Danan Gu

Abstract: The United Nations (UN) recently released population projections based on data until 2012 and a Bayesian probabilistic methodology. Analysis of these data reveals that, contrary to previous literature, the world population is unlikely to stop growing this century. There is an 80% probability that world population, now 7.2 billion people, will increase to between 9.6 billion and 12.3 billion in 2100. This uncertainty is much smaller than the range from the traditional UN high and low variants. Much of the increase is expected to happen in Africa, in part due to higher fertility rates and a recent slowdown in the pace of fertility decline. Also, the ratio of working-age people to older people is likely to decline substantially in all countries, even those that currently have young populations.

Abstract: BACKGROUNDEastern and South-Eastern Asian countries have witnessed a marked decline in old age mortality in recent decades. Yet no studies have investigated the trends and patterns in old age mortality and cause-of-death in the region.OBJECTIVEWe reviewed the trends and patterns of old age mortality and cause-of-death for countries in the region.METHODSWe examined data on old age mortality in terms of life expectancy at age 65 and age-specific death rates from the 2012 Revision of the World Population Prospects for 14 countries in the region (China, Hong Kong, Democratic People's Republic of Korea, Indonesia, Japan, Lao People's Democratic Republic, Myanmar, Malaysi a, Mongolia, Philippines, Republic of Korea, Singapore, Thailand, and Viet Nam) and data on cause-of-death from the WHO for five countries (China, Hong Kong, Japan, Republic of Korea, and Singapore) from 1980 to 2010.RESULTSWhile mortality transitions in these populations took place in different times, and at different levels of socioeconomic development and living environment, changes in their age patterns and sex differentials in mortality showed certain similarities: women witnessed a similar decline to men in spite of their lower mortality, and young elders had a larger decline than the oldest-old. In all five countries examined for cause-of-death, most of the increases in life expectancy at age 65 in both men and women were attributable to declines in mortality from stroke and heart disease. GDP per capita, educational level, and urbanization explained much of the variations in life expectancy and cause-specific mortality, indicating critical contributions of these basic socioeconomic development indicators to the mortality decline over time in the region.CONCLUSIONSThese findings shed light on the relationship between epidemiological transition, changing age patterns of mortality, and improving life expectancy in these populations.(ProQuest: ... denotes formula omitted.)1. IntroductionLike many other countries in the world, Eastern and South-Eastern Asian populations have witnessed a marked decline in old age mortality in recent decades. Life expectancy for both sexes combined at age 65 in Eastern Asia rose from 9.2 years in 1950-1955 to 16.8 years in 2005-2010, a net increase of 7.6 years, and the largest gain of any geographic region of the world. The corresponding gain in life expectancy at age 65 for South-Eastern Asia was 4.0 years rising from 11.2 years in 1950-1955, ranking the middle among all geographic regions in terms of gained years (United Nations Population Division(UNPOP) 2013).Eastern and South-Eastern Asia is unique for studying old age mortality.3 First, this region is home to nearly one-third of the world's total population today, the largest region in the world (UNPOP 2013); some countries 4 in the region have completed the demographic transition while many others are still undergoing transition, which provides promising data for summarizing patterns and trajectories of old age mortality over time (Bongaarts 2009; McNicoll 2006). Second, this region is economically diverse. For example, Japan, Hong Kong,5 and Republic of Korea are high-income economies; China and Thailand are upper middle income countries; Viet Nam and Philippines are lower middle income societies; and Myanmar is a low income country (World Bank 2011). Third, there is a substantial heterogeneity in mortality across countries in the region. Life expectancy at birth for both sexes combined in Japan, Hong Kong, Republic of Korea and Singapore was already above 80 years in 2005-2010, one of the highest in the world, whereas it was just above 64 years in Myanmar, one of the lowest ones in the world among countries not affected by the HIV/AIDS epidemic. Fourth, the low fertility and the declining mortality of populations in the region have contributed remarkably to elderly population growth. …

Abstract: Estimates of the worldwide incidence and mortality from 27 major cancers and for all cancers combined for 2012 are now available in the GLOBOCAN series of the International Agency for Research on Cancer. We review the sources and methods used in compiling the national cancer incidence and mortality estimates, and briefly describe the key results by cancer site and in 20 large “areas” of the world. Overall, there were 14.1 million new cases and 8.2 million deaths in 2012. The most commonly diagnosed cancers were lung (1.82 million), breast (1.67 million), and colorectal (1.36 million); the most common causes of cancer death were lung cancer (1.6 million deaths), liver cancer (745,000 deaths), and stomach cancer (723,000 deaths).

Abstract: 抗原变异可使得多种致病微生物易于逃避宿主免疫应答。表达在感染红细胞表面的恶性疟原虫红细胞表面蛋白1（PfPMP1）与感染红细胞、内皮细胞、树突状细胞以及胎盘的单个或多个受体作用，在黏附及免疫逃避中起关键的作用。每个单倍体基因组var基因家族编码约60种成员，通过启动转录不同的var基因变异体为抗原变异提供了分子基础。

Abstract: Summary Background We used data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010) to estimate the burden of disease attributable to mental and substance use disorders in terms of disability-adjusted life years (DALYs), years of life lost to premature mortality (YLLs), and years lived with disability (YLDs). Methods For each of the 20 mental and substance use disorders included in GBD 2010, we systematically reviewed epidemiological data and used a Bayesian meta-regression tool, DisMod-MR, to model prevalence by age, sex, country, region, and year. We obtained disability weights from representative community surveys and an internet-based survey to calculate YLDs. We calculated premature mortality as YLLs from cause of death estimates for 1980–2010 for 20 age groups, both sexes, and 187 countries. We derived DALYs from the sum of YLDs and YLLs. We adjusted burden estimates for comorbidity and present them with 95% uncertainty intervals. Findings In 2010, mental and substance use disorders accounted for 183·9 million DALYs (95% UI 153·5 million–216·7 million), or 7·4% (6·2–8·6) of all DALYs worldwide. Such disorders accounted for 8·6 million YLLs (6·5 million–12·1 million; 0·5% [0·4–0·7] of all YLLs) and 175·3 million YLDs (144·5 million–207·8 million; 22·9% [18·6–27·2] of all YLDs). Mental and substance use disorders were the leading cause of YLDs worldwide. Depressive disorders accounted for 40·5% (31·7–49·2) of DALYs caused by mental and substance use disorders, with anxiety disorders accounting for 14·6% (11·2–18·4), illicit drug use disorders for 10·9% (8·9–13·2), alcohol use disorders for 9·6% (7·7–11·8), schizophrenia for 7·4% (5·0–9·8), bipolar disorder for 7·0% (4·4–10·3), pervasive developmental disorders for 4·2% (3·2–5·3), childhood behavioural disorders for 3·4% (2·2–4·7), and eating disorders for 1·2% (0·9–1·5). DALYs varied by age and sex, with the highest proportion of total DALYs occurring in people aged 10–29 years. The burden of mental and substance use disorders increased by 37·6% between 1990 and 2010, which for most disorders was driven by population growth and ageing. Interpretation Despite the apparently small contribution of YLLs—with deaths in people with mental disorders coded to the physical cause of death and suicide coded to the category of injuries under self-harm—our findings show the striking and growing challenge that these disorders pose for health systems in developed and developing regions. In view of the magnitude of their contribution, improvement in population health is only possible if countries make the prevention and treatment of mental and substance use disorders a public health priority. Funding Queensland Department of Health, National Health and Medical Research Council of Australia, National Drug and Alcohol Research Centre-University of New South Wales, Bill & Melinda Gates Foundation, University of Toronto, Technische Universitat, Ontario Ministry of Health and Long Term Care, and the US National Institute of Alcohol Abuse and Alcoholism.

Abstract: This paper is a re-make of Chapters 1-3 of the Interim Report World Agriculture: towards 2030/2050 (FAO, 2006). In addition, this new paper includes a Chapter 4 on production factors (land, water, yields, fertilizers). Revised and more recent data have been used as basis for the new projections, as follows: (a) updated historical data from the Food Balance Sheets 1961-2007 as of June 2010; (b) undernourishment estimates from The State of Food Insecurity in the World 2010 (SOFI) and related new parameters (CVs, minimum daily energy requirements) are used in the projections; (c) new population data and projections from the UN World Population Prospects - Revision of 2008; (d) new GDP data and projections from the World Bank; (e) a new base year of 2005/2007 (the previous edition used the base year 1999/2001); (f) updated estimates of land resources from the new evaluation of the Global Agro-ecological Zones (GAEZ) study of FAO and IIASA. Estimates of land under forest and in protected areas from the GAEZ are taken into account and excluded from the estimates of land areas suitable for crop production into which agriculture could expand in the future; (g) updated estimates of existing irrigation, renewable water resources and potentials for irrigation expansion; and (h) changes in the text as required by the new historical data and projections. Like the interim report, this re-make does not include projections for the Fisheries and Forestry sectors. Calories from fish are, however, included, in the food consumption projections, along with those from other commodities (e.g. spices) not analysed individually. The projections presented reflect the magnitudes and trajectories we estimate the major food and agriculture variables may assume in the future; they are not meant to reflect how these variables may be required to evolve in the future in order to achieve some normative objective, e.g. ensure food security for all, eliminate undernourishment or reduce it to any given desired level, or avoid food overconsumption leading to obesity and related NonCommunicable Diseases.

Abstract: As policy-makers search for ways to reduce poverty and income inequality, and to achieve sustainable income growth, they are being encouraged to focus on an emerging challenge to health, well-being and development: non-communicable diseases (NCDs). After all, 63% of all deaths worldwide currently stem from NCDs – chiefly cardiovascular diseases, cancers, chronic respiratory diseases and diabetes. These deaths are distributed widely among the world’s population – from highincome to low-income countries and from young to old (about one-quarter of all NCD deaths occur below the age of 60, amounting to approximately 9 million deaths per year). NCDs have a large impact, undercutting productivity and boosting healthcare outlays. Moreover, the number of people affected by NCDs is expected to rise substantially in the coming decades, reflecting an ageing and increasing global population. With this in mind, the United Nations is holding its first High-Level Meeting on NCDs on 19-20 September 2011 – this is only the second time that a high-level UN meeting is being dedicated to a health topic (the first time being on HIV/ AIDS in 2001). Over the years, much work has been done estimating the human toll of NCDs, but work on estimating the economic toll is far less advanced. In this report, the World Economic Forum and the Harvard School of Public Health try to inform and stimulate further debate by developing new estimates of the global economic burden of NCDs in 2010, and projecting the size of the burden through 2030. Three distinct approaches are used to compute the economic burden: (1) the standard cost of illness method; (2) macroeconomic simulation and (3) the value of a statistical life. This report includes not only the four major NCDs (the focus of the UN meeting), but also mental illness, which is a major contributor to the burden of disease worldwide. This evaluation takes place in the context of enormous global health spending, serious concerns about already strained public finances and worries about lacklustre economic growth. The report also tries to capture the thinking of the business community about the impact of NCDs on their enterprises. Five key messages emerge: • First, NCDs already pose a substantial economic burden and this burden will evolve into a staggering one over the next two decades. For example, with respect to cardiovascular disease, chronic respiratory disease, cancer, diabetes and mental health, the macroeconomic simulations suggest a cumulative output loss of US$ 47 trillion over the next two decades. This loss represents 75% of global GDP in 2010 (US$ 63 trillion). It also represents enough money to eradicate two dollar-a-day poverty among the 2.5 billion people in that state for more than half a century. • Second, although high-income countries currently bear the biggest economic burden of NCDs, the developing world, especially middle-income countries, is expected to assume an ever larger share as their economies and populations grow. • Third, cardiovascular disease and mental health conditions are the dominant contributors to the global economic burden of NCDs. • Fourth, NCDs are front and centre on business leaders’ radar. The World Economic Forum’s annual Executive Opinion Survey (EOS), which feeds into its Global Competitiveness Report, shows that about half of all business leaders surveyed worry that at least one NCD will hurt their company’s bottom line in the next five years, with similarly high levels of concern in low-, middle- and high-income countries – especially in countries where the quality of healthcare or access to healthcare is perceived to be poor. These NCD-driven concerns are markedly higher than those reported for the communicable diseases of HIV/AIDS, malaria and tuberculosis. • Fifth, the good news is that there appear to be numerous options available to prevent and control NCDs. For example, the WHO has identified a set of interventions they call “Best Buys”. There is also considerable scope for the design and implementation of programmes aimed at behaviour change among youth and adolescents, and more costeffective models of care – models that reduce the care-taking burden that falls on untrained family members. Further research on the benefits of such interventions in relation to their costs is much needed. It is our hope that this report informs the resource allocation decisions of the world’s economic leaders – top government officials, including finance ministers and their economic advisors – who control large amounts of spending at the national level and have the power to react to the formidable economic threat posed by NCDs.