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Recent meta-analyses demonstrate that small-quantity lipid-based nutrient supplements (SQ-LNS) for young children significantly reduce child mortality, stunting, wasting, anaemia and adverse developmental outcomes. Cost considerations should inform policy decisions. We developed a modelling framework to estimate the cost and cost-effectiveness of SQ-LNS and applied the framework in the context of rural Uganda.
Design:
We adapted costs from a costing study of micronutrient powder (MNP) in Uganda, and based effectiveness estimates on recent meta-analyses and Uganda-specific estimates of baseline mortality and the prevalence of stunting, wasting, anaemia and developmental disability.
Setting:
Rural Uganda.
Participants:
Not applicable.
Results:
Providing SQ-LNS daily to all children in rural Uganda (> 1 million) for 12 months (from 6 to 18 months of age) via the existing Village Health Team system would cost ∼$52 per child (2020 US dollars) or ∼$58·7 million annually. SQ-LNS could avert an average of > 242 000 disability-adjusted life years (DALYs) annually as a result of preventing 3689 deaths, > 160 000 cases of moderate or severe anaemia and ∼6000 cases of developmental disability. The estimated cost per DALY averted is $242.
Conclusions:
In this context, SQ-LNS may be more cost-effective than other options such as MNP or the provision of complementary food, although the total cost for a programme including all age-eligible children would be high. Strategies to reduce costs, such as targeting to the most vulnerable populations and the elimination of taxes on SQ-LNS, may enhance financial feasibility.
The development of laser wakefield accelerators (LWFA) over the past several years has led to an interest in very compact sources of X-ray radiation – such as “table-top” free electron lasers. However, the use of conventional undulators using permanent magnets also implies system sizes which are large. In this work, we assess the possibilities for the use of novel mini-undulators in conjunction with a LWFA so that the dimensions of the undulator become comparable with the acceleration distances for LWFA experiments (i.e., centimeters). The use of a prototype undulator using laser machining of permanent magnets for this application is described and the emission characteristics and limitations of such a system are determined. Preliminary electron propagation and X-ray emission measurements are taken with a LWFA electron beam at the University of Michigan.
In greenhouse studies, magnesium-deficient tomato (Lycopersicon esculentum Mill.) plants were more susceptible to 2-chloro-4-(ethylamino)-6-(isopropylamino)-s-triazine (atrazine) than normal plants when grown under continuous light. Under a 12-hr photoperiod, magnesium-atrazine interactions were not significant. Magnesium deficiency and continuous light each caused reductions in chlorophyll content in tomatoes. A combination of these two conditions caused an additive reduction in chlorophyll content and also caused the greatest susceptibility to atrazine. The influence of magnesium on atrazine toxicity may be due to its effect on chlorophyll content rather than a direct effect on atrazine action.
Three experiments were conducted in the greenhouse to study the effect of 1,1′-dimethyl-4,4′-bipyridinium salt (paraquat) when sprayed directly on seeds at the soil surface. Germination of alfalfa (Medicago sativa L., var. DuPuit) and red clover (Trifolium pratense L., var. Kenland) was not affected at 1 1b/A paraquat, but germination of Kentucky bluegrass (Poa pratensis L., var. Newport) and perennial ryegrass (Lolium perenne L., var. Linn) was severely reduced at that rate. A protecting layer of soil approximately 0.25 inch thick was completely effective in protecting the seeds from the effect of paraquat. Germination of seven other grass species was reduced by 0.5 1b/A paraquat.
To present the auditory implant manipulator, a navigation-controlled mechanical and electronic system which enables minimally invasive (‘keyhole’) transmastoid access to the tympanic cavity.
Materials and methods:
The auditory implant manipulator is a miniaturised robotic system with five axes of movement and an integrated drill. It can be mounted on the operating table. We evaluated the surgical work field provided by the system, and the work sequence involved, using an anatomical whole head specimen.
Results:
The work field provided by the auditory implant manipulator is considerably greater than required for conventional mastoidectomy. The work sequence for a keyhole procedure included pre-operative planning, arrangement of equipment, the procedure itself and post-operative analysis.
Conclusion:
Although system improvements are necessary, our preliminary results indicate that the auditory implant manipulator has the potential to perform keyhole insertion of implantable hearing devices.
Results from two studies involving challenge with respiratory syncytial viruses showed that volunteers who developed colds were more sensitive to a visually distracting pattern presented prior to virus challenge than were volunteers who did not get a cold. Volunteers with sub-clinical infections reported more illusions after virus challenge than they had done before, whereas uninfected volunteers and those with colds tended to report fewer illusions on the second test. These effects did not occur when volunteers were challenged with either a coronavirus or rhinovirus. Overall, the results confirm that behavioural measures may be related to susceptibility to subsequent illness, and that viral infections may influence visual perception. They also show that the effects vary according to the nature of the infecting agent, which agrees with results from studies looking at other aspects of behaviour.
Adult plaice (Pleuronectes platessa L.) in the southern North Sea use selective tidal stream transport to migrate between their summer feeding grounds and winter spawning grounds. The fish come up into midwater when the tidal stream is flowing in one direction, but remain on the bottom when it is flowing in the opposite direction. This behaviour can theoretically save energy, which can be used for growth or reproduction. Alternatively, it may provide a transport system by means of which fish that have no ability to navigate over long distances can be conveyed reliably between their feeding grounds and spawning grounds.
To determine the prescribing patterns for antipsychotics in care homes for the elderly, a cross-sectional study was carried out using data from the intervention group of a randomised controlled trial of medication review in care homes.
Results
Of 331 residents studied, 67 (20%) were prescribed an antipsychotic (70% atypical); 57 of these (85%) did not have a diagnosis of a psychotic disorder. The antipsychotic prescribing rate was 32% (46 out of 146) for those with dementia and 10% (17 out of 174) for those without dementia. A quarter (82 out of 331) had received a medication review by the general practitioner in the preceding 12 months.
Clinical Implications
One-fifth of residents were prescribed an antipsychotic with little evidence of review. Systems should ensure residents' treatment is reviewed regularly.
Alternate 2·4 m wide strips of a mixture of birdsfoot trefoil (Lotus corniculatus L.) with white clover (Trifolium repens L.) (BW), and of red clover (Trifolium pratense L.) (RC) were offered in the proportions (by area) of 0·80[ratio ]0·20, 0·67[ratio ]0·33, 0·33[ratio ]0·67 and 0·20[ratio ]0·80 to yearling heifers in groups of three for periods of 3 days over four replicates in time, balanced for effects of previous treatments. Observations on the distribution of grazing activity and biting rate were made over 3 h periods each evening, and on the morning of Day 2. Biting rates were consistently higher on BW than RC (52·3 v. 46·3±0·59 bites/min, P<0·001). Initially the animals showed a strong tendency to concentrate grazing on the sward of smaller proportional area, but the selection coefficient (log θ) changed from positive to negative with time as herbage on minority strips was depleted. These results are discussed in the context of concepts of partial grazing preference.
The effects of manipulation of sward maturity on ingestive behaviour and diet selection of grazing cattle were tested in two experiments using legumes which are equally preferred by cattle. Yearling heifers, in groups of three, grazed plots formed by alternate 2·4 m wide strips of a mixture of birdsfoot trefoil (Lotus corniculatus L.) and white clover (Trifolium repens L.) (BW) and strips of red clover (Trifolium pratense L.) (RC). The treatments comprised four combinations of each of the two swards at two contrasting levels of maturity/height replicated over four successive 3-day periods, in an order which balanced the effect of previous treatments. Observations of the distribution of grazing activity and biting rate were made over 3-hour periods each evening and in the morning of Day 2.
Rate of biting was generally greater on immature than mature swards, and on BW than on RC, with little evidence of interactions between these effects. The animals demonstrated partial preference throughout the two studies, the proportion of grazing time devoted to BW being 0·40±0·010 in Expt 1 and 0·47±0·017 in Expt 2. The distribution of grazing time between sward type and maturity combinations was influenced progressively by herbage mass and height contrasts as strips were grazed down. An overall analysis using the results from these studies and a companion experiment indicated differences between studies in partial preference for BW and RC which appeared to be related to variations in sward morphology.
from
PART I
-
ULTRASOUND PHYSICS, TECHNOLOGY AND HEMODYNAMICS
By
Arnold P. G. Hoeks, Departments of Biophysics and Physiology, Cardiovascular Research Institute Maastricht, The Netherlands,
Robert S. Reneman, Departments of Biophysics and Physiology, Cardiovascular Research Institute Maastricht, The Netherlands
Since 1990 a growing interest has developed for the dimensions, composition and structure of the arterial wall, specifically of such elastic arteries as the ascending and descending aorta and the carotid arteries. Functionally, the elastic arteries dampen the pressure pulse associated with a given volume pulse as ejected by the heart by an increase in cross-sectional area, thereby absorbing temporarily the volume pulse. The arterial wall will respond to a chronically elevated blood pressure by an increase in wall thickness to maintain wall stress at the same level. To what extent the increase in wall thickness is associated with a change in wall structure and composition, or can be regarded as a prelude to pathophysiological changes, like atherosclerosis, is still subject to debate. To be able to shed light on these relations, if any, direct and local information, among others, about the end-diastolic artery diameter and its change during the cardiac cycle, wall thickness and local blood pressure are required. These data allow the computation of the Young's modulus, a measure of elasticity, which characterizes the mechanical properties of the wall independent of wall mass, as well as the compliance, a measure of blood volume storage capacity which is of relevance for the hemodynamics.
The dimensions, mass and composition of the arterial wall do not only change in response to the transmural (pulsatile) pressure, but also in relation to the prevailing wall shear stress, i.e. the drag exerted by the flowing blood on the wall.
Various silicate glasses (fused silica, soda-lime, Na- and K-borosilicates, lithia-alumina silicate, and Pyrex®) were implanted with 8 x 1015 285 keV Au/cm2. Colloid growth was monitored as a function of annealing and N implantation (2 x 1017 35 keV N/cm2). Annealing to 1040 °C for fused silica and to 600 °C for the other glasses resulted in Au aggregation and optical absorption. Radiation damage removal is associated with the fused silica annealing; the aggregation of Au at lower temperatures for the other glasses is expected because of the lower glass transition temperature. Phase-seption in the alkali-borosilicates may be important because of grain-boundary diffusion. N implantation did not significantly affect nanocluster growth.
The construction of a prototype telescope is now reaching the stage of mirror polishing and building the active cell. Three blanks have already been produced. Two polishing methods are tested, utilizing the stressing technics, or involving excentered polishing strokes. A working model of one leg of the telescope translator has been built.
The pattern of food intake can affect the regulation of body weight and lipogenesis. We studied the effect of meal frequency on human energy expenditure (EE) and its components. During 1 week ten male adults (age 25–61 years, body mass index 20·7–30·4 kg/m2) were fed to energy balance at two meals/d (gorging pattern) and during another week at seven meals/d (nibbling pattern). For the first 6 d of each week the food was provided at home, followed by a 36 h stay in a respiration chamber. O2 consumption and CO2 production (and hence EE) were calculated over 24 h. EE in free-living conditions was measured over the 2 weeks with doubly-labelled water (average daily metabolic rate, ADMR). The three major components of ADMR are basal metabolic rate (BMR), diet-induced thermogenesis (DIT) and EE for physical activity (ACT). There was no significant effect of meal frequency on 24 h EE or ADMR. Furthermore, BMR and ACT did not differ between the two patterns. DIT was significantly elevated in the gorging pattern, but this effect was neutralized by correction for the relevant time interval. With the method used for determination of DIT no significant effect of meal frequency on the contribution of DIT to ADMR could be demonstrated.
Damage depths for Ar-implanted fused silica have been examined by Rutherford backscattering (RBS) and elastic recoil detection (ERD) ion-beam analysis. H incursion (6 at. %) from ambient atmospheres to twice TRIM values was found for damage depths which intersected the surface. H implants were used to decorate Ar damage for deeper Ar implants. The incursion of H for high-fluence implants is important for optoelectronic applications.