Archivio Istituzionale della Ricerca - Università degli Studi di Pavia
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The global, regional, and national burden of cancer, 1990–2023, with forecasts to 2050: a systematic analysis for the Global Burden of Disease Study 2023
No full textBackground: Cancer is a leading cause of death globally. Accurate cancer burden information is crucial for policy planning, but many countries do not have up-to-date cancer surveillance data. To inform global cancer-control efforts, we used the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023 framework to generate and analyse estimates of cancer burden for 47 cancer types or groupings by age, sex, and 204 countries and territories from 1990 to 2023, cancer burden attributable to selected risk factors from 1990 to 2023, and forecasted cancer burden up to 2050. Methods: Cancer estimation in GBD 2023 used data from population-based cancer registration systems, vital registration systems, and verbal autopsies. Cancer mortality was estimated using ensemble models, with incidence informed by mortality estimates and mortality-to-incidence ratios (MIRs). Prevalence estimates were generated from modelled survival estimates, then multiplied by disability weights to estimate years lived with disability (YLDs). Years of life lost (YLLs) were estimated by multiplying age-specific cancer deaths by the GBD standard life expectancy at the age of death. Disability-adjusted life-years (DALYs) were calculated as the sum of YLLs and YLDs. We used the GBD 2023 comparative risk assessment framework to estimate cancer burden attributable to 44 behavioural, environmental and occupational, and metabolic risk factors. To forecast cancer burden from 2024 to 2050, we used the GBD 2023 forecasting framework, which included forecasts of relevant risk factor exposures and used Socio-demographic Index as a covariate for forecasting the proportion of each cancer not affected by these risk factors. Progress towards the UN Sustainable Development Goal (SDG) target 3.4 aim to reduce non-communicable disease mortality by a third between 2015 and 2030 was estimated for cancer. Findings: In 2023, excluding non-melanoma skin cancers, there were 18·5 million (95% uncertainty interval 16·4 to 20·7) incident cases of cancer and 10·4 million (9·65 to 10·9) deaths, contributing to 271 million (255 to 285) DALYs globally. Of these, 57·9% (56·1 to 59·8) of incident cases and 65·8% (64·3 to 67·6) of cancer deaths occurred in low-income to upper-middle-income countries based on World Bank income group classifications. Cancer was the second leading cause of deaths globally in 2023 after cardiovascular diseases. There were 4·33 million (3·85 to 4·78) risk-attributable cancer deaths globally in 2023, comprising 41·7% (37·8 to 45·4) of all cancer deaths. Risk-attributable cancer deaths increased by 72·3% (57·1 to 86·8) from 1990 to 2023, whereas overall global cancer deaths increased by 74·3% (62·2 to 86·2) over the same period. The reference forecasts (the most likely future) estimate that in 2050 there will be 30·5 million (22·9 to 38·9) cases and 18·6 million (15·6 to 21·5) deaths from cancer globally, 60·7% (41·9 to 80·6) and 74·5% (50·1 to 104·2) increases from 2024, respectively. These forecasted increases in deaths are greater in low-income and middle-income countries (90·6% [61·0 to 127·0]) compared with high-income countries (42·8% [28·3 to 58·6]). Most of these increases are likely due to demographic changes, as age-standardised death rates are forecast to change by –5·6% (–12·8 to 4·6) between 2024 and 2050 globally. Between 2015 and 2030, the probability of dying due to cancer between the ages of 30 years and 70 years was forecasted to have a relative decrease of 6·5% (3·2 to 10·3). Interpretation: Cancer is a major contributor to global disease burden, with increasing numbers of cases and deaths forecasted up to 2050 and a disproportionate growth in burden in countries with scarce resources. The decline in age-standardised mortality rates from cancer is encouraging but insufficient to meet the SDG target set for 2030. Effectively and sustainably addressing cancer burden globally will require comprehensive national and international efforts that consider health systems and context in the development and implementation of cancer-control strategies across the continuum of prevention, diagnosis, and treatment. Funding: Gates Foundation, St Jude Children's Research Hospital, and St Baldrick's Foundation
Copper-Catalyzed Asymmetric Nitrenoid Transfer to Access Fused δ-Lactams via HFIP-Assisted Aziridination and Cascade Cyclization
No full textAza-steroids and terpenoid alkaloids are prominent entities of biorelevant ring-fused azacycles with significant pharmaceutical applications. Despite their importance, synthetic approaches to these complex molecules remain a great challenge due to the lack of strategic routes to the multiple contiguous chiral centers, particularly in the case of thermodynamically unstable cis-ring frameworks. Herein, we report a Cu-catalyzed asymmetric cascade cyclization of arylalkenyl dioxazolones to access ring-fused δ-lactams. It is initiated to form a bicyclic N-acylaziridine intermediate to involve a concerted transition state, allowing an asynchronous C–N bond formation on the open-shell singlet surface. This key reactivity is enabled by 1,1,1,3,3,3-hexafluoropropan-2-ol (HFIP), which stabilizes the reactive Cu-acylnitrenoid intermediate via inner-sphere hydrogen bonding. The resulting N-acylaziridine undergoes HFIP-promoted regio- and diastereoselective ring-opening with pendant arene or heteroarene nucleophiles to deliver condensed δ-lactam products with excellent anti-selectivity
SEMANTIC METADATA AND LEXICAL STANDARDS FOR ARCHITECTURAL HERITAGE DOCUMENTATION
No full textDigital technologies are becoming increasingly essential for documenting, conserving, and disseminating knowledge of cultural heritage. A notable transition from traditional archival methods to advanced digital representations is evident, particularly in the con-text of cultural heritage data. Metadata, functioning as descriptive information, is crucial in systematically organising data generated while developing digital representations of cultural heritage structures. It consistently requires a comprehensive metadata schema to effectively display architectural structures with their contextual richness and the differ-ent technologies used. Widely adopted metadata standards provide essential descriptive metadata; however, they often lack specific fields needed to capture detailed administra-tive-technical data of 3D models – such as acquisition methods, geometric details, and accuracy metrics – elements crucial for assessing the authenticity and scholarly value of these digital representations. Such digital structures need precise information about the technologies and processes used in their creation to ensure accuracy and interoperability. This study examines the need for a more comprehensive metadata schema designed ex-plicitly for 3D models of architectural heritage, emphasizing the importance of a lexical standardization approach to represent its multifaceted nature. 3D documentation tech-niques, such as photogrammetry and laser scanning, produce a large volume of complex and multilayered data whose management requires structured descriptive systems. The proposed metadata schema aims to standardize the extensive volume of supporting data generated by these methodologies, thereby facilitating the creation of semantically rich metadata that enhances the accessibility and retrieval of heritage information
Pianificazione Urbanistica e Territoriale: Metodi e Modelli di Interpretazione degli Usi del Suolo e Relativi Impatti Ambientali
No full textThree-Dimensional Modelling Approach for Low Angle Normal Faults in Southern Italy: The Need for 3D Analysis
No full textThis paper presents three 3D reconstructions of different analogue models used to reproduce, interpret, and describe the geological setting of a seismogenic area in Southern Italy—the Messina Strait. Three-dimensional analysis is a technique that allows for less sparse and more congruent and coherent information about a study zone whose complete understanding reduces uncertainties and risks. A thorough structural and geodynamic description of the effects of low-angle normal faulting in the same region through analogue models has been widely investigated in the scientific literature. Sandbox models for fault behaviour during deformation and the effects of a Low Angle Normal Fault (LANF) on the seismotectonic setting are also studied. The deformational patterns associated with seismogenic faults, rotational behaviour of faults, and other related problems have not yet been thoroughly analysed. Most problems, like the evolution of normal faults, fault geometry, and others, have been cited and briefly outlined in earlier published works, but a three-dimensional approach is still significant. Here, we carried out a three-dimensional digital model for a complete and continuous structural model of a debated, studied area. The aim of this study is to highlight the importance of fully representing faults in complex and/or non-cylindrical structures, mainly when the shape and dimensions of the fault(s) are key parameters, like in seismogenic contexts
Urban Health Assessment Through a Planetary Health Perspective: Methods and First Results from the Rome NBFC Experiment
No full textGlobal, regional, and national prevalence of child and adolescent overweight and obesity, 1990-2021, with forecasts to 2050: a forecasting study for the Global Burden of Disease Study 2021
No full textBackground: Despite the well documented consequences of obesity during childhood and adolescence and future risks of excess body mass on non-communicable diseases in adulthood, coordinated global action on excess body mass in early life is still insufficient. Inconsistent measurement and reporting are a barrier to specific targets, resource allocation, and interventions. In this Article we report current estimates of overweight and obesity across childhood and adolescence, progress over time, and forecasts to inform specific actions. Methods: Using established methodology from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021, we modelled overweight and obesity across childhood and adolescence from 1990 to 2021, and then forecasted to 2050. Primary data for our models included 1321 unique measured and self-reported anthropometric data sources from 180 countries and territories from survey microdata, reports, and published literature. These data were used to estimate age-standardised global, regional, and national overweight prevalence and obesity prevalence (separately) for children and young adolescents (aged 5-14 years, typically in school and cared for by child health services) and older adolescents (aged 15-24 years, increasingly out of school and cared for by adult services) by sex for 204 countries and territories from 1990 to 2021. Prevalence estimates from 1990 to 2021 were generated using spatiotemporal Gaussian process regression models, which leveraged temporal and spatial correlation in epidemiological trends to ensure comparability of results across time and geography. Prevalence forecasts from 2022 to 2050 were generated using a generalised ensemble modelling approach assuming continuation of current trends. For every age-sex-location population across time (1990-2050), we estimated obesity (vs overweight) predominance using the log ratio of obesity percentage to overweight percentage. Findings: Between 1990 and 2021, the combined prevalence of overweight and obesity in children and adolescents doubled, and that of obesity alone tripled. By 2021, 93·1 million (95% uncertainty interval 89·6-96·6) individuals aged 5-14 years and 80·6 million (78·2-83·3) aged 15-24 years had obesity. At the super-region level in 2021, the prevalence of overweight and of obesity was highest in north Africa and the Middle East (eg, United Arab Emirates and Kuwait), and the greatest increase from 1990 to 2021 was seen in southeast Asia, east Asia, and Oceania (eg, Taiwan [province of China], Maldives, and China). By 2021, for females in both age groups, many countries in Australasia (eg, Australia) and in high-income North America (eg, Canada) had already transitioned to obesity predominance, as had males and females in a number of countries in north Africa and the Middle East (eg, United Arab Emirates and Qatar) and Oceania (eg, Cook Islands and American Samoa). From 2022 to 2050, global increases in overweight (not obesity) prevalence are forecasted to stabilise, yet the increase in the absolute proportion of the global population with obesity is forecasted to be greater than between 1990 and 2021, with substantial increases forecast between 2022 and 2030, which continue between 2031 and 2050. By 2050, super-region obesity prevalence is forecasted to remain highest in north Africa and the Middle East (eg, United Arab Emirates and Kuwait), and forecasted increases in obesity are still expected to be largest across southeast Asia, east Asia, and Oceania (eg, Timor-Leste and North Korea), but also in south Asia (eg, Nepal and Bangladesh). Compared with those aged 15-24 years, in most super-regions (except Latin America and the Caribbean and the high-income super-region) a greater proportion of those aged 5-14 years are forecasted to have obesity than overweight by 2050. Globally, 15·6% (12·7-17·2) of those aged 5-14 years are forecasted to have obesity by 2050 (186 million [141-221]), compared with 14·2% (11·4-15·7) of those aged 15-24 years (175 million [136-203]). We forecasted that by 2050, there will be more young males (aged 5-14 years) living with obesity (16·5% [13·3-18·3]) than overweight (12·9% [12·2-13·6]); while for females (aged 5-24 years) and older males (aged 15-24 years), overweight will remain more prevalent than obesity. At a regional level, the following populations are forecast to have transitioned to obesity (vs overweight) predominance before 2041-50: children and adolescents (males and females aged 5-24 years) in north Africa and the Middle East and Tropical Latin America; males aged 5-14 years in east Asia, central and southern sub-Saharan Africa, and central Latin America; females aged 5-14 years in Australasia; females aged 15-24 years in Australasia, high-income North America, and southern sub-Saharan Africa; and males aged 15-24 years in high-income North America. Interpretation: Both overweight and obesity increased substantially in every world region between 1990 and 2021, suggesting that current approaches to curbing increases in overweight and obesity have failed a generation of children and adolescents. Beyond 2021, overweight during childhood and adolescence is forecast to stabilise due to further increases in the population who have obesity. Increases in obesity are expected to continue for all populations in all world regions. Because substantial change is forecasted to occur between 2022 and 2030, immediate actions are needed to address this public health crisis. Funding: Bill & Melinda Gates Foundation and Australian National Health and Medical Research Council
L’édition des « motets entés » du chansonnier N (Paris, BnF, fr. 845) : un petit cas de synergie vertueuse entre philologie et musicologie
No full textLes « motets entés » sont un corpus monodique de 15 courtes compositions lyriques en français que seul le chansonnier N des trouvères (Paris, BnF, fr. 845, dernier quart du XIIIe siècle) transmet dans sa double composante textuelle et musicale. L’article présente les principaux problèmes que pose l’édition critique de ce corpus – donnée dans l’Annexe – en suggérant des solutions éditoriales fondées sur la mise en valeur du rapport entre la transcription du texte et la notation de la musique