Costs and consequences of chronic pain due to musculoskeletal disorders from a health system perspective in Chile

Copyright © 2018 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The International Association for the Study of Pain. Background: Chronic pain is a prevalent and distressing condition caused by an unceasing pain lasting more than 3 months or a pain that persists beyond the normal healing time. There is evidence of inadequate management partly explained by the unawareness regarding the magnitude of the problem. Objectives: To estimate the annual expected costs and consequences of chronic pain caused by musculoskeletal diseases from the health system perspective in Chile. Methods: A Markov cohort model was built to represent chronic pain and estimate expected costs and consequences over 1-year time horizon. Transition probabilities were obtained through expert elicitation. Consequences examined were: years lost to disability (YLD), depression, anxiety, and productivity losses. Direct health care costs were estimated using local sources. Probabilistic sensitivity analysis was performed to characterize second-order uncertainty. Results: The annual expected cost due to musculoskeletal chronic pain was estimated in USD $1387.2 million, equivalent to 0.417$94 million (Bayesian credibility interval 95% $49.1-$156.26). Productivity losses were also important cost, although early retirement and presenteeism were not measured. Chronic pain causes 137,037 YLDs. Conclusion: Chronic pain is not only an important cause of disability but also responsible for high social and financial burden in Chile. Public health programs focused on managing chronic pain may decrease burden of disease and possibly reduce costs.

Sustainable sugarcane vinasse biorefinement for trans-aconitic acid-based biopolymer synthesis and bioenergy generation

This study aimed at developing a multiproduct biorefinery scheme for vinase valorization. It involved the extraction of trans-aconitic acid, its transformation into biopolymers using microwave irradiation and the use of the raffinated-vinasse for biogas production. Each technology was assessed individually, followed by a process integration at bench scale, from which a mass balance was calculated, supporting the feasibility of the approach. As a renewable source derived from a residue, these bioproducts can replace crude-oil-based materials in various chemical industrial processes; however, a detailed techno-economic and life-cycle analysis are required to defined the sustainability of the process

Condición física de niños futbolistas en función de la posición de juego

The practice of football, requires the execution of demanding movements of high energy demand, being the position in the field of play one of the factors that influences the physiological requirements of these athletes, so the objective of this study is to assess the Physical condition of children footballers depending on the playing position. The present is a cross-sectional correlational study; A sample of 240 children belonging to the soccer schools of Neiva, which have a minimum age of 7 years and a maximum of 17 with an average of 13 years, were available for its realization. For the measurement of aerobic power the Course Navette test was taken, the anaerobic power the RAST test, for the power of the lower limbs the horizontal jump test and for flexibility the Flexitest. As a result, statistically significant differences were found between the game position and fatigue index, maximum power and horizontal jump p <0.001, so it is concluded that the aerobic and anaerobic power varies depending on the position. La práctica del fútbol, requiere de la ejecución de movimientos exigentes de alta demanda energética, siendo la posición en el terreno de juego uno de los factores que influye en los requerimientos fisiológicos de estos deportistas, por lo que el objetivo del estudio es valorar la condición física de niños futbolistas en función de la posición de juego. El estudio es de tipo correlacional, transversal; para su realización se contó con una muestra de 240 niños pertenecientes a las escuelas de fútbol de Neiva-Huila Colombia, los cuales presentan una edad mínima de 7 años y máxima de 17 con una media de 13 años. Para la medición de la potencia aeróbica se tomó el test Course Navette, la potencia anaeróbica el test de RAST, para la potencia de miembros inferiores el test de salto horizontal y para la flexibilidad el Flexitest. Como resultado se encontraron diferencias estadísticamente significativas entre la posición de juego y el índice de fatiga, potencia máxima y salto horizontal p<0,001, por lo que se concluye que la potencia aeróbica y anaeróbica varía en función de la posición

Provision of education for sustainability development and sustainability literacy in business programs in three higher education institutions in Brazil, Colombia and Peru

Purpose: This paper aims to report on the status and the development of education for sustainable development (ESD) and sustainability literacy (SL) in three Latin American (LA) higher education institutions (HEIs) business programs in Peru, Brazil and Colombia. The paper examines institutional efforts to both introduce and implement ESD curricula and provide SL. Design/methodology/approach: The methods used in this paper included reviews of university Web pages and course materials. Structured interviews were also conducted with program leaders, to examine the level of ESD, as input affecting the business programs curricula of the universities concerned. Findings: Initial findings suggest that, in the three HEIs surveyed, there is still a tendency to talk about issues related to ESD but actions that confirm this interest are not sufficiently advanced. The authors surveys a sample of business programs curricula and interviewed its leaders and a mixed and dated picture emerged. When compared to other regions particularly the USA and Europe, the findings show that the HEIs surveyed still have not developed enough work to distinguish conceptually between sustainable development, ESD and SL making the embedment of these concepts in the curriculum not fully developed. Originality/value: In LA HEIs, the ESD message seems to be slowly taking ground, equipping HEIs to respond to SL concerns. Implementation and practice in some HEIs are still at an embryonic and conceptually confused stage with regard to LA HEIs SL. This paper sheds light to help ESD delivery. It offers some strategies for moving on from this inception phase to a more structured SL provision and ESD outlook

Quantitative principles of cis-translational control by general mRNA sequence features in eukaryotes.

BackgroundGeneral translational cis-elements are present in the mRNAs of all genes and affect the recruitment, assembly, and progress of preinitiation complexes and the ribosome under many physiological states. These elements include mRNA folding, upstream open reading frames, specific nucleotides flanking the initiating AUG codon, protein coding sequence length, and codon usage. The quantitative contributions of these sequence features and how and why they coordinate to control translation rates are not well understood.ResultsHere, we show that these sequence features specify 42-81% of the variance in translation rates in Saccharomyces cerevisiae, Schizosaccharomyces pombe, Arabidopsis thaliana, Mus musculus, and Homo sapiens. We establish that control by RNA secondary structure is chiefly mediated by highly folded 25-60 nucleotide segments within mRNA 5' regions, that changes in tri-nucleotide frequencies between highly and poorly translated 5' regions are correlated between all species, and that control by distinct biochemical processes is extensively correlated as is regulation by a single process acting in different parts of the same mRNA.ConclusionsOur work shows that general features control a much larger fraction of the variance in translation rates than previously realized. We provide a more detailed and accurate understanding of the aspects of RNA structure that directs translation in diverse eukaryotes. In addition, we note that the strongly correlated regulation between and within cis-control features will cause more even densities of translational complexes along each mRNA and therefore more efficient use of the translation machinery by the cell

High Diversity of vacA and cagA Helicobacter pylori Genotypes in Patients with and without Gastric Cancer

BACKGROUND: Helicobacter pylori is associated with chronic gastritis, peptic ulcers, and gastric cancer. The aim of this study was to assess the topographical distribution of H. pylori in the stomach as well as the vacA and cagA genotypes in patients with and without gastric cancer. METHODOLOGY/PRINCIPAL FINDINGS: Three gastric biopsies, from predetermined regions, were evaluated in 16 patients with gastric cancer and 14 patients with dyspeptic symptoms. From cancer patients, additional biopsy specimens were obtained from tumor centers and margins; among these samples, the presence of H. pylori vacA and cagA genotypes was evaluated. Positive H. pylori was 38% and 26% in biopsies obtained from the gastric cancer and non-cancer groups, respectively (p = 0.008), and 36% in tumor sites. In cancer patients, we found a preferential distribution of H. pylori in the fundus and corpus, whereas, in the non-cancer group, the distribution was uniform (p = 0.003). A majority of the biopsies were simultaneously cagA gene-positive and -negative. The fundus and corpus demonstrated a higher positivity rate for the cagA gene in the non-cancer group (p = 0.036). A mixture of cagA gene sizes was also significantly more frequent in this group (p = 0.003). Ninety-two percent of all the subjects showed more than one vacA gene genotype; s1b and m1 vacA genotypes were predominantly found in the gastric cancer group. The highest vacA-genotype signal-sequence diversity was found in the corpus and 5 cm from tumor margins. CONCLUSION/SIGNIFICANCE: High H. pylori colonization diversity, along with the cagA gene, was found predominantly in the fundus and corpus of patients with gastric cancer. The genotype diversity observed across systematic whole-organ and tumor sampling was remarkable. We find that there is insufficient evidence to support the association of one isolate with a specific disease, due to the multistrain nature of H. pylori infection shown in this work

Survival and dispersal of a defined cohort of Irish cattle

An understanding of livestock movement is critical to effective disease prevention, control and prediction. However, livestock movement in Ireland has not yet been quantified. This study has sought to define the survival and dispersal of a defined cohort of cattle born in Co. Kerry during 2000. The cohort was observed for a maximum of four years, from January 1, 2000 to December 31, 2004. Beef and dairy animals moved an average 1.31 and 0.83 times, respectively. At study end, 18.8% of the beef animals remained alive on Irish farms, including 6.7% at the farm-of-birth, compared with 48.6% and 27.7% for dairy animals respectively. Beef animals werae dispersed to all Irish counties, but mainly to Cork, Limerick, Tipperary and Galway. Dairy animals mainly moved to Cork, Limerick, and Tipperary, with less animals going to Galway, Meath and Kilkenny. The four-year survival probability was 0.07 (male beef animals), 0.25 (male dairy), 0.38 (female beef), and 0.72 (female dairy). Although there was considerable dispersal, the number of moves per animal was less than expected

Genetic, environmental and stochastic factors in monozygotic twin discordance with a focus on epigenetic differences

PMCID: PMC3566971This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited

Reduced auditory steady state responses in autism spectrum disorder

Background Auditory steady state responses (ASSRs) are elicited by clicktrains or amplitude-modulated tones, which entrain auditory cortex at their specific modulation rate. Previous research has reported reductions in ASSRs at 40 Hz for autism spectrum disorder (ASD) participants and first-degree relatives of people diagnosed with ASD (Mol Autism. 2011;2:11, Biol Psychiatry. 2007;62:192–197). Methods Using a 1.5 s-long auditory clicktrain stimulus, designed to elicit an ASSR at 40 Hz, this study attempted to replicate and extend these findings. Magnetencephalography (MEG) data were collected from 18 adolescent ASD participants and 18 typically developing controls. Results The ASSR localised to bilateral primary auditory regions. Regions of interest were thus defined in left and right primary auditory cortex (A1). While the transient gamma-band response (tGBR) from 0-0.1 s following presentation of the clicktrain stimulus was not different between groups, for either left or right A1, the ASD group had reduced oscillatory power at 40 Hz from 0.5 to 1.5 s post-stimulus onset, for both left and right A1. Additionally, the ASD group had reduced inter-trial coherence (phase consistency over trials) at 40 Hz from 0.64-0.82 s for right A1 and 1.04-1.22 s for left A1. Limitations In this study, we did not conduct a clinical autism assessment (e.g. the ADOS), and therefore, it remains unclear whether ASSR power and/or ITC are associated with the clinical symptoms of ASD. Conclusion Overall, our results support a specific reduction in ASSR oscillatory power and inter-trial coherence in ASD, rather than a generalised deficit in gamma-band responses. We argue that this could reflect a developmentally relevant reduction in non-linear neural processing