The global burden of injury: Incidence, mortality, disability-adjusted life years and time trends from the global burden of disease study 2013

Background The Global Burden of Diseases (GBD), Injuries, and Risk Factors study used the disabilityadjusted life year (DALY) to quantify the burden of diseases, injuries, and risk factors. This paper provides an overview of injury estimates from the 2013 update of GBD, with detailed information on incidence, mortality, DALYs and rates of change from 1990 to 2013 for 26 causes of injury, globally, by region and by country. Methods Injury mortality was estimated using the extensive GBD mortality database, corrections for illdefined cause of death and the cause of death ensemble modelling tool. Morbidity estimation was based on inpatient and outpatient data sets, 26 cause-of-injury and 47 nature-of-injury categories, and seven follow-up studies with patient-reported long-term outcome measures. Results In 2013, 973 million (uncertainty interval (UI) 942 to 993) people sustained injuries that warranted some type of healthcare and 4.8 million (UI 4.5 to 5.1) people died from injuries. Between 1990 and 2013 the global age-standardised injury DALY rate decreased by 31% (UI 26% to 35%). The rate of decline in DALY rates was significant for 22 cause-of-injury categories, including all the major injuries. Conclusions Injuries continue to be an important cause of morbidity and mortality in the developed and developing world. The decline in rates for almost all injuries is so prominent that it warrants a general statement that the world is becoming a safer place to live in. However, the patterns vary widely by cause, age, sex, region and time and there are still large improvements that need to be made

SARS-CoV-2 infection produces chronic pulmonary epithelial and immune cell dysfunction with fibrosis in mice

A subset of individuals who recover from coronavirus disease 2019 (COVID-19) develop post-acute sequelae of SARS-CoV-2 (PASC), but the mechanistic basis of PASC-associated lung abnormalities suffers from a lack of longitudinal tissue samples. The mouse-adapted severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) strain MA10 produces an acute respiratory distress syndrome (ARDS) in mice similar to humans. To investigate PASC pathogenesis, studies of MA10-infected mice were extended from acute to clinical recovery phases. At 15 to 120 days post-virus clearance, pulmonary histologic findings included subpleural lesions composed of collagen, proliferative fibroblasts, and chronic inflammation, including tertiary lymphoid structures. Longitudinal spatial transcriptional profiling identified global reparative and fibrotic pathways dysregulated in diseased regions, similar to human COVID-19. Populations of alveolar intermediate cells, coupled with focal up-regulation of pro-fibrotic markers, were identified in persistently diseased regions. Early intervention with antiviral EIDD-2801 reduced chronic disease, and early anti-fibrotic agent (nintedanib) intervention modified early disease severity. This murine model provides opportunities to identify pathways associated with persistent SARS-CoV-2 pulmonary disease and test countermeasures to ameliorate PASC., After recovery from acute SARS-CoV-2 infection, mice exhibit chronic lung disease similar to some humans, allowing for testing of therapeutics

2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease

The recommendations listed in this document are, whenever possible, evidence based. An extensive evidence review was conducted as the document was compiled through December 2008. Repeated literature searches were performed by the guideline development staff and writing committee members as new issues were considered. New clinical trials published in peer-reviewed journals and articles through December 2011 were also reviewed and incorporated when relevant. Furthermore, because of the extended development time period for this guideline, peer review comments indicated that the sections focused on imaging technologies required additional updating, which occurred during 2011. Therefore, the evidence review for the imaging sections includes published literature through December 2011

The development of religious law and the legal system in Judaism

In the Torah different terms are used for the concept of law. Originally the concept of law in the Torah is associated with a wide range of legal areas which include both individual, collective, ritual and cultic spheres. Authority was granted to priests, judges, and the king (‘the Law of the King’). However, since many laws of the Torah are stated in an idealistic and general way it is hard to speak about the status of law in the First Temple Era. The Second Tempel Era provides us with more documented material about the law and its development. In the Second Temple period, ritual elements were expanded and made more explicit, elements which can be performed and celebrated both by the individual(s) or in a collective/community. Examples are the Shabbat and Festivals, the dietary laws and prayer. In addition, the laws concerning the temple and the priests were emphasized and developed (including laws on purity and impurity), and the laws about marriage were interpreted in a stricter way as part of a possible new definition of Jewish identity. In the Second Temple Era a learning tradition arose which caused new legislation to flourish, based on new exegetical methods or being legitimated by the (supposed?) ‘tradition of the ancestors’. The period of the second half of the Second Temple Era created the basis for rabbinic Judaism as it is becoming visible to us after the destruction of the Temple in the year 70 CE. The emphasis in Rabbinic Judaism on the halacha as law included a complete legal system, some elements being utopian in character while others had a restorative orientation. Exegesis, logical reasoning and hermeneutics were used to adapt the law to new situations. There was a further shift to a personal religious identity based on rabbinic Halacha as visible in daily life: prayer, blessings, rituals, dietary laws and concrete ethical behavior. In the Middle Ages the Responsa Literature was an important tool for adjusting rabbinic law to new circumstances due to migration and changes in the socio-economical life of the Jewish community and in the surrounding culture. In the modern period, rabbinical authority was weakened and its impact on the personal life of the individual diminished through a process of secularization, integration and assimilation and the urge to reform the halacha by orthodox and non-orthodox denominations. The acceptance of Rabbinical authority became a personal and voluntary choice of the community member. In the twentieth century, the Shoah, the creation of the state of Israel and the rapid technological and social changes, present new challenges for the rabbinic halacha. This led to the emergence of differences between the denominations regarding subjects like individualism, autonomy, women rights and the attitude towards modernity. For the time being, the rabbinic halacha maintains its status – especially in Israel and the United States – as an attractive lifestyle for a growing group of Jews