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Publisher's version (útgefin grein) ; 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. ; Lucas Guimaraes Abreu acknowledges support from Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior -Brasil (Capes) -Finance Code 001, Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq) and Fundacao de Amparo a Pesquisa do Estado de Minas Gerais (FAPEMIG). Olatunji O Adetokunboh acknowledges South African Department of Science & Innovation, and National Research Foundation. Anurag Agrawal acknowledges support from the Wellcome Trust DBT India Alliance Senior Fellowship IA/CPHS/14/1/501489. Rufus Olusola Akinyemi acknowledges Grant U01HG010273 from the National Institutes of Health (NIH) as part of the H3Africa Consortium. Rufus Olusola Akinyemi is further supported by the FLAIR fellowship funded by the UK Royal Society and the African Academy of Sciences. Syed Mohamed Aljunid acknowledges the Department of Health Policy and Management, Faculty of Public Health, Kuwait University and International Centre for Casemix and Clinical Coding, Faculty of Medicine, National University of Malaysia for the approval and support to participate in this research project. Marcel Ausloos, Claudiu Herteliu, and Adrian Pana acknowledge partial support by a grant of the Romanian National Authority for Scientific Research and Innovation, CNDSUEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084. Till Winfried Barnighausen acknowledges support from the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor award, funded by the German Federal Ministry of Education and Research. Juan J Carrero was supported by the Swedish Research Council (2019-01059). Felix Carvalho acknowledges UID/MULTI/04378/2019 and UID/QUI/50006/2019 support with funding from FCT/MCTES through national funds. Vera Marisa Costa acknowledges support from grant (SFRH/BHD/110001/2015), received by Portuguese national funds through Fundacao para a Ciencia e a Tecnologia (FCT), IP, under the Norma TransitA3ria DL57/2016/CP1334/CT0006. Jan-Walter De Neve acknowledges support from the Alexander von Humboldt Foundation. Kebede Deribe acknowledges support by Wellcome Trust grant number 201900/Z/16/Z as part of his International Intermediate Fellowship. Claudiu Herteliu acknowledges partial support by a grant co-funded by European Fund for Regional Development through Operational Program for Competitiveness, Project ID P_40_382. Praveen Hoogar acknowledges the Centre for Bio Cultural Studies (CBiCS), Manipal Academy of Higher Education(MAHE), Manipal and Centre for Holistic Development and Research (CHDR), Kalghatgi. Bing-Fang Hwang acknowledges support from China Medical University (CMU108-MF-95), Taichung, Taiwan. Mihajlo Jakovljevic acknowledges the Serbian part of this GBD contribution was co-funded through the Grant OI175014 of the Ministry of Education Science and Technological Development of the Republic of Serbia. Aruna M Kamath acknowledges funding from the National Institutes of Health T32 grant (T32GM086270). Srinivasa Vittal Katikireddi acknowledges funding from the Medical Research Council (MC_UU_12017/13 & MC_UU_12017/15), Scottish Government Chief Scientist Office (SPHSU13 & SPHSU15) and an NRS Senior Clinical Fellowship (SCAF/15/02). Yun Jin Kim acknowledges support from the Research Management Centre, Xiamen University Malaysia (XMUMRF/2018-C2/ITCM/0001). Kewal Krishan acknowledges support from the DST PURSE grant and UGC Center of Advanced Study (CAS II) awarded to the Department of Anthropology, Panjab University, Chandigarh, India. Manasi Kumar acknowledges support from K43 TW010716 Fogarty International Center/NIMH. Ben Lacey acknowledges support from the NIHR Oxford Biomedical Research Centre and the BHF Centre of Research Excellence, Oxford. Ivan Landires is a member of the Sistema Nacional de InvestigaciA3n (SNI), which is supported by the Secretaria Nacional de Ciencia Tecnologia e Innovacion (SENACYT), Panama. Jeffrey V Lazarus acknowledges support by a Spanish Ministry of Science, Innovation and Universities Miguel Servet grant (Instituto de Salud Carlos III/ESF, European Union [CP18/00074]). Peter T N Memiah acknowledges CODESRIA; HISTP. Subas Neupane acknowledges partial support from the Competitive State Research Financing of the Expert Responsibility area of Tampere University Hospital. Shuhei Nomura acknowledges support from the Ministry of Education, Culture, Sports, Science, and Technology of Japan (18K10082). Alberto Ortiz acknowledges support by ISCIII PI19/00815, DTS18/00032, ISCIII-RETIC REDinREN RD016/0009 Fondos FEDER, FRIAT, Comunidad de Madrid B2017/BMD-3686 CIFRA2-CM. These funding sources had no role in the writing of the manuscript or the decision to submit it for publication. George C Patton acknowledges support from a National Health & Medical Research Council Fellowship. Marina Pinheiro acknowledges support from FCT for funding through program DL 57/2016 -Norma transitA3ria. Alberto Raggi, David Sattin, and Silvia Schiavolin acknowledge support by a grant from the Italian Ministry of Health (Ricerca Corrente, Fondazione Istituto Neurologico C Besta, Linea 4 -Outcome Research: dagli Indicatori alle Raccomandazioni Cliniche). Daniel Cury Ribeiro acknowledges support from the Sir Charles Hercus Health Research Fellowship -Health Research Council of New Zealand (18/111). Perminder S Sachdev acknowledges funding from the NHMRC Australia. Abdallah M Samy acknowledges support from a fellowship from the Egyptian Fulbright Mission Program. Milena M Santric-Milicevic acknowledges support from the Ministry of Education, Science and Technological Development of the Republic of Serbia (Contract No. 175087). Rodrigo Sarmiento-Suarez acknowledges institutional support from University of Applied and Environmental Sciences in Bogota, Colombia, and Carlos III Institute of Health in Madrid, Spain. Maria Ines Schmidt acknowledges grants from the Foundation for the Support of Research of the State of Rio Grande do Sul (IATS and PrInt) and the Brazilian Ministry of Health. Sheikh Mohammed Shariful Islam acknowledges a fellowship from the National Heart Foundation of Australia and Deakin University. Aziz Sheikh acknowledges support from Health Data Research UK. Kenji Shibuya acknowledges Japan Ministry of Education, Culture, Sports, Science and Technology. Joan B Soriano acknowledges support by Centro de Investigacion en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. Rafael Tabares-Seisdedos acknowledges partial support from grant PI17/00719 from ISCIII-FEDER. Santosh Kumar Tadakamadla acknowledges support from the National Health and Medical Research Council Early Career Fellowship, Australia. Marcello Tonelli acknowledges the David Freeze Chair in Health Services Research at the University of Calgary, AB, Canada. ; "Peer Reviewed"

United States National Science Foundation (NSF) ; Science and Technology Facilities Council (STFC) of the United Kingdom ; Max-Planck-Society (MPS) ; State of Niedersachsen/Germany ; Australian Research Council ; International Science Linkages program of the Commonwealth of Australia ; Council of Scientific and Industrial Research of India ; Department of Science and Technology, India ; Science & Engineering Research Board (SERB), India ; Ministry of Human Resource Development, India ; Spanish Ministerio de Economia y Competitividad ; Conselleria d'Economia i Competitivitat and Conselleria d'Educaci, Cultura i Universitats of the Govern de les Illes Balears ; Foundation for Fundamental Research on Matter - Netherlands Organization for Scientific Research ; Polish Ministry of Science and Higher Education ; FOCUS Programme of Foundation for Polish Science ; European Union ; Royal Society ; Scottish Funding Council ; Scottish Universities Physics Alliance ; National Aeronautics and Space Administration ; Hungarian Scientific Research Fund (OTKA) ; Lyon Institute of Origins (LIO) ; National Research Foundation of Korea ; Industry Canada ; Province of Ontario through the Ministry of Economic Development and Innovation ; National Science and Engineering Research Council Canada ; Brazilian Ministry of Science, Technology, and Innovation ; Carnegie Trust ; Leverhulme Trust ; David and Lucile Packard Foundation ; Research Corporation ; Alfred P. Sloan Foundation ; NSF ; STFC ; MPS ; INFN ; CNRS ; Science and Technology Facilities Council ; Science and Technology Facilities Council: ST/L000938/1 ; Science and Technology Facilities Council: ST/I006285/1 ; Science and Technology Facilities Council: ST/I006269/1 ; Science and Technology Facilities Council: ST/L000946/1 ; Science and Technology Facilities Council: ST/L000962/1 ; Science and Technology Facilities Council: ST/L003465/1 ; Science and Technology Facilities Council: ST/K000845/1 ; Science and Technology Facilities Council: ST/J00166X/1 ; Science and Technology Facilities Council: ST/L000911/1 Gravitational Waves ; Science and Technology Facilities Council: Gravitational Waves ; Science and Technology Facilities Council: PPA/G/S/2002/00652 ; Science and Technology Facilities Council: ST/I006269/1 Gravitational Waves ; Science and Technology Facilities Council: ST/L000911/1 ; Science and Technology Facilities Council: 1362895 ; Science and Technology Facilities Council: ST/I006277/1 ; Science and Technology Facilities Council: ST/H002359/1 ; Science and Technology Facilities Council: ST/K005014/1 ; Science and Technology Facilities Council: ST/K00137X/1 ; Science and Technology Facilities Council: ST/M006735/1 ; Science and Technology Facilities Council: ST/M000931/1 ; Science and Technology Facilities Council: ST/L000938/1 Gravitational Waves ; We describe directed searches for continuous gravitational waves (GWs) in data from the sixth Laser Interferometer Gravitational-wave Observatory (LIGO) science data run. The targets were nine young supernova remnants not associated with pulsars; eight of the remnants are associated with non-pulsing suspected neutron stars. One target ' s parameters are uncertain enough to warrant two searches, for a total of 10. Each search covered a broad band of frequencies and first and second frequency derivatives for a fixed sky direction. The searches coherently integrated data from the two LIGO interferometers over time spans from 5.3-25.3 days using the matched-filtering. -statistic. We found no evidence of GW signals. We set 95% confidence upper limits as strong (low) as 4 x 10(-25) on intrinsic strain, 2 x 10(-7) on fiducial ellipticity, and 4 x 10(-5) on r-mode amplitude. These beat the indirect limits from energy conservation and are within the range of theoretical predictions for neutron-star ellipticities and r-mode amplitudes.

Background A key component of achieving universal health coverage is ensuring that all populations have access to quality health care. Examining where gains have occurred or progress has faltered across and within countries is crucial to guiding decisions and strategies for future improvement. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016. Methods Drawing from established methods and updated estimates from GBD 2016, we used 32 causes from which death should not occur in the presence of effective care to approximate personal health-care access and quality by location and over time. To better isolate potential effects of personal health-care access and quality from underlying risk factor patterns, we risk-standardised cause-specific deaths due to non-cancers by location-year, replacing the local joint exposure of environmental and behavioural risks with the global level of exposure. Supported by the expansion of cancer registry data in GBD 2016, we used mortality-to-incidence ratios for cancers instead of risk-standardised death rates to provide a stronger signal of the effects of personal health care and access on cancer survival. We transformed each cause to a scale of 0-100, with 0 as the first percentile (worst) observed between 1990 and 2016, and 100 as the 99th percentile (best); we set these thresholds at the country level, and then applied them to subnational locations. We applied a principal components analysis to construct the HAQ Index using all scaled cause values, providing an overall score of 0-100 of personal health-care access and quality by location over time. We then compared HAQ Index levels and trends by quintiles on the Socio-demographic Index (SDI), a summary measure of overall development. As derived from the broader GBD study and other data sources, we examined relationships between national HAQ Index scores and potential correlates of performance, such as total health spending per capita. Findings In 2016, HAQ Index performance spanned from a high of 97.1 (95% UI 95.8-98.1) in Iceland, followed by 96.6 (94.9-97.9) in Norway and 96.1 (94.5-97.3) in the Netherlands, to values as low as 18.6 (13.1-24.4) in the Central African Republic, 19.0 (14.3-23.7) in Somalia, and 23.4 (20.2-26.8) in Guinea-Bissau. The pace of progress achieved between 1990 and 2016 varied, with markedly faster improvements occurring between 2000 and 2016 for many countries in sub-Saharan Africa and southeast Asia, whereas several countries in Latin America and elsewhere saw progress stagnate after experiencing considerable advances in the HAQ Index between 1990 and 2000. Striking subnational disparities emerged in personal health-care access and quality, with China and India having particularly large gaps between locations with the highest and lowest scores in 2016. In China, performance ranged from 91.5 (89.1-936) in Beijing to 48.0 (43.4-53.2) in Tibet (a 43.5-point difference), while India saw a 30.8-point disparity, from 64.8 (59.6-68.8) in Goa to 34.0 (30.3-38.1) in Assam. Japan recorded the smallest range in subnational HAQ performance in 2016 (a 4.8-point difference), whereas differences between subnational locations with the highest and lowest HAQ Index values were more than two times as high for the USA and three times as high for England. State-level gaps in the HAQ Index in Mexico somewhat narrowed from 1990 to 2016 (from a 20.9-point to 17.0-point difference), whereas in Brazil, disparities slightly increased across states during this time (a 17.2-point to 20.4-point difference). Performance on the HAQ Index showed strong linkages to overall development, with high and high-middle SDI countries generally having higher scores and faster gains for non-communicable diseases. Nonetheless, countries across the development spectrum saw substantial gains in some key health service areas from 2000 to 2016, most notably vaccine-preventable diseases. Overall, national performance on the HAQ Index was positively associated with higher levels of total health spending per capita, as well as health systems inputs, but these relationships were quite heterogeneous, particularly among low-to-middle SDI countries. Interpretation GBD 2016 provides a more detailed understanding of past success and current challenges in improving personal health-care access and quality worldwide. Despite substantial gains since 2000, many low-SDI and middle-SDI countries face considerable challenges unless heightened policy action and investments focus on advancing access to and quality of health care across key health services, especially non-communicable diseases. Stagnating or minimal improvements experienced by several low-middle to high-middle SDI countries could reflect the complexities of re-orienting both primary and secondary health-care services beyond the more limited foci of the Millennium Development Goals. Alongside initiatives to strengthen public health programmes, the pursuit of universal health coverage upon improving both access and quality worldwide, and thus requires adopting a more comprehensive view and subsequent provision of quality health care for all populations. ; Bill & Melinda Gates Foundation. Barbora de Courten is supported by a National Heart Foundation Future Leader Fellowship (100864). Ai Koyanagi's work is supported by the Miguel Servet contract financed by the CP13/00150 and PI15/00862 projects, integrated into the National R + D + I and funded by the ISCIII —General Branch Evaluation and Promotion of Health Research—and the European Regional Development Fund (ERDF-FEDER). Alberto Ortiz was supported by Spanish Government (Instituto de Salud Carlos III RETIC REDINREN RD16/0019 FEDER funds). Ashish Awasthi acknowledges funding support from Department of Science and Technology, Government of India through INSPIRE Faculty scheme Boris Bikbov has received funding from the European Union's Horizon 2020 research and innovation programme under Marie Sklodowska-Curie grant agreement No. 703226. Boris Bikbov acknowledges that work related to this paper has been done on the behalf of the GBD Genitourinary Disease Expert Group. Panniyammakal Jeemon acknowledges support from the clinical and public health intermediate fellowship from the Wellcome Trust and Department of Biotechnology, India Alliance (2015–20). Job F M van Boven was supported by the Department of Clinical Pharmacy & Pharmacology of the University Medical Center Groningen, University of Groningen, Netherlands. Olanrewaju Oladimeji is an African Research Fellow hosted by Human Sciences Research Council (HSRC), South Africa and he also has honorary affiliations with Walter Sisulu University (WSU), Eastern Cape, South Africa and School of Public Health, University of Namibia (UNAM), Namibia. He is indeed grateful for support from HSRC, WSU and UNAM. EUI is supported in part by the South African National Research Foundation (NRF UID: 86003). Ulrich Mueller acknowledges funding by the German National Cohort Study grant No 01ER1511/D, Gabrielle B Britton is supported by Secretaría Nacional de Ciencia, Tecnología e Innovación and Sistema Nacional de Investigación de Panamá. Giuseppe Remuzzi acknowledges that the work related to this paper has been done on behalf of the GBD Genitourinary Disease Expert Group. Behzad Heibati would like to acknowledge Air pollution Research Center, Iran University of Medical Sciences (IUMS), Tehran, Iran. Syed Aljunid acknowledges the National University of Malaysia for providing the approval to participate in this GBD Project. Azeem Majeed and Imperial College London are grateful for support from the Northwest London National Insititute of Health Research (NIHR) Collaboration for Leadership in Applied Health Research & Care. Tambe Ayuk acknowledges the Institute of Medical Research and Medicinal Plant Studies for office space provided. José das Neves was supported in his contribution to this work by a Fellowship from Fundação para a Ciência e a Tecnologia, Portugal (SFRH/BPD/92934/2013). João Fernandes gratefully acknowledges funding from FCT–Fundação para a Ciência e a Tecnologia (grant number UID/Multi/50016/2013). Jan-Walter De Neve was supported by the Alexander von Humboldt Foundation. Kebede Deribe is funded by a Wellcome Trust Intermediate Fellowship in Public Health and Tropical Medicine (201900). Kazem Rahimi was supported by grants from the Oxford Martin School, the NIHR Oxford BRC and the RCUK Global Challenges Research Fund. Laith J Abu-Raddad acknowledges the support of Qatar National Research Fund (NPRP 9-040-3-008) who provided the main funding for generating the data provided to the GBD-IHME effort. Liesl Zuhlke is funded by the national research foundation of South Africa and the Medical Research Council of South Africa. Monica Cortinovis acknowledges that work related to this paper has been done on the behalf of the GBD Genitourinary Disease Expert Group. Chuanhua Yu acknowleges support from the National Natural Science Foundation of China (grant number 81773552 and grant number 81273179) Norberto Perico acknowledges that work related to this paper has been done on behalf of the GBD Genitourinary Disease Expert Group. Charles Shey Wiysonge's work is supported by the South African Medical Research Council and the National Research Foundation of South Africa (grant numbers 106035 and 108571). John J McGrath is supported by grant APP1056929 from the John Cade Fellowship from the National Health and Medical Research Council and the Danish National Research Foundation (Niels Bohr Professorship). Quique Bassat is an ICREA (Catalan Institution for Research and Advanced Studies) research professor at ISGlobal. Richard G White is funded by the UK MRC and the UK Department for International Development (DFID) under the MRC/DFID Concordat agreement that is also part of the EDCTP2 programme supported by the European Union (MR/P002404/1), the Bill & Melinda Gates Foundation (TB Modelling and Analysis Consortium: OPP1084276/OPP1135288, CORTIS: OPP1137034/OPP1151915, Vaccines: OPP1160830), and UNITAID (4214-LSHTM-Sept15; PO 8477-0-600). Rafael Tabarés-Seisdedos was supported in part by grant number PROMETEOII/2015/021 from Generalitat Valenciana and the national grant PI17/00719 from ISCIII-FEDER. Mihajlo Jakovljevic acknowleges contribution from the Serbian Ministry of Education Science and Technological Development of the Republic of Serbia (grant OI 175 014). Shariful Islam is funded by a Senior Fellowship from Institute for Physical Activity and Nutrition, Deakin University and received career transition grants from High Blood Pressure Research Council of Australia. Sonia Saxena is funded by various grants from the NIHR. Stefanos Tyrovolas was supported by the Foundation for Education and European Culture, the Sara Borrell postdoctoral program (reference number CD15/00019 from the Instituto de Salud Carlos III (ISCIII–Spain) and the Fondos Europeo de Desarrollo Regional. Stefanos was awarded with a 6 months visiting fellowship funding at IHME from M-AES (reference no. MV16/00035 from the Instituto de Salud Carlos III). S Vittal Katikreddi was funded by a NHS Research Scotland Senior Clinical Fellowship (SCAF/15/02), the MRC (MC_UU_12017/13 & MC_ UU_12017/15) and the Scottish Government Chief Scientist Office (SPHSU13 & SPHSU15). Traolach S Brugha has received funding from NHS Digital UK to collect data used in this study. The work of Hamid Badali was financially supported by Mazandaran University of Medical Sciences, Sari, Iran. The work of Stefan Lorkowski is funded by the German Federal Ministry of Education and Research (nutriCARD, Grant agreement number 01EA1411A). Mariam Molokhia's research was supported by the National Institute for Health Research (NIHR) Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College London. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. We also thank the countless individuals who have contributed to GBD 2016 in various capacities. ; Peer reviewed

United States National Science Foundation (NSF) ; Science and Technology Facilities Council (STFC) of the United Kingdom ; Max-Planck-Society (MPS) ; State of Niedersachsen/Germany ; Italian Istituto Nazionale di Fisica Nucleare (INFN) ; French Centre National de la Recherche Scientifique (CNRS) ; Australian Research Council ; International Science Linkages program of the Commonwealth of Australia ; Council of Scientific and Industrial Research of India ; Department of Science and Technology, India ; Science & Engineering Research Board (SERB), India ; Ministry of Human Resource Development, India ; Spanish Ministerio de Economia y Competitividad ; Conselleria d'Economia i Competitivitat and Conselleria d'Educaci, Cultura i Universitats of the Govern de les Illes Balears ; Netherlands Organisation for Scientific Research ; National Science Centre of Poland ; European Union ; Royal Society ; Scottish Funding Council ; Scottish Universities Physics Alliance ; National Aeronautics and Space Administration ; Hungarian Scientific Research Fund (OTKA) ; Lyon Institute of Origins (LIO) ; National Research Foundation of Korea ; Industry Canada ; Province of Ontario through the Ministry of Economic Development and Innovation ; Natural Science and Engineering Research Council, Canada ; Brazilian Ministry of Science, Technology, and Innovation ; Carnegie Trust ; Leverhulme Trust ; David and Lucile Packard Foundation ; Research Corporation ; Alfred P. Sloan Foundation ; NSF ; STFC ; MPS ; INFN ; CNRS ; Science and Technology Facilities Council ; Science and Technology Facilities Council: ST/L000938/1 Gravitational Waves ; Science and Technology Facilities Council: 1362895 ; Science and Technology Facilities Council: ST/L000962/1 ; Science and Technology Facilities Council: ST/I006285/1 Gravitational Waves ; Science and Technology Facilities Council: ST/L003465/1 ; Science and Technology Facilities Council: ST/L000962/1 Gravitational Waves ; Science and Technology Facilities Council: ST/I006285/1 ; Science and Technology Facilities Council: ST/I006242/1 Gravitational Waves ; Science and Technology Facilities Council: ST/J000019/1 ; Science and Technology Facilities Council: ST/N00003X/1 ; Science and Technology Facilities Council: ST/L000946/1 ; Science and Technology Facilities Council: ST/N000064/1 ; Science and Technology Facilities Council: ST/L000954/1 Gravitational Waves ; Science and Technology Facilities Council: ST/K000845/1 ; Science and Technology Facilities Council: ST/I006269/1 ; Science and Technology Facilities Council: ST/L000938/1 ; Science and Technology Facilities Council: Gravitational Waves ; Science and Technology Facilities Council: ST/K005014/1 ; Science and Technology Facilities Council: ST/I006269/1 Gravitational Waves ; We present the results of a search for long-duration gravitational wave transients in two sets of data collected by the LIGO Hanford and LIGO Livingston detectors between November 5, 2005 and September 30, 2007, and July 7, 2009 and October 20, 2010, with a total observational time of 283.0 days and 132.9 days, respectively. The search targets gravitational wave transients of duration 10-500 s in a frequency band of 40-1000 Hz, with minimal assumptions about the signal waveform, polarization, source direction, or time of occurrence. All candidate triggers were consistent with the expected background; as a result we set 90% confidence upper limits on the rate of long-duration gravitational wave transients for different types of gravitational wave signals. For signals from black hole accretion disk instabilities, we set upper limits on the source rate density between 3.4 x 10(-5) and 9.4 x 10(-4) Mpc(-3) yr(-1) at 90% confidence. These are the first results from an all-sky search for unmodeled long-duration transient gravitational waves.

Advanced LIGO ; Science and Technology Facilities Council (STFC) of the United Kingdom ; Australian Research Council ; Council of Scientific and Industrial Research of India, Department of Science and Technology, India ; Science & Engineering Research Board (SERB), India ; Ministry of Human Resource Development, India ; Spanish Ministerio de Economia y Competitividad ; Conselleria d'Economia i Competitivitat and Conselleria d'Educacio, Cultura i Universitats of the Govern de les Illes Balears ; National Science Centre of Poland ; FOCUS Programme of Foundation for Polish Science ; European Union ; Royal Society ; Scottish Funding Council ; Scottish Universities Physics Alliance ; Lyon Institute of Origins (LIO) ; National Research Foundation of Korea ; Industry Canada ; Province of Ontario through the Ministry of Economic Development and Innovation ; National Science and Engineering Research Council Canada ; Brazilian Ministry of Science, Technology, and Innovation ; Research Corporation, Ministry of Science and Technology (MOST), Taiwan ; Kavli Foundation ; Science and Technology Facilities Council ; Science and Technology Facilities Council: ST/L000954/1 Gravitational Waves ; Science and Technology Facilities Council: ST/L000946/1 ; Science and Technology Facilities Council: ST/I006269/1 Gravitational Waves ; Science and Technology Facilities Council: ST/I006242/1 Gravitational Waves ; Science and Technology Facilities Council: ST/L003465/1 ; Science and Technology Facilities Council: ST/J000019/1 ; Science and Technology Facilities Council: ST/N000072/1 ; Science and Technology Facilities Council: ST/K000845/1 ; Science and Technology Facilities Council: ST/I006269/1 ; Science and Technology Facilities Council: ST/N000633/1 ; Science and Technology Facilities Council: ST/M000931/1 ; Science and Technology Facilities Council: ST/K005014/1 ; Science and Technology Facilities Council: PPA/G/S/2002/00652 ; Science and Technology Facilities Council: Gravitational Waves ; Science and Technology Facilities Council: ST/N00003X/1 ; We present a possible observing scenario for the Advanced LIGO and Advanced Virgo gravitational-wave detectors over the next decade, with the intention of providing information to the astronomy community to facilitate planning for multi-messenger astronomy with gravitational waves. We determine the expected sensitivity of the network to transient gravitational-wave signals, and study the capability of the network to determine the sky location of the source. We report our findings for gravitational-wave transients, with particular focus on gravitational-wave signals from the inspiral of binary neutron-star systems, which are considered the most promising for multi-messenger astronomy. The ability to localize the sources of the detected signals depends on the geographical distribution of the detectors and their relative sensitivity, and 90% credible regions can be as large as thousands of square degrees when only two sensitive detectors are operational. Determining the sky position of a significant fraction of detected signals to areas of 5 deg(2) to 20 deg(2) will require at least three detectors of sensitivity within a factor of similar to 2 of each other and with a broad frequency bandwidth. Should the third LIGO detector be relocated to India as expected, a significant fraction of gravitational-wave signals will be localized to a few square degrees by gravitational-wave observations alone.

Australian Research Council ; International Science Linkages program of the Commonwealth of Australia ; Council of Scientific and Industrial Research of India, Department of Science and Technology, India ; Science and Engineering Research Board, India ; Ministry of Human Resource Development, India ; Spanish Ministerio de Economia y Competitividad ; Conselleria d'Economia i Competitivitat ; Cultura i Universitats of the Govern de les Illes Balears ; Foundation for Fundamental Research on Matter - Netherlands Organisation for Scientific Research ; National Science Centre of Poland ; European Union ; Royal Society ; Scottish Funding Council ; Scottish Universities Physics Alliance ; National Aeronautics and Space Administration ; Hungarian Scientific Research Fund ; Lyon Institute of Origins ; National Research Foundation of Korea ; Industry Canada ; Province of Ontario through the Ministry of Economic Development and Innovation ; National Science and Engineering Research Council Canada ; Brazilian Ministry of Science, Technology, and Innovation ; Carnegie Trust ; Leverhulme Trust ; David and Lucile Packard Foundation ; Research Corporation ; Alfred P. Sloan Foundation ; Conselleria d'Educacio ; Science and Technology Facilities Council ; Science and Technology Facilities Council: ST/L000962/1 Gravitational Waves ; Science and Technology Facilities Council: 1362895 ; Science and Technology Facilities Council: ST/I006285/1 Gravitational Waves ; Science and Technology Facilities Council: ST/L000938/1 Gravitational Waves ; Science and Technology Facilities Council: ST/L000962/1 ; Science and Technology Facilities Council: ST/K000845/1 ; Science and Technology Facilities Council: Gravitational Waves ; Science and Technology Facilities Council: ST/K005014/1 ; Science and Technology Facilities Council: ST/L003465/1 ; Science and Technology Facilities Council: ST/L000938/1 ; Science and Technology Facilities Council: ST/N000064/1 ; Science and Technology Facilities Council: ST/L000946/1 ; Science and Technology Facilities Council: ST/L000954/1 Gravitational Waves ; Science and Technology Facilities Council: ST/I006269/1 Gravitational Waves ; Science and Technology Facilities Council: ST/I006269/1 ; Science and Technology Facilities Council: ST/J000019/1 ; Science and Technology Facilities Council: ST/I006242/1 Gravitational Waves ; In this paper we present the results of the first low frequency all-sky search of continuous gravitational wave signals conducted on Virgo VSR2 and VSR4 data. The search covered the full sky, a frequency range between 20 and 128 Hz with a range of spin-down between -1.0 x 10(-10) and +1.5 x 10(-11) Hz/s, and was based on a hierarchical approach. The starting point was a set of short fast Fourier transforms, of length 8192 s, built from the calibrated strain data. Aggressive data cleaning, in both the time and frequency domains, has been done in order to remove, as much as possible, the effect of disturbances of instrumental origin. On each data set a number of candidates has been selected, using the Frequency Hough transform in an incoherent step. Only coincident candidates among VSR2 and VSR4 have been examined in order to strongly reduce the false alarm probability, and the most significant candidates have been selected. The criteria we have used for candidate selection and for the coincidence step greatly reduce the harmful effect of large instrumental artifacts. Selected candidates have been subject to a follow-up by constructing a new set of longer fast Fourier transforms followed by a further incoherent analysis, still based on the Frequency Hough transform. No evidence for continuous gravitational wave signals was found, and therefore we have set a population-based joint VSR2-VSR4 90% confidence level upper limit on the dimensionless gravitational wave strain in the frequency range between 20 and 128 Hz. This is the first all-sky search for continuous gravitational waves conducted, on data of ground-based interferometric detectors, at frequencies below 50 Hz. We set upper limits in the range between about 10(-24) and 2 x 10(-23) at most frequencies. Our upper limits on signal strain show an improvement of up to a factor of similar to 2 with respect to the results of previous all-sky searches at frequencies below 80 Hz.

United States National Science Foundation (NSF) ; Science and Technology Facilities Council (STFC) of the United Kingdom ; MaxPlanck- Society (MPS) ; State of Niedersachsen/Germany ; Australian Research Council ; Netherlands Organisation for Scientific Research ; EGO consortium ; Council of Scientific and Industrial Research of India, Department of Science and Technology, India ; Science AMP; Engineering Research Board (SERB), India ; Ministry of Human Resource Development, India ; Spanish Ministerio de Economia y Competitividad ; Conselleria d'Economia i Competitivitat and Conselleria d'Educacio Cultura i Universitats of the Govern de les Illes Balears ; National Science Centre of Poland ; European Union ; Royal Society ; Scottish Funding Council ; Scottish Universities Physics Alliance ; Lyon Institute of Origins (LIO) ; National Research Foundation of Korea, Industry Canada ; Province of Ontario through the Ministry of Economic Development and Innovation ; National Science and Engineering Research Council Canada ; Brazilian Ministry of Science, Technology, and Innovation ; Leverhulme Trust ; Research Corporation, Ministry of Science and Technology (MOST), Taiwan ; Kavli Foundation ; NSF ; STFC ; MPS ; INFN ; CNRS ; Science and Technology Facilities Council ; State of Niedersachsen/Germany: GEO600 ; Science and Technology Facilities Council: ST/K005014/1 ; Science and Technology Facilities Council: ST/L000938/1 Gravitational Waves ; Science and Technology Facilities Council: ST/N000072/1 ; Science and Technology Facilities Council: PPA/G/S/2002/00652 ; Science and Technology Facilities Council: ST/I006269/1 ; Science and Technology Facilities Council: ST/L000962/1 ; Science and Technology Facilities Council: ST/J00166X/1 ; Science and Technology Facilities Council: ST/M006735/1 ; Science and Technology Facilities Council: ST/I006285/1 Gravitational Waves ; Science and Technology Facilities Council: ST/J000019/1 Gravitational Waves ; Science and Technology Facilities Council: ST/I006285/1 ; Science and Technology Facilities Council: ST/J000019/1 ; Science and Technology Facilities Council: 1362895 ; Science and Technology Facilities Council: ST/M000931/1 ; Science and Technology Facilities Council: ST/L000962/1 Gravitational Waves ; Science and Technology Facilities Council: ST/L000938/1 ; Science and Technology Facilities Council: ST/K000845/1 ; Science and Technology Facilities Council: ST/I006242/1 Gravitational Waves ; Science and Technology Facilities Council: ST/L003465/1 ; Science and Technology Facilities Council: ST/G504284/1 ; Science and Technology Facilities Council: ST/I006269/1 Gravitational Waves ; Science and Technology Facilities Council: ST/L000954/1 Gravitational Waves ; Science and Technology Facilities Council: ST/N00003X/1 ; Science and Technology Facilities Council: Gravitational Waves ; Science and Technology Facilities Council: ST/N000633/1 ; Science and Technology Facilities Council: ST/L000946/1 ; The discovery of the gravitational-wave (GW) source GW150914 with the Advanced LIGO detectors provides the first observational evidence for the existence of binary black hole (BH) systems that inspiral and merge within the age of the universe. Such BH mergers have been predicted in two main types of formation models, involving isolated binaries in galactic fields or dynamical interactions in young and old dense stellar environments. The measured masses robustly demonstrate that relatively heavy BHs (greater than or similar to 25M(circle dot)) can form in nature. This discovery implies relatively weak massive-star winds and thus the formation of GW150914 in an environment with a metallicity lower than about 1/2 of the solar value. The rate of binary-BH (BBH) mergers inferred from the observation of GW150914 is consistent with the higher end of rate predictions (greater than or similar to 1 Gpc(-3) yr(-1)) from both types of formation models. The low measured redshift (z similar or equal to 0.1) of GW150914 and the low inferred metallicity of the stellar progenitor imply either BBH formation in a low-mass galaxy in the local universe and a prompt merger, or formation at high redshift with a time delay between formation and merger of several Gyr. This discovery motivates further studies of binary-BH formation astrophysics. It also has implications for future detections and studies by Advanced LIGO and Advanced Virgo, and GW detectors in space.