The burden of unintentional drowning: Global, regional and national estimates of mortality from the Global Burden of Disease 2017 Study

__Background:__ Drowning is a leading cause of injury-related mortality globally. Unintentional drowning (International Classification of Diseases (ICD) 10 codes W65-74 and ICD9 E910) is one of the 30 mutually exclusive and collectively exhaustive causes of injury-related mortality in the Global Burden of Disease (GBD) study. This study's objective is to describe unintentional drowning using GBD estimates from 1990 to 2017. __Methods:__ Unintentional drowning from GBD 2017 was estimated for cause-specific mortality and years of life lost (YLLs), age, sex, country, region, Socio-demographic Index (SDI) quintile, and trends from 1990 to 2017. GBD 2017 used standard GBD methods for estimating mortality from drowning. __Results:__ Globally, unintentional drowning mortality decreased by 44.5% between 1990 and 2017, from 531 956 (uncertainty interval (UI): 484 107 to 572 854) to 295 210 (284 493 to 306 187) deaths. Global age-standardised mortality rates decreased 57.4%, from 9.3 (8.5 to 10.0) in 1990 to 4.0 (3.8 to 4.1) per 100 000 per annum in 2017. Unintentional drowning-associated mortality was generally higher in children, males and in low-SDI to middle-SDI countries. China, India, Pakistan and Bangladesh accounted for 51.2% of all drowning deaths in 2017. Oceania was the region with the highest rate of age-standardised YLLs in 2017, with 45 434 (40 850 to 50 539) YLLs per 100 000 across both sexes. __Conclusions:__ There has been a decline in global drowning rates. This study shows that the decline was not consistent across countries. The results reinforce the need for continued and improved policy, prevention and research efforts, with a focus on low-and middle-income countries

Assessment of gradient-based iterative learning controllers using a multivariable test facility with varying interaction

A multi-variable input, multi-variable output (MIMO) experimental test facility is developed for the evaluation, benchmarking and comparison of iterative learning control (ILC) strategies. The system addresses the distinct lack of experimental studies for the multivariable case and enables controller performance and robustness to be rigorously investigated over a broad range of operating conditions. The electromechanical facility is multi-configurable with up to 3 inputs and permits both exogenous disturbance injection and a variable level of coupling to be applied between input and output pairs. Experimental results confirm its suitability as a benchmarking platform for evaluation and comparison of ILC. The paper concentrates on two popular forms of gradient-type algorithm which both involve the same objective function. The test facility is used to compare robustness and performance over a wide range of operating conditions, and establish how well theoretical convergence rates and input norms match observed results. Relaxing the need to track the reference at all time points is then shown to address the poor performance and low robustness observed at high levels of interaction

Norm optimal iterative learning control with intermediate point weighting: theory, algorithms and experimental evaluation

This brief considers the iterative learning control(ILC) problem when tracking is only required at a subset of isolated time points along the trial duration. It presents a norm optimal ILC solution to the problem with well-defined convergence properties, design guidelines, and supporting experimental results using an electromechanical test facility

Dexamethasone treatment of tumor necrosis factor-alpha challenged organ of Corti explants activates nuclear factor kappa B signaling that induces changes in gene expression that favor hair cell survival

The objective was to determine the role of nuclear factor kappa B (NFκB) in dexamethasone base (DXMb) protection of auditory hair cells from tumor necrosis factor-alpha (TNFα)-induced loss on gene expression and cell signaling levels. Organ of Corti (OC) explants from 3-day-old rats were cultured under one of the following conditions: (1) media only—no treatment; (2) media+TNFα; (3) media+TNFα+DXMb; (4) media+TNFα+DXMb+NFκB-Inhibitor (NFκB-I); or (5) media+TNFα+DXMb+NFκBI-Scrambled control (NFκBI-C). A total of 60 organ of Corti explants (OC) were stained with FITC-Phalloidin after 96 h in culture (conditions 1–5) for hair cell counts and imaging of surface characteristics. A total of 108 OC were used for gene expression studies (i.e. B-actin, Bax, Bcl-2, Bcl-xl, and TNFR1) after 0, 24, or 48 h in vitro (conditions 1–4). A total of 86 OC were cultured (conditions 1–3) for 48 h, 36 of which were used for phosphorylated NFκB (p-NFκB) ELISA studies and 50 for whole mount anti-p-NFκB immunostain experiments. TNFα+DXMb exposed cultures demonstrated significant upregulation in anti-apoptotic Bcl-2 and Bcl-xl genes and downregulation in pro-apoptotic Bax gene expression; DXMb treatment of TNFα explants also lowered the Bax/Bcl-2 ratio and inhibited TNFR1 upregulation. After inhibiting NFκB activity with NFκB-I, the gene expression profile following TNFα+DXMb treatment now mimics that of TNFα-challenged OC explants. The levels of p-NFκB and the degree of nuclear translocation are significantly greater in TNFα+DXMb exposed OC explants than observed in the TNFα and control groups in the middle+basal turns of OC explants. These findings were supported by the results of the hair cell counts and the imaging results obtained from the whole mount OC specimens. DXMb protects against TNFα-induced apoptosis of auditory hair cells in vitro via activation of NFκB signaling in hair cell nuclei, and regulation of the expression levels of anti- and pro-apoptotic genes and a pro-inflammatory gene. ▶TNFα can initiate programmed cell death in rat organ of Corti explants. ▶DXM protects against TNFα-induced apoptosis of rat auditory hair cells. ▶DXM treatment promotes activation and nuclear translocation of NFκB. ▶NFκB activation results in changes in gene expression that favor hair cell survival

Hierarchically structured LaFeO3 with hollow core and porous shell as efficient sensing material for ethanol detection

Hollow LaFeO3 (LFO-HS) was synthesized by a facile hydrothermal method with the use of cetyltrimethylammonium bromide. Its structural, morphological, microstructural and textual characterizations were performed using X-ray diffraction, scanning electron microscopy, transmission electron microscopy and nitrogen adsorption-desorption analysis. The gas-sensing performance of LFO-HS sensor was studied towards different gases, including ammonia (NH3), ethanol (C2H5OH), acetone (CH3COCH3), and liquefied petroleum gas (LPG). The LFO-HS sensor exhibited p-type gas sensing behavior and enhanced sensing performance towards ethanol gas as compared with bulk LaFeO3 sensor. A rapid, high, and stable response was seen at 300 °C. Meanwhile, a linear response and low limit of detection (1 ppb) to ethanol was observed. After the investigation on sensitivity to different reducing gases, our results revealed that the LFO-HS sensor exhibited good selectivity to ethanol and suggested it being a promising sensor candidate for future practical use in trace ethanol detection

Harmonising Individual Patient Level Cardiac Registry Data Across the Asia Pacific Region - A Feasibility Study of In-Hospital Outcomes of STEMI Patients From the Asia Pacific Evaluation of Cardiovascular Therapies (ASPECT) Network.

Objective The Asia-Pacific Evaluation of Cardiovascular Therapies (ASPECT) collaboration was established to inform on percutaneous coronary intervention (PCI) in the Asia-Pacific Region. Our aims were to (i) determine the operational requirements to assemble an international individual patient dataset and validate the processes of governance, data quality and data security, and subsequently (ii) describe the characteristics and outcomes for ST-elevation myocardial infarction (STEMI) patients undergoing PCI in the ASPECT registry. Methods Seven (7) ASPECT members were approached to provide a harmonised anonymised dataset from their local registry. Patient characteristics were summarised and associations between the characteristics and in-hospital outcomes for STEMI patients were analysed. Results Six (6) participating sites (86%) provided governance approvals for the collation of individual anonymised patient data from 2015 to 2017. Five (5) sites (83%) provided >90% of agreed data elements and 68% of the collated elements had <10% missingness. From the registry (n=12,620), 84% were male. The mean age was 59.2±12.3 years. The Malaysian cohort had a high prevalence of previous myocardial infarction (34%), almost twice that of any other sites (p<0.001). Adverse in-hospital outcomes were the lowest in Hong Kong whilst in-hospital mortality varied from 2.7% in Vietnam to 7.9% in Singapore. Conclusions Governance approvals for the collation of individual patient anonymised data was achieved with a high level of data alignment. Secure data transfer process and repository were established. Patient characteristics and presentation varied significantly across the Asia-Pacific region with this likely to be a major predictor of variations in the clinical outcomes observed across the region.Christopher M. Reid, HuiJun Chih, Stephen J. Duffy, Angela L. Brennan, Andrew E. Ajani, John Beltrame, Rosanna Tavella, Bryan P. Yan, Diem Dinh, Chee Tang Chin, Loi Doan Do, Quang Ngoc Nguyen, Hoai T.T. Nguyen, Ika Prasetya Wijaya, Muhammad Yamin, Lusiani Rusdi, Idrus Alwi, Kui Hian Sim, Alan Yean Yip Fong, l, Wan Azman Wan Ahmad, Khung Keong Yeo, on behalf of the ASPECT Investigator

DC Programming and DCA for General DC Programs

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