Clean Home-Delivery in Rural Southern Tanzania: Barriers, Influencers, and Facilitators

The study explored the childbirth-related hygiene and newborn care practices in home-deliveries in Southern\ud Tanzania and barriers to and facilitators of behaviour change. Eleven home-birth narratives and six focus group discussions were conducted with recently-delivering women; two focus group discussions were conducted with birth attendants. The use of clean cloth for delivery was reported as common in the birth narratives; however, respondents did not link its use to newborn’s health. Handwashing and wearing of gloves by birth attendants varied and were not discussed in terms of being important for newborn’s health, with few women giving reasons for this behaviour. The lack of handwashing and wearing of gloves was most commonly linked to the lack of water, gloves, and awareness. A common practice was the insertion\ud of any family member’s hands into the vagina of delivering woman to check labour progress before calling the birth attendant. The use of a new razor blade to cut the cord was near-universal; however, the cord was usually tied with a used thread due to the lack of knowledge and the low availability of clean thread. Applying something to the cord was near-universal and was considered essential for newborn’s health. Three hygiene practices were identified as needing improvement: family members inserting a hand into\ud the vagina of delivering woman before calling the birth attendant, the use of unclean thread, and putting\ud substances on the cord. Little is known about families conducting internal checks of women in labour, and more research is needed before this behaviour is targeted in interventions. The use of clean thread as cord-tie appears acceptable and can be addressed, using the same channels and methods that were used for successfully encouraging the use of new razor blade

Genetic analyses of celiac disease in a Spanish population confirm association with CELIAC3 but not with CELIAC4

[EN] Genetic predisposition to celiac disease (CD) is determined primarily by the human leukocyte antigen (HLA) genes (CELIAC1 region; 6p21), although many loci are involved in disease susceptibility. First, we have analysed a large series of CD patients from the Spanish Mediterranean region who had previously been characterised for the HLA complex. We have investigated how relevant regions contribute to CD susceptibility: CELIAC3 (CD28/CTLA4/ICOS region on 2q33) and CELIAC4 (19p13) as well as the tumour necrosis factor alpha (TNF-alpha) and the linfotoxin loci by case-control and association analyses. We highlight the association with the +49*A allele of cytotoxic T-lymphocyte-associated antigen 4 locus (P = 0.01), and the -308*A of TNF-alpha locus (P = 0.0008) in DQ2 individuals, although an independent role for TNF-alpha as risk factor has not been proven. Moreover, we do not confirm the association with the CELIAC4 region polymorphisms described in other populations.We are grateful for the kind collaboration of patients and families and Asociación de Celíacos de la Comunidad Valenciana (ACECOVA). This work was supported by the Fondo de Investigacio¿n Sanitaria (grant PI02573) and by the CSIC Intramural Frontiers Project (PROFICEL). ED holds a fellowship from the Fundacio¿n La Fe. English text revised by F. BarracloughCapilla, A.; Donat, E.; Planelles, D.; Espinós-Armero, CÁ.; Ribes-Koninckx, C.; Palau, F. (2007). Genetic analyses of celiac disease in a Spanish population confirm association with CELIAC3 but not with CELIAC4. Tissue Antigens. 70(4):324-329. https://doi.org/10.1111/j.1399-0039.2007.00899.x32432970

Extreme rainfall variability in Australia: Patterns, drivers and predictability

Leading patterns of observed monthly extreme rainfall variability in Australia are examined using an Empirical Orthogonal Teleconnection (EOT) method. Extreme rainfall variability is more closely related to mean rainfall variability during austral summer than in winter. The leading EOT patterns of extreme rainfall explain less variance in Australia-wide extreme rainfall than is the case for mean rainfall EOTs. We illustrate that, as with mean rainfall, the El Niño-Southern Oscillation (ENSO) has the strongest association with warm-season extreme rainfall variability, while in the cool-season the primary drivers are atmospheric blocking and the subtropical ridge. The Indian Ocean Dipole and Southern Annular Mode also have significant relationships with patterns of variability during austral winter and spring. Leading patterns of summer extreme rainfall variability have predictability several months ahead from Pacific sea surface temperatures (SSTs) and as much as a year in advance from Indian Ocean SSTs. Predictability from the Pacific is greater for wetter than average summer months than for months that are drier than average, whereas for the Indian Ocean the relationship has greater linearity. Several cool-season EOTs are associated with mid-latitude synoptic-scale patterns along the south and east coasts. These patterns have common atmospheric signatures denoting moist onshore flow and strong cyclonic anomalies often to the north of a blocking anti-cyclone. Tropical cyclone activity is observed to have significant relationships with some warm season EOTs. This analysis shows that extreme rainfall variability in Australia can be related to remote drivers and local synoptic-scale patterns throughout the year

Traumatic brain injury leads to alterations in contusional cortical miRNAs involved in dementia

There is compelling evidence that head injury is a significant environmental risk factor for Alzheimer's disease (AD) and that a history of traumatic brain injury (TBI) accelerates the onset of AD. Amyloid-β plaques and tau aggregates have been observed in the post-mortem brains of TBI patients; however, the mechanisms leading to AD neuropathology in TBI are still unknown. In this study, we hypothesized that focal TBI induces changes in miRNA expression in and around affected areas, resulting in the altered expression of genes involved in neurodegeneration and AD pathology. For this purpose, we performed a miRNA array in extracts from rats subjected to experimental TBI, using the controlled cortical impact (CCI) model. In and around the contusion, we observed alterations of miRNAs associated with dementia/AD, compared to the contralateral side. Specifically, the expression of miR-9 was significantly upregulated, while miR-29b, miR-34a, miR-106b, miR-181a and miR-107 were downregulated. Via qPCR, we confirmed these results in an additional group of injured rats when compared to naïve animals. Interestingly, the changes in those miRNAs were concomitant with alterations in the gene expression of mRNAs involved in amyloid generation and tau pathology, such as β-APP cleaving enzyme (BACE1) and Glycogen synthase-3-β (GSK3β). In addition increased levels of neuroinflammatory markers (TNF-α), glial activation, neuronal loss, and tau phosphorylation were observed in pericontusional areas. Therefore, our results suggest that the secondary injury cascade in TBI affects miRNAs regulating the expression of genes involved in AD dementia

Relativistic Hydrodynamics around Black Holes and Horizon Adapted Coordinate Systems

Despite the fact that the Schwarzschild and Kerr solutions for the Einstein equations, when written in standard Schwarzschild and Boyer-Lindquist coordinates, present coordinate singularities, all numerical studies of accretion flows onto collapsed objects have been widely using them over the years. This approach introduces conceptual and practical complications in places where a smooth solution should be guaranteed, i.e., at the gravitational radius. In the present paper, we propose an alternative way of solving the general relativistic hydrodynamic equations in background (fixed) black hole spacetimes. We identify classes of coordinates in which the (possibly rotating) black hole metric is free of coordinate singularities at the horizon, independent of time, and admits a spacelike decomposition. In the spherically symmetric, non-rotating case, we re-derive exact solutions for dust and perfect fluid accretion in Eddington-Finkelstein coordinates, and compare with numerical hydrodynamic integrations. We perform representative axisymmetric computations. These demonstrations suggest that the use of those coordinate systems carries significant improvements over the standard approach, especially for higher dimensional studies.Comment: 10 pages, 4 postscript figures, accepted for publication in Phys. Rev.

Planar cell polarity signalling coordinates heart tube remodelling through tissue-scale polarisation of actomyosin activity

Development of a multiple-chambered heart from the linear heart tube is inherently linked to cardiac looping. Although many molecular factors regulating the process of cardiac chamber ballooning have been identified, the cellular mechanisms underlying the chamber formation remain unclear. Here, we demonstrate that cardiac chambers remodel by cell neighbour exchange of cardiomyocytes guided by the planar cell polarity (PCP) pathway triggered by two non-canonical Wnt ligands, Wnt5b and Wnt11. We find that PCP signalling coordinates the localisation of actomyosin activity, and thus the efficiency of cell neighbour exchange. On a tissue-scale, PCP signalling planar-polarises tissue tension by restricting the actomyosin contractility to the apical membranes of outflow tract cells. The tissue-scale polarisation of actomyosin contractility is required for cardiac looping that occurs concurrently with chamber ballooning. Taken together, our data reveal that instructive PCP signals couple cardiac chamber expansion with cardiac looping through the organ-scale polarisation of actomyosin-based tissue tension

Three Dimensional Numerical General Relativistic Hydrodynamics I: Formulations, Methods, and Code Tests

This is the first in a series of papers on the construction and validation of a three-dimensional code for general relativistic hydrodynamics, and its application to general relativistic astrophysics. This paper studies the consistency and convergence of our general relativistic hydrodynamic treatment and its coupling to the spacetime evolutions described by the full set of Einstein equations with a perfect fluid source. The numerical treatment of the general relativistic hydrodynamic equations is based on high resolution shock capturing schemes. These schemes rely on the characteristic information of the system. A spectral decomposition for general relativistic hydrodynamics suitable for a general spacetime metric is presented. Evolutions based on three different approximate Riemann solvers coupled to four different discretizations of the Einstein equations are studied and compared. The coupling between the hydrodynamics and the spacetime (the right and left hand side of the Einstein equations) is carried out in a treatment which is second order accurate in {\it both} space and time. Convergence tests for all twelve combinations with a variety of test beds are studied, showing consistency with the differential equations and correct convergence properties. The test-beds examined include shocktubes, Friedmann-Robertson-Walker cosmology tests, evolutions of self-gravitating compact (TOV) stars, and evolutions of relativistically boosted TOV stars. Special attention is paid to the numerical evolution of strongly gravitating objects, e.g., neutron stars, in the full theory of general relativity, including a simple, yet effective treatment for the surface region of the star (where the rest mass density is abruptly dropping to zero).Comment: 45 pages RevTeX, 34 figure

Impact of Atlantic multidecadal variability on rainfall intensity distribution and timing of the West African monsoon

Previous studies agree on an impact of the Atlantic multidecadal variability (AMV) on the total seasonal rainfall amounts over the Sahel. However, whether and how the AMV affects the distribution of rainfall or the timing of the West African monsoon is not well known. Here we seek to explore these impacts by analyzing daily rainfall outputs from climate model simulations with an idealized AMV forcing imposed in the North Atlantic, which is representative of the observed one. The setup follows a protocol largely consistent with the one proposed by the Component C of the Decadal Climate Prediction Project (DCPP-C). We start by evaluating model's performance in simulating precipitation, showing that models underestimate it over the Sahel, where the mean intensity is consistently smaller than observations. Conversely, models overestimate precipitation over the Guinea coast, where too many rainy days are simulated. In addition, most models underestimate the average length of the rainy season over the Sahel; some are due to a monsoon onset that is too late and others due to a cessation that is too early. In response to a persistent positive AMV pattern, models show an enhancement in total summer rainfall over continental West Africa, including the Sahel. Under a positive AMV phase, the number of wet days and the intensity of daily rainfall events are also enhanced over the Sahel. The former explains most of the changes in seasonal rainfall in the northern fringe, while the latter is more relevant in the southern region, where higher rainfall anomalies occur. This dominance is connected to the changes in the number of days per type of event; the frequency of both moderate and heavy events increases over the Sahel's northern fringe. Conversely, over the southern limit, it is mostly the frequency of heavy events which is enhanced, thus affecting the mean rainfall intensity there. Extreme rainfall events are also enhanced over the whole Sahel in response to a positive phase of the AMV. Over the Sahel, models with stronger negative biases in rainfall amounts compared to observations show weaker changes in response to AMV, suggesting that systematic biases could affect the simulated responses. The monsoon onset over the Sahel shows no clear response to AMV, while the demise tends to be delayed, and the overall length of the monsoon season enhanced between 2 and 5 d with the positive AMV pattern. The effect of AMV on the seasonality of the monsoon is more consistent to the west of 10∘ W, with all models showing a statistically significant earlier onset, later demise, and enhanced monsoon season with the positive phase of the AMV. Our results suggest a potential for the decadal prediction of changes in the intraseasonal characteristics of rainfall over the Sahel, including the occurrence of extreme events.</p

Summer weather becomes more persistent in a 2 °C world

Heat and rainfall extremes have intensified over the past few decades and this trend is projected to continue with future global warming1–3. A long persistence of extreme events often leads to societal impacts with warm-and-dry conditions severely affecting agriculture and consecutive days of heavy rainfall leading to flooding. Here we report systematic increases in the persistence of boreal summer weather in a multi-model analysis of a world 2 °C above pre-industrial compared to present-day climate. Averaged over the Northern Hemisphere mid-latitude land area, the probability of warm periods lasting longer than two weeks is projected to increase by 4% (2–6% full uncertainty range) after removing seasonal-mean warming. Compound dry–warm persistence increases at a similar magnitude on average but regionally up to 20% (11–42%) in eastern North America. The probability of at least seven consecutive days of strong precipitation increases by 26% (15–37%) for the mid-latitudes. We present evidence that weakening storm track activity contributes to the projected increase in warm and dry persistence. These changes in persistence are largely avoided when warming is limited to 1.5 °C. In conjunction with the projected intensification of heat and rainfall extremes, an increase in persistence can substantially worsen the effects of future weather extremes

Relativistic hydrodynamics on spacelike and null surfaces: Formalism and computations of spherically symmetric spacetimes

We introduce a formulation of Eulerian general relativistic hydrodynamics which is applicable for (perfect) fluid data prescribed on either spacelike or null hypersurfaces. Simple explicit expressions for the characteristic speeds and fields are derived in the general case. A complete implementation of the formalism is developed in the case of spherical symmetry. The algorithm is tested in a number of different situations, predisposing for a range of possible applications. We consider the Riemann problem for a polytropic gas, with initial data given on a retarded/advanced time slice of Minkowski spacetime. We compute perfect fluid accretion onto a Schwarzschild black hole spacetime using ingoing null Eddington-Finkelstein coordinates. Tests of fluid evolution on dynamic background include constant density and TOV stars sliced along the radial null cones. Finally, we consider the accretion of self-gravitating matter onto a central black hole and the ensuing increase in the mass of the black hole horizon.Comment: 23 pages, 13 figures, submitted to Phys. Rev.