Iodine deficiency and functional performance of schoolchildren in Benin

The notion that iodine deficiency may lead not only to goiter and cretinism, but to a much wider range of disorders, from stillbirth and abortions, to hearing problems and mental and physical underdevelopment began to be accepted beyond the research community since the early 1980's. In 1990 it was estimated that these problems, collectively called iodine deficiency disorders (IDD), presented a public health problem in 118 countries and that over 40 million people were affected by some degree of mental impairment. Children who have been exposed to iodine deficiency in the pre- and early post-natal phases of life show varying degrees of mental and psychomotor retardation, depending on the duration and degree of the deficiency. Adequate maternal iodine intake before and during pregnancy prevents such disorders. The question however whether or not deficits in mental and psychomotor performance of iodine deficient children may be reversed by supple-mentation with iodine later in life has not yet been answered unequivocally.The research described in this thesis was set up to address this question. A double-blind placebo-controlled intervention was carried out in an iodine deficient area of northern Benin in the period 1995-1996. A single oral dose of iodized oil or placebo was administrated to 2 groups of schoolchildren, aged 7-11 years. The observation period was 10-11 months. However, 3 to 4 months after supple-mentation the population started to have access to iodized salt, in addition to non-iodized salt. Because iodine became available to both groups, the main hypothesis, i.e. that iodine supplementation would improve mental performance had to be modified. It was decided to take children whose iodine status, as measured by different indicators, did not change during the observation period as the "control" group. In addition to mental and psychomotor performance, other aspects associated with iodine deficiency were studied, including behavioral change and hearing thresholds and their relation with mental performance. The suitability of several indicators for measuring iodine status and thyroid function was evaluated.Results showed that an improvement in iodine status as measured by urinary iodine concentration, was reflected in a significantly improved performance on the combination of mental tests, 10 months after supplementation. Moreover, children with better iodine status could hear better than their peers with a poorer iodine status, while hearing thresholds were negatively correlated with performance on all mental tests, but one. The serum concentration of thyroglobulin and the urinary iodine concentration were found to be indicators most suitable for measuring change in iodine status in this age group. Although the influx of iodine into the area precludes the drawing of "hard" conclusions, the results presented suggest that iodine supplementation is likely to promote a catch-up process in functional performance of iodine deficient schoolchildren.</p

Whole blood NAD and NADP concentrations are not depressed in subjects with clinical pellagra

Population surveys for niacin deficiency are normally based on clinical signs or on biochemical measurements of urinary niacin metabolites. Status may also be determined by measurement of whole blood NAD and NADP concentrations. To compare these methods, whole blood samples and spot urine samples were collected from healthy subjects (n = 2) consuming a western diet, from patients (n = 34) diagnosed with pellagra and attending a pellagra clinic in Kuito (central Angola, where niacin deficiency is endemic), and from female community control subjects (n = 107) who had no clinical signs of pellagra. Whole blood NAD and NADP concentrations were measured by microtiter plate-based enzymatic assays and the niacin urinary metabolites 1-methyl-2-pyridone-5-carboxamide (2-PYR) and 1-methylnicotinamide (1-MN) by HPLC. In healthy volunteers, inter- and intra-day variations for NAD and NADP concentrations were much lower than for the urinary metabolites, suggesting a more stable measure of status. However, whole blood concentrations of NAD and NADP or the NAD:NADP ratio were not significantly depressed in clinical pellagra. In contrast, the concentrations of 2-PYR and 1-MN, expressed relative to either creatinine or osmolality, were lower in pellagra patients and markedly higher following treatment. The use of the combined cut-offs (2-PYR <3.0 micromol/mmol creatinine and 1-MN <1.3 micromol/mmol creatinine) gave a sensitivity of 91% and specificity of 72%. In conclusion, whole blood NAD and NADP concentrations gave an erroneously low estimate of niacin deficiency. In contrast, spot urine sample 2-PYR and 1-MN concentrations, relative to creatinine, were a sensitive and specific measure of deficiency

Low-dose RUTF protocol and improved service delivery lead to good programme outcomes in the treatment of uncomplicated SAM: a programme report from Myanmar.

The treatment of uncomplicated severe acute malnutrition (SAM) requires substantial amounts of ready-to-use therapeutic food (RUTF). In 2009, Action Contre la Faim anticipated a shortfall of RUTF for their nutrition programme in Myanmar. A low-dose RUTF protocol to treat children with uncomplicated SAM was adopted. In this protocol, RUTF was dosed according to beneficiary's body weight, until the child reached a Weight-for-Height z-score of ≥-3 and mid-upper arm circumference ≥110 mm. From this point, the child received a fixed quantity of RUTF per day, independent of body weight until discharge. Specific measures were implemented as part of this low-dose RUTF protocol in order to improve service quality and beneficiary support. We analysed individual records of 3083 children treated from July 2009 to January 2010. Up to 90.2% of children recovered, 2.0% defaulted and 0.9% were classified as non-responders. No deaths were recorded. Among children who recovered, median [IQR] length of stay and weight gain were 42 days [28; 56] and 4.0 g kg(-1) day(-1) [3.0; 5.7], respectively. Multivariable logistic regression showed that children older than 48 months had higher odds of non-response to treatment than younger children (adjusted odds ratio: 3.51, 95% CI: 1.67-7.42). Our results indicate that a low-dose RUTF protocol, combined with specific measures to ensure good service quality and beneficiary support, was successful in treating uncomplicated SAM in this setting. This programmatic experience should be validated by randomised studies aiming to test, quantify and attribute the effect of the protocol adaptation and programme improvements presented here

Low and deficient niacin status and pellagra are endemic in postwar Angola

BACKGROUND: Outbreaks of pellagra were documented during the civil war in Angola, but no contemporary data on the incidence of pellagra or the prevalence of niacin deficiency were available. OBJECTIVE: The objective was to investigate the incidence of pellagra and the prevalence of niacin deficiency in postwar Angola and their relation with dietary intake, poverty, and anthropometric status. DESIGN: Admissions data from 1999 to 2004 from the pellagra treatment clinic in Kuito, Angola, were analyzed. New patients admitted over 1 wk were examined, and urine and blood samples were collected. A multistage cluster population survey collected data on anthropometric measures, household dietary intakes, socioeconomic status, and clinical signs of pellagra for women and children. Urinary excretion of 1-methylnicotinamide, 1-methyl-2-pyridone-5-carboxymide, and creatinine was measured and hemoglobin concentrations were measured with a portable photometer. RESULTS: The incidence of clinical pellagra has not decreased since the end of the civil war in 2002. Low excretion of niacin metabolites was confirmed in 10 of 11 new clinic patients. Survey data were collected for 723 women aged 15-49 y and for 690 children aged 6-59 mo. Excretion of niacin metabolites was low in 29.4% of the women and 6.0% of the children, and the creatinine-adjusted concentrations were significantly lower in the women than in the children (P < 0.001, t test). In children, niacin status was positively correlated with the household consumption of peanuts (r = 0.374, P = 0.001) and eggs (r = 0.290, P = 0.012) but negatively correlated with socioeconomic status (r = -0.228, P = 0.037). CONCLUSIONS: The expected decrease in pellagra incidence after the end of the civil war has not occurred. The identification of niacin deficiency as a public health problem should refocus attention on this nutritional deficiency in Angola and other areas of Africa where maize is the staple

The North Ecliptic Pole Supercluster

We have used the ROSAT All-Sky Survey to detect a known supercluster at z=0.087 in the North Ecliptic Pole region. The X-ray data greatly improve our understanding of this supercluster's characteristics, approximately doubling our knowledge of the structure's spatial extent and tripling the cluster/group membership compared to the optical discovery data. The supercluster is a rich structure consisting of at least 21 galaxy clusters and groups, 12 AGN, 61 IRAS galaxies, and various other objects. A majority of these components were discovered with the X-ray data, but the supercluster is also robustly detected in optical, IR, and UV wavebands. Extending 129 x 102 x 67 (1/h50 Mpc)^3, the North Ecliptic Pole Supercluster has a flattened shape oriented nearly edge-on to our line-of-sight. Owing to the softness of the ROSAT X-ray passband and the deep exposure over a large solid angle, we have detected for the first time a significant population of X-ray emitting galaxy groups in a supercluster. These results demonstrate the effectiveness of X-ray observations with contiguous coverage for studying structure in the Universe.Comment: Accepted for publication in The Astrophysical Journal; 5 pages with 2 embedded figures; uses emulateapj.sty; For associated animations, see http://www.ifa.hawaii.edu/~mullis/nep3d.html; A high-resolution color postscript version of the full paper is available at http://www.ifa.hawaii.edu/~mullis/papers/nepsc.ps.g

The discovery of diffuse steep spectrum sources in Abell 2256

Context: Hierarchical galaxy formation models indicate that during their lifetime galaxy clusters undergo several mergers. Here we report on the discovery of three diffuse radio sources in the periphery of Abell 2256, using the GMRT. Aims: The aim of the observations was to search for diffuse ultra-steep spectrum radio sources within the galaxy cluster Abell 2256. Methods: We have carried out GMRT 325 MHz radio continuum observations of Abell 2256. V, R and I band images of the cluster were taken with the 4.2m WHT. Results: We have discovered three diffuse elongated radio sources located about 1 Mpc from the cluster center. Two are located to the west of the cluster center, and one to the southeast. The sources have a measured physical extent of 170, 140 and 240 kpc, respectively. The two western sources are also visible in deep low-resolution 115-165 MHz WSRT images, although they are blended into a single source. For the combined emission of the blended source we find an extreme spectral index of -2.05\pm 0.14 between 140 and 351 MHz. The extremely steep spectral index suggests these two sources are most likely the result of adiabatic compression of fossil radio plasma due to merger shocks. Conclusions: The discovery of the steep spectrum sources implies the existence of a population of faint diffuse radio sources in (merging) clusters with such steep spectra that they have gone unnoticed in higher frequency (\gtrsim 1 GHz) observations. An exciting possibility therefore is that such sources will determine the general appearance of clusters in low-frequency high resolution radio maps as will be produced by for example LOFAR or LWA.Comment: 5 pages, 2 figures, accepted for publication in A&A on October 16, 200

Reviving Fossil Radio Plasma in Clusters of Galaxies by Adiabatic Compression in Environmental Shock Waves

We give for a plasma with a history of several expansion and contraction phases an analytical model of the evolution of a contained relativistic electron population under synchrotron, inverse Compton and adiabatic energy losses or gains. This is applied to different scenarios for evolution of radio plasma inside the cocoons of radio galaxies, after the activity of the central engine has ceased. It is demonstrated that fossil radio plasma with an age of even up to 2 Gyr can be revived by compression in a shock wave of large-scale structure formation, caused during the merging events of galaxy clusters, or by the accretion onto galaxy clusters. We argue, that this is a highly plausible explanation for the observed cluster radio relics, which are the regions of diffuse radio emission found in clusters of galaxies, without any likely parent radio galaxy seen nearby. An implication of this model is the existence of a population of diffuse, ultra-steep spectrum, very low frequency radio sources located inside and possibly outside of clusters of galaxies, tracing the revival of aged fossil radio plasma by the shock waves associated with large-scale structure formation.Comment: 10 pages, 5 figures, accepted by A&

A Collision of Subclusters in Abell 754

We present direct evidence of a collision of subclusters in the galaxy cluster Abell 754. Our comparison of new optical data and archival ROSAT PSPC X-ray data reveal three collision signatures predicted by n-body/hydrodynamical simulations of hierarchical cluster evolution. First, there is strong evidence of a non-hydrostatic process; neither of the two major clumps in the galaxy distribution lies on the off-center peak of the X-ray emission from the intracluster gas. Second, the peak of the X-ray emission is elongated perpendicular to the collision axis defined by the centroids of the two galaxy clumps. Third, there is evidence of compression-heated gas; one of A754's two X-ray temperature components (Henry & Briel 1995) is among the hottest observed in any cluster and hotter than that inferred from the velocity dispersion of the associated galaxy clump. These signatures are consistent with the qualitative features of simulations (Evrard 1990a,b) in which two subclusters have collided in the plane of the sky during roughly the last Gyr. The detection of such collisions is crucial for understanding both the dynamics of individual clusters and the underlying cosmology. First, for systems like A754, estimating the cluster X-ray mass from assumptions of hydrostatic equilibrium and isothermality is incorrect and may produce the discrepancies sometimes found between X-ray masses and those derived from gravitational lens models (Babul & Miralda-Escude 1994). Second, the fraction of nearby clusters in which subclusters have collided in the last Gyr is especially sensitive to the mean mass density parameter Omega_0 (cf. Richstone et al. 1992; Evrard et al. 1993; Lacey & Cole 1993). With a large, well-defined cluster sample, it will be possible to place a new and powerful constraint on cosmological models.Comment: 4 pages + 1 color figure (Postscript). Accepted for Publication in ApJ Letter

South-West extension of the hard X-ray emission from the Coma cluster

We explore the morphology of hard (18-30 keV) X-ray emission from the Coma cluster of galaxies. We analyze a deep (1.1 Ms) observation of the Coma cluster with the ISGRI imager on board the \emph{INTEGRAL} satellite. We show that the source extension in the North-East to South-West (SW) direction ($\sim 17'$) significantly exceeds the size of the point spread function of ISGRI, and that the centroid of the image of the source in the 18-30 keV band is displaced in the SW direction compared to the centroid in the 1-10 keV band. To test the nature of the SW extension we fit the data assuming different models of source morphology. The best fit is achieved with a diffuse source of elliptical shape, although an acceptable fit can be achieved assuming an additional point source SW of the cluster core. In the case of an elliptical source, the direction of extension of the source coincides with the direction toward the subcluster falling onto the Coma cluster. If the SW excess is due to the presence of a point source with a hard spectrum, we show that there is no obvious X-ray counterpart for this additional source, and that the closest X-ray source is the quasar EXO 1256+281, which is located $6.1'$ from the centroid of the excess. The observed morphology of the hard X-ray emission clarifies the nature of the hard X-ray "excess" emission from the Coma cluster, which is due to the presence of an extended hard X-ray source SW of the cluster core.Comment: 7pages, 10 figure

Nonthermal Emission from Accreting and Merging Clusters of Galaxies

We compare the nonthermal emission from clusters of galaxies undergoing minor mergers (``accreting'' clusters) and major mergers (``merging'' clusters). For accreting clusters, the radial distribution of the nonthermal emission in the clusters is also calculated. The relativistic electrons, which are the origin of the nonthermal radiation through inverse Compton (IC) and synchrotron mission, are assumed to be accelerated at shocks produced by accretion or mergers. We estimate the typical accretion rate and merger probability according to a hierarchical clustering model. We show that the total luminosity of IC emission from accreting and merging clusters are similar. On the other hand, the luminosity of synchrotron radio emission of the former is much smaller than that of the latter. We show that about 10% of clusters at z~0 should have hard X-ray and radio nonthermal emissions due to their last major merger, which are comparable to or dominate those due to ongoing accretion. Moreover, 20-40% of clusters should have significant EUV emission due to their last merger. We also investigate the case where the criterion of mergers is relaxed. If we extend the definition of a merger to an increase in the mass of the larger subcluster by at least 10% of its initial mass, about 20-30% of clusters at z~0 should have hard X-ray and radio nonthermal emissions due to the merger even in a low density universe. We compare the results with observations. We find that the observed EUV emission from clusters is not attributed to accretion. If the diffuse radio emission observed in clusters is synchrotron emission from electrons accelerated via accretion or merging, the magnetic fields of clusters are generally as small as ~0.1 mu G.Comment: 33 pages, 18 figures, accepted by Ap