Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990–2013: Quantifying the epidemiological transition

Background The Global Burden of Disease Study 2013 (GBD 2013) aims to bring together all available epidemiological data using a coherent measurement framework, standardised estimation methods, and transparent data sources to enable comparisons of health loss over time and across causes, age–sex groups, and countries. The GBD can be used to generate summary measures such as disability-adjusted life-years (DALYs) and healthy life expectancy (HALE) that make possible comparative assessments of broad epidemiological patterns across countries and time. These summary measures can also be used to quantify the component of variation in epidemiology that is related to sociodemographic development. Methods We used the published GBD 2013 data for age-specific mortality, years of life lost due to premature mortality (YLLs), and years lived with disability (YLDs) to calculate DALYs and HALE for 1990, 1995, 2000, 2005, 2010, and 2013 for 188 countries. We calculated HALE using the Sullivan method; 95% uncertainty intervals (UIs) represent uncertainty in age-specific death rates and YLDs per person for each country, age, sex, and year. We estimated DALYs for 306 causes for each country as the sum of YLLs and YLDs; 95% UIs represent uncertainty in YLL and YLD rates. We quantified patterns of the epidemiological transition with a composite indicator of sociodemographic status, which we constructed from income per person, average years of schooling after age 15 years, and the total fertility rate and mean age of the population. We applied hierarchical regression to DALY rates by cause across countries to decompose variance related to the sociodemographic status variable, country, and time. Findings Worldwide, from 1990 to 2013, life expectancy at birth rose by 6·2 years (95% UI 5·6–6·6), from 65·3 years (65·0–65·6) in 1990 to 71·5 years (71·0–71·9) in 2013, HALE at birth rose by 5·4 years (4·9–5·8), from 56·9 years (54·5–59·1) to 62·3 years (59·7–64·8), total DALYs fell by 3·6% (0·3–7·4), and age-standardised DALY rates per 100 000 people fell by 26·7% (24·6–29·1). For communicable, maternal, neonatal, and nutritional disorders, global DALY numbers, crude rates, and age-standardised rates have all declined between 1990 and 2013, whereas for non–communicable diseases, global DALYs have been increasing, DALY rates have remained nearly constant, and age-standardised DALY rates declined during the same period. From 2005 to 2013, the number of DALYs increased for most specific non-communicable diseases, including cardiovascular diseases and neoplasms, in addition to dengue, food-borne trematodes, and leishmaniasis; DALYs decreased for nearly all other causes. By 2013, the five leading causes of DALYs were ischaemic heart disease, lower respiratory infections, cerebrovascular disease, low back and neck pain, and road injuries. Sociodemographic status explained more than 50% of the variance between countries and over time for diarrhoea, lower respiratory infections, and other common infectious diseases; maternal disorders; neonatal disorders; nutritional deficiencies; other communicable, maternal, neonatal, and nutritional diseases; musculoskeletal disorders; and other non-communicable diseases. However, sociodemographic status explained less than 10% of the variance in DALY rates for cardiovascular diseases; chronic respiratory diseases; cirrhosis; diabetes, urogenital, blood, and endocrine diseases; unintentional injuries; and self-harm and interpersonal violence. Predictably, increased sociodemographic status was associated with a shift in burden from YLLs to YLDs, driven by declines in YLLs and increases in YLDs from musculoskeletal disorders, neurological disorders, and mental and substance use disorders. In most country-specific estimates, the increase in life expectancy was greater than that in HALE. Leading causes of DALYs are highly variable across countries. Interpretation Global health is improving. Population growth and ageing have driven up numbers of DALYs, but crude rates have remained relatively constant, showing that progress in health does not mean fewer demands on health systems. The notion of an epidemiological transition—in which increasing sociodemographic status brings structured change in disease burden—is useful, but there is tremendous variation in burden of disease that is not associated with sociodemographic status. This further underscores the need for country-specific assessments of DALYs and HALE to appropriately inform health policy decisions and attendant actions.

Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

Background The Global Burden of Disease, Injuries, and Risk Factor study 2013 (GBD 2013) is the first of a series of annual updates of the GBD. Risk factor quantification, particularly of modifiable risk factors, can help to identify emerging threats to population health and opportunities for prevention. The GBD 2013 provides a timely opportunity to update the comparative risk assessment with new data for exposure, relative risks, and evidence on the appropriate counterfactual risk distribution. Methods Attributable deaths, years of life lost, years lived with disability, and disability-adjusted life-years (DALYs) have been estimated for 79 risks or clusters of risks using the GBD 2010 methods. Risk–outcome pairs meeting explicit evidence criteria were assessed for 188 countries for the period 1990–2013 by age and sex using three inputs: risk exposure, relative risks, and the theoretical minimum risk exposure level (TMREL). Risks are organised into a hierarchy with blocks of behavioural, environmental and occupational, and metabolic risks at the first level of the hierarchy. The next level in the hierarchy includes nine clusters of related risks and two individual risks, with more detail provided at levels 3 and 4 of the hierarchy. Compared with GBD 2010, six new risk factors have been added: handwashing practices, occupational exposure to trichloroethylene, childhood wasting, childhood stunting, unsafe sex, and low glomerular filtration rate. For most risks, data for exposure were synthesised with a Bayesian meta-regression method, DisMod-MR 2.0, or spatial-temporal Gaussian process regression. Relative risks were based on meta-regressions of published cohort and intervention studies. Attributable burden for clusters of risks and all risks combined took into account evidence on the mediation of some risks such as high body-mass index (BMI) through other risks such as high systolic blood pressure and high cholesterol. Findings All risks combined account for 57·2% (95% uncertainty interval [UI] 55·8–58·5) of deaths and 41·6% (40·1–43·0) of DALYs. Risks quantified account for 87·9% (86·5–89·3) of cardiovascular disease DALYs, ranging to a low of 0% for neonatal disorders and neglected tropical diseases and malaria. In terms of global DALYs in 2013, six risks or clusters of risks each caused more than 5% of DALYs: dietary risks accounting for 11·3 million deaths and 241·4 million DALYs, high systolic blood pressure for 10·4 million deaths and 208·1 million DALYs, child and maternal malnutrition for 1·7 million deaths and 176·9 million DALYs, tobacco smoke for 6·1 million deaths and 143·5 million DALYs, air pollution for 5·5 million deaths and 141·5 million DALYs, and high BMI for 4·4 million deaths and 134·0 million DALYs. Risk factor patterns vary across regions and countries and with time. In sub-Saharan Africa, the leading risk factors are child and maternal malnutrition, unsafe sex, and unsafe water, sanitation, and handwashing. In women, in nearly all countries in the Americas, north Africa, and the Middle East, and in many other high-income countries, high BMI is the leading risk factor, with high systolic blood pressure as the leading risk in most of Central and Eastern Europe and south and east Asia. For men, high systolic blood pressure or tobacco use are the leading risks in nearly all high-income countries, in north Africa and the Middle East, Europe, and Asia. For men and women, unsafe sex is the leading risk in a corridor from Kenya to South Africa. Interpretation Behavioural, environmental and occupational, and metabolic risks can explain half of global mortality and more than one-third of global DALYs providing many opportunities for prevention. Of the larger risks, the attributable burden of high BMI has increased in the past 23 years. In view of the prominence of behavioural risk factors, behavioural and social science research on interventions for these risks should be strengthened. Many prevention and primary care policy options are available now to act on key risks.

Critical Cation Balance In B-]Z Transition - Role Of Li+

The sodium salt of poly(dG-dC) is known to exhibit a B + Z transition in the presence of various cations and 60% alcohol. We here show that the lithium salt of poly(dG-dC) does not undergo B 4 Z transition in the presence of 60% alcohol since Li’ with its large hydration shell cannot stabilize the Z-form. On the other hand, high concentrations of Mg2* or micromolar concentrations of the cobalt hexamine complex which are known to stabilize the Z-form can compete with Li+ for charge neutraIization and hence bring about a B--t Z transition in the same polymer. From the model building studies the mode of action of the cobalt-hexamine complex in stabilizing the Z-form is postulated.

Breakdown voltage and V-Z characteristics of sodium vapour using coaxial cylindrical electrodes

Experimental results for breakdown voltage of sodium vapour measured for the first time using coaxial cylindrical electrodes of fixed gap distance (5 mm) and pressure (corrected to2 0 "C) in the range2 1 to 652 Pa are reported, and are founfdo l ltoow Paschen's Law. The investigations also reveal that V th-Ie characteristics are pressure dependent; the current during the breakdown and the buoifl dc-uurpre nt after a breakdoiws nei ther positive or negative. in spite of the central cylinder being always maintained at a positive potential

Relocating the American Dream : The America of the 1960s as Portrayed by the New Journalists Norman Mailer, Hunter S. Thompson, and Tom Wolfe

The concept of the American Dream was subject to a strong re-evaluation process in the 1960s, as counterculture became a prominent force in American society. A massive generation of young people, moved by the Vietnam War, the hippie movement, and psychedelic experimentation, created substantial social turbulence in their efforts to break out of conventional patterns and to create a new kind of society. This thesis outlines and analyses the concept of the American Dream in popular imagination through three works of new journalism. My primary data consists of Tom Wolfe’s The Electric Kool-Aid Acid Test (1967), Hunter S. Thompson’s Fear and Loathing in Las Vegas: A Savage Journey to the Heart of the American Dream (1971), and Norman Mailer’s Armies of the Night: History as a Novel, the Novel as History (1968). In defining the American Dream, I discuss the history of the concept as well as its manifestations in popular culture. Because of its elusive and amorphous nature, the concept of the American Dream can only be examined in cultural texts that portray the values, sentiments, and customs of a certain era. I have divided the analytical section of my thesis into three parts. In the first part I examine how the authors discuss the American society of their time in relation to ideology, capitalism, and the media. In the second part I focus on the Vietnam War and the controversy it creates in relation to the notions of freedom and patriotism. In the third part I discuss how the authors portray the countercultural visions of a better America that challenged the traditional interpretations of the American Dream. I also discuss the dark side of the new dream: the problems and disillusions that came with the effort to change the world. This thesis is an effort to trace the relocation of the American Dream in the context of the 1960s counterculture and new journalism. It hopes to provide a valuable addition to the cultural history of the sixties and to the effort of conceptualizing the American Dream.

(Z)-11-Hexadecenal and (3Z,6Z,9Z)-Tricosatriene: Sex Pheromone Components of the Red Banded Mango Caterpillar Deanolis sublimbalis

The sex pheromone of the red banded mango caterpillar, Deanolis sublimbalis (Lepidoptera: Crambidae), a serious pest of the mango Mangifera indica (Anacardiaceae) in India and Southeast Asia and a recent invader into northern Australia, has been identified. Three candidate compounds were identified from pheromone gland extracts of female moths, using gas chromatography (GC), GC-electroantennographic detection and GC-mass spectrometric analyses, in conjunction with dimethyldisulfide derivatization. Field bioassays established that both (Z)-11-hexadecenal (Z11-16:Ald) and (3Z,6Z,9Z)-tricosatriene (3Z,6Z,9Z-23:Hy) were required for attraction of male D. sublimbalis moths, and 1,000 μg of a 1:1 mix of Z11-16:Ald and 3Z,6Z,9Z-23:Hy was more attractive to male moths than caged virgin females. However, the binary blend was only attractive when the isomeric purity of the monounsaturated aldehyde was >99%, suggesting that the (E)-isomer was inhibitory. Although (Z)-11-hexadecen-1-ol (Z11-16:OH) was tentatively identified in gland extracts, the addition of this compound to the binary blend did not increase the numbers of moths captured. The pheromone can now be used in integrated pest management strategies.

Thomsenista Kalimaan : Vanhimpien itämerensuomalais-balttilaisten kielikontaktien tutkimushistoria vuoteen 1936

Itämerensuomalaisissa kielissä esiintyy suuri joukko sanoja, jotka muistuttavat balttilaisten kielten sanoja sekä muotonsa että merkityksensä puolesta. Yhtäläisyyksiä oli yritetty selittää eri tavoin 1700-luvulta lähtien, kunnes Vilhelm Thomsen vuonna 1869 osoitti tämän sanastokerrostuman olevan lainaa jostakin muinaisbalttilaisesta kielimuodosta nykyisten itämerensuomalaisten kielten yhteiseen kantakieleen. Vuonna 1890 Thomsen julkaisi aiheesta laajemman tutkimuksen, jossa hän esitti noin 200 muinaisbalttilaista lainaetymologiaa ja käsitteli lainojen äännevastaavuuksia sekä kielellisten kontaktien paikkaa, aikakautta ja kulttuurikontekstia. Nykykäsitys itämerensuomalaisten kielten vanhoista balttilaisista lainasanoista perustuu tähän Thomsenin esitykseen, ainoastaan kontaktien ajoituksia on arkeologian tulosten myötä siirretty taaksepäin. Thomsen sovelsi ensimmäisenä suomalais-ugrilaisten kielten tutkimukseen aikakautensa uusinta kielitieteellistä metodia, nuorgrammatiikkaa. Nuorgrammatiikka keskittyi kielihistoriaan ja antoi eksaktit välineet etymologialle. Suomeen nuorgrammatiikan toi E. N. Setälä, jonka johdolla metodi uudisti nopeasti koko fennougristiikan ja nosti Suomen tutkimuksen kärkeen. Suomalaistutkijat tarkensivat myös Thomsenin luomaa kuvaa vanhoista balttilaisista lainoista. Setälän ohella keskeisiä etymologeja olivat J. J. Mikkola ja Heikki Paasonen. Muualla tutkimus ei ollut yhtä intensiivistä: vain liettualainen Kazimieras Būga perehtyi mainittavasti aiheeseen, ja hänenkin tutkijan uransa jäi lyhyeksi. Vasta 1910-luvun puolessa välissä Thomsenin ja Setälän teesejä alettiin kritikoida. Torsten Karsten ja K. B. Wiklund esittivät vanhimmille balttilaiskontakteille paljon kauemmas menneisyyteen ulottuvia ajoituksia kuin Thomsen. Setälän auktoriteetti kuitenkin torjui uudet teoriat, jotka on vasta paljon myöhemmin yleisesti hyväksytty. Sotien välinen kausi oli erittäin vilkkaan etymologisen tutkimuksen aikaa, ja balttilaisiakin lainoja esitettiin kymmeniä lisää. Ajan uutterimmat tutkijat olivat Heikki Ojansuu, Yrjö Toivonen ja Jalo Kalima. Luonnollisesti myös monet Thomsenin balttilaiset etymologiat korvattiin paremmin sopivilla lainaetymologioilla tai rinnastuksilla sukukielistä. Mikkola arvosteli hyvin voimakkaasti Thomsenin lainaetymologioita. Mikkolan kritiikki osoittautui pääosin pätemättömäksi, mutta on päässyt epäsuorasti vaikuttamaan myöhempään tutkimukseen. Eino Nieminen taas esitti vuonna 1934 hypoteesin, jonka mukaan ainakin osa vanhoista balttilaislainoista voisi olla peräisin muinaiskuurin kielestä, jota baltologit olivat parin vuosikymmenen ajan pyrkineet rekonstruoimaan. Jalo Kalima julkaisi vuonna 1936 oppikirjan itämerensuomalaisten kielten vanhoista balttilaislainoista. Kalima pyrki antamaan kattavan kuvan aiheesta, mutta ei onnistunut kovin hyvin. Kaliman tiedot balttilaisista kielistä eivät olleet ajan tutkimuksen tasolla, ja hän jätti kirjassansa käsittelemättä suuren osan uudempaa tutkimusta, mm. Thomsenin ajoituksia kohtaan osoitetun kritiikin sekä kymmenittäin niin Thomsenin kuin myöhempienkin tutkijoitten esittämiä etymologioita. Kaliman kirja on kuitenkin selkeästi laadittu ja sisältää uusia, ansiokkaitakin etymologioita. Kaliman jälkeen kukaan ei ole kirjoittanut yleisesitystä aiheesta. Tämän tutkielman tavoite on antaa kattava kuva vanhimpien itämerensuomalais-balttilaisten kielikontaktien tutkimuksesta ennen Kaliman oppikirjaa. Näin se voisi tasoittaa tietä uudelle alan yleisesitykselle.

Molecular Dynamics in [(CH8)aN]z Cd14 A Proton Magnetic Relaxation Study

second moment measurements are carried out on [(CH,),N], CdI, in the temperature range 77 to 400 K. The results are interpreted based on a molecular dynamical model of randomly reorienting methyl groups and isotropically tumbling tetramethyl ammonium group. The relaxation data show contributions from spin-rotation interaction at high temperatures and presence of inequivalent methyl groups. The correlation times and associated activation energies, connected with this model, are calculated from the data. The structure in the absorption line and in the free-induction decay signal at 77 K indicates the possibility of tunnelling motion of the methyl groups. Im Temperaturbereich 77 bis 400 K werden an [(CH,),N],CdI, Protonen-Spin-Gitter-Relaxationsexperimente (bei Larmorfrequenzen von 10,20 und 30 MHz) und Messungen des zweiten Moments durchgefiihrt. Die Ergebnisse werden an Hand eines molekularen dynamischen Modells sich statistisch umorientierender Methylgruppen und isotrop taumelnder Tetramethyl-Ammoniumgruppen interpretiert. Die Relaxationswerte zeigen Beitriige von Spin-Rotations-Wechselwirkung bei hohen Temperaturen und die Anwesenheit von inaquivalenten Methylgruppen. Die Korrelationszeiten und verknupften Aktivierungsenergien, die mit diesem Model1 verbunden sind, werden am den Werten berechnet. Die Struktur in der Absorptionslinie und im Abklingsignal der freien Induktion bei 77 K zeigt die Moglichkeit einer Tunnelbewegung der Methylgruppen.

A novel Z-structure for poly d(GC).poly d(GC)

A novel zig-zag (Z) structure is proposed for poly d(GC).poly d(GC). The proposed model closely resembles the crystal structure of d(CG)3.

A Novel Structural Transition In Poly(Dg-Me5dc) - Z Reversible B Reversible Z

Poly(dG-Me5dC) is known to exhibit a B→Z transition in the presence of very high concentrations of NaCl. For the first time, we report the presence of a Z-structure in sodium concentrations as low as 0.5 mM. A novel Z B Z transition is observed as the salt concentration is gradually increased. The role of water structure in B to Z transitions is discussed.

Trust, participation and health among ageing people : A cross-sectional cohort study of men and women born in 1926-30, 1936-40, and 1946-50 in the Lahti region, southern Finland

The purpose of the present study was to explore the associations between good self-rated health and economic and social factors in different regions among ageing people in the Päijät-Häme region in southern Finland. The data of this study were collected in 2002 as part of the research and development project Ikihyvä 2002 2012 (Good Ageing in Lahti region GOAL project). The baseline data set consisted of 2,815 participants born in 1926 30, 1936 40, and 1946 50. The response rate was 66 %. According to the previous studies, trust in other people and social participation as the main aspects of social capital are associated with self-rated health. In addition, socioeconomic position (SEP) and self-rated health are associated, but all SEP indicators do not have identical associations with health. However, there is a lack of knowledge of the health associations and regional differences with these factors, especially among ageing people. Regarding these questions, the present study gives new information. According to the results of this study, self-perceived adequacy of income was significantly associated with good self-rated health, especially in the urban areas. Similar associations were found in the rural areas, though education was also considered an important factor. Adequacy of income was an even stronger predictor of good health than the actual income. Women had better self-rated health than men only in the urban areas. The youngest respondents had quite equally better self-rated health than the others. Social participation and access to help when needed were associated with good self-rated health, especially in the urban area and the sparsely populated rural areas. The result was comparable in the rural population centres. The correlation of trust with self-rated health was significant in the urban area. High social capital was associated with good self-rated health in the urban area. The association was quite similar in the other areas, though it was statistically insignificant. High social capital consisted of co-existent high social participation and high trust. The association of traditionalism (low participation and high trust) with self-rated health was also substantial in the urban area. The associations of self-rated health with low social capital (low participation and low trust) and the miniaturisation of community (high participation and low trust) were less significant. From the forms of single participation, going to art exhibitions, theatre, movies, and concerts among women, and studying and self-development among men were positively related to self-rated health. Unexpectedly, among women, active participation in religious events and voluntary work was negatively associated with self-rated health. This may indicate a coping method with ill-health. As a whole, only minor variations in self-rated health were found between the areas. However, the significance of the factors associated with self-rated health varied according to the areas. Economic factors, especially self-perceived adequacy of income was strongly associated with good self-rated health. Also when adjusting for economic and several other background factors social factors (particularly high social capital, social participation, and access to help when needed) were associated with self-rated health. Thus, economic and social factors have a significant relation with the health of the ageing, and improving these factors may have favourable effects on health among ageing people.

Czechoslovak President Tomáš Garrigue Masaryk

Czechoslovak President Tomáš Garrigue Masaryk seated at the head of an outdoor dining table under palm trees surrounded by unidentified men and women

Sequence dependence and role of 5'-phosphate in the B to Z transition

Spectroscopic studies on pd(CG)3 and pd(GC)3 have been carried out to elucidate the sequence dependence and effect of free 5'-phosphate on the B to Z transition. Unlike d(CG)3, pd(CG)3 fails to undergo salt-induced B to Z transition at ambient temperature. Model building studies have been carried out to determine the inhibitory role of the 5'-phosphate group, but have been unsuccessful.

Plan U.S.R.R. Melitopol'skogo okruga Genicheskogo raiona poluostrova Chongar vymezhevannogo v poriadke chastichnogo izmeneniia ustroistva kolfonda s ustroistvom poselkov, razbivkoiu na polia sevooborota, gony soglasno nakazu N.K.Z dnia 1927, n 52-2825. Izmerenie v nature proizvedeno i plan etot sostovlen X. partieiu po ustroistvu kolfondov

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Lucien Wolf and David Mowshowitch papers, [ca. 1869-1959]

Correspondence, reports, minutes, manuscripts, and clippings relating to the activities of Wolf, Mowshowitch, and the Joint Foreign Committee, as well as to the political situation of Jews in various countries and to the Paris Peace Conference. Papers of Lucien Wolf include his diary, lectures on English-German relations and English-Russian relations; bibliography of Wolf's works on Jewish themes; clippings of Wolf's articles; congratulations on his seventieth birthday; article on his last interview with Chamberlain; and correspondence with parents, 1869-1882, A. Abrahams, 1914-1925, Chief Rabbi Dr. J.H. Hertz, 1892-1923, Clara Melchior, 1913-1929, Jacob Schiff, 1910, Maxim Vinawer, 1917, Mark Wischnitzer, 1926-1928, Lord Robert Cecil, 1916-1919, Lord Rothschild, 1906, Cyrus Adler, Count J. Bernstorff, Szymon Ashkenazy, Solomon Dingol, Louis Marshall, Claude G. Montefiore, Sir Edward Sassoon, Jacob Schiff, Lord William Selborne, Nakhum Sokolow, Oscar Straus, Chaim Weizmann, the American Jewish Congress, 1916-1923, Hilfsverein der Deutschen Juden, 1913, and Jewish Historical Society of England.