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In the present study, we aimed to compare anthropometric indicators as predictors of mortality in a community-based setting.
We conducted a population-based longitudinal study nested in a cluster-randomized trial. We assessed weight, height and mid-upper arm circumference (MUAC) on children 12 months after the trial began and used the trial’s annual census and monitoring visits to assess mortality over 2 years.
Children aged 6–60 months during the study.
Of 1023 children included in the study at baseline, height-for-age Z-score, weight-for-age Z-score, weight-for-height Z-score and MUAC classified 777 (76·0 %), 630 (61·6 %), 131 (12·9 %) and eighty (7·8 %) children as moderately to severely malnourished, respectively. Over the 2-year study period, fifty-eight children (5·7 %) died. MUAC had the greatest AUC (0·68, 95 % CI 0·61, 0·75) and had the strongest association with mortality in this sample (hazard ratio = 2·21, 95 % CI 1·26, 3·89, P = 0·006).
MUAC appears to be a better predictor of mortality than other anthropometric indicators in this community-based, high-malnutrition setting in Niger.
Combined archaeological, ecological, and geologic research on Chuginadak and Carlisle Islands in the Islands of Four Mountains (IFM) probed questions about the sustainability of human settlements over the past 4000 years in the face of geologic, ecological, and social hazards. We use a human ecodynamics approach to frame the investigation and present original archaeological evidence from this poorly known region of the remote Aleutian Islands. Several village sites occupied during the last four millennia are clustered in locations that were not damaged by earthquake-induced tsunamis; however, new geologic evidence indicates that at least one volcanic eruption forced humans to abandon one or more prehistoric village sites. Combined archaeological, ecological, and geologic analyses demonstrate resilient Unangax̂ occupations of the IFM through long-term climate change as well as earthquakes, tsunamis, and volcanic eruptions with occasional community vulnerability to volcanic eruptions.
The conservation benefits of maintaining social groupings during and after animal translocations are unclear. Although some studies report improved post-release survival, others found no discernible influence on reintroduction success. Understanding the effects of social groupings is difficult because release methods can influence the animals’ ability to maintain social groups. We explored this relationship by first studying whether release protocols influenced post-release cohesion in the communal burrowing bettong Bettongia lesueur, and then investigating whether maintenance of social cohesion conferred any post-release advantage. We released bettongs into a small (8 ha) and large (2,600 ha) area and compared the proportion that maintained social groupings in the different settings. The proportion of bettongs sharing with previous warren co-occupants was higher than expected by chance in both areas, however, a significantly higher proportion of bettongs maintained social groupings in the small (75%) compared to the large release area (13%). This suggests bettongs prefer to maintain social groupings but are unable to locate members of their group in large release areas. Bettongs that did maintain social groupings showed no difference in reproductive or health outcomes compared to those that formed new social groupings, suggesting no benefit to reintroduction success. We conclude that release protocols can influence post-release cohesion, but that greater cohesion does not necessarily confer advantages to group-living animals. To test the importance of social cohesion, further research on reintroductions should compare post-release parameters for animals released using protocols that do and do not facilitate maintenance of social groupings.
We are currently performing a monitoring program of the 1612 MHz OH maser emission of several dozen Galactic disk OH/IR stars with the Nancay Radio Telescope (NRT). They are complemented by several OH/IR stars toward the Galactic center, which were monitored with the Hartebeesthoek radio telescope. We use the maser variations to probe the underlying stellar variability. As early monitoring programs already have shown, some stars are large amplitude variables with periods up to 7 years, others show small or even no amplitude variations. This dichotomy in the variability behaviour is assumed to mark the border between the AGB and the post-AGB stages. With the current program, we wish to find objects in transition and to describe their variability properties. We consider the fading out of pulsations with steadily declining amplitudes as a viable process. Promising candidates in the disk are the small-amplitude variables OH 138.0+7.2 and OH 51.8−0.2. ’Non-variable’ OH/IR stars in the Galactic center region may be as frequent as in the disk.
The US Center for Medicare and Medicaid Services (CMS) requires nursing homes and long-term-care facilities to document residents' vaccination status on the Resident Assessment Instrument (RAI). Vaccinating residents can prevent costly hospital admissions and deaths. CMS and public health officials use RAI data to measure vaccination rates in long-term-care residents and assess the quality of care in nursing homes. We assessed the accuracy of RAI data against medical records in 39 nursing homes in Florida, Georgia, and Wisconsin. We randomly sampled residents in each home during the 2010–2011 and 2011–2012 influenza seasons. We collected data on receipt of influenza vaccination from charts and RAI data. Our final sample included 840 medical charts with matched RAI records. The agreement rate was 0·86. Using the chart as a gold standard, the sensitivity of the RAI with respect to influenza vaccination was 85% and the specificity was 77%. Agreement rates varied within facilities from 55% to 100%. Monitoring vaccination rates in the population is important for gauging the impact of programmes and policies to promote adherence to vaccination recommendations. Use of data from RAIs is a reasonable approach for gauging influenza vaccination rates in nursing-home residents.
Findings from multi-year, multi-site field trial experiments measuring maize yield response to inoculation with the phosphorus-solubilizing fungus, Penicillium bilaiae Chalabuda are presented. The main objective was to evaluate representative data on crop response to the inoculant across a broad set of different soil, agronomic management and climate conditions. A statistical analysis of crop yield response and its variability was conducted to guide further implementation of a stratified trial and sampling plan. Field trials, analysed in the present study, were conducted across the major maize producing agricultural cropland of the United States (2005–11) comprising 92 small (with sampling replication) and 369 large (without replication) trials. The multi-plot design enabled both a determination of how sampling area affects the estimation of maize yield and yield variance and an estimation of the ability of inoculation with P. bilaiae to increase maize yield. Inoculation increased maize yield in 66 of the 92 small and 295 of the 369 large field trials (within the small plots, yield increased significantly at the 95% confidence level, by 0·17 ± 0·044 t/ha or 1·8%, while in the larger plots, yield increases were higher and less variable (i.e., 0·33 ± 0·026 t/ha or 3·5%). There was considerable inter-annual variability in maize yield response attributed to inoculation compared to the un-inoculated control, with yield increases varying from 0·7 ± 0·75 up to 3·7 ± 0·73%. No significant correlation between yield response and soil acidity (i.e., pH) was detected, and it appears that pH reduction (through organic acid or proton efflux) was unlikely to be the primary pathway for better phosphorus availability measured as increased yield. Seed treatment and granular or dribble band formulations of the inoculant were found to be equally effective. Inoculation was most effective at increasing maize yield in fields that had low or very low soil phosphorus status for both small and large plots. At higher levels of soil phosphorus, yield in the large plots increased more with inoculation than in the small plots, which could be explained by phosphorus fertilization histories for the different field locations, as well as transient (e.g., rainfall) and topographic effects.
A randomised, cross-over, controlled-feeding study was conducted to evaluate the cholesterol-lowering effects of diets containing pistachios as a strategy for increasing total fat (TF) levels v. a control (step I) lower-fat diet. Ex vivo techniques were used to evaluate the effects of pistachio consumption on lipoprotein subclasses and functionality in individuals (n 28) with elevated LDL levels ( ≥ 2·86 mmol/l). The following test diets (SFA approximately 8 % and cholesterol < 300 mg/d) were used: a control diet (25 % TF); a diet comprising one serving of pistachios per d (1PD; 30 % TF); a diet comprising two servings of pistachios per d (2PD; 34 % TF). A significant decrease in small and dense LDL (sdLDL) levels was observed following the 2PD dietary treatment v. the 1PD dietary treatment (P= 0·03) and following the 2PD dietary treatment v. the control treatment (P= 0·001). Furthermore, reductions in sdLDL levels were correlated with reductions in TAG levels (r 0·424, P= 0·025) following the 2PD dietary treatment v. the control treatment. In addition, inclusion of pistachios increased the levels of functional α-1 (P= 0·073) and α-2 (P= 0·056) HDL particles. However, ATP-binding cassette transporter A1-mediated serum cholesterol efflux capacity (P= 0·016) and global serum cholesterol efflux capacity (P= 0·076) were only improved following the 2PD dietary treatment v. the 1PD dietary treatment when baseline C-reactive protein status was low ( < 103μg/l). Moreover, a significant decrease in the TAG:HDL ratio was observed following the 2PD dietary treatment v. the control treatment (P= 0·036). There was a significant increase in β-sitosterol levels (P< 0·0001) with the inclusion of pistachios, confirming adherence to the study protocol. In conclusion, the inclusion of pistachios in a moderate-fat diet favourably affects the cardiometabolic profile in individuals with an increased risk of CVD.
Although the cadmium chloride treatment is an essential process for high efficiency thin film cadmium telluride photovoltaic devices, the precise mechanisms involved that improve the cadmium telluride layer are not well understood. In this investigation we apply advanced micro-structural characterization techniques to study the effect of varying the time of the cadmium chloride annealing treatment on the micro-structure of cadmium telluride solar cells deposited by close spaced sublimation (CSS) and relate this to cell performance. A range of techniques has been used to observe the morphological changes to the micro-structure as well as the chemical and crystallographic changes as a function of treatment parameters. Electrical tests that link the device performance with the micro-structural properties of the cells have also been undertaken. Techniques used include Transmission Electron Microscopy (TEM) for sub-grain analysis and XPS for composition-depth profiling. The study provides a new insight in to the mechanisms involved in the initiation and the subsequent complete re-crystallization of the cadmium telluride layer.
To review our institutional experience with Gamma Knife (GK) stereotactic radiosurgery in treating focally recurrent high grade glial neoplasms of World Health Organization (WHO) grade III or IV.
We conducted a retrospective cohort review of all patients treated with GK for focally recurrent high grade gliomas at our institution between November 2003 and April 2013. Data on age, sex, tumor volume, location and maximal diameter, presenting clinical status, complications and clinical outcome was recorded.
A total of 33 patients were identified. Four were lost to follow-up. Average post-GK and overall survival was 20.4 months (range: 3 – 72) and 63.3 months (range: 10 – 214) respectively. For WHO grade IV gliomas, the average post-GK and overall survival was 15.8 months (range: 3 – 77) and 40.1 months (range: 13 – 148) respectively. Similarily, for WHO grade III gliomas, the average post-GK and overall survival was 34.9 months (range: 6 – 72) and 136.4 months (range: 22 – 214) respectively. Twenty-two patients (75.9%) had post-GK edema, with 14 requiring dexamethasone and eight being asymptomatic. Four patients (13.8%) had imaging defined radiation necrosis.
Gamma Knife SRS affords an extension of local tumor control, acceptable morbidity, and potentially prolonged survival, for highly selected patients with focally recurrent high grade glial neoplasms.
Lurasidone is an atypical antipsychotic medication approved for the treatment of schizophrenia over a dose range of 40–160 mg/day. This study examined D2 receptor occupancy and its association with clinical improvement and side effects in patients with schizophrenia or schizoaffective disorder following repeated doses of 80, 120, or 160 mg/day of lurasidone.
Twenty-five patients with The Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) diagnoses of schizophrenia or schizoaffective disorder were washed out of their antipsychotic medications (5 half-lives) and randomly assigned to 80, 120, or 160 mg/day of lurasidone. Subjects were imaged with 18F-fallypride at baseline and at steady-state lurasidone treatment to determine D2 receptor occupancy.
Blood lurasidone concentration (plus major metabolite), but not dose, significantly correlated with D2 receptor occupancy. D2 receptor occupancy in several subcortical structures is associated with positive but not negative symptom improvement or the presence of movement symptoms.
Blood concentrations greater than 70 ng/mL may be required to achieve a 65% occupancy level in subcortical areas. Intersubject blood concentrations at fixed dose were highly variable and may account for the lack of dose correlations.
Positron emission tomography (PET) occupancy data suggest that greater than 65% occupancy can be achieved across the dose range of 80–160 mg/day and that some patients require higher doses to achieve antipsychotic efficacy; this finding supports prior randomized clinical trial results.
Gamma Knife (GK) radiosurgery for pituitary adenomas can offer a means of tumor and biologic control with acceptable risk and low complication rates.
Retrospective review of all the patients treated at our center with GK for pituitary adenomas from Nov 2003 to June 2011.
We treated a total of 86 patients. Ten were lost to follow-up. Mean follow was 32.8 months. There were 21 (24.4%) growth hormone secreting adenomas (GH), 8 (9.3%) prolactinomas (PRL), 8 (9.3%) adrenocorticotropic hormone secreting (ACTH) adenomas, 2 (2.3%) follicle stimulating hormone/luteinizing hormone secreting (FSH/LH) adenomas, and 47 (54.7%) null cell pituitary adenomas that were treated. Average maximum tumor diameter and volume was 2.21cm and 5.41cm3, respectively. The average dose to the 50% isodose line was 14.2 Gy and 23.6 Gy for secreting and non-secreting adenomas respectively. Mean maximal optic nerve dose was 8.87 Gy. Local control rate was 75 of 76 (98.7%), for those with followup. Thirty-three (43.4%) patients experienced arrest of tumor growth, while 42 (55.2%) patients experienced tumor regression. Of the 39 patients with secreting pituitary tumors, 6 were lost to follow-up. Improved endocrine status occurred in 16 (50.0%), while 14 (43.8%) demonstrated stability of hormone status on continued pre-operative medical management. Permanent complications included: panhypopituitarism (4), hypothyroidism (4), hypocortisolemia (1), diabetes insipidus (1), apoplexy (1), visual field defect (2), and diplopia (1).
Gamma Knife radiosurgery is a safe and effective means of achieving tumor growth control and endocrine remission/stability in pituitary adenomas.
To review our institutional experience with Gamma Knife (GK) stereotactic radiosurgery in treating large vestibular schwannomas (VS) of 3 to 4 cm diameter.
We conducted a retrospective cohort review of all patients treated with GK for VS at our institution between November 2003 and March 2012. Data on age, sex, VS volume, location and maximal diameter, House-Brackmann (HB) facial nerve scores pre and post-GK, Gardner-Robertson (GR) hearing score pre and post-GK, GK treatment parameters, VS response time, complications and clinical outcome was recorded.
A total of 28 patients during the defined time period were identified. Three patients were lost to follow-up. Mean follow-up was 34.5 months. Tumor control occurred in 92%, and was maintained in 85.7% at two years. Facial nerve or hearing preservation occurred in all treated compared to pre-GK status, as per HB and GR grading. Transient complications occurred in 80%. Temporary vestibular dysfunction occurred in seven patients (28%). One patient (4%) had the permanent complication of worsening pre-GK hemifacial spasm. Four patients (16%) developed hydrocephalus post-GK.
GK stereotactic radiosurgery as a primary treatment modality for large VS can provide acceptable tumor control rates with good facial nerve and hearing preservation, and low complication rates.
We study the mutual effects of photoinduced processes (irradiation effects) and plasmonic emission enhancement in close-packed CdSe/ZnS colloidal quantum dots in the vicinity of gold metallic nanoparticles with two significantly different size distributions. For this we examine the impact of the heat generated by the metallic nanoparticles, the strength of plasmonic field enhancement, and the rate of energy transfer from the quantum dots to metallic nanoparticles in the presence of a laser field with low and moderate intensities. Our results show that the interplay between the photophysics of the quantum dots and their plasmonic emission enhancement is significantly pronounced when the metallic nanoparticles are large. In such a case we observed large suppression of photoinduced fluorescence enhancement (PFE). For smaller metallic nanoparticles the results suggest mostly an overall time-independent suppression of the quantum dots’ emission with no significant impact on PFE.
It is well known that the cadmium chloride annealing treatment is an essential step in the manufacture of efficient thin film cadmium telluride solar cells. It has been recognized that the combination of annealing at ∼4000C together with the addition of cadmium chloride at the surface induces re-crystallisation of the cadmium telluride layer and also affects the n-type cadmium sulfide. We have applied advanced micro-structural characterization techniques to distinguish the effect of the annealing and the cadmium chloride treatments on the properties of the cadmium telluride deposited via close space sublimation (CSS) and relate these observations to device performance. Transmission electron microscopy (TEM) has shown a variation in stacking fault density with annealing temperature and annealing time. Stacking faults observed within the cadmium telluride grains in TEM were partially removed post annealing; these findings show that temperature alone has a role in the reduction of stacking faults. However, since we have previously observed almost complete removal of stacking faults with annealing in combination with cadmium chloride, the cadmium chloride is essential to defect removal and high efficiency cells.