Mapping the risk of anaemia in preschool-age children: the contribution of malnutrition, malaria, and helminth infections in West Africa

BACKGROUND Childhood anaemia is considered a severe public health problem in most countries of sub-Saharan Africa. We investigated the geographical distribution of prevalence of anaemia and mean haemoglobin concentration (Hb) in children aged 1-4 y (preschool children) in West Africa. The aim was to estimate the geographical risk profile of anaemia accounting for malnutrition, malaria, and helminth infections, the risk of anaemia attributable to these factors, and the number of anaemia cases in preschool children for 2011. METHODS AND FINDINGS National cross-sectional household-based demographic health surveys were conducted in 7,147 children aged 1-4 y in Burkina Faso, Ghana, and Mali in 2003-2006. Bayesian geostatistical models were developed to predict the geographical distribution of mean Hb and anaemia risk, adjusting for the nutritional status of preschool children, the location of their residence, predicted Plasmodium falciparum parasite rate in the 2- to 10-y age group (Pf PR(2-10)), and predicted prevalence of Schistosoma haematobium and hookworm infections. In the four countries, prevalence of mild, moderate, and severe anaemia was 21%, 66%, and 13% in Burkina Faso; 28%, 65%, and 7% in Ghana, and 26%, 62%, and 12% in Mali. The mean Hb was lowest in Burkina Faso (89 g/l), in males (93 g/l), and for children 1-2 y (88 g/l). In West Africa, severe malnutrition, Pf PR(2-10), and biological synergisms between S. haematobium and hookworm infections were significantly associated with anaemia risk; an estimated 36.8%, 14.9%, 3.7%, 4.2%, and 0.9% of anaemia cases could be averted by treating malnutrition, malaria, S. haematobium infections, hookworm infections, and S. haematobium/hookworm coinfections, respectively. A large spatial cluster of low mean Hb (95%) was predicted for an area shared by Burkina Faso and Mali. We estimate that in 2011, approximately 6.7 million children aged 1-4 y are anaemic in the three study countries. CONCLUSIONS By mapping the distribution of anaemia risk in preschool children adjusted for malnutrition and parasitic infections, we provide a means to identify the geographical limits of anaemia burden and the contribution that malnutrition and parasites make to anaemia. Spatial targeting of ancillary micronutrient supplementation and control of other anaemia causes, such as malaria and helminth infection, can contribute to efficiently reducing the burden of anaemia in preschool children in Africa.Funded by the University of Queensland and National Health and Medical Research Council (NHMRC), Australia

Process Mining for IS Project Success Factors Management: A proposal

Research on Success Factors (SF) of Information Systems (IS) projects carried out over the last decades has resulted in a vast literature. However, extant studies typically aim to identify and list generic SF for projects, denoting a static perspective, with few concerns of practical nature regarding their use as management tools to support decisions throughout the projects’ lifecycle. On the other hand, process mining has been used to discover, analyze, and improve project management processes. In this paper, we propose a new approach that involves relating the performance of those processes with SF in IS projects. By using process mining, the aim is to automatically extract and manage SF in projects, measure processes performance, and provide project managers with information on how SF correlate with performance. This will provide managers with enhanced information regarding status and improvement opportunities for current and future projects. The main purpose is to contribute to the project management theory and practice by providing a decision support system that can associate performance with IS projects’ SF automatically obtained from internal and external data sources

Levels, trends, and inequalities in using institutional delivery services in low- and middle-income countries: a stratified analysis by facility type

Introduction: To ensure equitable and accessible services and improved utilization of institutional delivery it is important to identify what progress has been achieved, whether there are vulnerable and disadvantaged groups that need specific attention and what are the key factors affecting the utilization of institutional delivery services. In this study, we examined levels, trends, and inequalities in the utilization of institutional delivery services in low- and middle-income countries. Methods: We used nationally representative cross-sectional data from Demographic and Health Surveys (DHS) conducted during 1990–2018. Bayesian linear regression analysis was performed. Results: Among 74 countries, the utilization of institutional delivery services ranged from 23.7% in Chad to 100% in Ukraine and Armenia (with >90% in 19 countries and <50% in 13 countries) during the latest DHS rounds. Trend analysis in 63 countries with at least 2 surveys showed that the utilization of institutional delivery services increased in 60 countries during 1990–2018, with the highest increase being in Cambodia (18.3%). During this period, the utilization of institutional delivery services increased in 90.3% of countries among the richest, 95.2% of countries in urban, and 84.1% of countries among secondary+ educated women. The utilization of institutional delivery services was higher among wealthiest, urban, and secondary+ educated women compared to their counterparts. Greater utilization of private facilities for delivery was observed in women from the highest income group and urban communities, whereas highest utilization of public facilities was observed for women from the lowest income group and rural communities. Conclusions: The utilization of institutional delivery services varied substantially between and within countries over time. Significant disparities in service utilization identified in this study highlight the need for tailored support for women from disadvantaged and vulnerable groups

Consumption, housing and financial wealth, asset returns, and monetary policy.

This work analyzes the linkages between consumption, housing and financial wealth, asset returns, and monetary policy. In Chapter I, I show, from the consumer's budget constraint, that the residuals of the trend relationship among consumption, financial wealth, housing wealth and labor income, cday, should better predict stock returns than a variable like cay from Lettau and Ludvigson (2001), and that this is due to: (i) the ability to track changes in the wealth composition; and (ii) the faster rate of convergence of the coefficients to the "long-run equilibrium" parameters. In Chapter II, I analyze the empirical relationship between wealth shocks and portfolio composition, and find evidence consistent with counter-cyclical risk aversion. I also show that: (i) there is no evidence of inertia; and (ii) time-variation in expectations about future returns partially explains changes in the risky asset share. In Chapter III, I show that monetary policy contractions have a large and negative impact on housing prices, although the reaction is extremely slow. On the contrary, the effect on stock markets is small and very quick. In Chapter IV, I analyze the importance of the risks for the long-run, and show that they explain a large fraction of the cross-sectional variation of average returns. I also find that the preference for a smooth path of consumption, a low intertemporal elasticity of substitution, and a high risk aversion, imply that agents demand large equity risk premia when they fear a reduction in economic prospects. In Chapter V, I investigate the role of three major sources of risk: future changes in the housing consumption share, cr, future labour income growth, Ir, and future consumption growth, Irc. I show that the predictability of many empirical proxies can be achieved without relying on a specific functional form for consumer's preferences

Gut microbiota disturbance during helminth infection: can it affect cognition and behaviour of children?

Background: Bidirectional signalling between the brain and the gastrointestinal tract is regulated at neural, hormonal, and immunological levels. Recent studies have shown that helminth infections can alter the normal gut microbiota. Studies have also shown that the gut microbiota is instrumental in the normal development, maturation and function of the brain. The pathophysiological pathways by which helminth infections contribute to altered cognitive function remain poorly understood. Discussion: We put forward the hypothesis that gastrointestinal infections with parasitic worms, such as helminths, induce an imbalance of the gut-brain axis, which, in turn, can detrimentally manifest in brain development. Factors supporting this hypothesis are: 1) research focusing on intelligence and school performance in school-aged children has shown helminth infections to be associated with cognitive impairment, 2) disturbances in gut microbiota have been shown to be associated with important cognitive developmental effects, and 3) helminth infections have been shown to alter the gut microbiota structure. Evidence on the complex interactions between extrinsic (parasite) and intrinsic (host-derived) factors has been synthesised and discussed. Summary: While evidence in favour of the helminth-gut microbiota-central nervous system hypothesis is circumstantial, it would be unwise to rule it out as a possible mechanism by which gastrointestinal helminth infections induce childhood cognitive morbidity. Further empirical studies are necessary to test an indirect effect of helminth infections on the modulation of mood and behaviour through its effects on the gut microbiota

Altered frontoparietal connectivity in patients with obsessive-compulsive disorder during an fMRI cognitive reappraisal task

Patients with obsessive-compulsive disorder (OCD) present increased brain activity in orbitofrontal and limbic regions when experiencing negative emotions, which could be related to deficits in emotion regulation abilities. 30 OCD patients and 29 healthy controls (HC) performed a cognitive reappraisal functional magnetic resonance imaging (fMRI) task and completed emotion regulation and OCD symptomatology questionnaires. Besides task activation, connectivity was also compared between groups through psychophysiological interaction analysis (PPI), using regions previously reported to be hyperactive in OCD as seeds. Finally, brain-behavior correlations were performed between activation/connectivity strength in group differential regions and the questionnaires’ scores, as well as the emotional ratings reported during the task. Behaviorally, patients with OCD were less successful than controls at lowering the emotional impact of negative images. At the brain level, there were no significant between-group differences in brain activation. Contrarily, PPI analyses showed that HC had increased frontoparietal connectivity when experiencing negative emotions in comparison to OCD patients, while this pattern was reversed when regulating emotions (increased connectivity in patients). Finally, frontoparietal connectivity was correlated with measures of emotion regulation success and OCD symptomatology. Our findings point towards frontoparietal altered connectivity as a potential compensatory mechanism during emotion regulation in OCD patients

Administrative and clinical denials by a large dental insurance provider

The objective of this study was to assess the prevalence and the type of claim denials (administrative, clinical or both) made by a large dental insurance plan. This was a cross-sectional, observational study, which retrospectively collected data from the claims and denial reports of a dental insurance company. The sample consisted of the payment claims submitted by network dentists, based on their procedure reports, reviewed in the third trimester of 2012. The denials were classified and grouped into ‘administrative’, ‘clinical’ or ‘both’. The data were tabulated and submitted to uni- and bivariate analyses. The confidence intervals were 95% and the level of significance was set at 5%. The overall frequency of denials was 8.2% of the total number of procedures performed. The frequency of administrative denials was 72.88%, whereas that of technical denials was 25.95% and that of both, 1.17% (p < 0.05). It was concluded that the overall prevalence of denials in the studied sample was low. Administrative denials were the most prevalent. This type of denial could be reduced if all dental insurance providers had unified clinical and administrative protocols, and if dentists submitted all of the required documentation in accordance with these protocols29

Use of big data in the surveillance of veterinary diseases: early detection of tick paralysis in companion animals

Background: Tick paralysis, resultant from envenomation by the scrub-tick Ixodes holocyclus, is a serious threat for small companion animals in the eastern coast of Australia. We hypothesise that surveillance systems that are built on Internet search queries may provide a more timely indication of high-risk periods more effectively than current approaches. Methods: Monthly tick paralysis notifications in dogs and cats across Australia and the states of Queensland (QLD) and New South Wales (NSW) were retrieved from Disease WatchDog surveillance system for the period 2011-2013. Internet search terms related to tick paralysis in small companion animals were identified using Google Correlate, and corresponding search frequency metrics were downloaded from Google Trends. Spearman's rank correlations and time series cross correlations were performed to assess which Google search terms lead or are synchronous with tick paralysis notifications. Results: Metrics data were available for 24 relevant search terms at national level, 16 for QLD and 18 for NSW, and they were all significantly correlated with tick paralysis notifications (P < 0.05). Among those terms, 70.8, 56.3 and 50 % showed strong Spearman's correlations, at national level, for QLD, and for NSW respectively, and cross correlation analyses identified searches which lead notifications at national or state levels. Conclusion: This study demonstrates that Internet search metrics can be used to monitor the occurrence of tick paralysis in companion animals, which would facilitate early detection of high-risk periods for tick paralysis cases. This study constitutes the first application of the rapidly emerging field of Internet-based surveillance to veterinary science

Efectos de la administración neonatal de zeranol sobre testículos de terneros y peso corporal

To determine if zeranol neonatal implants (NI) produce testes alterations the same way as the estrogenic hormones,20 male Abeerden Angus calves were used divided in two gruops of equal number. The implanted group (IG) received a 24 mg zeranol NI while the control group (CG) did not get any treatment. The animals were weighed at birth and at 8 months of age, when they were castrated. The body weight gain between the IG was compared and testicular development difference between both groups was estimated through testes weight. A decrease of testes development (p0.001) and an increase in body weight gain (p0.10) were found in the IG regarding the CG. It is concluded that zeranol NI upon the testes and body gain, produces a similar effect to that of the estrogenic gonad hormonesPara determinar si los implantes neonatales (IN) de zeranol producen alteracioneste sticulares al igual que las hormonas estrogénicas se utilizaron 20 terneros machos Aberdeen Angus divididos en dos grupos de igual número. El Grupo Implantado (GI) recibió un IN de 24 mg de zeranol mientras que el Grupo Testigo (GT) no recibió ningún tratamiento. Los animales fueron pesados al nacimiento y a los 8 meses de edad, momento en que fueron castrados. Se comparó la ganancia de peso corporal entre el GI y el GT y se estimó la diferencia del desarrollo testicular entre ambos grupos a través del peso de los testículos. Se encontró una disminución del desarrollo testicular (p&lt;0,001) y un aumento de la ganancia de peso corporal (p&lt;0,10) en el GI respecto al GT. Se concluye que el IN de zeranol produce sobre los testículos y la ganancia de peso corporal un efecto similar a la aplicaciónn eonatald e las hormonal gonadalese strogénica