The effect of Helicobacter pylori infection on growth velocity in young children from poor urban communities in Ecuador

SummaryObjectiveTo characterize the potential effects of Helicobacter infections on growth velocity in low socioeconomic status young children in a developing country.MethodsChildren were recruited in poor suburbs of Quito, Ecuador. Normally nourished, mildly and substantially malnourished children (defined using weight-for-age Z-scores at recruitment) formed equal strata. Six height and weight measurements were collected during one year. Enrollment and exit serum samples were analyzed for anti-Helicobacter IgG and exit non-diarrheal feces tested for Helicobacter antigen.ResultsAmong 124 participants (enrollment age 19±9 months), 76 (61%) excreted fecal antigen at exit (were infected). Of these, 44 were seropositive at least once (chronic infections) and 32 tested seronegative both times (new or acute phase infections). The adjusted linear growth velocity during follow-up in children with new infections was reduced by 9.7 (3.8, 15.6) mm/year compared to uninfected controls and 6.4 (0.0, 12.9) mm/year compared to children with chronic infections. The effects of Helicobacter infections on ponderal growth were not significant.ConclusionThese results suggest that linear growth velocity is reduced in young children during the initial phase of Helicobacter infection

Innovations in nutrition education and global health: the Bangalore Boston nutrition collaborative

Background: India has a wide range of nutrition and health problems which require professionals with appropriate skills, knowledge and trans-disciplinary collaborative abilities to influence policy making at the national and global level. Methods: The Bangalore Boston Nutrition Collaborative (BBNC) was established as collaboration between St. John’s Research Institute (SJRI), Harvard School of Public Health and Tufts University, with a focus on nutrition research and training. The goals of the BBNC were to conduct an interdisciplinary course, develop web-based courses and identify promising Indian students and junior faculty for graduate training in Boston. Results: From 2010, an annual two-week short course in nutrition research methods was conducted on the SJRI campus taught by international faculty from Indian and US universities. More than 100 students applied yearly for approximately 30 positions. The course had didactic lectures in the morning and practical hands-on sessions in the afternoon. Student rating of the course was excellent and consistent across the years. The ratings on the design and conduct of the course significantly improved (p <0.001) from 2010 to 2012. Through open-ended questions, students reported the main strengths of the course to be the excellent faculty and practical “hands-on” sessions. A web based learning system TYRO, was developed, which can be used for distance learning. Four faculty members/graduate students from SJRI have visited Boston for collaborative research efforts. Conclusion: The BBNC has become a well-established capacity building and research training program for young professionals in nutrition and global health. Efforts are ongoing to secure long term funding to sustain and expand this collaboration to deliver high quality nutrition and global health education enabled by information and communication technologies

Dimensional errors in LIGA-produced metal structures due to thermal expansion and swelling of PMMA.

Numerical methods are used to examine dimensional errors in metal structures microfabricated by the LIGA process. These errors result from elastic displacements of the PMMA mold during electrodeposition and arise from thermal expansion of the PMMA when electroforming is performed at elevated temperatures and from PMMA swelling due to absorption of water from aqueous electrolytes. Both numerical solutions and simple analytical approximations describing PMMA displacements for idealized linear and axisymmetric geometries are presented and discussed. We find that such displacements result in tapered metal structures having sidewall slopes up to 14 {micro}m per millimeter of height for linear structures bounded by large areas of PMMA. Tapers for curved structures are of similar magnitude, but these structures are additionally skewed from the vertical. Potential remedies for reducing dimensional errors are also discussed. Here we find that auxiliary moat-like features patterned into the PMMA surrounding mold cavities can reduce taper by an order of magnitude or more. Such moats dramatically reduce tapers for all structures, but increase skew for curved structures when the radius of curvature is comparable to the structure height

Irrigation and women’s diet in Ethiopia: A longitudinal study

Some agricultural practices, such as irrigation, have the potential to buffer seasonal dietary gaps and thus improve diets, particularly for subsistence farmers but also for rural and urban households that purchase irrigated produce from local markets. While the seasonality of households and children’s diets is well documented, little is known about the seasonality of women’s diets and the influence of irrigation. Using longitudinal data from Ethiopia, this study characterized women’s diet over time and evaluated the potential implications of seasonality and irrigation on women’s diet. Women’s dietary diversity was low (3-4 out of 10 food groups) and exhibited high seasonal variability (P<0.05). Diets were predominantly plant-based, with little consumption of nutrientdense foods, such as fruits and animal source foods. High seasonal variability in energy, protein, vitamin C, calcium, iron, and zinc intakes were observed (P<0.01). Irrigators were more likely to meet the minimum dietary diversity for women (MDDW), had higher energy and calcium intake, and lower prevalence of anemia, than women from non-irrigating households (P< 0.05). No cases of malaria were reported from the three rounds of screening. Our preliminary findings suggest that there is high seasonal variation in women’s diet, but this can be partly offset by irrigation practices

Radiocarbon Analyses Quantify Peat Carbon Losses With Increasing Temperature in a Whole Ecosystem Warming Experiment

Climate warming is expected to accelerate peatland degradation and release rates of carbon dioxide (CO2) and methane (CH4). Spruce and Peatlands Responses Under Changing Environments is an ecosystem-scale climate manipulation experiment, designed to examine peatland ecosystem response to climate forcings. We examined whether heating up to +9 °C to 3 m-deep in a peat bog over a 7-year period led to higher C turnover and CO2 and CH4 emissions, by measuring 14C of solid peat, dissolved organic carbon (DOC), CH4, and dissolved CO2 (DIC). DOC, a major substrate for heterotrophic respiration, increased significantly with warming. There was no 7-year trend in the DI14 C of the ambient plots which remained similar to their DO14 C. At +6.75 °C and +9 °C, the 14C of DIC, a product of microbial respiration, initially resembled ambient plots but became more depleted over 7 years of warming. We attributed the shifts in DI14 C to the increasing importance of solid phase peat as a substrate for microbial respiration and quantified this shift via the radiocarbon mass balance. The mass-balance model revealed increases in peat-supported respiration of the catotelm depths in heated plots over time and relative to ambient enclosures, from a baseline of 20%–25% in ambient enclosures, to 35%–40% in the heated plots. We find that warming stimulates microorganisms to respire ancient peat C, deposited under prior climate (cooler) conditions. This apparent destabilization of the large peat C reservoir has implications for peatland-climate feedbacks especially if the balance of the peatland is tipped from net C sink to C source. Plain Language Summary Since the end of the last glacial period, about 20 thousand years ago, peatlands have taken up carbon and now store an amount nearly equivalent to the quantity in the atmosphere. Microorganisms consume and respire that peat C releasing it back to the atmosphere as CO2 and CH4. Until now, many studies have shown that microorganisms prefer to consume the most recently fixed carbon and that the deeply buried ancient peat carbon reservoir is relatively stable. However, climate warming is expected to upset that balance. The Spruce and Peatlands Responses Under Changing Environments is large-scale experimental warming of a Minnesota peatland designed to study these effects. We conducted radiocarbon analysis of the peat and the microbially produced CO2 and dissolved organic carbon in ambient and heated areas of the peatland and show that at warmer temperatures more of the ancient peat carbon is being mobilized and respired to CO2. This is troubling as it signifies a positive feedback loop wherein warming stimulates peat to produce more CO2 which further exacerbates climate change

Seasonal Patterns of Gastrointestinal Illness and Streamflow along the Ohio River

Waterborne gastrointestinal (GI) illnesses demonstrate seasonal increases associated with water quality and meteorological characteristics. However, few studies have been conducted on the association of hydrological parameters, such as streamflow, and seasonality of GI illnesses. Streamflow is correlated with biological contamination and can be used as proxy for drinking water contamination. We compare seasonal patterns of GI illnesses in the elderly (65 years and older) along the Ohio River for a 14-year period (1991–2004) to seasonal patterns of streamflow. Focusing on six counties in close proximity to the river, we compiled weekly time series of hospitalizations for GI illnesses and streamflow data. Seasonal patterns were explored using Poisson annual harmonic regression with and without adjustment for streamflow. GI illnesses demonstrated significant seasonal patterns with peak timing preceding peak timing of streamflow for all six counties. Seasonal patterns of illness remain consistent after adjusting for streamflow. This study found that the time of peak GI illness precedes the peak of streamflow, suggesting either an indirect relationship or a more direct path whereby pathogens enter water supplies prior to the peak in streamflow. Such findings call for interdisciplinary research to better understand associations among streamflow, pathogen loading, and rates of gastrointestinal illnesses

Reliability and validity of the center for epidemiologic studies-depression scale in screening for depression among HIV-infected and -uninfected pregnant women attending antenatal services in northern Uganda: a cross-sectional study.

BACKGROUND: There are limited data on the prevalence and approaches to screening for depression among pregnant women living in resource poor settings with high HIV burden. METHODS: We studied the reliability and accuracy of the Center for Epidemiologic Studies Depression (CES-D) scale in 123 (36 HIV-infected and 87 -uninfected) pregnant women receiving antenatal care at Gulu Regional Referral Hospital, Uganda. CES-D scores were compared to results from the psychiatrist-administered Mini-International Neuropsychiatric Interview (MINI) for current major depressive disorder (MDD), a "gold standard" for assessing depression. We employed measures of internal consistency (Cronbach's alpha), and criterion validity [Area Under the Receiver Operating Characteristic Curve (AUROC), sensitivity (Se), specificity (Sp), and positive predictive value (PPV)] to evaluate the reliability and validity of the CES-D scale. RESULTS: 35.8% of respondents were currently experiencing an MDD, as defined from outputs of the MINI-depression module. The CES-D had high internal consistency (Cronbach's alpha = 0.92) and good discriminatory ability in detecting MINI-defined current MDDs (AUROC = 0.82). The optimum CES-D cutoff score for the identification of probable MDD was between 16 and 17. A CES-D cutoff score of 17, corresponding to Se, Sp, and PPV values of 72.7%, 78.5%, and 76.5%, is proposed for adoption in this population and performs well for HIV-infected and -uninfected women. After adjusting for baseline differences between the HIV subgroups (maternal age and marital status), HIV-infected pregnant women scored 6.2 points higher on the CES-D than HIV-uninfected women (p = 0.032). CONCLUSIONS: The CES-D is a suitable instrument for screening for probable major depression among pregnant women of mixed HIV status attending antenatal services in northern Uganda

Designing clinical trials in paediatric inflammatory bowel diseases:a PIBDnet commentary

Introduction: The optimal trial design for assessing novel therapies in paediatric IBD (PIBD) is a subject of intense ongoing global discussions and debate among the different stakeholders. However, there is a consensus that the current situation in which most medications used in children with IBD are prescribed as off-label without sufficient paediatric data is unacceptable. Shortening the time lag between adult and paediatric approval of drugs is of the upmost importance. In this position paper we aimed to provide guidance from the global clinical research network (Pediatric Inflammatory Bowel Disease Network, PIBDnet) for designing clinical trials in PIBD in order to facilitate drug approval for children. Methods: A writing group has been established by PIBDnet and topics were assigned to different members. After an iterative process of revisions among the writing group and one face-to-face meeting, all statements have reached consensus of &gt;80% as defined a priori. Next, all core members of PIBDnet voted on the statements, reaching consensus of &gt;80% on all statements. Comments from the members were incorporated in the text. Results: The commentary includes 18 statements for guiding data extrapolation from adults, eligibility criteria to PIBD trials, use of placebo, dosing, endpoints and recommendations for feasible trials. Controversial issues have been highlighted in the text. Conclusion: The viewpoints expressed in this paper could assist planning clinical trials in PIBD which are both of high quality and ethical, while remaining pragmatic

Soil Metabolome Response to Whole-Ecosystem Warming at the Spruce and Peatland Responses Under Changing Environments Experiment

While peatlands have historically stored massive amounts of soil carbon, warming is expected to enhance decomposition, leading to a positive feedback with climate change. In this study, a unique whole-ecosystem warming experiment was conducted in northern Minnesota to warm peat profiles to 2 m deep while keeping water flow intact. After nearly 2 y, warming enhanced the degradation of soil organic matter and increased greenhouse gas production. Changes in organic matter quality with warming were accompanied by a stimulation of methane production relative to carbon dioxide. Our results revealed increased decomposition to be fueled by the availability of reactive carbon substrates produced by surface vegetation. The elevated rates of methanogenesis are likely to persist and exacerbate climate warming

The Elderly and Waterborne Cryptosporidium Infection: Gastroenteritis Hospitalizations before and during the 1993 Milwaukee Outbreak

We used the Temporal Exposure Response Surfaces modeling technique to examine the association between gastroenteritis-related emergency room visits and hospitalizations in the elderly and drinking water turbidity before and during the 1993 Milwaukee waterborne Cryptosporidium outbreak. Before the outbreak, the rate of such events increased with age in the elderly (p<0.002), suggesting that the elderly are at an increased risk. During the outbreak, strong associations between turbidity and gastroenteritis-related emergency room visits and hospitalizations occurred at temporal lags of 5–6 days (consistent with the Cryptosporidium incubation period). A pronounced second wave of these illnesses in the elderly peaked at 13 days. This wave represented approximately 40% of all excess cases in the elderly. Our findings suggest that the elderly had an increased risk of severe disease due to Cryptosporidium infection, with a shorter incubation period than has been previously reported in all adults and with a high risk for secondary person-to-person transmission