this important global health threat is developing and prepares us to make informed decisions regarding interventions. Our findings show the importance of infection prevention, as shown by the reduction of AMR deaths in those younger than 5 years. Simultaneously, our results underscore the concerning trend of AMR burden among those older than 70 years, alongside a rapidly ageing global community. The opposing trends in the burden of AMR deaths between younger and older individuals explains the moderate future increase in global number of DALYs versus number of deaths. Given the high variability of AMR burden by location and age, it is important that interventions combine infection prevention, vaccination, minimisation of inappropriate antibiotic use in farming and humans, and research into new antibiotics to mitigate the number of AMR deaths that are forecasted for 2050. Funding: UK Department of Health and Social Care's Fleming Fund using UK aid, and the Wellcome Trust. © 2024 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 fertility in 204 countries and territories, 1950–2021, with forecasts to 2100: a comprehensive demographic analysis for the Global Burden of Disease Study 2021
    (2024)
    Bhattacharjee, Natalia V. (57203791372)
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    Mahesh Padukudru, P.A. (57195664371)
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    Fallahy, Mohammad Taha Pahlevan (57224307689)
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    Pan, Feng (57220873446)
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    Pan, Hai-Feng (35234356200)
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    Background: Accurate assessments of current and future fertility—including overall trends and changing population age structures across countries and regions—are essential to help plan for the profound social, economic, environmental, and geopolitical challenges that these changes will bring. Estimates and projections of fertility are necessary to inform policies involving resource and health-care needs, labour supply, education, gender equality, and family planning and support. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 produced up-to-date and comprehensive demographic assessments of key fertility indicators at global, regional, and national levels from 1950 to 2021 and forecast fertility metrics to 2100 based on a reference scenario and key policy-dependent alternative scenarios. Methods: To estimate fertility indicators from 1950 to 2021, mixed-effects regression models and spatiotemporal Gaussian process regression were used to synthesise data from 8709 country-years of vital and sample registrations, 1455 surveys and censuses, and 150 other sources, and to generate age-specific fertility rates (ASFRs) for 5-year age groups from age 10 years to 54 years. ASFRs were summed across age groups to produce estimates of total fertility rate (TFR). Livebirths were calculated by multiplying ASFR and age-specific female population, then summing across ages 10–54 years. To forecast future fertility up to 2100, our Institute for Health Metrics and Evaluation (IHME) forecasting model was based on projections of completed cohort fertility at age 50 years (CCF50; the average number of children born over time to females from a specified birth cohort), which yields more stable and accurate measures of fertility than directly modelling TFR. CCF50 was modelled using an ensemble approach in which three sub-models (with two, three, and four covariates variously consisting of female educational attainment, contraceptive met need, population density in habitable areas, and under-5 mortality) were given equal weights, and analyses were conducted utilising the MR-BRT (meta-regression—Bayesian, regularised, trimmed) tool. To capture time-series trends in CCF50 not explained by these covariates, we used a first-order autoregressive model on the residual term. CCF50 as a proportion of each 5-year ASFR was predicted using a linear mixed-effects model with fixed-effects covariates (female educational attainment and contraceptive met need) and random intercepts for geographical regions. Projected TFRs were then computed for each calendar year as the sum of single-year ASFRs across age groups. The reference forecast is our estimate of the most likely fertility future given the model, past fertility, forecasts of covariates, and historical relationships between covariates and fertility. We additionally produced forecasts for multiple alternative scenarios in each location: the UN Sustainable Development Goal (SDG) for education is achieved by 2030; the contraceptive met need SDG is achieved by 2030; pro-natal policies are enacted to create supportive environments for those who give birth; and the previous three scenarios combined. Uncertainty from past data inputs and model estimation was propagated throughout analyses by taking 1000 draws for past and present fertility estimates and 500 draws for future forecasts from the estimated distribution for each metric, with 95% uncertainty intervals (UIs) given as the 2·5 and 97·5 percentiles of the draws. To evaluate the forecasting performance of our model and others, we computed skill values—a metric assessing gain in forecasting accuracy—by comparing predicted versus observed ASFRs from the past 15 years (2007–21). A positive skill metric indicates that the model being evaluated performs better than the baseline model (here, a simplified model holding 2007 values constant in the future), and a negative metric indicates that the evaluated model performs worse than baseline. Findings: During the period from 1950 to 2021, global TFR more than halved, from 4·84 (95% UI 4·63–5·06) to 2·23 (2·09–2·38). Global annual livebirths peaked in 2016 at 142 million (95% UI 137–147), declining to 129 million (121–138) in 2021. Fertility rates declined in all countries and territories since 1950, with TFR remaining above 2·1—canonically considered replacement-level fertility—in 94 (46·1%) countries and territories in 2021. This included 44 of 46 countries in sub-Saharan Africa, which was the super-region with the largest share of livebirths in 2021 (29·2% [28·7–29·6]). 47 countries and territories in which lowest estimated fertility between 1950 and 2021 was below replacement experienced one or more subsequent years with higher fertility; only three of these locations rebounded above replacement levels. Future fertility rates were projected to continue to decline worldwide, reaching a global TFR of 1·83 (1·59–2·08) in 2050 and 1·59 (1·25–1·96) in 2100 under the reference scenario. The number of countries and territories with fertility rates remaining above replacement was forecast to be 49 (24·0%) in 2050 and only six (2·9%) in 2100, with three of these six countries included in the 2021 World Bank-defined low-income group, all located in the GBD super-region of sub-Saharan Africa. The proportion of livebirths occurring in sub-Saharan Africa was forecast to increase to more than half of the world's livebirths in 2100, to 41·3% (39·6–43·1) in 2050 and 54·3% (47·1–59·5) in 2100. The share of livebirths was projected to decline between 2021 and 2100 in most of the six other super-regions—decreasing, for example, in south Asia from 24·8% (23·7–25·8) in 2021 to 16·7% (14·3–19·1) in 2050 and 7·1% (4·4–10·1) in 2100—but was forecast to increase modestly in the north Africa and Middle East and high-income super-regions. Forecast estimates for the alternative combined scenario suggest that meeting SDG targets for education and contraceptive met need, as well as implementing pro-natal policies, would result in global TFRs of 1·65 (1·40–1·92) in 2050 and 1·62 (1·35–1·95) in 2100. The forecasting skill metric values for the IHME model were positive across all age groups, indicating that the model is better than the constant prediction. Interpretation: Fertility is declining globally, with rates in more than half of all countries and territories in 2021 below replacement level. Trends since 2000 show considerable heterogeneity in the steepness of declines, and only a small number of countries experienced even a slight fertility rebound after their lowest observed rate, with none reaching replacement level. Additionally, the distribution of livebirths across the globe is shifting, with a greater proportion occurring in the lowest-income countries. Future fertility rates will continue to decline worldwide and will remain low even under successful implementation of pro-natal policies. These changes will have far-reaching economic and societal consequences due to ageing populations and declining workforces in higher-income countries, combined with an increasing share of livebirths among the already poorest regions of the world. Funding: Bill & Melinda Gates Foundation. © 2024 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 age-sex-specific mortality and life expectancy, 1950-2017: A systematic analysis for the Global Burden of Disease Study 2017
    (2018)
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    Ur Rahman, Sajjad (15835524800)
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    Rai, Rajesh Kumar (51864423900)
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    Rajsic, Sasa (57196448260)
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    Raju, Sree Bhushan (8983666100)
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    Ram, Usha (26653819000)
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    Rawaf, David Laith (57209228052)
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    Rawaf, Salman (6602475959)
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    Ray, Sarah E. (57196078769)
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    Razo-García, Christian (57209275722)
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    Rego, Maria Albertina Santiago (35099389600)
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    Reinig, Nickolas (57208577401)
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    Remuzzi, Giuseppe (56466188600)
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    Renzaho, Andre M N. (6505786588)
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    Resnikoff, Serge (7006012071)
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    Saxena, Sonia (57203151746)
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    Sayyah, Mehdi (10540414200)
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    Scaria, Vinod (57192120979)
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    Schaeffner, Elke (6507021741)
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    Schelonka, Kathryn (57195377099)
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    Schmidt, Maria Inês (7404398885)
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    Schneider, Ione J C. (57201292772)
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    Schöttker, Ben (57209275668)
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    Schwebel, David C. (6603681532)
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    Schwendicke, Falk (55639536600)
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    Scott, James G. (57218307442)
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    Sepanlou, Sadaf G. (36248136000)
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    Serván-Mori, Edson (57209275629)
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    Shabaninejad, Hosein (56047947500)
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    Shackelford, Katya Anne (57202959163)
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    Shafieesabet, Azadeh (56964338900)
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    Shaheen, Amira A. (57202560956)
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    Shaikh, Masood Ali (57203122601)
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    Shakir, Raad A. (55374140100)
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    Shamsizadeh, Morteza (57195940127)
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    Sharafi, Heidar (57322506400)
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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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    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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    Mirabi, Parvaneh (51864302500)
    ;
    Mirarefin, Mojde (57222113397)
    ;
    Mirica, Andreea (57188983765)
    ;
    Mirrakhimov, Erkin M. (57216202888)
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    Misganaw, Awoke Temesgen (57202808713)
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    Mitiku, Habtamu (49864023500)
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    Moazen, Babak (57204324006)
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    Mohammad, Karzan Abdulmuhsin (57205300378)
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    Mohammadi, Moslem (56274033300)
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    Mohammadifard, Noushin (23110866700)
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    Mohammed, Mohammed A. (57196575014)
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    Mohammed, Shafiu (57838689000)
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    Mohan, Viswanathan (57216603627)
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    Mokdad, Ali H. (7004813962)
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    Molokhia, Mariam (7004121920)
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    Monasta, Lorenzo (7801520497)
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    Moradi, Ghobad (48161434000)
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    Moradi-Lakeh, Maziar (35617421300)
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    Moradinazar, Mehdi (59750499200)
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    Moraga, Paula (46761426800)
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    Morawska, Lidia (7004773965)
    ;
    Velasquez, Ilais Moreno (56499291900)
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    Morgado-Da-Costa, Joana (57204560697)
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    Morrison, Shane Douglas (45661573100)
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    Moschos, Marilita M. (7004456074)
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    Mouodi, Simin (55372646500)
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    Mousavi, Seyyed Meysam (56165159700)
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    Muchie, Kindie Fentahun (57194458469)
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    Mueller, Ulrich Otto (8512347500)
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    Mukhopadhyay, Satinath (36342847700)
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    Muller, Kate (57196075658)
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    Mumford, John Everett (57221821974)
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    Musa, Jonah (15022919200)
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    Musa, Kamarul Imran (57194536466)
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    Mustafa, Ghulam (57190395960)
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    Muthupandian, Saravanan (54585668500)
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    Nachega, Jean B. (6701544088)
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    Nagel, Gabriele (7103201623)
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    Naheed, Aliya (57202560989)
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    Nahvijou, Azin (18837247000)
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    Naik, Gurudatta (56020694000)
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    Nair, Sanjeev (7402726229)
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    Najafi, Farid (21743304900)
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    Naldi, Luigi (7004954781)
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    Nam, Hae Sung (7102066169)
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    Nangia, Vinay (57201490837)
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    Nansseu, Jobert Richie (55548984700)
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    Nascimento, Bruno Ramos (14424406800)
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    Natarajan, Gopalakrishnan (55804491100)
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    Neamati, Nahid (57204566952)
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    Negoi, Ionut (57200640014)
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    Negoi, Ruxandra Irina (55566106200)
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    Neupane, Subas (57215632313)
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    Newton, Charles R.J. (35465836500)
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    Ngalesoni, Frida N. (57219463339)
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    Ngunjiri, Josephine W. (57195296110)
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    Nguyen, Anh Quynh (57204557413)
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    Nguyen, Grant (57191591002)
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    Nguyen, Ha Thu (57468278900)
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    Nguyen, Huong Thanh (37093238600)
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    Nguyen, Long Hoang (56567321800)
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    Nguyen, Minh (58203329200)
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    Nguyen, Trang Huyen (59142352200)
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    Nichols, Emma (57205756163)
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    Ningrum, Dina Nur Anggraini (57195329470)
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    Nirayo, Yirga Legesse (57201651103)
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    Nixon, Molly R. (57204562047)
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    Nolutshungu, Nomonde (57204567895)
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    Nomura, Shuhei (55632290700)
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    Norheim, Ole F. (7004082597)
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    Noroozi, Mehdi (57035125300)
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    Norrving, Bo (12792377500)
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    Noubiap, Jean Jacques (55490374000)
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    Nouri, Hamid Reza (58754802100)
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    Shiadeh, Malihe Nourollahpour (56960536000)
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    Nowroozi, Mohammad Reza (8866311900)
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    Nyasulu, Peter S. (36700333500)
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    Odell, Christopher M. (57204283884)
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    Ofori-Asenso, Richard (57209300265)
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    Ogbo, Felix Akpojene (57217186813)
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    Oh, In-Hwan (57204090669)
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    Oladimeji, Olanrewaju (57216495380)
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    Olagunju, Andrew T. (26029995700)
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    Olivares, Pedro R. (7003510190)
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    Olsen, Helen Elizabeth (57203080494)
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    Olusanya, Bolajoko Olubukunola (57218504682)
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    Olusanya, Jacob Olusegun (57222488860)
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    Ong, Kanyin L. (57210793447)
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    Ong, Sok King Sk (36614524300)
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    Oren, Eyal (36815569400)
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    Orpana, Heather M. (6507559930)
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    Ortiz, Alberto (7201911399)
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    Ortiz, Justin R. (57201758478)
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    Otstavnov, Stanislav S. (57204561394)
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    Overland, Simon (23028540300)
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    Mahesh, P.A. (57202421244)
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    Pacella, Rosana (57194839077)
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    Pati, Sanghamitra (55441302100)
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    Paturi, Vishnupriya Rao (56499299400)
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    Piel, Frederic B. (56866735900)
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    Rios-Blancas, Maria Jesus (57208577330)
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    Rostami, Ali (59144808300)
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    Rothenbacher, Dietrich (7004765162)
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    Roy, Ambuj (7402704658)
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    Rubagotti, Enrico (57208389589)
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    Sachdev, Perminder S. (7102284091)
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    Saddik, Basema (23020079300)
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    Sadeghi, Ehsan (37010381500)
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    De Freitas Saldanha, Raphael (57193063393)
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    Salimi, Yahya (54421017000)
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    Salz, Inbal (57199623777)
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    Samy, Abdallah M. (36973661300)
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    Dolores Sanchez-Nino, Maria (57202569015)
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    Santomauro, Damian Francesco (56912450700)
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    Santos, Itamar S. (57198312911)
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    Santos, Joao Vasco (57226214352)
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    Santric Milicevic, Milena M. (57211144346)
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    Jose, Bruno Piassi Sao (57202052980)
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    Sarker, Abdur Razzaque (55908816200)
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    Sarmiento-Suarez, Rodrigo (57204744430)
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    Sarrafzadegan, Nizal (6701751316)
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    Sawhney, Monika (57217153893)
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    Saxena, Sonia (57203151746)
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    Sayyah, Mehdi (10540414200)
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    Schaeffner, Elke (6507021741)
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    Schmidt, Maria Ines (7404398885)
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    Schneider, Ione J.C. (57201292772)
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    Schottker, Ben (7006697270)
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    Schutte, Aletta Elisabeth (57216814352)
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    Schwebel, David C. (6603681532)
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    Schwendicke, Falk (55639536600)
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    Scott, James G. (57218307442)
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    Sekerija, Mario (30268005400)
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    Sepanlou, Sadaf G. (36248136000)
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    Servan-Mori, Edson (57202594826)
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    Seyedmousavi, Seyedmojtaba (57204698893)
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    Shabaninejad, Hosein (56047947500)
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    Shackelford, Katya Anne (57202959163)
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    Shafieesabet, Azadeh (56964338900)
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    Shahbazi, Mehdi (58427375600)
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    Shaheen, Amira A. (57202560956)
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    Shaikh, Masood Ali (57203122601)
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    Shams-Beyranvand, Mehran (57193608415)
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    Shamsi, Mohammadbagher (57204557980)
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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, Rajesh (58228412600)
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    She, Jun (57209122131)
    ;
    Sheikh, Aziz (7202522962)
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    Shi, Peilin (57203064901)
    ;
    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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    Si, Si (56706979500)
    ;
    Siabani, Soraya (25227131300)
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    Siddiqi, Tariq J. (57193718539)
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    Sigfusdottir, Inga Dora (57195363778)
    ;
    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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    Da Silva, Natacha Torres (57207324515)
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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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    Singh, Prashant Kumar (57208090732)
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    Singh, Virendra (57191848598)
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    Sinha, Dhirendra Narain (7201637609)
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    Sliwa, Karen (57207223988)
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    Smith, Mari (57195484737)
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    Sobaih, Badr Hasan (57202564080)
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    Sobhani, Soheila (57193095221)
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    Sobngwi, Eugene (6701427993)
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    Soneji, Samir S. (57204096389)
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    Soofi, Moslem (56373891000)
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    Sorensen, Reed J.D. (57196918748)
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    Soriano, Joan B. (7101973935)
    ;
    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)
    ;
    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)
    ;
    Subart, Michelle L. (57194140438)
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    Sudaryanto, Agus (57305372500)
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    Sufiyan, Mu'Awiyyah Babale (58294633600)
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    Sur, Patrick John (57218360398)
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    Sutradhar, Ipsita (57202349742)
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    Sykes, Bryan L. (57211183396)
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    Sylaja, P.N. (12787344300)
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    Sylte, Dillon O. (57211183601)
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    Szoeke, Cassandra E.I. (6505920990)
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    Tabares-Seisdedos, Rafael (6602981102)
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    Tabuchi, Takahiro (55177892400)
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    Tadakamadla, Santosh Kumar (57207799926)
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    Takahashi, Ken (55741242600)
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    Tandon, Nikhil (7101833756)
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    Tassew, Segen Gebremeskel (57204569108)
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    Taveira, Nuno (6602731390)
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    Tehrani-Banihashemi, Arash (57204006020)
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    Tekalign, Tigist Gashaw (57204558037)
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    Tekle, Merhawi Gebremedhin (57204237146)
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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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    Thrift, Amanda G. (7004824524)
    ;
    Thurston, George D. (7102270013)
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    Tilahun, Binyam (57212075730)
    ;
    To, Quyen G. (55827789100)
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    Tobe-Gai, Ruoyan (57209276611)
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    Tonelli, Marcello (7103102534)
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    Topor-Madry, Roman (57211182892)
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    Torre, Anna E. (57196074351)
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    Tortajada-Girbes, Miguel (16242320900)
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    Touvier, Mathilde (8877033300)
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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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    Tripathi, Suryakant (57225821627)
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    Troeger, Christopher E. (57195223624)
    ;
    Truelsen, Thomas Clement (57202824565)
    ;
    Truong, Nu Thi (57204178907)
    ;
    Tsadik, Afewerki Gebremeskel (57204562442)
    ;
    Tsoi, Derrick (57196074984)
    ;
    Tudor Car, Lorainne (48561867100)
    ;
    Murat Tuzcu, E. (7005951350)
    ;
    Tyrovolas, Stefanos (57207793475)
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    Ukwaja, Kingsley N. (57202824584)
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    Ullah, Irfan (56992676600)
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    Undurraga, Eduardo A. (57204092789)
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    Updike, Rachel L. (57204698680)
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    Usman, Muhammad Shariq (57203046075)
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    Uthman, Olalekan A. (23026328100)
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    Uzun, Selen Begum (57200327315)
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    Vaduganathan, Muthiah (16417973600)
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    Valdez, Pascual R. (57202115577)
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    Varavikova, Elena (7801408611)
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    Venketasubramanian, Narayanaswamy (56804702100)
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    Villafaina, Santos (57195804127)
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    Violante, Francesco S. (7003555890)
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    Vladimirov, Sergey Konstantinovitch (57195959162)
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    Vlassov, Vasily (57211633239)
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    Vollset, Stein Emil (57196315778)
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    Wagner, Gregory R. (57219005948)
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    Wagnew, Fasil Shiferaw (57200917385)
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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, Yanping (57215440165)
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    Wang, Yuan-Pang (8576812100)
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    Wassie, Molla Mesele (56499356400)
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    Weiderpass, Elisabete (57205018947)
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    Weintraub, Robert G. (7006079405)
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    Weldegebreal, Fitsum (56112812300)
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    Weldegwergs, Kidu Gidey (57203308107)
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    Werkneh, Adhena Ayaliew (57195675398)
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    West, T. Eoin (57756844000)
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    Westerman, Ronny (57218361023)
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    Whiteford, Harvey A. (55906494000)
    ;
    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 stillbirths at 20 weeks' gestation or longer in 204 countries and territories, 1990–2021: findings from the Global Burden of Disease Study 2021
    (2024)
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    Defo, Barthelemy Kuate (6602271655)
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    Kuchay, Raja Amir Hassan (49961819900)
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    Kuddus, Mohammed (8596487800)
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    Kumar, G. Anil (57139550500)
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    Kurmi, Om P. (57219034567)
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    Vecchia, Carlo La (36063266200)
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    Lacey, Ben (7004338442)
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    Lahariya, Chandrakant (13205447400)
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    Laksono, Tri (58537561100)
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    Lal, Dharmesh Kumar (57222488984)
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    Lasrado, Savita (36632480900)
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    Latief, Kamaluddin (26428870800)
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    Latifinaibin, Kaveh (58957217400)
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    Le, Thao Thi Thu (57736182100)
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    Lee, Munjae (58964400000)
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    Lee, Sang-Woong (57193130569)
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    Lee, Wei-Chen (57394248700)
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    Lee, Yo Han (57193632340)
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    Lenzi, Jacopo (57200000691)
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    Li, Ming-Chieh (56144176300)
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    Li, Shanshan (57216631901)
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    Ligade, Virendra S. (15769728900)
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    Lim, Stephen S. (57201800433)
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    Liu, Gang (57189061134)
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    Liu, Jue (56797105100)
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    Liu, Xuefeng (37050047900)
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    Lorenzovici, László (57200941835)
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    Lotfizadeh, Masoud (55853761600)
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    Afifi, Ahmed M. (57196175428)
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    Madureira-Carvalho, Áurea M. (57201779481)
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    Magee, Laura A. (7007010568)
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    Majeed, Azeem (57217722657)
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    Rad, Elaheh Malakan (55105272200)
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    Malhotra, Kashish (57224508895)
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    Malik, Ahmad Azam (57198682313)
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    Malik, Iram (57209103879)
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    Mallhi, Tauqeer Hussain (57214875058)
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    Maravilla, Joemer C. (57008289000)
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    Martini, Santi (57162600900)
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    Martins-Melo, Francisco Rogerlândio Rogerlândio (57204796807)
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    Martorell, Miquel (57211415589)
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    Marzan, Melvin Barrientos (57200737144)
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    Mathangasinghe, Yasith (57193006575)
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    Mattiello, Rita (25223467700)
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    Mediratta, Rishi P. (6507995312)
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    Mehrabani-Zeinabad, Kamran (57202425863)
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    Meles, Gebrekiros Gebremichael (57211140536)
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    Meles, Hadush Negash (57209110507)
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    Mendez-Lopez, Max Alberto (57207774180)
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    Menezes, Ritesh G. (55517099900)
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    Meretoja, Atte (12775885500)
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    Meretoja, Tuomo J. (57219008708)
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    Michalek, Irmina Maria (56982945900)
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    Minh, Le Huu Nhat (57201722696)
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    Bawa, Eric Mishio (58203486800)
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    Misra, Sanjeev (35501005200)
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    Mizana, Biru Abdissa (57211044854)
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    Mohammad-Alizadeh-Charandabi, Sakineh (35727236500)
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    Mohammed, Ghada (57393386800)
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    Mohammed, Salahuddin (57567912700)
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    Mohammed, Shafiu (57838689000)
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    Muriithi, Moses K. (55824830500)
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    Otoiu, Adrian (56375694100)
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    Otstavnov, Stanislav S. (57204561394)
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    Owolabi, Mayowa O. (59372043000)
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    Pereira, Gavin (35091486200)
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    Pereira, Marcos (56073937400)
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    Pereira, Maria Odete (42462181200)
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    Perianayagam, Arokiasamy (15053062900)
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    Perico, Norberto (57220168045)
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    Pesudovs, Konrad (59156861800)
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    Petcu, Ionela-Roxana (59195104100)
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    Petermann-Rocha, Fanny Emily (57220028899)
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    Pezeshki, Parmida Sadat (57222013905)
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    Pham, Tom (59352178000)
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    Phan, My Kieu (59408542700)
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    Philip, Anil K. (14042434800)
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    Pigeolet, Manon (57205716569)
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    Piracha, Zahra Zahid (57189084862)
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    Podder, Vivek (57201487580)
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    Poddighe, Dimitri (14623163000)
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    Pradhan, Pranil Man Singh (55622537400)
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    Shahraki, Hadi Raeisi (57194484011)
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    Raghav, Pankaja (57208123272)
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    Rahman, Mosiur (55457953000)
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    Rahmanian, Vahid (55367908800)
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    Raimondo, Ivano (57208108469)
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    Ramasamy, Shakthi Kumaran (58321724400)
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    Ranabhat, Chhabi Lal (56719695500)
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    Rancic, Nemanja (54941042300)
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    Rao, Chythra R. (35771430100)
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    Rao, Sowmya J. (57195423591)
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    Rasella, Davide (36184697300)
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    Rashid, Ahmed Mustafa (57463539300)
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    Rawassizadeh, Reza (36634807900)
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    Redwan, Elrashdy Moustafa Mohamed (8519808500)
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    Remuzzi, Giuseppe (56466188600)
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    Rengasamy, Kannan R. R. (57574957600)
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    Renzaho, Andre M. N. (6505786588)
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    Rezaei, Nazila (36700192900)
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    Rezaei, Negar (57218820767)
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    Rezaeian, Mohsen (15053682700)
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    Robinson-Oden, Hannah Elizabeth (58955995600)
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    Roever, Leonardo (56641632800)
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    Ronfani, Luca (58842981900)
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    Saeb, Mohammad Reza (24833454900)
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    Saeed, Umar (36612315100)
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    Saghazadeh, Amene (55634259200)
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    Sagoe, Dominic (55505787200)
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    Saheb Sharif-Askari, Fatemeh (56161060900)
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    Saheb Sharif-Askari, Narjes (56160973000)
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    Sahebkar, Amirhossein (26639699900)
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    Sahoo, Harihar (44462008100)
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    Sahoo, Soumya Swaroop (57204573139)
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    Saleh, Mohamed A. (7201797507)
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    Salehi, Sana (57209618440)
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    Salem, Marwa Rashad (57194137372)
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    Sanjeev, Rama Krishna (57076705500)
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    Sarikhani, Yaser (36094715700)
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    Shahid, Samiah (57208126144)
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    Shaikh, Masood Ali (56673685600)
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    Shannawaz, Mohammed (56349680200)
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    Sharma, Manoj (55468811500)
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    Shetty, B. Suresh Kumar (7102818010)
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    Shetty, Pavanchand H. (56366875300)
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    Shiri, Rahman (59113518300)
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    Shirkoohi, Reza (12776374400)
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    Shivalli, Siddharudha (55604704500)
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    Shool, Sina (57221702987)
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    Shorofi, Seyed Afshin (35086976700)
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    Shuja, Kanwar Hamza (57216520437)
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    Shuval, Kerem (8215146800)
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    Sibhat, Migbar Mekonnen (57222351357)
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    Sidamo, Negussie Boti (57203119983)
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    Silva, João Pedro (57204703526)
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    Simpson, Colin R. (56018813700)
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    Singh, Jasvinder A. (58179112300)
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    Singh, Paramdeep (57202809996)
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    Singh, Surjit (55740397100)
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    Skhvitaridze, Natia (55444916100)
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    Socea, Bogdan (32267661900)
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    Sohag, Abdullah Al Mamun (57204421562)
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    Soleimani, Hamidreza (57211498732)
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    Solomon, Yonatan (57220875005)
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    Song, Suhang (57194455017)
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    Song, Yi (55494038200)
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    Spartalis, Michael (55862161100)
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    Sreeramareddy, Chandrashekhar T. (57212263335)
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    Stergachis, Andy (7006802396)
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    Suleman, Muhammad (57196800921)
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    Sultana, Saima (57404748200)
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    Sun, Haitong Zhe (57193728053)
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    Sun, Jing (55547135859)
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    Szeto, Mindy D. (57218347447)
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    Tabarés-Seisdedos, Rafael (57441540700)
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    Oliaee, Razieh Tavakoli (57070503900)
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    Tefera, Yibekal Manaye (57216210591)
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    Teramoto, Masayuki (57222309775)
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    Tesfamariam, Wegen Beyene (58856953300)
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    Teye-Kwadjo, Enoch (57192819020)
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    Tharwat, Samar (57192417685)
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    Thavamani, Aravind (57202135529)
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    Thomas, Nihal (7401830494)
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    Titova, Mariya Vladimirovna (57216631666)
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    Tiyuri, Amir (57201850751)
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    Topor-Madry, Roman (57211182892)
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    Tovani-Palone, Marcos Roberto (56644977900)
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    Tripathy, Jaya Prasad (55290251600)
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    Tromans, Samuel Joseph (56925199300)
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    Ubah, Chukwudi S. (57224538923)
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    Umair, Muhammad (56641365200)
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    Umakanthan, Srikanth (56814926400)
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    Unim, Brigid (37862108700)
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    Vaithinathan, Asokan Govindaraj (58309502900)
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    Tahbaz, Sahel Valadan (57216154072)
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    Valenti, Mario (57212270726)
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    Valizadeh, Rohollah (57192641339)
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    Van den Eynde, Jef (56507221200)
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    Veroux, Massimiliano (7003920425)
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    Villani, Leonardo (57215274597)
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    Violante, Francesco S. (37105152000)
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    Vlassov, Vasily (57211633239)
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    Walde, Mandaras Tariku (57851610900)
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    Wang, Fang (57216134149)
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    Wang, Shu (57216923903)
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    Wang, Yanqing (59130006900)
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    Wang, Yanzhong (59417336500)
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    Wassie, Emebet Gashaw (57996127100)
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    Weerakoon, Kosala Gayan (36456582000)
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    Wolde, Asrat Arja (57226497047)
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    Xu, Xiaoyue (59560820600)
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    Yadav, Vikas (57200144815)
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    Yang, Lin (57189045362)
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    Yano, Yuichiro (57196965200)
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    Yehualashet, Sisay Shewasinad (57206778326)
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    Yi, Siyan (16837551600)
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    Yigit, Arzu (57820497600)
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    Yigit, Vahit (57222328239)
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    Yip, Paul (7102503720)
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    Yonemoto, Naohiro (57204947657)
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    Zaki, Nazar (16044448200)
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    Zamagni, Giulia (57303993500)
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    Zaman, Burhan Abdullah (57209607964)
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    Zastrozhin, Michael (56728932200)
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    Zhang, Haijun (59340699800)
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    Zhang, Yunquan (56568510200)
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    Zhang, Zhi-Jiang (56068578400)
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    Zhao, Hanqing (59742707300)
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    Zhong, Claire Chenwen (59289905900)
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    Zielinska, Magdalena (58491440100)
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    Zuhriyah, Lilik (55753460700)
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    Hay, Simon I. (7101875313)
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    Naghavi, Mohsen (59116090300)
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    Murray, Christopher J. L. (57224556036)
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    Dandona, Rakhi (57203043697)
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    Kassebaum, Nicholas J. (57202562224)
    Background: Stillbirth is a devastating and often avoidable adverse pregnancy outcome. Monitoring stillbirth levels and trends—in a comprehensive manner that leaves no one uncounted—is imperative for continuing progress in pregnancy loss reduction. This analysis, completed as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, methodically accounted for different stillbirth definitions with the aim of comprehensively estimating all stillbirths at 20 weeks or longer for 204 countries and territories from 1990 to 2021. Methods: We extracted data on stillbirths from 11 412 sources across 185 of 204 countries and territories, including 234 surveys, 231 published studies, 1633 vital statistics reports, and 10 585 unique location-year combinations from vital registration systems. Our final dataset comprised 11 different definitions, which were adjusted to match two gestational age thresholds: 20 weeks or longer (reference) and 28 weeks or longer (for comparisons). We modelled the ratio of stillbirth rate to neonatal mortality rate with spatiotemporal Gaussian process regression for each location and year, and then used final GBD 2021 assessments of fertility and all-cause neonatal mortality to calculate total stillbirths. Secondary analyses evaluated the number of stillbirths missed with the more restrictive gestational age definition, trends in stillbirths as a function of Socio-demographic Index, and progress in reducing stillbirths relative to neonatal deaths. Findings: In 2021, the global stillbirth rate was 23·0 (95% uncertainty interval [UI] 19·7–27·2) per 1000 births (stillbirths plus livebirths) at 20 weeks' gestation or longer, compared to 16·1 (13·9–19·0) per 1000 births at 28 weeks' gestation or longer. The global neonatal mortality rate in 2021 was 17·1 (14·8–19·9) per 1000 livebirths, corresponding to 2·19 million (1·90–2·55) neonatal deaths. The estimated number of stillbirths occurring at 20 weeks' gestation or longer decreased from 5·08 million (95% UI 4·07–6·35) in 1990 to 3·04 million (2·61–3·62) in 2021, corresponding to a 39·8% (31·8–48·0) reduction, which lagged behind a global improvement in neonatal deaths of 45·6% (36·3–53·1) for the same period (down from 4·03 million [3·86–4·22] neonatal deaths in 1990). Stillbirths in south Asia and sub-Saharan Africa comprised 77·4% (2·35 million of 3·04 million) of the global total, an increase from 60·3% (3·07 million of 5·08 million) in 1990. In 2021, 0·926 million (0·792–1·10) stillbirths, corresponding to 30·5% of the global total (3·04 million), occurred between 20 weeks' gestation and 28 weeks' gestation, with substantial variation at the country level. Interpretation: Despite the gradual global decline in stillbirths between 1990 and 2021, the overall number of stillbirths remains substantially high. Counting all stillbirths is paramount to progress, as nearly a third—close to 1 million in total—are left uncounted at the 28 weeks or longer threshold. Our findings draw attention to the differential progress in reducing stillbirths, with a high burden concentrated in countries with low development status. Scarce data availability and poor data quality constrain our capacity to precisely account for stillbirths in many locations. Addressing inequities in universal maternal health coverage, strengthening the quality of maternal health care, and improving the robustness of data systems are urgently needed to reduce the global burden of stillbirths. Funding: Bill & Melinda Gates Foundation. © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
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    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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    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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    Abdel-Rahman, Omar (55777635800)
    ;
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    Serván-Mori, Edson (57202594826)
    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
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    Population and fertility by age and sex for 195 countries and territories, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017
    (2018)
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    Vaezi, Afsane (55698015300)
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    Vaidya, Gaurang (55551507300)
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    Valdez, Pascual R. (57202115577)
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    Varavikova, Elena (7801408611)
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    Varughese, Santosh (22942817500)
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    Background: Population estimates underpin demographic and epidemiological research and are used to track progress on numerous international indicators of health and development. To date, internationally available estimates of population and fertility, although useful, have not been produced with transparent and replicable methods and do not use standardised estimates of mortality. We present single-calendar year and single-year of age estimates of fertility and population by sex with standardised and replicable methods. Methods: We estimated population in 195 locations by single year of age and single calendar year from 1950 to 2017 with standardised and replicable methods. We based the estimates on the demographic balancing equation, with inputs of fertility, mortality, population, and migration data. Fertility data came from 7817 location-years of vital registration data, 429 surveys reporting complete birth histories, and 977 surveys and censuses reporting summary birth histories. We estimated age-specific fertility rates (ASFRs; the annual number of livebirths to women of a specified age group per 1000 women in that age group) by use of spatiotemporal Gaussian process regression and used the ASFRs to estimate total fertility rates (TFRs; the average number of children a woman would bear if she survived through the end of the reproductive age span [age 10–54 years] and experienced at each age a particular set of ASFRs observed in the year of interest). Because of sparse data, fertility at ages 10–14 years and 50–54 years was estimated from data on fertility in women aged 15–19 years and 45–49 years, through use of linear regression. Age-specific mortality data came from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 estimates. Data on population came from 1257 censuses and 761 population registry location-years and were adjusted for underenumeration and age misreporting with standard demographic methods. Migration was estimated with the GBD Bayesian demographic balancing model, after incorporating information about refugee migration into the model prior. Final population estimates used the cohort-component method of population projection, with inputs of fertility, mortality, and migration data. Population uncertainty was estimated by use of out-of-sample predictive validity testing. With these data, we estimated the trends in population by age and sex and in fertility by age between 1950 and 2017 in 195 countries and territories. Findings: From 1950 to 2017, TFRs decreased by 49·4% (95% uncertainty interval [UI] 46·4–52·0). The TFR decreased from 4·7 livebirths (4·5–4·9) to 2·4 livebirths (2·2–2·5), and the ASFR of mothers aged 10–19 years decreased from 37 livebirths (34–40) to 22 livebirths (19–24) per 1000 women. Despite reductions in the TFR, the global population has been increasing by an average of 83·8 million people per year since 1985. The global population increased by 197·2% (193·3–200·8) since 1950, from 2·6 billion (2·5–2·6) to 7·6 billion (7·4–7·9) people in 2017; much of this increase was in the proportion of the global population in south Asia and sub-Saharan Africa. The global annual rate of population growth increased between 1950 and 1964, when it peaked at 2·0%; this rate then remained nearly constant until 1970 and then decreased to 1·1% in 2017. Population growth rates in the southeast Asia, east Asia, and Oceania GBD super-region decreased from 2·5% in 1963 to 0·7% in 2017, whereas in sub-Saharan Africa, population growth rates were almost at the highest reported levels ever in 2017, when they were at 2·7%. The global average age increased from 26·6 years in 1950 to 32·1 years in 2017, and the proportion of the population that is of working age (age 15–64 years) increased from 59·9% to 65·3%. At the national level, the TFR decreased in all countries and territories between 1950 and 2017; in 2017, TFRs ranged from a low of 1·0 livebirths (95% UI 0·9–1·2) in Cyprus to a high of 7·1 livebirths (6·8–7·4) in Niger. The TFR under age 25 years (TFU25; number of livebirths expected by age 25 years for a hypothetical woman who survived the age group and was exposed to current ASFRs) in 2017 ranged from 0·08 livebirths (0·07–0·09) in South Korea to 2·4 livebirths (2·2–2·6) in Niger, and the TFR over age 30 years (TFO30; number of livebirths expected for a hypothetical woman ageing from 30 to 54 years who survived the age group and was exposed to current ASFRs) ranged from a low of 0·3 livebirths (0·3–0·4) in Puerto Rico to a high of 3·1 livebirths (3·0–3·2) in Niger. TFO30 was higher than TFU25 in 145 countries and territories in 2017. 33 countries had a negative population growth rate from 2010 to 2017, most of which were located in central, eastern, and western Europe, whereas population growth rates of more than 2·0% were seen in 33 of 46 countries in sub-Saharan Africa. In 2017, less than 65% of the national population was of working age in 12 of 34 high-income countries, and less than 50% of the national population was of working age in Mali, Chad, and Niger. Interpretation: Population trends create demographic dividends and headwinds (ie, economic benefits and detriments) that affect national economies and determine national planning needs. Although TFRs are decreasing, the global population continues to grow as mortality declines, with diverse patterns at the national level and across age groups. To our knowledge, this is the first study to provide transparent and replicable estimates of population and fertility, which can be used to inform decision making and to monitor progress. 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