Investing in breastfeeding – the world breastfeeding costing initiative

BACKGROUND Despite scientific evidence substantiating the importance of breastfeeding in child survival and development and its economic benefits, assessments show gaps in many countries' implementation of the 2003 WHO and UNICEF Global Strategy for Infant and Young Child Feeding (Global Strategy). Optimal breastfeeding is a particular example: initiation of breastfeeding within the first hour of birth, exclusive breastfeeding for the first six months; and continued breastfeeding for two years or more, together with safe, adequate, appropriate, responsive complementary feeding starting in the sixth month. While the understanding of "optimal" may vary among countries, there is a need for governments to facilitate an enabling environment for women to achieve optimal breastfeeding. Lack of financial resources for key programs is a major impediment, making economic perspectives important for implementation. Globally, while achieving optimal breastfeeding could prevent more than 800,000 under five deaths annually, in 2013, US$58 billion was spent on commercial baby food including milk formula. Support for improved breastfeeding is inadequately prioritized by policy and practice internationally. METHODS The World Breastfeeding Costing Initiative (WBCi) launched in 2013, attempts to determine the financial investment that is necessary to implement the Global Strategy, and to introduce a tool to estimate the costs for individual countries. The article presents detailed cost estimates for implementing the Global Strategy, and outlines the WBCi Financial Planning Tool. Estimates use demographic data from UNICEF's State of the World's Children 2013. RESULTS The WBCi takes a programmatic approach to scaling up interventions, including policy and planning, health and nutrition care systems, community services and mother support, media promotion, maternity protection, WHO International Code of Marketing of Breastmilk Substitutes implementation, monitoring and research, for optimal breastfeeding practices. The financial cost of a program to implement the Global Strategy in 214 countries is estimated at US$17.5 billion ($130 per live birth). The major recurring cost is maternity entitlements. CONCLUSIONS WBCi is a policy advocacy initiative to encourage integrated actions that enable breastfeeding. WBCi will help countries plan and prioritize actions and budget them accurately. International agencies and donors can also use the tool to calculate or track investments in breastfeeding.The project was possible through financial support from SAFANSI (South Asia Food and Nutrition Security Initiative) project and a contribution by DFID (Department for International Development) and AusAID (Australian Agency for International Development)

A Study of Noon F2 Ionization in Relation to Geomagnetic Co-ordinates

The relation of F2 layer noon critical frequency with magnetic dip and geomagnetic latitude is studied for constant values of solar zenithal angle. The constant-x plots show two maxima situated on the two sides of the magnetic equator. An asymmetry between the northern and southern hemispheres is also revealed. For chosen values of solar zenith distance the ratio of noon fF2 at sunspot maximum to that at sunspot minimum is studied in relation to magnetic dip. The ratio is found to vary with magnetic dip displaying a minimum to the north of the magnetic equator

Phantom energy supported wormhole model in f(R, T)f(R,\,T) gravity assuming conformal motion

In this article, we have discussed Morris and Thorne (MT) wormhole solutions in a modified theory of gravity that admits conformal motion. Here we explore the wormhole solutions in $f(R,\,T)$ gravity, which is a function of the Ricci scalar ($R$) and the trace of the stress-energy tensor ($T$). To study wormhole geometries, we make assumption of spherical symmetric static spacetime and the existence of conformal Killing symmetry to get more acceptable astrophysical outcomes. To do this, we choose the expression of $f(R,\,T)$ as $f(R,T)= R+2 \gamma T$. Here we employ the phantom energy EoS relating to radial pressure and density given by $p_r=\omega \rho$ with $\omega<-1$ to constrain our model. Following a discussion of wormhole geometry and behavior of shape function, the study moves on to the computation of proper radial distance, active mass function, the nature of total gravitational energy and a discussion on the violation of energy conditions. We have shown that the wormhole solutions exist for positive as well as negative values of the coupling constant $\gamma$. From our analysis we see that no wormhole solution exists for $\gamma =-4\pi,\,-\pi(3+\omega)$. All the physical parameters have been drawn by employing the values of $\gamma$ as $\gamma=-0.3,\,-0.2,\,-0.1,\,0,\,0.1$ and $0.2$, where $\gamma=0$ corresponds to general relativity (GR) case. It is found that for our proposed model, a realistic wormhole solutions satisfying all the properties can be obtained.Comment: Accepted in International Journal of Modern Physics D on 23 November 2021; 15 Pages, 8 Figure

Relativistic compact stars in Tolman spacetime via an anisotropic approach

In this present work, we have obtained a singularity-free spherically symmetric stellar model with anisotropic pressure in the background of Einstein's general theory of relativity. The Einstein's field equations have been solved by exploiting Tolman {\em ansatz} [Richard C Tolman, Phys. Rev. 55:364, 1939] in $(3+1)$-dimensional space-time. Using observed values of mass and radius of the compact star PSR J1903+327, we have calculated the numerical values of all the constants from the boundary conditions. All the physical characteristics of the proposed model have been discussed both analytically and graphically. The new exact solution satisfies all the physical criteria for a realistic compact star. The matter variables are regular and well behaved throughout the stellar structure. Constraints on model parameters have been obtained. All the energy conditions are verified with the help of graphical representation. The stability condition of the present model has been described through different testings.Comment: 18 Pages, 8 Figures, Accepted in European Physical Journal C on 12.06.202

Probing pre-formed alpha particles in the ground state of nuclei

In this Letter, we report on alpha particle emission through the nuclear break-up in the reaction 40Ca on a 40Ca target at 50A MeV. It is observed that, similarly to nucleons, alpha particles can be emitted to the continuum with very specific angular distribution during the reaction. The alpha particle properties can be understood as resulting from an alpha cluster in the daughter nucleus that is perturbed by the short range nuclear attraction of the collision partner and emitted. A time-dependent theory that describe the alpha particle wave-function evolution is able to reproduce qualitatively the observed angular distribution. This mechanism offers new possibilities to study alpha particle properties in the nuclear medium.Comment: 4 pages, 3 figure

Assessment of a conduction-repolarisation metric to predict Arrhythmogenesis in right ventricular disorders

Background: The re-entry vulnerability index (RVI) is a recently proposed activation-repolarization metric designed to quantify tissue susceptibility to re-entry. This study aimed to test feasibility of an RVI-based algorithm to predict the earliest endocardial activation site of ventricular tachycardia (VT) during electrophysiological studies and occurrence of haemodynamically significant ventricular arrhythmias in follow-up. Methods: Patients with Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) (n = 11), Brugada Syndrome (BrS) (n = 13) and focal RV outflow tract VT (n = 9) underwent programmed stimulation with unipolar electrograms recorded from a non-contact array in the RV. Results: Lowest values of RVI co-localised with VT earliest activation site in ARVC/BrS but not in focal VT. The distance between region of lowest RVI and site of VT earliest site (D min ) was lower in ARVC/BrS than in focal VT (6.8 ± 6.7 mm vs 26.9 ± 13.3 mm, p = 0.005). ARVC/BrS patients with inducible VT had lower Global-RVI (RVI G ) than those who were non-inducible (−54.9 ± 13.0 ms vs −35.9 ± 8.6 ms, p = 0.005) or those with focal VT (−30.6 ± 11.5 ms, p = 0.001). Patients were followed up for 112 ± 19 months. Those with clinical VT events had lower Global-RVI than both ARVC and BrS patients without VT (−54.5 ± 13.5 ms vs −36.2 ± 8.8 ms, p = 0.007) and focal VT patients (−30.6 ± 11.5 ms, p = 0.002). Conclusions: RVI reliably identifies the earliest RV endocardial activation site of VT in BrS and ARVC but not focal ventricular arrhythmias and predicts the incidence of haemodynamically significant arrhythmias. Therefore, RVI may be of value in predicting VT exit sites and hence targeting of re-entrant arrhythmias

Autonomic modulation of the electrical substrate in mice haploinsufficient for cardiac sodium channels: a model of the Brugada syndrome

British Heart Foundation (RG/15/15/31742)NIHR Biomedical Research Centre at Bart

Knowledge and competency standards for specialized cognitive behavior therapy for adult obsessive-compulsive disorder

Obsessive-Compulsive Disorder (OCD) is a leading cause of disability world-wide (World Health Organization, 2008). Treatment of OCD is a specialized field whose aim is recovery from illness for as many patients as possible. The evidence-based psychotherapeutic treatment for OCD is specialized cognitive behavior therapy (CBT, NICE, 2005, Koran and Simpson, 2013). However, these treatments are not accessible to many sufferers around the world. Currently available guidelines for care are deemed to be essential but insufficient because of highly variable clinician knowledge and competencies specific to OCD. The phase two mandate of the 14 nation International OCD Accreditation Task Force (ATF) created by the Canadian Institute for Obsessive Compulsive Disorders is development of knowledge and competency standards for specialized treatments for OCD through the lifespan deemed by experts to be foundational to transformative change in this field. This paper presents knowledge and competency standards for specialized CBT for adult OCD developed to inform, advance, and offer a model for clinical practice and training for OCD. During upcoming ATF phases three and four criteria and processes for training in specialized treatments for OCD through the lifespan for certification (individuals) and accreditation (sites) will be developed based on the ATF standards

Pharmacological Modulation of Right Ventricular Endocardial-Epicardial Gradients in Brugada Syndrome.

Background We explored the hypothesis that increased cholinergic tone exerts its proarrhythmic effects in Brugada syndrome (BrS) through increasing dispersion of transmural repolarization in patients with spontaneous and drug-induced BrS. Methods BrS and supraventricular tachycardia patients were studied after deploying an Ensite Array in the right ventricular outflow tract and a Cardima catheter in the great cardiac vein to record endo and epicardial signals, respectively. S1-S2 restitution curves from the right ventricular apex were conducted at baseline and after edrophonium challenge to promote increased cholinergic tone. The local unipolar electrograms were then analyzed to study transmural conduction and repolarization dynamics. Results The study included 8 BrS patients (5 men:3 women; mean age, 56 years) and 8 controls patients with supraventricular tachycardia (5 men:3 women; mean age, 48 years). Electrophysiological studies in controls demonstrated shorter endocardial than epicardial right ventricular activation times (mean difference: 26 ms; P<0.001). In contrast, patients with BrS showed longer endocardial than epicardial activation time (mean difference: -15 ms; P=0.001). BrS hearts, compared with controls, showed significantly larger transmural gradients in their activation recovery intervals (mean intervals, 20.5 versus 3.5 ms; P<0.01), with longer endocardial than epicardial activation recovery intervals. Edrophonium challenge increased such gradients in both controls (to a mean of 16 ms [ P<0.001]) and BrS (to 29.7 ms; P<0.001). However, these were attributable to epicardial and endocardial activation recovery interval prolongations in control and BrS hearts, respectively. Dynamic changes in repolarization gradients were also observed across the BrS right ventricular wall in BrS. Conclusions Differential contributions of conduction and repolarization were identified in BrS which critically modulated transmural dispersion of repolarization with significant cholinergic effects only identified in the patients with BrS. This has important implications for explaining the proarrhythmic effects of increased vagal tone in BrS, as well as evaluating autonomic modulation and epicardial ablation as therapeutic strategies.Dr Bhar-Amato was funded by a Heart Research UK Fellowship. Dr Orini is funded by a Marie Curie Fellowship. D. Santos funded by a Medical Research Council industrial Collaborative Awards in Science and Engineering Studentship. Dr Lambiase is supported by University College London Hospitals Biomedicine National Institute for Health Research & Stephen Lyness Memorial Fund. Dr Huang funded by the British Heart Foundatio

Molecular architecture of a dynamin adaptor: implications for assembly of mitochondrial fission complexes

Structural and functional studies of the Mdv1 dimer reveal how this mitochondria-associated adaptor protein orients and stabilizes the assembly of dynamins on membranes to promote mitochondrial fission