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Dockree S, Aye C, Ioannou C, Cavallaro A, Black R, Impey L. Adverse perinatal outcomes are strongly associated with degree of abnormality in uterine artery Doppler pulsatility index. Ultrasound Obstet Gynecol 2024. [PMID: 38669595 DOI: 10.1002/uog.27668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 04/03/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024]
Abstract
OBJECTIVES To investigate the association between varying degrees of abnormality in the uterine artery Doppler pulsatility index (UtA-PI) and adverse perinatal outcomes. METHODS Prospective study of 33,364 women who gave birth to singleton, non-anomalous babies in Oxford, following universal measurement of UtA-PI in mid-pregnancy. Relative risk ratios for the primary outcomes of extended perinatal mortality and live birth with severe small-for-gestational-age (SGA) were calculated by multinomial logistic regression, for early preterm birth (<34+0) and late preterm/term birth (≥34+0). The risks were also investigated for iatrogenic preterm birth or a composite adverse outcome before 34+0 weeks. RESULTS Compared with women with normal UtA-PI, the risk of extended perinatal mortality before 34+0 weeks was higher in women with UtA-PI >90th centile (RRR 4.7, 95% CI 2.7-8.0, p<0.001), but this was not demonstrated in later births. The risk of severe SGA birth was strongly associated with abnormal UtA-PI for both early births (RRR 26.0, 95% CI 11.6-58.2, p<0.001), and later births (RRR 2.3, 95% CI 1.8-2.9, p<0.001). Women with a raised UtA-PI were more likely to undergo early iatrogenic birth (RRR 7.8, 95% CI 5.5-11.2, p<0.001). For each of the outcomes and the composite outcome, the risk increased significantly in association with the degree of abnormality, through the 90th, 90-94th, 95-99th and >99th centiles (ptrend<0.001). CONCLUSIONS An elevated UtA-PI is a key predictor of iatrogenic preterm birth, severe SGA and perinatal loss up to 34+0 weeks. It is the 90th centile that should be used, and management should be further tailored to the degree of abnormality, as pregnancies with very raised UtA-PI measurements constitute a group at extreme risk. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- S Dockree
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - C Aye
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- University of Oxford, Oxford, UK
| | - C Ioannou
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- University of Oxford, Oxford, UK
| | - A Cavallaro
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - R Black
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- University of Oxford, Oxford, UK
| | - L Impey
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- University of Oxford, Oxford, UK
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Ahn IE, Brander DM, Ren Y, Zhou Y, Tyekucheva S, Walker HA, Black R, Montegaard J, Alencar A, Shune L, Omaira M, Jacobson CA, Armand P, Ng SY, Crombie J, Fisher DC, LaCasce AS, Arnason J, Hochberg EP, Takvorian RW, Abramson JS, Brown JR, Davids MS. Five-year follow-up of a phase 2 study of ibrutinib plus fludarabine, cyclophosphamide, and rituximab as initial therapy in CLL. Blood Adv 2024; 8:832-841. [PMID: 38163317 PMCID: PMC10874751 DOI: 10.1182/bloodadvances.2023011574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 11/21/2023] [Accepted: 11/22/2023] [Indexed: 01/03/2024] Open
Abstract
ABSTRACT We previously reported high rates of undetectable minimal residual disease <10-4 (uMRD4) with ibrutinib plus fludarabine, cyclophosphamide, and rituximab (iFCR) followed by 2-year ibrutinib maintenance (I-M) in treatment-naïve chronic lymphocytic leukemia (CLL). Here, we report updated data from this phase 2 study with a median follow-up of 63 months. Of 85 patients enrolled, including 5 (6%) with deletion 17p or TP53 mutation, 91% completed iFCR and 2-year I-M. Five-year progression-free survival (PFS) and overall survival were 94% (95% confidence interval [CI], 89%-100%) and 99% (95% CI, 96%-100%), respectively. No additional deaths have occurred with this extended follow-up. No difference in PFS was observed by immunoglobulin heavy-chain variable region gene status or duration of I-M. High rates of peripheral blood (PB) uMRD4 were maintained (72% at the end of iFCR, 66% at the end of 2-year I-M, and 44% at 4.5 years from treatment initiation). Thirteen patients developed MRD conversion without clinical progression, mostly (77%) after stopping ibrutinib. None had Bruton tyrosine kinase (BTK) mutations. One patient had PLCG2 mutation. Six of these patients underwent ibrutinib retreatment per protocol. Median time on ibrutinib retreatment was 34 months. The cumulative incidence of atrial fibrillation was 8%. Second malignancy or nonmalignant hematologic disease occurred in 13%, mostly nonmelanoma skin cancer. Overall, iFCR with 2-year I-M achieved durably deep responses in patients with diverse CLL genetic markers. Re-emergent clones lacked BTK mutation and retained sensitivity to ibrutinib upon retreatment. This trial is registered at www.clinicaltrials.gov as #NCT02251548.
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Affiliation(s)
- Inhye E. Ahn
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
- Harvard Medical School, Boston, MA
| | | | - Yue Ren
- Department of Data Science, Dana-Farber Cancer Institute, Boston, MA
| | - Yinglu Zhou
- Department of Data Science, Dana-Farber Cancer Institute, Boston, MA
| | | | - Heather A. Walker
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Robert Black
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Josie Montegaard
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Alvaro Alencar
- Division of Hematology, University of Miami Sylvester Comprehensive Cancer Center, Miami, FL
| | - Leyla Shune
- Department of Hematologic Malignancies, University of Kansas Cancer Center, Westwood, KS
| | - Mohammad Omaira
- Department of Medical Oncology, West Michigan Cancer Center, Kalamazoo, MI
| | - Caron A. Jacobson
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
- Harvard Medical School, Boston, MA
| | - Philippe Armand
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
- Harvard Medical School, Boston, MA
| | - Samuel Y. Ng
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
- Harvard Medical School, Boston, MA
| | - Jennifer Crombie
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
- Harvard Medical School, Boston, MA
| | - David C. Fisher
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
- Harvard Medical School, Boston, MA
| | - Ann S. LaCasce
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
- Harvard Medical School, Boston, MA
| | - Jon Arnason
- Harvard Medical School, Boston, MA
- Department of Medical Oncology, Beth Israel Deaconess Medical Center, Boston, MA
| | - Ephraim P. Hochberg
- Harvard Medical School, Boston, MA
- Department of Medical Oncology, Massachusetts General Hospital, Boston, MA
| | - Ronald W. Takvorian
- Harvard Medical School, Boston, MA
- Department of Medical Oncology, Massachusetts General Hospital, Boston, MA
| | - Jeremy S. Abramson
- Harvard Medical School, Boston, MA
- Department of Medical Oncology, Massachusetts General Hospital, Boston, MA
| | - Jennifer R. Brown
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
- Harvard Medical School, Boston, MA
| | - Matthew S. Davids
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
- Harvard Medical School, Boston, MA
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3
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Abdellah AM, Ismail F, Siig OW, Yang J, Andrei CM, DiCecco LA, Rakhsha A, Salem KE, Grandfield K, Bassim N, Black R, Kastlunger G, Soleymani L, Higgins D. Impact of palladium/palladium hydride conversion on electrochemical CO 2 reduction via in-situ transmission electron microscopy and diffraction. Nat Commun 2024; 15:938. [PMID: 38296966 PMCID: PMC10831057 DOI: 10.1038/s41467-024-45096-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 01/15/2024] [Indexed: 02/02/2024] Open
Abstract
Electrochemical conversion of CO2 offers a sustainable route for producing fuels and chemicals. Pd-based catalysts are effective for converting CO2 into formate at low overpotentials and CO/H2 at high overpotentials, while undergoing poorly understood morphology and phase structure transformations under reaction conditions that impact performance. Herein, in-situ liquid-phase transmission electron microscopy and select area diffraction measurements are applied to track the morphology and Pd/PdHx phase interconversion under reaction conditions as a function of electrode potential. These studies identify the degradation mechanisms, including poisoning and physical structure changes, occurring in PdHx/Pd electrodes. Constant potential density functional theory calculations are used to probe the reaction mechanisms occurring on the PdHx structures observed under reaction conditions. Microkinetic modeling reveals that the intercalation of *H into Pd is essential for formate production. However, the change in electrochemical CO2 conversion selectivity away from formate and towards CO/H2 at increasing overpotentials is due to electrode potential dependent changes in the reaction energetics and not a consequence of morphology or phase structure changes.
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Affiliation(s)
- Ahmed M Abdellah
- Department of Chemical Engineering, McMaster University, Hamilton, ON, Canada
| | - Fatma Ismail
- Department of Chemical Engineering, McMaster University, Hamilton, ON, Canada
| | - Oliver W Siig
- CatTheory, Department of Physics, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Jie Yang
- Department of Materials Science and Engineering, McMaster University, Hamilton, ON, Canada
| | - Carmen M Andrei
- Canadian Centre for Electron Microscopy, McMaster University, Hamilton, Canada
| | | | - Amirhossein Rakhsha
- Department of Chemical Engineering, McMaster University, Hamilton, ON, Canada
| | - Kholoud E Salem
- Department of Chemical Engineering, McMaster University, Hamilton, ON, Canada
| | - Kathryn Grandfield
- Department of Materials Science and Engineering, McMaster University, Hamilton, ON, Canada
- School of Biomedical Engineering, McMaster University, Hamilton, Canada
| | - Nabil Bassim
- Department of Materials Science and Engineering, McMaster University, Hamilton, ON, Canada
- Canadian Centre for Electron Microscopy, McMaster University, Hamilton, Canada
| | - Robert Black
- National Research Council of Canada, Energy, Mining, and Environment Research Centre, Mississauga, ON, Canada
| | - Georg Kastlunger
- CatTheory, Department of Physics, Technical University of Denmark, Kongens Lyngby, Denmark.
| | - Leyla Soleymani
- School of Biomedical Engineering, McMaster University, Hamilton, Canada
- Department of Engineering Physics, McMaster University, Hamilton, Canada
| | - Drew Higgins
- Department of Chemical Engineering, McMaster University, Hamilton, ON, Canada.
- Canadian Centre for Electron Microscopy, McMaster University, Hamilton, Canada.
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Fiksel J, Gilbert B, Wilson E, Kalter H, Kante A, Akum A, Blau D, Bassat Q, Macicame I, Samo Gudo E, Black R, Zeger S, Amouzou A, Datta A. Correcting for Verbal Autopsy Misclassification Bias in Cause-Specific Mortality Estimates. Am J Trop Med Hyg 2023; 108:66-77. [PMID: 37037438 PMCID: PMC10160858 DOI: 10.4269/ajtmh.22-0318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 01/19/2023] [Indexed: 04/12/2023] Open
Abstract
Verbal autopsies (VAs) are extensively used to determine cause of death (COD) in many low- and middle-income countries. However, COD determination from VA can be inaccurate. Computer coded verbal autopsy (CCVA) algorithms used for this task are imperfect and misclassify COD for a large proportion of deaths. If not accounted for, this misclassification leads to biased estimates of cause-specific mortality fractions (CSMFs), a critical piece in health-policy making. Recent work has demonstrated that the knowledge of the CCVA misclassification rates can be used to calibrate raw VA-based CSMF estimates to account for the misclassification bias. In this manuscript, we review the current practices and issues with raw COD predictions from CCVA algorithms and provide a complete primer on how to use the VA calibration approach with the calibratedVA software to correct for verbal autopsy misclassification bias in cause-specific mortality estimates. We use calibratedVA to obtain CSMFs for child (1-59 months) and neonatal deaths using VA data from the Countrywide Mortality Surveillance for Action project in Mozambique.
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Affiliation(s)
- Jacob Fiksel
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Brian Gilbert
- Department of Biostatistics, Johns Hopkins University, Baltimore, Maryland
| | - Emily Wilson
- Department of International Health, Johns Hopkins University, Baltimore, Maryland
| | - Henry Kalter
- Department of International Health, Johns Hopkins University, Baltimore, Maryland
| | - Almamy Kante
- Department of International Health, Johns Hopkins University, Baltimore, Maryland
| | - Aveika Akum
- Department of International Health, Johns Hopkins University, Baltimore, Maryland
| | - Dianna Blau
- Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Quique Bassat
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
- ICREA, Barcelona, Spain
- Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | | | - Robert Black
- Department of International Health, Johns Hopkins University, Baltimore, Maryland
| | - Scott Zeger
- Department of Biostatistics, Johns Hopkins University, Baltimore, Maryland
| | - Agbessi Amouzou
- Department of International Health, Johns Hopkins University, Baltimore, Maryland
| | - Abhirup Datta
- Department of Biostatistics, Johns Hopkins University, Baltimore, Maryland
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5
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Gilbert B, Fiksel J, Wilson E, Kalter H, Kante A, Akum A, Blau D, Bassat Q, Macicame I, Samo Gudo E, Black R, Zeger S, Amouzou A, Datta A. Multi-Cause Calibration of Verbal Autopsy-Based Cause-Specific Mortality Estimates of Children and Neonates in Mozambique. Am J Trop Med Hyg 2023; 108:78-89. [PMID: 37037430 PMCID: PMC10160855 DOI: 10.4269/ajtmh.22-0319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 01/19/2023] [Indexed: 04/12/2023] Open
Abstract
The Countrywide Mortality Surveillance for Action platform is collecting verbal autopsy (VA) records from a nationally representative sample in Mozambique. These records are used to estimate the national and subnational cause-specific mortality fractions (CSMFs) for children (1-59 months) and neonates (1-28 days). Cross-tabulation of VA-based cause-of-death (COD) determination against that from the minimally invasive tissue sampling (MITS) from the Child Health and Mortality Prevention project revealed important misclassification errors for all the VA algorithms, which if not accounted for will lead to bias in the estimates of CSMF from VA. A recently proposed Bayesian VA-calibration method is used that accounts for this misclassification bias and produces calibrated estimates of CSMF. Both the VA-COD and the MITS-COD can be multi-cause (i.e., suggest more than one probable COD for some of the records). To fully use this probabilistic COD data, we use the multi-cause VA calibration. Two different computer-coded VA algorithms are considered-InSilicoVA and EAVA-and the final CSMF estimates are obtained using an ensemble calibration that uses data from both the algorithms. The calibrated estimates consistently offer a better fit to the data and reveal important changes in the CSMF for both children and neonates in Mozambique after accounting for VA misclassification bias.
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Affiliation(s)
- Brian Gilbert
- Department of Biostatistics, Johns Hopkins University, Baltimore, Maryland
| | - Jacob Fiksel
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Emily Wilson
- Department of International Health, Johns Hopkins University, Baltimore, Maryland
| | - Henry Kalter
- Department of International Health, Johns Hopkins University, Baltimore, Maryland
| | - Almamy Kante
- Department of International Health, Johns Hopkins University, Baltimore, Maryland
| | - Aveika Akum
- Department of International Health, Johns Hopkins University, Baltimore, Maryland
| | - Dianna Blau
- Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Quique Bassat
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
- Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
- Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | | | - Robert Black
- Department of International Health, Johns Hopkins University, Baltimore, Maryland
| | - Scott Zeger
- Department of Biostatistics, Johns Hopkins University, Baltimore, Maryland
| | - Agbessi Amouzou
- Department of International Health, Johns Hopkins University, Baltimore, Maryland
| | - Abhirup Datta
- Department of Biostatistics, Johns Hopkins University, Baltimore, Maryland
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Kevat A, Bernard A, Harris MA, Heussler H, Black R, Cheng A, Waters K, Chawla J. Impact of adenotonsillectomy on growth trajectories in preschool children with mild-moderate obstructive sleep apnea. J Clin Sleep Med 2023; 19:55-62. [PMID: 36004732 PMCID: PMC9806775 DOI: 10.5664/jcsm.10266] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 08/14/2022] [Accepted: 08/17/2022] [Indexed: 01/07/2023]
Abstract
STUDY OBJECTIVES Adenotonsillectomy (AT) forms part of first-line management for pediatric obstructive sleep apnea. In nonrandomized studies of preschool-aged children, postoperative weight gain has been seen following AT, raising concerns regarding later obesity. Using longitudinal data from a multicenter randomized controlled trial, we assessed the impact of AT on growth trajectories in preschool-aged children with mild-moderate obstructive sleep apnea. METHODS A total of 190 children (aged 3-5 years) with obstructive apnea-hypopnea index ≤ 10 events/h were randomly assigned to early (within 2 months) or routine (12-month wait) AT. Anthropometry and polysomnography were performed at baseline, 12-month, and 24-month time points for 126 children. Baseline characteristics were compared using a Mann-Whitney or t test for continuous variables and Fisher's exact test for categorical variables. Longitudinal data underwent linear mixed modeling. RESULTS For body mass index (BMI) z-score there was a significant increase in the early surgery group between 0 and 12 months (0.4, 95% confidence interval 0.1-0.8) but not from 12-24 months. For the routine surgery group there was an identical significant BMI z-score increase in the first 12 months following surgery, ie, between 12- and 24-month time points (0.45, 95% confidence interval 0.1-0.8) but not from 0-12 months (preoperative time). Final BMI z-score was similar between groups. Findings for weight-for-age z-score were similar to the findings for BMI z-score. Height-for-age z-score was not significantly different between different time points or intervention groups. CONCLUSIONS This study provides randomized controlled trial evidence of notable, but time-limited, increase in the BMI and weight of preschool children with mild-moderate obstructive sleep apnea in the months immediately following AT. CLINICAL TRIAL REGISTRATION Registry: Australian New Zealand Clinical Trials Registry; Name: POSTA Child Study (Preschool Obstructive Sleep Apnea Tonsillectomy Adenoidectomy Study); URL: https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=336273&isReview=true; Identifier: ACTRN12611000021976. CITATION Kevat A, Bernard A, Harris M-A, et al. Impact of adenotonsillectomy on growth trajectories in preschool children with mild-moderate obstructive sleep apnea. J Clin Sleep Med. 2023;19(1):55-62.
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Affiliation(s)
- Ajay Kevat
- Department of Respiratory and Sleep Medicine, Queensland Children’s Hospital, Brisbane, Queensland, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Anne Bernard
- QCIF Bioinformatics, Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
| | - Margaret-Anne Harris
- Department of Respiratory and Sleep Medicine, Queensland Children’s Hospital, Brisbane, Queensland, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
- The Mater Research Institute, University of Queensland, Brisbane, Queensland, Australia
| | - Helen Heussler
- Department of Respiratory and Sleep Medicine, Queensland Children’s Hospital, Brisbane, Queensland, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
- The Mater Research Institute, University of Queensland, Brisbane, Queensland, Australia
| | - Robert Black
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
- Department of Paediatric Otolaryngology Head and Neck Surgery, Queensland Children’s Hospital, Brisbane, Queensland, Australia
| | - Alan Cheng
- Department of Paediatric Otolaryngology, The Children’s Hospital at Westmead, Sydney, New South Wales, Australia
- Discipline of Child and Adolescent Health, Faculty of Medicine, The University of Sydney, Sydney, New South Wales, Australia
| | - Karen Waters
- Discipline of Child and Adolescent Health, Faculty of Medicine, The University of Sydney, Sydney, New South Wales, Australia
- Department of Sleep Medicine, The Children’s Hospital at Westmead, Sydney, New South Wales, Australia
| | - Jasneek Chawla
- Department of Respiratory and Sleep Medicine, Queensland Children’s Hospital, Brisbane, Queensland, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
- The Mater Research Institute, University of Queensland, Brisbane, Queensland, Australia
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McKechnie A, Black R. Major complications of airway management: a prospective multicentre observational study. Anaesthesia 2022; 77:1067. [PMID: 35587257 DOI: 10.1111/anae.15761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2022] [Indexed: 11/28/2022]
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Gallagher MK, Baker J, Black R, Oliver AG, Lappin AG. An X-ray investigation of stereoselectivity in the interactions of [Co(en) 3] 3+ with [Co(ox) 3] 3− (en is ethane-1,2-diamine and ox is oxalate). Acta Crystallogr C Struct Chem 2022; 78:212-217. [DOI: 10.1107/s2053229622002194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 02/24/2022] [Indexed: 11/10/2022]
Abstract
The X-ray structure of racemic tris(ethane-1,2-diamine-κ2
N,N′)cobalt(III) tris(oxalato-κ2
O
1,O
2)cobaltate(III) pentahydrate, [Co(C2H8N2)3][Co(C2O4)3]·5H2O or [Co(en)3][Co(ox)3]·5H2O, has been determined. Hydrogen-bonding interactions along the C
3-axis of the [Co(en)3]3+ cation with the [Co(ox)3]3− anion are heterochiral, while those perpendicular to this axis are homochiral. Implications for the interpretation of chiral discriminations and induction in electron-transfer reactions in solution are discussed.
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Sharrow D, Hug L, You D, Alkema L, Black R, Cousens S, Croft T, Gaigbe-Togbe V, Gerland P, Guillot M, Hill K, Masquelier B, Mathers C, Pedersen J, Strong KL, Suzuki E, Wakefield J, Walker N. Global, regional, and national trends in under-5 mortality between 1990 and 2019 with scenario-based projections until 2030: a systematic analysis by the UN Inter-agency Group for Child Mortality Estimation. Lancet Glob Health 2022; 10:e195-e206. [PMID: 35063111 PMCID: PMC8789561 DOI: 10.1016/s2214-109x(21)00515-5] [Citation(s) in RCA: 90] [Impact Index Per Article: 45.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 09/29/2021] [Accepted: 10/25/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND The Sustainable Development Goals (SDGs), set in 2015 by the UN General Assembly, call for all countries to reach an under-5 mortality rate (U5MR) of at least as low as 25 deaths per 1000 livebirths and a neonatal mortality rate (NMR) of at least as low as 12 deaths per 1000 livebirths by 2030. We estimated levels and trends in under-5 mortality for 195 countries from 1990 to 2019, and conducted scenario-based projections of the U5MR and NMR from 2020 to 2030 to assess country progress in, and potential for, reaching SDG targets on child survival and the potential under-5 and neonatal deaths over the next decade. METHODS Levels and trends in under-5 mortality are based on the UN Inter-agency Group for Child Mortality Estimation (UN IGME) database on under-5 mortality, which contains around 18 000 country-year datapoints for 195 countries-nearly 10 000 of those datapoints since 1990. The database includes nationally representative mortality data from vital registration systems, sample registration systems, population censuses, and household surveys. As with previous sets of national UN IGME estimates, a Bayesian B-spline bias-reduction model (B3) that considers the systematic biases associated with the different data source types was fitted to these data to generate estimates of under-5 (age 0-4 years) mortality with uncertainty intervals for 1990-2019 for all countries. Levels and trends in the neonatal mortality rate (0-27 days) are modelled separately as the log ratio of the neonatal mortality rate to the under-5 mortality rate using a Bayesian model. Estimated mortality rates are combined with livebirths data to calculate the number of under-5 and neonatal deaths. To assess the regional and global burden of under-5 deaths in the present decade and progress towards SDG targets, we constructed several scenario-based projections of under-5 mortality from 2020 to 2030 and estimated national, regional, and global under-5 mortality trends up to 2030 for each scenario. FINDINGS The global U5MR decreased by 59% (90% uncertainty interval [UI] 56-61) from 93·0 (91·7-94·5) deaths per 1000 livebirths in 1990 to 37·7 (36·1-40·8) in 2019, while the annual number of global under-5 deaths declined from 12·5 (12·3-12·7) million in 1990 to 5·2 (5·0-5·6) million in 2019-a 58% (55-60) reduction. The global NMR decreased by 52% (90% UI 48-55) from 36·6 (35·6-37·8) deaths per 1000 livebirths in 1990, to 17·5 (16·6-19·0) in 2019, and the annual number of global neonatal deaths declined from 5·0 (4·9-5·2) million in 1990, to 2·4 (2·3-2·7) million in 2019, a 51% (47-54) reduction. As of 2019, 122 of 195 countries have achieved the SDG U5MR target, and 20 countries are on track to achieve the target by 2030, while 53 will need to accelerate progress to meet the target by 2030. 116 countries have reached the SDG NMR target with 16 on track, leaving 63 at risk of missing the target. If current trends continue, 48·1 million under-5 deaths are projected to occur between 2020 and 2030, almost half of them projected to occur during the neonatal period. If all countries met the SDG target on under-5 mortality, 11 million under-5 deaths could be averted between 2020 and 2030. INTERPRETATION As a result of effective global health initiatives, millions of child deaths have been prevented since 1990. However, the task of ending all preventable child deaths is not done and millions more deaths could be averted by meeting international targets. Geographical and economic variation demonstrate the possibility of even lower mortality rates for children under age 5 years and point to the regions and countries with highest mortality rates and in greatest need of resources and action. FUNDING Bill & Melinda Gates Foundation, US Agency for International Development.
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Affiliation(s)
- David Sharrow
- Division of Data, Analytics, Planning and Monitoring, UNICEF, New York, NY, USA
| | - Lucia Hug
- Division of Data, Analytics, Planning and Monitoring, UNICEF, New York, NY, USA
| | - Danzhen You
- Division of Data, Analytics, Planning and Monitoring, UNICEF, New York, NY, USA.
| | - Leontine Alkema
- Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, MA, USA
| | - Robert Black
- Department of International Health, Johns Hopkins University, Baltimore, MD, USA
| | - Simon Cousens
- London School of Hygiene & Tropical Medicine, London, UK
| | - Trevor Croft
- The Demographic and Health Surveys Program, ICF, Rockville, MD, USA
| | | | | | - Michel Guillot
- Population Studies Center, University of Pennsylvania, Philadelphia, PA, USA; French Institute for Demographic Studies, Paris, France
| | | | | | | | | | - Kathleen L Strong
- Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva, Switzerland
| | | | | | - Neff Walker
- Department of International Health, Johns Hopkins University, Baltimore, MD, USA
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10
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Kanji JN, Chan YLE, Boychuk LR, Boyington C, Turay S, Kobelsky M, Doroshuk C, Choo P, Jacka S, Roberts E, Leighton K, Smith SW, Sikora C, Black R. SARS-CoV-2 outbreak in a Canadian suburban tertiary hospital necessitating full facility closure: a descriptive observational study. CMAJ Open 2022; 10:E137-E145. [PMID: 35193878 PMCID: PMC9259436 DOI: 10.9778/cmajo.20210064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND SARS-CoV-2 can cause outbreaks in community- and hospital-based settings. The aim of this study was to provide a detailed epidemiologic account of a hospital-wide SARS-CoV-2 outbreak and provide a description of case evaluations, transmission networks and the interventions implemented to stem the outbreak. METHODS We conducted a retrospective descriptive study of a hospital-wide SARS-CoV-2 outbreak at the Misericordia Community Hospital (Edmonton) from June 21 to Aug. 14, 2020. We reviewed hospital chart, public health and occupational health records to determine demographics, case type (community- or hospital-acquired), need for critical care and outcome for each case linked to the outbreak (patients, hospital staff, and community and patient visitors). We developed detailed transmission networks using epidemiologic data to determine what variables may have contributed to transmission. RESULTS Fifty-eight cases of SARS-CoV-2 infection were linked to this hospital outbreak (31 patients, 25 staff members and 2 visitors; 66% female, age range 19-97 years). One patient required critical care, and 11 deaths were recorded (all among inpatients). Most cases were hospital-acquired (91%), and 28% were asymptomatic at the time of diagnosis. The outbreak was composed of 2 clusters driven by protective equipment breaches, premature removal of precautions, transmission in small staff quarters and infection of a staff member after exposure to a wandering patient with dementia and asymptomatic, undetected SARS-CoV-2 infection. INTERPRETATION A detailed epidemiologic review of this hospital-wide outbreak shows that a SARS-CoV-2 outbreak can involve complex transmission chains and clusters. Multipronged bundled approaches, aggressive contact tracing, and patient and staff prevalence screening are important to help bring such outbreaks under control, along with ongoing vigilance in detecting delayed cases.
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Affiliation(s)
- Jamil N Kanji
- Division of Infectious Diseases, Department of Medicine (Kanji, Boychuk, Boyington, Smith), University of Alberta; Covenant Health (Kanji, Boychuk, Boyington, Turay, Kobelsky, Doroshuk, Choo, Jacka, Roberts, Leighton, Black); Canadian Public Health Service, Public Health Agency of Canada (Chan); Division of Preventive Medicine, Faculty of Medicine and Dentistry (Sikora), University of Alberta; Medical Officer of Health (Edmonton Zone), (Sikora) Alberta Health Services; Department of Obstetrics and Gynecology, Faculty of Medicine and Dentistry (Black), University of Alberta, Edmonton, Alta. Note: Dr. J.N. Kanji is now with the Division of Infectious Diseases, Department of Medicine and Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alta.
| | - Y L Elaine Chan
- Division of Infectious Diseases, Department of Medicine (Kanji, Boychuk, Boyington, Smith), University of Alberta; Covenant Health (Kanji, Boychuk, Boyington, Turay, Kobelsky, Doroshuk, Choo, Jacka, Roberts, Leighton, Black); Canadian Public Health Service, Public Health Agency of Canada (Chan); Division of Preventive Medicine, Faculty of Medicine and Dentistry (Sikora), University of Alberta; Medical Officer of Health (Edmonton Zone), (Sikora) Alberta Health Services; Department of Obstetrics and Gynecology, Faculty of Medicine and Dentistry (Black), University of Alberta, Edmonton, Alta. Note: Dr. J.N. Kanji is now with the Division of Infectious Diseases, Department of Medicine and Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alta
| | - Lesia R Boychuk
- Division of Infectious Diseases, Department of Medicine (Kanji, Boychuk, Boyington, Smith), University of Alberta; Covenant Health (Kanji, Boychuk, Boyington, Turay, Kobelsky, Doroshuk, Choo, Jacka, Roberts, Leighton, Black); Canadian Public Health Service, Public Health Agency of Canada (Chan); Division of Preventive Medicine, Faculty of Medicine and Dentistry (Sikora), University of Alberta; Medical Officer of Health (Edmonton Zone), (Sikora) Alberta Health Services; Department of Obstetrics and Gynecology, Faculty of Medicine and Dentistry (Black), University of Alberta, Edmonton, Alta. Note: Dr. J.N. Kanji is now with the Division of Infectious Diseases, Department of Medicine and Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alta
| | - Curtiss Boyington
- Division of Infectious Diseases, Department of Medicine (Kanji, Boychuk, Boyington, Smith), University of Alberta; Covenant Health (Kanji, Boychuk, Boyington, Turay, Kobelsky, Doroshuk, Choo, Jacka, Roberts, Leighton, Black); Canadian Public Health Service, Public Health Agency of Canada (Chan); Division of Preventive Medicine, Faculty of Medicine and Dentistry (Sikora), University of Alberta; Medical Officer of Health (Edmonton Zone), (Sikora) Alberta Health Services; Department of Obstetrics and Gynecology, Faculty of Medicine and Dentistry (Black), University of Alberta, Edmonton, Alta. Note: Dr. J.N. Kanji is now with the Division of Infectious Diseases, Department of Medicine and Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alta
| | - Sebora Turay
- Division of Infectious Diseases, Department of Medicine (Kanji, Boychuk, Boyington, Smith), University of Alberta; Covenant Health (Kanji, Boychuk, Boyington, Turay, Kobelsky, Doroshuk, Choo, Jacka, Roberts, Leighton, Black); Canadian Public Health Service, Public Health Agency of Canada (Chan); Division of Preventive Medicine, Faculty of Medicine and Dentistry (Sikora), University of Alberta; Medical Officer of Health (Edmonton Zone), (Sikora) Alberta Health Services; Department of Obstetrics and Gynecology, Faculty of Medicine and Dentistry (Black), University of Alberta, Edmonton, Alta. Note: Dr. J.N. Kanji is now with the Division of Infectious Diseases, Department of Medicine and Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alta
| | - Melissa Kobelsky
- Division of Infectious Diseases, Department of Medicine (Kanji, Boychuk, Boyington, Smith), University of Alberta; Covenant Health (Kanji, Boychuk, Boyington, Turay, Kobelsky, Doroshuk, Choo, Jacka, Roberts, Leighton, Black); Canadian Public Health Service, Public Health Agency of Canada (Chan); Division of Preventive Medicine, Faculty of Medicine and Dentistry (Sikora), University of Alberta; Medical Officer of Health (Edmonton Zone), (Sikora) Alberta Health Services; Department of Obstetrics and Gynecology, Faculty of Medicine and Dentistry (Black), University of Alberta, Edmonton, Alta. Note: Dr. J.N. Kanji is now with the Division of Infectious Diseases, Department of Medicine and Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alta
| | - Carolyn Doroshuk
- Division of Infectious Diseases, Department of Medicine (Kanji, Boychuk, Boyington, Smith), University of Alberta; Covenant Health (Kanji, Boychuk, Boyington, Turay, Kobelsky, Doroshuk, Choo, Jacka, Roberts, Leighton, Black); Canadian Public Health Service, Public Health Agency of Canada (Chan); Division of Preventive Medicine, Faculty of Medicine and Dentistry (Sikora), University of Alberta; Medical Officer of Health (Edmonton Zone), (Sikora) Alberta Health Services; Department of Obstetrics and Gynecology, Faculty of Medicine and Dentistry (Black), University of Alberta, Edmonton, Alta. Note: Dr. J.N. Kanji is now with the Division of Infectious Diseases, Department of Medicine and Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alta
| | - Philana Choo
- Division of Infectious Diseases, Department of Medicine (Kanji, Boychuk, Boyington, Smith), University of Alberta; Covenant Health (Kanji, Boychuk, Boyington, Turay, Kobelsky, Doroshuk, Choo, Jacka, Roberts, Leighton, Black); Canadian Public Health Service, Public Health Agency of Canada (Chan); Division of Preventive Medicine, Faculty of Medicine and Dentistry (Sikora), University of Alberta; Medical Officer of Health (Edmonton Zone), (Sikora) Alberta Health Services; Department of Obstetrics and Gynecology, Faculty of Medicine and Dentistry (Black), University of Alberta, Edmonton, Alta. Note: Dr. J.N. Kanji is now with the Division of Infectious Diseases, Department of Medicine and Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alta
| | - Susan Jacka
- Division of Infectious Diseases, Department of Medicine (Kanji, Boychuk, Boyington, Smith), University of Alberta; Covenant Health (Kanji, Boychuk, Boyington, Turay, Kobelsky, Doroshuk, Choo, Jacka, Roberts, Leighton, Black); Canadian Public Health Service, Public Health Agency of Canada (Chan); Division of Preventive Medicine, Faculty of Medicine and Dentistry (Sikora), University of Alberta; Medical Officer of Health (Edmonton Zone), (Sikora) Alberta Health Services; Department of Obstetrics and Gynecology, Faculty of Medicine and Dentistry (Black), University of Alberta, Edmonton, Alta. Note: Dr. J.N. Kanji is now with the Division of Infectious Diseases, Department of Medicine and Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alta
| | - Erin Roberts
- Division of Infectious Diseases, Department of Medicine (Kanji, Boychuk, Boyington, Smith), University of Alberta; Covenant Health (Kanji, Boychuk, Boyington, Turay, Kobelsky, Doroshuk, Choo, Jacka, Roberts, Leighton, Black); Canadian Public Health Service, Public Health Agency of Canada (Chan); Division of Preventive Medicine, Faculty of Medicine and Dentistry (Sikora), University of Alberta; Medical Officer of Health (Edmonton Zone), (Sikora) Alberta Health Services; Department of Obstetrics and Gynecology, Faculty of Medicine and Dentistry (Black), University of Alberta, Edmonton, Alta. Note: Dr. J.N. Kanji is now with the Division of Infectious Diseases, Department of Medicine and Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alta
| | - Karen Leighton
- Division of Infectious Diseases, Department of Medicine (Kanji, Boychuk, Boyington, Smith), University of Alberta; Covenant Health (Kanji, Boychuk, Boyington, Turay, Kobelsky, Doroshuk, Choo, Jacka, Roberts, Leighton, Black); Canadian Public Health Service, Public Health Agency of Canada (Chan); Division of Preventive Medicine, Faculty of Medicine and Dentistry (Sikora), University of Alberta; Medical Officer of Health (Edmonton Zone), (Sikora) Alberta Health Services; Department of Obstetrics and Gynecology, Faculty of Medicine and Dentistry (Black), University of Alberta, Edmonton, Alta. Note: Dr. J.N. Kanji is now with the Division of Infectious Diseases, Department of Medicine and Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alta
| | - Stephanie W Smith
- Division of Infectious Diseases, Department of Medicine (Kanji, Boychuk, Boyington, Smith), University of Alberta; Covenant Health (Kanji, Boychuk, Boyington, Turay, Kobelsky, Doroshuk, Choo, Jacka, Roberts, Leighton, Black); Canadian Public Health Service, Public Health Agency of Canada (Chan); Division of Preventive Medicine, Faculty of Medicine and Dentistry (Sikora), University of Alberta; Medical Officer of Health (Edmonton Zone), (Sikora) Alberta Health Services; Department of Obstetrics and Gynecology, Faculty of Medicine and Dentistry (Black), University of Alberta, Edmonton, Alta. Note: Dr. J.N. Kanji is now with the Division of Infectious Diseases, Department of Medicine and Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alta
| | - Christopher Sikora
- Division of Infectious Diseases, Department of Medicine (Kanji, Boychuk, Boyington, Smith), University of Alberta; Covenant Health (Kanji, Boychuk, Boyington, Turay, Kobelsky, Doroshuk, Choo, Jacka, Roberts, Leighton, Black); Canadian Public Health Service, Public Health Agency of Canada (Chan); Division of Preventive Medicine, Faculty of Medicine and Dentistry (Sikora), University of Alberta; Medical Officer of Health (Edmonton Zone), (Sikora) Alberta Health Services; Department of Obstetrics and Gynecology, Faculty of Medicine and Dentistry (Black), University of Alberta, Edmonton, Alta. Note: Dr. J.N. Kanji is now with the Division of Infectious Diseases, Department of Medicine and Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alta
| | - Robert Black
- Division of Infectious Diseases, Department of Medicine (Kanji, Boychuk, Boyington, Smith), University of Alberta; Covenant Health (Kanji, Boychuk, Boyington, Turay, Kobelsky, Doroshuk, Choo, Jacka, Roberts, Leighton, Black); Canadian Public Health Service, Public Health Agency of Canada (Chan); Division of Preventive Medicine, Faculty of Medicine and Dentistry (Sikora), University of Alberta; Medical Officer of Health (Edmonton Zone), (Sikora) Alberta Health Services; Department of Obstetrics and Gynecology, Faculty of Medicine and Dentistry (Black), University of Alberta, Edmonton, Alta. Note: Dr. J.N. Kanji is now with the Division of Infectious Diseases, Department of Medicine and Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alta
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Tsang BL, Holsted E, McDonald CM, Brown KH, Black R, Mbuya MNN, Grant F, Rowe LA, Manger MS. Effects of Foods Fortified with Zinc, Alone or Cofortified with Multiple Micronutrients, on Health and Functional Outcomes: A Systematic Review and Meta-Analysis. Adv Nutr 2021; 12:1821-1837. [PMID: 34167148 PMCID: PMC8483949 DOI: 10.1093/advances/nmab065] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 03/02/2021] [Accepted: 05/05/2021] [Indexed: 12/29/2022] Open
Abstract
Seventeen per cent of the world's population is estimated to be at risk of inadequate zinc intake, which could in part be addressed by zinc fortification of widely consumed foods. We conducted a review of efficacy and effectiveness studies to ascertain the effect of zinc fortification [postharvest fortification of an industrially produced food or beverage; alone or with multiple micronutrients (MMN)] on a range of health outcomes. Previous reviews have required that the effect of zinc be isolated; because zinc is always cofortified with MMN in existing fortification programs, we did not impose this condition. Outcomes assessed were zinc-related biomarkers (plasma or serum, hair or urine zinc concentrations, comet assay, plasma fatty acid concentrations, and the proportion of and total zinc absorbed in the intestine from the diet), child anthropometry, morbidity, mortality, cognition, plasma or serum iron and copper concentrations, and for observational studies, a change in consumption of the food vehicle. Fifty-nine studies were included in the review; 54 in meta-analyses, totaling 73 comparisons. Zinc fortification with and without MMN increased plasma zinc concentrations (efficacy, n = 27: 4.68 μg/dL; 95% CI: 2.62-6.75; effectiveness, n = 13: 6.28 μg/dL; 95% CI: 5.03-7.77 μg/dL) and reduced the prevalence of zinc deficiency (efficacy, n = 11: OR: 0.76, 95% CI: 0.60-0.96; effectiveness, n = 10: OR: 0.45, 95% CI: 0.31-0.64). There were statistically significant increases in child weight (efficacy, n = 11: 0.43 kg, 95% CI: 0.11-0.75 kg), improvements in short-term auditory memory (efficacy, n = 3: 0.32 point, 95% CI: 0.13-0.50 point), and decreased incidence of diarrhea (efficacy, n = 3: RR: 0.79, 95% CI: 0.68-0.92) and fever (efficacy, n = 2: RR: 0.85, 95% CI: 0.74-0.97). However, these effects cannot be solely attributed to zinc. Our review found that zinc fortification with or without MMN reduced the prevalence of zinc deficiency and may provide health and functional benefits, including a reduced incidence of diarrhea.
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Affiliation(s)
- Becky L Tsang
- IZiNCG Fortification Task Force
- Food Fortification Initiative, Atlanta, GA, USA
| | - Erin Holsted
- IZiNCG Fortification Task Force
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Christine M McDonald
- IZiNCG Fortification Task Force
- International Zinc Nutrition Consultative Group, Oakland, CA, USA
- Department of Pediatrics, University of California San Francisco School of Medicine, San Francisco, CA, USA
| | - Kenneth H Brown
- IZiNCG Fortification Task Force
- Department of Nutrition and Institute for Global Nutrition, University of California, Davis, CA, USA
| | - Robert Black
- IZiNCG Fortification Task Force
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Mduduzi N N Mbuya
- IZiNCG Fortification Task Force
- Global Alliance for Improved Nutrition, Washington, DC, USA
| | - Frederick Grant
- IZiNCG Fortification Task Force
- Helen Keller International, Phnom Penh, Cambodia
| | - Laura A Rowe
- IZiNCG Fortification Task Force
- Food Fortification Initiative, Atlanta, GA, USA
| | - Mari S Manger
- IZiNCG Fortification Task Force
- International Zinc Nutrition Consultative Group, Oakland, CA, USA
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12
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Russell O, Lester S, Black R, Hill C. AB0142 SOCIOECONOMIC STATUS (SES) AND MEDICATION USE IN RHEUMATOID ARTHRITIS (RA): A SCOPING REVIEW. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.3439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Socioeconomic status (SES) influences disease outcomes in rheumatoid arthritis (RA) patients. (1, 2) Differences in medication use could partly explain this association. (3) A scoping review was used to identify research conducted on this topic and determine what knowledge gaps remain.Objectives:To determine what research has been conducted on this topic, how this research has defined SES and medication use, and establish what knowledge gaps remain.Methods:MEDLINE, EMBASE and PsychInfo were searched from their inception until May 2019 for studies which assessed SES and medication use as outcome variables. Studies were included if they measured medication use and incorporated an SES measure as a comparator variable.SES was defined using any of the “PROGRESS” framework variables (4) including patients’ stated gender, age, educational attainment, employment, occupational class, personal income, marital status, health insurance coverage, area- (neighbourhood) level SES, or patients’ stated race and/or ethnicity. Medication use was broadly defined as either prescription or dispensation of a medicine, medication adherence, or delays in treatment. Data was extracted on studies’ primary objectives, measurement of specific SES measures, patients’ medication use, and whether studies assessed for differences in patients’ medication use according to SES variables.Results:1464 studies were identified by this search from which 74 studies were selected for inclusion, including 52 published articles. Studies’ publication year ranged from 1994-2019, and originated from 20 countries; most commonly from the USA.Studies measured a median of 4 SES variables (IQR 3-6), with educational achievement, area level SES and race/ethnicity the most frequently recorded.Likelihood of disease modifying antirheumatic drug (DMARD) prescription was the most frequent primary objective recorded.96% of studies reported on patients’ use of DMARDs, with glucocorticoids and analgesics being reported in fewer studies (51% and 23% respectively.)Most included studies found at least one SES measure to be significantly associated with differences in patients’ medication use. In some studies, however, this result was not necessarily drawn from the primary outcome and therefore may not have been adjusted for covariates.70% of published studies measuring patients’ income (n=14 of 20) and 58% of those that measured race/ethnicity (n=14 of 24) documented significant differences in patients’ medication use according to these SES variables, although the direction of this effect – whether it led to ‘greater’ or ‘lesser’ medication use – varied between studies.Conclusion:Multiple definitions of SES are used in studies of medication use in RA patients. Despite this, most identified studies found evidence of a difference in medication use by patient groups that differed by an SES variable, although how medication use differed was found to vary between studies. This latter observation may relate to contextual factors pertaining to differences in countries’ healthcare systems. Further prospective studies with clearly defined SES and medication use measures may help confirm the apparent association between SES and differences in medication use.References:[1]Jacobi CE, Mol GD, Boshuizen HC, Rupp I, Dinant HJ, Van Den Bos GA. Impact of socioeconomic status on the course of rheumatoid arthritis and on related use of health care services. Arthritis Rheum. 2003;49(4):567-73.[2]ERAS Study Group. Socioeconomic deprivation and rheumatoid disease: what lessons for the health service? ERAS Study Group. Early Rheumatoid Arthritis Study. Annals of the rheumatic diseases. 2000;59(10):794-9.[3]Verstappen SMM. The impact of socio-economic status in rheumatoid arthritis. Rheumatology (Oxford). 2017;56(7):1051-2.[4]O’Neill J, Tabish H, Welch V, Petticrew M, Pottie K, Clarke M, et al. Applying an equity lens to interventions: using PROGRESS ensures consideration of socially stratifying factors to illuminate inequities in health. J Clin Epidemiol. 2014;67(1):56-64.Acknowledgements:This research was supported by an Australian Government Research Training Program Scholarship.Disclosure of Interests:None declared
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Kevat A, Chawla J, Bernard A, Harris MA, Heussler H, Black R, Waters K. 552 Impact of Adenotonsillectomy on Growth Trajectories in Preschool Children with Mild Obstructive Sleep Apnea. Sleep 2021. [DOI: 10.1093/sleep/zsab072.550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Adenotonsillectomy forms part of first-line management for pediatric obstructive sleep apnea (OSA). In nonrandomized studies of preschool-aged children, it is associated with postoperative weight gain. Being overweight or obese in childhood is a predictor of cardiovascular and metabolic disease in later life. Using longitudinal data from a multicenter randomised controlled trial, we assessed the impact of adenotonsillectomy on growth trajectory in preschool-aged children with mild-moderate OSA. Secondary aims were to assess the influence of social factors and baseline polysomnography parameters on growth trajectory.
Methods
A total of 190 children (aged 3–5 years) with obstructive apnea hypopnea index ≤10 were randomly assigned to early (within 2 months) or routine (12-month wait) adenotonsillectomy. Anthropometry and polysomnography were performed at baseline, 12-month and 24-month timepoints for 126 children. Social risk factors were recorded using a questionnaire. Baseline characteristics were compared using a Mann-Whitney or t-test for continuous variables, and Fisher’s exact test for categorical variables. Data were analyzed using linear mixed modelling.
Results
Demographic and polysomnographic parameters were similar between groups at baseline. Baseline body mass index (BMI) z-score was 0.52 for both groups. For BMI z-score, there was a significant increase in the early surgery group between 0 and 12 months (0.4, 95%CI 0.1–0.8) but not from 12–24 months. For the routine surgery group, there was a significant BMI z-score increase following surgery between 12 and 24 months (0.45, 95%CI 0.1–0.8), but not from 0–12 months. Final BMI z-score was similar between the two groups. Findings for weight-for-age z-score were similar to the abovementioned findings for BMI z-score. Height-for-age z-score was not significantly different between different timepoints or intervention groups. Children with an unemployed primary income earner had a higher BMI z-score than those with a full-time employed income earner. No other social risk or polysomnography parameters were statistically significant.
Conclusion
This study provides randomized controlled trial evidence of notable weight increase in preschool children with milder spectrum OSA that occurs in the months immediately following adenotonsillectomy. For children undergoing adenotonsillectomy, counselling regarding nutritional intake and exercise alongside weight monitoring should be considered, especially for those already at risk of becoming overweight or obese.
Support (if any):
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Schaefer R, Mayberry A, Briend A, Manary M, Walker P, Stobaugh H, Hanson K, McGrath M, Black R. Relapse and regression to severe wasting in children under 5 years: A theoretical framework. Matern Child Nutr 2021; 17:e13107. [PMID: 33145990 PMCID: PMC7988852 DOI: 10.1111/mcn.13107] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 10/04/2020] [Accepted: 10/15/2020] [Indexed: 12/21/2022]
Abstract
Systematic reviews have highlighted that repeated severe wasting after receiving treatment is likely to be common, but standardised measurement is needed urgently. The Council of Research & Technical Advice for Acute Malnutrition (CORTASAM) released recommendations on standard measurement of relapse (wasting within 6 months after exiting treatment as per recommended discharge criteria), regression (wasting within 6 months after exiting treatment before reaching recommended discharge criteria) and reoccurrence (wasting after 6 months of exit from treatment as per recommended discharge criteria). We provide a theoretical framework of post-treatment relapse and regression to severe wasting to guide discussions, risk factor analyses, and development and evaluations of interventions. This framework highlights that there are factors that may impact risk of relapse and regression in addition to the impact of contextual factors associated with incidence and reoccurrence of severe wasting more generally. Factors hypothesised to be associated with relapse and regression relate specifically to the nutrition and health status of the child on admission to, during and exit from treatment and treatment interventions, platforms and approaches as well as type of exit from treatment (e.g., before reaching recommended criteria). These factors influence whether children reach full recovery, and poorer nutritional and immunological status at exit from treatment are more proximate determinants of risk of severe wasting after treatment, although post-treatment interventions may modify risks. The evidence base for many of these factors is weak. Our framework can guide research to improve our understanding of risks of relapse and regression and how to prevent them and inform programmes on what data to collect to evaluate relapse. Implementation research is needed to operationalise results in programmes and reduce post-treatment severe wasting at scale.
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Affiliation(s)
| | - Amy Mayberry
- No Wasted Lives TeamAction Against Hunger UKLondonUK
| | - André Briend
- Center for Child Health ResearchTampere UniversityTampereFinland
- Department of Nutrition, Exercise and SportsUniversity of CopenhagenCopenhagenDenmark
| | - Mark Manary
- Department of PediatricsWashington University in St. LouisSt. LouisMissouriUSA
- School of Public Health and Family Medicine, College of MedicineUniversity of MalawiBlantyreMalawi
| | - Polly Walker
- No Wasted Lives TeamAction Against Hunger UKLondonUK
| | - Heather Stobaugh
- Action Against Hunger USNew YorkNew YorkUSA
- Friedman School Friedman School of Nutrition Science and PolicyTufts UniversityBostonMassachusettsUSA
| | | | | | - Robert Black
- Bloomberg School of Public HealthJohns Hopkins UniversityBaltimoreMarylandUSA
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Wise PH, Shiel A, Southard N, Bendavid E, Welsh J, Stedman S, Fazal T, Felbab-Brown V, Polatty D, Waldman RJ, Spiegel PB, Blanchet K, Dayoub R, Zakayo A, Barry M, Martinez Garcia D, Pagano H, Black R, Gaffey MF, Bhutta ZA. The political and security dimensions of the humanitarian health response to violent conflict. Lancet 2021; 397:511-521. [PMID: 33503458 DOI: 10.1016/s0140-6736(21)00130-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 10/01/2020] [Accepted: 10/02/2020] [Indexed: 11/22/2022]
Abstract
The nature of armed conflict throughout the world is intensely dynamic. Consequently, the protection of non-combatants and the provision of humanitarian services must continually adapt to this changing conflict environment. Complex political affiliations, the systematic use of explosive weapons and sexual violence, and the use of new communication technology, including social media, have created new challenges for humanitarian actors in negotiating access to affected populations and security for their own personnel. The nature of combatants has also evolved as armed, non-state actors might have varying motivations, use different forms of violence, and engage in a variety of criminal activities to generate requisite funds. New health threats, such as the COVID-19 pandemic, and new capabilities, such as modern trauma care, have also created new challenges and opportunities for humanitarian health provision. In response, humanitarian policies and practices must develop negotiation and safety capabilities, informed by political and security realities on the ground, and guidance from affected communities. More fundamentally, humanitarian policies will need to confront a changing geopolitical environment, in which traditional humanitarian norms and protections might encounter wavering support in the years to come.
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Affiliation(s)
- Paul H Wise
- Department of Pediatrics, Stanford University, CA, USA; Center for Innovation in Global Health, Stanford University, CA, USA; Stanford University School of Medicine, and The Freeman Spogli Institute for International Studies, Stanford University, CA, USA.
| | - Annie Shiel
- Stanford University School of Medicine, and The Freeman Spogli Institute for International Studies, Stanford University, CA, USA; Center for Civilians in Conflict, Washington DC, USA
| | - Nicole Southard
- Stanford University School of Medicine, and The Freeman Spogli Institute for International Studies, Stanford University, CA, USA
| | - Eran Bendavid
- Center for Innovation in Global Health, Stanford University, CA, USA; Department of Medicine, Stanford University, CA, USA; Stanford University School of Medicine, and The Freeman Spogli Institute for International Studies, Stanford University, CA, USA
| | - Jennifer Welsh
- Department of Political Science, McGill University, Montreal, QC, Canada
| | - Stephen Stedman
- Stanford University School of Medicine, and The Freeman Spogli Institute for International Studies, Stanford University, CA, USA
| | - Tanisha Fazal
- Department of Political Science, University of Minnesota, Minneapolis, MN, USA
| | - Vanda Felbab-Brown
- The Initiative on Nonstate Armed Actors, Foreign Policy Program, The Brookings Institution, Washington DC, USA
| | - David Polatty
- Civilian-Military Humanitarian Response Program, United States Naval War College, Newport, RI, USA
| | - Ronald J Waldman
- Milken Institute School of Public Health, George Washington University, Washington DC, USA
| | - Paul B Spiegel
- Center for Humanitarian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Karl Blanchet
- Geneva Centre for Education and Research in Humanitarian Action, University of Geneva, Geneva, Switzerland; Health and Humanitarian Crises Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Rita Dayoub
- Centre on Global Health Security, Chatham House, London, UK
| | | | - Michele Barry
- Center for Innovation in Global Health, Stanford University, CA, USA; Department of Medicine, Stanford University, CA, USA; Stanford University School of Medicine, and The Freeman Spogli Institute for International Studies, Stanford University, CA, USA
| | | | | | - Robert Black
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Michelle F Gaffey
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Zulfiqar A Bhutta
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Centre of Excellence in Women and Child Health and Institute for Global Health and Development, The Aga Khan University, Karachi, Pakistan
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Rodriguez-Martinez A, Zhou B, Sophiea MK, Bentham J, Paciorek CJ, Iurilli MLC, Carrillo-Larco RM, Bennett JE, Di Cesare M, Taddei C, Bixby H, Stevens GA, Riley LM, Cowan MJ, Savin S, Danaei G, Chirita-Emandi A, Kengne AP, Khang YH, Laxmaiah A, Malekzadeh R, Miranda JJ, Moon JS, Popovic SR, Sørensen TIA, Soric M, Starc G, Zainuddin AA, Gregg EW, Bhutta ZA, Black R, Abarca-Gómez L, Abdeen ZA, Abdrakhmanova S, Abdul Ghaffar S, Abdul Rahim HF, Abu-Rmeileh NM, Abubakar Garba J, Acosta-Cazares B, Adams RJ, Aekplakorn W, Afsana K, Afzal S, Agdeppa IA, Aghazadeh-Attari J, Aguilar-Salinas CA, Agyemang C, Ahmad MH, Ahmad NA, Ahmadi A, Ahmadi N, Ahmed SH, Ahrens W, Aitmurzaeva G, Ajlouni K, Al-Hazzaa HM, Al-Othman AR, Al-Raddadi R, Alarouj M, AlBuhairan F, AlDhukair S, Ali MM, Alkandari A, Alkerwi A, Allin K, Alvarez-Pedrerol M, Aly E, Amarapurkar DN, Amiri P, Amougou N, Amouyel P, Andersen LB, Anderssen SA, Ängquist L, Anjana RM, Ansari-Moghaddam A, Aounallah-Skhiri H, Araújo J, Ariansen I, Aris T, Arku RE, Arlappa N, Aryal KK, Aspelund T, Assah FK, Assunção MCF, Aung MS, Auvinen J, Avdicová M, Azevedo A, Azimi-Nezhad M, Azizi F, Azmin M, Babu BV, Bæksgaard Jørgensen M, Baharudin A, Bahijri S, Baker JL, Balakrishna N, Bamoshmoosh M, Banach M, Bandosz P, Banegas JR, Baran J, Barbagallo CM, Barceló A, Barkat A, Barros AJD, Barros MVG, Basit A, Bastos JLD, Bata I, Batieha AM, Batista RL, Battakova Z, Batyrbek A, Baur LA, Beaglehole R, Bel-Serrat S, Belavendra A, Ben Romdhane H, Benedics J, Benet M, Bennett JE, Berkinbayev S, Bernabe-Ortiz A, Bernotiene G, Bettiol H, Bezerra J, Bhagyalaxmi A, Bharadwaj S, Bhargava SK, Bhutta ZA, Bi H, Bi Y, Bia D, Bika Lele EC, Bikbov MM, Bista B, Bjelica DJ, Bjerregaard P, Bjertness E, Bjertness MB, Björkelund C, Bloch KV, Blokstra A, Bo S, Bobak M, Boddy LM, Boehm BO, Boeing H, Boggia JG, Bogova E, Boissonnet CP, Bojesen SE, Bonaccio M, Bongard V, Bonilla-Vargas A, Bopp M, Borghs H, Bovet P, Braeckevelt L, Braeckman L, Bragt MCE, Brajkovich I, Branca F, Breckenkamp J, Breda J, Brenner H, Brewster LM, Brian GR, Brinduse L, Brophy S, Bruno G, Bueno-de-Mesquita HB, Bugge A, Buoncristiano M, Burazeri G, Burns C, Cabrera de León A, Cacciottolo J, Cai H, Cama T, Cameron C, Camolas J, Can G, Cândido APC, Cañete F, Capanzana MV, Capková N, Capuano E, Capuano V, Cardol M, Cardoso VC, Carlsson AC, Carmuega E, Carvalho J, Casajús JA, Casanueva FF, Celikcan E, Censi L, Cervantes-Loaiza M, Cesar JA, Chamukuttan S, Chan AW, Chan Q, Chaturvedi HK, Chaturvedi N, Che Abdul Rahim N, Chen CJ, Chen F, Chen H, Chen S, Chen Z, Cheng CY, Cheraghian B, Chetrit A, Chikova-Iscener E, Chiolero A, Chiou ST, Chirita-Emandi A, Chirlaque MD, Cho B, Christensen K, Christofaro DG, Chudek J, Cifkova R, Cilia M, Cinteza E, Claessens F, Clarke J, Clays E, Cohen E, Concin H, Confortin SC, Cooper C, Coppinger TC, Corpeleijn E, Costanzo S, Cottel D, Cowell C, Craig CL, Crampin AC, Crujeiras AB, Csilla S, Cucu AM, Cui L, Cureau FV, D'Arrigo G, d'Orsi E, Dacica L, Dal Re Saavedra MÁ, Dallongeville J, Damasceno A, Damsgaard CT, Danaei G, Dankner R, Dantoft TM, Dasgupta P, Dastgiri S, Dauchet L, Davletov K, De Backer G, De Bacquer D, de Gaetano G, De Henauw S, de Oliveira PD, De Ridder D, De Ridder K, de Rooij SR, De Smedt D, Deepa M, Deev AD, DeGennaro VJ, Dehghan A, Delisle H, Delpeuch F, Demarest S, Dennison E, Deren K, Deschamps V, Dhana K, Dhimal M, Di Castelnuovo AF, Dias-da-Costa JS, Díaz-Sánchez ME, Diaz A, Dika Z, Djalalinia S, Djordjic V, Do HTP, Dobson AJ, Donati MB, Donfrancesco C, Donoso SP, Döring A, Dorobantu M, Dorosty AR, Doua K, Drygas W, Duan JL, Duante CA, Duboz P, Duda RB, Duleva V, Dulskiene V, Dumith SC, Dushpanova A, Dzerve V, Dziankowska-Zaborszczyk E, Eddie R, Eftekhar E, Egbagbe EE, Eggertsen R, Eghtesad S, Eiben G, Ekelund U, El-Khateeb M, El Ati J, Eldemire-Shearer D, Eliasen M, Elliott P, Engle-Stone R, Enguerran M, Erasmus RT, Erbel R, Erem C, Eriksen L, Eriksson JG, Escobedo-de la Peña J, Eslami S, Esmaeili A, Evans A, Faeh D, Fakhretdinova AA, Fall CH, Faramarzi E, Farjam M, Farrugia Sant'Angelo V, Farzadfar F, Fattahi MR, Fawwad A, Felix-Redondo FJ, Ferguson TS, Fernandes RA, Fernández-Bergés D, Ferrante D, Ferrao T, Ferrari M, Ferrario MM, Ferreccio C, Ferrer E, Ferrieres J, Figueiró TH, Fijalkowska A, Fink G, Fischer K, Föger B, Foo LH, Forsner M, Fouad HM, Francis DK, Franco MDC, Franco OH, Frikke-Schmidt R, Frontera G, Fuchs FD, Fuchs SC, Fujiati II, Fujita Y, Fumihiko M, Furusawa T, Gaciong Z, Gafencu M, Galbarczyk A, Galenkamp H, Galeone D, Galfo M, Galvano F, Gao J, Garcia-de-la-Hera M, García-Solano M, Gareta D, Garnett SP, Gaspoz JM, Gasull M, Gaya ACA, Gaya AR, Gazzinelli A, Gehring U, Geiger H, Geleijnse JM, Ghanbari A, Ghasemi E, Gheorghe-Fronea OF, Giampaoli S, Gianfagna F, Gill TK, Giovannelli J, Gironella G, Giwercman A, Gkiouras K, Godos J, Gogen S, Goldsmith RA, Goltzman D, Gómez SF, Gomula A, Goncalves Cordeiro da Silva B, Gonçalves H, Gonzalez-Chica DA, Gonzalez-Gross M, González-Leon M, González-Rivas JP, González-Villalpando C, González-Villalpando ME, Gonzalez AR, Gottrand F, Graça AP, Graff-Iversen S, Grafnetter D, Grajda A, Grammatikopoulou MG, Gregor RD, Grodzicki T, Grøholt EK, Grøntved A, Grosso G, Gruden G, Gu D, Gualdi-Russo E, Guallar-Castillón P, Gualtieri A, Gudmundsson EF, Gudnason V, Guerrero R, Guessous I, Guimaraes AL, Gulliford MC, Gunnlaugsdottir J, Gunter MJ, Guo XH, Guo Y, Gupta PC, Gupta R, Gureje O, Gurzkowska B, Gutiérrez-González E, Gutierrez L, Gutzwiller F, Ha S, Hadaegh F, Hadjigeorgiou CA, Haghshenas R, Hakimi H, Halkjær J, Hambleton IR, Hamzeh B, Hange D, Hanif AAM, Hantunen S, Hari Kumar R, Hashemi-Shahri SM, Hassapidou M, Hata J, Haugsgjerd T, Hayes AJ, He J, He Y, He Y, Heidinger-Felso R, Heinen M, Hejgaard T, Hendriks ME, Henrique RDS, Henriques A, Hernandez Cadena L, Herrala S, Herrera VM, Herter-Aeberli I, Heshmat R, Hill AG, Ho SY, Ho SC, Hobbs M, Hofman A, Holden Bergh I, Holdsworth M, Homayounfar R, Homs C, Hopman WM, Horimoto ARVR, Hormiga CM, Horta BL, Houti L, Howitt C, Htay TT, Htet AS, Htike MMT, Hu Y, Huerta JM, Huhtaniemi IT, Huidumac Petrescu C, Husseini A, Huu CN, Huybrechts I, Hwalla N, Hyska J, Iacoviello L, Ibarluzea JM, Ibrahim MM, Ibrahim Wong N, Ikeda N, Ikram MA, Iotova V, Irazola VE, Ishida T, Islam M, Islam SMS, Iwasaki M, Jackson RT, Jacobs JM, Jaddou HY, Jafar T, James K, Jamil KM, Jamrozik K, Janszky I, Janus E, Jarani J, Jarvelin MR, Jasienska G, Jelakovic A, Jelakovic B, Jennings G, Jha AK, Jiang CQ, Jimenez RO, Jöckel KH, Joffres M, Johansson M, Jokelainen JJ, Jonas JB, Jørgensen T, Joshi P, Joukar F, Jovic DP, Józwiak JJ, Juolevi A, Jurak G, Jurca Simina I, Juresa V, Kaaks R, Kaducu FO, Kafatos A, Kajantie EO, Kalmatayeva Z, Kalter-Leibovici O, Kameli Y, Kanala KR, Kannan S, Kapantais E, Karki KB, Katibeh M, Katz J, Katzmarzyk PT, Kauhanen J, Kaur P, Kavousi M, Kazakbaeva GM, Keil U, Keinan Boker L, Keinänen-Kiukaanniemi S, Kelishadi R, Kelleher C, Kemper HCG, Kengne AP, Keramati M, Kerimkulova A, Kersting M, Key T, Khader YS, Khalili D, Khang YH, Khaw KT, Kheiri B, Kheradmand M, Khosravi A, Khouw IMSL, Kiechl-Kohlendorfer U, Kiechl S, Killewo J, Kim DW, Kim HC, Kim J, Kindblom JM, Klakk H, Klimek M, Klimont J, Klumbiene J, Knoflach M, Koirala B, Kolle E, Kolsteren P, König J, Korpelainen R, Korrovits P, Korzycka M, Kos J, Koskinen S, Kouda K, Kovacs VA, Kowlessur S, Koziel S, Kratzer W, Kriemler S, Kristensen PL, Krokstad S, Kromhout D, Krtalic B, Kruger HS, Kubinova R, Kuciene R, Kujala UM, Kujundzic E, Kulaga Z, Kumar RK, Kunešová M, Kurjata P, Kusuma YS, Kuulasmaa K, Kyobutungi C, La QN, Laamiri FZ, Laatikainen T, Lachat C, Laid Y, Lam TH, Lambrinou CP, Landais E, Lanska V, Lappas G, Larijani B, Latt TS, Lauria L, Laxmaiah A, Lazo-Porras M, Le Nguyen Bao K, Le Port A, Le TD, Lee J, Lee J, Lee PH, Lehmann N, Lehtimäki T, Lemogoum D, Levitt NS, Li Y, Liivak M, Lilly CL, Lim WY, Lima-Costa MF, Lin HH, Lin X, Lin YT, Lind L, Linneberg A, Lissner L, Litwin M, Liu J, Liu L, Lo WC, Loit HM, Long KQ, Lopes L, Lopes O, Lopez-Garcia E, Lopez T, Lotufo PA, Lozano JE, Lukrafka JL, Luksiene D, Lundqvist A, Lundqvist R, Lunet N, Lunogelo C, Lustigová M, Luszczki E, Ma G, Ma J, Ma X, Machado-Coelho GLL, Machado-Rodrigues AM, Machi S, Macieira LM, Madar AA, Maggi S, Magliano DJ, Magnacca S, Magriplis E, Mahasampath G, Maire B, Majer M, Makdisse M, Mäki P, Malekzadeh F, Malekzadeh R, Malhotra R, Mallikharjuna Rao K, Malyutina SK, Maniego LV, Manios Y, Mann JI, Mansour-Ghanaei F, Manzato E, Margozzini P, Markaki A, Markey O, Markidou Ioannidou E, Marques-Vidal P, Marques LP, Marrugat J, Martin-Prevel Y, Martin R, Martorell R, Martos E, Marventano S, Mascarenhas LP, Masoodi SR, Mathiesen EB, Mathur P, Matijasevich A, Matsha TE, Mavrogianni C, Mazur A, Mbanya JCN, McFarlane SR, McGarvey ST, McKee M, McLachlan S, McLean RM, McLean SB, McNulty BA, Mediene-Benchekor S, Medzioniene J, Mehdipour P, Mehlig K, Mehrparvar AH, Meirhaeghe A, Meisfjord J, 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X, Yiallouros PK, Yoosefi M, Yoshihara A, You QS, You SL, Younger-Coleman NO, Yusof SM, Yusoff AF, Zaccagni L, Zafiropulos V, Zainuddin AA, Zakavi SR, Zamani F, Zambon S, Zampelas A, Zamrazilová H, Zapata ME, Zargar AH, Zaw KK, Zdrojewski T, Zeljkovic Vrkic T, Zeng Y, Zhang L, Zhang ZY, Zhao D, Zhao MH, Zhao W, Zhen S, Zheng W, Zheng Y, Zholdin B, Zhou M, Zhu D, Zocalo Y, Zuñiga Cisneros J, Zuziak M, Ezzati M. Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants. Lancet 2020; 396:1511-1524. [PMID: 33160572 PMCID: PMC7658740 DOI: 10.1016/s0140-6736(20)31859-6] [Citation(s) in RCA: 171] [Impact Index Per Article: 42.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 08/03/2020] [Accepted: 08/19/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. METHODS For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5-19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. FINDINGS We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9-10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes-gaining too little height, too much weight for their height compared with children in other countries, or both-occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. INTERPRETATION The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks. FUNDING Wellcome Trust, AstraZeneca Young Health Programme, EU.
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17
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Ahmad R, Xie L, Pyle M, Suarez MF, Broger T, Steinberg D, Ame SM, Lucero MG, Szucs MJ, MacMullan M, Berven FS, Dutta A, Sanvictores DM, Tallo VL, Bencher R, Eisinger DP, Dhingra U, Deb S, Ali SM, Mehta S, Fawzi WW, Riley ID, Sazawal S, Premji Z, Black R, Murray CJL, Rodriguez B, Carr SA, Walt DR, Gillette MA. A rapid triage test for active pulmonary tuberculosis in adult patients with persistent cough. Sci Transl Med 2020; 11:11/515/eaaw8287. [PMID: 31645455 DOI: 10.1126/scitranslmed.aaw8287] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 08/23/2019] [Indexed: 01/08/2023]
Abstract
Improved tuberculosis (TB) prevention and control depend critically on the development of a simple, readily accessible rapid triage test to stratify TB risk. We hypothesized that a blood protein-based host response signature for active TB (ATB) could distinguish it from other TB-like disease (OTD) in adult patients with persistent cough, thereby providing a foundation for a point-of-care (POC) triage test for ATB. Three adult cohorts consisting of ATB suspects were recruited. A bead-based immunoassay and machine learning algorithms identified a panel of four host blood proteins, interleukin-6 (IL-6), IL-8, IL-18, and vascular endothelial growth factor (VEGF), that distinguished ATB from OTD. An ultrasensitive POC-amenable single-molecule array (Simoa) panel was configured, and the ATB diagnostic algorithm underwent blind validation in an independent, multinational cohort in which ATB was distinguished from OTD with receiver operator characteristic-area under the curve (ROC-AUC) of 0.80 [95% confidence interval (CI), 0.75 to 0.85], 80% sensitivity (95% CI, 73 to 85%), and 65% specificity (95% CI, 57 to 71%). When host antibodies against TB antigen Ag85B were added to the panel, performance improved to 86% sensitivity and 69% specificity. A blood-based host response panel consisting of four proteins and antibodies to one TB antigen can help to differentiate ATB from other causes of persistent cough in patients with and without HIV infection from Africa, Asia, and South America. Performance characteristics approach World Health Organization (WHO) target product profile accuracy requirements and may provide the foundation for an urgently needed blood-based POC TB triage test.
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Affiliation(s)
- Rushdy Ahmad
- Broad Institute of Harvard and MIT, 415 Main Street, Cambridge, MA 02142, USA.
| | - Liangxia Xie
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, 60 Fenwood Road, Boston, MA 02115, USA.,Wyss Institute for Biologically Inspired Engineering at Harvard University, 3 Blackfan Circle, Boston, MA 02115, USA.,Department of Chemistry, Tufts University, Medford, MA 02155, USA
| | - Margaret Pyle
- University of Maryland Medical Center, 22 South Greene Street, Baltimore, MD 21201, USA
| | - Marta F Suarez
- Daktari Diagnostics, 85 Bolton Street, Cambridge, MA 02140, USA
| | - Tobias Broger
- Foundation for Innovative New Diagnostics, 9 Chemin des Mines, 1202 Geneva, Switzerland
| | - Dan Steinberg
- Salford Systems, 9685 Via Excelencia, Suite 208, San Diego, CA 92126, USA
| | - Shaali M Ame
- Public Health Laboratory-Ivo de Carneri, Wawi, Chake Chake, Pemba 5501021, Tanzania
| | - Marilla G Lucero
- Research Institute for Tropical Medicine, 9002 Research Drive, Filinvest Corporate City, Alabang, Muntinlupa City, 1781, Metro Manila, Philippines
| | - Matthew J Szucs
- Broad Institute of Harvard and MIT, 415 Main Street, Cambridge, MA 02142, USA
| | - Melanie MacMullan
- Broad Institute of Harvard and MIT, 415 Main Street, Cambridge, MA 02142, USA
| | - Frode S Berven
- Proteomics Unit, Department of Biomedicine, University of Bergen, 5009 Bergen, Norway
| | - Arup Dutta
- Center for Public Health Kinetics, 214A Vinobapuri, Lajpat Nagar-II, New Delhi 110024, India
| | - Diozele M Sanvictores
- Research Institute for Tropical Medicine, 9002 Research Drive, Filinvest Corporate City, Alabang, Muntinlupa City, 1781, Metro Manila, Philippines
| | - Veronica L Tallo
- Research Institute for Tropical Medicine, 9002 Research Drive, Filinvest Corporate City, Alabang, Muntinlupa City, 1781, Metro Manila, Philippines
| | | | | | - Usha Dhingra
- Center for Public Health Kinetics, 214A Vinobapuri, Lajpat Nagar-II, New Delhi 110024, India
| | - Saikat Deb
- Center for Public Health Kinetics, 214A Vinobapuri, Lajpat Nagar-II, New Delhi 110024, India
| | - Said M Ali
- Public Health Laboratory-Ivo de Carneri, Wawi, Chake Chake, Pemba 5501021, Tanzania
| | - Saurabh Mehta
- Institute for Nutritional Sciences, Global Health, and Technology, Cornell University, 314 Savage Hall, Ithaca, NY 14850, USA
| | - Wafaie W Fawzi
- Department of Global Health and Population, Harvard School of Public Health, 665 Huntington Avenue, Building 1, Room 1102, Boston, MA 02115, USA
| | - Ian D Riley
- The University of Queensland, Brisbane, QLD 4072, Australia
| | - Sunil Sazawal
- Center for Public Health Kinetics, 214A Vinobapuri, Lajpat Nagar-II, New Delhi 110024, India
| | - Zul Premji
- Department of Parasitology and Entomology, Muhimbili University of Health and Allied Sciences, United Nations Road, Dar es Salaam 0702172, Tanzania
| | - Robert Black
- Institute for International Programs, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA
| | - Christopher J L Murray
- Institute for Health Metrics and Evaluation, University of Washington, 2301 5th Avenue, Suite 600, Seattle, WA 98121, USA
| | - Bill Rodriguez
- Draper Richards Kaplan Foundation, 535 Boylston Street, Boston, MA 02116, USA
| | - Steven A Carr
- Broad Institute of Harvard and MIT, 415 Main Street, Cambridge, MA 02142, USA
| | - David R Walt
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, 60 Fenwood Road, Boston, MA 02115, USA. .,Wyss Institute for Biologically Inspired Engineering at Harvard University, 3 Blackfan Circle, Boston, MA 02115, USA.,Department of Chemistry, Tufts University, Medford, MA 02155, USA
| | - Michael A Gillette
- Broad Institute of Harvard and MIT, 415 Main Street, Cambridge, MA 02142, USA. .,Massachusetts General Hospital Division of Pulmonary and Critical Care Medicine, 55 Fruit Street, Boston, MA 02114, USA
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Bhutta ZA, Akseer N, Keats EC, Vaivada T, Baker S, Horton SE, Katz J, Menon P, Piwoz E, Shekar M, Victora C, Black R. How countries can reduce child stunting at scale: lessons from exemplar countries. Am J Clin Nutr 2020; 112:894S-904S. [PMID: 32692800 PMCID: PMC7487427 DOI: 10.1093/ajcn/nqaa153] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Child stunting and linear growth faltering have declined over the past few decades and several countries have made exemplary progress. OBJECTIVES To synthesize findings from mixed methods studies of exemplar countries to provide guidance on how to accelerate reduction in child stunting. METHODS We did a qualitative and quantitative synthesis of findings from existing literature and 5 exemplar country studies (Nepal, Ethiopia, Peru, Kyrgyz Republic, Senegal). Methodology included 4 broad research activities: 1) a series of descriptive analyses of cross-sectional data from demographic and health surveys and multiple indicator cluster surveys; 2) multivariable analysis of quantitative drivers of change in linear growth; 3) interviews and focus groups with national experts and community stakeholders and mothers; and 4) a review of policy and program evolution related to nutrition. RESULTS Several countries have dramatically reduced child stunting prevalence, with or without closing geographical, economic, and other population inequalities. Countries made progress through interventions from within and outside the health sector, and despite significant heterogeneity and differences in context, contributions were comparable from health and nutrition sectors (40% of change) and other sectors (50%), previously called nutrition-specific and -sensitive strategies. Improvements in maternal education, maternal nutrition, maternal and newborn care, and reductions in fertility/reduced interpregnancy intervals were strong contributors to change. A roadmap to reducing child stunting at scale includes several steps related to diagnostics, stakeholder consultations, and implementing direct and indirect nutrition interventions related to the health sector and nonhealth sector . CONCLUSIONS Our results show that child stunting reduction is possible even in diverse and challenging contexts. We propose that our framework of organizing nutrition interventions as direct/indirect and inside/outside the health sector should be considered when mapping causal pathways of child stunting and planning interventions and strategies to accelerate stunting reduction to achieve the 2030 Sustainable Development Goals.
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Affiliation(s)
- Zulfiqar A Bhutta
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Center of Excellence in Women and Child Health, the Aga Khan University, Karachi, Pakistan
| | - Nadia Akseer
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Emily C Keats
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Tyler Vaivada
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Shawn Baker
- United States Agency for International Development, Washington, DC, USA
| | - Susan E Horton
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Joanne Katz
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Purnima Menon
- Poverty, Health and Nutrition Division, International Food Policy Research Institute, South Asia Office, New Delhi, India
| | - Ellen Piwoz
- Global Development Division, Bill & Melinda Gates Foundation, Seattle, WA, USA
| | - Meera Shekar
- Health, Nutrition & Population, World Bank, Washington, DC, USA
| | - Cesar Victora
- Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Robert Black
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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19
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Headey D, Heidkamp R, Osendarp S, Ruel M, Scott N, Black R, Shekar M, Bouis H, Flory A, Haddad L, Walker N. Impacts of COVID-19 on childhood malnutrition and nutrition-related mortality. Lancet 2020; 396:519-521. [PMID: 32730743 PMCID: PMC7384798 DOI: 10.1016/s0140-6736(20)31647-0] [Citation(s) in RCA: 203] [Impact Index Per Article: 50.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 07/21/2020] [Indexed: 12/03/2022]
Affiliation(s)
- Derek Headey
- International Food Policy Research Institute (IFPRI), Washington, DC, USA
| | - Rebecca Heidkamp
- Johns Hopkins Bloomberg School of Public Health, Baltimore MD, USA
| | | | - Marie Ruel
- International Food Policy Research Institute (IFPRI), Washington, DC, USA
| | - Nick Scott
- Burnett Institute, Melbourne, VIC, Australia
| | - Robert Black
- Johns Hopkins Bloomberg School of Public Health, Baltimore MD, USA
| | | | - Howarth Bouis
- International Food Policy Research Institute (IFPRI), Washington, DC, USA
| | | | - Lawrence Haddad
- Global Alliance for Improved Nutrition (GAIN), Geneva, Switzerland
| | - Neff Walker
- Johns Hopkins Bloomberg School of Public Health, Baltimore MD, USA
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20
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Wahl B, Sharan A, Deloria Knoll M, Kumar R, Liu L, Chu Y, McAllister DA, Nair H, Campbell H, Rudan I, Ram U, Sauer M, Shet A, Black R, Santosham M, O'Brien KL, Arora NK. National, regional, and state-level burden of Streptococcus pneumoniae and Haemophilus influenzae type b disease in children in India: modelled estimates for 2000-15. Lancet Glob Health 2020; 7:e735-e747. [PMID: 31097277 PMCID: PMC6527518 DOI: 10.1016/s2214-109x(19)30081-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 12/21/2018] [Accepted: 01/25/2019] [Indexed: 11/17/2022]
Abstract
Background India accounts for a disproportionate burden of global childhood illnesses. To inform policies and measure progress towards achieving child health targets, we estimated the annual national and state-specific childhood mortality and morbidity attributable to Streptococcus pneumoniae and Haemophilus influenzae type b (Hib) between 2000 and 2015. Methods In this modelling study, we used vaccine clinical trial data to estimate the proportion of pneumonia deaths attributable to pneumococcus and Hib. The proportion of meningitis deaths attributable to each pathogen was derived from pathogen-specific meningitis case fatality and bacterial meningitis case data from surveillance studies. We applied these proportions to modelled state-specific pneumonia and meningitis deaths from 2000 to 2015 prepared by the WHO Maternal and Child Epidemiology Estimation collaboration (WHO/MCEE) on the basis of verbal autopsy studies from India. The burden of clinical and severe pneumonia cases attributable to pneumococcus and Hib was ascertained with vaccine clinical trial data and state-specific all-cause pneumonia case estimates prepared by WHO/MCEE by use of risk factor prevalence data from India. Pathogen-specific meningitis cases were derived from state-level modelled pathogen-specific meningitis deaths and state-level meningitis case fatality estimates. Pneumococcal and Hib morbidity due to non-pneumonia, non-meningitis (NPNM) invasive syndromes were derived by applying the ratio of pathogen-specific NPNM cases to pathogen-specific meningitis cases to the state-level pathogen-specific meningitis cases. Mortality due to pathogen-specific NPNM was calculated with the ratio of pneumococcal and Hib meningitis case fatality to pneumococcal and Hib meningitis NPNM case fatality. Census data from India provided the population at risk. Findings Between 2000 and 2015, estimates of pneumococcal deaths in Indian children aged 1–59 months fell from 166 000 (uncertainty range [UR] 110 000–198 000) to 68 700 (44 600–86 000), while Hib deaths fell from 82 600 (52 300–112 000) to 15 600 (9800–21 500), representing a 58% (UR 22–78) decline in pneumococcal deaths and an 81% (59–91) decline in Hib deaths. In 2015, national mortality rates in children aged 1–59 months were 56 (UR 37–71) per 100 000 for pneumococcal infection and 13 (UR 8–18) per 100 000 for Hib. Uttar Pradesh (18 900 [UR 12 300–23 600]) and Bihar (8600 [5600–10 700]) had the highest numbers of pneumococcal deaths in 2015. Uttar Pradesh (9300 [UR 5900–12 700]) and Odisha (1100 [700–1500]) had the highest numbers of Hib deaths in 2015. Less conservative assumptions related to the proportion of pneumonia deaths attributable to pneumococcus indicate that as many as 118 000 (UR 69 000–140 000) total pneumococcal deaths could have occurred in 2015 in India. Interpretation Pneumococcal and Hib mortality have declined in children aged 1–59 months in India since 2000, even before nationwide implementation of conjugate vaccines. Introduction of the Hib vaccine in several states corresponded with a more rapid reduction in morbidity and mortality associated with Hib infection. Rapid scale-up and widespread use of the pneumococcal conjugate vaccine and sustained use of the Hib vaccine could help accelerate achievement of child survival targets in India. Funding Bill & Melinda Gates Foundation.
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Affiliation(s)
- Brian Wahl
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | | | - Maria Deloria Knoll
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Rajesh Kumar
- School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Li Liu
- Institute for International Programs, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of International Health, and Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Yue Chu
- Institute for International Programs, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Harish Nair
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, Medical School, University of Edinburgh, Edinburgh, UK; Public Health Foundation of India, New Delhi, India
| | - Harry Campbell
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, Medical School, University of Edinburgh, Edinburgh, UK
| | - Igor Rudan
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, Medical School, University of Edinburgh, Edinburgh, UK
| | - Usha Ram
- Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, India
| | - Molly Sauer
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Anita Shet
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Robert Black
- Institute for International Programs, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Mathuram Santosham
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Katherine L O'Brien
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Welch VA, Hossain A, Ghogomu E, Riddle A, Cousens S, Gaffey M, Arora P, Black R, Bundy D, Castro MC, Chen L, Dewidar O, Elliott A, Friis H, Hollingsworth TD, Horton S, King CH, Thi HL, Liu C, Rohner F, Rousham EK, Salam R, Sartono E, Steinmann P, Supali T, Tugwell P, Webb E, Wieringa F, Winnichagoon P, Yazdanbakhsh M, Bhutta ZA, Wells GA. Deworming children for soil-transmitted helminths in low and middle-income countries: systematic review and individual participant data network meta-analysis. J Dev Effect 2019; 11:288-306. [PMID: 32256965 PMCID: PMC7077355 DOI: 10.1080/19439342.2019.1691627] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 11/07/2019] [Indexed: 06/11/2023]
Abstract
Intestinal parasites affect millions of children globally. We aimed to assess effects of deworming children on nutritional and cognitive outcomes across potential effect modifiers using individual participant data (IPD). We searched multiple databases to 27 March 2018, grey literature, and other sources. We included randomised and quasi randomised trials of deworming compared to placebo or other nutritional interventions with data on baseline infection. We used a random-effects network meta-analysis with IPD and assessed overall quality, following a pre-specified protocol. We received IPD from 19 trials of STH deworming. Overall risk of bias was low. There were no statistically significant subgroup effects across age, sex, nutritional status or infection intensity for each type of STH. These analyses showed that children with moderate or heavy intensity infections, deworming for STH may increase weight gain (very low certainty). The added value of this review is an exploration of effects on growth and cognition in children with moderate to heavy infections as well as replicating prior systematic review results of small effects at the population level. Policy implications are that complementary public health strategies need to be assessed and considered to achieve growth and cognition benefits for children in helminth endemic areas.
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Affiliation(s)
- Vivian Andrea Welch
- Bruyère Research Institute, Ottawa, Ontario, Canada
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Alomgir Hossain
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Cardiovascular Research Methods, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Institute for Clinical Evaluative Sciences (ICES), University of Ottawa, Ottawa, Ontario, Canada
| | - Elizabeth Ghogomu
- Bruyère Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Alison Riddle
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Simon Cousens
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine (LSHTM), London, UK
| | - Michelle Gaffey
- Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Paul Arora
- Public Health Agency of Canada in the National Public Health Laboratory, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Robert Black
- Department of International Health, Johns Hopkins School of Hygiene and Public Health, Baltimore, MD, USA
| | - Donald Bundy
- London School of Hygiene & Tropical Medicine, London, UK
| | | | - Li Chen
- Cardiovascular Research Methods, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Omar Dewidar
- Bruyère Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Alison Elliott
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene & Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | - Henrik Friis
- Department of Human Nutrition, University of Copenhagen, Frederiksberg, Denmark
| | - T. Déirdre Hollingsworth
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Sue Horton
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Charles H. King
- Center for Global Health and Diseases, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Huong Le Thi
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Chengfang Liu
- School of Advanced Agricultural Sciences (SAAS), China Center for Agricultural Policy (CCAP), Peking University, Beijing, China
| | | | - Emily K Rousham
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, UK
| | - Rehana Salam
- South Australian Health and Medical Research Institute, University of Adelaide, Adelaide, Australia
| | - Erliyani Sartono
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
| | - Peter Steinmann
- Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland
| | - Taniawati Supali
- Department of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Peter Tugwell
- Center for Global Health, WHO Collaborating Centre for Knowledge Translation and Health Technology Assessment in Health Equity, Bruyère Research Institute, School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Emily Webb
- Faculty of Epidemiology and Population Health, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Franck Wieringa
- UMR204 Nutripass, Institute de Recherche pour le Développement, IRD/UM/SupAgro, Montpellier, France
| | - Pattanee Winnichagoon
- Community/International Nutrition, Institute of Nutrition, Mahidol University, Salaya, Thailand
| | - Maria Yazdanbakhsh
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
| | - Zulfiqar A Bhutta
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada
- Center of Excellence in Women and Child Health, Aga Khan University
| | - George A Wells
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Cardiovascular Research Methods, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
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Welch VA, Ghogomu E, Hossain A, Riddle A, Gaffey M, Arora P, Dewidar O, Salam R, Cousens S, Black R, Hollingsworth TD, Horton S, Tugwell P, Bundy D, Castro MC, Elliott A, Friis H, Le HT, Liu C, Rousham EK, Rohner F, King C, Sartono E, Supali T, Steinmann P, Webb E, Wieringa F, Winnichagoon P, Yazdanbakhsh M, Bhutta ZA, Wells G. Mass deworming for improving health and cognition of children in endemic helminth areas: A systematic review and individual participant data network meta-analysis. Campbell Syst Rev 2019; 15:e1058. [PMID: 37131850 PMCID: PMC8356492 DOI: 10.1002/cl2.1058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Background Soil transmitted (or intestinal) helminths and schistosomes affect millions of children worldwide. Objectives To use individual participant data network meta-analysis (NMA) to explore the effects of different types and frequency of deworming drugs on anaemia, cognition and growth across potential effect modifiers. Search Methods We developed a search strategy with an information scientist to search MEDLINE, CINAHL, LILACS, Embase, the Cochrane Library, Econlit, Internet Documents in Economics Access Service (IDEAS), Public Affairs Information Service (PAIS), Social Services Abstracts, Global Health CABI and CAB Abstracts up to March 27, 2018. We also searched grey literature, websites, contacted authors and screened references of relevant systematic reviews. Selection Criteria We included randomised and quasirandomised deworming trials in children for deworming compared to placebo or other interventions with data on baseline infection. Data Collection and Analysis We conducted NMA with individual participant data (IPD), using a frequentist approach for random-effects NMA. The covariates were: age, sex, weight, height, haemoglobin and infection intensity. The effect estimate chosen was the mean difference for the continuous outcome of interest. Results We received data from 19 randomized controlled trials with 31,945 participants. Overall risk of bias was low. There were no statistically significant subgroup effects across any of the potential effect modifiers. However, analyses showed that there may be greater effects on weight for moderate to heavily infected children (very low certainty evidence). Authors' Conclusions This analysis reinforces the case against mass deworming at a population-level, finding little effect on nutritional status or cognition. However, children with heavier intensity infections may benefit more. We urge the global community to adopt calls to make data available in open repositories to facilitate IPD analyses such as this, which aim to assess effects for the most vulnerable individuals.
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Affiliation(s)
- Vivian A. Welch
- Centre for Global HealthBruyère Research InstituteOttawaOntarioCanada
- School of EpidemiologyPublic Health and Preventive Medicine, University of OttawaOttawaOntarioCanada
| | | | - Alomgir Hossain
- Cardiovascular Research MethodsUniversity of Ottawa Heart InstituteOttawaOntarioCanada
| | - Alison Riddle
- School of EpidemiologyPublic Health and Preventive Medicine, University of OttawaOttawaOntarioCanada
| | - Michelle Gaffey
- Hospital for Sick ChildrenUniversity of TorontoTorontoOntarioCanada
| | - Paul Arora
- Public Health Agency of Canada in the National Public Health Laboratory and Dalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
| | - Omar Dewidar
- Bruyère Research InstituteUniversity of OttawaOttawaOntarioCanada
| | - Rehana Salam
- South Australian Health and Medical Research InstituteUniversity of AdelaideAdelaideAustralia
| | - Simon Cousens
- London School of Hygiene and Tropical Medicine (LSHTM)LondonUK
| | - Robert Black
- Department of International HealthJohns Hopkins School of Hygiene and Public HealthBaltimoreMaryland
| | - T. Déirdre Hollingsworth
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of MedicineUniversity of OxfordOxfordUK
| | - Sue Horton
- School of Public Health and Health SystemsUniversity of WaterlooWaterlooOntarioCanada
| | - Peter Tugwell
- School of EpidemiologyPublic Health and Preventive Medicine, University of OttawaOttawaOntarioCanada
- Center for Global Health, WHO Collaborating Centre for Knowledge Translation and Health Technology Assessment in Health EquityBruyère Research InstituteOttawaOntarioCanada
| | | | | | - Alison Elliott
- Medical Research Council/Uganda Virus Research InstituteLondon School of Hygiene and Tropical Medicine Uganda Research UnitEntebbeUganda
| | - Henrik Friis
- Department of Human NutritionUniversity of CopenhagenFrederiksbergDenmark
| | - Huong T. Le
- Institute for Preventive Medicine and Public HealthHanoi Medical UniversityHanoiVietnam
| | - Chengfang Liu
- School of Advanced Agricultural Sciences (SAAS)China Center for Agricultural Policy (CCAP), Peking UniversityBeijingChina
| | - Emily K. Rousham
- School of Sport, Exercise and Health SciencesLoughborough UniversityLeicestershireUK
| | | | - Charles King
- Department of PediatricsUniversity of CaliforniaLa JollaCalifornia
| | - Erliyani Sartono
- Department of ParasitologyLeiden University Medical CenterLeidenThe Netherlands
| | - Taniawati Supali
- Department Parasitology, Faculty of MedicineUniversitas IndonesiaJakartaIndonesia
| | - Peter Steinmann
- Swiss Tropical and Public Health InstituteUniversity of BaselBaselSwitzerland
| | - Emily Webb
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population HealthLondon School of Hygiene and Tropical MedicineLondonUK
| | - Franck Wieringa
- UMR204 NutripassInstitute de Recherche pour le DéveloppementMontpellierFrance
| | - Pattanee Winnichagoon
- Community/International Nutrition, Institute of NutritionMahidol UniversityNakhon PathomThailand
| | - Maria Yazdanbakhsh
- Department of ParasitologyLeiden University Medical CenterLeidenThe Netherlands
| | - Zulfiqar A. Bhutta
- Centre for Global Child Health, The Hospital for Sick Children, Center of Excellence in Women and Child HealthAga Khan UniversityKarachiPakistan
| | - George Wells
- Cardiovascular Research MethodsUniversity of Ottawa Heart InstituteOttawaOntarioCanada
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23
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Black R, Fontaine O, Lamberti L, Bhan M, Huicho L, El Arifeen S, Masanja H, Walker CF, Mengestu TK, Pearson L, Young M, Orobaton N, Chu Y, Jackson B, Bateman M, Walker N, Merson M. Drivers of the reduction in childhood diarrhea mortality 1980-2015 and interventions to eliminate preventable diarrhea deaths by 2030. J Glob Health 2019; 9:020801. [PMID: 31673345 PMCID: PMC6815873 DOI: 10.7189/jogh.09.020801] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Childhood diarrhea deaths have declined more than 80% from 1980 to 2015, in spite of an increase in the number of children in low- and middle-income countries (LMIC). Possible drivers of this remarkable accomplishment can guide the further reduction of the half million annual child deaths from diarrhea that still occur. METHODS We used the Lives Saved Tool, which models effects on mortality due to changes in coverage of preventive or therapeutic interventions or risk factors, for 50 LMIC to determine the proximal drivers of the diarrhea mortality reduction. RESULTS Diarrhea treatment (oral rehydration solution [ORS], zinc, antibiotics for dysentery and management of persistent diarrhea) and use of rotavirus vaccine accounted for 49.7% of the diarrhea mortality reduction from 1980 to 2015. Improvements in nutrition (stunting, wasting, breastfeeding practices, vitamin A) accounted for 38.8% and improvements in water, sanitation and handwashing for 11.5%. The contribution of ORS was greater from 1980 to 2000 (58.0% of the reduction) than from 2000 to 2015 (30.7%); coverage of ORS increased from zero in 1980 to 29.5% in 2000 and more slowly to 44.1% by 2015. To eliminate the remaining childhood diarrhea deaths globally, all these interventions will be needed. Scaling up diarrhea treatment and rotavirus vaccine, to 90% coverage could reduce global child diarrhea mortality by 74.1% from 2015 levels by 2030. Adding improved nutrition could increase that to 89.1%. Finally, adding increased use of improved water sources, sanitation and handwashing could result in a 92.8% reduction from the 2015 level. CONCLUSIONS Employing the interventions that have resulted in such a large reduction in diarrhea mortality in the last 35 years can virtually eliminate remaining childhood diarrhea deaths by 2030.
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Affiliation(s)
- Robert Black
- Johns Hopkins University, Bloomberg School of Public Health, Department of International Health, Institute for International Programs, Baltimore, Maryland, USA
| | - Olivier Fontaine
- World Health Organization, Department of Maternal, Newborn, Child and Adolescent Health Child and Adolescent Health and Development, Geneva, Switzerland
| | - Laura Lamberti
- Bill & Melinda Gates Foundation, Enteric Diarrheal Diseases, Seattle, Washington, USA
| | - Maharaj Bhan
- Indian Institute of Technology, New Delhi, India
| | - Luis Huicho
- Centro de Investigación en Salud Materna e Infantil, Centro de Investigación para el Desarrollo Integral y Sostenible and School of Medicine, Lima, Peru
| | - Shams El Arifeen
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | | | - Christa Fischer Walker
- US Centers for Disease Control and Prevention, Maternal and Child Health, Windhoek, Namibia
| | | | - Luwei Pearson
- United Nations Children's Fund (UNICEF), New York, New York, USA
| | - Mark Young
- United Nations Children's Fund (UNICEF), New York, New York, USA
| | - Nosa Orobaton
- Bill & Melinda Gates Foundation, Maternal, Newborn and Child Health, Seattle, Washington, USA
| | - Yue Chu
- Johns Hopkins University, Bloomberg School of Public Health, Department of International Health, Institute for International Programs, Baltimore, Maryland, USA
| | - Bianca Jackson
- Johns Hopkins University, Bloomberg School of Public Health, Department of International Health, Institute for International Programs, Baltimore, Maryland, USA
| | - Massee Bateman
- US Agency for International Development (USAID), Jakarta, Indonesia
| | - Neff Walker
- Johns Hopkins University, Bloomberg School of Public Health, Department of International Health, Institute for International Programs, Baltimore, Maryland, USA (deceased)
| | - Michael Merson
- Duke University, Duke Global Health Institute, Durham, North Carolina, USA
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24
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Abstract
While glucocorticoids have been used for over 50 years to treat rheumatoid and osteoarthritis pain, the prescription of glucocorticoids remains controversial because of potentially harmful side effects at the molecular, cellular and tissue levels. One member of the glucocorticoid family, dexamethasone (DEX) has recently been demonstrated to rescue cartilage matrix loss and chondrocyte viability in animal studies and cartilage explant models of tissue injury and post-traumatic osteoarthritis, suggesting the possibility of DEX as a disease-modifying drug if used appropriately. However, the literature on the effects of DEX on cartilage reveals conflicting results on the drug's safety, depending on the dose and duration of DEX exposure as well as the model system used. Overall, DEX has been shown to protect against arthritis-related changes in cartilage structure and function, including matrix loss, inflammation and cartilage viability. These beneficial effects are not always observed in model systems using initially healthy cartilage or isolated chondrocytes, where many studies have reported significant increases in chondrocyte apoptosis. It is crucially important to understand under what conditions DEX may be beneficial or harmful to cartilage and other joint tissues and to determine potential for safe use of this glucocorticoid in the clinic as a disease-modifying drug.
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Affiliation(s)
- R. Black
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - A. J. Grodzinsky
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA,Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA,Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA, USA,Address for correspondence: Prof. Al Grodzinsky, MIT, Centre for Biomedical Engineering, 500 Technology Square, Cambridge, MA, 02139, USA.
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25
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Bourassa MW, Osendarp SJM, Adu-Afarwuah S, Ahmed S, Ajello C, Bergeron G, Black R, Christian P, Cousens S, de Pee S, Dewey KG, Arifeen SE, Engle-Stone R, Fleet A, Gernand AD, Hoddinott J, Klemm R, Kraemer K, Kupka R, McLean E, Moore SE, Neufeld LM, Persson LÅ, Rasmussen KM, Shankar AH, Smith E, Sudfeld CR, Udomkesmalee E, Vosti SA. Antenatal multiple micronutrient supplementation: call to action for change in recommendation. Ann N Y Acad Sci 2019; 1465:5-7. [PMID: 31691295 PMCID: PMC7053381 DOI: 10.1111/nyas.14271] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 10/18/2019] [Indexed: 01/22/2023]
Affiliation(s)
| | | | - Seth Adu-Afarwuah
- Department of Nutrition and Food Science, University of Ghana, Legon, Accra, Ghana
| | - Saima Ahmed
- The New York Academy of Sciences, New York, New York
| | - Clayton Ajello
- The Vitamin Angels Alliance, Inc., Santa Barbara, California
| | | | - Robert Black
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Parul Christian
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Bill & Melinda Gates Foundation, Seattle, Washington
| | - Simon Cousens
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Saskia de Pee
- Division of Human Nutrition and Health, Wageningen University, Wageningen, the Netherlands.,UN World Food Programme, Rome, Italy.,Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
| | - Kathryn G Dewey
- Department of Agricultural and Resource Economics, University of California, Davis, Davis, California
| | - Shams El Arifeen
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Reina Engle-Stone
- Department of Agricultural and Resource Economics, University of California, Davis, Davis, California
| | | | - Alison D Gernand
- The Pennsylvania State University, University Park, Pennsylvania
| | - John Hoddinott
- Division of Nutritional Sciences, Cornell University, Ithaca, New York
| | - Rolf Klemm
- The Vitamin Angels Alliance, Inc., Santa Barbara, California.,Helen Keller International, Baltimore, Maryland
| | | | | | | | - Sophie E Moore
- Department of Women and Children's Health, King's College London, London, United Kingdom
| | | | - Lars-Åke Persson
- London School of Hygiene and Tropical Medicine, Addis Ababa, Ethiopia
| | | | - Anuraj H Shankar
- Summit Institute of Development, Mataram, Indonesia.,Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom
| | - Emily Smith
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.,Departments of Global Health, and Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, D.C
| | - Christopher R Sudfeld
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | | | - Stephen A Vosti
- Department of Agricultural and Resource Economics, University of California, Davis, Davis, California
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26
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Gomes F, Bourassa MW, Adu-Afarwuah S, Ajello C, Bhutta ZA, Black R, Catarino E, Chowdhury R, Dalmiya N, Dwarkanath P, Engle-Stone R, Gernand AD, Goudet S, Hoddinott J, Kaestel P, Manger MS, McDonald CM, Mehta S, Moore SE, Neufeld LM, Osendarp S, Ramachandran P, Rasmussen KM, Stewart C, Sudfeld C, West K, Bergeron G. Setting research priorities on multiple micronutrient supplementation in pregnancy. Ann N Y Acad Sci 2019; 1465:76-88. [PMID: 31696532 PMCID: PMC7186835 DOI: 10.1111/nyas.14267] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 10/09/2019] [Accepted: 10/16/2019] [Indexed: 11/30/2022]
Abstract
Prenatal micronutrient deficiencies are associated with negative maternal and birth
outcomes. Multiple micronutrient supplementation (MMS) during pregnancy is a
cost-effective intervention to reduce these adverse outcomes. However, important knowledge
gaps remain in the implementation of MMS interventions. The Child Health and Nutrition
Research Initiative (CHNRI) methodology was applied to inform the direction of research
and investments needed to support the implementation of MMS interventions for pregnant
women in low- and middle-income countries (LMIC). Following CHNRI methodology guidelines,
a group of international experts in nutrition and maternal health provided and ranked the
research questions that most urgently need to be resolved for prenatal MMS interventions
to be successfully implemented. Seventy-three research questions were received, analyzed,
and reorganized, resulting in 35 consolidated research questions. These were scored
against four criteria, yielding a priority ranking where the top 10 research options
focused on strategies to increase antenatal care attendance and MMS adherence, methods
needed to identify populations more likely to benefit from MMS interventions and some
discovery issues (e.g., potential benefit of extending MMS through lactation). This
exercise prioritized 35 discrete research questions that merit serious consideration for
the potential of MMS during pregnancy to be optimized in LMIC.
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Affiliation(s)
| | | | | | | | - Zulfiqar A Bhutta
- Centre for Global Child Health, the Hospital for Sick Children, Toronto, Ontario, Canada.,Center of Excellence in Women and Child Health, the Aga Khan University, Karachi, Pakistan
| | - Robert Black
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | - Ranadip Chowdhury
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | | | | | | | | | | | - John Hoddinott
- Division of Nutritional Sciences, Cornell University, Ithaca, New York
| | - Pernille Kaestel
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Mari S Manger
- IZiNCG, Children's Hospital Oakland Research Institute, Oakland, California
| | | | - Saurabh Mehta
- Division of Nutritional Sciences, Cornell University, Ithaca, New York
| | - Sophie E Moore
- Department of Women & Children's Health, King's College London, London, United Kingdom
| | | | | | | | | | | | | | - Keith West
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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27
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Gillespie S, Menon P, Heidkamp R, Piwoz E, Rawat R, Munos M, Black R, Hayashi C, Kumar Saha K, Requejo J. Measuring the coverage of nutrition interventions along the continuum of care: time to act at scale. BMJ Glob Health 2019; 4:e001290. [PMID: 31297250 PMCID: PMC6590959 DOI: 10.1136/bmjgh-2018-001290] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 01/11/2019] [Accepted: 01/19/2019] [Indexed: 11/21/2022] Open
Abstract
The global community is committed to addressing malnutrition. And yet, coverage data for high-impact interventions along the continuum of care remain scarce due to several measurement and data collection challenges. In this analysis paper, we identify 24 nutrition interventions that should be tracked by all countries, and determine if their coverage is currently measured by major household nutrition and health surveys. We then present three case studies, using published literature and empirical data from large-scale initiatives, to illustrate the kind of data collection innovations that are feasible. We find that data are not routinely collected in a standardised way across countries for most of the core set of interventions. Case studies—of growth monitoring and screening for acute malnutrition, infant and young child feeding counselling, and nutrition monitoring in India—highlight both challenges and potential solutions. Advancing the nutrition intervention coverage measurement agenda is essential for sustained progress in driving down rates of malnutrition. It will require (1) global consensus on a core set of validated coverage indicators on proven, high-impact nutrition-specific interventions; (2) the inclusion of coverage measurement and indicator guidance in WHO intervention recommendations; (3) the incorporation of these indicators into data collection mechanisms and relevant intervention delivery platforms; and (4) an agenda for continuous measurement improvement.
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Affiliation(s)
- Stuart Gillespie
- Poverty, Health and Nutrition Division, International Food Policy Research Institute, Washington, District of Columbia, USA
| | - Purnima Menon
- Poverty, Health and Nutrition Division, International Food Policy Research Institute, Washington, District of Columbia, USA
| | - Rebecca Heidkamp
- International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ellen Piwoz
- Global Development Program, Bill and Melinda Gates Foundation, Seattle, Washington, USA
| | - Rahul Rawat
- Global Development Program, Bill and Melinda Gates Foundation, Seattle, Washington, USA
| | - Melinda Munos
- International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Robert Black
- International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Chika Hayashi
- Monitoring and Statistics, Unicef USA, New York, New York, USA
| | - Kuntal Kumar Saha
- Nutrition for Health and Development, Organisation mondiale de la Sante, Geneva, Switzerland
| | - Jennifer Requejo
- International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
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28
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Boerma T, Tappis H, Saad-Haddad G, Das J, Melesse DY, DeJong J, Spiegel P, Black R, Victora C, Bhutta ZA, Barros AJD. Armed conflicts and national trends in reproductive, maternal, newborn and child health in sub-Saharan Africa: what can national health surveys tell us? BMJ Glob Health 2019; 4:e001300. [PMID: 31297253 PMCID: PMC6590971 DOI: 10.1136/bmjgh-2018-001300] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Revised: 01/28/2019] [Accepted: 02/25/2019] [Indexed: 01/22/2023] Open
Abstract
Armed conflicts are widespread in sub-Saharan Africa and considered to be an important factor in slowing down national progress in reproductive, maternal, newborn and child health (RMNCH). The measurement of the impact of conflicts on national levels and trends in RMNCH is difficult. National surveys conducted before and sometimes during and after conflicts are a major source of information on the national and local effects of conflicts on RMNCH. We examined data from national surveys in 13 countries in sub-Saharan Africa with major conflicts during 1990–2016 to assess the levels and trends in RMNCH intervention coverage, nutritional status and mortality in children under 5 years in comparison with subregional trends. The surveys provide substantive evidence of a negative association between levels and trends in national indicators of RMNCH service coverage, child growth and under-5 mortality with armed conflict, with some notable exceptions. National surveys are an important source of data to assess the longer term national consequences of conflicts for RMNCH in most countries, despite limitations due to sampling and timing of the surveys.
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Affiliation(s)
- Ties Boerma
- Center for Global Public Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Hannah Tappis
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ghada Saad-Haddad
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Jai Das
- Faculty of Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Dessalegn Y Melesse
- Community Health Science, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jocelyn DeJong
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Paul Spiegel
- International Health, Bloomberg School of Public Health, Johns Hopkins Unversity, Baltimore, Maryland, USA
| | - Robert Black
- International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Cesar Victora
- Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | | | - Aluisio J D Barros
- International Center for Equity in Health, Universidade Federal de Pelotas, Pelotas, Brazil
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29
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Marchant T, Bhutta ZA, Black R, Grove J, Kyobutungi C, Peterson S. Advancing measurement and monitoring of reproductive, maternal, newborn and child health and nutrition: global and country perspectives. BMJ Glob Health 2019; 4:e001512. [PMID: 31297256 PMCID: PMC6590963 DOI: 10.1136/bmjgh-2019-001512] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 02/25/2019] [Indexed: 12/05/2022] Open
Affiliation(s)
- Tanya Marchant
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, UK
| | - Zulfiqar A Bhutta
- Sick Kids, University of Toronto, Toronto, Ontario, Canada
- Aga Khan University, Karachi, Pakistan
| | - Robert Black
- Institute for International Programs, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - John Grove
- World Health Organization, Geneva, Switzerland
| | | | - Stefan Peterson
- UNICEF, Health Section, Programme Division, New York City, New York, USA
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30
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Ciulei M, Hamadani J, Black R, Murray-Kolb L. Maternal and Infant Iron Status Are Related to Mother-Infant Interactions (P10-094-19). Curr Dev Nutr 2019. [DOI: 10.1093/cdn/nzz034.p10-094-19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Objectives
To examine the association between iron status and mother-infant interactions in dyads from rural Bangladesh.
Methods
Maternal-infant interactions were assessed in dyads from a substudy nested within a randomized controlled trial in rural Bangladesh. Recorded interactions (10 minutes free-play; 2 minutes diapering) at baseline (BL) (infant age 6–18 mo; n = 116), midline (ML) (+ 3 mo; n = 324), and endline (EL) (+ 6 mo; n = 336) were coded per the Emotional Availability Scales (EAS; 4 maternal scales: sensitivity, structuring, non-intrusiveness, non-hostility; 2 child scales: responsiveness, involvement). Ferritin (Ft), transferrin receptor (TfR), and hemoglobin (Hb; in infants only) concentrations were measured at BL and EL. Group differences (categorized by iron status irrespective of intervention group) were assessed via ANCOVA (covariates: socioeconomic status, mean upper arm circumference, weight-for-age Z-score, child sex and age and maternal depressive symptoms (Center for Epidemiologic Studies Depression Scale) and reasoning abilities (Raven's Progressive Matrices)). Stepwise regressions were run to determine predictors of the EAS scores.
Results
Prevalence of iron deficiency (ID; Ft < 23.7 mg/L) in infants dropped from 55% to 38% and of ID anemia (IDA; Hb < 110 g/L) from 53% to 32%, respectively. Only 12% of mothers were ID (Ft < 15.0 µg/L). Dyads of iron sufficient (IS) infants had higher involvement scores at BL and ML (both P ≤ 0.04), and higher sensitivity and structuring but lower non-intrusiveness scores (all P < 0.01) at ML vs dyads of ID infants. In the regressions, iron status of the mother and/or child was significantly predictive of maternal behaviors for most of the EA scales at all time points with better iron status predicting better behavioral scores except for non-intrusiveness. At BL (but not EL), child BL TfR was negatively related to involvement and responsiveness. No other iron status variables were associated with child behavior at any time point.
Conclusions
An association exists between maternal and infant iron status and dyadic interaction. Adequate iron status appears to benefit the dyadic relationship.
Funding Sources
USAID through the Johns Hopkins Global Research Activity Cooperative Agreement.
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Affiliation(s)
| | - Jena Hamadani
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
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31
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Sylvetsky AC, Hiedacavage A, Shah N, Pokorney P, Baldauf S, Merrigan K, Smith V, Long MW, Black R, Robien K, Avena N, Gaine C, Greenberg D, Wootan MG, Talegawkar S, Colon‐Ramos U, Leahy M, Ohmes A, Mennella JA, Sacheck J, Dietz WH. From biology to behavior: a cross-disciplinary seminar series surrounding added sugar and low-calorie sweetener consumption. Obes Sci Pract 2019; 5:203-219. [PMID: 31275594 PMCID: PMC6587329 DOI: 10.1002/osp4.334] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 02/06/2019] [Accepted: 02/10/2019] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION This report presents a synopsis of a three-part, cross-sector, seminar series held at the George Washington University (GWU) in Washington, DC from February-April, 2018. The overarching goal of the seminar series was to provide a neutral forum for diverse stakeholders to discuss and critically evaluate approaches to address added sugar intake, with a key focus on the role of low-calorie sweeteners (LCS). METHODS During three seminars, twelve speakers from academic institutions, federal agencies, non-profit organizations, and the food and beverage industries participated in six interactive panel discussions to address: 1) Do Farm Bill Policies Impact Population Sugar Intake? 2) What is the Impact of Sugar-sweetened Beverage (SSB) Taxes on Health and Business? 3) Is Sugar Addictive? 4) Product Reformulation Efforts: Progress, Challenges, and Concerns? 5) Low-calorie Sweeteners: Helpful or Harmful, and 6) Are Novel Sweeteners a Plausible Solution? Discussion of each topic involved brief 15-minute presentations from the speakers, which were followed by a 25-minute panel discussion moderated by GWU faculty members and addressed questions generated by the audience. Sessions were designed to represent opposing views and stimulate meaningful debate. Given the provocative nature of the seminar series, attendee questions were gathered anonymously using Pigeonhole™, an interactive, online, question and answer platform. RESULTS This report summarizes each presentation and recapitulates key perspectives offered by the speakers and moderators. CONCLUSIONS The seminar series set the foundation for robust cross-sector dialogue necessary to inform meaningful future research, and ultimately, effective policies for lowering added sugar intakes.
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Affiliation(s)
- A. C. Sylvetsky
- Milken Institute School of Public HealthThe George Washington University
| | - A. Hiedacavage
- Milken Institute School of Public HealthThe George Washington University
| | - N. Shah
- Milken Institute School of Public HealthThe George Washington University
| | - P. Pokorney
- Milken Institute School of Public HealthThe George Washington University
| | - S. Baldauf
- Milken Institute School of Public HealthThe George Washington University
| | - K. Merrigan
- Milken Institute School of Public HealthThe George Washington University
- Swette Center for Sustainable Food SystemsArizona State University
| | - V. Smith
- Department of Agricultural EconomicsMontana State University
| | - M. W. Long
- Milken Institute School of Public HealthThe George Washington University
| | - R. Black
- Quadrant D Consulting, LLCTufts University Friedman School of Nutrition Science & Policy
| | - K. Robien
- Milken Institute School of Public HealthThe George Washington University
| | - N. Avena
- Department of NeuroscienceMount Sinai School of Medicine
- Department of PsychologyPrinceton University
| | | | - D. Greenberg
- PepsiCo Inc. (Current affiliation NutriSci Inc.)
| | | | - S. Talegawkar
- Milken Institute School of Public HealthThe George Washington University
| | - U. Colon‐Ramos
- Milken Institute School of Public HealthThe George Washington University
| | - M. Leahy
- Food, Nutrition & Policy Solutions LLC
| | | | | | - J. Sacheck
- Milken Institute School of Public HealthThe George Washington University
| | - W. H. Dietz
- Milken Institute School of Public HealthThe George Washington University
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Headey D, Black R, Hoddinott J, Menon P, Victora C. The Evolution of Growth Faltering in 37 Developing Countries: A Spline-regression Approach (OR10-08-19). Curr Dev Nutr 2019. [DOI: 10.1093/cdn/nzz034.or10-08-19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objectives
Childhood height-for-age z-scores (HAZ) have been improving in many countries over the last few decades. Most HAZ faltering in malnourished populations takes place during the first 1000 days of life, in the prenatal period and the first two years after birth, but little is known about how growth faltering evolves over time in countries witnessing significant HAZ improvement. We aimed to quantify the evolution of population-level patterns of growth faltering using a novel analytic approach.
Methods
We selected 37 low and middle-income countries with at least two Demographic and Health Surveys 7 + years apart with statistically significant increases in HAZ among children 0–59 m. For the first (T1) and second (T2) round for each country we use spline-based regressions to estimate monthly HAZ loss over the prenatal period (conception to 1 m of age) and three postnatal periods (1–6 m, 6–20 m and 20 m onwards). We tested for statistically significant changes in the speed of HAZ loss between T1 and T2. We report results by T1 HAZ, country, and region.
Results
The fastest HAZ improvements between T1 and T2 occurred in Armenia, Ethiopia, Bangladesh, Nepal and India. South Asia had the fastest HAZ improvement of any major region. In South Asia and Eastern Africa, where baseline prenatal HAZ loss was prominent, the majority of HAZ improvement occurred in the prenatal period, suggesting progress in maternal factors. Improvements in regions with less baseline growth faltering typically stemmed from gains in postnatal HAZ, in the 1–6 m or 6–24 m period, but never the 24–59 m period. Several countries in Central and Western Africa, where overall HAZ changes were modest, showed improvement in some age ranges but deterioration in others (e.g., Nigeria).
Conclusions
HAZ improvements between T1 and T2 stemmed from a mix of changes in prenatal and postnatal growth faltering, with substantial variability across countries. The timing and speed of HAZ changes varied markedly by country and region, and over time. Examining the patterns of growth faltering over time can yield important insights into the biological origins of population-level HAZ improvements and point to successes and failures of policy efforts to address the drivers of child growth, and the challenges for designing new and improved approaches.
Funding Sources
Bill & Melinda Gates Foundation through ARENA, led by International Food Policy Research Institute, Wellcome Trust grant to Federal University of Pelotas.
Supporting Tables, Images and/or Graphs
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Bourassa MW, Osendarp SJM, Adu-Afarwuah S, Ahmed S, Ajello C, Bergeron G, Black R, Christian P, Cousens S, de Pee S, Dewey KG, Arifeen SE, Engle-Stone R, Fleet A, Gernand AD, Hoddinott J, Klemm R, Kraemer K, Kupka R, McLean E, Moore SE, Neufeld LM, Persson LÅ, Rasmussen KM, Shankar AH, Smith E, Sudfeld CR, Udomkesmalee E, Vosti SA. Review of the evidence regarding the use of antenatal multiple micronutrient supplementation in low- and middle-income countries. Ann N Y Acad Sci 2019; 1444:6-21. [PMID: 31134643 PMCID: PMC6852202 DOI: 10.1111/nyas.14121] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 04/26/2019] [Accepted: 04/26/2019] [Indexed: 12/22/2022]
Abstract
Inadequate micronutrient intakes are relatively common in low- and middle-income countries (LMICs), especially among pregnant women, who have increased micronutrient requirements. This can lead to an increase in adverse pregnancy and birth outcomes. This review presents the conclusions of a task force that set out to assess the prevalence of inadequate micronutrient intakes and adverse birth outcomes in LMICs; the data from trials comparing multiple micronutrient supplements (MMS) that contain iron and folic acid (IFA) with IFA supplements alone; the risks of reaching the upper intake levels with MMS; and the cost-effectiveness of MMS compared with IFA. Recent meta-analyses demonstrate that MMS can reduce the risks of preterm birth, low birth weight, and small for gestational age in comparison with IFA alone. An individual-participant data meta-analysis also revealed even greater benefits for anemic and underweight women and female infants. Importantly, there was no increased risk of harm for the pregnant women or their infants with MMS. These data suggest that countries with inadequate micronutrient intakes should consider supplementing pregnant women with MMS as a cost-effective method to reduce the risk of adverse birth outcomes.
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Affiliation(s)
| | - Saskia J M Osendarp
- Osendarp Nutrition, Berkel & Rodenrijs, the Netherlands.,Division of Human Nutrition and Health, Wageningen University, Wageningen, the Netherlands
| | - Seth Adu-Afarwuah
- Department of Nutrition and Food Science, University of Ghana, Legon, Accra, Ghana
| | - Saima Ahmed
- The New York Academy of Sciences, New York, New York
| | - Clayton Ajello
- The Vitamin Angels Alliance, Inc., Santa Barbara, California
| | | | - Robert Black
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Parul Christian
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Bill & Melinda Gates Foundation, Seattle, Washington
| | - Simon Cousens
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Saskia de Pee
- Division of Human Nutrition and Health, Wageningen University, Wageningen, the Netherlands.,UN World Food Programme, Rome, Italy.,Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
| | - Kathryn G Dewey
- Department of Nutrition, University of California, Davis, Davis, California
| | - Shams El Arifeen
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Reina Engle-Stone
- Department of Nutrition, University of California, Davis, Davis, California
| | | | | | - John Hoddinott
- Division of Nutritional Sciences, Cornell University, Ithaca, New York
| | - Rolf Klemm
- The Vitamin Angels Alliance, Inc., Santa Barbara, California.,Helen Keller International, Baltimore, Maryland
| | | | | | | | - Sophie E Moore
- Department of Women and Children's Health, King's College London, London, United Kingdom
| | | | - Lars-Åke Persson
- London School of Hygiene and Tropical Medicine, Addis Ababa, Ethiopia
| | | | - Anuraj H Shankar
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.,Summit Institute of Development, Mataram, Indonesia
| | - Emily Smith
- Bill & Melinda Gates Foundation, Seattle, Washington.,Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Christopher R Sudfeld
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | | | - Stephen A Vosti
- Department of Nutrition, University of California, Davis, Davis, California
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Novakovic D, Cheng ATL, Zurynski Y, Booy R, Walker PJ, Berkowitz R, Harrison H, Black R, Perry C, Vijayasekaran S, Wabnitz D, Burns H, Tabrizi SN, Garland SM, Elliott E, Brotherton JML. A Prospective Study of the Incidence of Juvenile-Onset Recurrent Respiratory Papillomatosis After Implementation of a National HPV Vaccination Program. J Infect Dis 2019; 217:208-212. [PMID: 29136168 DOI: 10.1093/infdis/jix498] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 09/14/2017] [Indexed: 11/13/2022] Open
Abstract
Background Recurrent respiratory papillomatosis is a rare but morbid disease caused by human papillomavirus (HPV) types 6 and 11. Infection is preventable through HPV vaccination. Following an extensive quadrivalent HPV vaccination program (females 12-26 years in 2007-2009) in Australia, we established a method to monitor incidence and demographics of juvenile-onset recurrent respiratory papillomatosis (JORRP) cases. Methods The Australian Paediatric Surveillance Unit undertakes surveillance of rare pediatric diseases by contacting practitioners monthly. We enrolled pediatric otorhinolaryngologists and offered HPV typing. We report findings for 5 years to end 2016. Results The average annual incidence rate was 0.07 per 100000. The largest number of cases was reported in the first year, with decreasing annual frequency thereafter. Rates declined from 0.16 per 100000 in 2012 to 0.02 per 100000 in 2016 (P = .034). Among the 15 incident cases (60% male), no mothers were vaccinated prepregnancy, 20% had maternal history of genital warts, and 60% were first born; 13/15 were born vaginally. Genotyped cases were HPV-6 (n = 4) or HPV-11 (n = 3). Conclusion To our knowledge, this is the first report internationally documenting decline in JORRP incidence in children following a quadrivalent HPV vaccination program.
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Affiliation(s)
- Daniel Novakovic
- University of Sydney Medical School, University of Sydney and Kids Research Institute, Sydney Children's Hospitals Network (Westmead)
| | - Alan T L Cheng
- University of Sydney Medical School, University of Sydney and Kids Research Institute, Sydney Children's Hospitals Network (Westmead).,ENT Department, Children's Hospital Westmead, University of Sydney and Kids Research Institute, Sydney Children's Hospitals Network (Westmead)
| | - Yvonne Zurynski
- University of Sydney Medical School, University of Sydney and Kids Research Institute, Sydney Children's Hospitals Network (Westmead).,Australian Paediatric Surveillance Unit, University of Sydney and Kids Research Institute, Sydney Children's Hospitals Network (Westmead)
| | - Robert Booy
- National Centre for Immunisation Research and Surveillance, Children's Hospital Westmead
| | - Paul J Walker
- Otolaryngology Department, John Hunter Children's Hospital, Newcastle, New South Wales
| | - Robert Berkowitz
- Otolaryngology Department, Royal Children's Hospital, Melbourne, Victoria
| | - Henley Harrison
- ENT Department, Sydney Children's Hospital, Randwick, New South Wales
| | - Robert Black
- Paediatric Otolaryngology Head and Neck Surgery Department, Lady Cilento Children's Hospital, Brisbane, Queensland
| | - Christopher Perry
- Paediatric Otolaryngology Head and Neck Surgery Department, Lady Cilento Children's Hospital, Brisbane, Queensland
| | - Shyan Vijayasekaran
- Department of Otolaryngology - Head and Neck Surgery, Princess Margaret Hospital for Children, Perth, Western Australia
| | - David Wabnitz
- Department of Otolaryngology - Head and Neck Surgery, Women's and Children's Hospital, Adelaide, South Australia
| | - Hannah Burns
- Paediatric Otolaryngology Head and Neck Surgery Department, Lady Cilento Children's Hospital, Brisbane, Queensland
| | - Sepehr N Tabrizi
- Royal Women's Hospital, Department of Microbiology and Infectious Diseases, and Murdoch Children's Research Institute, Infection and Immunity Theme, Parkville.,Department of Obstetrics and Gynaecology, University of Melbourne, Parkville
| | - Suzanne M Garland
- Royal Women's Hospital, Department of Microbiology and Infectious Diseases, and Murdoch Children's Research Institute, Infection and Immunity Theme, Parkville.,Department of Obstetrics and Gynaecology, University of Melbourne, Parkville
| | - Elizabeth Elliott
- Australian Paediatric Surveillance Unit, University of Sydney and Kids Research Institute, Sydney Children's Hospitals Network (Westmead)
| | - Julia M L Brotherton
- National HPV Vaccination Program Register, VCS, East Melbourne.,School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia
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Stobaugh HC, Mayberry A, McGrath M, Bahwere P, Zagre NM, Manary MJ, Black R, Lelijveld N. Relapse after severe acute malnutrition: A systematic literature review and secondary data analysis. Matern Child Nutr 2018; 15:e12702. [PMID: 30246929 PMCID: PMC6587999 DOI: 10.1111/mcn.12702] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 09/13/2018] [Accepted: 09/15/2018] [Indexed: 12/02/2022]
Abstract
The objectives of most treatment programs for severe acute malnutrition (SAM) in children focus on initial recovery only, leaving post‐discharge outcomes, such as relapse, poorly understood and undefined. This study aimed to systematically review current literature and conduct secondary data analyses of studies that captured relapse rates, up to 18‐month post‐discharge, in children following recovery from SAM treatment. The literature search (including PubMed and Google Scholar) built upon two recent reviews to identify a variety of up‐to‐date published studies and grey literature. This search yielded 26 articles and programme reports that provided information on relapse. The proportion of children who relapsed after SAM treatment varied greatly from 0% to 37% across varying lengths of time following discharge. The lack of a standard definition of relapse limited comparability even among the few studies that have quantified post‐discharge relapse. Inconsistent treatment protocols and poor adherence to protocols likely add to the wide range of relapse reported. Secondary analysis of a database from Malawi found no significant association between potential individual risk factors at admission and discharge, except being an orphan, which resulted in five times greater odds of relapse at 6 months post‐discharge (95% CI [1.7, 12.4], P = 0.003). The development of a standard definition of relapse is needed for programme implementers and researchers. This will allow for assessment of programme quality regarding sustained recovery and better understanding of the contribution of relapse to local and global burden of SAM.
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Affiliation(s)
- Heather C Stobaugh
- Food, Nutrition, and Obesity Policy and Research Team, RTI International, Research Triangle Park, North Carolina
| | - Amy Mayberry
- No Wasted Lives Team, Action Against Hunger, London, UK
| | | | - Paluku Bahwere
- Valid International, Oxford, UK.,Centre de Recherche en Epidémiologie, Biostatistique et Recherche Clinique, Ecole de santé publique, Université Libre de Bruxelles, City of Brussels, Belgium
| | - Noël Marie Zagre
- West and Central Africa Regional Office, UNICEF West and Central Africa Regional Office, Dakar, Senegal
| | - Mark J Manary
- Department of Pediatrics, Washington University in St. Louis, St. Louis, Missouri
| | - Robert Black
- Institute for International Programs, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Natasha Lelijveld
- No Wasted Lives Team, Action Against Hunger, London, UK.,Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada
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Veglia M, Cavallaro A, Papageorghiou A, Black R, Impey L. Small-for-gestational-age babies after 37 weeks: impact study of risk-stratification protocol. Ultrasound Obstet Gynecol 2018; 52:66-71. [PMID: 28600829 DOI: 10.1002/uog.17544] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 05/30/2017] [Accepted: 06/02/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE Although no clear evidence exists, many international guidelines advocate early-term delivery of small-for-gestational-age (SGA) fetuses. The aim of this study was to determine whether a risk-stratification protocol in which low-risk SGA fetuses are managed expectantly beyond 37 weeks affects perinatal and maternal outcomes. METHODS This was an impact study examining data collected over a 39-month period (1 January 2013 to 30 April 2016) at a tertiary referral unit. The study included women who were referred to the fetal medicine unit with a singleton non-anomalous fetus diagnosed antenatally as SGA (estimated fetal weight < 10th centile) from 36 + 0 weeks' gestation. In 2014, a protocol for management of SGA was introduced, which included risk stratification with surveillance and expectant management after 37 weeks for lower-risk babies (protocol group). This was compared with the previous strategy, which recommended delivery at around 37 weeks (pre-protocol group). Primary outcome was neonatal composite adverse outcome. RESULTS In the pre-protocol group, there were 138 SGA babies; in the protocol group there were 143. Mean gestational ages at delivery were 37.4 weeks in the pre-protocol group and 38.2 weeks in the protocol group (P = 0.04). The incidence of neonatal composite adverse outcome was lower in the protocol group (9% vs 22%; P < 0.01), as was neonatal unit admission (13% vs 39%; P < 0.01). Induction of labor and Cesarean section rates were lower, and vaginal delivery rate (83% vs 60%; P < 0.01) was higher, in the protocol group. Most of the differences were as a result of delayed delivery of SGA babies that were stratified as low risk. CONCLUSIONS The findings of this study suggest that protocol-based management of SGA babies may improve outcome, and that identification of moderate SGA should not in isolation prompt delivery. Larger numbers are required to assess any impact on perinatal mortality. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- M Veglia
- Nuffield Department of Obstetrics and Gynaecology, John Radcliffe Hospital, University of Oxford, Oxford, UK
- Department of Obstetrics and Gynaecology, Ospedale Cristo Re, Rome, Italy
| | - A Cavallaro
- Nuffield Department of Obstetrics and Gynaecology, John Radcliffe Hospital, University of Oxford, Oxford, UK
- Oxford Fetal Medicine Unit, Department of Maternal and Fetal Medicine, The Women's Center, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - A Papageorghiou
- Nuffield Department of Obstetrics and Gynaecology, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | - R Black
- Oxford Fetal Medicine Unit, Department of Maternal and Fetal Medicine, The Women's Center, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - L Impey
- Oxford Fetal Medicine Unit, Department of Maternal and Fetal Medicine, The Women's Center, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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Jamison DT, Alwan A, Mock CN, Nugent R, Watkins D, Adeyi O, Anand S, Atun R, Bertozzi S, Bhutta Z, Binagwaho A, Black R, Blecher M, Bloom BR, Brouwer E, Bundy DAP, Chisholm D, Cieza A, Cullen M, Danforth K, de Silva N, Debas HT, Donkor P, Dua T, Fleming KA, Gallivan M, Garcia PJ, Gawande A, Gaziano T, Gelband H, Glass R, Glassman A, Gray G, Habte D, Holmes KK, Horton S, Hutton G, Jha P, Knaul FM, Kobusingye O, Krakauer EL, Kruk ME, Lachmann P, Laxminarayan R, Levin C, Looi LM, Madhav N, Mahmoud A, Mbanya JC, Measham A, Medina-Mora ME, Medlin C, Mills A, Mills JA, Montoya J, Norheim O, Olson Z, Omokhodion F, Oppenheim B, Ord T, Patel V, Patton GC, Peabody J, Prabhakaran D, Qi J, Reynolds T, Ruacan S, Sankaranarayanan R, Sepúlveda J, Skolnik R, Smith KR, Temmerman M, Tollman S, Verguet S, Walker DG, Walker N, Wu Y, Zhao K. Universal health coverage and intersectoral action for health: key messages from Disease Control Priorities, 3rd edition. Lancet 2018; 391:1108-1120. [PMID: 29179954 PMCID: PMC5996988 DOI: 10.1016/s0140-6736(17)32906-9] [Citation(s) in RCA: 95] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 11/01/2017] [Accepted: 11/15/2017] [Indexed: 12/23/2022]
Abstract
The World Bank is publishing nine volumes of Disease Control Priorities, 3rd edition (DCP3) between 2015 and 2018. Volume 9, Improving Health and Reducing Poverty, summarises the main messages from all the volumes and contains cross-cutting analyses. This Review draws on all nine volumes to convey conclusions. The analysis in DCP3 is built around 21 essential packages that were developed in the nine volumes. Each essential package addresses the concerns of a major professional community (eg, child health or surgery) and contains a mix of intersectoral policies and health-sector interventions. 71 intersectoral prevention policies were identified in total, 29 of which are priorities for early introduction. Interventions within the health sector were grouped onto five platforms (population based, community level, health centre, first-level hospital, and referral hospital). DCP3 defines a model concept of essential universal health coverage (EUHC) with 218 interventions that provides a starting point for country-specific analysis of priorities. Assuming steady-state implementation by 2030, EUHC in lower-middle-income countries would reduce premature deaths by an estimated 4·2 million per year. Estimated total costs prove substantial: about 9·1% of (current) gross national income (GNI) in low-income countries and 5·2% of GNI in lower-middle-income countries. Financing provision of continuing intervention against chronic conditions accounts for about half of estimated incremental costs. For lower-middle-income countries, the mortality reduction from implementing the EUHC can only reach about half the mortality reduction in non-communicable diseases called for by the Sustainable Development Goals. Full achievement will require increased investment or sustained intersectoral action, and actions by finance ministries to tax smoking and polluting emissions and to reduce or eliminate (often large) subsidies on fossil fuels appear of central importance. DCP3 is intended to be a model starting point for analyses at the country level, but country-specific cost structures, epidemiological needs, and national priorities will generally lead to definitions of EUHC that differ from country to country and from the model in this Review. DCP3 is particularly relevant as achievement of EUHC relies increasingly on greater domestic finance, with global developmental assistance in health focusing more on global public goods. In addition to assessing effects on mortality, DCP3 looked at outcomes of EUHC not encompassed by the disability-adjusted life-year metric and related cost-effectiveness analyses. The other objectives included financial protection (potentially better provided upstream by keeping people out of the hospital rather than downstream by paying their hospital bills for them), stillbirths averted, palliative care, contraception, and child physical and intellectual growth. The first 1000 days after conception are highly important for child development, but the next 7000 days are likewise important and often neglected.
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Affiliation(s)
- Dean T Jamison
- University of California, San Francisco, San Francisco, CA, USA.
| | - Ala Alwan
- University of Washington, Seattle, WA, USA
| | | | | | | | | | | | - Rifat Atun
- Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | | | | | | | - Robert Black
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Mark Blecher
- National Treasury of South Africa, Cape Town, South Africa
| | - Barry R Bloom
- Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | | | | | - Dan Chisholm
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | | | | | | | | | - Haile T Debas
- University of California, San Francisco, San Francisco, CA, USA
| | - Peter Donkor
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Tarun Dua
- World Health Organization, Geneva, Switzerland
| | - Kenneth A Fleming
- Center for Global Health, National Cancer Institute, Bethesda, MD, USA; University of Oxford, Oxford, UK
| | | | | | - Atul Gawande
- Harvard T. H. Chan School of Public Health, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Brigham and Women's Hospital, Boston, MA, USA
| | - Thomas Gaziano
- Harvard Medical School, Boston, MA, USA; Brigham and Women's Hospital, Boston, MA, USA
| | | | - Roger Glass
- Fogarty International Center, US National Institutes of Health, Bethesda, MD, USA
| | | | - Glenda Gray
- University of the Witwatersrand, Johannesburg, South Africa
| | - Demissie Habte
- International Clinical Epidemiology Network, New Delhi, India
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Carol Medlin
- Praxis Social Impact Consulting, Washington, DC, USA
| | - Anne Mills
- London School of Hygiene & Tropical Medicine, London, UK
| | | | | | | | - Zachary Olson
- University of California, Berkeley, Berkeley, CA, USA
| | | | | | - Toby Ord
- University of Oxford, Oxford, UK
| | | | - George C Patton
- Murdoch Childrens Research Institute, Melbourne, VIC, Australia; University of Melbourne, Melbourne, VIC, Australia
| | - John Peabody
- University of California, San Francisco, San Francisco, CA, USA
| | - Dorairaj Prabhakaran
- London School of Hygiene & Tropical Medicine, London, UK; Public Health Foundation of India, New Delhi, India
| | - Jinyuan Qi
- Princeton, University, Princeton, NJ, USA
| | | | | | | | - Jaime Sepúlveda
- University of California, San Francisco, San Francisco, CA, USA
| | | | - Kirk R Smith
- University of California, Berkeley, Berkeley, CA, USA
| | | | | | | | | | - Neff Walker
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Yangfeng Wu
- The George Institute for Global Health at Peking University Health Science Center, Beijing, China
| | - Kun Zhao
- China National Health Development Research Center, Beijing, China
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Preiss B, Black R, Caron C, Shapcott D. Graphic Summaries of Expert Knowledge for the Medical Curriculum: An Experiment in Second-Year Nephrology. Methods Inf Med 2018. [DOI: 10.1055/s-0038-1634880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Abstract:This study was conducted to test the effects of Concept Graphics on learning in clinical nephrology. Second-year medical students were exposed to summaries of the major renal pathologies presented as text with, or without Concept Graphics for 30 minutes, followed by a quiz. Concept Graphics summarize diagnoses using icons that are metaphors of objects or processes. Of nine quiz questions, five were classified as correlation questions and four as memorization questions. The experimental group (n = 39) performed better than the controls (n = 33) in answering the correlation questions (p = 0.018). The experimental group mentioned more frequently than the controls two pathognomonic criteria of the nephritic syndrome (p = 0.02). Results of an opinion poll of the students, comparing sources used in their studies of nephrology were treated by correspondence analysis; the Concept Graphics ranked closest to the classification “very useful”.
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Clark A, Black R, Tate J, Roose A, Kotloff K, Lam D, Blackwelder W, Parashar U, Lanata C, Kang G, Troeger C, Platts-Mills J, Mokdad A, Sanderson C, Lamberti L, Levine M, Santosham M, Steele D. Estimating global, regional and national rotavirus deaths in children aged <5 years: Current approaches, new analyses and proposed improvements. PLoS One 2017; 12:e0183392. [PMID: 28892480 PMCID: PMC5593200 DOI: 10.1371/journal.pone.0183392] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 08/03/2017] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Rotavirus is a leading cause of diarrhoeal mortality in children but there is considerable disagreement about how many deaths occur each year. METHODS AND FINDINGS We compared CHERG, GBD and WHO/CDC estimates of age under 5 years (U5) rotavirus deaths at the global, regional and national level using a standard year (2013) and standard list of 186 countries. The global estimates were 157,398 (CHERG), 122,322 (GBD) and 215,757 (WHO/CDC). The three groups used different methods: (i) to select data points for rotavirus-positive proportions; (ii) to extrapolate data points to individual countries; (iii) to account for rotavirus vaccine coverage; (iv) to convert rotavirus-positive proportions to rotavirus attributable fractions; and (v) to calculate uncertainty ranges. We conducted new analyses to inform future estimates. We found that acute watery diarrhoea was associated with 87% (95% CI 83-90%) of U5 diarrhoea hospitalisations based on data from 84 hospital sites in 9 countries, and 65% (95% CI 57-74%) of U5 diarrhoea deaths based on verbal autopsy reports from 9 country sites. We reanalysed data from the Global Enteric Multicenter Study (GEMS) and found 44% (55% in Asia, and 32% in Africa) rotavirus-positivity among U5 acute watery diarrhoea hospitalisations, and 28% rotavirus-positivity among U5 acute watery diarrhoea deaths. 97% (95% CI 95-98%) of the U5 diarrhoea hospitalisations that tested positive for rotavirus were entirely attributable to rotavirus. For all clinical syndromes combined the rotavirus attributable fraction was 34% (95% CI 31-36%). This increased by a factor of 1.08 (95% CI 1.02-1.14) when the GEMS results were reanalysed using a more sensitive molecular test. CONCLUSIONS We developed consensus on seven proposals for improving the quality and transparency of future rotavirus mortality estimates.
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Affiliation(s)
- Andrew Clark
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Robert Black
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Jacqueline Tate
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Anna Roose
- University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | - Karen Kotloff
- University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | - Diana Lam
- University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | - William Blackwelder
- University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | - Umesh Parashar
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Claudio Lanata
- Instituto de Investigacion Nutricional, Lima, Peru
- Vanderbilt University, Nashville, Tennessee, United States of America
| | | | - Christopher Troeger
- Institute for Health Metrics and Evaluation, Seattle, Washington, United States of America
| | - James Platts-Mills
- University of Virginia, Charlottesville, Virginia, United States of America
| | - Ali Mokdad
- Institute for Health Metrics and Evaluation, Seattle, Washington, United States of America
| | | | - Colin Sanderson
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Laura Lamberti
- Bill & Melinda Gates Foundation, Seattle, Washington, United States of America
| | - Myron Levine
- University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | - Mathuram Santosham
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Duncan Steele
- Bill & Melinda Gates Foundation, Seattle, Washington, United States of America
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Krawczel PD, Ferneborg S, Black R, Agenäs S, Svennersten-Sjaunja K, Ternman E. 507 Milking efficiency in AMS using quarter level milking can be improved by applying a high take off level. J Anim Sci 2017. [DOI: 10.2527/asasann.2017.507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Krawczel P, Ferneborg S, Wiking L, Dalsgaard T, Gregersen S, Black R, Larsen T, Agenäs S, Svennersten-Sjaunja K, Ternman E. Milking time and risk of over-milking can be decreased with early teat cup removal based on udder quarter milk flow without loss in milk yield. J Dairy Sci 2017; 100:6640-6647. [DOI: 10.3168/jds.2016-12312] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 04/20/2017] [Indexed: 11/19/2022]
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Johnson MS, Black R. PATTERN BENEATH THE CHAOS: THE EFFECT OF RECRUITMENT ON GENETIC PATCHINESS IN AN INTERTIDAL LIMPET. Evolution 2017; 38:1371-1383. [PMID: 28563786 DOI: 10.1111/j.1558-5646.1984.tb05658.x] [Citation(s) in RCA: 114] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/1983] [Accepted: 05/08/1984] [Indexed: 11/30/2022]
Affiliation(s)
- Michael S. Johnson
- Department of Zoology; University of Western Australia; Nedlands 6009 Western Australia
| | - Robert Black
- Department of Zoology; University of Western Australia; Nedlands 6009 Western Australia
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Flacke GL, Tomkins JL, Black R, Steck B. Demographics of polycystic kidney disease and captive population viability in pygmy hippopotamus (Choeropsis liberiensis). Zoo Biol 2017; 36:136-151. [PMID: 28198143 DOI: 10.1002/zoo.21351] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 12/09/2016] [Accepted: 01/03/2017] [Indexed: 11/12/2022]
Abstract
Polycystic kidney disease (PKD) was previously diagnosed at necropsy in several pygmy hippopotami (Choeropsis liberiensis) from the Smithsonian National Zoo and Zoo Basel, suggesting a threat to the long-term viability of the captive population. We determined the incidence and demographics of PKD in the captive population historically; we tested if the condition is linked to pedigree; we investigated mode of inheritance; we examined effects of PKD on longevity; we conducted survival analysis; and we examined long-term population viability. Thirty-seven percent of 149 necropsied adult pygmy hippos were affected by PKD, and it was more common in females, controlling for the overall female-biased sex-ratio. Prevalence increased significantly with age, but most hippos were beyond their reproductive prime before developing clinical signs; thus fecundity was likely unaffected. PKD was linked to pedigree and may exhibit X-linked dominance, but further research is needed to definitively establish the mode of inheritance. PKD did not affect longevity, overall or within any age class. There was no significant correlation between inbreeding coefficient (F) and PKD, and the prevalence in wild-caught and captive-born animals was similar. Longevity for both captive-born and inbred hippos (F > 0) was significantly shorter than longevity for their wild-caught and non-inbred counterparts. Demographic projections indicated the extant population will likely experience a slow increase over time, provided there are no space constraints. We conclude that although PKD is an important cause of morbidity and mortality in pygmy hippos, the condition is not a primary concern for overall viability of the captive population.
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Affiliation(s)
- Gabriella L Flacke
- School of Animal Biology, University of Western Australia, Crawley, Australia
| | - Joseph L Tomkins
- School of Animal Biology, University of Western Australia, Crawley, Australia.,Center for Evolutionary Biology, School of Animal Biology, University of Western Australia, Crawley, Australia
| | - Robert Black
- School of Animal Biology, University of Western Australia, Crawley, Australia
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Waters KA, Chawla J, Harris MA, Dakin C, Heussler H, Black R, Cheng A, Burns H, Kennedy JD, Lushington K. Rationale for and design of the "POSTA" study: Evaluation of neurocognitive outcomes after immediate adenotonsillectomy compared to watchful waiting in preschool children. BMC Pediatr 2017; 17:47. [PMID: 28152984 PMCID: PMC5290671 DOI: 10.1186/s12887-016-0758-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 12/09/2016] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND IQ deficits are linked to even mild obstructive sleep apnoea (OSA) in children. Although OSA is commonly first diagnosed in the pre-school age group, a randomised trial is still needed to assess IQ outcomes after adenotonsillectomy in the pre-school age-group. This randomised control trial (RCT) will primarily determine whether adenotonsillectomy improves IQ compared to no adenotonsillectomy after 12 months, in preschool (3-5 year-old) children with mild to moderate OSA. METHODS This protocol is for an ongoing multi-centred RCT with a recruitment target of 210 subjects (105 in each arm). Children age 3-5 years with symptoms of OSA, are recruited through doctor referral, at the point of referral to the Ear Nose and Throat (ENT) services. Screening is initially with a questionnaire (Paediatric Sleep Questionnaire, PSQ) for symptoms of obstructive sleep apnoea (OSA). Where questionnaires are positive (suggestive of OSA) and ENT surgeons recommend them for adenotonsillectomy, they are invited to participate in POSTA. Baseline testing includes neurocognitive testing (IQ and psychometric evaluation with the neuropsychologist blinded to randomisation) and overnight polysomnography (PSG). Where the Obstructive Apnoea-Hypopnea Index (OAHI) from the PSG is <10/h per hour, consent for randomisation is sought; children with severe OSA (OAHI ≥ 10/h) are sent for immediate treatment and excluded from the study. After consent is obtained, participants are randomised to early surgery (within 2 months) or to surgery after a usual wait time of 12 months. Follow-up studies include repeat neurocognitive testing and PSG at 12 (with the waiting list group studied before their surgery) and 24 months after randomisation. Analysis will be by intention to treat. The primary outcome is IQ at 12 months' follow-up. DISCUSSION If IQ deficits associated with OSA are reversible 12 months after adenotonsillectomy compared to controls, future clinical practice advise would be to undertake early surgery in young children with OSA. The study could provide data on whether a window of opportunity exists for reversing IQ deficits linked to OSA in the pre-school age-group. TRIAL REGISTRATION Australian and New Zealand Clinical Trials Registration Number ACTRN12611000021976 .
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Affiliation(s)
- Karen A Waters
- The Children's Hospital at Westmead, Sydney, NSW, 2145, Australia. .,The University of Sydney, Sydney, Australia.
| | - Jasneek Chawla
- The Lady Cilento Children's Hospital, Brisbane, Australia.,The Mater Research Institute - The University of Queensland, Queensland, Australia
| | - Margaret-Anne Harris
- The Lady Cilento Children's Hospital, Brisbane, Australia.,The Mater Research Institute - The University of Queensland, Queensland, Australia
| | - Carolyn Dakin
- The Mater Research Institute - The University of Queensland, Queensland, Australia
| | - Helen Heussler
- The Lady Cilento Children's Hospital, Brisbane, Australia.,The Mater Research Institute - The University of Queensland, Queensland, Australia
| | - Robert Black
- The Lady Cilento Children's Hospital, Brisbane, Australia.,The Mater Research Institute - The University of Queensland, Queensland, Australia
| | - Alan Cheng
- The Children's Hospital at Westmead, Sydney, NSW, 2145, Australia
| | - Hannah Burns
- The Lady Cilento Children's Hospital, Brisbane, Australia.,The Mater Research Institute - The University of Queensland, Queensland, Australia
| | - John D Kennedy
- Women and Children's Hospital, Adelaide, Australia.,The University of South Australia, Adelaide, Australia
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Abstract
A 17-item students' rating scale, the Student Perception of Teacher Style, was developed by Tuckman as a measure of teachers' directiveness. Tuckman argues that this instrument provides a practical, valid and reliable alternative to ratings of teachers' behavior by trained observers. Ratings of male and female mathematics and English teachers were obtained from Grade 10 boys and girls. Factor analyses of ratings of male mathematics teachers ( n = 7) by boys ( n = 195), male English teachers ( n = 6) by boys ( n = 114), female mathematics teachers ( n = 3) by girls ( n = 40) and female English teachers ( n = 7) by girls ( n = 108) did not confirm Tuckman's factor structure.
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Affiliation(s)
| | - R. Black
- Alberta Vocational Centre Calgary
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46
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Fitchett EJA, Seale AC, Vergnano S, Sharland M, Heath PT, Saha SK, Agarwal R, Ayede AI, Bhutta ZA, Black R, Bojang K, Campbell H, Cousens S, Darmstadt GL, Madhi SA, Meulen AST, Modi N, Patterson J, Qazi S, Schrag SJ, Stoll BJ, Wall SN, Wammanda RD, Lawn JE. Strengthening the Reporting of Observational Studies in Epidemiology for Newborn Infection (STROBE-NI): an extension of the STROBE statement for neonatal infection research. Lancet Infect Dis 2016; 16:e202-e213. [PMID: 27633910 DOI: 10.1016/s1473-3099(16)30082-2] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 01/14/2016] [Accepted: 04/28/2016] [Indexed: 12/22/2022]
Abstract
Neonatal infections are estimated to account for a quarter of the 2·8 million annual neonatal deaths, as well as approximately 3% of all disability-adjusted life-years. Despite this burden, few data are available on incidence, aetiology, and outcomes, particularly regarding impairment. We aimed to develop guidelines for improved scientific reporting of observational neonatal infection studies, to increase comparability and to strengthen research in this area. This checklist, Strengthening the Reporting of Observational Studies in Epidemiology for Newborn Infection (STROBE- NI), is an extension of the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) statement. STROBE-NI was developed following systematic reviews of published literature (1996-2015), compilation of more than 130 potential reporting recommendations, and circulation of a survey to relevant professionals worldwide, eliciting responses from 147 professionals from 37 countries. An international consensus meeting of 18 participants (with expertise in infectious diseases, neonatology, microbiology, epidemiology, and statistics) identified priority recommendations for reporting, additional to the STROBE statement. Implementation of these STROBE-NI recommendations, and linked checklist, aims to improve scientific reporting of neonatal infection studies, increasing data utility and allowing meta-analyses and pathogen-specific burden estimates to inform global policy and new interventions, including maternal vaccines.
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Affiliation(s)
| | - Anna C Seale
- MARCH Centre, London School of Hygiene & Tropical Medicine, London, UK; The Farr Institute of Health Informatics Research, University College London, London, UK
| | - Stefania Vergnano
- Paediatric Infectious Disease Research Group, St George's University of London, London, UK
| | - Michael Sharland
- Paediatric Infectious Disease Research Group, St George's University of London, London, UK
| | - Paul T Heath
- Paediatric Infectious Disease Research Group, St George's University of London, London, UK
| | - Samir K Saha
- Child Health Research Foundation, Department of Microbiology, Dhaka Shishu Hospital, Dhaka, Bangladesh
| | - Ramesh Agarwal
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Adejumoke I Ayede
- Department of Paediatrics, College Of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria
| | - Zulfiqar A Bhutta
- Center of Excellence in Women and Child Health, The Aga Khan University, Karachi, Pakistan; Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada
| | - Robert Black
- Institute for International Programs, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kalifa Bojang
- Medical Research Council, The Gambia Unit, Banjul, The Gambia
| | - Harry Campbell
- Centre for Global Health Research, University of Edinburgh, Edinburgh, UK
| | - Simon Cousens
- MARCH Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Gary L Darmstadt
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Shabir A Madhi
- Medical Research Council: Respiratory and Meningeal Pathogens Research Unit & DST/NRF Vaccine Preventable Diseases, Faculty Health Science, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Neena Modi
- Royal College of Paediatrics and Child Health, London, UK; Department of Medicine, Section of Neonatal Medicine, Imperial College London, London, UK
| | - Janna Patterson
- Maternal, Newborn, and Child Health, Bill & Melinda Gates Foundation, Seattle, WA, USA
| | - Shamim Qazi
- Department of Maternal Newborn Child and Adolescent Health, WHO, Geneva, Switzerland
| | - Stephanie J Schrag
- Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Barbara J Stoll
- Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Stephen N Wall
- Saving Newborn Lives, Save the Children, Washington, DC, USA
| | - Robinson D Wammanda
- Department of Paediatrics, Ahmadu Bello University Teaching Hospital, Ahmadu Bello University, Zaria, Nigeria
| | - Joy E Lawn
- MARCH Centre, London School of Hygiene & Tropical Medicine, London, UK.
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Black R, Shyamsunder A, Adeli P, Kundu D, Murphy GK, Nazar LF. The Nature and Impact of Side Reactions in Glyme-based Sodium-Oxygen Batteries. ChemSusChem 2016; 9:1795-1803. [PMID: 27265118 DOI: 10.1002/cssc.201600034] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Revised: 03/15/2016] [Indexed: 06/05/2023]
Abstract
Although Na-O2 batteries have a low overpotential and good capacity retention, degradation reactions of glyme-based electrolytes are the primary reason for inefficiency in cell performance. The discharge capacity is accounted for through analysis of the side-products. Although sodium superoxide is the primary product (90 % theoretical), quantitative and qualitative evaluation of the side-products (using (1) H NMR, iodometric titration, and on-line mass spectrometry) shows the presence of sodium acetate (∼3.5 %), and three-fold less sodium formate, methoxy (oxo)acetic anhydride, and sodium carbonate. Our reaction mechanism proposes two paths for their formation. Because the side-products are not fully removed during oxidation, they accumulate on the cathode upon cycling. Resting the cell at open circuit potential during discharge results in consumption of the superoxide through the reaction with diglyme, which greatly increases the fraction of side products, as also confirmed by ex situ reaction studies. These findings have implications in the search for more stable electrolytes.
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Affiliation(s)
- Robert Black
- Department of Chemistry and the Waterloo Institute for Nanotechnology, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada
| | - Abhinandan Shyamsunder
- Department of Chemistry and the Waterloo Institute for Nanotechnology, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada
| | - Parvin Adeli
- Department of Chemistry and the Waterloo Institute for Nanotechnology, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada
| | - Dipan Kundu
- Department of Chemistry and the Waterloo Institute for Nanotechnology, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada
| | - Graham K Murphy
- Department of Chemistry and the Waterloo Institute for Nanotechnology, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada
| | - Linda F Nazar
- Department of Chemistry and the Waterloo Institute for Nanotechnology, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada.
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Johnson MS, Prince J, Brearley A, Rosser NL, Black R. Is Tridacna maxima (Bivalvia: Tridacnidae) at Ningaloo Reef, Western Australia? Molluscan Research 2016. [DOI: 10.1080/13235818.2016.1181141] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Michael S. Johnson
- School of Animal Biology, M092, University of Western Australia, Crawley, WA, Australia
| | - Jane Prince
- School of Animal Biology, M092, University of Western Australia, Crawley, WA, Australia
- Oceans Institute, University of Western Australia, Crawley, WA, Australia
| | - Anne Brearley
- School of Plant Biology, University of Western Australia, Crawley, WA, Australia
- Oceans Institute, University of Western Australia, Crawley, WA, Australia
| | - Natalie L. Rosser
- School of Animal Biology, M092, University of Western Australia, Crawley, WA, Australia
| | - Robert Black
- School of Animal Biology, M092, University of Western Australia, Crawley, WA, Australia
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Quinn S, Herron D, Menzies R, Scott L, Black R, Zhou Y, Waller A, Humphris G, Freeman R. The Video Interaction Guidance approach applied to teaching communication skills in dentistry. Eur J Dent Educ 2016; 20:94-101. [PMID: 25891196 DOI: 10.1111/eje.12146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/16/2015] [Indexed: 06/04/2023]
Abstract
PURPOSE To examine dentists' views of a novel video review technique to improve communication skills in complex clinical situations. MATERIALS AND METHODS Dentists (n = 3) participated in a video review known as Video Interaction Guidance to encourage more attuned interactions with their patients (n = 4). Part of this process is to identify where dentists and patients reacted positively and effectively. Each dentist was presented with short segments of video footage taken during an appointment with a patient with intellectual disabilities and communication difficulties. Having observed their interactions with patients, dentists were asked to reflect on their communication strategies with the assistance of a trained VIG specialist. RESULTS Dentists reflected that their VIG session had been insightful and considered the review process as beneficial to communication skills training in dentistry. They believed that this technique could significantly improve the way dentists interact and communicate with patients. The VIG sessions increased their awareness of the communication strategies they use with their patients and were perceived as neither uncomfortable nor threatening. DISCUSSION The VIG session was beneficial in this exploratory investigation because the dentists could identify when their interactions were most effective. Awareness of their non-verbal communication strategies and the need to adopt these behaviours frequently were identified as key benefits of this training approach. One dentist suggested that the video review method was supportive because it was undertaken by a behavioural scientist rather than a professional counterpart. CONCLUSION Some evidence supports the VIG approach in this specialist area of communication skills and dental training.
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Affiliation(s)
- S Quinn
- Dental Health Services Research Unit, University of Dundee, Dundee, UK
| | - D Herron
- School of Computing, University of Dundee, Dundee, UK
| | - R Menzies
- School of Computing, University of Dundee, Dundee, UK
| | - L Scott
- School of Computing, University of Dundee, Dundee, UK
| | - R Black
- School of Computing, University of Dundee, Dundee, UK
| | - Y Zhou
- School of Medicine, University of St Andrews, St Andrews, UK
| | - A Waller
- School of Computing, University of Dundee, Dundee, UK
| | - G Humphris
- School of Medicine, University of St Andrews, St Andrews, UK
| | - R Freeman
- Dental Health Services Research Unit, University of Dundee, Dundee, UK
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Fisher Walker CL, Taneja S, Lamberti LM, Lefevre A, Black R, Mazumder S. Management of childhood diarrhea among private providers in Uttar Pradesh, India. J Glob Health 2016; 6:010402. [PMID: 26955470 PMCID: PMC4756640 DOI: 10.7189/jogh.06.010402] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background In Uttar Pradesh (UP), India, a new initiative to introduce zinc and reinvigorate ORS for diarrhea treatment in the public and private sectors was rolled out in selected districts. We conducted an external evaluation of the program that included assessing the knowledge and practices of private sector providers 6 months after the initial program rollout. Methods We conducted interviews and direct observations among a randomly selected group of formal and informal private sector providers in 12 districts of UP. We calculated summary statistics for reported provider characteristics, diarrhea treatment knowledge and preferred treatments, as well as the treatments advised during consultation with a child with diarrhea. Results We interviewed 232 providers, of whom 67% reported receiving a diarrhea treatment training/drug detailing visit. In the interview, 14% of providers reported prescribing zinc to all children with diarrhea and 36% reported prescribing zinc to more than half of diarrhea cases. During direct observation, ORS and zinc were prescribed by 77.3% and 29.9% of providers, respectively. Treatments other than zinc and ORS were also commonly prescribed, including antibiotics (61.9%) and antidiarrheals (17.5%). Conclusion Adequate treatment of childhood diarrhea with zinc and ORS remains a challenge among private sector providers in rural UP, India. Additional training and knowledge transfer activities are needed to curb the overprescription of antibiotics and antidiarrheals and to increase the confidence of private providers in advising zinc and ORS. In addition, policymakers and program implementers must ensure collaborative efforts to target and meaningfully engage informal private providers who play a major role in childhood diarrhea treatment in hard–to–reach areas.
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Affiliation(s)
- Christa L Fisher Walker
- Johns Hopkins Bloomberg School of Public Health, Department of International Health, Baltimore, MD, USA
| | | | - Laura M Lamberti
- Johns Hopkins Bloomberg School of Public Health, Department of International Health, Baltimore, MD, USA
| | - Amnesty Lefevre
- Johns Hopkins Bloomberg School of Public Health, Department of International Health, Baltimore, MD, USA
| | - Robert Black
- Johns Hopkins Bloomberg School of Public Health, Department of International Health, Baltimore, MD, USA
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