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.

Prediction of compressive strength of SCC and HPC with high volume fly ash using ANN

An artificial neural network (ANN) is presented to predict a 28-day compressive strength of a normal and high strength self compacting concrete (SCC) and high performance concrete (HPC) with high volume fly ash. The ANN is trained by the data available in literature on normal volume fly ash because data on SCC with high volume fly ash is not available in sufficient quantity. Further, while predicting the strength of HPC the same data meant for SCC has been used to train in order to economise on computational effort. The compressive strengths of SCC and HPC as well as slump flow of SCC estimated by the proposed neural network are validated by experimental results.

Ulkomaisen kirjallisuuden tuonti Suomeen 1800-luvun alkupuolella : Waseniuksen kirjakaupan kansainväliset yhteydet 1823-1836

Opinnäytetyöni tarkastelee eurooppalaisen kulttuurin kannalta keskeistä kommunikaatiovälinettä, painettua kirjaa, ja sen kansainvälistä luonnetta ja liikkumista. Teemaan perehdytään helsinkiläisen Gustaf Otto Waseniuksen (1789-1852) kirjakaupan toiminnan avulla keskittyen tarkastelemaan ulkomaisen kirjallisuuden tuomista Suomeen 1800-luvun alkupuolella. Tutkielma käsittelee ensisijaisesti itse kauppiastoimintaa: mitä kirjakauppayhteyksiä Waseniuksella oli sekä miten ja keiden ehdoilla ne toimivat. Näiden kysymysten ohessa pohdin myös itse kirjojen välityksellä tapahtunutta tiedonvälitystä. Työn tavoitteena on paljastaa, minkälaisia suomalaisten kirjakauppiaiden ja lukijoiden kirjallisuudenhankinnan sekä lukemisen kontekstit ja resurssit olivat 1800-luvun alkupuolella. Tutkielman lähteinä on käytetty Waseniuksen kirjakaupan kirjeitä ja kuitteja sekä sensuuriviranomaisten arkistoja. Tutkielmani jakautuu kolmeen osaan. Ensiksi paneudun Waseniuksen kauppaverkoston syntyyn ja sen esittelyyn: Waseniuksen kansainväliset yhteydet keskittyivät kolmelle kulttuurialueelle. Ruotsista hän sai kirjoja kaikilta merkittäviltä kustantajilta, kauppiailta sekä itsenäisesti toimivilta kirjailijoilta. Saksankielisen kulttuurin tarjontaa Wasenius pystyi hankkimaan Leipzigin kansainvälisten kirjakauppiaiden avulla. Ranskalaisen kirjallisuuden osalta Wasenius omasi toimivat yhteydet Pariisin kirjakauppiaisiin. Sen sijaan Brittein saaret jäivät vielä Waseniuksen kontaktiverkoston ulkopuolelle, samoin myös Pietarin huomattava kulttuurikeskus. Tämän jälkeen keskityn yhteyksien toimintaan. Wasenius solmi kauppakumppaniensa kanssa yleiseurooppalaisen komissionääri-sopimuksen, jonka valtuuttamana hän sai myydä kunkin ulkomaisen kauppiaan tuotteita liikkeessään. Ensiksi tarkastelen kauppiaiden välisten etäisyyksien ylittämistä. Aikakauden kuljetustavat huomioonottaen suuret etäisyydet eivät Waseniuksen kirjojen hankintaa juuri haitanneet, vaan suurkauppiaana hän pystyi käyttämään aikansa parhaat resurssit lähetystensä kuljettamiseen. Toiseksi pohdin aikakauden kauppiastoimintojen ja kulttuuripiirteiden vaikutusta kirjakauppaan. Waseniuksen toiminta kirjakauppiaana perustui taloudellisen voiton tavoittelulle, mikä tarkoitti mm. sitä, että lähetysten sisältö määrättiin etukäteen hyvin tarkasti. Ennen Suomeen saapumistaan kirjoilla piti olla varma ostaja, minkä Wasenius useimmiten varmisti ennakkotilausluetteloin ja etumaksuin. Kolmanneksi esiin nousevat 1800-luvun alun poliittiset tapahtumat, jotka osaltaan, kauppiaan silmiin kaikkein näkyvimmin, vaikuttivat kirjojen tuontiin. Sensuurin piti periaatteessa estää useiden satojen vaarallisena pidetyn kirjan levittäminen ja lukeminen Suomessa, mutta Wasenius ei suinkaan lopettanut kiellettyjen kirjojen tuontia, vaan salakuljetti sensuroitavia teoksia jatkuvasti liikkeeseensä myytäväksi. Suomalaiset viranomaiset hyväksyivät usein tämänkaltaisen toiminnan, joten venäläistä sensuuriasetusta tai hallintoa ei juuri kunnioitettu. Vertailu eurooppalaiseen kirjakauppatoimintaan osoittaa Waseniuksen omanneen erittäin hyvät kansainväliset suhteet. Tämä kuitenkin johtui niin kirjakauppatoiminnan keskittymisestä harvojen kauppiaiden käsiin kuin myös oman kustannustoiminnan vähyydestä. Tiedonvälityksen kehityksen ja kulttuurihistorian kannalta Waseniuksen kansainvälinen toiminta osoittautuu noudattelevan vielä vanhan eliittikulttuurin muotoja, mutta kirjakauppainstituution kehittyminen aivan uudenlaiseen kukoistukseen valmisteli jo kansallisen kulttuurin nousemista lähivuosikymmeninä.

Ann and Grete Unger seated outdoors with Dick and Gitta Meier with their infant daughter Karen.

Digital Image

New genetic loci link adipose and insulin biology to body fat distribution

Body fat distribution is a heritable trait and a well-established predictor of adverse metabolic outcomes, independent of overall adiposity. To increase our understanding of the genetic basis of body fat distribution and its molecular links to cardiometabolic traits, here we conduct genome-wide association meta-analyses of traits related to waist and hip circumferences in up to 224,459 individuals. We identify 49 loci (33 new) associated with waist-to-hip ratio adjusted for body mass index (BMI), and an additional 19 loci newly associated with related waist and hip circumference measures (P < 5 × 10−8). In total, 20 of the 49 waist-to-hip ratio adjusted for BMI loci show significant sexual dimorphism, 19 of which display a stronger effect in women. The identified loci were enriched for genes expressed in adipose tissue and for putative regulatory elements in adipocytes. Pathway analyses implicated adipogenesis, angiogenesis, transcriptional regulation and insulin resistance as processes affecting fat distribution, providing insight into potential pathophysiological mechanisms.

Genetic studies of body mass index yield new insights for obesity biology

Obesity is heritable and predisposes to many diseases. To understand the genetic basis of obesity better, here we conduct a genome-wide association study and Metabochip meta-analysis of body mass index (BMI), a measure commonly used to define obesity and assess adiposity, in up to 339,224 individuals. This analysis identifies 97 BMI-associated loci (P < 5 × 10−8), 56 of which are novel. Five loci demonstrate clear evidence of several independent association signals, and many loci have significant effects on other metabolic phenotypes. The 97 loci account for ~2.7% of BMI variation, and genome-wide estimates suggest that common variation accounts for >20% of BMI variation. Pathway analyses provide strong support for a role of the central nervous system in obesity susceptibility and implicate new genes and pathways, including those related to synaptic function, glutamate signalling, insulin secretion/action, energy metabolism, lipid biology and adipogenesis.

Meta-analysis identifies 13 new loci associated with waist-hip ratio and reveals sexual dimorphism in the genetic basis of fat distribution

Waist-hip ratio (WHR) is a measure of body fat distribution and a predictor of metabolic consequences independent of overall adiposity. WHR is heritable, but few genetic variants influencing this trait have been identified. We conducted a meta-analysis of 32 genome-wide association studies for WHR adjusted for body mass index (comprising up to 77,167 participants), following up 16 loci in an additional 29 studies (comprising up to 113,636 subjects). We identified 13 new loci in or near RSPO3, VEGFA, TBX15-WARS2, NFE2L3, GRB14, DNM3-PIGC, ITPR2-SSPN, LY86, HOXC13, ADAMTS9, ZNRF3-KREMEN1, NISCH-STAB1 and CPEB4 (P = 1.9 × 10−9 to P = 1.8 × 10−40) and the known signal at LYPLAL1. Seven of these loci exhibited marked sexual dimorphism, all with a stronger effect on WHR in women than men (P for sex difference = 1.9 × 10−3 to P = 1.2 × 10−13). These findings provide evidence for multiple loci that modulate body fat distribution independent of overall adiposity and reveal strong gene-by-sex interactions.

Save Left Shark: Katy Perry, Intellectual Property, and 3D Printing

There has been much interest in how intellectual property law, policy and practice will adapt to the emergence of 3D printing and the maker movement. Intellectual property lawyers will have to grapple with the impact of additive manufacturing upon a variety of forms of intellectual property — including copyright law, trade mark law, designs law, patent law and trade secrets. The disruptive technology of 3D printing will both pose opportunities and challenges for legal practitioners and policy makers.A performance by pop princess Katy Perry at the 2015 Super Bowl has sparked a public controversy over intellectual property, internet memes and 3D printing.

Ruelfenrod; Jewish Community Collection 1836

Photocopies of documents by Baruch Bilstein and Wolf Levi of Ruelfenrod regarding the Jewish cemetery of Ruelfenrod

Characterization of Failure Modes in CFRP Composites - An ANN Approach

Carbon fiber reinforced polymer (CFRP) composite specimens with different thickness, geometry, and stacking sequences were subjected to fatigue spectrum loading in stages. Another set of specimens was subjected to static compression load. On-line acoustic Emission (AE) monitoring was carried out during these tests. Two artificial neural networks, Kohonen-self organizing feature map (KSOM), and multi-layer perceptron (MLP) have been developed for AE signal analysis. AE signals from specimens were clustered using the unsupervised learning KSOM. These clusters were correlated to the failure modes using available a priori information such as AE signal amplitude distributions, time of occurrence of signals, ultrasonic imaging, design of the laminates (stacking sequences, orientation of fibers), and AE parametric plots. Thereafter, AE signals generated from the rest of the specimens were classified by supervised learning MLP. The network developed is made suitable for on-line monitoring of AE signals in the presence of noise, which can be used for detection and identification of failure modes and their growth. The results indicate that the characteristics of AE signals from different failure modes in CFRP remain largely unaffected by the type of load, fiber orientation, and stacking sequences, they being representatives of the type of failure phenomena. The type of loading can have effect only on the extent of damage allowed before the specimens fail and hence on the number of AE signals during the test. The artificial neural networks (ANN) developed and the methods and procedures adopted show significant success in AE signal characterization under noisy environment (detection and identification of failure modes and their growth).

Comparison of ANN models for predicting water quality in distribution systems

Deterministic models have been widely used to predict water quality in distribution systems, but their calibration requires extensive and accurate data sets for numerous parameters. In this study, alternative data-driven modeling approaches based on artificial neural networks (ANNs) were used to predict temporal variations of two important characteristics of water quality chlorine residual and biomass concentrations. The authors considered three types of ANN algorithms. Of these, the Levenberg-Marquardt algorithm provided the best results in predicting residual chlorine and biomass with error-free and ``noisy'' data. The ANN models developed here can generate water quality scenarios of piped systems in real time to help utilities determine weak points of low chlorine residual and high biomass concentration and select optimum remedial strategies.

An ANN based approach for voltage stability assessment

Artificial Neural Networks (ANNs) have recently been proposed as an alterative method for salving certain traditional problems in power systems where conventional techniques have not achieved the desired speed, accuracy or efficiency. This paper presents application of ANN where the aim is to achieve fast voltage stability margin assessment of power network in an energy control centre (ECC), with reduced number of appropriate inputs. L-index has been used for assessing voltage stability margin. Investigations are carried out on the influence of information encompassed in input vector and target out put vector, on the learning time and test performance of multi layer perceptron (MLP) based ANN model. LP based algorithm for voltage stability improvement, is used for generating meaningful training patterns in the normal operating range of the system. From the generated set of training patterns, appropriate training patterns are selected based on statistical correlation process, sensitivity matrix approach, contingency ranking approach and concentric relaxation method. Simulation results on a 24 bus EHV system, 30 bus modified IEEE system, and a 82 bus Indian power network are presented for illustration purposes.

Intelligent prediction of ground vibration in coal formations using ANN

The present paper details the prediction of blast induced ground vibration, using artificial neural network. The data was generated from five different coal mines. Twenty one different parameters involving rock mass parameters, explosive parameters and blast design parameters, were used to develop the one comprehensive ANN model for five different coal bearing formations. A total of 131 datasets was used to develop the ANN model and 44 datasets was used to test the model. The developed ANN model was compared with the USBM model. The prediction capability to predict blast induced ground vibration, of the comprehensive ANN model was found to be superior.