Geochemical and Microbial Community Attributes in Relation to Hyporheic Zone Geological Facies.

The hyporheic zone (HZ) is the active ecotone between the surface stream and groundwater, where exchanges of nutrients and organic carbon have been shown to stimulate microbial activity and transformations of carbon and nitrogen. To examine the relationship between sediment texture, biogeochemistry, and biological activity in the Columbia River HZ, the grain size distributions for sediment samples were characterized to define geological facies, and the relationships among physical properties of the facies, physicochemical attributes of the local environment, and the structure and activity of associated microbial communities were examined. Mud and sand content and the presence of microbial heterotrophic and nitrifying communities partially explained the variability in many biogeochemical attributes such as C:N ratio and %TOC. Microbial community analysis revealed a high relative abundance of putative ammonia-oxidizing Thaumarchaeota and nitrite-oxidizing Nitrospirae. Network analysis showed negative relationships between sets of co-varying organisms and sand and mud contents, and positive relationships with total organic carbon. Our results indicate grain size distribution is a good predictor of biogeochemical properties, and that subsets of the overall microbial community respond to different sediment texture. Relationships between facies and hydrobiogeochemical properties enable facies-based conditional simulation/mapping of these properties to inform multiscale modeling of hyporheic exchange and biogeochemical processes.

Global, Regional, and National Prevalence, Incidence, and Disability-Adjusted Life Years for Oral Conditions for 195 Countries, 1990-2015: A Systematic Analysis for the Global Burden of Diseases, Injuries, and Risk Factors.

The Global Burden of Disease 2015 study aims to use all available data of sufficient quality to generate reliable and valid prevalence, incidence, and disability-adjusted life year (DALY) estimates of oral conditions for the period of 1990 to 2015. Since death as a direct result of oral diseases is rare, DALY estimates were based on years lived with disability, which are estimated only on those persons with unmet need for dental care. We used our data to assess progress toward the Federation Dental International, World Health Organization, and International Association for Dental Research's oral health goals of reducing the level of oral diseases and minimizing their impact by 2020. Oral health has not improved in the last 25 y, and oral conditions remained a major public health challenge all over the world in 2015. Due to demographic changes, including population growth and aging, the cumulative burden of oral conditions dramatically increased between 1990 and 2015. The number of people with untreated oral conditions rose from 2.5 billion in 1990 to 3.5 billion in 2015, with a 64% increase in DALYs due to oral conditions throughout the world. Clearly, oral diseases are highly prevalent in the globe, posing a very serious public health challenge to policy makers. Greater efforts and potentially different approaches are needed if the oral health goal of reducing the level of oral diseases and minimizing their impact is to be achieved by 2020. Despite some challenges with current measurement methodologies for oral diseases, measurable specific oral health goals should be developed to advance global public health.

Global burden of untreated caries: a systematic review and metaregression.

We aimed to consolidate all epidemiologic data about untreated caries and subsequently generate internally consistent prevalence and incidence estimates for all countries, 20 age groups, and both sexes for 1990 and 2010. The systematic search of the literature yielded 18,311 unique citations. After screening titles and abstracts, we excluded 10,461 citations as clearly irrelevant to this systematic review, leaving 1,682 for full-text review. Furthermore, 1,373 publications were excluded following the validity assessment. Overall, 192 studies of 1,502,260 children aged 1 to 14 y in 74 countries and 186 studies of 3,265,546 individuals aged 5 y or older in 67 countries were included in separate metaregressions for untreated caries in deciduous and permanent teeth, respectively, using modeling resources from the Global Burden of Disease 2010 study. In 2010, untreated caries in permanent teeth was the most prevalent condition worldwide, affecting 2.4 billion people, and untreated caries in deciduous teeth was the 10th-most prevalent condition, affecting 621 million children worldwide. The global age-standardized prevalence and incidence of untreated caries remained static between 1990 and 2010. There is evidence that the burden of untreated caries is shifting from children to adults, with 3 peaks in prevalence at ages 6, 25, and 70 y. Also, there were considerable variations in prevalence and incidence between regions and countries. Policy makers need to be aware of a predictable increasing burden of untreated caries due to population growth and longevity and a significant decrease in the prevalence of total tooth loss throughout the world from 1990 to 2010.

Global burden of severe periodontitis in 1990-2010: a systematic review and meta-regression.

We aimed to consolidate all epidemiologic data about severe periodontitis (SP) and, subsequently, to generate internally consistent prevalence and incidence estimates for all countries, 20 age groups, and both sexes for 1990 and 2010. The systematic search of the literature yielded 6,394 unique citations. After screening titles and abstracts, we excluded 5,881 citations as clearly not relevant to this systematic review, leaving 513 for full-text review. A further 441 publications were excluded following the validity assessment. A total of 72 studies, including 291,170 individuals aged 15 yr or older in 37 countries, were included in the metaregression based on modeling resources of the Global Burden of Disease 2010 Study. SP was the sixth-most prevalent condition in the world. Between 1990 and 2010, the global age-standardized prevalence of SP was static at 11.2% (95% uncertainty interval: 10.4%-11.9% in 1990 and 10.5%-12.0% in 2010). The age-standardized incidence of SP in 2010 was 701 cases per 100,000 person-years (95% uncertainty interval: 599-823), a nonsignificant increase from the 1990 incidence of SP. Prevalence increased gradually with age, showing a steep increase between the third and fourth decades of life that was driven by a peak in incidence at around 38 yr of age. There were considerable variations in prevalence and incidence between regions and countries. Policy makers need to be aware of a predictable increasing burden of SP due to the growing world population associated with an increasing life expectancy and a significant decrease in the prevalence of total tooth loss throughout the world from 1990 to 2010.

Global Burden of Severe Tooth Loss: A Systematic Review and Meta-analysis.

The goal of the Global Burden of Disease 2010 Study has been to systematically produce comparable estimates of the burden of 291 diseases and injuries and their associated 1,160 sequelae from 1990 to 2010. We aimed to report here internally consistent prevalence and incidence estimates of severe tooth loss for all countries, 20 age groups, and both sexes for 1990 and 2010. The systematic search of the literature yielded 5,618 unique citations. After titles and abstracts were screened, 5,285 citations were excluded as clearly not relevant to this systematic review, leaving 333 for full-text review; 265 publications were further excluded following the validity assessment. A total of 68 studies-including 285,746 individuals aged 12 yr or older in 26 countries-were included in the meta-analysis using modeling resources of the Global Burden of Disease 2010 Study. Between 1990 and 2010, the global age-standardized prevalence of edentate people decreased from 4.4% (95% uncertainty interval: 4.1%, 4.8%) to 2.4% (95% UI: 2.2%, 2.7%), and incidence rate decreased from 374 cases per 100,000 person-years (95% UI: 347, 406) to 205 cases (95% UI: 187, 226). No differences were found by sex in 2010. Prevalence increased gradually with age, showing a steep increase around the seventh decade of life that was associated with a peak in incidence at 65 years. Geographic differences in prevalence, incidence, and rate of improvement from 1990 to 2010 were stark. Our review of available quality literature on the epidemiology of tooth loss shows a significant decline in the prevalence and incidence of severe tooth loss between 1990 and 2010 at the global, regional, and country levels.

The effects of speed-dependent treadmill training and rhythmic auditory-cued overground walking on balance function, fall incidence, and quality of life in individuals with idiopathic Parkinson's disease: a randomized controlled trial.

OBJECTIVES: The purpose of this single-blinded, randomized controlled study was to examine and compare the immediate and retention effects of progressive speed-dependent treadmill training (SDTT) and rhythmic auditory-cued (RAC) training on balance function, fall incidence, and quality of life (QOL) in individuals with PD. METHODS: Twenty participants (mean age 66.1 yrs) with idiopathic PD were randomized into either SDTT (n = 10) or RAC (n = 10) progressive, interval-based locomotor training for 6 weeks. Measures included the Berg Balance Scale (BBS), Rapid Step-Up Test (RST), Activities-specific Balance Confidence Scale, Parkinson's Disease Questionnaire-39 (PDQ), and the NeuroCom Sensory Organization Test (SOT), Motor Control Test, and Limits of Stability (LOS). Fall incidence was assessed prospectively post-training based on six monthly self-report fall calendars. RESULTS: Significant gains in balance measures were observed post-training in BBS, RST and SOT for the RAC group and in RST, SOT and LOS for the SDTT group. Gains were retained at 3 months post-training in all measures for RAC group, but only the RST for the SDTT group. No clear trend in reduction in fall frequency was evident. CONCLUSION: Externally-cued locomotor training paradigms with progressive speed challenges produced significant improvements in dynamic balance function in persons with PD, with stronger retention of gains in RAC group.

Global burden of oral conditions in 1990-2010: a systematic analysis.

The Global Burden of Disease (GBD) 2010 Study produced comparable estimates of the burden of 291 diseases and injuries in 1990, 2005, and 2010. This article reports on the global burden of untreated caries, severe periodontitis, and severe tooth loss in 2010 and compares those figures with new estimates for 1990. We used disability-adjusted life-years (DALYs) and years lived with disability (YLDs) metrics to quantify burden. Oral conditions affected 3.9 billion people, and untreated caries in permanent teeth was the most prevalent condition evaluated for the entire GBD 2010 Study (global prevalence of 35% for all ages combined). Oral conditions combined accounted for 15 million DALYs globally (1.9% of all YLDs; 0.6% of all DALYs), implying an average health loss of 224 years per 100,000 population. DALYs due to oral conditions increased 20.8% between 1990 and 2010, mainly due to population growth and aging. While DALYs due to severe periodontitis and untreated caries increased, those due to severe tooth loss decreased. DALYs differed by age groups and regions, but not by genders. The findings highlight the challenge in responding to the diversity of urgent oral health needs worldwide, particularly in developing communities.

Incidence of road injuries in Mexico: country report.

We used data from various sources to triangulate to a national snapshot of the incidence of fatal and non-fatal road traffic injuries in Mexico in 2005. Data sources used include national death registration data, national hospital discharge data and a nationally representative health survey. We estimate that in 2005, 19,389 people died due to injuries and nearly one million were injured in road traffic crashes. While deaths in high-income countries are declining, this is not the case in Mexico. Young adult males are the demographic at the highest risk in non-fatal crashes, but the elderly have the highest road death rates primarily due to pedestrian crashes. Pedestrians alone comprise nearly half (48%) of all deaths. Cars pose a substantial threat to occupants (38% of deaths and 39% of hospital admissions) and to other road users.

Building national estimates of the burden of road traffic injuries in developing countries from all available data sources: Iran.

OBJECTIVE: To use a range of existing information sources to develop a national snapshot of the burden of road traffic injuries in one developing country-Iran. METHODS: The distribution of deaths was estimated by using data from the national death registration system, hospital admissions and outpatient visits from a time-limited hospital registry in 12 of 30 provinces, and injuries that received no institutional care using the 2000 demographic and health survey. Results were extrapolated to national annual incidence of health burden differentiated by age, sex, external cause, nature of injuries and institutional care. RESULTS: In 2005, 30,721 Iranians died annually in road traffic crashes and over one million were injured. The death rate (44 per 100,000) is the highest of any country in the world for which reliable estimates are available. Road traffic injuries are the third leading cause of death in Iran. While young adults are at high risk in non-fatal crashes, the elderly have the highest total death rates, largely due to pedestrian crashes. While car occupants lead the death count, motorized two-wheeler riders dominate hospital admissions, outpatient visits and health burden. CONCLUSIONS: Reliable estimates of the burden of road traffic injuries are an essential input for rational priority setting. Most low income countries are unlikely to have national injury surveillance systems for several decades. Thus national estimates of the burden of injuries should be built by collating information from all existing information sources by appropriately correcting for source specific shortcomings.

Measuring quality of health care from the user's perspective in 41 countries: psychometric properties of WHO's questions on health systems responsiveness.

OBJECTIVE: To evaluate, for different populations, psychometric properties of questions on "health systems responsiveness", a concept developed by World Health Organization (WHO) to describe non-clinical and non-financial aspects of quality of health care. DATA SOURCES/STUDY SETTING/DATA COLLECTION: The 2000-2002 WHO Multi-Country Study comprised 70 general population surveys. Forty-one surveys were interviewer-administered, from which we extracted respondent records indicating ambulatory and inpatient health services use (excluding long-term institutions) in the previous 12 months (50,876 ambulatory and 7,964 hospital interviews). STUDY DESIGN: We evaluated feasibility, reliability, and construct validity using 33 items with polytomous response options, comparing responses from populations identified by countries, sex, age, education, health and income. PRINCIPAL FINDINGS: Average item missing rates ranged from 0 to 16%. Domain-specific alpha coefficients exceeded 0.7 in 7 (of 9) cases. Average intertemporal reliability was acceptable in 6 (of 10) sites, where Kappas ranged from 0.54 to 0.79, but low in 4 sites (K < 0.5). Kappa statistics were higher for male, educated and healthier populations than for female, less educated and less healthy populations. Factor solutions confirmed the domain structure of 7 domains (only 7 were operationalized for ambulatory settings). As in other studies, higher incomes and age was associated with more positive responsiveness reports and ratings. CONCLUSIONS: Quality issues addressed by WHO's questions are understood and reported adequately across diverse populations. More research is needed to interpret user-assessed quality of care comparisons across population groups within and between countries.

Selective targeting of a laccase from Stachybotrys chartarum covalently linked to a carotenoid-binding peptide.

Atwo-step targeting strategy was used to identify improved laccases for bleaching carotenoid-containing stains on fabric. We first applied a modified phage display technique to identify peptide sequences capable of binding specifically to carotenoid stains and not to fabric. Prior deselection on the support on which the carotenoid was localized, increased stringency during the biopanning target selection process, and analysis of the phage peptides' binding to the target after acid elution and polymerase chain reaction (PCR) postacid elution, were used to isolate phage peptide libraries with increased binding selectivity and affinity. Peptide sequences were selected based on identified consensus motifs. We verified the enhanced carotenoid-binding properties of the peptide YGYLPSR and subsequently cloned and expressed C-terminal variants of laccase from Stachybotrys chartarum containing carotenoid-binding peptides YGYLPSR, IERSAPATAPPP, KASAPAL, CKASAPALC, and SLLNATK. These targeted peptide-laccase fusions demonstrate enhanced catalytic properties on stained fabrics.

Global burden of depressive disorders in the year 2000.

BACKGROUND: The initial Global Burden of Disease study found that depression was the fourth leading cause of disease burden, accounting for 3.7% of total disability adjusted life years (DALYs) in the world in 1990. AIMS: To present the new estimates of depression burden for the year 2000. METHOD: DALYs for depressive disorders in each world region were calculated, based on new estimates of mortality, prevalence, incidence, average age at onset, duration and disability severity. RESULTS: Depression is the fourth leading cause of disease burden, accounting for 4.4% of total DALYs in the year 2000, and it causes the largest amount of non-fatal burden, accounting for almost 12% of all total years lived with disability worldwide. CONCLUSIONS: These data on the burden of depression worldwide represent a major public health problem that affects patients and society.

Technetium reduction in sediments of a shallow aquifer exhibiting dissimilatory iron reduction potential.

Pertechnetate ion [Tc(VII)O(4) (-)] reduction rate was determined in core samples from a shallow sandy aquifer located on the US Atlantic Coastal Plain. The aquifer is generally low in dissolved O(2) (<1 mg L(-1)) and composed of weakly indurated late Pleistocene sediments differing markedly in physicochemical properties. Thermodynamic calculations, X-ray absorption spectroscopy and statistical analyses were used to establish the dominant reduction mechanisms, constraints on Tc solubility, and the oxidation state, and speciation of sediment reduction products. The extent of Tc(VII) reduction differed markedly between sediments (ranging from 0% to 100% after 10 days of equilibration), with low solubility Tc(IV) hydrous oxide the major solid phase reduction product. The dominant electron donor in the sediments proved to be (0.5 M HCl extractable) Fe(II). Sediment Fe(II)/Tc(VII) concentrations >4.3 were generally sufficient for complete reduction of Tc(VII) added [1-2.5 micromol (dry wt. sediment) g(-1)]. At these Fe(II) concentrations, the Tc (VII) reduction rate exceeded that observed previously for Fe(II)-mediated reduction on isolated solids of geologic or biogenic origin, suggesting that sediment Fe(II) was either more reactive and/or that electron shuttles played a role in sediment Tc(VII) reduction processes. In buried peats, Fe(II) in excess did not result in complete removal of Tc from solution, perhaps because organic complexation of Tc(IV) limited formation of the Tc(IV) hydrous oxide. In some sands exhibiting Fe(II)/Tc(VII) concentrations <1.1, there was presumptive evidence for direct enzymatic reduction of Tc(VII). Addition of organic electron donors (acetate, lactate) resulted in microbial reduction of (up to 35%) Fe(III) and corresponding increases in extractable Fe(II) in sands that exhibited lowest initial Tc(VII) reduction and highest hydraulic conductivities, suggesting that accelerated microbial reduction of Fe(III) could offer a viable means of attenuating mobile Tc(VII) in this type of sediment system.

Health Systems Performance Assessment: debates, methods and empiricism

It provides a comprehensive exploration of many different facets of health systems performance assessment. It will be relevant for researchers, students and decision-makers seeking a more detailed understanding of concepts, methods and the latest empirical findings. Document in pdf format; Acrobat Reader required.

Summary measures of population health - concepts, ethics, measurement and applications

It addresses a wide array of critical issues regarding the measurement of population health using comprehensive indices combining information on mortality and ill-health. Document in pdf format; Acrobat Reader required.