The Long Term Impact of Micronutrient Supplementation during Infancy on Cognition and Executive Function Performance in Pre-School Children

Brain growth and development are critically dependent on several micronutrients. During early development cellular activity may be sensitive to micronutrient deficiencies, however the evidence from human studies is equivocal. The objective of this study was to examine the long-term cognitive and social-emotional effects of multiple micronutrient supplementation compared with iron supplementation alone, administered during infancy. This study was a follow-up to an initial randomized, double-blind controlled trial (RCT) in 2010 in which 902 infants, aged 6-17 months, from Lima, Peru, were given daily supplements of either iron (Fe) or multiple micronutrients (MMN) including zinc (451 in each group). The supplementation period for both groups was six months. In 2012, a subsample of 184 children from the original cohort (now aged 36-48 months) was randomly selected to participate in a follow-up trial and was assessed for intelligence, working memory, inhibition, and executive function. The tests showed no significant differences between the supplementation groups though there were some gender differences, with girls displaying higher scores than boys across both groups on the Wechsler Preschool and Primary Scale of Intelligence (WPPSI) Verbal IQ sentences subtest, the Day-Night cognitive test and on the Brief Infant-Toddler Social Emotional Assessment (BITSEA) social competency, and boys scoring higher than girls in problem behaviour. The results indicate that MMN supplementation had no long term additional effects on cognitive function compared with iron supplementation alone. The timing of supplement administration for maximum impact on a child's cognitive development requires further investigation

High-Temperature Nuclear Power Cycle Using Either Helium or s-CO2

The goal of this process was to model the helium-based modular, nuclear reactor power cycle after the existing MIT Pebble-Bed Nuclear Reactor Power Cycle (Kadak, 2005), and to improve on the design by changing the working fluid to supercritical carbon dioxide (s-CO2). The power output of the process as specified in the problem statement, provided by Adam Brostow, was 120 MW. S-CO2 is a much denser fluid, and should theoretically require smaller equipment sizes, making it the more economically viable option for this process. However, it was found that with a return on investment (ROI) of -2.13% and a net present value (NPV) of -$489 million, this process was not economically feasible, due to the high temperatures, pressures, and flow rates required. This process had an electrical output of 118 MW, while the helium met the design condition of 120 MW. The helium process had a ROI of 11$241 million. For this reason, helium is recommended as the working fluid for a nuclear reactor power cycle of this magnitude

Effects of a nutrition education programme in stage IV cardiac rehabilitation patients: a 3-arm randomized controlled trial.

This trial examined the influence of two nutrition intervention programmes on health-related and nutritional intake indices pertinent to cardiovascular disease compared to Usual care in stage IV cardiac rehabilitation patients. Sixty-six patients were recruited from Heartbeat North-West cardiac rehabilitation centre in Preston (United Kingdom). Patients were randomly assigned to Usual care, Biggest loser or Nutrition education arms. Usual care undertook their usual two exercise classes per week without nutritional support, Biggest loser underwent weekly education sessions focussing on weight loss using the themes within the British Heart Foundation ‘so you want to lose weight for good’ guidelines and Nutrition education followed the same themes as Biggest loser but in a more focussed manner informed by patient focus groups. In total this was a 12-week trial in which patients spent 6-weeks engaged in their allocated intervention arm, after which all participants switched to Usual care. The primary outcome was systolic blood pressure, and secondary measures of anthropometric, blood biomarker, nutritional knowledge (via the Mediterranean Diet Assessment Tool) and nutritional intake indices were measured at baseline, 6-weeks, and 12-weeks (follow-up). Intention-to-treat analyses revealed no significant alterations in the primary outcome (Usual care: baseline=130.45mmHg, 6-weeks=127.83mmHg, and fol-low-up=126.35mmHg, Biggest loser: baseline=133.50mmHg, 6-weeks=123.06mmHg, and fol-low-up=135.22mmHg, or Nutrition education: baseline=135.23mmHg, 6-weeks=129.20mmHg, and follow-up=126.26mmHg) between arms. However, at 6-weeks, improvements in triglycerides were significantly greater in Usual care (baseline=1.61mmol/L and 6-weeks=1.43mmol/L) group compared to Nutrition education (baseline=1.70mmol/L and 6-weeks=2.21mmol/L). Improvements in nutrition knowledge were significantly greater in Nutrition education (baseline=8.48, 6-weeks=9.77, and follow-up=10.07) compared to Usual care (baseline=7.71, 6-weeks=8.00, and follow-up=8.00) and Biggest loser (baseline=7.71, 6-weeks=8.73, and follow-up=8.36). At 6-weeks, the Biggest loser group (baseline=4.75g and 6-weeks=3.83g) exhibited significantly greater improvements in salt intake compared to Usual care (baseline=4.87g and 6-weeks=4.28g) and Nutrition education (baseline=19.25g and 6-weeks=16.78g) in saturated fatty acids compared to Usual care (baseline=20.26g and 6-weeks=21.34g). This trial shows the effectiveness of nutritional interventions for improving nutritional knowledge and dietary practices in stage IV cardiac rehabilitation, but the mechanisms and longer-term effects of increased triglyceride levels in the Nutrition education group requires further exploration

Enhancement of HIV-1 infection and intestinal CD4+ T cell depletion ex vivo by gut microbes altered during chronic HIV-1 infection

Additional file 3: Table S2. Clinical Study Participant Characteristics

Reliability and Validity of the COPE Index among Caregivers of Hemodialysis Patients in Pakistan

Objective: To assess the reliability and validity of the COPE (Carers of Older People in Europe) index tool among the caregivers of dialysis-dependent patients in Pakistan. Study Design: Cross-sectional study. Place and Duration of Study: The study was conducted at the Dialysis Unit of Pakistan Kidney Patients Association Rawalpindi, Bahria International Hospital Rawalpindi and Fauji Foundation Hospital Rawalpindi, Pakistan, from December 2018 to January 2019. Methods: A 15-item COPE index questionnaire was administered, and data were collected from 124 caregivers of patients undergoing regular hemodialysis. A Principal Component Analysis (PCA) was performed on all items of the COPE index to retain the underlying components. Further, Cronbach's alpha was used to assess the internal consistency of the retained component structure and loadings obtained from the PCA and the entire instrument separately. Results: The PCA analysis revealed that, with the context of this study, the COPE index had good internal consistency for the negative aspects of caregiving and social support (Cronbach's alpha scores were 0.864 and 0.781, respectively). For the positive impact items, a Cronbach's alpha score of 0.655 indicated modest internal consistency. Cronbach's alpha of 0.714 for the entire 15 items indicated that the COPE index had good overall internal consistency in our study population. Conclusion: The COPE index was found to be a valid tool for use in Pakistan to assess the caregiver experience, including both positive and negative aspects of caregiving

The Importance of Cultural and Socioeconomic Context in Health Research Design--- Lessons Learnt from a Pilot Study in Pakistan

BACKGROUND AND OBJECTIVE: For many health outcomes, there are an array of published methods, however not all have been validated in the target population. So, it is better to first pilot the selected tools and research strategies thus can reduce cost, effort and time in a larger project. The objective of this study was to present the significance of the pilot study by using an example of an observational study in a tertiary care hospital in Pakistan. METHODOLOGY: This pilot study was carried out in a tertiary hospital located in Peshawar, Pakistan. The data (Socio-demographics, anthropometric measurements, biochemical tests, blood pressure measurement and diet intake) was collected from the un-paid female caregivers looking after hemodialysis-dependent family members The caregiver experience was assessed using the Zarit burden interview (ZBI) scale. Pregnant and lactating caregivers were excluded. RESULTS: Data were collected from 20 participants. The decision to participate in the study was based on male family members. Females were reluctant for providing anthropometric measurements and were not aware of monthly income. The majorities were interested in blood pressure measurement and blood tests as offered free of cost. Almost all participants reported positive aspects of caregiving, thus ZBI was not found suitable in the selected sample. CONCLUSION: The results of the pilot study highlighted the strengths and limitations of the selected data collection tools. The results of the survey can be useful for the healthcare professionals involved in researching on South Asian family caregivers

Elimination of Schistosoma mansoni Adult Worms by Rhesus Macaques: Basis for a Therapeutic Vaccine?

Infection with blood-dwelling schistosome worms is a major cause of human disease in many tropical countries. Despite intensive efforts a vaccine has proved elusive, not least because the chronic nature of the infection provides few pointers for vaccine development. The rhesus macaque appears unique among animal models in that adult worms establish but are eventually lost. We investigated whether this was due to pathological or immunological causes by monitoring the fate of a schistosome infection, and were able to rule out escape of worms from the portal system as a result of egg-induced vascular shunts. A substantial worm population established in all animals but there was a wide variation in the numbers recovered at 18 weeks. We observed a strong inverse association between the rapidity and intensity of the IgG response and worm burden. Rather than an acute lethal attack, immune-mediated elimination of worms appeared to be a prolonged process directed against vital components of exposed surfaces, causing worms to starve to death. We suggest that if the mechanisms deployed by the rhesus macaque could be replicated in humans by administration of key recombinant antigens, they would form the basis for a vaccine with both prophylactic and therapeutic properties

Isotopic and spin selectivity of H_2 adsorbed in bundles of carbon nanotubes

Due to its large surface area and strongly attractive potential, a bundle of carbon nanotubes is an ideal substrate material for gas storage. In addition, adsorption in nanotubes can be exploited in order to separate the components of a mixture. In this paper, we investigate the preferential adsorption of D_2 versus H_2(isotope selectivity) and of ortho versus para(spin selectivity) molecules confined in the one-dimensional grooves and interstitial channels of carbon nanotube bundles. We perform selectivity calculations in the low coverage regime, neglecting interactions between adsorbate molecules. We find substantial spin selectivity for a range of temperatures up to 100 K, and even greater isotope selectivity for an extended range of temperatures,up to 300 K. This isotope selectivity is consistent with recent experimental data, which exhibit a large difference between the isosteric heats of D_2 and H_2 adsorbed in these bundles.Comment: Paper submitted to Phys.Rev. B; 17 pages, 2 tables, 6 figure