The Lives Saved Tool (LiST) as a model for diarrhea mortality reduction

BACKGROUND: Diarrhea is a leading cause of morbidity and mortality among children under five years of age. The Lives Saved Tool (LiST) is a model used to calculate deaths averted or lives saved by past interventions and for the purposes of program planning when costly and time consuming impact studies are not possible. DISCUSSION: LiST models the relationship between coverage of interventions and outputs, such as stunting, diarrhea incidence and diarrhea mortality. Each intervention directly prevents a proportion of diarrhea deaths such that the effect size of the intervention is multiplied by coverage to calculate lives saved. That is, the maximum effect size could be achieved at 100% coverage, but at 50% coverage only 50% of possible deaths are prevented. Diarrhea mortality is one of the most complex causes of death to be modeled. The complexity is driven by the combination of direct prevention and treatment interventions as well as interventions that operate indirectly via the reduction in risk factors, such as stunting and wasting. Published evidence is used to quantify the effect sizes for each direct and indirect relationship. Several studies have compared measured changes in mortality to LiST estimates of mortality change looking at different sets of interventions in different countries. While comparison work has generally found good agreement between the LiST estimates and measured mortality reduction, where data availability is weak, the model is less likely to produce accurate results. LiST can be used as a component of program evaluation, but should be coupled with more complete information on inputs, processes and outputs, not just outcomes and impact. SUMMARY: LiST is an effective tool for modeling diarrhea mortality and can be a useful alternative to large and expensive mortality impact studies. Predicting the impact of interventions or comparing the impact of more than one intervention without having to wait for the results of large and expensive mortality studies is critical to keep programs focused and results oriented for continued reductions in diarrhea and all-cause mortality among children under five years of age

Performance evaluation and optimal design of supermarket refrigeration systems with supermarket model "SuperSim", Part I: Model description and validation

This is the post-print version of the final paper published in International Journal of Refrigeration. The published article is available from the link below. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. Copyright @ 2010 Elsevier B.V.Conventional supermarket refrigeration systems are responsible for considerable CO2 emissions due to high energy consumption and large quantities of refrigerant leakage. In the effort to conserve energy and reduce environmental impacts, an efficient design tool for the analysis, evaluation and comparison of the performance of alternative system designs and controls is required. This paper provides a description of the modelling procedure employed in the supermarket simulation model ‘SuperSim’ for the simulation of the performance of centralised vapour compression refrigeration systems and their interaction with the building envelope and HVAC systems. The model which has been validated against data from a supermarket has been used for the comparison of R404A and CO2 refrigeration systems and the optimisation of the performance of transcritical CO2 systems. These results are presented in Part II of the paper.DEFR

Standards for CHERG reviews of intervention effects on child survival

Background The Lives Saved Tool (LiST) uses estimates of the effects of interventions on cause-specific child mortality as a basis for generating projections of child lives that could be saved by increasing coverage of effective interventions. Estimates of intervention effects are an essential element of LiST, and need to reflect the best available scientific evidence. This article describes the guidelines developed by the Child Health Epidemiology Reference Group (CHERG) that are applied by scientists conducting reviews of intervention effects for use in LiST. Methods The guidelines build on and extend those developed by the Cochrane Collaboration and the Working Group for Grading of Recommendations Assessment, Development and Evaluation (GRADE). They reflect the experience gained by the CHERG intervention review groups in conducting the reviews published in this volume, and will continue to be refined through future reviews. Presentation of the guidelines Expected products and guidelines are described for six steps in the CHERG intervention review process: (i) defining the scope of the review; (ii) conducting the literature search; (iii) extracting information from individual studies; (iv) assessing and summarizing the evidence; (v) translating the evidence into estimates of intervention effects and (vi) presenting the results. Conclusions The CHERG intervention reviews represent an ambitious effort to summarize existing evidence and use it as the basis for supporting sound public health decision making through LiST. These efforts will continue, and a similar process is now under way to assess intervention effects for reducing maternal mortalit

Astrometric jitter of the sun as a star

The daily variation of the solar photocenter over some 11 years is derived from the Mount Wilson data reprocessed by Ulrich et al. 2010 to closely match the surface distribution of solar irradiance. The standard deviations of astrometric jitter are 0.52 $\mu$AU and 0.39 $\mu$AU in the equatorial and the axial dimensions, respectively. The overall dispersion is strongly correlated with the solar cycle, reaching $0.91 \mu$AU at the maximum activity in 2000. The largest short-term deviations from the running average (up to 2.6 $\mu$AU) occur when a group of large spots happen to lie on one side with respect to the center of the disk. The amplitude spectrum of the photocenter variations never exceeds 0.033 $\mu$AU for the range of periods 0.6--1.4 yr, corresponding to the orbital periods of planets in the habitable zone. Astrometric detection of Earth-like planets around stars as quiet as the Sun is not affected by star spot noise, but the prospects for more active stars may be limited to giant planets.Comment: Accepted in Ap

Rotavirus vaccine and diarrhea mortality: quantifying regional variation in effect size

<p>Abstract</p> <p>Background</p> <p>Diarrhea mortality remains a leading cause of child death and rotavirus vaccine an effective tool for preventing severe rotavirus diarrhea. New data suggest vaccine efficacy may vary by region.</p> <p>Methods</p> <p>We reviewed published vaccine efficacy trials to estimate a regional-specific effect of vaccine efficacy on severe rotavirus diarrhea and hospitalizations. We assessed the quality of evidence using a standard protocol and conducted meta-analyses where more than 1 data point was available.</p> <p>Results</p> <p>Rotavirus vaccine prevented severe rotavirus episodes in all regions; 81% of episodes in Latin America, 42.7% of episodes in high-mortality Asia, 50% of episodes in sub-Saharan Africa, 88% of episodes low-mortality Asia and North Africa, and 91% of episodes in developed countries. The effect sizes observed for preventing severe rotavirus diarrhea will be used in <it>LiST</it> as the effect size for rotavirus vaccine on rotavirus-specific diarrhea mortality.</p> <p>Conclusions</p> <p>Vaccine trials have not measured the effect of vaccine on diarrhea mortality. The overall quality of the evidence and consistency observed across studies suggests that estimating mortality based on a severe morbidity reduction is highly plausible.</p

Nuclear structure of the exotic mass region along the rp process path

Isomeric states in the nuclei along the rapid proton capture process path are studied by the projected shell model. Emphasis is given to two waiting point nuclei 68Se and 72Kr that are characterized by shape coexistence. Energy surface calculations indicate that the ground state of these nuclei corresponds to an oblate-deformed minimum, while the lowest state at the prolate-deformed minimum can be considered as a shape isomer. The impact of these isomer states on isotopic abundance in x-ray bursts is studied in a multi-mass-zone x-ray burst model by assuming an upper-lower limit approach.Comment: Proceedings of Nuclei in Cosmos VIII, to appear in Nucl. Phys.

Practice Makes Imperfect: Restorative Effects of Sleep on Motor Learning

Emerging evidence suggests that sleep plays a key role in procedural learning, particularly in the continued development of motor skill learning following initial acquisition. We argue that a detailed examination of the time course of performance across sleep on the finger-tapping task, established as the paradigm for studying the effect of sleep on motor learning, will help distinguish a restorative role of sleep in motor skill learning from a proactive one. Healthy subjects rehearsed for 12 trials and, following a night of sleep, were tested. Early training rapidly improved speed as well as accuracy on pre-sleep training. Additional rehearsal caused a marked slow-down in further improvement or partial reversal in performance to observed levels below theoretical upper limits derived on the basis of early pre-sleep rehearsal. This decrement in learning efficacy does not occur always, but if and only if it does, overnight sleep has an effect in fully or partly restoring the efficacy and actual performance to the optimal theoretically achieveable level. Our findings re-interpret the sleep-dependent memory enhancement in motor learning reported in the literature as a restoration of fatigued circuitry specialized for the skill. In providing restitution to the fatigued brain, sleep eliminates the rehearsal-induced synaptic fatigue of the circuitry specialized for the task and restores the benefit of early pre-sleep rehearsal. The present findings lend support to the notion that latent sleep-dependent enhancement of performance is a behavioral expression of the brain's restitution in sleep

Standards for CHERG reviews of intervention effects on child survival

Background The Lives Saved Tool (LiST) uses estimates of the effects of interventions on cause-specific child mortality as a basis for generating projections of child lives that could be saved by increasing coverage of effective interventions. Estimates of intervention effects are an essential element of LiST, and need to reflect the best available scientific evidence. This article describes the guidelines developed by the Child Health Epidemiology Reference Group (CHERG) that are applied by scientists conducting reviews of intervention effects for use in LiST

Quantifying the Association between Campylobacter Infection and Guillain-Barré Syndrome: A Systematic Review

Guillain-Barré Syndrome (GBS) is a neurologic disease that causes ascending paralysis and is triggered by a preceding bacterial or viral infection. Several studies have shown that patients with GBS have a recent history of infection due to Campylobacter jejuni. A literature review of published studies that reported rates of Campylobacter infection before or in conjunction with GBS was done. These reported data were used for calculating the proportion of GBS cases who tested positive for Campylobacter compared to the control population and the incidence of GBS among patients infected with Campylobacter. Results of the analysis suggest that 31% of 2,502 GBS cases included in these papers are attributable to Campylobacter infection