The socio-economic cost of asthma, COPD and chronic bronchitis in Europe.

Introduction. Common chronic respiratory diseases place a huge economic burden on both society and individual but very few COI studies have been carried out in the general European population and have evaluated (i) both direct and indirect costs, (ii) the change over time in asthma costs, (iii) the relationship with the level of asthma severity and control, and (iv) the presence of comorbidities in chronic bronchitis (CB). Aims. This thesis is aimed at estimating (i) the differential costs of asthma, COPD and CB among adult subjects from the general population in Europe and (ii) the 10-year variation of asthma costs in adult asthmatics. Methods. Subjects participating in the ECRHS II (1998-2002) and III (2010-2013) were classified as patients with intermittent and persistent (\u201ccontrolled/partlially controlled\u201d or \u201cuncontrolled\u201d) asthma, COPD and CB. The monetary unit value of each cost component was calculated in Euro as the median of the national figures in 9 European countries and adjusted for the purchasing power parity. The cost components were estimated by multiplying for each patient the number of (i) times he/she resorted to healthcare services, (ii) doses of each drug consumed, (iii) lost working days and (iv) days with limited not work-related activities, by their proper monetary unit value. Multivariable analyses of the association among the individual total cost for each disease and a set of potential determinants were performed by using 2-level random-intercept negative binomial regression models (centre: level 2 unit). Cost variations in the individual total cost were estimated by using a 2-level random-intercept Laplace quantile regression model (centre: level 2 unit), adjusting for the effect of sex, age, ever smoking and low socio-economic status. Results. The mean annual cost per patient increased as the degree of disease control decreased, ranging from EUR 143 (95%CI: 94-204) and EUR 398 (95%CI: 345-457) for the subjects with an intermittent and a persistent controlled/partially controlled asthma, respectively, to EUR 5,050 (95%CI: 3,296-6,275) for those with a persistent uncontrolled disease. Among the persistent uncontrolled asthmatics, the 80% of the total cost was due to the INMCs. The lack of control of a persistent disease was about 27-fold higher compared to the cost of an intermittent asthma (IRR=26.80, 95% CI: 16.82-42.69) after adjusting for the effect of potential predictors. The mean annual cost per patient over a 10-year period (i) was stable in the \u201cintermittent group\u201d (from 166 to 157 EUR), (ii) decreased in the \u201cimproved group\u201d (from 1,058 to 308 EUR), (iii) increased in the \u201cworsened group\u201d (from 2,137 to 4,023 EUR). After adjusting for a set of potential confounders, the patients with an improved or worsened asthma from the ECRHS II to the ECRHS III showed reduced [-145 (95%CI: -275;-15) EUR; p=0.029] and increased [185 (95%CI: 59;311) EUR; p=0.005] mean annual costs, respectively, compared to the patients with an intermittent disease status at both the examinations. The COPD sample was mainly represented by individuals with a mild/moderate disease (96%) and the mean annual cost per patient was 694 EUR (95%CI: 198-1,253). In patients with CB the mean annual cost (i) largely increased from 94 EUR (95%CI: 38-166) to 642 EUR (95%CI: 249-1,131) according to the presence of comorbidities and (ii) was more than 3-fold higher among patients with comorbidities compared with those with CB only (IRR=2.88, 95% CI: 1.10-7.55), after adjusting for the effect of the other potential predictors. Conclusions. The mean annual cost per patient (i) was impressive in persistent uncontrolled asthmatics and largely driven by the INMCs, (ii) significantly increased/decreased when the asthma status worsened/improved over 10 years, (iii) was not negligible even in patients with a mild/moderate form of COPD and (iv) was higher when comorbidities were present in patients with CB

Simulation Model for Sea Clutter in Airborne Radars

This paper presents the architecture and the methods used to dynamically simulate the sea backscatter of an airborne radar operating in a medium repetition frequency mode (MPRF). It offers a method of generating a sea backscatter signal which fulfills the intensity statistics of real clutter in time domain, spatial correlation and local Doppler spectrum of real data. Three antenna channels (sum, guard and difference) and their cross-correlation properties are simulated. The objective of this clutter generator is to serve as the signal source for the simulation of complex airborne pulsed radar signal processor

Specification of osteoblast cell fate by canonical Wnt signaling requires Bmp2

Enhanced BMP or canonical Wnt (cWnt) signaling are therapeutic strategies employed to enhance bone formation and fracture repair, but the mechanisms each pathway utilizes to specify cell fate of bone-forming osteoblasts remain poorly understood. Among all BMPs expressed in bone, we find that singular deficiency of Bmp2 blocks the ability of cWnt signaling to specify osteoblasts from limb bud or bone marrow progenitors. When exposed to cWnts, Bmp2-deficient cells fail to progress through the Runx2/Osx1 checkpoint and thus do not upregulate multiple genes controlling mineral metabolism in osteoblasts. Cells lacking Bmp2 after induction of Osx1 differentiate normally in response to cWnts, suggesting that pre-Osx1(+) osteoprogenitors are an essential source and a target of BMP2. Our analysis furthermore reveals Grainyhead-like 3 (Grhl3) as a transcription factor in the osteoblast gene regulatory network induced during bone development and bone repair, which acts upstream of Osx1 in a BMP2-dependent manner. The Runx2/Osx1 transition therefore receives crucial regulatory inputs from BMP2 that are not compensated for by cWnt signaling, and this is mediated at least in part by induction and activation of Grhl3.National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIH-NIAMS)Harvard Sch Dent Med, Dept Dev Biol, 188 Longwood Ave, Boston, MA 02115 USASaitama Med Univ, Res Ctr Genom Med, Div Pathophysiol, 1397-1 Yamane, Hidaka, Saitama 3501241, JapanUniv Fed Sao Paulo, Inst Ciencia & Tecnol, Rua Talim 330, BR-12231280 Sao Jose Dos Campos, SP, BrazilUniversidade Federal de São Paulo, Rua Talim, 330, São José dos Campos, São Paulo, CEP 12231-280, BrazilNIH-NIAMS: R01 AR055904Web of Scienc

Study of animal remains dug out during the excavations of a Nuragic village in Sardinia

This paper presents the results of the zooarchaeological analysis of the faunal materials brought to light during the excavations set up in the Nuragic village surrounding the Santu Antine Nuraghe, near Torralba (Sassari), Sardinia. Precisely, the remains come from the structure of the village named by archaeologists hut 12. They are 779 specimens out of thousands animal remains from the whole archaeological site. The majority of the rests belong to sheep (Ovis aries) or goats (Capra hircus), cattle (Bos taurus), pigs (Sus scrofa) and deers (Cervus elaphus). Such material may provide suggestions about the productive use of animals in the village and point out the importance of the economical management of animals in the Nuragic society. Indeed, many remains show signs with human origin, which testify that the hut may have been a workplace where bone fragments were processed to obtain different kind of tools

Anatomical study of animal remains from Phoenician-Punic amphorae found in the Santa Giusta Pond, Sardinia (Italy)

During the underwater excavations carried out in the Santa Giusta Pond, near Oristano, Sardinia, a significant amount of Phoenician- Punic materials was brought to light including amphorae (dating back to 7th-2nd century BC) and vegetal and animal remains. All of these archaeological finds may come from Othoca, an important Phoenician- Punic city on the eastern shore of the pond, geographically corresponding with the modern-day town of Santa Giusta. Animal materials consist of more than 3000 very well-preserved remains, belonging to sheep (Ovis aries), goat (Capra hircus) and cattle (Bos taurus). Bone analyses allowed reconstructing the slaughtering methods, as well as manipulation procedures carried out to preserve meat in order to be exported overseas. Although pig (Sus scrofa) played an important economical role in other Sardinian Phoenician-Punic settlements, in this archaeological context this species is absent, suggesting that the meat contained in the amphorae was probably destined to other areas of the Mediterranean basin, where people did not eat pork

Lung Development Genes and Adult Lung Function

Non-commercial use onl

Aula de juegos para el fomento del aprendizaje autónomo y la creatividad

El juego como modo de aprendizaje es algo inherente no sólo al ser humano sino, en general, al reino animal. Para cualquier mamífero el juego constituye la forma de aprendizaje fundamental. A través del juego se aprende a luchar, a defenderse y las normas básicas de convivencia en la manada. Sin embargo en el ser humano, juego y aprendizaje se han ido desligando progresivamente, excepto en las etapas iniciales de crecimiento, en las que los niños siguen aprendiendo los comportamientos más básicos a través de juegos. A medida que vamos avanzando en la escuela, se va abandonando el juego, contraponiendo las actividades lúdicas a las estrictamente relacionadas con el trabajo, con un aprendizaje más costoso. De esta forma al llegar a la etapa universitaria, el juego se ha abandonado por completo como forma de aprendizaje. No es fácil definir lo que es el juego o cuáles son sus características. Tiene una fuerte componente cultural, actividades que unas culturas pueden considerar eminentemente lúdicas, no lo serán en contextos culturales distintos. No obstante, una vez admitida la importancia del juego en el desarrollo de la personalidad, sí podemos establecer algunas de las funciones básicas que el juego desempeña en el ser humano, en relación con el perfeccionamiento y adquisición de habilidades tanto cognitivas como sociales o conductuales. El juego facilita la integración de experiencias en la conducta, contribuye a inhibir conductas no admitidas socialmente y a reforzar aquéllas con una mayor aceptación dentro del marco cultural de referencia. Mejora considerablemente la interacción social y la adquisición de las habilidades básicas necesarias para que se produzca dicha interacción de modo satisfactorio. En el caso de juegos competitivos, enseña a manejar situaciones desfavorables, a soportar y superar la frustración. Tradicionalmente, los juegos se han usado en los niveles iniciales de enseñanza, sin embargo son una poderosa herramienta también en el nivel universitario, especialmente para promover el aprendizaje activo y la adquisición de variadas competencias profesionales. En este proyecto se plantea la elaboración de una herramienta para la creación de simuladores de juegos de mesa con fines didácticos

Meta-analysis of gene–environment-wide association scans accounting for education level identifies additional loci for refractive error

This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/Myopia is the most common human eye disorder and it results from complex genetic and environmental causes. The rapidly increasing prevalence of myopia poses a major public health challenge. Here, the CREAM consortium performs a joint meta-analysis to test single-nucleotide polymorphism (SNP) main effects and SNP × education interaction effects on refractive error in 40,036 adults from 25 studies of European ancestry and 10,315 adults from 9 studies of Asian ancestry. In European ancestry individuals, we identify six novel loci (FAM150B-ACP1, LINC00340, FBN1, DIS3L-MAP2K1, ARID2-SNAT1 and SLC14A2) associated with refractive error. In Asian populations, three genome-wide significant loci AREG, GABRR1 and PDE10A also exhibit strong interactions with education (P<8.5 × 10(-5)), whereas the interactions are less evident in Europeans. The discovery of these loci represents an important advance in understanding how gene and environment interactions contribute to the heterogeneity of myopia

Genome-wide meta-analysis of myopia and hyperopia provides evidence for replication of 11 loci

Refractive error (RE) is a complex, multifactorial disorder characterized by a mismatch between the optical power of the eye and its axial length that causes object images to be focused off the retina. The two major subtypes of RE are myopia (nearsightedness) and hyperopia (farsightedness), which represent opposite ends of the distribution of the quantitative measure of spherical refraction. We performed a fixed effects meta-analysis of genome-wide association results of myopia and hyperopia from 9 studies of European-derived populations: AREDS, KORA, FES, OGP-Talana, MESA, RSI, RSII, RSIII and ERF. One genome-wide significant region was observed for myopia, corresponding to a previously identified myopia locus on 8q12 (p = 1.25610-8), which has been reported by Kiefer et al. as significantly associated with myopia age at onset and Verhoeven et al. as significantly associated to mean spherical-equivalent (MSE) refractive error. We observed two genomewide significant association