Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4.4 million participants.

One of the global targets for non-communicable diseases is to halt, by 2025, the rise in the age-standardised adult prevalence of diabetes at its 2010 levels. We aimed to estimate worldwide trends in diabetes, how likely it is for countries to achieve the global target, and how changes in prevalence, together with population growth and ageing, are affecting the number of adults with diabetes. We pooled data from population-based studies that had collected data on diabetes through measurement of its biomarkers. We used a Bayesian hierarchical model to estimate trends in diabetes prevalence-defined as fasting plasma glucose of 7.0 mmol/L or higher, or history of diagnosis with diabetes, or use of insulin or oral hypoglycaemic drugs-in 200 countries and territories in 21 regions, by sex and from 1980 to 2014. We also calculated the posterior probability of meeting the global diabetes target if post-2000 trends continue. We used data from 751 studies including 4,372,000 adults from 146 of the 200 countries we make estimates for. Global age-standardised diabetes prevalence increased from 4.3% (95% credible interval 2.4-7.0) in 1980 to 9.0% (7.2-11.1) in 2014 in men, and from 5.0% (2.9-7.9) to 7.9% (6.4-9.7) in women. The number of adults with diabetes in the world increased from 108 million in 1980 to 422 million in 2014 (28.5% due to the rise in prevalence, 39.7% due to population growth and ageing, and 31.8% due to interaction of these two factors). Age-standardised adult diabetes prevalence in 2014 was lowest in northwestern Europe, and highest in Polynesia and Micronesia, at nearly 25%, followed by Melanesia and the Middle East and north Africa. Between 1980 and 2014 there was little change in age-standardised diabetes prevalence in adult women in continental western Europe, although crude prevalence rose because of ageing of the population. By contrast, age-standardised adult prevalence rose by 15 percentage points in men and women in Polynesia and Micronesia. In 2014, American Samoa had the highest national prevalence of diabetes (>30% in both sexes), with age-standardised adult prevalence also higher than 25% in some other islands in Polynesia and Micronesia. If post-2000 trends continue, the probability of meeting the global target of halting the rise in the prevalence of diabetes by 2025 at the 2010 level worldwide is lower than 1% for men and is 1% for women. Only nine countries for men and 29 countries for women, mostly in western Europe, have a 50% or higher probability of meeting the global target. Since 1980, age-standardised diabetes prevalence in adults has increased, or at best remained unchanged, in every country. Together with population growth and ageing, this rise has led to a near quadrupling of the number of adults with diabetes worldwide. The burden of diabetes, both in terms of prevalence and number of adults affected, has increased faster in low-income and middle-income countries than in high-income countries. Wellcome Trust.

Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19·2 million participants.

BACKGROUND: Underweight and severe and morbid obesity are associated with highly elevated risks of adverse health outcomes. We estimated trends in mean body-mass index (BMI), which characterises its population distribution, and in the prevalences of a complete set of BMI categories for adults in all countries. METHODS: We analysed, with use of a consistent protocol, population-based studies that had measured height and weight in adults aged 18 years and older. We applied a Bayesian hierarchical model to these data to estimate trends from 1975 to 2014 in mean BMI and in the prevalences of BMI categories (<18·5 kg/m(2) [underweight], 18·5 kg/m(2) to <20 kg/m(2), 20 kg/m(2) to <25 kg/m(2), 25 kg/m(2) to <30 kg/m(2), 30 kg/m(2) to <35 kg/m(2), 35 kg/m(2) to <40 kg/m(2), ≥40 kg/m(2) [morbid obesity]), by sex in 200 countries and territories, organised in 21 regions. We calculated the posterior probability of meeting the target of halting by 2025 the rise in obesity at its 2010 levels, if post-2000 trends continue. FINDINGS: We used 1698 population-based data sources, with more than 19·2 million adult participants (9·9 million men and 9·3 million women) in 186 of 200 countries for which estimates were made. Global age-standardised mean BMI increased from 21·7 kg/m(2) (95% credible interval 21·3-22·1) in 1975 to 24·2 kg/m(2) (24·0-24·4) in 2014 in men, and from 22·1 kg/m(2) (21·7-22·5) in 1975 to 24·4 kg/m(2) (24·2-24·6) in 2014 in women. Regional mean BMIs in 2014 for men ranged from 21·4 kg/m(2) in central Africa and south Asia to 29·2 kg/m(2) (28·6-29·8) in Polynesia and Micronesia; for women the range was from 21·8 kg/m(2) (21·4-22·3) in south Asia to 32·2 kg/m(2) (31·5-32·8) in Polynesia and Micronesia. Over these four decades, age-standardised global prevalence of underweight decreased from 13·8% (10·5-17·4) to 8·8% (7·4-10·3) in men and from 14·6% (11·6-17·9) to 9·7% (8·3-11·1) in women. South Asia had the highest prevalence of underweight in 2014, 23·4% (17·8-29·2) in men and 24·0% (18·9-29·3) in women. Age-standardised prevalence of obesity increased from 3·2% (2·4-4·1) in 1975 to 10·8% (9·7-12·0) in 2014 in men, and from 6·4% (5·1-7·8) to 14·9% (13·6-16·1) in women. 2·3% (2·0-2·7) of the world's men and 5·0% (4·4-5·6) of women were severely obese (ie, have BMI ≥35 kg/m(2)). Globally, prevalence of morbid obesity was 0·64% (0·46-0·86) in men and 1·6% (1·3-1·9) in women. INTERPRETATION: If post-2000 trends continue, the probability of meeting the global obesity target is virtually zero. Rather, if these trends continue, by 2025, global obesity prevalence will reach 18% in men and surpass 21% in women; severe obesity will surpass 6% in men and 9% in women. Nonetheless, underweight remains prevalent in the world's poorest regions, especially in south Asia. FUNDING: Wellcome Trust, Grand Challenges Canada.

Automobile Corporate Networks in Europe : Sectoral Specialization of Central and Eastern European Cities

The global automobile industry is made up of very large corporations and their various subsidiaries containing different functions that create complex locational structures. The networks formed by the 19 largest automobile transnational corporations constitute an automobile "oligopoly" representing more than 90% (OICA, 2012) of the world's production. Since the mid-1990s, Central and Eastern European cities have become attractive for transnational corporations and particularly for the production functions in the automobile sector. This leads to a crucial question. Are strategic functions (such as R&D) within these networks also located in Central and Eastern Europe, or is the region still manufacturing-oriented in the automobile industry? This paper focuses on the patterns and the main factors influencing the role of some of these new central and Eastern European cities that have become integrated in the global value chain of the automobile industry. By analysing the various locations of the specialized functions within the corporations, this study aims to extend the research on global value chains (Gereffi and Korzeniewicz; 1994, Sturgeon, 2000; Krätke, 2014). The spatial patterns of the various functions and the ownerships networks of the automobile industry are constructed in order to identify the cities supporting it. In particular, the way that national metropolises bring their national territories into the globalization of the automobile industry is addressed. For example, are there some specific advantages of capital cities compared to cities that have less integration in globalization terms?

Characterization of Mechanically Alloyed Nanocrystalline Fe(Al): Crystallite Size and Dislocation Density

A nanostructured disordered Fe(Al) solid solution was obtained from elemental powders of Fe and Al using a high-energy ball mill. The transformations occurring in the material during milling were studied with the use of X-ray diffraction. In addition lattice microstrain, average crystallite size, dislocation density, and the lattice parameter were determined. Scanning electron microscopy (SEM) was employed to examine the morphology of the samples as a function of milling times. Thermal behaviour of the milled powders was examined by differential scanning calorimetry (DSC). The results, as well as dissimilarity between calorimetric curves of the powders after 2 and 20 h of milling, indicated the formation of a nanostructured Fe(Al) solid solution

The Intonation of absolute questions of Brazilian Portuguese

In this paper we describe three melodic patterns of absolute interrogatives from a phonetic point of view, obtained from a corpus in Goiás (Brazil). The patterns are: a) Rising Final Inflection (30% to 52%), b) Rising-Falling Final Inflection, c) High Nucleus Final Inflection. These patterns have been established from the acoustic analysis and standardisation of 55 questions and from the verification of their validity in a perception test. We compared them with interrogative patterns obtained in different parts of Brazil and also in two Romance languages, Spanish and Catalan.

Epidemiology of measles virus outbreaks in Catalonia: importance of immunization in the elimination era

Eradicating measles represents a major public health achievement, yet outbreaks still occur in territories where endemic measles virus (MV) had been eliminated. In Catalonia from the year 2000 cases have occurred as isolated cases or small outbreaks, both linked to imported cases up to the end of 2006 when a large outbreak started out affecting mainly children ≤15m. In consequence, immunization schedule was amended lowering first dose to 12m. Again new MV importations from neighboring countries triggered another outbreak on November 2010 with a different age distribution sparing small children from infection. Differences in incidence (IR), rate ratio (RR) and 95% CI and hospitalization rate (HR) by age group were determined. Statistic z was used for comparing proportions. Total number of confirmed cases was 305 vs 381 in 2006; mean age 20 yrs (SD 14.8yrs; 3m -51yrs) vs 15m (SD13.1yrs; 1m-50yrs). Highest proportion of cases was set in ≥25yrs (47%) vs 24.2% in 2006 (p<0.001). Difference in IR for ≤ 15m was statistically significant (49/100,000 vs 278.2/100,000; RR:3.9; 95%CI 2.9-5.4) and in HR 30.2% vs 15.7% (p<0.001). The change of the month of administration of the first dose proved successful. Given the current epidemiological situation, continued awareness and efforts to reach young adult population are needed to stop the spread of the virus.

Epidemiology of measles virus outbreaks in Catalonia: importance of immunization in the elimination era

Eradicating measles represents a major public health achievement, yet outbreaks still occur in territories where endemic measles virus (MV) had been eliminated. In Catalonia from the year 2000 cases have occurred as isolated cases or small outbreaks, both linked to imported cases up to the end of 2006 when a large outbreak started out affecting mainly children ≤15m. In consequence, immunization schedule was amended lowering first dose to 12m. Again new MV importations from neighboring countries triggered another outbreak on November 2010 with a different age distribution sparing small children from infection. Differences in incidence (IR), rate ratio (RR) and 95% CI and hospitalization rate (HR) by age group were determined. Statistic z was used for comparing proportions. Total number of confirmed cases was 305 vs 381 in 2006; mean age 20 yrs (SD 14.8yrs; 3m -51yrs) vs 15m (SD13.1yrs; 1m-50yrs). Highest proportion of cases was set in ≥25yrs (47%) vs 24.2% in 2006 (p<0.001). Difference in IR for ≤ 15m was statistically significant (49/100,000 vs 278.2/100,000; RR:3.9; 95%CI 2.9-5.4) and in HR 30.2% vs 15.7% (p<0.001). The change of the month of administration of the first dose proved successful. Given the current epidemiological situation, continued awareness and efforts to reach young adult population are needed to stop the spread of the virus.

Equivalent representation form of oscillators with elastic and damping nonlinear terms

In this work we consider the nonlinear equivalent representation form of oscillators that exhibit nonlinearities in both the elastic and the damping terms. The nonlinear damping effects are considered to be described by fractional power velocity terms which provide better predictions of the dissipative effects observed in some physical systems. It is shown that their effects on the system dynamics response are equivalent to a shift in the coefficient of the linear damping term of a Duffing oscillator. Then, its numerical integration predictions, based on its equivalent representation form given by the well-known forced, damped Duffing equation, are compared to the numerical integration values of its original equations of motion. The applicability of the proposed procedure is evaluated by studying the dynamics response of four nonlinear oscillators that arise in some engineering applications such as nanoresonators, microresonators, human wrist movements, structural engineering design, and chain dynamics of polymeric materials at high extensibility, among others

Creating dynamic continuous improvement system for Larox Corporation

Today´s organizations must have the ability to react to rapid changes in the market. These rapid changes cause pressure to continuously find new efficient ways to organize work practices. Increased competition requires businesses to become more effective and to pay attention to quality of management and to make people to understand their work's impact on the final result. The fundamentals in continmuois improvement are systematic and agile tackling of indentified individual process constraints and the fact tha nothin finally improves without changes. Successful continuous improvement requires management commitment, education, implementation, measurement, recognition and regeneration. These ingredients form the foundation, both for breakthrough projects and small step ongoing improvement activities. One part of the organization's management system are the quality tools, which provide systematic methodologies for identifying problems, defining their root causes, finding solutions, gathering and sorting of data, supporting decision making and implementing the changes, and many other management tasks. Organizational change management includes processes and tools for managing the people in an organizational level change. These tools include a structured approach, which can be used for effective transition of organizations through change. When combined with the understanding of change management of individuals, these tools provide a framework for managing people in change,

A Quantitative method for the characterization of lytic metastases of the bone from radiographic images

The aim of our study was to assess the diagnostic usefulness of the gray level parameters to distinguish osteolytic lesions using radiological images. Materials and Methods: A retrospective study was carried out. A total of 76 skeletal radiographs of osteolytic metastases and 67 radiographs of multiple myeloma were used. The cases were classified into nonflat (MM1 and OL1) and flat bones (MM2 and OL2). These radiological images were analyzed by using a computerized method. The parameters calculated were mean, standard deviation, and coefficient of variation (MGL, SDGL, and CVGL) based on gray level histogram analysis of a region-of-interest.Diagnostic utility was quantified bymeasurement of parameters on osteolyticmetastases andmultiplemyeloma, yielding quantification of area under the receiver operating characteristic (ROC) curve (AUC). Results: Flat bone groups (MM2 and OL2) showed significant differences in mean values of MGL ( = 0.048) and SDGL ( = 0.003). Their corresponding values of AUC were 0.758 for MGL and 0.883 for SDGL in flat bones. In nonflat bones these gray level parameters do not show diagnostic ability. Conclusion: The gray level parametersMGL and SDGL show a good discriminatory diagnostic ability to distinguish between multiple myeloma and lytic metastases in flat bones.

Developmental Readiness in the Understanding of Own and Other’s False Beliefs

One of the most important milestones in the development of theory of mind is the understanding of false beliefs. This study compares children’s understanding of representational change and others’ false beliefs and evaluates the effectiveness of an appearance-reality training for improving children’s false belief understanding. A total of 78 children ranging in age from 41 to 47 months were trained in three sessions and evaluated in a pretest and in a posttest. The results show that for children it is easier to understand representational change than false beliefs in others, and that the improvement after training was greater when starting from a higher score in the pretest. The implications of this for training in false belief understanding are discussed

Supply chain costs of a small board lot: sheet cutting and logistics

Succeeding in small board lot (0-20 tons) deliveries, is not always prosperous and failures as well as extra costs compared to standard costs arise. Failure deliveries from converting plants to customer locations tie a lot of unwanted and unexpected costs. Extra costs are handled as quality costs and more precise, internal failure costs. These costs revolve from unsuccessful truck payloads, redundant warehousing or unfavorable routing as examples. Quality costs are becoming more and more important factor in company’s financial decision making. Actual, realized truck payload correlates with the extra costs occurring, so filling the truck payload all get-out well is a key to lower the extra costs. Case company in this study is Corporation A, business segment Boards. Boards have outsourced half of their converting in order to gain better customer service via flexibility, lead time reductions and logistics efficiency improvements. Examination period of the study is first two quarters of year 2008 and deliveries examined are from converters to the customer locations. In Corporation A’s case, the total loss in failure deliveries is hundreds of thousands of Euros during the examination period. So, the logistics goal of getting the right product to the right place and right time for the least cost, does not completely realize.

Cultural aspects of globalizing university-industry knowledge interaction in China

Previous studies of the local involvement of multinational corporation (MNC) subsidiaries focus on host-country firms and local business partners such as suppliers and customers. The role of host-country universities in the same context of innovation networks is neglected. Furthermore, there are many organizational culture- and knowledge-related differences between universities and companies, and this is likely to pose additional challenges for successful collaboration. Early university-industry (U-I) studies have primarily been limited within a national boundary, being concerned with a single level of culture (i.e., at an organizational level) and one-way knowledge transfer from university to industry. Research on more dynamic knowledge interaction in multinational settings is lacking. This is particularly true in the business context of China. In today’s globalizing and rapidly changing organizations, addressing cultural differences and clashes is an everyday reality, and inter-cultural U-I collaboration is becoming a key asset for gaining global competitiveness. This study deals with Finnish MNC subsidiaries’ research collaboration with Chinese universities. It aims to explore the essence of such U-I collaboration and knowledge interaction, uncovering the deep functioning mechanisms of culture underlying effective collaborative knowledge creation and innovation. The study reviews critically different bodies of literature including knowledge management theories and studies, U-I collaboration and knowledge interaction, and cross-cultural research in terms of organizational knowledge generation and utilization. It adopts a case study strategy with qualitative research methods, and data is collected through in-depth interviews and participant observation. The study presents the following major findings: 1. In the light of a comprehensive analysis of U-I collaboration, an effective matching strategy is proposed, in the assumption that good alignment of knowledge interaction strategies and approaches with their corresponding knowledge type, capability development and research task may greatly enhance the effectiveness of cross-cultural U-I collaboration and knowledge interaction. 2. It is proposed that in the Chinese MNC context more dynamic types of knowledge interaction like knowledge co-creation should be of key concern particularly when dealing simultaneously with multi-disciplinary applied research of human factors and technologies. U-I knowledge interaction, otherwise, pays attention only to the study of one-way technology and knowledge transfer. 3. It is posited that the influence of culture on collaborative knowledge interaction can be studied in a valuable way when knowledge-related variables are simultaneously taken into account. A systematic analysis of the role of knowledge in cross-cultural knowledge interaction could best be approached from multi-aspects of knowledge including not only nature, characteristics and types of knowledge but also the process of knowledge (e.g., intensifications of knowledge interaction). 4. The study demonstrates the significant role of aspects of the host-country culture (e.g., Chinese guanxi) in U-I collaboration and knowledge interaction. This is evident, for instance, in issues related to interpersonal relationships and trust, true interest and the relatedness of the research, mutual commitment and learning, communication intensity and interaction, and awareness of cultural and knowledge-related differences between collaboration partners. Theoretical and practical implications of the findings are suggested and discussed.

Welding development of crane main girder

Konecranes Corporation manufactures huge steel structures in 16 factories worldwide, in which the environment and quality varies. The company has a desire to achieve the same weld quality in each factory, regardless of the manufacturing place. The main subject of this master’s thesis was to develop the present box girder crane welding process, submerged arc welding and especially the fillet welding. Throughput time and manufacturing costs can be decreased by welding the full penetration fillet weld without a bevel, changing present groove types for more appropriate ones and by achieving the desired weld quality on the first time. Welding experiments of longitudinal fillet welding were made according to the present challenges, which the manufacturing process is facing. In longitudinal fillet welding tests the main focus was to achieve full penetration fillet weld for 6, 8 and 10 millimeters thick web plates with single and twin wire submerged arc welding. Full penetration was achieved with all the material thicknesses, both with single and twin wire submerged arc welding processes. The main problem concerning the weld was undercutting and shape of the weld bead. The question about insufficiency of presently used power sources with twin wire was risen up during testing, due to the thicknesses that require high welding current. Bigger power source is required when box girders are welded nonstop, if twin wire is used. For single wire process the penetration was achieved with significantly less amperage than with twin wire.

The potential of social networking sites in inpatriate adjustment

People make up one of the most important resources for a corporation and therefore it has to continuously seek an ever more diverse and international workforce. Inpatriation is another way of utilizing foreign expertise in a corporation. An inpatriate refers to a person that is on an international assignment at the headquarters of a corporation, where they have been sent either from a subsidiary abroad or from a third country outside the corporation. Strengthening the social network of the inpatriate and their family contributes to the adjustment process and furthermore the success of the work assignment. As social networking sites are currently the fastest developing personal networking tools in the world, it is interesting to see how they can help in inpatriate adjustment. The objective of this thesis is to explore the potential of social networking sites (SNS) in inpatriate adjustment. The main objective can be divided into three sub objectives: 1. What is SNS used for during the inpatriate assignment? 2. What are the inpatriates’ motivations to use SNS? 3. Could the three facets of adjustment (work, interaction and general) be gained through SNS? This qualitative study utilizes the theme interview data collection method and the thematic analysis approach for analysing the interview data. From the interviews with five Indian inpatriates in Finland the most mentioned uses of SNS were related to participating (sharing opinions, recommendations and discussing things and connecting to friends, family and colleagues) and consuming (collecting information for work and free time), the least mentioned use of SNS was producing (posting videos, photos and updates). An interesting finding was that the five interviewees did not use SNS for purely entertainment motives at all during their assignment. This thesis found that all three facets of adjustment could potentially be gained through SNS.