Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: A systematic analysis for the Global Burden of Disease Study 2010

BACKGROUND Measuring disease and injury burden in populations requires a composite metric that captures both premature mortality and the prevalence and severity of ill-health. The 1990 Global Burden of Disease study proposed disability-adjusted life years (DALYs) to measure disease burden. No comprehensive update of disease burden worldwide incorporating a systematic reassessment of disease and injury-specific epidemiology has been done since the 1990 study. We aimed to calculate disease burden worldwide and for 21 regions for 1990, 2005, and 2010 with methods to enable meaningful comparisons over time. METHODS We calculated DALYs as the sum of years of life lost (YLLs) and years lived with disability (YLDs). DALYs were calculated for 291 causes, 20 age groups, both sexes, and for 187 countries, and aggregated to regional and global estimates of disease burden for three points in time with strictly comparable definitions and methods. YLLs were calculated from age-sex-country-time-specific estimates of mortality by cause, with death by standardised lost life expectancy at each age. YLDs were calculated as prevalence of 1160 disabling sequelae, by age, sex, and cause, and weighted by new disability weights for each health state. Neither YLLs nor YLDs were age-weighted or discounted. Uncertainty around cause-specific DALYs was calculated incorporating uncertainty in levels of all-cause mortality, cause-specific mortality, prevalence, and disability weights. FINDINGS Global DALYs remained stable from 1990 (2·503 billion) to 2010 (2·490 billion). Crude DALYs per 1000 decreased by 23% (472 per 1000 to 361 per 1000). An important shift has occurred in DALY composition with the contribution of deaths and disability among children (younger than 5 years of age) declining from 41% of global DALYs in 1990 to 25% in 2010. YLLs typically account for about half of disease burden in more developed regions (high-income Asia Pacific, western Europe, high-income North America, and Australasia), rising to over 80% of DALYs in sub-Saharan Africa. In 1990, 47% of DALYs worldwide were from communicable, maternal, neonatal, and nutritional disorders, 43% from non-communicable diseases, and 10% from injuries. By 2010, this had shifted to 35%, 54%, and 11%, respectively. Ischaemic heart disease was the leading cause of DALYs worldwide in 2010 (up from fourth rank in 1990, increasing by 29%), followed by lower respiratory infections (top rank in 1990; 44% decline in DALYs), stroke (fifth in 1990; 19% increase), diarrhoeal diseases (second in 1990; 51% decrease), and HIV/AIDS (33rd in 1990; 351% increase). Major depressive disorder increased from 15th to 11th rank (37% increase) and road injury from 12th to 10th rank (34% increase). Substantial heterogeneity exists in rankings of leading causes of disease burden among regions. INTERPRETATION Global disease burden has continued to shift away from communicable to non-communicable diseases and from premature death to years lived with disability. In sub-Saharan Africa, however, many communicable, maternal, neonatal, and nutritional disorders remain the dominant causes of disease burden. The rising burden from mental and behavioural disorders, musculoskeletal disorders, and diabetes will impose new challenges on health systems. Regional heterogeneity highlights the importance of understanding local burden of disease and setting goals and targets for the post-2015 agenda taking such patterns into account. Because of improved definitions, methods, and data, these results for 1990 and 2010 supersede all previously published Global Burden of Disease results.

Refractive indices used by the Haag-Streit Lenstar to calculate axial biometric dimensions

PURPOSE To estimate refractive indices used by the Lenstar biometer to translate measured optical path lengths into geometrical path lengths within the eye. METHODS Axial lengths of model eyes were determined using the IOLMaster and Lenstar biometers; comparing those lengths gave an overall eye refractive index estimate for the Lenstar. Using the Lenstar Graphical User Interface, we noticed that boundaries between media could be manipulated and opposite changes in optical path lengths on either side of the boundary could be introduced. Those ratios were combined with the overall eye refractive index to estimate separate refractive indices. Furthermore, Haag-Streit provided us with a template to obtain 'air thicknesses' to compare with geometrical distances. RESULTS The axial length estimates obtained using the IOLMaster and the Lenstar agreed to within 0.01 mm. Estimates of group refractive indices used in the Lenstar were 1.340, 1.341, 1.415, and 1.354 for cornea, aqueous, lens, and overall eye, respectively. Those refractive indices did not match those of schematic eyes, but were close in the cases of aqueous and lens. Linear equations relating air thicknesses to geometrical thicknesses were consistent with our findings. CONCLUSION The Lenstar uses different refractive indices for different ocular media. Some of the refractive indices, such as that for the cornea, are not physiological; therefore, it is likely that the calibrations in the instrument correspond to instrument-specific corrections and are not the real optical path lengths.

Editorial: Measuring refractive index distribution in the human eye lens

Non-invasive measurements of the age dependence of refractive index distribution in human eye lenses in vitro using a novel X-ray Talbot Interferometry method. In their paper, the authors make frequent reference to our own work in which we employed magnetic resonance imaging (MRI) to make similar non-invasive measurements of the refractive index distribution in the human eye lens [2, 3]. Prior to the current work, ours was the only method for making such measurements both non-invasively and without prior assumptions about the shape of the refractive index distribution. For this reason, the latest work is to be welcomed. However at several points in the paper, Pierscionek et al. [1] make statements about our technique which are factually incorrect...

Threshold photoproduction of charged pions on14N

Pion photoproduction processes14Ngs(gamma, pgr +)14C and14Ngs(gamma, pgr –)14O have been studied in the threshold region. These processes provide an excellent tool to study the corrections to soft pion theorems and Kroll-Ruderman limit as applied to nuclear processes. The agreement with the available experimental data for these processes is better with the empirical wave functions while the shell-model wave functions predict a much higher value. Detailed experimental studies of these reactions at threshold, it is shown, are expected to lead to a better understanding of the shell-model inputs and radial distributions in the 1p state. We thank Dr. S.C.K. Nair for a helpful discussion during the initial stages of this work. One of us (MVN) thanks Dr. J.M. Laget for sending some unpublished data on pion photoproduction. He is also thankful to Dr. J. Pasupathy and Dr. R. Rajaraman for their interest and encouragement.

Neutron spectrum in muon capture by 40Ca

A new simple-pole model for muon capture by 40Ca with emission of neutrons is suggested, in close analogy with radiative pion capture, and the calculated energy spectrum of the emitted neutron agrees well with the experimental results of the Columbia group for higher neutron energies.

Spin and relativistic motion of bound states

The wave functions of moving bound states may be expected to contract in the direction of motion, in analogy to a rigid rod in classical special relativity, when the constituents are at equal (ordinary) time. Indeed, the Lorentz contraction of wave functions is often appealed to in qualitative discussions. However, only few field theory studies exist of equal-time wave functions in motion. In this thesis I use the Bethe-Salpeter formalism to study the wave function of a weakly bound state such as a hydrogen atom or positronium in a general frame. The wave function of the e^-e^+ component of positronium indeed turns out to Lorentz contract both in 1+1 and in 3+1 dimensional quantum electrodynamics, whereas the next-to-leading e^-e^+\gamma Fock component of the 3+1 dimensional theory deviates from classical contraction. The second topic of this thesis concerns single spin asymmetries measured in scattering on polarized bound states. Such spin asymmetries have so far mainly been analyzed using the twist expansion of perturbative QCD. I note that QCD vacuum effects may give rise to a helicity flip in the soft rescattering of the struck quark, and that this would cause a nonvanishing spin asymmetry in \ell p^\uparrow -> \ell' + \pi + X in the Bjorken limit. An analogous asymmetry may arise in p p^\uparrow -> \pi + X from Pomeron-Odderon interference, if the Odderon has a helicity-flip coupling. Finally, I study the possibility that the large single spin asymmetry observed in p p^\uparrow -> \pi(x_F,k_\perp) + X when the pion carries a high momentum fraction x_F of the polarized proton momentum arises from coherent effects involving the entire polarized bound state.

Pressure and thermally induced stages of wear in dry sliding of a steel ball against an aluminium-silicon alloy flat

Wear of etched near-eutectic aluminium silicon alloy slid against a steel ball under ambient is explored. The sliding velocity is kept low (0.01 m/s) and the nominal contact pressure is varied in a 15-40 MPa range. Four stages of wear are identified; ultra mild wear, mild wear, severe wear and post severe oxidative wear. The first transition is controlled by the protrusions of silicon particles, projecting out of the aluminium alloy matrix. Once these protrusions disappear under pressure and sliding, oxidation and bulk energy dissipation mechanisms take over to institute transitions to other stages of wear. The phenomenological characteristics of wear stages are explored using a variety of techniques including nanoindentation, focused ion beam milling, electron microscopy, X-ray photoelectron spectroscopy (XPS), energy dispersive X-ray spectroscopy (EDS) and optical interferometry. (c) 2010 Elsevier B.V. All rights reserved.

Simplified optical system for holographic subtraction

Subtraction of one complex spatial function from another can be accomplished holographically by shifting the phase of the reference beam by pi between the two exposures. A simple and reliable system for this purpose, which makes use of the fact that the beam from a gas laser is usually plane-polarized, is described, and its application to obtain the equivalent of a dark field with the frozen-fringe technique in holographic interferometry is demonstrated.

Partially conserved axial-vector current inS-matrix theory

Mandelstam�s argument that PCAC follows from assigning Lorentz quantum numberM=1 to the massless pion is examined in the context of multiparticle dual resonance model. We construct a factorisable dual model for pions which is formulated operatorially on the harmonic oscillator Fock space along the lines of Neveu-Schwarz model. The model has bothm ? andm ? as arbitrary parameters unconstrained by the duality requirement. Adler self-consistency condition is satisfied if and only if the conditionm?2?m?2=1/2 is imposed, in which case the model reduces to the chiral dual pion model of Neveu and Thorn, and Schwarz. The Lorentz quantum number of the pion in the dual model is shown to beM=0.

QCD with dynamical Wilson fermions. II

We present results for the QCD spectrum and the matrix elements of scalar and axial-vector densities at β=6/g2=5.4, 5.5, 5.6. The lattice update was done using the hybrid Monte Carlo algorithm to include two flavors of dynamical Wilson fermions. We have explored quark masses in the range ms≤mq≤3ms. The results for the spectrum are similar to quenched simulations and mass ratios are consistent with phenomenological heavy-quark models. The results for matrix elements of the scalar density show that the contribution of sea quarks is comparable to that of the valence quarks. This has important implications for the pion-nucleon σ term.

Structure of Relativistic States

QCD factorization in the Bjorken limit allows to separate the long-distance physics from the hard subprocess. At leading twist, only one parton in each hadron is coherent with the hard subprocess. Higher twist effects increase as one of the active partons carries most of the longitudinal momentum of the hadron, x -> 1. In the Drell-Yan process \pi N -> \mu^- mu^+ + X, the polarization of the virtual photon is observed to change to longitudinal when the photon carries x_F > 0.6 of the pion. I define and study the Berger-Brodsky limit of Q^2 -> \infty with Q^2(1-x) fixed. A new kind of factorization holds in the Drell-Yan process in this limit, in which both pion valence quarks are coherent with the hard subprocess, the virtual photon is longitudinal rather than transverse, and the cross section is proportional to a multiparton distribution. Generalized parton distributions contain information on the longitudinal momentum and transverse position densities of partons in a hadron. Transverse charge densities are Fourier transforms of the electromagnetic form factors. I discuss the application of these methods to the QED electron, studying the form factors, charge densities and spin distributions of the leading order |e\gamma> Fock state in impact parameter and longitudinal momentum space. I show how the transverse shape of any virtual photon induced process, \gamma^*(q)+i -> f, may be measured. Qualitative arguments concerning the size of such transitions have been previously made in the literature, but without a precise analysis. Properly defined, the amplitudes and the cross section in impact parameter space provide information on the transverse shape of the transition process.

Direct measurement of phase of foreward-scattered light using polarization heterodyne interferometer

We describe direct measurement of phase of ballistic photons transmitted through objects hidden in a turbid medium using a polarization interferometer employing a rotating analyzer. The unwrapped phase difference measurements from interferometry was possible for medium levels of turbidity and accurate phase measurement from the sinusoidal intensity was not detectable when l/l* is increased beyond 4.3. The measured phase on reconstruction using standard tomographic algorithms resulted in the recovery of the refractive index profile of the object hidden in the turbid medium.

Multiple beam interference of light in an absorbing wedge

Multiple beam interference of light in a wedge is considered when the wedge is filled with an absorbing medium. The aim is to examine a method that may give values of both the real and the imaginary parts of the refractive index of the absorbing medium. We propose here a method to determine these quantities from simple techniques like fringe counting and interferometry, by using as the incident wave either a single Gaussian beam or two parallel Gaussian beams.

The Kπ form factors from analyticity and unitarity

Analyticity and unitarity techniques are employed to obtain bounds on the shape parameters of the scalar and vector form factors of semileptonic K l3 decays. For this purpose we use vector and scalar correlators evaluated in pQCD, a low energy theorem for scalar form factor, lattice results for the ratio of kaon and pion decay constants, chiral perturbation theory calculations for the scalar form factor at the Callan-Treiman point and experimental information on the phase and modulus of Kπ form factors up to an energy t in = 1GeV 2. We further derive regions on the real axis and in the complex-energy plane where the form factors cannot have zeros.

Measurement of in-plane and out-of-plane displacements and strains using digital holographic moire

The paper proposes a non-destructive method for simultaneous measurement of in-plane and out-of-plane displacements and strains undergone by a deformed specimen from a single moire fringe pattern obtained on the specimen in a dual beam digital holographic interferometry setup. The moire fringe pattern encodes multiple interference phases which carry the information on multidimensional deformation. The interference field is segmented in each column and is modeled as multicomponent quadratic/cubic frequency-modulated signal in each segment. Subsequently, the product form of modified cubic phase function is used for accurate estimation of phase parameters. The estimated phase parameters are further utilized for direct estimation of the unwrapped interference phases and phase derivatives. The simulation and experimental results are provided to validate the effectiveness of the proposed method.