Feeding interventions for growth and development in infants with cleft lip, cleft palate or cleft lip and palate.

BACKGROUND: Cleft lip and cleft palate are common birth defects, affecting about one baby of every 700 born. Feeding these babies is an immediate concern and there is evidence of delay in growth of children with a cleft as compared to those without clefting. In an effort to combat reduced weight for height, a variety of advice and devices are recommended to aid feeding of babies with clefts. OBJECTIVES: This review aims to assess the effects of these feeding interventions in babies with cleft lip and/or palate on growth, development and parental satisfaction. SEARCH STRATEGY: The following electronic databases were searched: the Cochrane Oral Health Group Trials Register (to 27 October 2010), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2010, Issue 4), MEDLINE via OVID (1950 to 27 October 2010), EMBASE via OVID (1980 to 27 October 2010), PsycINFO via OVID (1950 to 27 October 2010) and CINAHL via EBSCO (1980 to 27 October 2010). Attempts were made to identify both unpublished and ongoing studies. There was no restriction with regard to language of publication. SELECTION CRITERIA: Studies were included if they were randomised controlled trials (RCTs) of feeding interventions for babies born with cleft lip, cleft palate or cleft lip and palate up to the age of 6 months (from term). DATA COLLECTION AND ANALYSIS: Studies were assessed for relevance independently and in duplicate. All studies meeting the inclusion criteria were data extracted and assessed for validity independently by each member of the review team. Authors were contacted for clarification or missing information whenever possible. MAIN RESULTS: Five RCTs with a total of 292 babies, were included in the review. Comparisons made within the RCTs were squeezable versus rigid feeding bottles (two studies), breastfeeding versus spoon-feeding (one study) and maxillary plate versus no plate (two studies). No statistically significant differences were shown for any of the primary outcomes when comparing bottle types, although squeezable bottles were less likely to require modification. No difference was shown for infants fitted with a maxillary plate compared to no plate. However, there was some evidence of an effect on weight at 6 weeks post-surgery in favour of breastfeeding when compared to spoon-feeding (mean difference 0.47; 95% confidence interval 0.20 to 0.74). AUTHORS' CONCLUSIONS: Squeezable bottles appear easier to use than rigid feeding bottles for babies born with clefts of the lip and/or palate, however, there is no evidence of a difference in growth outcomes between the bottle types. There is weak evidence that breastfeeding is better than spoon-feeding following surgery for cleft. There was no evidence to suggest that maxillary plates assist growth in babies with clefts of the palate. No evidence was found to assess the use of any types of maternal advice and/or support for these babies

Proof Theory and Ordered Groups

Ordering theorems, characterizing when partial orders of a group extend to total orders, are used to generate hypersequent calculi for varieties of lattice-ordered groups (l-groups). These calculi are then used to provide new proofs of theorems arising in the theory of ordered groups. More precisely: an analytic calculus for abelian l-groups is generated using an ordering theorem for abelian groups; a calculus is generated for l-groups and new decidability proofs are obtained for the equational theory of this variety and extending finite subsets of free groups to right orders; and a calculus for representable l-groups is generated and a new proof is obtained that free groups are orderable

On p-adic lattices and Grassmannians

It is well-known that the coset spaces G(k((z)))/G(k[[z]]), for a reductive group G over a field k, carry the geometric structure of an inductive limit of projective k-schemes. This k-ind-scheme is known as the affine Grassmannian for G. From the point of view of number theory it would be interesting to obtain an analogous geometric interpretation of quotients of the form G(W(k)[1/p])/G(W(k)), where p is a rational prime, W denotes the ring scheme of p-typical Witt vectors, k is a perfect field of characteristic p and G is a reductive group scheme over W(k). The present paper is an attempt to describe which constructions carry over from the function field case to the p-adic case, more precisely to the situation of the p-adic affine Grassmannian for the special linear group G=SL_n. We start with a description of the R-valued points of the p-adic affine Grassmannian for SL_n in terms of lattices over W(R), where R is a perfect k-algebra. In order to obtain a link with geometry we further construct projective k-subvarieties of the multigraded Hilbert scheme which map equivariantly to the p-adic affine Grassmannian. The images of these morphisms play the role of Schubert varieties in the p-adic setting. Further, for any reduced k-algebra R these morphisms induce bijective maps between the sets of R-valued points of the respective open orbits in the multigraded Hilbert scheme and the corresponding Schubert cells of the p-adic affine Grassmannian for SL_n.Comment: 36 pages. This is a thorough revision, in the form accepted by Math. Zeitschrift, of the previously published preprint "On p-adic loop groups and Grassmannians

Effects of mixing on evolution of hydrocarbon ratios in the troposphere

Nonmethane hydrocarbon (NMHC) concentration ratios provide useful indicators of tropospheric oxidation and transport processes. However, the influences of both photochemical and mixing processes are inextricably linked in the evolution of these ratios. We present a model for investigating these influences by combining the transport treatment of the Lagrangian particle dispersion model FLEXPART with an ultrasimple (i.e., constant OH concentration) chemical treatment. Required model input includes NMHC emission ratios, but not ad hoc assumed background NMHC concentrations. The model results give NMHC relationships that can be directly compared, in a statistical manner, with measurements. The measured concentration ratios of the longest-lived alkanes show strong deviations from purely kinetic behavior, which the model nicely reproduces. In contrast, some measured aromatic ratio relationships show even stronger deviations that are not well reproduced by the model for reasons that are not understood. The model-measurement comparisons indicate that the interaction of mixing and photochemical processing prevent a simple interpretation of "photochemical age," but that the average age of any particular NMHC can be well defined and can be approximated by a properly chosen and interpreted NMHC ratio. In summary, the relationships of NMHC concentration ratios not only yield useful measures of photochemical processing in the troposphere, but also provide useful test of the treatment of mixing and chemical processing in chemical transport models. Copyright 2007 by the American Geophysical Union

Directional well trajectory design: The theoritical development of Azimuth bends and turns in complex well trajectory designs

Most complex well trajectories usually have bends and turns. The design requires some considerations to be made from the structure of subsurface formations to be drilled, to the available technology and equipment, as well as economics. When a complex well trajectory is being worked on, the effect of bends/turns in the azimuth is highly critical and care is taken not to exceed a set maximum tolerable dogleg severity.  In this work, several well trajectories with varying bends and turns were modelled mathematically, for an easy calculation and pre-survey record presentation of a desired complex directional well trajectory, also from which the overall angle change (dogleg) is observed not to exceed a set maximum tolerable dogleg. A scenario was considered with few assumptions using a specially developed application, WellTIT v. 1.0, which assisted in calculating and presenting survey records to express the need for carefully developed bends in a Complex well trajectory design. http://dx.doi.org/10.4314/njt.v35i4.18

An XMM and Chandra view of massive clusters of galaxies to z=1

The X-ray properties of a sample of high redshift (z>0.6), massive clusters observed with XMM-Newton and Chandra are described, including two exceptional systems. One, at z=0.89, has an X-ray temperature of T=11.5 (+1.1, -0.9) keV (the highest temperature of any cluster known at z>0.6), an estimated mass of (1.4+/-0.2)x10^15 solar masses and appears relaxed. The other, at z=0.83, has at least three sub-clumps, probably in the process of merging, and may also show signs of faint filamentary structure at large radii,observed in X-rays. In general there is a mix of X-ray morphologies, from those clusters which appear relaxed and containing little substructure to some highly non-virialized and probably merging systems. The X-ray gas metallicities and gas mass fractions of the relaxed systems are similar to those of low redshift clusters of the same temperature, suggesting that the gas was in place, and containing its metals, by z=0.8. The evolution of the mass-temperature relation may be consistent with no evolution or with the ``late formation'' assumption. The effect of point source contamination in the ROSAT survey from which these clusters were selected is estimated, and the implications for the ROSAT X-ray luminosity function discussed.Comment: 9 pages, in Carnegie Observatories Astrophysics Series, Vol. 3: Clusters of Galaxies: Probes of Cosmological Structure and Galaxy Evolution, ed. J. S. Mulchaey, A. Dressler, and A. Oemler. See http://www.ociw.edu/ociw/symposia/series/symposium3/proceedings.html for a full-resolution versio

Prevalence of depression, anxiety, and apathy symptoms across dementia stages: a systematic review and meta-analysis

OBJECTIVE: The present study aimed to resolve inconsistency in reported prevalence of affective symptoms by dementia stage. METHODS/DESIGN: We conducted a meta-analysis of studies with data on dementia stage and prevalence of depression, anxiety, or apathy assessed using validated tools. We performed random-effects meta-analysis and subgroup analysis on symptom prevalence by dementia stage, according to CDR. RESULTS: The meta-analysis included 5,897 people with dementia from 20 studies. Prevalence rates of depression in mild, moderate, and severe dementia were 38% (95% CI 32-45%), 41% (95% CI 33-49%), and 37% (95% CI 17-56%) respectively. The corresponding prevalence for anxiety was 38% (95% CI 31-45%), 41% (95% CI 31-52%), and 37% (95% CI -8-82%); and 54% (95% CI 45-62%), 59% (95% CI 44-73%), and 43% (95% CI 10-75%) for apathy. The prevalence of depression, anxiety, and apathy did not differ with regard to dementia stage and type. The prevalence of depression in AD was significantly lower when it was assessed using diagnostic criteria compared to screening tools. The prevalence of depression in AD was lowest in America, while anxiety in VaD was higher in Europe than Asia. CONCLUSIONS: Depression, anxiety, and apathy symptoms are highly prevalent across dementia stages. There is no evidence of any changes in prevalence of affective symptom as the illness progresses. Evaluation methods and cultural difference may explain some of the variance, suggesting further investigation of factors that may influence the report of symptoms, such as carer psychosocial characteristics, and more cross-cultural studies are needed. This article is protected by copyright. All rights reserved

Mean blood pressure according to the hypertension care cascade: Analysis of six national health surveys in Peru

Background: While we have good evidence about the hypertension care cascade, we do not know the mean blood pressure (BP) in these groups. We described the mean BP in four groups based on the hypertension care cascade at the national and sub-national levels in Peru. Methods: Descriptive analysis of six national health surveys. Blood pressure was measured twice and the second record herein analysed. We defined four groups: i) people with self-reported hypertension diagnosis receiving antihypertensive medication; ii) people with self-reported hypertension diagnosis not receiving antihypertensive medication; iii) people unaware they have hypertension with blood pressure ≥140 or 90 mmHg; and iv) otherwise healthy people. Findings: There were 125,066 people; mean age was 49.8 years and there were more women (51.7%). At the national level, in men and women and throughout the study period, we observed that the mean systolic BP (SBP) was the highest in people unaware they have hypertension; the mean SBP was similar between those with and without antihypertension medication, yet slightly higher in the former group. At the sub-national level, even though the mean SBP in the unaware group was usually the highest, there were some regions and years in which the mean SBP was the highest in the untreated and treated groups. Interpretation: These results complement the hypertension care cascade with a clinically relevant parameter: mean BP. The results point where policies may be needed to secure effective interventions to control hypertension in Peru, suggesting that improving early diagnosis and treatment coverage could be priorities. Funding: Wellcome Trust (214185/Z/18/Z)

Who is getting screened for diabetes according to body mass index and waist circumference categories in Peru? a pooled analysis of national surveys between 2015 and 2019

BACKGROUND: At the population level we would expect that people with obesity undergo diabetes screening tests more often than people with overweight and much more often than people with normal weight. We described the trends of diabetes screening according to body mass index (BMI) and waist circumference (WC) in Peru. METHODS: Pooled analysis of health national surveys (2015-2019); men and women aged 35-70 years. We used relative frequencies to study: among those who have had a glucose test in the last year, how many there were in each BMI and WC category. We fitted a Poisson model to study whether people with high BMI or WC were more likely to have had a glucose test. RESULTS: People with overweight (PR = 1.34; 95% CI: 1.29-1.38), obesity (PR = 1.57; 95% CI: 1.51-1.63) and central obesity (PR = 1.63; 95% CI: 1.35-1.96) were more likely to have had a glucose test. At the sub-national level, there was one (of twenty-five) region in which men with obesity were more often screened for diabetes than men with overweight and much more than men with normal weight. There were seven regions in which women with obesity were the most often screened for diabetes. CONCLUSIONS: Consistent with a risk-based prevention approach, people with obesity would be screened for diabetes more often than those with overweight and those with normal weight. This ideal profile was only observed in few regions. Diabetes screening strategies should be strengthened and homogenised, so that they reach those at high risk of diabetes

Mechanistic Studies of Liquid Metal Anode SOFCs: I. Oxidation of Hydrogen in Chemical - Electrochemical Mode

Liquid metal anode (LMA) solid oxide fuel cells (SOFCs) are a promising type of high temperature fuel cell suitable for the direct oxidation of gaseous or solid fuel. Depending upon the operating conditions they can be run in four different modes. In this first of a series of studies concerning the mechanism of reaction and species transport in LMA SOFCs, the oxidation of hydrogen fuel in a liquid tin anode has been investigated. An electrochemical model is developed based upon fast dissolution of hydrogen in a molten tin anode, slow, rate-determining homogeneous reaction of hydrogen with oxygen dissolved in the liquid tin, followed by anodic oxygen injection under diffusion control to replace the oxygen removed by reaction (so-called Chemical - Electrochemical mode or CE mode). Experimentally-generated data are used to validate the model. The model has introduced a new key parameter, z¯, which takes a value between zero and unity; its value is determined by geometric and convective factors in the cell as well as the partial pressure of the supplied hydrogen fuel. Current output of the cell is proportional to the value of z¯