Towards uncertainty mapping in air-quality modelling and assessment

The aim of this paper is to promote the use of uncertainty mapping when spatial assessments of air quality are made. A large number of air quality maps are produced for scientific and policy purposes but rarely are corresponding maps of their uncertainty included. The need for such maps and the methods to produce them are described. Several uncertainty parameters are discussed but it is recommended to use the probability density function as the basis of the uncertainty estimates. Several examples are provided discussing indicative uncertainty, ensemble methods, comparisons with observations, spatial representativeness, uncertainty in exceedances and probability of exceedance.publishe

High CD56++CD16- natural killer (NK) cells among suboptimal immune responders after four years of suppressive antiretroviral therapy in an African adult HIV treatment cohort

BACKGROUND: Up to 40% of HIV-infected individuals receiving Highly Active Antiretroviral Therapy (HAART) have poor CD4+ T-cell recovery. The role of natural killer (NK) cells in immune recovery during HAART is not well understood. We described the profiles of NK cell subsets and their expression of activating receptor, NKG2D and cytotoxicity receptor NKp46 among suboptimal immune responders to despite four years of suppressive HAART. METHODS: A case control study utilized frozen peripheral blood mononuclear cells (PBMC) from a cohort of HIV-infected adults that initiated HAART in 2004/5, at CD4 < 200 cells/μl. Cases were ‘suboptimal’ responders; patients within the lowest quartile of CD4+ T-cell reconstitution, with a median CD4 count increase of 129 (-43-199) cells/μl (difference between CD4 count at baseline and after 4 years of HAART) and controls were ‘super-optimal’ responders; patients within the highest quartile of CD4 T-cell reconstitution with a median CD4 count increase of 528 (416-878) cells/μl). Expression of NK cell lineage markers (CD56(+/-)CD16(+/-)) and receptors NKG2D and NKp46, was measured among PBMC from 29 cases of ‘suboptimal’ responders’ and 23 controls of ‘super-optimal responders’, and compared among ‘suboptimal’ and ‘super-optimal’ responders. NK cell populations were compared using the Holm Sidak multiple comparison test and p values < 0.05 were considered statistically significant. Data was analyzed using FLOWJO and GraphPad Prism 6. RESULTS: ‘Suboptimal responders’ had a higher proportion of cytokine producing CD56(++)CD16(+/-) (CD56(bri)) NK cells than the ‘super-optimal responders’ p = 0.017, and CD56(neg) NK cells were lower among suboptimal than super-optimal responders (p = 0.007). The largest NK cell subset, CD56(dim), was comparable among suboptimal responders and ‘super-optimal immune responders’. Expression of NKG2D and NKp46 receptors on NK cell subsets (CD56(bri), CD56(neg) and CD56(dim)), was comparable among ‘suboptimal’ and ‘super-optimal’ immune responders. CONCLUSIONS: The pro-inflammatory CD56(++)CD16(--) NK cells were higher among ‘suboptimal’ responders relative to ‘super-optimal’ responders, despite four years of suppressive HAART. Alteration of NK cell populations could inhibit host immune responses to infections among suboptimal responders. We recommend further analysis of NK cell function among suboptimal immune responders in order to inform targeted interventions to optimize immune recovery among HAART-treated adults

Centimeter to decimeter hollow concretions and voids in Gale Crater sediments, Mars

Voids and hollow spheroids between ∼1 and 23 cm in diameter occur at several locations along the traverse of the Curiosity rover in Gale crater, Mars. These hollow spherical features are significantly different from anything observed in previous landed missions. The voids appear in dark-toned, rough-textured outcrops, most notably at Point Lake (sols 302-305) and Twin Cairns Island (sol 343). Point Lake displays both voids and cemented spheroids in close proximity; other locations show one or the other form. The spheroids have 1-4 mm thick walls and appear relatively dark-toned in all cases, some with a reddish hue. Only one hollow spheroid (Winnipesaukee, sol 653) was analyzed for composition, appearing mafic (Fe-rich), in contrast to the relatively felsic host rock. The interior surface of the spheroid appears to have a similar composition to the exterior with the possible exceptions of being more hydrated and slightly depleted in Fe and K. Origins of the spheroids as Martian tektites or volcanic bombs appear unlikely due to their hollow and relatively fragile nature and the absence of in-place clearly igneous rocks. A more likely explanation to both the voids and the hollow spheroids is reaction of reduced iron with oxidizing groundwater followed by some re-precipitation as cemented rind concretions at a chemical reaction front. Although some terrestrial concretion analogs are produced from a precursor siderite or pyrite, diagenetic minerals could also be direct precipitates for other terrestrial concretions. The Gale sediments differ from terrestrial sandstones in their high initial iron content, perhaps facilitating a higher occurrence of such diagenetic reactions

Effect of different processing conditions on proximate and bioactive contents of Solanum aethiopicum (Shum) powders, and acceptability for cottage scale production

The purpose of this study was to investigate the effects of different processing conditions for production of dried Solanum aethiopicum (S.) leaf powder by comparing solar drying and cabinet drying processing techniques. Four (4) pre-treatments were done on S. aethiopicum leaves to inhibit enzyme action and prolong storage life. Treatments included dipping in; 10% saline solution, 10% vinegar solution, water (as the control), and steam blanching; done for both whole and sliced S. aethiopicum leaves. Each of the resultant samples were dried in both solar and cabinet dryers for a period of 24 hours. The dried leaf samples were grounded into powder using a coffee grinder and subjected to different laboratory analyses including; catalase activity, moisture content, vitamin C retention capacity and phytate content analyses. The results obtained were analysed using MINITAB version 16.0 at 5% significance level. The results showed that there was a reduction in catalase activity after pre-treatment and drying from 5.0±0.0 cm3 for the fresh un-treated leaves to a range of 4.5±0.7 – 3.0±0.0 cm3 for whole solar dried; 4.5±0.7-4.0±0.0 cm3 for sliced solar dried; 4.0±0.0 - 3.0±0.0 cm3 for whole cabinet dried and 3.5±0.7-2.3±0.7 cm3 for sliced cabinet dried leaf powder. Solar dried S. aethiopicum leaf powder contained significantly high moisture content than hot air cabinet dried one (24.9±0.5 % for saline treated sliced leaves to 8.9±0.8 % for blanched sliced leaves, than hot air cabinet dried one with 9.3±0.0 % for sliced plain water treated leaves to 7.0±0.2 % for sliced vinegar treated leaves; respectively). Cabinet dried S. aethiopicum contained significantly more vitamin C content (1.1±0.2 mg for whole blanched leaves compared to 0.6±0.1 mg for sliced vinegar treated leaves) than the solar dried one (1.0±0.2 mg for sliced plain water treated leaves to 0.6±0.1 mg for sliced vinegar treated leaves). There was no significant difference in phytate content between the hot air cabinet dried and solar dried i.e. 0.7±0.1 - 0.2±0.1 mg for solar and 0.7±0.1 - 0.3±0.3 mg for cabinet dried. Solar dried S. aethiopicum powder contained significantly higher catalase than the hot air cabinet dried one (4.5±0.7 - 3.0±0.0 and 4.0±0.0 - 2.5±0.7 cm3; respectively). However, in terms of acceptability, there was high preference for saline treated leaf powder soups compared to other soups. It can be concluded that High activity of catalase, moisture retention and high loss of Vit.C occurs in the solar drier than in cabinet drier. Whole leaf saline pretreated leaf powder soup is rated high compared to other dried soups. Therefore, the best method for production of dried S. aethiopicum powder is by slicing, dipping it in plain water and drying using a cabinet dryer. Under circumstances where cabinet drying is not achievable, solar drying is recommended using whole leaf, pretreated with saline water to promote preservation and consumption of the vegetable

Neonatal cranial ultrasound abnormalities in LBW infants: Relation to cognitive outcomes at age six

bjective: To assess the independent relation of neonatal cranial ultrasound (US) abnormalities in low birth weight (LBW) infants to cognitive outcomes at 6 years of age.Design: Prospective cohort study.Sample and Methods: Six-year follow-up data were obtained on a regional birth cohort of LBW infants (\u3c 2 kg) systematically screened as neonates with serial US. US abnormalities were dichotomized into isolated germinal matrix/intraventricular hemorrhage (GM/IVH) and parenchymal lesions/ventricular enlargement (PL/VE). Global cognitive outcomes (mental retardation, borderline intelligence, and normal intelligence) and selected specific cognitive abilities were assessed at 6 years of age with standardized instruments. Multivariate techniques were used to assess the effects of US independent of maternal social disadvantage at birth and other perinatal and neonatal risk factors.Results: The sample as a whole had a significantly elevated rate of mental retardation (MR; 5%), almost all moderate to profound in severity. PL/VE was independently related to MR (odds ratio [OR], 65.8; confidence interval [CI], 19.1 to 22.4) and borderline intelligence (OR, 3.7; CI, 1.3 to 10.8); isolated GM/IVH was more modestly related to MR (OR, 4.6; CI, 1.2 to 18.6) but not related to borderline intelligence. Approximately half of the cases of MR were attributable to PL/VE independent of other factors. Of non-US factors, the number of days receiving mechanical ventilation increased the risk for MR. Maternal social disadvantage increased the risk for borderline intelligence but not MR. Among children of normal intelligence, those with PL/VE, but not isolated GM/IVH, performed more poorly than those without US abnormalities on tests of visual perceptual organization but not on tests of language, memory, or quantitative skills.Conclusion: Prevention of white matter injury would substantially improve cognitive outcomes for LBW infants

Intravenous artesunate plus Artemisnin based Combination Therapy (ACT) or intravenous quinine plus ACT for treatment of severe malaria in Ugandan children: a randomized controlled clinical trial.

BACKGROUND: Severe malaria is a medical emergency associated with high mortality. Adequate treatment requires initial parenteral therapy for fast parasite clearance followed by longer acting oral antimalarial drugs for cure and prevention of recrudescence. METHODS: In a randomized controlled clinical trial, we evaluated the 42-day parasitological outcomes of severe malaria treatment with intravenous artesunate (AS) or intravenous quinine (QNN) followed by oral artemisinin based combination therapy (ACT) in children living in a high malaria transmission setting in Eastern Uganda. RESULTS: We enrolled 300 participants and all were included in the intention to treat analysis. Baseline characteristics were similar across treatment arms. The median and interquartile range for number of days from baseline to parasite clearance was significantly lower among participants who received intravenous AS (2 (1-2) vs 3 (2-3), P < 0.001). Overall, 63.3% (178/281) of the participants had unadjusted parasitological treatment failure over the 42-day follow-up period. Molecular genotyping to distinguish re-infection from recrudescence was performed in a sample of 127 of the 178 participants, of whom majority 93 (73.2%) had re-infection and 34 (26.8%) had recrudescence. The 42 day risk of recrudescence did not differ with ACT administered. Adverse events were of mild to moderate severity and consistent with malaria symptoms. CONCLUSION: In this high transmission setting, we observed adequate initial treatment outcomes followed by very high rates of malaria re-infection post severe malaria treatment. The impact of recurrent antimalarial treatment on the long term efficacy of antimalarial regimens needs to be investigated and surveillance mechanisms for resistance markers established since recurrent malaria infections are likely to be exposed to sub-therapeutic drug concentrations. More strategies for prevention of recurrent malaria infections in the most at risk populations are needed. TRIAL REGISTRATION: The study was registered with the Pan African Clinical Trial Registry ( PACTR201110000321348 )

Appropriateness of clinical severity classification of new WHO childhood pneumonia guidance : a multi-hospital, retrospective, cohort study

Background: Management of pneumonia in many low-income and middle-income countries is based on WHO guidelines that classify children according to clinical signs that define thresholds of risk. We aimed to establish whether some children categorised as eligible for outpatient treatment might have a risk of death warranting their treatment in hospital. Methods: We did a retrospective cohort study of children aged 2–59 months admitted to one of 14 hospitals in Kenya with pneumonia between March 1, 2014, and Feb 29, 2016, before revised WHO pneumonia guidelines were adopted in the country. We modelled associations with inpatient mortality using logistic regression and calculated absolute risks of mortality for presenting clinical features among children who would, as part of revised WHO pneumonia guidelines, be eligible for outpatient treatment (non-severe pneumonia). Findings: We assessed 16 162 children who were admitted to hospital in this period. 832 (5%) of 16 031 children died. Among groups defined according to new WHO guidelines, 321 (3%) of 11 788 patients with non-severe pneumonia died compared with 488 (14%) of 3434 patients with severe pneumonia. Three characteristics were strongly associated with death of children retrospectively classified as having non-severe pneumonia: severe pallor (adjusted risk ratio 5·9, 95% CI 5·1–6·8), mild to moderate pallor (3·4, 3·0–3·8), and weight-for-age Z score (WAZ) less than −3 SD (3·8, 3·4–4·3). Additional factors that were independently associated with death were: WAZ less than −2 to −3 SD, age younger than 12 months, lower chest wall indrawing, respiratory rate of 70 breaths per min or more, female sex, admission to hospital in a malaria endemic region, moderate dehydration, and an axillary temperature of 39°C or more. Interpretation: In settings of high mortality, WAZ less than −3 SD or any degree of pallor among children with non-severe pneumonia was associated with a clinically important risk of death. Our data suggest that admission to hospital should not be denied to children with these signs and we urge clinicians to consider these risk factors in addition to WHO criteria in their decision making