Paediatric anaemia at Kamuzu Central Hospital

This retrospective study assessed the outcome of children admitted during a six week period to Kamuzu Central Hospital (KCH) with anaemia. 19% of admissions had a primary discharge diagnosis of anaemia and there was a 12% mortality. Children who died were more likely than those who did not to have other diagnoses that may have contributed to mortality. 72% had a diagnosis that included both anaemia and malaria, but malaria was only documented in 36%. Malaria may be oveJlodiagnosed in that 57% of cases with a diagnosis that included malaria had negative blood smears for malaria. More data is required to determine whether delays in obtaining blood for transfusion influence mortality

Overview of the current status of familial hypercholesterolaemia care in over 60 countries - The EAS Familial Hypercholesterolaemia Studies Collaboration (FHSC)

Background and aims: Management of familial hypercholesterolaemia (FH) may vary across different settings due to factors related to population characteristics, practice, resources and/or policies. We conducted a survey among the worldwide network of EAS FHSC Lead Investigators to provide an overview of FH status in different countries. Methods: Lead Investigators from countries formally involved in the EAS FHSC by mid-May 2018 were invited to provide a brief report on FH status in their countries, including available information, programmes, initiatives, and management. Results: 63 countries provided reports. Data on FH prevalence are lacking in most countries. Where available, data tend to align with recent estimates, suggesting a higher frequency than that traditionally considered. Low rates of FH detection are reported across all regions. National registries and education programmes to improve FH awareness/knowledge are a recognised priority, but funding is often lacking. In most countries, diagnosis primarily relies on the Dutch Lipid Clinics Network criteria. Although available in many countries, genetic testing is not widely implemented (frequent cost issues). There are only a few national official government programmes for FH. Under-treatment is an issue. FH therapy is not universally reimbursed. PCSK9-inhibitors are available in similar to 2/3 countries. Lipoprotein-apheresis is offered in similar to 60% countries, although access is limited. Conclusions: FH is a recognised public health concern. Management varies widely across countries, with overall suboptimal identification and under-treatment. Efforts and initiatives to improve FH knowledge and management are underway, including development of national registries, but support, particularly from health authorities, and better funding are greatly needed.Peer reviewe

Microbial community dynamics in the forefield of glaciers

Retreating ice fronts (as a result of a warming climate) expose large expanses of deglaciated forefield, which become colonized by microbes and plants. There has been increasing interest in characterizing the biogeochemical development of these ecosystems using a chronosequence approach. Prior to the establishment of plants, microbes use autochthonously produced and allochthonously delivered nutrients for growth. The microbial community composition is largely made up of heterotrophic microbes (both bacteria and fungi), autotrophic microbes and nitrogen-fixing diazotrophs. Microbial activity is thought to be responsible for the initial build-up of labile nutrient pools, facilitating the growth of higher order plant life in developed soils. However, it is unclear to what extent these ecosystems rely on external sources of nutrients such as ancient carbon pools and periodic nitrogen deposition. Furthermore, the seasonal variation of chronosequence dynamics and the effect of winter are largely unexplored. Modelling this ecosystem will provide a quantitative evaluation of the key processes and could guide the focus of future research. Year-round datasets combined with novel metagenomic techniques will help answer some of the pressing questions in this relatively new but rapidly expanding field, which is of growing interest in the context of future large-scale ice retreat

RANCANG BANGUN MESIN GERGAJI PEMBELAH KAYU DENGAN CIRCULAR SAW YANG BERBENTUK MEJA (PROSES PEMBUATAN) HALAMAN JUDUL

Laporan akhir ini berjudul rancang bangun mesin gergaji pembelah kayu dengan circularsaw yang berbentuk meja. Tujuannya adalah untuk merancang mesin pembelah kayu yang memiliki daya guna tinggi dan dapat menjadi pilihan produk yang sesuai dengan kondisi UMKM industri. Alat ini memiliki komponen pulleydan belt, gergaji potong, dan menggunakan tenaga motor listrik. Dengan menggunakan alat ini, didapatkan hasil untuk pembelahan satu blok kayu ketebalan 20mm dan panjang 50cm dibutuhkan waktu 90 detik. Dari penelitian ini, dapat disimpulkan pula bahwa perawatan dan perbaikan komponen-komponen penunjang alat harus di lakukan agar mencegah terjadinya kerusakan

Diffusive propagation of cosmic rays from supernova remnants in the Galaxy. II: anisotropy

We investigate the effects of stochasticity in the spatial and temporal distribution of supernova remnants on the anisotropy of cosmic rays observed at Earth. The calculations are carried out for different choices of the diffusion coefficient D(E) for propagation in the Galaxy. The propagation and spallation of nuclei are taken into account. At high energies we assume that $D(E)\sim(E/Z)^{\delta}$, with $\delta=1/3$ and $\delta=0.6$ being the reference scenarios. The large scale distribution of supernova remnants in the Galaxy is modeled following the distribution of pulsars with and without accounting for the spiral structure of the Galaxy. Our calculations allow us to determine the contribution to anisotropy resulting from both the large scale distribution of SNRs in the Galaxy and the random distribution of the nearest remnants. The naive expectation that the anisotropy amplitude scales as D(E) is shown to be an oversimplification which does not reflect in the predicted anisotropy for any realistic distribution of the sources. The fluctuations in the anisotropy pattern are dominated by nearby sources, so that predicting or explaining the observed anisotropy amplitude and phase becomes close to impossible. We find however that the very weak energy dependence of the anisotropy amplitude below $10^{5}$ GeV and the rise at higher energies, can best be explained if the diffusion coefficient is $D(E)\sim E^{1/3}$. Faster diffusion, for instance with $\delta=0.6$, leads in general to an exceedingly large anisotropy amplitude. The spiral structure introduces interesting trends in the energy dependence of the anisotropy pattern, which qualitatively reflect the trend seen in the data. For large values of the halo size we find that the anisotropy becomes dominated by the large scale regular structure of the source distribution, leading indeed to a monotonic increase of $\delta_A$ with energy.Comment: 21 Pages, to appear in JCA

Effects of the galactic magnetic field upon large scale anisotropies of extragalactic Cosmic Rays

The large scale pattern in the arrival directions of extragalactic cosmic rays that reach the Earth is different from that of the flux arriving to the halo of the Galaxy as a result of the propagation through the galactic magnetic field. Two different effects are relevant in this process: deflections of trajectories and (de)acceleration by the electric field component due to the galactic rotation. The deflection of the cosmic ray trajectories makes the flux intensity arriving to the halo from some direction to appear reaching the Earth from another direction. This applies to any intrinsic anisotropy in the extragalactic distribution or, even in the absence of intrinsic anisotropies, to the dipolar Compton-Getting anisotropy induced when the observer is moving with respect to the cosmic rays rest frame. For an observer moving with the solar system, cosmic rays traveling through far away regions of the Galaxy also experience an electric force coming from the relative motion (due to the rotation of the Galaxy) of the local system in which the field can be considered as being purely magnetic. This produces small changes in the particles momentum that can originate large scale anisotropies even for an isotropic extragalactic flux.Comment: 11 pages, 4 figure