The relationship between parental education and children's schooling in a time of economic turmoil: The case of East Zimbabwe, 2001 to 2011.

Using data collected from 1998 to 2011 in a general population cohort study in eastern Zimbabwe, we describe education trends and the relationship between parental education and children's schooling during the Zimbabwean economic collapse of the 2000s. During this period, the previously-rising trend in education stalled, with girls suffering disproportionately; however, female enrolment increased as the economy began to recover. Throughout the period, children with more educated parents continued to have better outcomes such that, at the population level, an underlying increase in the proportion of children with more educated parents may have helped to maintain the upwards education trend

Trends in Concurrency, Polygyny, and Multiple Sex Partnerships During a Decade of Declining HIV Prevalence in Eastern Zimbabwe.

Background. Observed declines in the prevalence of human immunodeficiency virus (HIV) infection in Zimbabwe have been attributed to population-level reductions in sexual partnership numbers. However, it remains unknown whether certain types of sex partnerships were more important to this decline. Particular debate surrounds the epidemiologic importance of polygyny (the practice of having multiple wives). Methods. We analyze changes in reported multiple partnerships, nonmarital concurrency, and polygyny in eastern Zimbabwe during a period of declining HIV prevalence, from 1998 to 2011. Trends are reported for adult men (age, 17–54 years) and women (age, 15–49 years) from 5 survey rounds of the Manicaland HIV/STD Prevention Project, a general-population open cohort study. Results. At baseline, 34.2% of men reported multiple partnerships, 11.9% reported nonmarital concurrency, and 4.6% reported polygyny. Among women, 4.6% and 1.8% reported multiple partnerships and concurrency, respectively. All 3 partnership indicators declined by similar relative amounts (around 60%–70%) over the period. Polygyny accounted for around 25% of male concurrency. Compared with monogamously married men, polygynous men reported higher levels of subsequent divorce/separation (adjusted relative risk [RR], 2.92; 95% confidence interval [CI], 1.87–4.55) and casual sex partnerships (adjusted RR, 1.63; 95% CI, 1.41–1.88). Conclusions. No indicator clearly dominated declines in partnerships. Polygyny was surprisingly unstable and, in this population, should not be considered a safe form of concurrency

Vascular risk factors and diabetic neuropathy

Background: Other than glycemic control, there are no treatments for diabetic neuropathy. Thus, identifying potentially modifiable risk factors for neuropathy is crucial. We studied risk factors for the development of distal symmetric neuropathy in 1172 patients with type 1 diabetes mellitus from 31 centers participating in the European Diabetes (EURODIAB) Prospective Complications Study. Methods: Neuropathy was assessed at baseline (1989 to 1991) and at follow-up (1997 to 1999), with a mean (±SD) follow-up of 7.3±0.6 years. A standardized protocol included clinical evaluation, quantitative sensory testing, and autonomic-function tests. Serum lipids and lipoproteins, glycosylated hemoglobin, and the urinary albumin excretion rate were measured in a central laboratory. Results: At follow-up, neuropathy had developed in 276 of 1172 patients without neuropathy at baseline (23.5 percent). The cumulative incidence of neuropathy was related to the glycosylated hemoglobin value and the duration of diabetes. After adjustment for these factors, we found that higher levels of total and low-density lipoprotein cholesterol and triglycerides, a higher body-mass index, higher von Willebrand factor levels and urinary albumin excretion rate, hypertension, and smoking were all significantly associated with the cumulative incidence of neuropathy. After adjustment for other risk factors and diabetic complications, we found that duration of diabetes, current glycosylated hemoglobin value, change in glycosylated hemoglobin value during the follow-up period, body-mass index, and smoking remained independently associated with the incidence of neuropathy. Cardiovascular disease at baseline was associated with double the risk of neuropathy, independent of cardiovascular risk factors. Conclusions: This prospective study indicates that, apart from glycemic control, the incidence of neuropathy is associated with potentially modifiable cardiovascular risk factors, including a raised triglyceride level, body-mass index, smoking, and hypertension

In situ sensors for measurements in the global trosposphere

Current techniques available for the in situ measurement of ambient trace gas species, particulate composition, and particulate size distribution are reviewed. The operational specifications of the various techniques are described. Most of the techniques described are those that have been used in airborne applications or show promise of being adaptable to airborne applications. Some of the instruments described are specialty items that are not commercially-available. In situ measurement techniques for several meteorological parameters important in the study of the distribution and transport of ambient air pollutants are discussed. Some remote measurement techniques for meteorological parameters are also discussed. State-of-the-art measurement capabilities are compared with a list of capabilities and specifications desired by NASA for ambient measurements in the global troposphere

The Rotation Period of the Planet-Hosting Star HD 189733

We present synoptic optical photometry of HD 189733, the chromospherically active parent star of one of the most intensively studied exoplanets. We have significantly extended the timespan of our previously reported observations and refined the estimate of the stellar rotation period by more than an order of magnitude: $P = 11.953\pm 0.009$ days. We derive a lower limit on the inclination of the stellar rotation axis of 56\arcdeg (with 95% confidence), corroborating earlier evidence that the stellar spin axis and planetary orbital axis are well aligned.Comment: To appear in A

Biomarkers of gut injury in neonates – where are we in predicting necrotising enterocolitis?

Despite advances in neonatal care Necrotising Enterocolitis (NEC) continues to have a significant mortality and morbidity rate, and with increasing survival of those more immature infants the population at risk of NEC is increasing. Ischaemia, reperfusion, and inflammation underpin diseases affecting intestinal blood flow causing gut injury including Necrotising Enterocolitis. There is increasing interest in tissue biomarkers of gut injury in neonates, particularly those representing changes in intestinal wall barrier and permeability, to determine whether these could be useful biomarkers of gut injury. This article reviews current and newly proposed markers of gut injury, the available literature evidence, recent advances and considers how effective they are in clinical practice. We discuss each biomarker in terms of its effectiveness in predicting NEC onset and diagnosis or predicting NEC severity and then those that will aid in surveillance and identifying those infants are greatest risk of developing NEC

Vascular risk factors and diabetic neuropathy

Background: Other than glycemic control, there are no treatments for diabetic neuropathy. Thus, identifying potentially modifiable risk factors for neuropathy is crucial. We studied risk factors for the development of distal symmetric neuropathy in 1172 patients with type 1 diabetes mellitus from 31 centers participating in the European Diabetes (EURODIAB) Prospective Complications Study. Methods: Neuropathy was assessed at baseline (1989 to 1991) and at follow-up (1997 to 1999), with a mean (±SD) follow-up of 7.3±0.6 years. A standardized protocol included clinical evaluation, quantitative sensory testing, and autonomic-function tests. Serum lipids and lipoproteins, glycosylated hemoglobin, and the urinary albumin excretion rate were measured in a central laboratory. Results: At follow-up, neuropathy had developed in 276 of 1172 patients without neuropathy at baseline (23.5 percent). The cumulative incidence of neuropathy was related to the glycosylated hemoglobin value and the duration of diabetes. After adjustment for these factors, we found that higher levels of total and low-density lipoprotein cholesterol and triglycerides, a higher body-mass index, higher von Willebrand factor levels and urinary albumin excretion rate, hypertension, and smoking were all significantly associated with the cumulative incidence of neuropathy. After adjustment for other risk factors and diabetic complications, we found that duration of diabetes, current glycosylated hemoglobin value, change in glycosylated hemoglobin value during the follow-up period, body-mass index, and smoking remained independently associated with the incidence of neuropathy. Cardiovascular disease at baseline was associated with double the risk of neuropathy, independent of cardiovascular risk factors. Conclusions: This prospective study indicates that, apart from glycemic control, the incidence of neuropathy is associated with potentially modifiable cardiovascular risk factors, including a raised triglyceride level, body-mass index, smoking, and hypertension

Cost-utility of transcatheter aortic valve implantation for inoperable patients with severe aortic stenosis treated by medical management: a UK cost-utility analysis based on patient-level data from the ADVANCE study.

OBJECTIVE: To use patient-level data from the ADVANCE study to evaluate the cost-effectiveness of transcatheter aortic valve implantation (TAVI) compared to medical management (MM) in patients with severe aortic stenosis from the perspective of the UK NHS. METHODS: A published decision-analytic model was adapted to include information on TAVI from the ADVANCE study. Patient-level data informed the choice as well as the form of mathematical functions that were used to model all-cause mortality, health-related quality of life and hospitalisations. TAVI-related resource use protocols were based on the ADVANCE study. MM was modelled on publicly available information from the PARTNER-B study. The outcome measures were incremental cost-effectiveness ratios (ICERs) estimated at a range of time horizons with benefits expressed as quality-adjusted life-years (QALY). Extensive sensitivity/subgroup analyses were undertaken to explore the impact of uncertainty in key clinical areas. RESULTS: Using a 5-year time horizon, the ICER for the comparison of all ADVANCE to all PARTNER-B patients was £13 943 per QALY gained. For the subset of ADVANCE patients classified as high risk (Logistic EuroSCORE >20%) the ICER was £17 718 per QALY gained). The ICER was below £30 000 per QALY gained in all sensitivity analyses relating to choice of MM data source and alternative modelling approaches for key parameters. When the time horizon was extended to 10 years, all ICERs generated in all analyses were below £20 000 per QALY gained. CONCLUSION: TAVI is highly likely to be a cost-effective treatment for patients with severe aortic stenosis

Reactivity Initiated Accident Test Series RIA Scoping Test Experiment Predictions

The Reactivity 'Initiated Accident (RIA) test series to be conducted in the Power Burst Facility (PBF) has been designed.to determine fuel failure thresholds, modes, and consequences as a function of energy deposition, irradiation history, and fuel design. The RIA Scoping Test will be comprised of five single unirradiated rod sub-tests. The first rod will be subjected to a series of transient power bursts of increasing energy release to determine the energy deposition at cladding failure. The second and third rods will be subjected to energy depositions near that which caused failure of the first rod, to further define the failure threshold. Rods four and five will be subjected to large radially averaged energy depositions, 1990 and 2510 J/g respectively, to investigate facility safety concerns. Several analyses were performed to predict test fuel rod and system behavior during the five RIA Scoping Test phases. A reactor physics analysis was performed to obtain the relationship between test fuel rod and reactor core energy during a power transient. The calculations were made with the RAFFLE computer code. The thermal-hydraulic behavior of the test rod coolant was investigated for pellet surface energy depositions of 900, 1125, and 1350 J/g for the first three phases of the Scoping Test. The RELAP4 computer code was used for these thermal-hydraulic analyses. The results of the RELAP4 calculations provided input to the FRAP-T4 computer code for three fuel rod behavior analyses at pellet surface energy depositions of 815, 1020, and 1225 J/g. A cladding embrittlement analysis, using the results of the FRAP-T4 calculations as input, was made to investigate the cladding oxidation mode of rod failure for the lower energy phases. BUILD5 was the analytical tool used in this investigation. Finally, the pressure pulses generated as a result of failure of the test fuel rods in the final two high energy test phases were calculated using the SPIRT computer code. In previous reactivity initiated accident tests performed in the SPERT, TREAT, and NSRR facilities a pellet surface energy deposition of 12.350 x 10{sup 3} J/cm{sup 3} was identified as the failure threshold for unirradiated fuel rods with the ambient test conditions of 300 K, 0.1 MPa, and no forced flow. This volumetric energy deposition is equivalent to a pellet surface energy deposition of 1190 J/g (284 cal/g) when the RIA-ST fuel pellet density of 10.365 g/cm{sup 3} is considered. ·For no-flow conditions, it was further observed that the presence of a flow shroud caused a reduction of up to 10% in the failure threshold. The modes of failure seen in the previous tests were cladding embrittlement and low pressure rupture as the zircaloy melting temperature was approached. In general, the rod failures occurred only when a peak cladding temperature of 2073 K or above was reached. Based on the analyses, it is predicted that the test fuel rod energy deposition failure threshold will be 1035 J/g (247 cal/g) at the pellet surface for the fuel rods used in the initial three phases of the RIA Scoping Test. The initial coolant conditions for these cases are equivalent to a fuel enthalpy of 69 J/g (16.5 cal/g) at the fuel surface over ambient conditions. When the difference in initial coolant conditions is considered, the total fuel enthalpy increase leading to cladding failure observed in the previous RIA tests is equivalent to 1122 J/g (268 cal/g) at the fuel pellet surface. The difference between the predicted failure threshold value and that observed in previous tests (87 J/g) is believed to be a combined result of the presence of a flow shroud and uncertainies in the computer codes used to make the predictions. The mode of failure according to the analyses will be rupture due to high temperature cladding weakening. The consequences of these failures are predicted to he minimal. The mode of failure for the high energy phases of the Scoping Test will be cladding rupture due to internal rod pressurization from UO{sub 2} vaporization. The high energy rod failures were predicted by the SPIRT code to result in source pressure pulses of 24.1 and 24.8 MPa for the 1990 and 2510 J/g energy depositions, respectively. Pressure doubling will occur in each case with a rise time of 7 ms, resulting in maximum pressures of 31.7 and 34.5 MPa, respectively