Vitamin A and zinc supplementation among pregnant women to prevent placental malaria: a randomized, double-blind, placebo-controlled trial in Tanzania

BACKGROUND: Malaria causes nearly 200 million clinical cases and approximately half a million deaths each year, primarily in sub-Saharan Africa.1 The risk of malaria increases during pregnancy,2 a period during which its prevention is especially important. Not only do pregnant women experience greater severity of illness compared with nonpregnant women,2 but studies have shown strong associations between prenatal malaria and maternal anemia,2 fetal loss, low birthweight, and infant mortality.2 Improving preventive measures that specifically target malaria in pregnancy is a global health priority.3 METHODS: Study design and participants. This randomized, doubleblind, placebo-controlled trial was implemented at 8 antenatal care clinics in the urban Temeke and Ilala districts of Dar es Salaam, Tanzania. The trial was registered RESULTS: A total of 2,500 screened participants were enrolled in the trial. The trial profile is shown in Figure 1. It was not possible to collect placentas from 875 participants for the following reasons: miscarriages (fetal loss before 28 weeks of gestation) (N = 234), delivery outside of Dar es Salaam or at a non-study hospital (N = 577), or withdrawal from the study (N = 34). Of the remaining 1,589 women, 1,404 placental samples were obtained (88%); histology results were available for 1,361 participants. PCR results were available for 1,158 participants, and 1,404 participants had either histology or PCR results available. CONCLUSION: This study is the first to examine the impact of vitamin A and zinc supplementation starting in early pregnancy on placental malaria. We observed that supplementation with 25 mg zinc per day from the first trimester until delivery was associated with a 36% (95% CI = 9–56%) reduced risk of histopathology-positive placental infection, but not PCRpositive infection. Vitamin A supplementation had no impact on placental malaria, but was associated with an increased risk for severe anemia

Agrobacterium-mediated transformation of sorghum: factors that affect transformation efficiency.

The results presented in this work support the hypothesis that Agrobacterium-mediated transformation of sorghum is feasible, analogous to what has been demonstrated for other cereals such as rice, maize, barley and wheat. The four factors that we found most influenced transformation were: the sensitivity of immature sorghum embryos to Agrobacterium infection, the growth conditions of the donor plant, type of explant and co-cultivation medium. A major problem during the development of our protocol was a necrotic response which developed in explants after co-cultivation. Immature sorghum embryos proved to be very sensitive to Agrobacterium infection and we found that the level of embryo death after co-cultivation was the limiting step in improving transformation efficiency. The addition of coconut water to the co-cultivation medium, the use of vigorous and actively growing immature embryos and the removal of excess bacteria significantly improved the survival rate of sorghum embryos and was critical for successful transformation. Hygromycin phosphotransferase (hpt) proved to be a good selectable marker for sorghum. We also found that β-glucuronidase (GUS) activity was low in most of the transgenic plant tissues tested, although it was very high in immature inflorescences. Although promising, the overall transformation efficiency of the protocol is still low and further optimization will require particular attention to be given to the number of Agrobacterium in the inoculum and the selection of sorghum genotypes and explants less sensitive to Agrobacterium infection

Depression at antiretroviral therapy initiation and clinical outcomes among a cohort of Tanzanian women living with HIV

OBJECTIVE: The objective of the study was to assess the relationship of depression at antiretroviral therapy (ART) initiation with mortality and clinical outcomes among Tanzanian women living with HIV. DESIGN: We conducted a prospective cohort study of 1487 women who initiated ART in Dar es Salaam, Tanzania. METHODS: Symptoms of depression and anxiety were assessed using a Tanzanian-adapted and validated version of the Hopkins Symptom Checklist. Participants attended monthly clinic visits during the first 2 years of ART and CD4 T-cell counts were assessed every 4 months. Proportional hazard models were used to assess the relationship of depression with mortality and clinical outcomes. RESULTS: Symptoms consistent with depression were prevalent among 57.8% of women at ART initiation. After multivariate adjustment, including social support and stigma, depression at ART initiation was associated with increased risk of mortality [hazard ratio (HR): 1.92; 95% confidence interval (CI): 1.15-3.20; P = 0.01] and incidence of severe anemia (hemoglobin 0.05). CONCLUSION: Elimination of depression may reduce mortality during the first 2 years of ART by one-third in our study cohort. Randomized trials and rigorous implementation studies are needed to evaluate the individual and population-level effects of integrated mental health interventions and HIV treatment approaches in resource-limited settings

On the status and mechanisms of coastal erosion in Marawila Beach, Sri Lanka

Coastal erosion remains a problem in many developing countries because of a limited understating of erosion mechanisms and management. Sri Lanka is one of the countries that recognized coastal erosion management as a governmental responsibility, in 1984. Nevertheless, erosion mechanisms have not yet been fully understood. We investigate the status and mechanisms of coastal erosion using empirically collected data and various techniques, such as Geographic Information System analysis of satellite images, drone mapping, bathymetric surveys, hindcasting of wind-induced wave climate, questionnaires, and semi-structured interview surveys. We identified wave climate change, reduction in river sand supply, interruptions from previous erosion management measures, and offshore sand mining as potential causes of erosion considering sediment flux and rates of erosion. Erosion of Marawila Beach began during 2005–2010 and has been continuing ever since, due to a lack of integration in the beach and the entire sediment system. It is necessary to identify the long-term, large-scale changes in the sediment system through data collection. This study highlights the importance of an integrated coastal erosion management plan and could facilitate better coastal erosion management in Sri Lanka, as well as in other developing countries

On the Optimal Boundary of a Three-Dimensional Singular Stochastic Control Problem Arising in Irreversible Investment

de Angelis T, Federico S, Ferrari G. On the Optimal Boundary of a Three-Dimensional Singular Stochastic Control Problem Arising in Irreversible Investment. Center for Mathematical Economics Working Papers. Vol 509. Bielefeld: Center for Mathematical Economics; 2014.This paper examines a Markovian model for the optimal irreversible investment problem of a firm aiming at minimizing total expected costs of production. We model market uncertainty and the cost of investment per unit of production capacity as two independent one-dimensional regular diffusions, and we consider a general convex running cost function. The optimization problem is set as a three-dimensional degenerate singular stochastic control problem. We provide the optimal control as the solution of a Skorohod reflection problem at a suitable free-boundary surface. Such boundary arises from the analysis of a family of two-dimensional parameter-dependent optimal stopping problems and it is characterized in terms of the family of unique continuous solutions to parameter-dependent nonlinear integral equations of Fredholm type

Quality Protein Maize Germplasm Characterized for Amino Acid Profiles and Endosperm Opacity

Quality protein maize (QPM) is improved over normal (non-QPM) maize in grain concentrations of the essential amino acids lysine and tryptophan. Quality protein maize has a long history as tropical adapted germplasm, but little effort has been made to incorporate temperate or sub-tropical germplasm for temperate adaptation and interactions between different modifier loci in these backgrounds are poorly understood. A design-II mating scheme including new temperate and subtropical lines produced 69 hybrids. Large hybrid genetic variation components resulted in substantial broad-sense heritability H2 estimates, specifically tryptophan (0.46) and endosperm opacity (0.82). A microbial assay for amino acid estimation proved robust across diverse environments with minimal genotype × environment (G×E) effects. Endosperm opacity had no G×E effects across both Texas and Iowa locations demonstrating stability for this trait. Endosperm opacity primarily followed an additive, midparent trend, with a few hybrids deviating from the trend (36%) suggesting a complex nature of multiple modifier loci across diverse germplasm. The top QPM hybrid outperformed the top commercial hybrid by 35 and 30% for lysine and tryptophan as a proportion of grain, respectively. QPM line Tx832 was a parent of top hybrids for lysine and tryptophan, and the highest noncommercial hybrids for methionine. Minimal correlations with yield and other traits suggest that future breeding should result in QPM hybrids with increasingly competitive yields

A long view of liberal peace and its crisis

The ‘crisis’ of liberal peace has generated considerable debate in International Relations. However, analysis is inhibited by a shared set of spatial, cultural and temporal assumptions that rest on and reproduce a problematic separation between self-evident ‘liberal’ and ‘non-liberal’ worlds, and locates the crisis in presentist terms of the latter’s resistance to the former’s expansion. By contrast, this article argues that efforts to advance liberal rule have always been interwoven with processes of alternative order-making, and in this way are actively integral, not external, to the generation of the subjectivities, contestations, violence and rival social orders that are then apprehended as self-evident obstacles and threats to liberal peace and as characteristic of its periphery. Making visible these intimate relations of co-constitution elided by representations of liberal peace and its crisis requires a long view and an analytical frame that encompasses both liberalism and its others in the world. The argument is developed using a Foucauldian governmentality framework and illustrated with reference to Sri Lanka