Association of sickle cell disease with anthropometric indices among under-five children: evidence from 2018 Nigeria Demographic and Health Survey

Background: Malnutrition continues to affect under-five children in Africa to an overwhelming proportion. The situation is further compounded by the burden of sickle cell disease (SCD). However, association of SCD with stunting, wasting, and underweight in a nationally representative sample of under-five children remains unexplored.We aimed to describe prevalence of undernutrition by sickle cell status, to evaluate its association with growthfaltering ascertained by anthropometric indices, and to explore mediating role of hemoglobin. Methods: We availed data from the 2018 Nigeria Demographic and Health Survey (DHS) and the sample comprised 11,233 children aged 6–59 months who were successfully genotyped for SCD. The DHS employeda two-stage, stratified sampling strategy. SickleSCAN rapid diagnostic test was used for SCD genotyping. Zscoresof length/height-for-age (HAZ), weight-for-height (WHZ), and weight-for-age (WAZ) were computedagainst the 2006 World Health Organization Child Growth Standards. We fitted logistic regression models to evaluate association of SCD with stunting, wasting, and underweight. Mediation analysis was performed tocapture the indirect effect of and proportion of total effect mediated through hemoglobin level in SCD-anthropometric indices association. Results: Prevalences of stunting, wasting, and underweight among children with SCD were 55.4% (54.5–56.4), 9.1% (8.6–9.7), and 38.9% (38.0–39.8), respectively. The odds of stunting were 2.39 times higher (adjusted odds ratio (aOR) 2.39, 95% CI:1.26–4.54) among sickle children than those with normal hemoglobin. SCD was also significantly associated withunderweight (aOR 2.64, 95% CI: 1.25–5.98), but not with wasting (aOR: 1.60, 95% CI 0.85–3.02). Association of SCD with all three anthropometric indices was significantly mediated through hemoglobin level: for SCD-HAZ, the adjusted indirect effect(aIE) was − 0.328 (95% CI: − 0.387, − 0.270); for SCD-WHZ, the aIE was − 0.080 (95% CI: − 0.114, − 0.050); and for SCD-WAZ, the aIE was − 0.245 (95% CI: − 0.291, − 0.200). Conclusion: We presented compelling evidence of the negative impact of SCD on anthropometric indices of nutritional status of under-five children. Integration of a nutrition-oriented approach into a definitive SCD care package and its nationwide implementation could bring promising results by mitigating the nutritional vulnerability of children with SCD

Fast dispersible tablet of paroxetine hydrochloride: taste masking and administration in depressed patients

The bitter taste of paroxetine hydrochloride was masked by complexation with beta cyclodextrin. Complexation of paroxetine hydrochloride with beta cyclodextrin was characterized by differential scanning calorimetry and X-ray powder diffraction. The taste masked complex was directly compressed into tablets using povidone Cl as a super-disintegrant along with other excipients which aid in further improvement of taste. The prepared tablets containing the taste masked complex were evaluated for taste by both in vitro release profile and through panel testing. The taste masked tablets were administered to actual patients by mixing with juices to study weather the patients identifies the presence of medicine in the juices. The results of this study were satisfactory.Colegio de Farmacéuticos de la Provincia de Buenos Aire

Relationship of Anthropometric Indicators of General and Abdominal Obesity with Hypertension and Their Predictive Performance among Albanians: A Nationwide Cross-Sectional Study

Anthropometric indicators of general and abdominal obesity can predict cardiovascular disease outcomes. Their performance in predicting hypertension (HTN) varies across populations. We aimed to analyze the relationship of body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR) and conicity index (CI) with HTN, to examine their predictive performance and to determine their optimal cut-offs in a nationally representative sample of Albanians aged 15–59 years (n = 20,635). Logistic regression models were fitted and sex-specific receiver-operating characteristic (ROC) curves were constructed. The indicators were positively associated with HTN. Sex modified the relationships, as associations appeared significantly stronger among females than males in the highest categories of the indicators. The area under ROC curves (AUCs) for BMI were 0.729 (95% confidence interval (CI): 0.720–0.738) among females and 0.648 (95% CI: 0.633–0.663) among males, and AUCs for WHtR were 0.725 (95% CI: 0.716–0.734) among females and 0.637 (95% CI: 0.622–0.652) among males. However, the AUCs for BMI and WHtR did not differ significantly among females (p = 0.279) and males (p = 0.227). BMI outperformed WC and CI in both sexes. The optimal BMI cut-offs were 27.0 kg/m2 among females and 25.6 kg/m2 among males, and that for WHtR were 0.53 among females and 0.54 among males. BMI and WHtR demonstrated similar discriminatory power, and the identified cut-offs may inform initiatives for structured HTN screening in Albania

An Adaptive Learning Rate for RBFNN Using Time-Domain Feedback Analysis

Radial basis function neural networks are used in a variety of applications such as pattern recognition, nonlinear identification, control and time series prediction. In this paper, the learning algorithm of radial basis function neural networks is analyzed in a feedback structure. The robustness of the learning algorithm is discussed in the presence of uncertainties that might be due to noisy perturbations at the input or to modeling mismatch. An intelligent adaptation rule is developed for the learning rate of RBFNN which gives faster convergence via an estimate of error energy while giving guarantee to the l2 stability governed by the upper bounding via small gain theorem. Simulation results are presented to support our theoretical development

Investigating the Role of Vitamin D and DNA Repair in Influencing Cancer Presentation and Outcomes

Recent studies have identified differences in cancer risk, severity, and response to treatments in different ethnic groups. When comparing Americans of African descent to those of Caucasian descent, symptoms in African American patients were consistently severe with increased mortality rates. Research has indicated that this difference in the cancer phenotype between these two ethnic groups may be a result of both biological and socioeconomic factors 1. Our current study will focus on the potential- biological factors. We hypothesize that vitamin D deficiency in the AA population and associated differences in DNA repair capacity are the biological basis of the cancer- phenotypic variance between these populations. Lymphoblastic (LCL) cell lines cataloged in (http://www.1000genomes.org/) with known genotypes of human repair genes will be quantified for DNA repair capacity using comet assay, cell cycle analysis, and gene expression of key DNA repair genes (for both ethnic groups) after exposure to DNA damaging chemotherapeutic agents. Chi-square based population association approach will be used to associate genotypes of DNA repair genes to DRC capacity, thus providing the basis of population difference in the cancer phenotype

Multivariate Analysis of Some Mangrove Forests from Coastal Areas of Pakistan

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Image guidance and inter-fractional anatomical variation in paediatric abdominal radiotherapy

OBJECTIVES: To identify variables predicting inter fractional anatomical variationsmeasured with cone-beam CT (CBCT) throughout abdominal paediatric radiotherapy, and to assess the potential of surface-guided radiotherapy (SGRT) to monitor these changes. METHODS: Metrics of variation in gastrointestinal (GI) gas volume andseparation of the body contour and abdominal wallwere calculated from 21 planning CTs and 77 weekly CBCTs for 21 abdominal neuroblastoma patients (median 4y, range: 2 -19y). Age, sex, feeding tubes, and general anaesthesia (GA) were explored as predictive variables for anatomical variation. Furthermore,GI gas variationwas correlated with changes in body and abdominal wall separation, as well as simulated SGRT metrics of translational and rotationalcorrections between CT/CBCT. RESULTS: GI gas volumes varied 74 ± 54 ml across all scans, while body and abdominal wall separationvaried 2.0 ± 0.7 mm and4.1±1.5mmfrom planning, respectively. Patients < 3.5y (p = 0.04) and treated under GA (p < 0.01) experienced greater GI gas variation; GA was the strongest predictor in multivariate analysis (p < 0.01). Absence of feeding tubes was linked to greater body contour variation (p = 0.03). GI gas variation correlated with body (R = 0.53) and abdominal wall (R = 0.63) changes. The strongest correlations with SGRT metrics were found for anteroposterior translation (R = 0.65) androtation of the left-right axis (R = -0.36). CONCLUSIONS: Young age, GA, and absence of feeding tubes were linked to stronger inter fractional anatomical variation and are likely indicative of patients benefiting from adaptive/robust planning pathways.Our data suggests a role for SGRT toinformthe need for CBCT at each treatment fractionin this patient group. ADVANCES IN KNOWLEDGE: This is the first study to suggest the potential role of SGRT for the management of internal inter fractional anatomical variation in paediatric abdominal radiotherapy