PURPOSE: Multi-slice ungated double inversion recovery has been proposed as an alternative time-efficient and effective sequence for black-blood carotid imaging. The purpose of this study is to evaluate the comparative repeatability of this multi-contrast sequence with respect to a single slice double inversion recovery prepared gated sequence. MATERIALS AND METHODS: Ten healthy volunteers and three patients with Doppler ultrasound defined carotid artery stenosis >30% were recruited. T₁-weighted (T₁W) and T₂W fast spin-echo (FSE) images were acquired centered at the carotid bifurcation with and without cardiac gating. Repeat imaging was performed without patient repositioning to determine the variations in vessel wall measurement and signal intensity due to gating, while negating variations as a result of slice misalignment and anatomical displacement relative to the receiver coil. The distributions and the repeatability of lumen area, vessel wall area, signal and contrast-to-noise ratio (SNR/CNR) of the vessel wall and adjacent muscle were reported. RESULTS: The T₁W ungated sequence generally had comparable wall SNR/CNR with respect to the gated sequence, however the muscle SNR was lower (P = 0.013). The T₂W ungated multi-slice sequence had lower SNR/CNR than the gated single slice sequence (P < 0.001), but with equivalent effective wall CNR (P = 0.735). Vessel area measurements using the gated/ungated sequences were equivalent. Ungated sequences had better repeatability in SNR/CNR than the gated sequences with borderline and statistically significant differences. The repeatability of T₂W wall area measurement was better using the ungated sequences (P = 0.02), and the repeatability of the remaining vessel area measurements were equivalent. CONCLUSIONS: Ungated sequences can achieve comparable SNR/CNR and equivalent carotid vessel area measurements than gated sequences with improved repeatability of SNR/CNR. Ungated sequences are good alternatives of gated sequences for vessel area measurement and plaque composition quantification. ; This research is partly supported by ARTreat European Union Frame Project 7 and the National Institute of Health Research, Cambridge Biomedical Research Center grant.
A long-term, robust observational record of atmospheric black carbon (BC) concentrations at Fukue Island for 2009–2019 was produced by unifying the data from a continuous soot monitoring system (COSMOS) and a Multi-Angle Absorption Photometer (MAAP). This record was then used to analyze emission trends from China. We identified a rapid reduction in BC concentrations of (−5.8±1.5) % yr−1 or −48 % from 2010 to 2018. We concluded that an emission change of (−5.3±0.7) % yr−1, related to changes in China of as much as −4.6 % yr−1, was the main underlying driver. This evaluation was made after correcting for the interannual meteorological variability (IAV) by using the regional atmospheric chemistry model simulations from the Weather Research and Forecasting (WRF) and Community Multiscale Air Quality (CMAQ) models (collectively WRF/CMAQ) with the constant emissions. This resolves the current fundamental disagreements about the sign of the BC emissions trend from China over the past decade as assessed from bottom-up emission inventories. Our analysis supports inventories reflecting the governmental clean air actions after 2010 (e.g., MEIC1.3, ECLIPSE versions 5a and 6b, and the Regional Emission inventory in ASia (REAS) version 3.1) and recommends revisions to those that do not (e.g., Community Emissions Data System – CEDS). Our estimated emission trends were fairly uniform across seasons but diverse among air mass origins. Stronger BC reductions, accompanied by a reduction in carbon monoxide (CO) emissions, occurred in regions of south-central East China, while weaker BC reductions occurred in north-central East China and northeastern China. Prior to 2017, the BC and CO emissions trends were both unexpectedly positive in northeastern China during winter months, which possibly influenced the climate at higher latitudes. The pace of the estimated emissions reduction over China surpasses the Shared Socioeconomic Pathways (SSPs with reference to SSP1, specifically) scenarios for 2015–2030, which suggests highly successful emission control policies. At Fukue Island, the BC fraction of fine particulate matter (PM2.5) also steadily decreased over the last decade. This suggests that reductions in BC emissions started without significant delay when compared to other pollutants such as NOx and SO2, which are among the key precursors of scattering PM2.5.
A long-term, robust observational record of atmospheric black carbon (BC) concentrations at Fukue Island for 2009–2019 was produced by unifying the data from a continuous soot monitoring system (COSMOS) and a Multi-Angle Absorption Photometer (MAAP). This record was then used to analyze emission trends from China. We identified a rapid reduction in BC concentrations of (−5.8±1.5) % yr−1 or −48 % from 2010 to 2018. We concluded that an emission change of (−5.3±0.7) % yr−1, related to changes in China of as much as −4.6 % yr−1, was the main underlying driver. This evaluation was made after correcting for the interannual meteorological variability (IAV) by using the regional atmospheric chemistry model simulations from the Weather Research and Forecasting (WRF) and Community Multiscale Air Quality (CMAQ) models (collectively WRF/CMAQ) with the constant emissions. This resolves the current fundamental disagreements about the sign of the BC emissions trend from China over the past decade as assessed from bottom-up emission inventories. Our analysis supports inventories reflecting the governmental clean air actions after 2010 (e.g., MEIC1.3, ECLIPSE versions 5a and 6b, and the Regional Emission inventory in ASia (REAS) version 3.1) and recommends revisions to those that do not (e.g., Community Emissions Data System – CEDS). Our estimated emission trends were fairly uniform across seasons but diverse among air mass origins. Stronger BC reductions, accompanied by a reduction in carbon monoxide (CO) emissions, occurred in regions of south-central East China, while weaker BC reductions occurred in north-central East China and northeastern China. Prior to 2017, the BC and CO emissions trends were both unexpectedly positive in northeastern China during winter months, which possibly influenced the climate at higher latitudes. The pace of the estimated emissions reduction over China surpasses the Shared Socioeconomic Pathways (SSPs with reference to SSP1, specifically) scenarios for 2015–2030, which suggests highly successful emission control policies. At Fukue Island, the BC fraction of fine particulate matter (PM2.5) also steadily decreased over the last decade. This suggests that reductions in BC emissions started without significant delay when compared to other pollutants such as NOx and SO2, which are among the key precursors of scattering PM2.5.
Background Achieving universal health coverage (UHC) involves all people receiving the health services they need, of high quality, without experiencing financial hardship. Making progress towards UHC is a policy priority for both countries and global institutions, as highlighted by the agenda of the UN Sustainable Development Goals (SDGs) and WHO's Thirteenth General Programme of Work (GPW13). Measuring effective coverage at the health-system level is important for understanding whether health services are aligned with countries' health profiles and are of sufficient quality to produce health gains for populations of all ages. Methods Based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we assessed UHC effective coverage for 204 countries and territories from 1990 to 2019. Drawing from a measurement framework developed through WHO's GPW13 consultation, we mapped 23 effective coverage indicators to a matrix representing health service types (eg, promotion, prevention, and treatment) and five population-age groups spanning from reproductive and newborn to older adults (≥65 years). Effective coverage indicators were based on intervention coverage or outcome-based measures such as mortality-to-incidence ratios to approximate access to quality care; outcome-based measures were transformed to values on a scale of 0–100 based on the 2·5th and 97·5th percentile of location-year values. We constructed the UHC effective coverage index by weighting each effective coverage indicator relative to its associated potential health gains, as measured by disability-adjusted life-years for each location-year and population-age group. For three tests of validity (content, known-groups, and convergent), UHC effective coverage index performance was generally better than that of other UHC service coverage indices from WHO (ie, the current metric for SDG indicator 3.8.1 on UHC service coverage), the World Bank, and GBD 2017. We quantified frontiers of UHC effective coverage performance on the basis of pooled health spending per capita, representing UHC effective coverage index levels achieved in 2019 relative to country-level government health spending, prepaid private expenditures, and development assistance for health. To assess current trajectories towards the GPW13 UHC billion target—1 billion more people benefiting from UHC by 2023—we estimated additional population equivalents with UHC effective coverage from 2018 to 2023. Findings Globally, performance on the UHC effective coverage index improved from 45·8 (95% uncertainty interval 44·2–47·5) in 1990 to 60·3 (58·7–61·9) in 2019, yet country-level UHC effective coverage in 2019 still spanned from 95 or higher in Japan and Iceland to lower than 25 in Somalia and the Central African Republic. Since 2010, sub-Saharan Africa showed accelerated gains on the UHC effective coverage index (at an average increase of 2·6% [1·9–3·3] per year up to 2019); by contrast, most other GBD super-regions had slowed rates of progress in 2010–2019 relative to 1990–2010. Many countries showed lagging performance on effective coverage indicators for non-communicable diseases relative to those for communicable diseases and maternal and child health, despite non-communicable diseases accounting for a greater proportion of potential health gains in 2019, suggesting that many health systems are not keeping pace with the rising non-communicable disease burden and associated population health needs. In 2019, the UHC effective coverage index was associated with pooled health spending per capita (r=0·79), although countries across the development spectrum had much lower UHC effective coverage than is potentially achievable relative to their health spending. Under maximum efficiency of translating health spending into UHC effective coverage performance, countries would need to reach $1398 pooled health spending per capita (US$ adjusted for purchasing power parity) in order to achieve 80 on the UHC effective coverage index. From 2018 to 2023, an estimated 388·9 million (358·6–421·3) more population equivalents would have UHC effective coverage, falling well short of the GPW13 target of 1 billion more people benefiting from UHC during this time. Current projections point to an estimated 3·1 billion (3·0–3·2) population equivalents still lacking UHC effective coverage in 2023, with nearly a third (968·1 million [903·5–1040·3]) residing in south Asia. Interpretation The present study demonstrates the utility of measuring effective coverage and its role in supporting improved health outcomes for all people—the ultimate goal of UHC and its achievement. Global ambitions to accelerate progress on UHC service coverage are increasingly unlikely unless concerted action on non-communicable diseases occurs and countries can better translate health spending into improved performance. Focusing on effective coverage and accounting for the world's evolving health needs lays the groundwork for better understanding how close—or how far—all populations are in benefiting from UHC. Funding Bill & Melinda Gates Foundation.
ANPCyT, Argentina ; YerPhI, Armenia ; ARC, Australia ; BMWFW, Austria ; FWF, Austria ; ANAS, Azerbaijan ; SSTC, Belarus ; Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) ; Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) ; NSERC, Canada ; NRC, Canada ; CFI, Canada ; CERN ; CONICYT, Chile ; CAS, China ; MOST, China ; NSFC, China ; COLCIENCIAS, Colombia ; MSMT CR, Czech Republic ; MPO CR, Czech Republic ; VSC CR, Czech Republic ; DNRF, Denmark ; DNSRC, Denmark ; IN2P3-CNRS, CEA-DRF/IRFU, France ; SRNSFG, Georgia ; BMBF, Germany ; HGF, Germany ; MPG, Germany ; GSRT, Greece ; RGC, Hong Kong SAR, China ; ISF, Israel ; Benoziyo Center, Israel ; INFN, Italy ; MEXT, Japan ; JSPS, Japan ; CNRST, Morocco ; NWO, Netherlands ; RCN, Norway ; MNiSW, Poland ; NCN, Poland ; FCT, Portugal ; MNE/IFA, Romania ; MES of Russia, Russian Federation ; NRC KI, Russian Federation ; JINR ; MESTD, Serbia ; MSSR, Slovakia ; ARRS, Slovenia ; MIZS, Slovenia ; DST/NRF, South Africa ; MINECO, Spain ; SRC, Sweden ; Wallenberg Foundation, Sweden ; SERI, Switzerland ; SNSF, Switzerland ; Canton of Bern, Switzerland ; MOST, Taiwan ; TAEK, Turkey ; STFC, United Kingdom ; DOE, United States of America ; NSF, United States of America ; BCKDF, Canada ; CANARIE, Canada ; CRC, Canada ; Compute Canada, Canada ; COST, European Union ; ERC, European Union ; ERDF, European Union ; Horizon 2020, European Union ; Marie Sk lodowska-Curie Actions, European Union ; Investissements d' Avenir Labex and Idex, ANR, France ; DFG, Germany ; AvH Foundation, Germany ; Greek NSRF, Greece ; BSF-NSF, Israel ; GIF, Israel ; CERCA Programme Generalitat de Catalunya, Spain ; Royal Society, United Kingdom ; Leverhulme Trust, United Kingdom ; BMBWF (Austria) ; FWF (Austria) ; FNRS (Belgium) ; FWO (Belgium) ; Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) ; Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ) ; FAPERGS (Brazil) ; MES (Bulgaria) ; CAS (China) ; MoST (China) ; NSFC (China) ; COLCIENCIAS (Colombia) ; MSES (Croatia) ; CSF (Croatia) ; RPF (Cyprus) ; SENESCYT (Ecuador) ; MoER (Estonia) ; ERC IUT (Estonia) ; ERDF (Estonia) ; Academy of Finland (Finland) ; MEC (Finland) ; HIP (Finland) ; CEA (France) ; CNRS/IN2P3 (France) ; BMBF (Germany) ; DFG (Germany) ; HGF (Germany) ; GSRT (Greece) ; NKFIA (Hungary) ; DAE (India) ; DST (India) ; IPM (Iran) ; SFI (Ireland) ; INFN (Italy) ; MSIP (Republic of Korea) ; NRF (Republic of Korea) ; MES (Latvia) ; LAS (Lithuania) ; MOE (Malaysia) ; UM (Malaysia) ; BUAP (Mexico) ; CINVESTAV (Mexico) ; CONACYT (Mexico) ; LNS (Mexico) ; SEP (Mexico) ; UASLP-FAI (Mexico) ; MOS (Montenegro) ; MBIE (New Zealand) ; PAEC (Pakistan) ; MSHE (Poland) ; NSC (Poland) ; FCT (Portugal) ; JINR (Dubna) ; MON (Russia) ; RosAtom (Russia) ; RAS (Russia) ; RFBR (Russia) ; NRC KI (Russia) ; MESTD (Serbia) ; SEIDI (Spain) ; CPAN (Spain) ; PCTI (Spain) ; FEDER (Spain) ; MOSTR (Sri Lanka) ; MST (Taipei) ; ThEPCenter (Thailand) ; IPST (Thailand) ; STAR (Thailand) ; NSTDA (Thailand) ; TAEK (Turkey) ; NASU (Ukraine) ; SFFR (Ukraine) ; STFC (United Kingdom ; DOE (U.S.A.) ; NSF (U.S.A.) ; Marie-Curie programme ; Horizon 2020 Grant (European Union) ; Leventis Foundation ; A.P. Sloan Foundation ; Alexander von Humboldt Foundation ; Belgian Federal Science Policy Office ; Fonds pour la Formation a la Recherche dans l'Industrie et dans l'Agriculture (FRIA-Belgium) ; Agentschap voor Innovatie door Wetenschap en Technologie (IWT-Belgium) ; F.R.S.-FNRS (Belgium) ; Beijing Municipal Science & Technology Commission ; Ministry of Education, Youth and Sports (MEYS) of the Czech Republic ; Hungarian Academy of Sciences (Hungary) ; New National Excellence Program UNKP (Hungary) ; Council of Science and Industrial Research, India ; HOMING PLUS programme of the Foundation for Polish Science ; European Union, Regional Development Fund ; Mobility Plus programme of the Ministry of Science and Higher Education ; National Science Center (Poland) ; National Priorities Research Program by Qatar National Research Fund ; Programa Estatal de Fomento de la Investigacion Cientfica y Tecnica de Excelencia Maria de Maeztu ; Programa Severo Ochoa del Principado de Asturias ; EU-ESF ; Greek NSRF ; Rachadapisek Sompot Fund for Postdoctoral Fellowship, Chulalongkorn University (Thailand) ; Chulalongkorn Academic into Its 2nd Century Project Advancement Project (Thailand) ; Welch Foundation ; Weston Havens Foundation (U.S.A.) ; Canton of Geneva, Switzerland ; Herakleitos programme ; Thales programme ; Aristeia programme ; European Research Council (European Union) ; Horizon 2020 Grant (European Union): 675440 ; FWO (Belgium): 30820817 ; Beijing Municipal Science & Technology Commission: Z181100004218003 ; NKFIA (Hungary): 123842 ; NKFIA (Hungary): 123959 ; NKFIA (Hungary): 124845 ; NKFIA (Hungary): 124850 ; NKFIA (Hungary): 125105 ; National Science Center (Poland): Harmonia 2014/14/M/ST2/00428 ; National Science Center (Poland): Opus 2014/13/B/ST2/02543 ; National Science Center (Poland): 2014/15/B/ST2/03998 ; National Science Center (Poland): 2015/19/B/ST2/02861 ; National Science Center (Poland): Sonata-bis 2012/07/E/ST2/01406 ; Programa Estatal de Fomento de la Investigacion Cientfica y Tecnica de Excelencia Maria de Maeztu: MDM-2015-0509 ; Welch Foundation: C-1845 ; This paper presents the combinations of single-top-quark production cross-section measurements by the ATLAS and CMS Collaborations, using data from LHC proton-proton collisions at = 7 and 8 TeV corresponding to integrated luminosities of 1.17 to 5.1 fb(-1) at = 7 TeV and 12.2 to 20.3 fb(-1) at = 8 TeV. These combinations are performed per centre-of-mass energy and for each production mode: t-channel, tW, and s-channel. The combined t-channel cross-sections are 67.5 +/- 5.7 pb and 87.7 +/- 5.8 pb at = 7 and 8 TeV respectively. The combined tW cross-sections are 16.3 +/- 4.1 pb and 23.1 +/- 3.6 pb at = 7 and 8 TeV respectively. For the s-channel cross-section, the combination yields 4.9 +/- 1.4 pb at = 8 TeV. The square of the magnitude of the CKM matrix element V-tb multiplied by a form factor f(LV) is determined for each production mode and centre-of-mass energy, using the ratio of the measured cross-section to its theoretical prediction. It is assumed that the top-quark-related CKM matrix elements obey the relation |V-td|, |V-ts| « |V-tb|. All the |f(LV)V(tb)|(2) determinations, extracted from individual ratios at = 7 and 8 TeV, are combined, resulting in |f(LV)V(tb)| = 1.02 +/- 0.04 (meas.) +/- 0.02 (theo.). All combined measurements are consistent with their corresponding Standard Model predictions.