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To compare the impact on child diet and growth of a multisectoral community intervention v. nutrition education and livestock management training alone.
Longitudinal community-based randomized trial involving three groups of villages assigned to receive: (i) Full Package community development activities, delivered via women’s groups; (ii) livestock training and nutrition education alone (Partial Package); or (iii) no intervention (Control). Household surveys, child growth monitoring, child and household diet quality measures (diet diversity (DD), animal-source food (ASF) consumption) were collected at five visits over 36 months. Mixed-effect linear regression and Poisson models used survey round, treatment group and group-by-round interaction to predict outcomes of interest, adjusted for household- and child-specific characteristics.
Households (n 974) with children aged 1–60 months (n 1333).
Children in Full Package households had better endline anthropometry (weight-for-age, weight-for-height, mid-upper-arm-circumference Z-scores), DD, and more consumption of ASF, after adjusting for household- and child-specific characteristics. By endline, compared with Partial Package or Control groups, Full Package households demonstrated preferential child feeding practices and had significantly more improvement in household wealth and hygiene habits.
In this longitudinal study, a comprehensive multisectoral intervention was more successful in improving key growth indicators as well as diet quality in young children. Provision of training in livestock management and nutrition education alone had limited effect on these outcomes. Although more time-consuming and costly to administer, incorporating nutrition training with community social capital development was associated with better child growth and nutrition outcomes than isolated training programmes alone.
(1) To characterise changes in dead space fraction during the first 120 post-operative hours in neonates undergoing stage 1 palliation for hypoplastic left heart syndrome, including hybrid procedure; (2) to document whether dead space fraction varied by shunt type (Blalock–Taussig shunt and Sano) and hybrid procedure; and (3) to determine the association between dead space fraction and outcomes.
Retrospective chart review in neonates undergoing stage 1 palliation for hypoplastic left heart syndrome in a cardiac intensive care unit over a consecutive 30-month period. A linear mixed model was used to determine the differences in dead space over time. Multivariable linear regression and a multivariable linear mixed model were used to assess the association between dead space and outcomes at different time points and over time, respectively.
Thirty-four neonates received either a Blalock–Taussig shunt (20.5%), Sano shunt (59%), or hybrid procedure (20.5%). Hospital mortality was 8.8%. Dead space fractions in patients undergoing the hybrid procedure were significantly lower on day 1 (p = 0.01) and day 2 (p = 0.02) and increased over time. A dead space fraction >0.6 on post-operative days 3–5 was significantly associated with decreased duration of mechanical ventilation in all surgical groups (p < 0.001).
Dead space fraction >0.6 on post-operative days 3–5 was associated with lower duration of mechanical ventilation in all surgical groups. A more comprehensive, prospective assessment of dead space in this delicate patient population would likely be beneficial in improving outcomes.
South-east Asian apple snails, Pila spp., have been declining since the introduction of globally invasive, confamilial South American Pomacea spp., yet Pila ecology remains poorly studied, with most occurrence records unconfirmed. Pila scutata, a previously widespread species, presumed native to the Malay peninsula and assessed as Least Concern in the IUCN Red List, was formerly harvested for food, and may have experienced anthropogenic translocations. We surveyed the Malay peninsula (specifically Peninsular Malaysia and Singapore) to investigate the current distribution and genetic diversity of P. scutata. Six populations were found in Singapore, but only one in Peninsular Malaysia. Mitochondrial COI and 16S sequencing revealed that the Malaysian population shared a single haplotype of both genes with the Singapore populations (500 km distant). This low genetic diversity could stem from a recent anthropogenic introduction, which brings into question the true native range of P. scutata and, coupled with poorly resolved taxonomy of the genus, necessitates a reassessment of its IUCN Red List status. Introduced populations pose a dilemma, and the lack of genetic diversity is of concern in light of Pila decline throughout South-east Asia. Our results highlight that conservation management of P. scutata and its congeners must therefore be better informed by greater taxonomic resolution and more comprehensive investigations of their ecology, both in native and introduced ranges.
Crab Pulsar (PSR B0531+21) is known to emit pulsed emission in all bands of the electromagnetic spectrum. It also emits giant radio pulses (GRPs) frequently, which are roughly a hundred to million times brighter than the normal pulses. We aim to study whether there is a significant X-ray enhancement correlated with the occurrence of GRPs, using simultaneous observations with the ASTROSAT, the Giant Meterwave Radio telescope (1300 MHz) and the Ooty Radio telescope (325 MHz). This required determination of fixed pipeline offsets between different instruments. We find the offset between ASTROSAT and GMRT to be −30.181 ± 0.095 ms and that between ASTROSAT and ORT to be −18.4 ± 0.2 ms. Our preliminary results with 1300 MHz data also show a break in pulse intensity distribution at ~ 33 Jy in the main pulse and ~ 28 Jy in the inter-pulse.
Assaultive violence events are associated with increased risk for adverse psychiatric outcomes, including post-traumatic stress (PTS), depression, and generalized anxiety. Prior research has indicated that economic, legal, and social stressors that could follow assaultive events may explain the increased risk for adverse psychiatric outcomes, yet longitudinal studies have not adequately examined this pathway. In the current study, we aimed to address this limitation.
Participants (N = 1360) were part of a longitudinal population-based study of adults living in Detroit. At three waves, participants indicated their exposure to assaultive violence and economic, legal, and social stressors, and completed inventories of PTS, depression, and generalized anxiety. Longitudinal mediation models were used to test the hypothesized pathway from assaultive violence to each psychiatric outcome.
The hypothesized models evidenced good fit with the data and, in each, the paths from Wave 1 (W1) assaultive violence to W2 stressors, and from W2 stressors to W3 symptoms were significant (range of Standardized Estimates: 0.09–0.15, all p < 0.01). Additionally, the indirect paths from W1 assaultive violence to W3 symptoms were significant (range of Standardized Estimates: 0.01–0.02, all p < 0.05).
The findings illustrate that the economic, legal, and social stressors that could follow assaultive violence increase risk for a range of psychiatric symptoms. Although future research is needed, the results suggest that investment in interventions that prevent and mitigate assaultive violence survivors’ exposure to such stressors may be an effective way to prevent mental illness in the aftermath of violent assaults.
In order to understand the Galactic structure, we perform a statistical analysis of the distribution of various cluster parameters based on an almost complete sample of Galactic open clusters yet available. The geometrical and physical characteristics of a large number of open clusters given in the MWSC catalogue are used to study the spatial distribution of clusters in the Galaxy and determine the scale height, solar offset, local mass density and distribution of reddening material in the solar neighbourhood. We also explored the mass-radius and mass-age relations in the Galactic open star clusters. We find that the estimated parameters of the Galactic disk are largely influenced by the choice of cluster sample.
Docetaxel, cisplatin plus 5-fluorouracil is an efficacious induction regimen but is more toxic than cisplatin plus 5-fluorouracil. This study aimed to determine whether docetaxel and cisplatin without 5-fluorouracil maintains efficacy while decreasing toxicity.
A multicenter non-comparative pilot study of locally advanced squamous cell carcinoma of the head and neck was performed. Patients received primary therapy comprising three cycles of 75 mg/m2 docetaxel and 75 mg/m2 cisplatin followed by concurrent chemoradiotherapy. The primary endpoint was the response rate to the docetaxel and cisplatin induction regimen.
A total of 26 patients were enrolled: of these, 23 (88.5 per cent) received all three docetaxel and cisplatin cycles. Common grade 3–4 adverse events were febrile neutropenia (19.2 per cent of patients), diarrhoea (19.2 per cent) and non-neutropenic infection (15.4 per cent). The overall response rate to docetaxel and cisplatin induction chemotherapy was 65.4 per cent. A total of 23 patients (88.5 per cent) subsequently received chemoradiotherapy with a median radiotherapy dose of 70 Gy. The response rate to chemoradiotherapy was 73 per cent. At a median follow up of 44 months, the 3-year progression-free survival and overall survival rates were 62 per cent and 69 per cent, respectively.
Docetaxel and cisplatin induction chemotherapy is a feasible induction regimen with comparable efficacy to docetaxel, cisplatin and 5-fluorouracil induction chemotherapy.
It has been thirty years since the first genetically engineered animal with altered milk composition was reported. During the intervening years, the world population has increased from 5bn to 7bn people. An increasing demand for protein in the human diet has followed this population expansion, putting huge stress on the food supply chain. Many solutions to the grand challenge of food security for all have been proposed and are currently under investigation and study. Amongst these, genetics still has an important role to play, aiming to continually enable the selection of livestock with enhanced traits. Part of the geneticist's tool box is the technology of genetic engineering. In this Invited Review, we indicate that this technology has come a long way, we focus on the genetic engineering of dairy animals and we argue that the new strategies for precision breeding demand proper evaluation as to how they could contribute to the essential increases in agricultural productivity our society must achieve.
A regional, multistate investigation into a June–August 2013 cyclosporiasis outbreak was conducted in Nebraska, Iowa, and neighbouring states. Cases were confirmed on the basis of laboratory and clinical findings. Of 227 cases in Iowa (n = 140) and Nebraska (n = 87) residents, 162 (71%) reported dining at chain A/B restaurants – 96% reported house salad consumption. A case-control study identified chain A/B house salad as the most likely vehicle. Traceback was conducted to ascertain production lot codes of bagged salad mix (iceberg and romaine lettuce, red cabbage, and carrots) served as house salad in implicated restaurants. A single production lot code of salad mix supplied by both a common producer and distributor was linked to the majority of confirmed cases in persons reporting regional chain A/B exposure. The salad mix linked to illnesses contained imported romaine lettuce from two separate single-grower fields-of-origin and ⩾1 additional field from another grower.
This study assessed the utility of current sialendoscopes in the paranasal sinuses in a cadaveric model and evaluated novel uses for sialendoscopes.
Currently available sialendoscopes were used for visualisation and performing interventions in the paranasal sinuses. Ten cadaver heads were studied before and after dissection. Outcomes included ostia identification, sinus cannulation, success of mucosal biopsy collection and image clarity.
Marchal and Erlangen sialendoscopes were found to be effective for both visualising and cannulating the sphenoid sinuses before and after dissection. Both types demonstrated poor maxillary ostia visualisation without dissection, but did allow treatment after antrostomy. Larger diameter sialendoscopes were associated with the lowest image distortion during maxillary ostia assessment. Mucosal biopsy collection within the sphenoid sinus, but not in the maxillary sinus, was possible before dissection.
Sialendoscopes can be used for visualisation and performing interventions in the sinonasal cavity, but their utility is mainly limited to the sphenoid sinus. They may be considered a minimally invasive method for drug delivery and/or biopsy collection in the post-operative setting for all sinuses. Design improvements are suggested.
We present a complete spatial and dynamical study of the poorly populated stellar system ESO65SC03. The radial distribution of the system gives a core and cluster radii of 1.10±0.63 and 5.36±0.24 arcmin, respectively. The SNDP does not show any clear enhancement of the surface stellar number density between the stars of the system and the field regions. We derive the optimum isochrone solution for a particular grid size in the CMD using the statistical cleaning procedure. Using the statistically cleaned CMDs, we find the distance modulus, (m − M)0, and reddening, E(B − V), of the system to be 11.8±0.2 and 0.45 mag, respectively. The mean proper motion of this system is − 5.37±0.81 mas yr−1 and 0.31±0.40 in RA and DEC directions, respectively. The mean proper motion of this system is found to be almost similar to the field region. The mass function for the brighter stars is found to be too high for the system to be an open cluster. These combined results place constraints on whether stellar system ESO65SC03 is a POCR or an Asterism. Our understanding is that the ESO65SC03 is in a stage of POCR by losing their main-sequence stars in the dynamic evolution processes.
Central obesity has been associated with the risk of cardiovascular and metabolic disease in children. A total of 358 Delhi school girls aged 6–11 years were measured for height, weight, waist circumference and hip circumference. The study demonstrates a linear correlation between body mass index (BMI) and waist and hip circumference and suggests an indirect method of estimating waist and hip circumferences, whose high values may be used for the diagnosis of metabolic syndrome and cardiovascular disease. Further investigations on different groups are needed to substantiate these results and attribute BMI a predictive value in the clinical setting for the risk and diagnosis of childhood obesity-related metabolic disorders.
Here we present the report on the “Nainital–Cape survey” research project aiming to search for and study the pulsational variability of main-sequence chemically peculiar (CP) stars. For this study, the time-series photometric observations of the sample stars were carried out at the 1.04 m ARIES telescope (India), while the high-resolution spectroscopic and spectro-polarimetric observations were carried out at the the 6.0 m Russian telescope. Under this project, we have recently found clear evidence of photometric variability in the Am star HD 73045, which is likely to be pulsating in nature with a period of about 36 min, hence adding a new member to the family of the δ Scuti pulsating variables that have peculiar abundances.
Non-healing ulcers can be caused by a number of conditions, including vascular disease, diabetes, malignancy and some infections. Drug-related ulcers are rare, and a high index of clinical suspicion is required for diagnosis, in parallel with exclusion of more sinister underlying causes.
We present a patient with a complex medical background, who had a 10-week history of a non-healing ulcer on his nasal bridge. Inflammatory, autoimmune and malignant causes for the ulcer were excluded by histopathology.
Nicorandil was deemed to be the most likely cause for the patient's ulcer. Nicorandil is an anti-anginal medication known to cause oral ulceration and skin lesions in the perianal and peristomal regions and around surgical wounds. However, there are no previously reported cases of facial ulcers. The ulcer required surgical debridement and healed completely within six months, following discontinuation of nicorandil. This case highlights the importance of having a high index of clinical suspicion regarding non-healing ulcers, and of considering drugs as an aetiological factor, especially in patients with a complex medical background who are taking numerous medications.
Monitoring the glacier mass balance of summer-accumulation-type Himalayan glaciers is critical to not only assess the impact of climate change on the volume of such glaciers but also predict the downstream water availability and the global sea-level change in future. To better understand the change in meteorological parameters related to glacier mass balance and runoff in a glacierized basin and to assess the highly heterogeneous glacier responses to climate change in the Nepal Himalaya and nearby ranges, the Cryosphere Monitoring Project (CMP) carries out meteorological observations in Langtang Valley and mass-balance measurements on Yala Glacier, a debris-free glacier in the same valley. A negative annual mass balance of –0.89m w.e. and the rising equilibrium-line altitude of Yala Glacier indicate a continuation of a secular trend toward more negative mass balances. Lower temperature lapse rate during the monsoon, the effect of convective precipitation associated with mesoscale thermal circulation in the local precipitation and the occurrence of distinct diurnal cycles of temperature and precipitation at different stations in the valley are other conclusions of this comprehensive scientific study initiated by CMP which aims to yield multi-year glaciological, hydrological and meteorological observations in the glacierized Langtang River basin.