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Smartphone use patterns and the impact on accommodation and convergence system of the eyes among Malaysian teenagers

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International Journal of Ophthalmology(English edition) 2024年第11期17卷 2093-2099页

作者： Thilageswary Chellapan Norlaila Mat Daud Sumithira Narayanasamy Programme of Optometry and Vision Science Faculty of Health SciencesUniversiti Kebangsaan MalaysiaJalan Raja Muda Abdul Aziz 50300Kuala LumpurMalaysia

AIM:To determine the smartphone use patterns and effects of smartphone use on accommodation and convergence system of the eyes among Malaysian ***:A total of 62 participants aged between 13 and 17y were involved.A self-administered questionnaires containing 12 items was used to evaluate the smartphone usage *** was followed by an eye examination,involving a battery of accommodation and convergence assessments before and after the smartphone *** data analysis comprised descriptive statistics,paired t-test,and correlation ***:The use of smartphones is at a high level and at an optimal distance daily,with more than 6h a day watching video films,games,and completing school *** of the participants not reported eye strain factors and eye prescription changes with the use of digital *** use of a smartphone continuously for 30min was found to significantly decrease amplitude of accommodation,accommodative facility,and positive relative accommodation(P<0.001).Meanwhile,the lag of accommodation parameters and negative relative accommodation increased with the use of smartphones significantly(P<0.001).The near point of convergence(NPC)and distance and near negative fusional vergence decreased significantly(P<0.001).The NPC parameter was found to have a weak negative association with the frequency of smartphone use(R=-0.276,P<0.05).CONCLUSION:Frequent and continuous use of smartphones have increased visual stress and resulted in weakness of accommodation and vergence ***,frequent break is mandatory when using a smartphone and appropriate visual hygiene,the 20-20-20 rule(every 20min,view something 20 feet away for 20s)are required during smartphone use to maintain visual function.

关键词： smartphone use patterns accommodation and convergence visual function visual stress

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Comparison of vergence mechanisms between university students with good and poor sleep quality

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International Journal of Ophthalmology(English edition) 2024年第2期17卷 353-358页

作者： Pui Juan Woi Joyce Yi Ling Lu Mohd Izzuddin Hairol Wan Nur Amirah Ibrahim Optometry and Vision Science Programme Center for Community Health Studies(ReaCH)Faculty of Health SciencesUniversiti Kebangsaan MalaysiaKuala Lumpur 50300Malaysia Centre of Optometry Studies Faculty of Health SciencesUniversiti Teknologi MARASelangor BranchPuncak Alam CampusSelangor 42300Malaysia

AIM:To compare the vergence mechanisms between good and poor sleepers in university ***:A total of 64 university students were recruited in this *** validated Malay version of Pittsburgh Sleep Quality Index questionnaire(PSQI-M)was used to measure the participants’sleep quality over the past *** were categorized as good sleepers(n=32)and poor sleepers(n=32)based on the PSQI-M *** and fusional vergences were measured at distance and ***-Whitney U test was used to compare heterophoria,negative fusional vergence(NFV),and positive fusional vergence(PFV)at distance and near between good and poor *** correlation analysis was used to study the relationship between PSQI-M score and PFV at ***:Both distance and near heterophorias were not significantly different between good and poor sleepers(P>0.05).There was a difference in distance PFV(P<0.05)between good and poor sleepers,but not in distance NFV,near NFV,and near PFV(P>0.05).Distance PFV was negatively correlated with PSQI-M score(rs=-0.33,P<0.05).CONCLUSION:University students with poor sleep quality demonstrates a reduced ability to maintain fusion with increasing convergence demand at *** quality assessment during binocular vision examination in university students is recommended.

关键词： binocular vision vergence sleep quality university students

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Development of Knowledge,Attitude and Practice Questionnaire for age-related macular degeneration patients

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International Journal of Ophthalmology(English edition) 2023年第4期16卷 589-600页

作者： Mohd Harimi Abd Rahman Prashanti Amirtharatnam Sharanjeet Sharanjeet-Kaur Sumithira Narayanasamy Hanif Farhan Mohd Rasdi Mae-Lynn Catherine Bastion Optometry and Vision Science Programme Center for Rehabilitation and Special Needs Studies(iCaRehab)Faculty of Health SciencesUniversiti Kebangsaan MalaysiaKuala Lumpur 53000Malaysia Optometry and Vision Science Programme Center for Community Health Studies(Reach)Faculty of Health SciencesUniversity Kebangsaan MalaysiaKuala Lumpur 53000Malaysia Occupational Therapy Programme Center for Rehabilitation and Special Needs Studies(iCaRehab)Faculty of Health SciencesUniversiti Kebangsaan MalaysiaKuala Lumpur 53000Malaysia Ophthalmology Department Faculty of MedicineUniversiti Kebangsaan MalaysiaKuala Lumpur 56000Malaysia

AIM:To develop and validate a questionnaire to evaluate knowledge,attitude and practice of patients diagnosed with age-related macular degeneration(AMD)who have undergone intravitreal injection ***:This study was conducted among patients diagnosed with AMD in Kuala *** generation of the instrument included four phases which included item and domains development,content,face validity and exploratory factor *** validity and modified Kappa was used for validation of knowledge *** factor analysis was used for validation of both attitude and practice *** validity was conducted in 12 patients,content validity was ascertained in 120 patients and test-retest reliability was determined in 39 patients with ***:Content validity index(CVI)and modified kappa showed excellent values for most items in the knowledge domain with CVI for item(I-CVI)values between 0.78-1.0 and Kappa values of>*** Kaiser-MeyerOlkin(KMO)sampling adequacy showed acceptable scores of 0.70 and 0.75 for both attitude and practice domains respectively and Bartlett’s Test of sphericity were significant(χ^(2)=0.00,P<0.001).Factor analysis resulted in five factors with thirty items for attitude domain and four factors with twenty items for practice *** Cronbach’s alpha showed acceptable values for all items in knowledge,attitude and practice domain with values>0.70 and good test-retest *** final version of the questionnaire consisted of 93 items from four sections consisting of demographic details,knowledge,attitude and ***:The findings of this validation and reliability study show that the developed questionnaire has a satisfactory psychometric property for measuring KAP of patients diagnosed with AMD undergoing intravitreal injection treatment.

关键词： knowledge attitudes practice age-related macular degeneration instrument development

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Association between vision and cognitive function among community-dwelling older adults in Selangor,Malaysia

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International Journal of Ophthalmology(English edition) 2023年第1期16卷 115-120页

作者： Zainora Mohammed Qiu-Ting Kee Norliza Mohamad Fadzil Mohd Harimi Abd Rahman Normah Che Din Vanitha Mariappan Suzana Shahar Programme of Optometry and Vision Science Faculty of Health SciencesUniversiti Kebangsaan MalaysiaJalan Raja Muda Abdul Aziz 50300Kuala LumpurMalaysia Centre for Rehabilitation and Special Needs Study Faculty of Health SciencesUniversiti Kebangsaan MalaysiaJalan Raja Muda Abdul Aziz 50300Kuala LumpurMalaysia Center of Toxicology and Risk Health Faculty of Health SciencesUniversiti Kebangsaan MalaysiaJalan Raja Muda Abdul Aziz 50300Kuala LumpurMalaysia Programme of Dietetic Faculty of Health SciencesUniversiti Kebangsaan MalaysiaJalan Raja Muda Abdul Aziz 50300Kuala LumpurMalaysia.

AIM:To determine the association between distance and near visual acuity(VA)and cognitive function among older adults in Selangor,***:A total of 230 older adults(age≥60y)participated in this *** distance and near VA were measured using the Early Treatment Diabetic Retinopathy Study Chart and Lighthouse Near Visual Acuity Chart,*** cognitive function was assessed using the Mini-Mental State Examination(M-MSE)and the Malay language version of the Montreal Cognitive Assessment(M-MoCA).Digit Symbol(DS)subtest was used to measure information ***:No significant association was observed between vision and M-MSE and M-MoCA ***,poor distance and near VA were found to be significantly associated with low DS scores[distance VA:β=-0.01,R2=0.1,P=0.02;odds ratio(OR)=2.84,95%confidence interval(CI),1.10-7.33,P=0.03;near VA:β=-0.05,R2=0.08,P=0.00;OR=3.32,95%CI,1.28-8.59,P=0.01].CONCLUSION:Poor vision is associated with a decline in information processing in older adults and substantiates the importance of preserving good vision in maintaining cognitive function.

关键词： ageing cognition global cognitive function information processing vision

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Assessment of binocular vision and accommodation in myopic children wearing defocus incorporated multiple segments (DIMS) spectacle lenses for 24 months

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Journal of optometry 2025年第3期18卷 100558-100558页

作者： Yahaya, Nur Adibah Mohd-Ali, Bariah Norazman, Fatin Nur Najwa Syed Mohd Dardin, Syarifah Faiza Mohamad Shahimin, Mizhanim Mohamad Fadzil, Norliza Optometry and Vision Science Programme Center for Community Health Studies (ReaCH) Faculty of Health Sciences Universiti Kebangsaan Malaysia Jalan Raja Muda Abdul Aziz Kuala Lumpur 50300 Malaysia Optometry and Vision Science Programme Centre for Rehabilitation and Special Needs Study (iCaRehab) Faculty of Health Sciences Universiti Kebangsaan Malaysia Jalan Raja Muda Abdul Aziz Kuala Lumpur 50300 Malaysia

Purpose: This study aimed to determine the changes in binocular vision (BV) and accommodation in Malay myopic children following long-term wear of Defocus Incorporated Multiple Segments (DIMS) spectacle lenses for 24 months. Methods: Twenty-three Malay myopic children aged 7–12 years were enrolled in this prospective, self-controlled study. DIMS spectacle lenses were prescribed, and analyses were conducted at baseline, 12, and 24 months. Assessments included stereopsis, near point of convergence (NPC), phoria, positive/negative fusional vergence (PFV/NFV), amplitude of accommodation (AA), accommodative lag, positive/negative relative accommodation (PRA/NRA), and accommodative convergence to accommodation (AC/A) ratio. Visual acuity (VA), cycloplegic refraction (SER) and axial length (AL) were monitored. Data were analyzed using repeated-measures analysis of variance (ANOVA) within-subject or the Friedman test, with Bonferroni correction applied. p < 0.05 was considered statistically significant. Results: Statistically significant changes were observed after 24 months, including median changes in NPC (receded by 2 cm, p < 0.001), AA (reduced by 1.67D, p = 0.002), distance PFV break (increased by 8Δ, p = 0.026) and recovery (increased by 6Δ, p = 0.033), distance NFV break (no change, p = 0.043), stereopsis (improved by 10″, p < 0.001), accommodative lag (reduced by 0.25D, p = 0.002), and AC/A ratio (increased by 1Δ/D, p < 0.001). Additionally, distance and near VA improved (p < 0.001), while SER and AL increased (p < 0.001). Conclusion: : Wearing DIMS spectacle lenses for 24 months resulted in changes in BV and accommodation while slowing myopia progression. Regular NPC monitoring is recommended to maintain optimal BV function and visual comfort in children wearing DIMS lenses. © 2025 The Author(s)

关键词： accommodation binocular vision Defocus incorporated multiple segments (DIMS) lens long-term wear Myopia progression

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Automated Corneal Segmentation of Anterior Segment Photographed Images using Centroid-Based Active Contour Model 16

Automated Corneal Segmentation of Anterior Segment Photograp...

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16th International Learning and Technology Conference, L and T 2019

作者： Daud, Marizuana M. Diyana, W. Mimi Zaki, W. Hussain, Aini Mutalib, Haliza Md Saad, M. Hanif Razak, Aishah Centre of Integrated Systems Engineering and Advanced Technologies Faculty of Engineering and Built Environment University Kebangsaan Malaysia Bangi43600 Malaysia Optometry and Vision Sciences Programme School of Healthcare Sciences Faculty of Health Sciences University Kebangsaan Malaysia Kuala Lumpur50300 Malaysia Visual and Digital Production Effat University Jeddah21478 Saudi Arabia

In this paper, we propose an automatic Active Contour Model (ACM) using corneal centroid information for corneal segmentation. The algorithm was validated on 259 of Anterior Segment Photographed Images (ASPIs) that were captured using a smartphone. The proposed system comprises of four components;a) data collection, b) pre-processing, c) corneal segmentation using proposed automated centroid-based ACM, and (d) feature extraction. There were five corneal shape parameters employed, namely Horizontal Visible Iris Diameter (HVID), Vertical Visible Iris Diameter (VVID), eccentricity, asphericity and solidity. Each of these parameters has its own significant features in measuring the corneal shape quantitatively, which could potentially assist the ophthalmologists during a screening process. Using all ASPIs, the findings show that this method is competent in segmenting 231 corneal regions while Circular Hough Transform method only manage to segment 165 regions successfully. These segmentation results demonstrate a bright potential towards the development of intelligent classification system for ocular diseases. © 2019 The Authors. Published by Elsevier B.V.

关键词： Image segmentation

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Automated Corneal Segmentation of Anterior Segment Photographed Images using Centroid-Based Active Contour Model

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Procedia Computer Science 2019年 163卷 330-337页

作者： Marizuana M. Daud W. Mimi Diyana W. Zaki Aini Hussain Haliza Mutalib M. Hanif Md Saad Aishah Razak Centre of Integrated Systems Engineering and Advanced Technologies Faculty of Engineering and Built Environment University Kebangsaan Malaysia 43600 Bangi Malaysia Optometry and Vision Sciences Programme School of Healthcare Sciences Faculty of Health Sciences University Kebangsaan Malaysia 50300 Kuala Lumpur Malaysia Visual and Digital Production Effat University Jeddah 21478 Saudi Arabia

In this paper, we propose an automatic Active Contour Model (ACM) using corneal centroid information for corneal segmentation. The algorithm was validated on 259 of Anterior Segment Photographed Images (ASPIs) that were captured using a smartphone. The proposed system comprises of four components; a) data collection, b) pre-processing, c) corneal segmentation using proposed automated centroid-based ACM, and (d) feature extraction. There were five corneal shape parameters employed, namely Horizontal Visible Iris Diameter (HVID), Vertical Visible Iris Diameter (VVID), eccentricity, asphericity and solidity. Each of these parameters has its own significant features in measuring the corneal shape quantitatively, which could potentially assist the ophthalmologists during a screening process. Using all ASPIs, the findings show that this method is competent in segmenting 231 corneal regions while Circular Hough Transform method only manage to segment 165 regions successfully. These segmentation results demonstrate a bright potential towards the development of intelligent classification system for ocular diseases.

关键词： Corneal segmentation automated active contour model corneal features anterior segment photographed images

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International reporting guidelines for tear fluid research: A Delphi consensus

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Contact Lens and Anterior Eye 2025年 102448页

作者： Jente Schmeetz Nienke van de Sande William Rojas-Carabali Burak Mergen Clémence Bonnet Nikolay Boychev Carlos Cifuentes-González Karima Kessal Françoise Brignole-Baudouin Penny Asbell Necati Alp Kilicaslan Imre Lengyel Inmaculada Cuchillo Ibanez Rupesh Agrawal Marlies Gijs University Eye Clinic Maastricht Mental Health and Neuroscience Research Institute Maastricht University Maastricht the Netherlands National Healthcare Group Eye Institute Tan Tock Seng Hospital Singapore Singapore Programme for Ocular Inflammation & Infection Translational Research National Healthcare Group Eye Institute Singapore Colombian Visual Science and Translational Eye Research Institute (CERI) Bogotá Colombia Care Vision Freiburg Schnewlinstraße 2-10 Freiburg im Breisgau Germany University of Health Sciences Basaksehir Cam and Sakura City Hospital Department of Ophthalmology Istanbul Turkey Jules Stein Eye Institute University of California Los Angeles Los Angeles CA USA Department of Clinical Education and Clinical Sciences New England College of Optometry Boston USA Department of Ophthalmology Massachusetts Eye and Ear Harvard Medical School Schepens Eye Research Institute Boston USA Hôpital National de la Vision des 15-20 INSERM-DGOS CIC 1423 IHU FOReSIGHT Paris France Sorbonne Université INSERM CNRS Institut de la Vision Paris France Université Paris Cité Faculté de Pharmacie Analytical chemistry and Toxicology department Paris France University of Memphis Engineering Memphis TN USA Clinic for Geriatric Medicine and Early Rehabilitation Malteser Krankenhaus St. Franziskus Hospital Flensburg Germany Wellcome-Wolfson Institute for Experimental Medicine School of Medicine Dentistry and Biomedical Sciences Queen’s University Belfast Belfast UK Instituto de Neurociencias Universidad Miguel Hernández-Consejo Superior de Investigaciones Científicas (UMH-CSIC) 03550 Sant Joan d’Alacant Spain Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (Ciberned) 28029 Madrid Spain Instituto de Investigación Sanitaria y Biomédica de Alicante (Isabial) 03010 Alicante Spain Lee Kong Chian School of Medicine Nanyang Technological University of Singapore Singapore Singapore Eye Research Institute Singapore Duke NUS Medical School

Purpose Tear fluid is a valuable biomarker source for diagnostics, monitoring, and screening thanks to its minimally invasive, inexpensive, and rapid collection. However, the lack of standardized reporting has hindered reproducibility in the field. To address these challenges, this study aimed to establish international consensus-based reporting guidelines tailored to tear fluid research. Methods Using the Delphi methodology, the Tear Research Network engaged 74 international professionals to evaluate 35 proposed reporting statements. These statements covered essential aspects of tear fluid research, including terminology, collection, storage, pre-analytical processing, analysis, and data normalization. Professionals ranked their agreement on the need to include each of the statements based on a 5-point Likert scale (very unimportant – very important). Consensus was defined as ≥70 % agreement, and all ratings were collected and analyzed anonymously. Results Consensus was achieved for 34 of the 35 proposed statements in the first Delphi round, reflecting a high level of agreement among professionals, with 26 of these statements reaching strong consensus at agreement levels of 90% or higher. The resulting guidelines provide detailed recommendations to standardize reporting, improve transparency, and enhance reproducibility in tear fluid studies. Conclusions The TEAR-reporting guidelines (TEAR-RG) represent a significant step toward standardizing research practices in tear fluid studies. By addressing key methodological and reporting issues, these guidelines aim to improve the reproducibility and transparency of research in this rapidly evolving field. This work underscores the importance of standardized frameworks for advancing biomarker discovery and clinical applications in tear fluid research.

关键词： Reporting guidelines Tear fluid Biomarkers Delphi method Reproducibility Transparency

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Mapping geographical inequalities in childhood diarrhoeal morbidity and mortality in low-income and middle-income countries, 2000-17: analysis for the Global Burden of Disease Study 2017 (vol 395, pg 1779, 2020)

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LANCET 2020年第10239期395卷 1762-1762页

作者： Reiner, R. C., Jr. Hay, S., I Institute for Health Metrics and Evaluation University of Washington Seattle WA United States Department of Global Health School of Medicine University of Washington Seattle WA United States Department of Health Metrics Sciences School of Medicine University of Washington Seattle WA United States College of Health and Medical Sciences Haramaya University Harar Ethiopia Department of Epidemiology and Biostatistics Haramaya University Harar Ethiopia Department of Medical Laboratory Sciences Haramaya University Harar Ethiopia School of Nursing and Midwifery Haramaya University Harar Ethiopia School of Pharmacy Haramaya University Harar Ethiopia School of Public Health Haramaya University Harar Ethiopia Haramaya University Harar Ethiopia Advanced Diagnostic and Interventional Radiology Research Center Tehran University of Medical Sciences Tehran Iran Cancer Biology Research Center Tehran University of Medical Sciences Tehran Iran Cancer Research Institute Tehran University of Medical Sciences Tehran Iran Department of Economics and Management Sciences for Health Tehran University of Medical Sciences Tehran Iran Department of Environmental Health Engineering Tehran University of Medical Sciences Tehran Iran Department of Epidemiology and Biostatistics Tehran University of Medical Sciences Tehran Iran Department of Health Management and Economics Tehran University of Medical Sciences Tehran Iran Department of Microbiology Tehran University of Medical Sciences Tehran Iran Department of Pharmacology Tehran University of Medical Sciences Tehran Iran Digestive Diseases Research Institute Tehran University of Medical Sciences Tehran Iran Endocrinology and Metabolism Research Center Tehran University of Medical Sciences Tehran Iran Hematology-Oncology and Stem Cell Transplantation Research Center Tehran University of Medical Sciences Tehran Iran Iran National Institute of Health Research Tehran University of Medical Sciences Tehran Iran Metabolomics and

Summary Background Across low-income and middle-income countries (LMICs), one in ten deaths in children younger than 5 years is attributable to diarrhoea. The substantial between-country variation in both diarrhoea incidence and mortality is attributable to interventions that protect children, prevent infection, and treat disease. Identifying subnational regions with the highest burden and mapping associated risk factors can aid in reducing preventable childhood *** We used Bayesian model-based geostatistics and a geolocated dataset comprising 15 072 746 children younger than 5 years from 466 surveys in 94 LMICs, in combination with findings of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, to estimate posterior distributions of diarrhoea prevalence, incidence, and mortality from 2000 to 2017. From these data, we estimated the burden of diarrhoea at varying subnational levels (termed units) by spatially aggregating draws, and we investigated the drivers of subnational patterns by creating aggregated risk factor *** The greatest declines in diarrhoeal mortality were seen in south and southeast Asia and South America, where 54·0% (95% uncertainty interval [UI] 38·1-65·8), 17·4% (7·7-28·4), and 59·5% (34·2-86·9) of units, respectively, recorded decreases in deaths from diarrhoea greater than 10%. Although children in much of Africa remain at high risk of death due to diarrhoea, regions with the most deaths were outside Africa, with the highest mortality units located in Pakistan. Indonesia showed the greatest within-country geographical inequality; some regions had mortality rates nearly four times the average country rate. Reductions in mortality were correlated to improvements in water, sanitation, and hygiene (WASH) or reductions in child growth failure (CGF). Similarly, most high-risk areas had poor WASH, high CGF, or low oral rehydration therapy *** By co-analysing geospatial trends in d

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Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950–2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019

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The Lancet 2020年第10258期396卷 1160-1203页

作者： Abbafati, C. Machado, D.B. Cislaghi, B. Salman, O.M. Karanikolos, M. McKee, M. Abbas, K.M. Brady, O.J. Larson, H.J. Trias-Llimós, S. Cummins, S. Langan, S.M. Sartorius, B. Hafiz, A. Jenabi, E. Mohammad Gholi Mezerji, N. Borzouei, S. Azarian, G. Khazaei, S. Abbasi, M. Asghari, B. Masoumi, S. Komaki, H. Taherkhani, A. Adabi, M. Abbasifard, M. Bazmandegan, G. Kamiab, Z. Vakilian, A. Anjomshoa, M. Mokari, A. Sabour, S. Shahbaz, M. Saeedi, R. Ahmadieh, H. Yousefinezhadi, T. Haj-Mirzaian, A. Nikbakhsh, R. Safi, S. Asgari, S. Irvani, S.N. Jahanmehr, N. Ramezanzadeh, K. Abbasi-Kangevari, M. Khayamzadeh, M. Abbastabar, H. Shirkoohi, R. Fazlzadeh, M. Janjani, H. Hosseini, M. Mansournia, M. Tohidinik, H. Bakhtiari, A. Fazaeli, A. Mousavi, S. Hasanzadeh, A. Nabavizadeh, B. Malekzadeh, R. Hashemian, M. Pourshams, A. Salimzadeh, H. Sepanlou, S.G. Afarideh, M. Esteghamati, A. Esteghamati, S. Ghajar, A. Heidari, B. Rezaei, N. Mohamadi, E. Rahimi-Movaghar, A. Rahim, F. Eskandarieh, S. Sahraian, M. Mohebi, F. Aminorroaya, A. Ebrahimi, H. Farzadfar, F. Mohajer, B. Pishgar, F. Saeedi Moghaddam, S. Shabani, M. Zarafshan, H. Abolhassani, H. Hafezi-Nejad, N. Heidari-Soureshjani, R. Abdollahi, M. Farahmand, M. Salamati, P. Mehrabi Nasab, E. Tajdini, M. Aghamir, S. Mirzaei, R. Dibaji Forooshani, Z. Khater, M.M. Abd-Allah, F. Abdelalim, A. Abualhasan, A. El-Jaafary, S.I. Hassan, A. Elsharkawy, A. Khater, A.M. Elhabashy, H.R. Salem, M.R.R. Salem, H. Sadeghi, M. Jafarinia, M. Amini-Rarani, M. Mohammadifard, N. Sarrafzadegan, N. Abdollahpour, I. Sarveazad, A. Tehrani-Banihashemi, A. Yoosefi Lebni, J. Manafi, N. Pazoki Toroudi, H. Dorostkar, F. Alipour, V. Sheikhtaheri, A. Arabloo, J. Azari, S. Ghashghaee, A. Rezapour, A. Naserbakht, M. Kabir, A. Mehri, F. Yousefifard, M. Asadi-Aliabadi, M. Babaee, E. Eshrati, B. Goharinezhad, S. Moradi-Lakeh, M. Abedi, P. Rashedi, V. Kumar, V. Elgendy, I.Y. Basu, S. Park, J. Pereira, A. Norheim, O.F. Eagan, A.W. Cahill, L.E. Sheikh, A. Abushouk, A.I. Kraemer, M.U.G. Thakur, B. Bärnighausen, T.W. Shrime, M.G. Department of Juridical and Economic Studies La Sapienza University Rome Italy Centre for Global Mental Health (CGMH) London School of Hygiene & Tropical Medicine London United Kingdom Department of Global Health and Development London School of Hygiene & Tropical Medicine London United Kingdom Department of Health Services Research and Policy London School of Hygiene & Tropical Medicine London United Kingdom Department of Infectious Disease Epidemiology London School of Hygiene & Tropical Medicine London United Kingdom Department of Non-communicable Disease Epidemiology London School of Hygiene & Tropical Medicine London United Kingdom Department of Public Health Environments and Society London School of Hygiene & Tropical Medicine London United Kingdom European Observatory on Health Systems and Policies London School of Hygiene & Tropical Medicine London United Kingdom Faculty of Epidemiology and Population Health London School of Hygiene & Tropical Medicine London United Kingdom Faculty of Infectious and Tropical Diseases London School of Hygiene & Tropical Medicine London United Kingdom MSc Epidemiology Programme London School of Hygiene & Tropical Medicine London United Kingdom Autism Spectrum Disorders Research Center Hamadan Iran Department of Biostatistics Hamadan Iran Department of Endocrinology Hamadan Iran Department of Environmental Health Engineering Hamadan Iran Department of Epidemiology Hamadan Iran Department of Internal Medicine Hamadan Iran Department of Microbiology Hamadan Iran Department of Midwifery Hamadan Iran Neurophysiology Research Center Hamadan Iran Research Center for Molecular Medicine Hamadan Iran Hamadan University of Medical Sciences Hamadan Iran Clinical Research Development Unit Rafsanjan University of Medical Sciences Rafsanjan Iran Department of Internal Medicine Rafsanjan University of Medical Sciences Rafsanjan Iran Department of Neurology Rafsanjan University of Medical Sciences Rafsanjan Iran Department of

Background: Accurate and up-to-date assessment of demographic metrics is crucial for understanding a wide range of social, economic, and public health issues that affect populations worldwide. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 produced updated and comprehensive demographic assessments of the key indicators of fertility, mortality, migration, and population for 204 countries and territories and selected subnational locations from 1950 to 2019. Methods: 8078 country-years of vital registration and sample registration data, 938 surveys, 349 censuses, and 238 other sources were identified and used to estimate age-specific fertility. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate age-specific fertility rates for 5-year age groups between ages 15 and 49 years. With extensions to age groups 10–14 and 50–54 years, the total fertility rate (TFR) was then aggregated using the estimated age-specific fertility between ages 10 and 54 years. 7417 sources were used for under-5 mortality estimation and 7355 for adult mortality. ST-GPR was used to synthesise data sources after correction for known biases. Adult mortality was measured as the probability of death between ages 15 and 60 years based on vital registration, sample registration, and sibling histories, and was also estimated using ST-GPR. HIV-free life tables were then estimated using estimates of under-5 and adult mortality rates using a relational model life table system created for GBD, which closely tracks observed age-specific mortality rates from complete vital registration when available. Independent estimates of HIV-specific mortality generated by an epidemiological analysis of HIV prevalence surveys and antenatal clinic serosurveillance and other sources were incorporated into the estimates in countries with large epidemics. Annual and single-year age estimates of net migration and population for each country and territory were generated using a Bay

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