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Shared gene expression signatures between visceral adipose and skeletal muscle tissues are associated with cardiometabolic traits in children with obesity

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COMPUTERS IN BIOLOGY AND MEDICINE 2023年第1期163卷 107085-107085页

作者： Bustos-Aibar, Mireia Aguilera, Concepcion M. Alcala-Fdez, Jesus Ruiz-Ojeda, Francisco J. Plaza-Diaz, Julio Plaza-Florido, Abel Tofe, Ines Gil-Campos, Mercedes Gacto, Maria J. Anguita-Ruiz, Augusto Univ Granada Sch Pharm Dept Biochem & Mol Biol 2 Granada 18071 Spain Carlos III Hlth Inst Biomed Res Networking Ctr Physiopathol Obes & Nut Madrid 28029 Spain Univ Granada Andalusian Res Inst Data Sci & Computat Intellige Dept Comp Sci & Artificial Intelligence Granada 18071 Spain Helmholtz Zentrum Munchen Inst Diabet & Obes RG Adipocytes & Metab Helmholtz Diabet Ctr D-85764 Munich Germany Childrens Hosp Eastern Ontario Res Inst Ottawa ON 181 Canada Univ Granada Sport & Hlth Univ Dept Phys Educ & Sports PROmoting FITness & Hlth Phys act Res GrpRes Ins Granada 18071 Spain Univ Calif Irvine Pediat Exercise & Genom Res Ctr Sch Med Dept Pediat Irvine CA 92617 USA Univ Cordoba Univ Clin Hosp Inst Maimonides Biomed Invest Cordoba Cordoba 14004 Spain Univ Granada Dept Software Engn Granada 18071 Spain ISGlobal Barcelona Inst Global Hlth Barcelona 08003 Spain

Obesity in children is related to the development of cardiometabolic complications later in life, where molecular changes of visceral adipose tissue (VAT) and skeletal muscle tissue (SMT) have been proven to be fundamental. The aim of this study is to unveil the gene expression architecture of both tissues in a cohort of Spanish boys with obesity, using a clustering method known as weighted gene co-expression network analysis. For this purpose, we have followed a multi-objective analytic pipeline consisting of three main approaches;identification of gene co-expression clusters associated with childhood obesity, individually in VAT and SMT (intra-tissue, approach I);identification of gene co-expression clusters associated with obesity metabolic alterations, individually in VAT and SMT (intra-tissue, approach II);and identification of gene co-expression clusters associated with obesity-metabolic alterations simultaneously in VAT and SMT (inter tissue, approach III). In both tissues, we identified independent and inter-tissue gene co-expression signatures associated with obesity and cardiovascular risk, some of which exceeded multiple-test correction filters. In these signatures, we could identify some central hub genes (e.g., NDUFB8, GUCY1B1, KCNMA1, NPR2, PPP3CC) participating in relevant metabolic pathways exceeding multiple-testing correction filters. We identified the central hub genes PIK3R2, PPP3C and PTPN5 associated with MAPK signaling and insulin resistance terms. This is the first time that these genes have been associated with childhood obesity in both tissues. Therefore, they could be potential novel molecular targets for drugs and health interventions, opening new lines of research on the personalized care in this pathology. This work generates interesting hypotheses about the transcriptomics alterations underlying metabolic health alterations in obesity in the pediatric population.

关键词： Childhood obesity Gene co-expression Hierarchical clustering Inter-tissue molecular signatures Skeletal muscle tissue Visceral adipose tissue

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ASYNCHRONOUS TRANSFER MODE (ATM) OPERATION VIA SATELLITE - ISSUES, CHALLENGES AND RESOLUTIONS

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INTERNATIONAL JOURNAL OF SATELLITE COMMUNICATIONS 1994年第3期12卷 211-222页

作者： CHITRE, DM GOKHALE, DS HENDERSON, T LUNSFORD, JL MATHEWS, N COMSAT Laboratories 22300 Comsat Drive Clarksburg MD 20871 USA. Received his B.Sc. from the University of Bombay India an M.A. in mathematics from the University of Cambridge U.K. and a Ph.D. in physics from the University of Maryland. He is currently an Associate Executive Director of the Network Technology Division at COMSAT Laboratories. He has been involved in research and development activities in ISDN VSAT networks data communications and network systems and architectures. Prior to his current positions Dr. Chitre was a Principal Scientist in the Network Technology Division at COMSAT Laboratories. Dr. Chitre joined COMSAT Laboratories in 1980. He has made major contributions to the analysis and architecture of data communication ISDN and BISDN via satellite. Dr. Chitre directs and participates in the international and national standards activities in ISDN BISDN and data communication as they apply to satellite communication. He was Chairman of the Working Group on Protocols and Network Timing Function of the CCIR/CCITT Joint Ad Hoc Group on ISDN-Satellite Matters during 1990–1992. Currently he is the Chairman of the Working Group on New Technologies in the ITU Intersector Coordinating Group (ICG) on Satellite Matters. Dr. Chitre was a programme manager during 1990 and 1991 on a contract from INTELSAT on systems studies on satellite communications systems architectures for ISDN and broadband ISDN systems. Currently he is the technical manager of the DoD Contract on ATM via satellite demonstration and the programme manager for the INTELSAT contract on analysis and top-level specification of INTELSAT ISDN subnetworks and SDH compatible transport network. Department manager for ISDN/Data Communications in the Network Technology Division of COMSAT Laboratories. His responsibilities include managing the implementation of next generation telecommunication systems for fixed and mobile satellite systems. Current projects include the development of a high data rate gateway switch that provides for the

Key issues regarding the operation of the broadband integrated services digital network (BISDN) via satellite are presented herein. The specific issues, challenges, and their resolutions are detailed. In particular, the impact of error characteristics and propagation delay on the operation of BISDN via satellite is discussed. Solutions are presented for removing adverse effects and providing high-quality service to users of BISDN via satellite.

关键词： ATM BISDN

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Association between autism spectrum disorder and inflammatory bowel disease: A systematic review and meta-analysis

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AUTISM RESEARCH 2022年第2期15卷 340-352页

作者： Kim, Jong Yeob Choi, Min Je Ha, Sungji Hwang, Jimin Koyanagi, Ai Dragioti, Elena Radua, Joaquim Smith, Lee Jacob, Louis de Pablo, Gonzalo Salazar Lee, Seung Won Yon, Dong Keon Thompson, Trevor Cortese, Samuele Lollo, Gianluca Liang, Chih-Sung Chu, Che-Sheng Fusar-Poli, Paolo Cheon, Keun-Ah Shin, Jae Il Solmi, Marco Yonsei Univ Coll Med Seoul South Korea Yonsei Univ Coll Med Inst Behav Sci Med Dept Child & Adolescent PsychiatDept Psychiat 50 Yonsei RoCPO Box 525 Seoul 03722 South Korea Johns Hopkins Bloomberg Sch Publ Hlth Dept Epidemiol Baltimore MD USA Univ Barcelona Res & Dev Unit Parc Sanitari Sant Joan Deu CIBERSAM Fundaci Sant Joan Deu Barcelona Spain ICREA Barcelona Spain Linkoping Univ Pain & Rehabil Ctr Linkoping Sweden Linkoping Univ Dept Hlth Med & Caring Sci Linkoping Sweden Inst dInvest Biomed August Pi Sunyer IDIBAPS Mental Hlth Res Networking Ctr CIBERSAM Barcelona Spain Kings Coll London Inst Psychiat Dept Psychosis Studies Psychol & Neurosci London England Karolinska Inst Dept Clin Neurosci Ctr Psychiat Res Stockholm Sweden Anglia Ruskin Univ Ctre Hlth Performance & Wellbeing Cambridge England Univ Versailles St Quentin Yvelines Fac Med Montigny le Bretonneux France Kings Coll London Inst Psychiat Dept Psychosis Studies Early Psychosis Intervent & Clin detect EPIC Lab London England South London Maudsley NHS Trust Child & Adolescent Mental Hlth Serv London England Kings Coll London Inst Psychiat Psychol & Neurosci Department Child & Adolescent Psychiat London England Sejong Univ Coll Software Convergence Dept Data Sci Seoul South Korea Seoul Natl Univ Dept Pediat Coll Med 50 Yonsei RoCPOB 8044 Seoul 03722 South Korea Univ Greenwich Ctr Chron Illness & Ageing London England Univ Southampton Sch Psychol Fac Environm & Life Sci Clin & Expt Sci CNS & Psy Ctr Innovat Mental Hlth Southampton Hants England Solent NHS Trust Southampton Hants England Univ Nottingham Sch Med Div Psychiat & Appl Psychol Nottingham England New York Univ Child Study Ctr Childrens Hosp NYU Langone New York NY USA Osped Regionale Bellinzona Valli Ente Osped Dept Gastroenterol Bellinzona Switzerland Natl Def Med Ctr Sch Med Tri Serv Gen Hosp Beitou Branch Taipei Taiwan Natl Def Med Ctr Inst Med Sci Taipei Taiwan Kaohsiung Vet Gen Hosp Dept Psyc

Children with autism spectrum disorder (ASD) are frequently diagnosed with co-occurring medical conditions including inflammatory bowel disease (IBD). To investigate the association, we conducted a systematic review registered in PROSPERO (ID:CRD42021236263) with a random-effects meta-analysis. We searched PubMed, Embase, and PsycInfo (last search on January 25, 2021), and manually searched relevant publications. We included observational studies measuring the association between ASD and IBD. The primary outcome was the association (odds ratio, OR) between ASD and later development of IBD. Sensitivity analyses were conducted by quality, confounding adjustment, and study design. We performed meta-regression analyses and assessed heterogeneity, publication bias, and quality of studies with the Newcastle-Ottawa Scale. Overall, we included six studies consisting of eight datasets, including over 11 million participants. We found that ASD was significantly associated with subsequent incident IBD (any IBD, OR = 1.66, 95% confidence interval[CI] = 1.25-2.21, p < 0.001;ulcerative colitis, OR = 1.91, 95%CI = 1.41-2.6, p < 0.001;Crohn's disease, OR = 1.47, 95%CI = 1.15-1.88, p = 0.002). ASD and IBD were also associated regardless of temporal sequence of diagnosis (any IBD, OR = 1.57, 95%CI = 1.28-1.93, p < 0.001;ulcerative colitis, OR = 1.7, 95%CI = 1.36-2.12, p < 0.001;Crohn's disease, OR = 1.37, 95%CI = 1.12-1.69, p = 0.003). Sensitivity analyses confirmed the findings of the main analysis. Meta-regression did not identify any significant moderators. Publication bias was not detected. Quality was high in four datasets and medium in four. In conclusion, our findings highlight the need to screen for IBD in individuals with ASD, and future research should identify who, among those with ASD, has the highest risk of IBD, and elucidate the shared biological mechanisms between ASD and IBD.

关键词： autism spectrum disorder Crohn's disease inflammatory bowel disease meta-analysis ulcerative colitis

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Environmental risk factors, protective factors, and biomarkers for postpartum depressive symptoms: an umbrella review

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NEUROSCIENCE AND BIOBEHAVIORAL REVIEWS 2022年 140卷 104761页

作者： Kim, Jae Han Kim, Jong Yeob Lee, Seul Lee, San Stubbs, Brendon Koyanagi, Ai Dragioti, Elena Jacob, Louis Carvalho, Andre F. Radua, Joaquim Thompson, Trevor Smith, Lee Oh, Hans Yang, Lin Fornaro, Michele Stickley, Andrew de Pablo, Gonzalo Salazar Tizaoui, Kalthoum Yon, Dong Keon Lee, Seung Won Hwang, Jimin Shin, Jae Il Fusar-Poli, Paolo Yonsei Univ Coll Med Seoul South Korea Yonsei Univ Coll Med Dept Psychiat Seoul South Korea Kings Coll London Inst Psychiat Psychol & Neurosci London England South London & Maudsley NHS Fdn Trust London England Anglia Ruskin Univ Fac Hlth Social Care & Educ Chelmsford Essex England Univ Barcelona Parc Sanitari St Joan de Deu CIBERSAM Fundacio St Joan de Deu Barcelona Spain ICREA Pg Lluis Co 23 Barcelona 08010 Spain Linkoping Univ Pain & Rehabil Ctr Linkoping Sweden Linkoping Univ Dept Hlth Med & Caring Sci Linkoping Sweden CIBERSAM Parc Sanitari St Joan de Diu Res & Dev Unit Dr Antoni Pujadas 42 Barcelona 08830 Spain Univ Versailles St Quentin En Yvelines Fac Med Montigny Le Bretonneux France Ctr Addict & Mental Hlth CAMH Toronto ON Canada Univ Toronto Dept Psychiat Toronto ON Canada Kings Coll London Inst Psychiat Psychol & Neurosci Dept Psychosis Studies Early Psychosis Intervent & Clin Detect EPIC Lab London England Inst Invest Biomed August Pi & Sunyer IDIBAPS Imaging Mood & Anxiety Related Disorders IMARD Gr Barcelona Spain Mental Hlth Res Networking Ctr CIBERSAM Barcelona Spain Karolinska Inst Ctr Psychiat Res Dept Clin Neurosci Stockholm Sweden Univ Greenwich Dept Psychol London England Anglia Ruskin Univ Cambridge Ctr Sport & Exercise Sci Cambridge England Univ Southern Calif Sch Social Work Los Angeles CA 90015 USA Alberta Hlth Serv Dept Canc Epidemiol & Prevent Res Calgary AB Canada Univ Calgary Cumming Sch Med Dept Oncol Calgary AB Canada Univ Calgary Cumming Sch Med Dept Community Hlth Sci Calgary AB Canada Univ Naples Federico II Dept Neurosci Reprod Sci & Dent Naples Italy Natl Ctr Neurol & Psychiat Natl Inst Mental Hlth Dept Prevent Intervent Psychiat Disorders Tokyo Japan Sodertorn Univ Stockholm Ctr Hlth & Social Change SCOHOST Huddinge Sweden Kings Coll London Inst Psychiat Psychol & Neurosci Dept Child & Adolescent Psychiat London England Univ Complutense Hosp Gen Univ Gregorio MaranonSch MedCIBERS

We performed an umbrella review on environmental risk/protective factors and biomarkers for postpartum depressive symptoms to establish a hierarchy of evidence. We systematically searched PubMed, Embase, and the Cochrane database of Systematic Reviews from inception until 12 January 2021. We included systematic reviews providing meta-analyses related to our research objectives. Methodological quality was assessed by AMSTAR 2, and the certainty of evidence was evaluated by GRADE. This review was registered in PROSPERO (CRD42021230784). We identified 30 articles, which included 45 environmental risk/protective factors (154,594 cases, 7,302,273 population) and 9 biomarkers (2018 cases, 16,757 population). The credibility of evidence was convincing (class I) for antenatal anxiety (OR 2.49, 1.91-3.25) and psychological violence (OR 1.93, 1.54-2.42);and highly suggestive (class II) for intimate partner violence experience (OR 2.86, 2.12-3.87), intimate partner violence during pregnancy (RR 2.81, 2.11-3.74), smoking during pregnancy (OR 2.39, 1.78-3.2), history of premenstrual syndrome (OR 2.2, 1.81-2.68), any type of violence experience (OR 2.04, 1.72-2.41), primiparity compared to multiparity (RR 1.76, 1.59-1.96), and unintended pregnancy (OR 1.53,

关键词： Postpartum depressive symptoms Environmental risk and protective factors Biomarkers Umbrella review

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Comparative effectiveness of N95, surgical or medical, and non-medical facemasks in protection against respiratory virus infection: A systematic review and network meta-analysis

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REVIEWS IN MEDICAL VIROLOGY 2022年第5期32卷 e2336-e2336页

作者： Kim, Min Seo Seong, Dawon Li, Han Chung, Seo Kyoung Park, Youngjoo Lee, Minho Lee, Seung Won Yon, Dong Keon Kim, Jae Han Lee, Keum Hwa Solmi, Marco Dragioti, Elena Koyanagi, Ai Jacob, Louis Kronbichler, Andreas Tizaoui, Kalthoum Cargnin, Sarah Terrazzino, Salvatore Hong, Sung Hwi Abou Ghayda, Ramy Radua, Joaquim Oh, Hans Kostev, Karel Ogino, Shuji Lee, I-Min Giovannucci, Edward Barnett, Yvonne Butler, Laurie McDermott, Daragh Ilie, Petre-Cristian Shin, Jae Il Smith, Lee Sungkyunkwan Univ Samsung Med Ctr Samsung Adv Inst Hlth Sci & Technol SAIHST Seoul South Korea Yonsei Univ Coll Med Seoul South Korea Univ Florida Coll Med Gainesville FL USA Ewha Womans Univ Coll Med Seoul South Korea Sejong Univ Dept Data Sci Coll Software Convergence Seoul South Korea Sungkyunkwan Univ Dept Precis Med Sch Med Suwon South Korea Kyung Hee Univ Med Ctr Dept Pediat Coll Med Seoul South Korea Yonsei Univ Dept Pediat Coll Med 50-1 Yonsei RoC POB 8044 Seoul 03722 South Korea Univ Ottawa Dept Psychiat Ottawa ON Canada Ottawa Hosp Dept Mental Hlth Ottawa ON Canada Univ Ottawa Clin Epidemiol Program Ottawa Hosp Res Inst OHRI Ottawa ON Canada Univ Ottawa Fac Med Sch Epidemiol & Publ Hlth Ottawa ON Canada Linkoping Univ Pain & Rehabil Ctr Linkoping Sweden Linkoping Univ Dept Hlth Med & Caring Sci Linkoping Sweden Univ Barcelona Res & Dev Unit CIBERSAM Fundacio St Joan de Deu Parc Sanitari St Joan de Deu Barcelona Spain ICREA Barcelona Spain Inst Salud Carlos III Ctr Invest Biomed Red Salud Mental CIBERSAM Madrid Spain Univ Versailles St Quentin En Yvelines Fac Med Montigny Le Bretonneux France Univ Cambridge Dept Med Cambridge England Tunis El Manar Univ Med Fac Tunis Dept Basic Sci Tunis Tunisia Univ Piemonte Orientale Interdept Res Ctr Pharmacogenet & Pharmacogen CRI Dept Pharmaceut Sci Novara Italy Yonsei Univ Hlth Syst Severance Hosp Seoul South Korea Case Western Reserve Univ Sch Med Urol Inst Univ Hosp Syst Cleveland OH USA CIBERSAM Inst Invest Biomed August Pi & Sunyer IDIBAP Mental Hlth Res Networking Ctr Barcelona Spain Kings Coll London Inst Psychiat Psychol & Neurosci Dept Psychosis Studies London England Karolinska Inst Ctr Psychiat Res Dept Clin Neurosci Stockholm Sweden Univ Southern Calif Sch Social Work Los Angeles CA USA Univ Clin Marburg Marburg Germany Dana Farber Harvard Canc Ctr Canc Immunol & Canc Epidemiol Programs Boston MA USA Harvard TH Chan Sch Publ Hlth Dept Epidemiol

The aim of this systematic review and network meta-analysis is to evaluate the comparative effectiveness of N95, surgical/medical and non-medical facemasks as personal protective equipment against respiratory virus infection. The study incorporated 35 published and unpublished randomized controlled trials and observational studies investigating specific mask effectiveness against influenza virus, SARS-CoV, MERS-CoV and SARS-CoV-2. We searched PubMed, Google Scholar and medRxiv databases for studies published up to 5 February 2021 (PROSPERO registration: CRD42020214729). The primary outcome of interest was the rate of respiratory viral infection. The quality of evidence was estimated using the GRADE approach. High compliance to mask-wearing conferred a significantly better protection (odds ratio [OR], 0.43;95% confidence interval [CI], 0.23-0.82) than low compliance. N95 or equivalent masks were the most effective in providing protection against coronavirus infections (OR, 0.30;CI, 0.20-0.44) consistently across subgroup analyses of causative viruses and clinical settings. Evidence supporting the use of medical or surgical masks against influenza or coronavirus infections (SARS, MERS and COVID-19) was weak. Our study confirmed that the use of facemasks provides protection against respiratory viral infections in general;however, the effectiveness may vary according to the type of facemask used. Our findings encourage the use of N95 respirators or their equivalents (e.g., P2) for best personal protection in healthcare settings until more evidence on surgical and medical masks is accrued. This study highlights a substantial lack of evidence on the comparative effectiveness of mask types in community settings.

关键词： coronavirus COVID-19 facemask influenza virus network meta-analysis

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Mapping 123 million neonatal, infant and child deaths between 2000 and 2017

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NATURE 2019年第7778期574卷 353-+页

作者： Burstein, Roy Henry, Nathaniel J. Collison, Michael L. Marczak, Laurie B. Sligar, Amber Watson, Stefanie Marquez, Neal Abbasalizad-Farhangi, Mahdieh Abbasi, Masoumeh Abd-Allah, Foad Abdoli, Amir Abdollahi, Mohammad Abdollahpour, Ibrahim Abdulkader, Rizwan Suliankatchi Abrigo, Michael R. M. Acharya, Dilaram Adebayo, Oladimeji M. Adekanmbi, Victor Adham, Davoud Afshari, Mahdi Aghaali, Mohammad Ahmadi, Keivan Ahmadi, Mehdi Ahmadpour, Ehsan Ahmed, Rushdia Akal, Chalachew Genet Akinyemi, Joshua O. Alahdab, Fares Alam, Noore Alamene, Genet Melak Alene, Kefyalew Addis Alijanzadeh, Mehran Alinia, Cyrus Alipour, Vahid Aljunid, Syed Mohamed Almalki, Mohammed J. Al-Mekhlafi, Hesham M. Altirkawi, Khalid Alvis-Guzman, Nelson Amegah, Adeladza Kofi Amini, Saeed Amit, Arianna Maever Loreche Anbari, Zohreh Androudi, Sofia Anjomshoa, Mina Ansari, Fereshteh Antonio, Carl Abelardo T. Arabloo, Jalal Arefi, Zohreh Aremu, Olatunde Armoon, Bahram Arora, Amit Artaman, Al Asadi, Anvar Asadi-Aliabadi, Mehran Ashraf-Ganjouei, Amir Assadi, Reza Ataeinia, Bahar Atre, Sachin R. Quintanilla, Beatriz Paulina Ayala Ayanore, Martin Amogre Azari, Samad Babaee, Ebrahim Babazadeh, Arefeh Badawi, Alaa Bagheri, Soghra Bagherzadeh, Mojtaba Baheiraei, Nafiseh Balouchi, Abbas Barac, Aleksandra Bassat, Quique Baune, Bernhard T. Bayati, Mohsen Bedi, Neeraj Beghi, Ettore Behzadifar, Masoud Behzadifar, Meysam Belay, Yared Belete Bell, Brent Bell, Michelle L. Berbada, Dessalegn Ajema Bernstein, Robert S. Bhattacharjee, Natalia V. Bhattarai, Suraj Bhutta, Zulfiqar A. Bijani, Ali Bohlouli, Somayeh Breitborde, Nicholas J. K. Britton, Gabrielle Browne, Annie J. Nagaraja, Sharath Burugina Busse, Reinhard Butt, Zahid A. Car, Josip Cardenas, Rosario Castaneda-Orjuela, Carlos A. Cerin, Ester Chanie, Wagaye Fentahun Chatterjee, Pranab Chu, Dinh-Toi Cooper, Cyrus Costa, Vera M. Dalal, Koustuv Dandona, Lalit Dandona, Rakhi Daoud, Farah Daryani, Ahmad Das Gupta, Rajat Davis, Ian Weaver, Nicole Davis Davitoiu, Dragos Virgil De Neve, Jan-Walter Demeke, Feleke Mekonnen Demoz Univ Washington Inst Hlth Metr & Evaluat Seattle WA USA Tabriz Univ Med Sci Dept Nutr Tabriz Iran Kermanshah Univ Med Sci Kermanshah Iran Cairo Univ Dept Neurol Cairo Egypt Jahrom Univ Med Sci Dept Parasitol & Mycol Jahrom Iran Univ Tehran Med Sci Inst Pharmaceut Sci Tehran Iran Univ Tehran Med Sci Multiple Sclerosis Res Ctr Tehran Iran Arak Univ Med Sci Dept Epidemiol Arak Iran Minist Hlth Dept Publ Hlth Riyadh Saudi Arabia Philippine Inst Dev Studies Res Dept Quezon City Philippines Dongguk Univ Dept Prevent Med Gyeongju South Korea Kathmandu Univ Dept Community Med Kathmandu Nepal Univ Coll Hosp Coll Med Ibadan Nigeria Cardiff Univ Sch Med Cardiff S Glam Wales Ardabil Univ Med Sci Sch Hlth Ardebil Iran Zabol Univ Med Sci Dept Community Med Zabol Iran Qom Univ Med Sci Dept Epidemiol & Biostat Qom Iran Univ Lincoln Sch Pharm Lincoln England Ahvaz Jundishapur Univ Med Sci Environm Technol Res Ctr Ahvaz Iran Tabriz Univ Med Sci Dept Parasitol & Mycol Tabriz Iran Brac Univ James P Grant Sch Publ Hlth Dhaka Bangladesh Int Ctr Diarrhoeal Dis Res Hlth Syst & Populat Studies Div Dhaka Bangladesh Bahir Dar Univ Dept Med Lab Sci Bahir Dar Ethiopia Univ Ibadan Epidemiol & Med Stat Ibadan Nigeria Mayo Clin Fdn Med Educ & Res Evidence Based Practice Ctr Rochester MN USA Queensland Hlth Prevent Div Herston Qld Australia Madda Walabu Univ Sch Hlth Sci Bale Goba Switzerland Univ Gondar Inst Publ Hlth Gondar Ethiopia Australian Natl Univ Res Sch Populat Hlth Canberra ACT Australia Qazvin Univ Med Sci Qazvin Iran Urmia Univ Med Sci Dept Hlth Care Management & Econ Orumiyeh Iran Iran Univ Med Sci Hlth Econ Dept Tehran Iran Iran Univ Med Sci Hlth Management & Econ Res Ctr Tehran Iran Kuwait Univ Dept Hlth Policy & Management Safat Kuwait Natl Univ Malaysia Int Ctr Casemix & Clin Coding Bandar Tun Razak Malaysia Jazan Univ Fac Publ Hlth & Trop Med Jazan Saudi Arabia Jazan Univ Jazan Saudi Arabia Jazan Univ Med Res Ctr Ja

Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2-to end preventable child deaths by 2030-we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000-2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations.

关键词： Developing world Paediatrics Public health

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