Prevalence of Stunting and Relationship between Stunting and Associated Risk Factors with Academic Achievement and Cognitive Function: A Cross-Sectional Study with South African Primary School Children

Childhood stunting can have negative long-term consequences on cognitive development, academic achievement, and economic productivity later in life. We determined the prevalence of stunting and examined whether stunting and associated risk factors (low dietary diversity, insufficient hemoglobin, food insecurity, and soil-transmitted helminth (STH) infections) are associated with academic achievement and cognitive function among South African children living in marginalized communities. A cross-sectional sample of 1277 children (aged 5-12 years) was analyzed. Stunting was defined according to 2007 WHO growth references. Cognitive functioning was measured with the computerized Flanker task and academic performance via school grades. Blood and stool samples were collected to obtain hemoglobin level and STH infection. Dietary diversity was assessed by a food frequency questionnaire. Associations were examined via mixed linear regression (with school class as a random intercept). Nine percent of the children were stunted (95% CI: 7.6-10.8%). Low dietary diversity (β = 0.13,; p; = 0.004), food insecurity (β = -0.12,; p; = 0.034), and stunting (β = -0.13,; p; = 0.031) were associated with poorer end of the year results among girls. No such associations were found among boys. No significant associations were found for socioeconomic status and hemoglobin levels. The prevalence of stunting and STH infections were low in the present sample. Risk factors seem differently associated with girls' and boys' academic achievement. Promoting nutrition may help to promote academic achievement among girls living in low- and middle-income countries

Supplementation with vitamin A reduces watery diarrhoea and respiratory infections in Mexican children

Previous clinical vitamin A trials have found no consistent effect on diarrhoeal disease and respiratory tract infection. These inconsistent results may be due to the distinct effects vitamin A supplementation has among children stratified by factors related to socio-economic status, nutritional status and season. We evaluated the effect of supplementation on the overall incidence of diarrhoeal disease and respiratory tract infections and on the incidence among children stratified by these factors. A total of 188 children, aged 6–15 months, from periurban, marginalized communities of Mexico City were assigned to receive vitamin A ( < 12 months of age, 20 000 IU retinol; ≥ 12 months, 45 000 IU retinol) or a placebo every 2 months, and were followed for up to 15 months. Project personnel visited households twice a week to determine the onset and duration of diarrhoeal disease and respiratory tract infections. Vitamin A supplementation had no significant effect on risk of overall diarrhoeal disease but reduced mild watery diarrhoea (incidence rate ratio (RR) 0·69; 95 % CI 0·50, 0·93) and cough with fever (RR 0·69; 95 % CI 0·48, 0·98). Vitamin A supplementation decreased diarrhoeal disease during the summer (RR 0·74; 95 % CI 0·57, 0·94), among non-stunted children (RR 0·69; 95 % CI 0·52, 0·93) and among children from households with better socio-economic measures. Heterogeneity in the response to vitamin A supplementation may reflect heterogeneity in the aetiology and epidemiology of diarrhoeal disease and respiratory tract infections and the impact that supplementation has on the immune response

Associations of growth impairment and body composition among South African school-aged children enrolled in the KaziAfya project

(1) Background: Early childhood malnutrition may result in increased fat mass (FM) among school-aged children in low- and middle-income countries (LMICs). We explored whether South African children with shorter stature have greater overall and abdominal FM compared to normal stature children. (2) Methods: Baseline assessments of body composition and weight were determined among school-aged children enrolled in a randomized controlled trial in Port Elizabeth, South Africa, using bioelectrical impedance analysis. Multiple linear regression models tested associations of children's height and degree of stunting with FM, fat free mass (FFM), truncal fat mass (TrFM), and truncal fat free mass (TrFFM) overall and by sex. (3) Results: A total of 1287 children (619 girls, 668 boys) were assessed at baseline. Reduced child height was associated with higher FM and lower FFM and TrFFM, but these associations were reversed with increases in height. Girls classified as mildly or moderately/severely stunted had higher FM and TrFM but lower FFM and TrFFM, while no association was found for boys. (4) Conclusions: Our study suggests that efforts to reduce the non-communicable disease burden in LMICs should target growth-impaired children who may have greater overall FM and greater abdominal FM

Evaluation of a Physical Activity and Multi-Micronutrient Intervention on Cognitive and Academic Performance in South African Primary Schoolchildren

Executive functions (EFs) are essential for optimal academic development. Appropriate nutrition and physical activity (PA) have been shown to facilitate optimal cognitive development. Therefore, this study examined whether a 12-week school-based PA and multi-micronutrient supplementation (MMNS) intervention would improve cognitive and academic performance. A cluster-randomized controlled trial (RCT) was conducted. Children from four schools located in a peri-urban area of South Africa were randomly assigned to (i) PA + MMNS, (ii) PA + placebo, (iii) MMNS or (iv) placebo. Information processing and inhibitory control were measured with a computerized Flanker task. End-of-year results provided insight into academic achievement. Anthropometric measures were used to determine nutritional status. Data were analyzed with linear mixed-models, adjusting for baseline scores, school classes and age; 932 children (458 girls (49.1 completed baseline and post-intervention assessments. Cognitive performance improved among all four groups, with no significant group x time effects. For academic achievement, there was no significant interaction effect between the combined intervention group and placebo. We encourage future studies in this neglected area in order to determine the most optimal design of school-based nutrition and PA programs to enhance overall cognitive performance

Adiponectin gene (ADIPOQ) polymorphisms correlate with the progression of nephropathy in Taiwanese male patients with type 2 diabetes

Aims: Polymorphisms of the ADIPOQ gene were associated with diabetic nephropathy (DN) in case-control studies predominantly among European populations. Gender may modify the ADIPOQ associated risk for DN. We investigated the association of 18 ADIPOQ polymorphisms with DN in a prospective Taiwanese cohort of type 2 diabetes (T2D) and explored whether gender plays a role in this genetic association. Methods: Selected single nucleotide polymorphisms (SNPs) of ADIPOQ were genotyped in 566 T2D patients with normoalbuminuria at baseline. DN was defined based on urinary albumin-to-creatinine ratio (ACR). The Cox proportional hazard model was used to explore the association of individual SNP to DN events under different genetic models over a 6-year follow-up period. Analyses were further stratified by gender. Results: In male patients, the adjusted hazard ratios under the recessive models were 1.81 for rs2241766 TT (vs. GT+GG, 95% CI=1.10-2.96, p=0.019) and 1.89 for rs1063537 CC (vs. CT+TT, 95% CI=1.15-3.11, p=0.013). In the Kaplan-Meier survival curve, males carrying rs2241766 TT (vs. GT+GG, p=0.050) and rs1063537 CC (vs. CT+TT, p=0.037) recessive homozygotes also had a reduced nephropathy-free survival rate. SNPs rs2241767 and rs2082940, both in strong correlation with tag SNP rs1063537 (r≥0.96), were also associated with DN progression in males. In females, ADIPOQ polymorphisms were not associated with the progression of DN. Conclusions: ADIPOQ genetic polymorphisms rs2241766 (+45T>G), rs1063537, rs2241767 and rs2082940 were correlated with the progression of DN in Taiwanese male patients with T2D. The role of gender in this ADIPOQ genetic association needs to be further investigated in other populations

Specific micronutrient concentrations are associated with inflammatory cytokines in a rural population of Mexican women with a high prevalence of obesity

It has been recognised recently that obese individuals have lower concentrations of micronutrients and this may affect the concentrations of inflammatory cytokines. A cross-sectional study was carried out to evaluate the association of specific micronutrients' status with chronic inflammation caused by obesity in 280 women (36·1 (sd 7·5) years) from seven rural communities in Mexico. Measurements of weight, height and waist circumference were made on all women and body composition was determined by dual-energy X-ray absorptiometry. Concentrations of the cytokines IL-1, TNF-α, IL-6, IL-10 and IL-12, lipid profile, and the micronutrients Zn and vitamins A, C and E were determined in fasting blood samples. Ordered logistic regression models were used to determine associations between categorised cytokine levels and micronutrients. It was found that 80 % of women were overweight or obese, and had significantly higher concentrations of C-reactive protein than normal-weight women (P = 0·05). The risk of higher levels of TNF-α, IL-6, IL-10 and IL-12 was reduced significantly among women with higher Zn concentrations (OR 0·63, 95 % CI 0·42, 0·96, P = 0·03; OR 0·57, 95 % CI 0·39, 0·86, P = 0·025; OR 0·63, 95 % CI 0·41, 0·96, P = 0·04; OR 0·62, 95 % CI 0·41, 0·95, P = 0·03, respectively). Higher concentrations of vitamin A were slightly associated with reduced risks of higher levels of IL-1 and IL-12 (OR 0·97, 95 % CI 0·95, 0·99, P = 0·03; OR 0·97, 95 % CI 0·94, 0·99, P = 0·03, respectively); when adjusting for BMI, this association was lost. No associations were found between vitamin C or vitamin E:lipids concentrations and inflammatory cytokines. In conclusion, higher Zn concentrations are associated with reduced risks of higher concentration of inflammation markers in a population of women with a high prevalence of obesity

Dietary patterns, dietary biomarkers, and kidney disease in patients with type 2 diabetes: a repeated-measure study in Taiwan

Western dietary patterns have been linked with kidney disease. This study investigated the association between Chinese dietary patterns and kidney disease in a Taiwanese population with type 2 diabetes and evaluated dietary fatty acid patterns, a kidney-related dietary biomarker.We recruited 838 patients with type 2 diabetes and used their dietary and renal data obtained from three repeated measures in 2008, 2009 and 2010. Diet was assessed using food-frequency questionnaires, and factor analysis was performed to identify dietary patterns. Albuminuria was defined by having an albumin-to-creatinine ratio >=30 mg/g and kidney dysfunction by estimated glomerular filtration rat

Moderate-to-vigorous physical activity is associated with cardiorespiratory fitness among primary schoolchildren living in Côte d'Ivoire, South Africa, and Tanzania

Background:; Physical inactivity and low cardiorespiratory fitness (CRF) are independent cardiovascular risk factors among children, but have rarely been investigated concurrently in sub-Saharan Africa. The purpose of this study was to compare physical activity (PA) and CRF of primary schoolchildren living in Côte d'Ivoire (CI), South Africa (ZA), and Tanzania (TZ), to test sex- and age-related differences, and to examine whether PA and CRF are associated with each other.; Methods:; Baseline data from an ongoing cluster-randomized controlled trial were used, including 499 children from CI (Taabo, 49% girls,; M; = 8.0 ± 1.6 years), 1,074 children from ZA (Gqeberha, 49% girls,; M; = 8.3 ± 1.4 years), and 593 children from TZ (Ifakara, 51% girls,; M; = 9.4 ± 1.7 years). PA was assessed by accelerometry and CRF by a 20 m shuttle-run test. The data were analyzed using multi-/univariate analyses of variance and mixed linear models.; Results:; Most children met recommendations put forward by the World Health Organization for moderate-to-vigorous PA (MVPA) and achieved high CRF scores. In CI, 89.6% of the children met MVPA recommendations (boys: 91.7%, girls: 87.4%), whereas this rate was 76.9% in ZA (boys: 91.0%, girls: 62.4%), and 93.8% in TZ (boys: 95.5%, girls: 92.0%). Children from TZ had the highest CRF and MVPA levels, followed by children from CI and ZA. Boys had higher MVPA levels than girls, whereas girls engaged in more sedentary behavior. Sex differences were strongest in ZA. Sedentary behavior and MVPA were higher among older schoolchildren compared to their younger peers. Higher MVPA, but not sedentary behavior, was associated with better CRF.; Conclusions:; In all three settings, higher levels of MVPA were associated with higher CRF scores. Nevertheless, children living in the most urbanized setting (such as observed in ZA) were physically less active and had lower CRF than peers living in more rural areas (such as observed in CI and TZ). Particularly for girls, urbanization might increase the risk for insufficient MVPA, which may have negative effects on their CRF, thus negatively influencing health and well-being at later age

LSST: from Science Drivers to Reference Design and Anticipated Data Products

(Abridged) We describe here the most ambitious survey currently planned in the optical, the Large Synoptic Survey Telescope (LSST). A vast array of science will be enabled by a single wide-deep-fast sky survey, and LSST will have unique survey capability in the faint time domain. The LSST design is driven by four main science themes: probing dark energy and dark matter, taking an inventory of the Solar System, exploring the transient optical sky, and mapping the Milky Way. LSST will be a wide-field ground-based system sited at Cerro Pach\'{o}n in northern Chile. The telescope will have an 8.4 m (6.5 m effective) primary mirror, a 9.6 deg$^2$ field of view, and a 3.2 Gigapixel camera. The standard observing sequence will consist of pairs of 15-second exposures in a given field, with two such visits in each pointing in a given night. With these repeats, the LSST system is capable of imaging about 10,000 square degrees of sky in a single filter in three nights. The typical 5$\sigma$ point-source depth in a single visit in $r$ will be $\sim 24.5$ (AB). The project is in the construction phase and will begin regular survey operations by 2022. The survey area will be contained within 30,000 deg$^2$ with $\delta<+34.5^\circ$, and will be imaged multiple times in six bands, $ugrizy$, covering the wavelength range 320--1050 nm. About 90\% of the observing time will be devoted to a deep-wide-fast survey mode which will uniformly observe a 18,000 deg$^2$ region about 800 times (summed over all six bands) during the anticipated 10 years of operations, and yield a coadded map to $r\sim27.5$. The remaining 10\% of the observing time will be allocated to projects such as a Very Deep and Fast time domain survey. The goal is to make LSST data products, including a relational database of about 32 trillion observations of 40 billion objects, available to the public and scientists around the world.Comment: 57 pages, 32 color figures, version with high-resolution figures available from https://www.lsst.org/overvie

A Search for Dark Higgs Bosons

Recent astrophysical and terrestrial experiments have motivated the proposal of a dark sector with GeV-scale gauge boson force carriers and new Higgs bosons. We present a search for a dark Higgs boson using 516 fb-1 of data collected with the BABAR detector. We do not observe a significant signal and we set 90% confidence level upper limits on the product of the Standard Model-dark sector mixing angle and the dark sector coupling constant.Comment: 7 pages, 5 postscript figures, published version with improved plots for b/w printin