Purpose:It has been argued that rare diseases should be recognized as a public health priority. However, there is a shortage of epidemiological data describing the true burden of rare diseases. This study investigated hospital service use to provide a better understanding of the collective health and economic impacts of rare diseases.Methods:Novel methodology was developed using a carefully constructed set of diagnostic codes, a selection of rare disease cohorts from hospital administrative data, and advanced data-linkage technologies. Outcomes included health-service use and hospital admission costs.Results:In 2010, cohort members who were alive represented approximately 2.0% of the Western Australian population. The cohort accounted for 4.6% of people discharged from hospital and 9.9% of hospital discharges, and it had a greater average length of stay than the general population. The total cost of hospital discharges for the cohort represented 10.5% of 2010 state inpatient hospital costs.Conclusions:This population-based cohort study provides strong new evidence of a marked disparity between the proportion of the population with rare diseases and their combined health-system costs. The methodology will inform future rare-disease studies, and the evidence will guide government strategies for managing the service needs of people living with rare diseases.Genet Med advance online publication 22 September 2016

Two-dimensional simulations of the 11 January 1972 Boulder, Colorado, windstorm, obtained from 11 diverse nonhydrostatic models, are intercompared with special emphasis on the turbulent breakdown of topographically forced gravity waves, as part of the preparation for the Mesoscale Alpine Programme field phase. The sounding used to initialize the models is more representative of the actual lower stratosphere than those applied in previous simulations. Upper-level breaking is predicted by all models in comparable horizontal locations and vertical layers, which suggests that gravity wave breaking may be quite predictable in some circumstances. Characteristics of the breaking include the following: pronounced turbulence in the 13-16-km and 18-20-km layers positioned beneath a critical level near 21-km, a well-defined upstream tilt with height, and enhancement of upper-level breaking superpositioned above the low-level hydraulic jump. Sensitivity experiments indicate that the structure of the wave breaking was impacted by the numerical dissipation, numerical representation of the horizontal advection, and lateral boundary conditions. Small vertical wavelength variations in the shear and stability above 10 km contributed to significant changes in the structures associated with wave breaking. Simulation of this case is ideal for testing and evaluation of mesoscale numerical models and numerical algorithms because of the complex wave-breaking response.

BackgroundNeuropathic pain that caused by lesion or dysfunction of the nervous system is associated with gene expression changes in the sensory pathway. Long noncoding RNAs (lncRNAs) have been reported to be able to regulate gene expression. Identifying lncRNA expression patterns in the spinal cord under normal and neuropathic pain conditions is essential for understanding the genetic mechanisms behind the pathogenesis of neuropathic pain.ResultsSpinal nerve ligation (SNL) induced rapid and persistent pain hypersensitivity, characterized by mechanical allodynia and heat hyperalgesia. Meanwhile, astrocytes and microglia were dramatically activated in the ipsilateral spinal cord dorsal horn at 10 days after SNL. Further lncRNA microarray and mRNA microarray analysis showed that the expression profiles of lncRNA and mRNA between SNL and sham-operated mice were greatly changed at 10 days. The 511 differentially expressed (>2 fold) lncRNAs (366 up-regulated, 145 down-regulated) and 493 mRNAs (363 up-regulated, 122 down-regulated) were finally identified. The expression patterns of several lncRNAs and mRNAs were further confirmed by qPCR. Functional analysis of differentially expressed (DE) mRNAs showed that the most significant enriched biological processes of up-regulated genes in SNL include immune response, defense response, and inflammation response, which are important pathogenic mechanisms underlying neuropathic pain. 35 DE lncRNAs have neighboring or overlapping DE mRNAs in genome, which is related to Toll-like receptor signaling, cytokine–cytokine receptor interaction, and peroxisome proliferator-activated receptor signaling pathway.ConclusionOur findings uncovered the expression pattern of lncRNAs and mRNAs in the mice spinal cord under neuropathic pain condition. These lncRNAs and mRNAs may represent new therapeutic targets for the treatment of neuropathic pain.

No abstract