Lettera al rev. padre Giuseppe Ruiz.

Pamphlet.

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.

Giuseppe Ungaretti : un itinerario lírico

Resumen: El ensayo recorre momentos significativos de la poesía del poeta italiano, desde el carácter despojado y el silabeo de los versos de L’Allegria , al estilo barroco cristiano de Sentimento del Tempo, en el que se restituye la tradición del canto, silenciado en la época anterior, hasta llegar a Il dolore y La terra promessa, de la que se analiza desde un enfoque comparado el “Recitativo di Palinuro”. La obra lírica de Ungaretti refleja al “hombre de pena” que después de las tragedias bélicas, como un náufrago vive con la esperanza de que la vida renazca y la fe se renueve.

Estudio de oferta y demanda de Laurel (Cordia alliodora (Ruiz y Pavón)) Oken., en los municipios de Nandaime, Granada y Masaya, Nicaragua

El objetivo principal del estudio fue determinar los componentes de mercado, oferta y demanda de laurel (Cordia alliodora) en los Municipios de Nandaime, Granada y Masaya en el periodo Enero - Julio 2002. Para el levantamiento de la información se diseño una metodología basada en el sondeo, utilizando la encuesta como técnica principal para la recolección de los datos. Se diseñaron tres tipos de entrevistas de acuerdo con la información que se requería (aserraderos, carpinterías y mueblerías), las cuales identificarían el mercado local de la madera de laurel, precio y características demandadas. Se estudiaron 18 carpinterías que corresponden al 100 %de la muestra. Estas demandaron 32 550 pulgadas de madera de laurel, equivalente a 13.02 fletes. Se identificaron dos formas de comercialización de la madera de laurel. La primera es la forma legal que cumple con los requisitos de permisos e impuestos de acuerdo a la ley, y la segunda es la forma ilegal, obviando los pagos de permisos, impuestos y demás conforme a la ley. Los principales consumidores de la madera de laurel proceden los municipios estudiados y otros procedentes de las ciudades de Carazo, Rivas, Managua y Tipitapa. Los productos más comercializados en los puestos de venta corresponden a medidas para tablas de 1" X 16" X 4V y 1" X 12" X 5V, tablones de 2" X 6" X 4V y Alfajillas con medidas de 1" X 2" X 5V. Los productos más comercializados en las carpinterías son sillas, camas, roperos, puertas y comedores. Los factores principales que intervienen en la oferta y la demanda de madera de laurel, son: la poca cantidad de madera ofrecida, el alto valor de esta madera y del producto acabado, árboles aprovechados sin alcanzar el diámetro mínimo de corta, los gustos, y la capacidad adquisitiva del demandante. La estructura de costos indica que en el proceso legal de aprovechamiento, los gastos en concepto de pago de permisos e impuestos son excesivos, lo cual encarece el producto al consumidor final. El mercado legal más activo para esta madera es el de Masaya, debido a la presencia de un mayor número de carpinterías y puestos de venta que lo vuelven más competitivo. El hecho que este retirado de la zona rural permite que disminuya la competencia con el mercado negro de la madera, una ventaja al momento de la comercialización. Se proyecta que la demanda de madera aumentará a razón de 1.10 m' por año. Esta demanda es baja, pero se debe tomar en cuenta que está en función de la cantidad ofertada, si esta aumenta, aunmentara también la demanda.

Resumen de las Memorias de Jaime de Urkijo, por Luis Ruiz de Aguirre.

Fecha: >1970 / Unidad de instalación: Carpeta 53 - Expediente 10-1 / Nº de pág.: 14 (manuscritas)

Recopilación de artículos sobre la Guerra Civil publicados por "Deia" en el diario del mismo nombre, y en el suplemento semanal dominical del mismo. Contiene completos los suplementos número 243, 244, 255, y recortes sueltos de otros. Como autores destacan Ruiz de Aguirre, que escribe artículos con el título "La ruta de Santoña", y Koldo San Sebastián, que escribe sobre el Gobierno Vasco en Santander, y los niños evacuados al extranjero.

Fecha: 26-3-1981/18-7-1983 / Unidad de instalación: Carpeta 48 - Expediente 8-5 / Nº de pág.: 67 (mecanografiadas)

Memorias de Ruiz de Aguirre tituladas "Mi salida de Bilbao".

Fecha: 21/26-5-1973 / Unidad de instalación: Carpeta 48 - Expediente 7-19-1 / Nº de pág.: 7 (mecanografiadas)

Notas críticas de Ruiz de Aguirre sobre su papel como historiador, -"El bagaje intelectual de un historiador"-, sobre las reuniones efectuadas para obtener datos sobre la guerra (cita el ejemplo de Jaime Villanueva) y acerca de lo publicado sobre el Ejército Vasco por los historiadores militares franquistas.

Fecha: 21/26-5-1973 / Unidad de instalación: Carpeta 48 - Expediente 7-19-2 / Nº de pág.: 24 (22 mecanografiadas, 2 manuscritas)

Separatas de artículos de los que es autor Miguel Pelay Orozko, quien dedica alguno de ellos a Luis Ruiz de Aguirre.

Fecha: 1971-1972 / Unidad de instalación: Carpeta 48 - Expediente 7-17 / Nº de pág.: 8 (mecanografiadas)

Carta de Alberto Elósegi dirigida a Ruiz de Aguirre, y artículo de Jon Kortazar sobre el poeta "Lauaxeta" (Esteban Urkiaga).

Fecha: 9-5-1987 / Unidad de instalación: Carpeta 48 - Expediente 7-12 / Nº de pág.: 4 (mecanografiadas)

Caso Grúas Ruiz

Las estrategias competitivas son las posibles líneas de actuación de las que dispone la empresa para competir mejor en mercados determinados, con productos o servicios concretos, de tal forma que se genere una posición competitiva ventajosa para la misma. Aunque la empresa se proponga competir en un mercado provincial o regional, para tener éxito en un contexto global, tiene que combinar dos extremos aparentemente irreconciliables. Por un lado tendrá que «pegarse al terreno» para conocer y aportar valor a sus clientes, mientras que, por otro lado, tendrá que conocer y estar presente en las iniciativas de valor en todos los ámbitos. Desde el punto de vista de sus negocios, la empresa deberá plantear su estrategia competitiva de acuerdo con estas premisas.

Functional analysis of cancer-associated EGFR mutants using a cellular assay with YFP-tagged EGFR intracellular domain

Background: The presence of EGFR kinase domain mutations in a subset of NSCLC patients correlates with the response to treatment with the EGFR tyrosine kinase inhibitors gefitinib and erlotinib. Although most EGFR mutations detected are short deletions in exon 19 or the L858R point mutation in exon 21, more than 75 different EGFR kinase domain residues have been reported to be altered in NSCLC patients. The phenotypical consequences of different EGFR mutations may vary dramatically, but the majority of uncommon EGFR mutations have never been functionally evaluated. Results: We demonstrate that the relative kinase activity and erlotinib sensitivity of different EGFR mutants can be readily evaluated using transfection of an YFP-tagged fragment of the EGFR intracellular domain (YFP-EGFR-ICD), followed by immunofluorescence microscopy analysis. Using this assay, we show that the exon 20 insertions Ins770SVD and Ins774HV confer increased kinase activity, but no erlotinib sensitivity. We also show that, in contrast to the common L858R mutation, the uncommon exon 21 point mutations P848L and A859T appear to behave like functionally silent polymorphisms. Conclusion: The ability to rapidly obtain functional information on EGFR variants of unknown relevance using the YFP-EGFR-ICD assay might prove important in the future for the management of NSCLC patients bearing uncommon EGFR mutations. In addition, our assay may be used to determine the response of resistant EGFR mutants to novel second-generation TKIs.

Nota manuscrita “Para los Consejeros” del Gobierno Vasco, entregada en Trucios a Luis Ruiz de Aguirre, comisario general del Ejército Vasco, el 19 de junio de 1937

Fecha: 19-6-1937 / Unidad de ínstalación: Carpeta Rectorado - A-1 / Nº de pág.: 1 (manuscrita)Enmarcada

Parte de guerra del Batallón Euzko Indarra de ANV, firmado por el Comisario Político Bernabé Orbegozo y el Comisario General Luis Ruiz de Aguirre

Fecha: 18 de julio de 1937 / Unidad de ínstalación: Carpeta Rectorado - E-1 / Nº de pág.: 1 (Mecanografiada y firmas manuscritas)