MUAC as the sole discharge criterion from community‐based management of severe acute malnutrition in Burkina Faso

The use of mid upper arm circumference (MUAC) measurement to screen and determine eligibility for admission to therapeutic feeding programs has been established, but evidence and programmatic experience to inform guidance on the use of MUAC as a discharge criterion is limited. We present results from a large‐scale nutritional program using MUAC for admission and discharge and compare program outcomes and response to treatment when determining eligibility for discharge by proportional weight gain versus discharge by MUAC. The study population included all children admitted to the Ministry of Health therapeutic feeding program supported by Médecins Sans Frontières in northern Burkina Faso from September 2007 to December 2011 (n = 50,841). Recovery was high overall using both discharge criteria, with low risks of death, nonresponse, and transfer to inpatient care and high daily gains in weight, MUAC, weight‐for‐height Z score, and height. When discharge was made by MUAC only, recovery increased, while all adverse program outcomes and length of stay decreased, with increasing MUAC on admission. MUAC‐based programming, where MUAC is integrated into program screening, admission, and discharge, is one of several new approaches that can be used to target resources to the most at‐risk malnourished children and improve program efficiency and coherency. This analysis provides additional programmatic experience on the use of MUAC‐based discharge criterion, but more work may be needed to inform optimal discharge thresholds across settings

Physical and Optical Properties of Poly(3-AlkylThiophene) with a View to the Fabrication of a Highly Nonlinear Waveguide

Publisher: Bentham (ISSN: 1874-088X)International audienceIn order to take advantage of the very high nonlinear susceptibility of conjugated polymer materials, Poly(3-AlkylThiophene)s, P3AT, were synthesized in the laboratory. The physical, thermomechanical and linear optical propertiesof synthesized P3AT have been investigated and the first experimental attempts at creating nonlinear optical waveguides and determining their characteristics are presented. After synthesizing P3AT, the relationships between polymer chain characteristics and mechanical properties are investigated to see if the polymer is suitable for optical waveguide process technology. We also examine the optical attenuation of the synthesized material, a crucial factor in anticipating the relative opacity of the future component. For the first time we present the absorption spectrum of 3-Octylthiophenemolecules in the Near Infra-Red (NIR) region that suggests optical losses for the material are about 0.6 dB.cm-1 at 1550 nm. Next we examined several waveguide structures such as ridge, buried and Strip Loaded WaveGuides (SLWG) based on P3AT material. For the buried waveguides, we have observed the signal transmission and in our opinion the low optical transmission of P3AT ridge and SLWG could be attributed to extrinsic losses (mainly scattering) due to both the remaining insoluble products in the polymer and to the poor adhesion between optical layers

Health challenges of the Pacific Region: insights from history, geography, social determinants, genetics, and the microbiome

The Pacific region, also referred to as Oceania, is a geographically widespread region populated by people of diverse cultures and ethnicities. Indigenous people in the region (Melanesians, Polynesians, Micronesians, Papuans, and Indigenous Australians) are over-represented on national, regional, and global scales for the burden of infectious and non-communicable diseases. Although social and environmental factors such as poverty, education, and access to health-care are assumed to be major drivers of this disease burden, there is also developing evidence that genetic and microbiotic factors should also be considered. To date, studies investigating genetic and/or microbiotic links with vulnerabilities to infectious and non-communicable diseases have mostly focused on populations in Europe, Asia, and USA, with uncertain associations for other populations such as indigenous communities in Oceania. Recent developments in personalized medicine have shown that identifying ethnicity-linked genetic vulnerabilities can be important for medical management. Although our understanding of the impacts of the gut microbiome on health is still in the early stages, it is likely that equivalent vulnerabilities will also be identified through the interaction between gut microbiome composition and function with pathogens and the host immune system. As rapid economic, dietary, and cultural changes occur throughout Oceania it becomes increasingly important that further research is conducted within indigenous populations to address the double burden of high rates of infectious diseases and rapidly rising non-communicable diseases so that comprehensive development goals can be planned. In this article, we review the current knowledge on the impact of nutrition, genetics, and the gut microbiome on infectious diseases in indigenous people of the Pacific region

In-hospital safety in field conditions of Nifurtimox Eflornithine Combination Therapy (NECT) for T. B. Gambiense Sleeping Sickness

Trypanosoma brucei (T.b.) gambiense Human African trypanosomiasis (HAT; sleeping sickness) is a fatal disease. Until 2009, available treatments for 2(nd) stage HAT were complicated to use, expensive (eflornithine monotherapy), or toxic, and insufficiently effective in certain areas (melarsoprol). Recently, nifurtimox-eflornithine combination therapy (NECT) demonstrated good safety and efficacy in a randomised controlled trial (RCT) and was added to the World Health Organisation (WHO) essential medicines list (EML). Documentation of its safety profile in field conditions will support its wider use

Investigation of optimum wavelength converter based on nonlinear polarisation rotation in a bulk SOA

This work is focused on understanding and optimising the physical mechanisms responsible for wavelength conversion based on cross-polarisation modulation (XPolM) in a bulk semiconductor optical amplifier. A comparison is made between the conversion performance that can be achieved with cross-gain modulation (XGM) and XPolM in co- and counter-propagation configurations. Wavelength independent conversion can be achieved when nonlinear polarisation rotation and XGM effects are balanced in the case of non-inverted wavelength conversion

Increased autophagy-related 5 gene expression is associated with collagen expression in the airways of refractory asthmatics

Background: Fibrosis, particularly excessive collagen deposition, presents a challenge for treating asthmatic individuals. At present, no drugs can remove or reduce excessive collagen in asthmatic airways. Hence, the identification of pathways involved in collagen deposition would help to generate therapeutic targets to interfere with the airway remodeling process. Autophagy, a cellular degradation process, has been shown to be dysregulated in various fibrotic diseases, and genetic association studies in independent human populations have identified autophagy-related 5 (ATG5) to be associated with asthma pathogenesis. Hence, the dysregulation of autophagy may contribute to fibrosis in asthmatic airways. Objective: This study aimed to determine if (1) collagen deposition in asthmatic airways is associated with ATG5 expression and (2) ATG5 protein expression is associated with asthma per se and severity. Methods: Gene expression of transforming growth factor beta 1, various asthma-related collagen types [collagen, type I, alpha 1; collagen, type II, alpha 1; collagen, type III, alpha 1; collagen, type V, alpha 1 (COL5A1) and collagen, type V, alpha 2], and ATG5 were measured using mRNA isolated from bronchial biopsies of refractory asthmatic subjects and assessed for pairwise associations. Protein expression of ATG5 in the airways was measured and associations were assessed for asthma per se, severity, and lung function. Main results: In refractory asthmatic individuals, gene expression of ATG5 was positively associated with COL5A1 in the airways. No association was detected between ATG5 protein expression and asthma per se, severity, and lung function. Conclusion and clinical relevance: Positive correlation between the gene expression patterns of ATG5 and COL5A1 suggests that dysregulated autophagy may contribute to subepithelial fibrosis in the airways of refractory asthmatic individuals. This finding highlights the therapeutic potential of ATG5 in ameliorating airway remodeling in the difficult-to-treat refractory asthmatic individuals

Experimental investigation of polarisation rotation in semiconductor optical amplifiers

An experimental study of polarisation rotation in a semiconductor optical amplifier is presented. Two techniques are used to investigate the gain and birefringence along the two eigenmodes of the component waveguide, with and without injection. The first investigation is based on the residual reflectivity of the facet mirrors. From the modulation depth of polarisation resolved spectra, the gain and the refractive indices of these modes are determined. The second investigation takes into account the variation of the eigenmode gain and refractive indices as a function of injected power over the range 83.3 to 413 mW. The results of these two experiments are compared, and it is determined that the refractive index and the single-pass gain along the horizontal axis of the waveguide are higher than those along the vertical axis. Both gain and refractive index differences increase as a function of injected power in the sample under test. Furthermore, it is concluded that polarisation rotation in this component is heavily influenced by the power dependence of the relative gain in the TE and TM modes and birefringence