Evidence of trauma in a ca. 1-million-year-old patella of Homo antecessor, Gran Dolina-Atapuerca (Spain)

We present the palaeopathological study of a left patella (ATD6-56) belonging to the Early Pleistocene species Homo antecessor (Atapuerca-Gran Dolina, Spain). The abnormal morphology observed in the inferior margin of the patella is an osseous overgrowth (osteophyte). Macroscopic and microscopic techniques, including microtomography and zoom stereomicroscope, were used to describe the lesion. Externally, the osteophyte has a smooth and porous texture; the boundary between the more radiolucent osteophyte and the normal bone can be identified in X-ray images. We suggest that the observed signs could be secondary to a local trauma. The lesion would have involved either the bone or related soft tissues of the left limb, possibly affecting the stability of the joint. Consequently, the individual's knee would have suffered an abnormal mechanical load that could have eventually triggered osteoarthritic changes. This is also supported by the lack of changes observed in the associated right patella (ATD6-22)

The wearable co-design domino: A user-centered methodology to co-design and co-evaluate wearables

This paper presents a user-centered methodology to co-design and co-evaluate wearables that has been developed following a research-through design methodology. It has been based on the principles of human–computer interaction and on an empirical case entitled “Design and Development of a Low-Cost Wearable Glove to Track Forces Exerted by Workers in Car Assembly Lines” published in Sensors. Insights from both studies have been used to develop the wearable co-design domino presented in this study. The methodology consists of different design stages composed of an ideation stage, digital service development and test stages, hardware development and test stage, and a final test stage. The main conclusions state that it is necessary to maintain a close relationship between human factors and technical factors when designing wearable. Additionally, through the several studies, it has been concluded that there is need of different field experts that should co-design and co-evaluate wearable iteratively and involving users from the beginning of the process

Wearable design requirements identification and evaluation

: Wearable electronics make it possible to monitor human activity and behavior. Most of these devices have not taken into account human factors and they have instead focused on technological issues. This fact could not only affect human–computer interaction and user experience but also the devices’ use cycle. Firstly, this paper presents a classification of wearable design requirements that have been carried out by combining a quantitative and a qualitative methodology. Secondly, we present some evaluation procedures based on design methodologies and human–computer interaction measurement tools. Thus, this contribution aims to provide a roadmap for wearable designers and researchers in order to help them to find more efficient processes by providing a classification of the design requirements and evaluation tools. These resources represent time and resource-saving contributions. Therefore designers and researchers do not have to review the literature. It will no be necessary to carry out exploratory studies for the purposes of identifying requirements or evaluation tools either

Comparing the Boxgrove and Atapuerca (Sima de los Huesos) human fossils: Do they represent distinct paleodemes?

The early Middle Pleistocene human material from Boxgrove (West Sussex, UK) consists of a partial left tibia and two lower incisors from a separate adult individual. These remains derive from deposits assigned to the MIS 13 interglacial at about 480 ka and have been referred to as Homo cf. heidelbergensis. The much larger skeletal sample from the Sima de los Huesos (Atapuerca, Spain) is dated to the succeeding MIS 12, at about 430 ka. This fossil material has previously been assigned to Homo heidelbergensis but is now placed within the Neanderthal clade. Because of the scarcity of human remains from the Middle Pleistocene and their morphological variability, this study assessed whether the Boxgrove specimens fit within the morphological variability of the homogeneous Sima de los Huesos population. Based on morphometric analyses performed against 22 lower incisors from Sima de los Huesos and published material, the data from the Boxgrove incisors place them comfortably within the range of Sima de los Huesos. Both assemblages present robust incisors distinct from the overall small recent Homo sapiens incisors, and Boxgrove also aligns closely with Homo neanderthalensis and some other European Middle Pleistocene hominins. Following morphological and cross-sectional analyses of the Boxgrove tibia compared to seven adult Sima de los Huesos specimens and a set of comparative tibiae, Boxgrove is shown to be similar to Sima de los Huesos and Neanderthals in having thick cortices and bone walls, but in contrast resembles modern humans in having a straight anterior tibial crest and a suggestion of a lateral concavity. Based on the patterns observed, there is no justification for assigning the Boxgrove and Sima de los Huesos incisors to distinct paleodemes, but the tibial data show greater contrasts and suggest that all three of these samples are unlikely to represent the same paleodeme

Variation in antiosteoporotic drug prescribing and spending across Spain. A population-based ecological cross-sectional study

Introduction: Evidence has shown that utilization of antiosteoporotic medications does not correspond with risk, and studies on other therapies have shown that adequacy of pharmaceutical prescribing might vary between regions. Nevertheless, very few studies have addressed the variability in osteoporotic drug consumption. We aimed to describe variations in pharmaceutical utilization and spending on osteoporotic drugs between Health Areas (HA) in Spain. Methods: Population-based cross-sectional ecological study of expenditure and utilization of the five therapeutic groups marketed for osteoporosis treatment in Spain in 2009. Small area variation analysis (SAVA) methods were used. The units of analysis were the 168 HA of 13 Spanish regions, including 7.2 million women aged 50 years and older. The main outcomes were the defined daily dose (DDD) per 1000 inhabitants and day (DDD/1000/Day) dispensed according to the pharmaceutical claims reimbursed, and the expenditure on antiosteoporotics at retail price per woman =50 years old and per year. Results: The average osteoporosis drug consumption was 116.8 DDD/1000W/Day, ranging from 78.5 to 158.7 DDD/1000W/Day between the HAs in the 5th and 95th percentiles. Seventy-five percent of the antiosteoporotics consumed was bisphosphonates, followed by raloxifene, strontium ranelate, calcitonins, and parathyroid hormones including teriparatide. Regarding variability by therapeutic groups, biphosphonates showed the lowest variation, while calcitonins and parathyroid hormones showed the highest variation. The annual expenditure on antiosteoporotics was €426.5 million, translating into an expenditure of €59.2 for each woman =50 years old and varying between €38.1 and €83.3 between HAs in the 5th and 95th percentiles. Biphosphonates, despite accounting for 79% of utilization, only represented 63% of total expenditure, while parathyroid hormones with only 1.6% of utilization accounted for 15% of the pharmaceutical spending. Conclusion: This study highlights a marked geographical variation in the prescription of antiosteoporotics, being more pronounced in the case of costly drugs such as parathyroid hormones. The differences in rates of prescribing explained almost all of the variance in drug spending, suggesting that the difference in prescription volume between territories, and not the price of the drugs, is the main source of variation in this setting. Data on geographical variation of prescription can help guide policy proposals for targeting areas with inadequate antiosteoporotic drug use

International lower limb collaborative (INTELLECT) study: a multicentre, international retrospective audit of lower extremity open fractures

Trauma remains a major cause of mortality and disability across the world1, with a higher burden in developing nations2. Open lower extremity injuries are devastating events from a physical3, mental health4, and socioeconomic5 standpoint. The potential sequelae, including risk of chronic infection and amputation, can lead to delayed recovery and major disability6. This international study aimed to describe global disparities, timely intervention, guideline-directed care, and economic aspects of open lower limb injuries

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Dietary α‐Linolenic Acid, Marine ω‐3 Fatty Acids, and Mortality in a Population With High Fish Consumption: Findings From the PREvención con DIeta MEDiterránea (PREDIMED) Study

Background: Epidemiological evidence suggests a cardioprotective role of α‐linolenic acid (ALA), a plant‐derived ω‐3 fatty acid. It is unclear whether ALA is beneficial in a background of high marine ω‐3 fatty acids (long‐chain n‐3 polyunsaturated fatty acids) intake. In persons at high cardiovascular risk from Spain, a country in which fish consumption is customarily high, we investigated whether meeting the International Society for the Study of Fatty Acids and Lipids recommendation for dietary ALA (0.7% of total energy) at baseline was related to all‐cause and cardiovascular disease mortality. We also examined the effect of meeting the society's recommendation for long‐chain n‐3 polyunsaturated fatty acids (≥500 mg/day). Methods and Results: We longitudinally evaluated 7202 participants in the PREvención con DIeta MEDiterránea (PREDIMED) trial. Multivariable‐adjusted Cox regression models were fitted to estimate hazard ratios. ALA intake correlated to walnut consumption (r=0.94). During a 5.9‐y follow‐up, 431 deaths occurred (104 cardiovascular disease, 55 coronary heart disease, 32 sudden cardiac death, 25 stroke). The hazard ratios for meeting ALA recommendation (n=1615, 22.4%) were 0.72 (95% CI 0.56–0.92) for all‐cause mortality and 0.95 (95% CI 0.58–1.57) for fatal cardiovascular disease. The hazard ratios for meeting the recommendation for long‐chain n‐3 polyunsaturated fatty acids (n=5452, 75.7%) were 0.84 (95% CI 0.67–1.05) for all‐cause mortality, 0.61 (95% CI 0.39–0.96) for fatal cardiovascular disease, 0.54 (95% CI 0.29–0.99) for fatal coronary heart disease, and 0.49 (95% CI 0.22–1.01) for sudden cardiac death. The highest reduction in all‐cause mortality occurred in participants meeting both recommendations (hazard ratio 0.63 [95% CI 0.45–0.87]). Conclusions: In participants without prior cardiovascular disease and high fish consumption, dietary ALA, supplied mainly by walnuts and olive oil, relates inversely to all‐cause mortality, whereas protection from cardiac mortality is limited to fish‐derived long‐chain n‐3 polyunsaturated fatty acids. Clinical Trial Registration URL: http://www.Controlled-trials.com/. Unique identifier: ISRCTN35739639

Design and development of a low-cost wearable glove to track forces exerted by workers in car assembly lines

Wearables are gaining widespread use and technologies are making it possible to monitor human physical activity and behaviour as part of connected infrastructures. Many companies see wearables as an opportunity to enhance worker safety since they can monitor their workers’ activity in real life scenarios. One of the goals of this technology is to integrate existing electronic components, such as sensors or conductors, in order to create fully wearable systems. This integration is constrained not only by technical factors but also by user requirements and internal company standards. This paper considers such constraints and presents preliminary research for the design of a wearable glove as a new tool to track forces exerted by workers in car assembly lines. The objective of the glove is to measure forces and compare these to maximum forces already identified by the company. Thus, the main objectives are to: (1) integrate the components based on the requirements of the users and the context of application, and (2) provide a new tool that can be used “in situ” to track workers. This study was carried out in close collaboration with Volkswagen through a human-centred iterative design process. Thus, this paper presents the development of a wearable device glove based on a specific design methodology where both the human and technological aspects are considered

On the variability of the dmanisi mandibles

The description of a new skull (D4500) from the Dmanisi site (Republic of Georgia) has reopened the debate about the morphological variability within the genus Homo. The new skull fits with a mandible (D2600) often referred as ‘big’ or ‘enigmatic’ because of its differences with the other Dmanisi mandibles (D211 and D2735). In this report we present a comparative study of the variability of the Dmanisi mandibles under a different perspective, as we focus in morphological aspects related to growth and development. We have followed the notion of modularity and phenotypic integration in order to understand the architectural differences observed within the sample. Our study reveals remarkable shape differences between D2600 and the other two mandibles, that are established early in the ontogeny (during childhood or even before) and that do not depend on size or sexual dimorphism. In addition, D2600 exhibits a mosaic of primitive and derived features regarding the Homo clade, which is absent in D211 and D2735. This mosaic expression is related to the location of the features and can be explained under the concept of modularity. Our study would support the possibility of two different paleodemes represented at the Dmanisi site. This hypothesis has been previously rejected on the basis that all the individuals were constrained in the same stratigraphic and taphonomic settings. However, our revision of the complex Dmanisi stratigraphy suggests that the accumulation could cover an undetermined period of time. Even if ‘‘short’’ in geological terms, the hominin accumulation was not necessarily synchronic. In the same line we discard that the differences between D2600 and the small mandibles are consequence of wear-related dentoalveolar remodeling. In addition, dental wear pattern of D2600 could suggest an adaptation to a different ecological niche than the other Dmanisi individuals