Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990–2021:a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDetailed, comprehensive, and timely reporting on population health by underlying causes of disability and premature death is crucial to understanding and responding to complex patterns of disease and injury burden over time and across age groups, sexes, and locations. The availability of disease burden estimates can promote evidence-based interventions that enable public health researchers, policy makers, and other professionals to implement strategies that can mitigate diseases. It can also facilitate more rigorous monitoring of progress towards national and international health targets, such as the Sustainable Development Goals. For three decades, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) has filled that need. A global network of collaborators contributed to the production of GBD 2021 by providing, reviewing, and analysing all available data. GBD estimates are updated routinely with additional data and refined analytical methods. GBD 2021 presents, for the first time, estimates of health loss due to the COVID-19 pandemic.MethodsThe GBD 2021 disease and injury burden analysis estimated years lived with disability (YLDs), years of life lost (YLLs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries using 100 983 data sources. Data were extracted from vital registration systems, verbal autopsies, censuses, household surveys, disease-specific registries, health service contact data, and other sources. YLDs were calculated by multiplying cause-age-sex-location-year-specific prevalence of sequelae by their respective disability weights, for each disease and injury. YLLs were calculated by multiplying cause-age-sex-location-year-specific deaths by the standard life expectancy at the age that death occurred. DALYs were calculated by summing YLDs and YLLs. HALE estimates were produced using YLDs per capita and age-specific mortality rates by location, age, sex, year, and cause. 95% uncertainty intervals (UIs) were generated for all final estimates as the 2·5th and 97·5th percentiles values of 500 draws. Uncertainty was propagated at each step of the estimation process. Counts and age-standardised rates were calculated globally, for seven super-regions, 21 regions, 204 countries and territories (including 21 countries with subnational locations), and 811 subnational locations, from 1990 to 2021. Here we report data for 2010 to 2021 to highlight trends in disease burden over the past decade and through the first 2 years of the COVID-19 pandemic.FindingsGlobal DALYs increased from 2·63 billion (95% UI 2·44–2·85) in 2010 to 2·88 billion (2·64–3·15) in 2021 for all causes combined. Much of this increase in the number of DALYs was due to population growth and ageing, as indicated by a decrease in global age-standardised all-cause DALY rates of 14·2% (95% UI 10·7–17·3) between 2010 and 2019. Notably, however, this decrease in rates reversed during the first 2 years of the COVID-19 pandemic, with increases in global age-standardised all-cause DALY rates since 2019 of 4·1% (1·8–6·3) in 2020 and 7·2% (4·7–10·0) in 2021. In 2021, COVID-19 was the leading cause of DALYs globally (212·0 million [198·0–234·5] DALYs), followed by ischaemic heart disease (188·3 million [176·7–198·3]), neonatal disorders (186·3 million [162·3–214·9]), and stroke (160·4 million [148·0–171·7]). However, notable health gains were seen among other leading communicable, maternal, neonatal, and nutritional (CMNN) diseases. Globally between 2010 and 2021, the age-standardised DALY rates for HIV/AIDS decreased by 47·8% (43·3–51·7) and for diarrhoeal diseases decreased by 47·0% (39·9–52·9). Non-communicable diseases contributed 1·73 billion (95% UI 1·54–1·94) DALYs in 2021, with a decrease in age-standardised DALY rates since 2010 of 6·4% (95% UI 3·5–9·5). Between 2010 and 2021, among the 25 leading Level 3 causes, age-standardised DALY rates increased most substantially for anxiety disorders (16·7% [14·0–19·8]), depressive disorders (16·4% [11·9–21·3]), and diabetes (14·0% [10·0–17·4]). Age-standardised DALY rates due to injuries decreased globally by 24·0% (20·7–27·2) between 2010 and 2021, although improvements were not uniform across locations, ages, and sexes. Globally, HALE at birth improved slightly, from 61·3 years (58·6–63·6) in 2010 to 62·2 years (59·4–64·7) in 2021. However, despite this overall increase, HALE decreased by 2·2% (1·6–2·9) between 2019 and 2021.InterpretationPutting the COVID-19 pandemic in the context of a mutually exclusive and collectively exhaustive list of causes of health loss is crucial to understanding its impact and ensuring that health funding and policy address needs at both local and global levels through cost-effective and evidence-based interventions. A global epidemiological transition remains underway. Our findings suggest that prioritising non-communicable disease prevention and treatment policies, as well as strengthening health systems, continues to be crucially important. The progress on reducing the burden of CMNN diseases must not stall; although global trends are improving, the burden of CMNN diseases remains unacceptably high. Evidence-based interventions will help save the lives of young children and mothers and improve the overall health and economic conditions of societies across the world. Governments and multilateral organisations should prioritise pandemic preparedness planning alongside efforts to reduce the burden of diseases and injuries that will strain resources in the coming decades.FundingBill &amp; Melinda Gates Foundation.<br/

Socioeconomic inequality in clusters of health-related behaviours in Europe:latent class analysis of a cross-sectional European survey

Background: Modifiable health-related behaviours tend to cluster among most vulnerable sectors of the population, particularly those at the bottom of the social hierarchy. This study aimed to identify the clusters of health-related behaviours in 27 European countries and to examine the socioeconomic inequalities in these clusters.Methods: Data were from Eurobarometer 72.3–2009, a cross-sectional survey of 27 European countries. The analyses were conducted in 2016. The main sections of the survey included questions pertaining to sociodemographic factors, health-related behaviours, and use of services. In this study, those aged 18 years and older were included. We selected five health-related behaviours, namely smoking, excessive alcohol consumption, frequent fresh fruit consumption,physical activity and dental check-ups. Socioeconomic position was indicated by education, subjective social status and difficulty in paying bills. Latent class analysis was conducted to explore the clusters of these five behaviours.Multinomial logistic regression model was used to examine the relationships between the clusters and socioeconomic positions adjusting for age, gender, marital status and urbanisation.Results: The eligible total population was 23,842. Latent class analysis identified three clusters; healthy, moderate andrisky clusters in this European population. Individuals with the lowest socioeconomic position were more likely to haverisky and moderate clusters than healthy cluster compared to those with the highest socioeconomic position.Conclusions: There were clear socioeconomic gradients in clusters of health-related behaviours. The findings highlightthe importance of adopting interventions that address multiple health risk behaviours and policies that tackle thesocial determinants of health-related behaviours

Informe jurídico sobre expediente N° 02138_2019_0_1501_JR_CI_06

En el caso materia de estudio, se tiene que la persona de J. A. C. G. interpuso demanda de prescripción adquisitiva de dominio del predio ubicado en el distrito y provincia de Huancayo del departamento de Junín, solicitando se notifique a los colindantes N. R. C. G. y M. M. C. G. y se ponga en conocimiento de la Beneficencia Pública de Huancayo y la Municipalidad Provincial de Huancayo. Admitida la demanda y corrido traslado de la misma, la parte demandada no contestó la misma, por lo que se fue declarado rebelde. Transcurrido el proceso sin contratiempos, el el Sexto Juzgado Civil de Huancayo, emitió sentencia declarándola FUNDADA la demanda; contra dicha sentencia, el Procurador Público de la Municipalidad Provincial de Huancayo, al no estar de acuerdo con lo resuelto, interpuso recurso de apelación. La Sala Civil Permanente de Huancayo, resolvió el recurso de apelación, decidiendo: REVOCAR la Sentencia impugnada y REFORMÁNDOLA declararon infundada la demanda

Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015:a systematic analysis for the Global Burden of Disease Study 2015

BACKGROUND: The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 provides an up-to-date synthesis of the evidence for risk factor exposure and the attributable burden of disease. By providing national and subnational assessments spanning the past 25 years, this study can inform debates on the importance of addressing risks in context.METHODS: We used the comparative risk assessment framework developed for previous iterations of the Global Burden of Disease Study to estimate attributable deaths, disability-adjusted life-years (DALYs), and trends in exposure by age group, sex, year, and geography for 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2015. This study included 388 risk-outcome pairs that met World Cancer Research Fund-defined criteria for convincing or probable evidence. We extracted relative risk and exposure estimates from randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. We developed a metric that allows comparisons of exposure across risk factors-the summary exposure value. Using the counterfactual scenario of theoretical minimum risk level, we estimated the portion of deaths and DALYs that could be attributed to a given risk. We decomposed trends in attributable burden into contributions from population growth, population age structure, risk exposure, and risk-deleted cause-specific DALY rates. We characterised risk exposure in relation to a Socio-demographic Index (SDI).FINDINGS: Between 1990 and 2015, global exposure to unsafe sanitation, household air pollution, childhood underweight, childhood stunting, and smoking each decreased by more than 25%. Global exposure for several occupational risks, high body-mass index (BMI), and drug use increased by more than 25% over the same period. All risks jointly evaluated in 2015 accounted for 57·8% (95% CI 56·6-58·8) of global deaths and 41·2% (39·8-42·8) of DALYs. In 2015, the ten largest contributors to global DALYs among Level 3 risks were high systolic blood pressure (211·8 million [192·7 million to 231·1 million] global DALYs), smoking (148·6 million [134·2 million to 163·1 million]), high fasting plasma glucose (143·1 million [125·1 million to 163·5 million]), high BMI (120·1 million [83·8 million to 158·4 million]), childhood undernutrition (113·3 million [103·9 million to 123·4 million]), ambient particulate matter (103·1 million [90·8 million to 115·1 million]), high total cholesterol (88·7 million [74·6 million to 105·7 million]), household air pollution (85·6 million [66·7 million to 106·1 million]), alcohol use (85·0 million [77·2 million to 93·0 million]), and diets high in sodium (83·0 million [49·3 million to 127·5 million]). From 1990 to 2015, attributable DALYs declined for micronutrient deficiencies, childhood undernutrition, unsafe sanitation and water, and household air pollution; reductions in risk-deleted DALY rates rather than reductions in exposure drove these declines. Rising exposure contributed to notable increases in attributable DALYs from high BMI, high fasting plasma glucose, occupational carcinogens, and drug use. Environmental risks and childhood undernutrition declined steadily with SDI; low physical activity, high BMI, and high fasting plasma glucose increased with SDI. In 119 countries, metabolic risks, such as high BMI and fasting plasma glucose, contributed the most attributable DALYs in 2015. Regionally, smoking still ranked among the leading five risk factors for attributable DALYs in 109 countries; childhood underweight and unsafe sex remained primary drivers of early death and disability in much of sub-Saharan Africa.INTERPRETATION: Declines in some key environmental risks have contributed to declines in critical infectious diseases. Some risks appear to be invariant to SDI. Increasing risks, including high BMI, high fasting plasma glucose, drug use, and some occupational exposures, contribute to rising burden from some conditions, but also provide opportunities for intervention. Some highly preventable risks, such as smoking, remain major causes of attributable DALYs, even as exposure is declining. Public policy makers need to pay attention to the risks that are increasingly major contributors to global burden.FUNDING: Bill &amp; Melinda Gates Foundation.</p

Free ion diffusivity and charge concentration on cross-linked Polymeric Ionic Liquid iongels films based on sulfonated zwitterion salts and Lithium ions

[EN] The properties of various mixtures of a zwitterionic ionic liquid (ZIs-1) and LiNTf 2, including their conductivity, have been studied showing how they can be adjusted through their molar composition. Conductivity tends to increase with the LiNTf2 content although it presents a minimum at the region close to the eutectic point. These mixtures also provide excellent features as liquid phases for the preparation of composite materials based on crosslinked PILs. The prepared films display excellent and tuneable properties as conducting materials, with conductivities that can be higher than 10 2 S cm 1 above 100 1C. The selected polymeric compositions show very good mechanical properties and thermal stability, even for low crosslinking degrees, along with a suitable flexibility and good transparency. The final properties of the films correlate with the composition of the monomeric mixture used and with that of the ZIs-1:LiNTf2 mixture.Financial support has been provided by MINECO (ENE/2015-69203-R and RTI2018-098233-B-C22) and Generalitat Valenciana (PROMETEO/2016/071). Technical support from the SECIC of the UJI is also acknowledged. DV thanks UNED (Costa Rica) for a predoctoral fellowship.Valverde, D.; Garcia Bernabe, A.; Andrio Balado, A.; Garcia-Verdugo, E.; Luis Lafuente, S.; Compañ Moreno, V. (2019). Free ion diffusivity and charge concentration on cross-linked Polymeric Ionic Liquid iongels films based on sulfonated zwitterion salts and Lithium ions. Physical Chemistry Chemical Physics. 21(32):17923-17932. https://doi.org/10.1039/c9cp01903kS17923179322132Etacheri, V., Marom, R., Elazari, R., Salitra, G., & Aurbach, D. (2011). Challenges in the development of advanced Li-ion batteries: a review. Energy & Environmental Science, 4(9), 3243. doi:10.1039/c1ee01598bArya, A., & Sharma, A. L. (2017). Polymer electrolytes for lithium ion batteries: a critical study. Ionics, 23(3), 497-540. doi:10.1007/s11581-016-1908-6Kalhoff, J., Eshetu, G. G., Bresser, D., & Passerini, S. (2015). Safer Electrolytes for Lithium-Ion Batteries: State of the Art and Perspectives. ChemSusChem, 8(13), 2154-2175. doi:10.1002/cssc.201500284Eftekhari, A., Liu, Y., & Chen, P. (2016). Different roles of ionic liquids in lithium batteries. Journal of Power Sources, 334, 221-239. doi:10.1016/j.jpowsour.2016.10.025Osada, I., de Vries, H., Scrosati, B., & Passerini, S. (2015). Ionic-Liquid-Based Polymer Electrolytes for Battery Applications. Angewandte Chemie International Edition, 55(2), 500-513. doi:10.1002/anie.201504971Shaplov, A. S., Marcilla, R., & Mecerreyes, D. (2015). Recent Advances in Innovative Polymer Electrolytes based on Poly(ionic liquid)s. Electrochimica Acta, 175, 18-34. doi:10.1016/j.electacta.2015.03.038Yoshizawa, M., Hirao, M., Ito-Akita, K., & Ohno, H. (2001). Ion conduction in zwitterionic-type molten salts and their polymers. Journal of Materials Chemistry, 11(4), 1057-1062. doi:10.1039/b101079oWatanabe, M., Thomas, M. L., Zhang, S., Ueno, K., Yasuda, T., & Dokko, K. (2017). Application of Ionic Liquids to Energy Storage and Conversion Materials and Devices. Chemical Reviews, 117(10), 7190-7239. doi:10.1021/acs.chemrev.6b00504Yoshizawa, M., Narita, A., & Ohno, H. (2004). Design of Ionic Liquids for Electrochemical Applications. Australian Journal of Chemistry, 57(2), 139. doi:10.1071/ch03240Yoshizawa, M., & Ohno, H. (2004). Anhydrous proton transport system based on zwitterionic liquid and HTFSI. Chemical Communications, (16), 1828. doi:10.1039/b404137bYoshizawa-Fujita, M., Tamura, T., Takeoka, Y., & Rikukawa, M. (2011). Low-melting zwitterion: effect of oxyethylene units on thermal properties and conductivity. Chem. Commun., 47(8), 2345-2347. doi:10.1039/c0cc03754kPaschoal, V. H., Faria, L. F. O., & Ribeiro, M. C. C. (2017). Vibrational Spectroscopy of Ionic Liquids. Chemical Reviews, 117(10), 7053-7112. doi:10.1021/acs.chemrev.6b00461Narita, A., Shibayama, W., & Ohno, H. (2006). Structural factors to improve physico-chemical properties of zwitterions as ion conductive matrices. Journal of Materials Chemistry, 16(15), 1475. doi:10.1039/b515287aOhno, H., Yoshizawa-Fujita, M., & Kohno, Y. (2018). Design and properties of functional zwitterions derived from ionic liquids. Physical Chemistry Chemical Physics, 20(16), 10978-10991. doi:10.1039/c7cp08592cGarcía-Bernabé, A., Rivera, A., Granados, A., Luis, S. V., & Compañ, V. (2016). Ionic transport on composite polymers containing covalently attached and absorbed ionic liquid fragments. Electrochimica Acta, 213, 887-897. doi:10.1016/j.electacta.2016.08.018Altava, B., Compañ, V., Andrio, A., del Castillo, L. F., Mollá, S., Burguete, M. I., … Luis, S. V. (2015). Conductive films based on composite polymers containing ionic liquids absorbed on crosslinked polymeric ionic-like liquids (SILLPs). Polymer, 72, 69-81. doi:10.1016/j.polymer.2015.07.009Coelho, R. (1991). On the static permittivity of dipolar and conductive media — an educational approach. Journal of Non-Crystalline Solids, 131-133, 1136-1139. doi:10.1016/0022-3093(91)90740-wKlein, R. J., Zhang, S., Dou, S., Jones, B. H., Colby, R. H., & Runt, J. (2006). Modeling electrode polarization in dielectric spectroscopy: Ion mobility and mobile ion concentration of single-ion polymer electrolytes. The Journal of Chemical Physics, 124(14), 144903. doi:10.1063/1.2186638Bandara, T. M. W. J., Dissanayake, M. A. K. L., Albinsson, I., & Mellander, B.-E. (2011). Mobile charge carrier concentration and mobility of a polymer electrolyte containing PEO and Pr4N+I− using electrical and dielectric measurements. Solid State Ionics, 189(1), 63-68. doi:10.1016/j.ssi.2011.03.004Choi, U. H., Mittal, A., Price, T. L., Gibson, H. W., Runt, J., & Colby, R. H. (2013). Polymerized Ionic Liquids with Enhanced Static Dielectric Constants. Macromolecules, 46(3), 1175-1186. doi:10.1021/ma301833jSerghei, A., Tress, M., Sangoro, J. R., & Kremer, F. (2009). Electrode polarization and charge transport at solid interfaces. Physical Review B, 80(18). doi:10.1103/physrevb.80.184301Sørensen, T. S., Compañ, V., & Diaz-Calleja, R. (1996). Complex permittivity of a film of poly[4-(acryloxy)phenyl-(4-chlorophenyl)methanone] containing free ion impurities and the separation of the contributions from interfacial polarization, Maxwell–Wagner–Sillars effects and dielectric relaxations of the polymer chains. J. Chem. Soc., Faraday Trans., 92(11), 1947-1957. doi:10.1039/ft9969201947Sørensen, T. S., & Compañ, V. (1995). Complex permittivity of a conducting, dielectric layer containing arbitrary binary Nernst–Planck electrolytes with applications to polymer films and cellulose acetate membranes. J. Chem. Soc., Faraday Trans., 91(23), 4235-4250. doi:10.1039/ft9959104235Wang, Y., Fan, F., Agapov, A. L., Saito, T., Yang, J., Yu, X., … Sokolov, A. P. (2014). Examination of the fundamental relation between ionic transport and segmental relaxation in polymer electrolytes. Polymer, 55(16), 4067-4076. doi:10.1016/j.polymer.2014.06.085Krause, C., Sangoro, J. R., Iacob, C., & Kremer, F. (2010). Charge Transport and Dipolar Relaxations in Imidazolium-Based Ionic Liquids. The Journal of Physical Chemistry B, 114(1), 382-386. doi:10.1021/jp908519uFragiadakis, D., Dou, S., Colby, R. H., & Runt, J. (2009). Molecular mobility and Li+ conduction in polyester copolymer ionomers based on poly(ethylene oxide). The Journal of Chemical Physics, 130(6), 064907. doi:10.1063/1.3063659Fragiadakis, D., Dou, S., Colby, R. H., & Runt, J. (2008). Molecular Mobility, Ion Mobility, and Mobile Ion Concentration in Poly(ethylene oxide)-Based Polyurethane Ionomers. Macromolecules, 41(15), 5723-5728. doi:10.1021/ma800263bLeys, J., Wübbenhorst, M., Preethy Menon, C., Rajesh, R., Thoen, J., Glorieux, C., … Longuemart, S. (2008). Temperature dependence of the electrical conductivity of imidazolium ionic liquids. The Journal of Chemical Physics, 128(6), 064509. doi:10.1063/1.2827462Sangoro, J. R., Serghei, A., Naumov, S., Galvosas, P., Kärger, J., Wespe, C., … Kremer, F. (2008). Charge transport and mass transport in imidazolium-based ionic liquids. Physical Review E, 77(5). doi:10.1103/physreve.77.051202Munar, A., Andrio, A., Iserte, R., & Compañ, V. (2011). Ionic conductivity and diffusion coefficients of lithium salt polymer electrolytes measured with dielectric spectroscopy. Journal of Non-Crystalline Solids, 357(16-17), 3064-3069. doi:10.1016/j.jnoncrysol.2011.04.012Garcia-Bernabé, A., Compañ, V., Burguete, M. I., García-Verdugo, E., Karbass, N., Luis, S. V., & Riande, E. (2010). Conductivity and Polarization Processes in Highly Cross-Linked Supported Ionic Liquid-Like Phases. The Journal of Physical Chemistry C, 114(15), 7030-7037. doi:10.1021/jp910535zCompañ, V., Molla, S., García Verdugo, E., Luis, S. V., & Burguete, M. I. (2012). Synthesis and characterization of the conductivity and polarization processes in supported ionic liquid-like phases (SILLPs). Journal of Non-Crystalline Solids, 358(9), 1228-1237. doi:10.1016/j.jnoncrysol.2012.02.028Huber, B., Rossrucker, L., Sundermeyer, J., & Roling, B. (2013). Ion transport properties of ionic liquid-based polyelectrolytes. Solid State Ionics, 247-248, 15-21. doi:10.1016/j.ssi.2013.05.023Shaplov, A. S., Marcilla, R., & Mecerreyes, D. (2015). Recent Advances in Innovative Polymer Electrolytes based on Poly(ionic liquid)s. Electrochimica Acta, 175, 18-34. doi:10.1016/j.electacta.2015.03.038Green, M. D., Wang, D., Hemp, S. T., Choi, J.-H., Winey, K. I., Heflin, J. R., & Long, T. E. (2012). Synthesis of imidazolium ABA triblock copolymers for electromechanical transducers. Polymer, 53(17), 3677-3686. doi:10.1016/j.polymer.2012.06.023Compañ, V., Smith So/rensen, T., Diaz‐Calleja, R., & Riande, E. (1996). Diffusion coefficients of conductive ions in a copolymer of vinylidene cyanide and vinyl acetate obtained from dielectric measurements using the model of Trukhan. Journal of Applied Physics, 79(1), 403-411. doi:10.1063/1.360844Wang, Y., Sun, C.-N., Fan, F., Sangoro, J. R., Berman, M. B., Greenbaum, S. G., … Sokolov, A. P. (2013). Examination of methods to determine free-ion diffusivity and number density from analysis of electrode polarization. Physical Review E, 87(4). doi:10.1103/physreve.87.042308Kunal, K., Robertson, C. G., Pawlus, S., Hahn, S. F., & Sokolov, A. P. (2008). Role of Chemical Structure in Fragility of Polymers: A Qualitative Picture. Macromolecules, 41(19), 7232-7238. doi:10.1021/ma801155cShaplov, A. S., Ponkratov, D. O., Vlasov, P. S., Lozinskaya, E. I., Gumileva, L. V., Surcin, C., … Vygodskii, Y. S. (2015). Ionic semi-interpenetrating networks as a new approach for highly conductive and stretchable polymer materials. Journal of Materials Chemistry A, 3(5), 2188-2198. doi:10.1039/c4ta05833jDudowicz, J., Freed, K. F., & Douglas, J. F. (2005). The Glass Transition Temperature of Polymer Melts†. The Journal of Physical Chemistry B, 109(45), 21285-21292. doi:10.1021/jp0523266J. C. A. Maxwell , Treatise of Electricity & Magnetism , Dover , New York , 1954 , pp. 310–314Leys, J., Rajesh, R. N., Menon, P. C., Glorieux, C., Longuemart, S., Nockemann, P., … Binnemans, K. (2010). Influence of the anion on the electrical conductivity and glass formation of 1-butyl-3-methylimidazolium ionic liquids. The Journal of Chemical Physics, 133(3), 034503. doi:10.1063/1.3455892Hayamizu, K., Akiba, E., Bando, T., & Aihara, Y. (2002). 1H, 7Li, and 19F nuclear magnetic resonance and ionic conductivity studies for liquid electrolytes composed of glymes and polyetheneglycol dimethyl ethers of CH3O(CH2CH2O)nCH3 (n=3–50) doped with LiN(SO2CF3)2. The Journal of Chemical Physics, 117(12), 5929-5939. doi:10.1063/1.1501279Agrawal, R. C., Kumar, R., & Gupta, R. K. (1998). Estimation of ionic drift velocity on some fast Ag+ ion conducting systems. Materials Science and Engineering: B, 57(1), 46-51. doi:10.1016/s0921-5107(98)00261-xG. A. Niklasson , A. K.Jonsson , M.Stromme , Y.Barsoukova and J. R.MacDonald , Impedance Spectroscopy , 2nd edn, Wiley , New York , 2005 , pp. 302–326Schütt, H. J., & Gerdes, E. (1992). Space-charge relaxation in ionicly conducting oxide glasses. I. Model and frequency response. Journal of Non-Crystalline Solids, 144, 1-13. doi:10.1016/s0022-3093(05)80377-1R. Coelho , Physics of Dielectrics , Elsevier Scientific Publishing Company , New York , 1979 , pp. 97–102Smith Srensen, T., Diaz-Calleja, R., Riande, E., Guzman, J., & Andrio, u. (1997). Contributions from interfacial polarization, conductivity and polymer relaxations to the complex permittivity of a film of poly[(5-ethyl-1,3-dioxan-5-yl)methyl acrylate] containing ionic impurities. Journal of the Chemical Society, Faraday Transactions, 93(14), 2399-2411. doi:10.1039/a701239

Factors Associated with Anti-Tuberculosis Medication Adverse Effects: A Case-Control Study in Lima, Peru

BACKGROUND: Long-term exposure to anti-tuberculosis medication increases risk of adverse drug reactions and toxicity. The objective of this investigation was to determine factors associated with anti-tuberculosis adverse drug reactions in Lima, Peru, with special emphasis on MDR-TB medication, HIV infection, diabetes, age and tobacco use. METHODOLOGY AND RESULTS: A case-control study was performed using information from Peruvian TB Programme. A case was defined as having reported an anti-TB adverse drug reaction during 2005-2010 with appropriate notification on clinical records. Controls were defined as not having reported a side effect, receiving anti-TB therapy during the same time that the case had appeared. Crude, and age- and sex-adjusted models were calculated using odds ratios (OR) and 95% confidence intervals (95%CI). A multivariable model was created to look for independent factors associated with side effect from anti-TB therapy. A total of 720 patients (144 cases and 576 controls) were analyzed. In our multivariable model, age, especially those over 40 years (OR = 3.93; 95%CI: 1.65-9.35), overweight/obesity (OR = 2.13; 95%CI: 1.17-3.89), anemia (OR = 2.10; IC95%: 1.13-3.92), MDR-TB medication (OR = 11.1; 95%CI: 6.29-19.6), and smoking (OR = 2.00; 95%CI: 1.03-3.87) were independently associated with adverse drug reactions. CONCLUSIONS: Old age, anemia, MDR-TB medication, overweight/obesity status, and smoking history are independent risk factors associated with anti-tuberculosis adverse drug reactions. Patients with these risk factors should be monitored during the anti-TB therapy. A comprehensive clinical history and additional medical exams, including hematocrit and HIV-ELISA, might be useful to identify these patients

Appendiceal diverticulum associated with chronic appendicitis

AbstractINTRODUCTIONAppendiceal diverticulosis is a rare entity, with a global incidence between 0.004% and 2.1% of all appendectomies. It has been related with an elevated risk of perforation in comparison to acute appendicitis, as well as an increased risk for synchronic appendicular cancer in 48% of the cases, and colonic cancer in 43%. The incidence of chronic appendicitis has been reported in 1.5% of all appendicitis cases.PRESENTATION OF CASEWe present a 73-year-old female, with no relevant familial history, who presented due to a four-month-long oppressive, moderate pain in the lower right abdominal quadrant without irradiation or any other accompanying symptoms.DISCUSSIONThe documented incidence of appendiceal diverticula and chronic appendicitis by themselves is low; therefore the presence of both entities at the same time is extremely rare.CONCLUSIONWe present a case in which both diagnoses concurred in the same patient. The relevance of this case relies on the importance of the adequate knowledge of these pathologies, so we can approach them correctly. Although it does not represent an absolute surgical emergency, appendectomy represents the first therapeutic option

Auditoria e controle de execução de processos no setor público brasileiro / Audit and control of processes execution in the brazilian public sector

A falta de urgência para a melhoria, a gestão desestruturada da qualidade de serviço e a desconexão com a criação de valor, são alguns dos fatores que dificultam a busca pelo setor público da melhoria contínua dos serviços prestados à população em geral. Entretanto, a Gestão de Processos de Negócio (BPM) no setor público tem sido usada como fator decisivo para o aumento da eficácia e eficiência e para a reestruturação das organizações ao longo de processos interfuncionais. Além disso, somado ao BPM, a Auditoria é o componente fundamental de um sistema regulatório cujo objetivo é mostrar desvios de padrões aceitáveis e violações de princípios de legalidade, eficiência, efetividade e administração da economia pública. Diante dessas e outras constatações e por meio de um questionário de estrutura do tipo Survey, o presente artigo visou identificar as principais características de auditoria e controle de execução de processos em instituições públicas brasileiras, destacando métodos e ferramentas e evidenciando particularidades aplicáveis às mesmas.