The global burden of injury: Incidence, mortality, disability-adjusted life years and time trends from the Global Burden of Disease study 2013

Background The Global Burden of Diseases (GBD), Injuries, and Risk Factors study used the disability-adjusted life year (DALY) to quantify the burden of diseases, injuries, and risk factors. This paper provides an overview of injury estimates from the 2013 update of GBD, with detailed information on incidence, mortality, DALYs and rates of change from 1990 to 2013 for 26 causes of injury, globally, by region and by country. Methods Injury mortality was estimated using the extensive GBD mortality database, corrections for ill-defined cause of death and the cause of death ensemble modelling tool. Morbidity estimation was based on inpatient and outpatient data sets, 26 cause-of-injury and 47 nature-of-injury categories, and seven follow-up studies with patient-reported long-term outcome measures. Results In 2013, 973 million (uncertainty interval (UI) 942 to 993) people sustained injuries that warranted some type of healthcare and 4.8 million (UI 4.5 to 5.1) people died from injuries. Between 1990 and 2013 the global age-standardised injury DALY rate decreased by 31% (UI 26% to 35%). The rate of decline in DALY rates was significant for 22 cause-of-injury categories, including all the major injuries. Conclusions Injuries continue to be an important cause of morbidity and mortality in the developed and developing world. The decline in rates for almost all injuries is so prominent that it warrants a general statement that the world is becoming a safer place to live in. However, the patterns vary widely by cause, age, sex, region and time and there are still large improvements that need to be made.

ERAP2 functional knockout in humans does not alter surface heavy chains or HLA-B27, inflammatory cytokines or endoplasmic reticulum stress markers

Introduction Single nucleotide polymorphisms in ERAP2 are strongly associated with ankylosing spondylitis (AS). One AS-associated single nucleotide polymorphism, rs2248374, causes a truncated ERAP2 protein that is degraded by nonsense-mediated decay. Approximately 25% of the populations of European ancestry are therefore natural ERAP2 knockouts. We investigated the effect of this associated variant on HLA class I allele presentation, surface heavy chains, endoplasmic reticulum (ER) stress markers and cytokine gene transcription in AS. Methods Patients with AS and healthy controls with either AA or GG homozygous status for rs2248374 were studied. Antibodies to CD14, CD19-ECD, HLA-A-B-C, Valpha7.2, CD161, anti-HC10 and anti-HLA-B27 were used to analyse peripheral blood mononuclear cells. Expression levels of ER stress markers (GRP78 and CHOP) and proinflammatory genes (tumour necrosis factor (TNF), IL6, IL17 and IL22) were assessed by qPCR. Results There was no significant difference in HLAclass I allele presentation or major histocompatibility class I heavy chains or ER stress markers GRP78 and CHOP or proinflammatory gene expression between genotypes for rs2248374 either between cases, between cases and controls, and between controls. Discussion Large differences were not seen in HLAB27 expression or cytokine levels between subjects with and without ERAP2 in AS cases and controls. This suggests that ERAP2 is more likely to influence AS risk through other mechanisms.

Prevalence of foot disease and risk factors in general inpatient populations: A systematic review and meta-analysis

Objective: To systematically review studies reporting the prevalence in general adult inpatient populations of foot disease disorders (foot wounds, foot infections, collective ‘foot disease’) and risk factors (peripheral arterial disease (PAD), peripheral neuropathy (PN), foot deformity). Methods: A systematic review of studies published between 1980 and 2013 was undertaken using electronic databases (MEDLINE, EMBASE and CINAHL). Keywords and synonyms relating to prevalence, inpatients, foot disease disorders and risk factors were used. Studies reporting foot disease or risk factor prevalence data in general inpatient populations were included. Included study's reference lists and citations were searched and experts consulted to identify additional relevant studies. 2 authors, blinded to each other, assessed the methodological quality of included studies. Applicable data were extracted by 1 author and checked by a second author. Prevalence proportions and SEs were calculated for all included studies. Pooled prevalence estimates were calculated using random-effects models where 3 eligible studies were available. Results: Of the 4972 studies initially identified, 78 studies reporting 84 different cohorts (total 60 231 517 participants) were included. Foot disease prevalence included: foot wounds 0.01–13.5% (70 cohorts), foot infections 0.05–6.4% (7 cohorts), collective foot disease 0.2–11.9% (12 cohorts). Risk factor prevalence included: PAD 0.01–36.0% (10 cohorts), PN 0.003–2.8% (6 cohorts), foot deformity was not reported. Pooled prevalence estimates were only able to be calculated for pressure ulcer-related foot wounds 4.6% (95% CI 3.7% to 5.4%)), diabetes-related foot wounds 2.4% (1.5% to 3.4%), diabetes-related foot infections 3.4% (0.2% to 6.5%), diabetes-related foot disease 4.7% (0.3% to 9.2%). Heterogeneity was high in all pooled estimates (I2=94.2–97.8%, p<0.001). Conclusions: This review found high heterogeneity, yet suggests foot disease was present in 1 in every 20 inpatients and a major risk factor in 1 in 3 inpatients. These findings are likely an underestimate and more robust studies are required to provide more precise estimates.

IMPOSE (IMProving Outcomes after Sepsis)—the effect of a multidisciplinary follow-up service on health-related quality of life in patients postsepsis syndromes—a double-blinded randomised controlled trial: protocol

Introduction Patients post sepsis syndromes have a poor quality of life and a high rate of recurring illness or mortality. Follow-up clinics have been instituted for patients postgeneral intensive care but evidence is sparse, and there has been no clinic specifically for survivors of sepsis. The aim of this trial is to investigate if targeted screening and appropriate intervention to these patients can result in an improved quality of life (Short Form 36 health survey (SF36V.2)), decreased mortality in the first 12 months, decreased readmission to hospital and/or decreased use of health resources. Methods and analysis 204 patients postsepsis syndromes will be randomised to one of the two groups. The intervention group will attend an outpatient clinic two monthly for 6 months and receive screening and targeted intervention. The usual care group will remain under the care of their physician. To analyse the results, a baseline comparison will be carried out between each group. Generalised estimating equations will compare the SF36 domain scores between groups and across time points. Mortality will be compared between groups using a Cox proportional hazards (time until death) analysis. Time to first readmission will be compared between groups by a survival analysis. Healthcare costs will be compared between groups using a generalised linear model. Economic (health resource) evaluation will be a within-trial incremental cost utility analysis with a societal perspective. Ethics and dissemination Ethical approval has been granted by the Royal Brisbane and Women’s Hospital Human Research Ethics Committee (HREC; HREC/13/QRBW/17), The University of Queensland HREC (2013000543), Griffith University (RHS/08/14/HREC) and the Australian Government Department of Health (26/2013). The results of this study will be submitted to peer-reviewed intensive care journals and presented at national and international intensive care and/or rehabilitation conferences.

Fidgeting is associated with lower mortality risk

Context Evidence from prospective cohort studies has suggested that high volumes of reported daily sitting time is associated with mortality.1 ,2 However, not all have observed the same association.3 Fidgeting (small movements associated with nervousness or impatience), could provide additional energy expenditure when sitting, although the relationship with sitting and health outcomes had yet to be examined. Hagger-Johnson et al examined data from nearly 13 000 women to determine whether fidgeting modified the association between sitting time and mortality. Methods This study featured prospective data from 12 778 participants (aged 37–78 years) in the Women's Cohort Study (UK). Average daily sitting time was reported for weekdays and weekend days, and combined …

Novel application of a discrete choice experiment to identify preferences for a national healthcare-associated infection surveillance programme: A cross-sectional study

Objective: To identify key stakeholder preferences and priorities when considering a national healthcare-associated infection (HAI) surveillance programme through the use of a discrete choice experiment (DCE). Setting: Australia does not have a national HAI surveillance programme. An online web-based DCE was developed and made available to participants in Australia. Participants: A sample of 184 purposively selected healthcare workers based on their senior leadership role in infection prevention in Australia. Primary and secondary outcomes: A DCE requiring respondents to select 1 HAI surveillance programme over another based on 5 different characteristics (or attributes) in repeated hypothetical scenarios. Data were analysed using a mixed logit model to evaluate preferences and identify the relative importance of each attribute. Results: A total of 122 participants completed the survey (response rate 66%) over a 5-week period. Excluding 22 who mismatched a duplicate choice scenario, analysis was conducted on 100 responses. The key findings included: 72% of stakeholders exhibited a preference for a surveillance programme with continuous mandatory core components (mean coefficient 0.640 (p<0.01)), 65% for a standard surveillance protocol where patient-level data are collected on infected and non-infected patients (mean coefficient 0.641 (p<0.01)), and 92% for hospital-level data that are publicly reported on a website and not associated with financial penalties (mean coefficient 1.663 (p<0.01)). Conclusions: The use of the DCE has provided a unique insight to key stakeholder priorities when considering a national HAI surveillance programme. The application of a DCE offers a meaningful method to explore and quantify preferences in this setting.

Investigations on Bi2CuO4: a quasi-one-dimensional oxide system

The potential of Bi2CuO4 as the first oxide system to show a linear-chain magnetic behaviour is examined. Electron diffraction studies do not resolve the previously reported ambiguity regarding its space group. The magnetic susceptibility data at high temperatures are best fitted to a uniform antiferromagnetic spin-1/2 Heisenberg chain. At low temperatures, however, neither the uniform nor the alternating Heisenberg antiferromagnetic model fits the data. Magnetic susceptibility data over the entire temperature range can be fitted if one assumes dimeric units with a nearly degenerate second singlet state close to the ground state, these states being separated from an excited triplet state by an energy gap. A simple heuristic model of a dimer that gives such an energy level spectrum is examined.

Multilevel Dodecagonal Voltage Space Vector Generation using Flying Capacitor topology for Induction motor drives

In this paper, a multilevel flying capacitor inverter topology suitable for generating multilevel dodecagonal space vectors for an induction motor drive, is proposed. Because of the dodecagonal space vectors, it has increased modulation range with the absence of all 6n +/- 1, (n=odd) harmonics in the phase voltage and currents. The topology, realized by flying capacitor three level inverters feeding an open-end winding induction motor, does not suffer the neutral point voltage imbalance issues seen in NPC inverters and the capacitors have inherent charge-balancing capability with PWM control using switching state redundancies. Furthermore, the proposed technique uses lesser number of power supplies compared to cascaded H-bridge or NPC based dodecagonal schemes and has better ride-through capability. Finally, the voltage control is obtained through a simple carrier-based space vector PWM scheme implemented on a DSP.

Network, nodes and nexus: systems approach to multitarget therapeutics

Systems biology is revealing multiple layers of regulatory networks that manifest spatiotemporal variations. Since genes and environment also influence the emergent property of a cell, the biological output requires dynamic understanding of various molecular circuitries. The metabolic networks continually adapt and evolve to cope with the changing milieu of the system, which could also include infection by another organism. Such perturbations of the functional networks can result in disease phenotypes, for instance tuberculosis and cancer. In order to develop effective therapeutics, it is important to determine the disease progression profiles of complex disorders that can reveal dynamic aspects and to develop mutitarget systemic therapies that can help overcome pathway adaptations and redundancy.

分子动力学模拟的主要技术

综述了分子动力学模拟技术的发展，介绍了分子动力学的基本原理，有关的有限差分技术，势函数的发展，初始条件和边界条件的选取，平衡态系综及其调控，感兴趣量的提取，分子动力学的特别用途以及与其他计算方法的结合，最后还指出了分子动力学模拟方法本身进一步研究的方向。

Ikasleen hizkuntza erroreak eta hutsegiteak : zuzentzeko proposamena

[Es]El presente trabajo se basa en las consultas que los profesores y profesoras de distintas asignaturas nos hacen al profesorado de lengua. Muchas veces los profesores debemos corregir no sólo el contenido de los trabajos de nuestros alumnos, sino también la lengua. La discusión no es nueva: ¿somos todos los profesores también profesores de lengua? Es un desafío del que difícilmente podemos escapar, ya que la lengua además de ser una materia de estudio también es el vehículo en el que se imparten los contenidos de todas las asignaturas. Con el presente trabajo pretendemos ayudar a los profesores que no imparten lengua como asignatura a corregir los trabajos de sus alumnos. Esta propuesta consta de tres ejes de actuación marcados por un orden de prioridad: prevenir, autocorregir y ayudar.

La implicación del estudiante con la escuela

[Es]El objetivo de esta investigación ha sido analizar la implicación o compromiso de nuestros estudiantes con sus centros escolares. La implicación posee un componente conductual (la participación) y un componente psicológico (la identificación con el centro escolar). La muestra está compuesta por 656 alumnos de 14 colegios del País Vasco y Cataluña, divididos según diferentes tipologías de centro: 179 en pública-primaria, 151 alumnos en concertada-primaria, 203 alumnos en pública¬-secundaria y 123 alumnos en concertada-secundaria. Los resultados indican que las percepciones en las escalas de participación e identificación son más altas en los centros concertados, de primaria y con una sola línea educativa y modelo lingüístico. Así mismo hemos comprobado que existen correlaciones entre las dos dimensiones de la implicación y las variables independientes analizadas: autoconcepto y motivación académica, tipología de centro, trabajo de los profesores y el entorno familiar.

El desarrollo psicosocial

[Es] Esta línea de investigación integra dos perspectivas de aproximación a una temática de gran amplitud y complejidad como es la del desarrollo psicosocial humano, máxime teniendo en cuenta que se presta además una atención específica a la función que en dicho desarrollo cumple la mediación educativa. Obviamente el desarrollo personal y social de cada individuo admite otros muchos abordajes pero los aquí presentados son muy importantes. Se considera, en primer lugar, la incidencia que tienen las interacciones sociales producidas en el proceso de construcción del conocimiento sobre el desarrollo psicosocial. Y, en segundo lugar, se incide en el papel decisivo que los modos de entender la vida juegan en los procesos de sociopersonalización.

La investigación naturalista e interpretativa desde la actividad física y el deporte

[Es]Desde este artículo se revisan diversos estudios de investigación relativos a la sublínea de formación del profesorado de educación física y deportiva, así como a la intervención docente en esta área de conocimientos. Esta sublínea se enmarca en la línea de Actividad Física y Deportes en el área de Didáctica de la Expresión Corporal. En este caso, se incluyen estudios de carácter naturalista e interpretativo, con la intención de que las personas que investigan y sus protagonistas formen parte activa en el propio proceso investigador (Bodgan y Biklen, 1982; Colás y Buendía, 1992; Goetz y Lecompte, 1988; Vázquez y Angulo, 2003). La formación del profesorado de educación física y la actividad didáctica de dicha materia, se convierten en los contenidos que concretan el proceso de la investigación. Para ello, es preciso revisar las temáticas relacionadas con: la formación inicial y permanente, planes y programas de estudio, contenidos que se enseñan y aprenden en la actividad física escolar (dentro y fuera del horario lectivo), la presencia de los valores, los diferentes elementos que constituyen los diseños curriculares, así como todo, aquello que convierte a esta disciplina en una destacada propuesta formativa y de socialización.