Associations of Suboptimal Growth with All-Cause and Cause-Specific Mortality in Children under Five Years: A Pooled Analysis of Ten Prospective Studies

Background: Child undernutrition affects millions of children globally. We investigated associations between suboptimal growth and mortality by pooling large studies. Methods: Pooled analysis involving children 1 week to 59 months old in 10 prospective studies in Africa, Asia and South America. Utilizing most recent measurements, we calculated weight-for-age, height/length-for-age and weight-for-height/length Z scores, applying 2006 WHO Standards and the 1977 NCHS/WHO Reference. We estimated all-cause and cause-specific mortality hazard ratios (HR) using proportional hazards models comparing children with mild (−2≤Z<−1), moderate (−3≤Z<−2), or severe (Z<−3) anthropometric deficits with the reference category (Z≥−1). Results: 53 809 children were eligible for this re-analysis and contributed a total of 55 359 person-years, during which 1315 deaths were observed. All degrees of underweight, stunting and wasting were associated with significantly higher mortality. The strength of association increased monotonically as Z scores decreased. Pooled mortality HR was 1.52 (95% Confidence Interval 1.28, 1.81) for mild underweight; 2.63 (2.20, 3.14) for moderate underweight; and 9.40 (8.02, 11.03) for severe underweight. Wasting was a stronger determinant of mortality than stunting or underweight. Mortality HR for severe wasting was 11.63 (9.84, 13.76) compared with 5.48 (4.62, 6.50) for severe stunting. Using older NCHS standards resulted in larger HRs compared with WHO standards. In cause-specific analyses, all degrees of anthropometric deficits increased the hazards of dying from respiratory tract infections and diarrheal diseases. The study had insufficient power to precisely estimate effects of undernutrition on malaria mortality. Conclusions: All degrees of anthropometric deficits are associated with increased risk of under-five mortality using the 2006 WHO Standards. Even mild deficits substantially increase mortality, especially from infectious diseases

Intercomparison of global river discharge simulations focusing on dam operation --- Part II: Multiple models analysis in two case-study river basins, Missouri-Mississippi and Green-Colorado

We performed a twofold intercomparison of river discharge regulated by dams under multiple meteorological forcings among multiple global hydrological models for a historical period by simulation. Paper II provides an intercomparison of river discharge simulated by five hydrological models under four meteorological forcings. This is the first global multimodel intercomparison study on dam-regulated river flow. Although the simulations were conducted globally, the Missouri-Mississippi and Green-Colorado Rivers were chosen as case-study sites in this study. The hydrological models incorporate generic schemes of dam operation, not specific to a certain dam. We examined river discharge on a longitudinal section of river channels to investigate the effects of dams on simulated discharge, especially at the seasonal time scale. We found that the magnitude of dam regulation differed considerably among the hydrological models. The difference was attributable not only to dam operation schemes but also to the magnitude of simulated river discharge flowing into dams. That is, although a similar algorithm of dam operation schemes was incorporated in different hydrological models, the magnitude of dam regulation substantially differed among the models. Intermodel discrepancies tended to decrease toward the lower reaches of these river basins, which means model dependence is less significant toward lower reaches. These case-study results imply that, intermodel comparisons of river discharge should be made at different locations along the river’s course to critically examine the performance of hydrological models because the performance can vary with the locations

Full thickness material tests for impact analysis verification

Traditionally, a failure strain criterion is used in crash simulations in the maritime and offshore industry. More sophisticated methods for multi-axial stress states are based on the Forming Limit Diagram and the Fracture Forming Limit Diagram (FFLD). The diagrams are derived for the steel sheet forming industry, such as car parts. Few tests are performed on specimens with plate thickness repre-sentative for maritime application. Full thickness effects can not be neglected. In this paper, full thickness material failure tests are described. S355 and S690 samples have been subjected to lateral impact. Round specimens, fully clamped, simulate an equi-biaxial strain state. Apple core shaped specimens simulate the plane strain conditions. Tests results are analyzed by Digital Image Correlation techniques, acceler-ometers and ultrasonic thickness measurements. The failure of the specimens are depicted in the FLD diagrams, showing the relevance of these tests for updating failure criteria for maritime and offshore impact analysis