Famine in Ethiopia 1983–1985: kwashiorkor and marasmus in four regions

Introduction. In scientific literature, there is limited data on anaerobic performance in individuals of different age groups. Modern studies on human functional capabilities indicate significant differences among representatives of various morphological types. Considering that physical health is viewed not only as the current state of the body but also as its potential capabilities (aerobic and anaerobic performance) [3, 7, 14], it is essential to examine the peculiarities of its manifestation in individuals of different somatotypes. The geographical factor, which causes substantial differences in its expression, must also be taken into account; hence, its influence on physical health should be studied [1, 2, 5, 6], particularly the development levels of anaerobic alactate and lactate energy supply systems for muscular activity. Therefore, for an objective assessment of the indicators determining physical health, it is necessary to identify the degree of variation in these indicators among the population living in the mountainous and lowland areas of Zakarpattia.The purpose is to explore the features of anaerobic alactate and lactate energy supply modes for muscular activity among young males of different somatotypes residing in the mountain and lowland regions of Zakarpattia.Methodology and methods of research. In the study, 236 young males from the postpubertal period of ontogenesis, residing in Zakarpattia's mountainous and lowland regions participated. To obtain objective data on functional capabilities, the study selected young males with no prior experience in sports. All participants were categorized by somatotype using the methods of caliperometry and anthropometry, according to the methodology of J. Carter and B. Heath [6]. All anaerobic tests (WAnT 10, WAnT 30, and PPO) were conducted using the method of cycle ergometry, following the Wingate anaerobic test [2] and the test developed by Shogy A. and Cherebetin G. [20]. Statistical analysis of the research data was carried out using Microsoft Excel 2010 spreadsheets.Results and discussion. After determining the somatotype of young males from the mountainous regions, we found that the largest group of mountain youth was of the endomorph somatotype (33.9%), while the smallest group was of the ectomorph somatotype (4.8%). Among the young males from the lowland areas, the most numerous group was represented by those with the mesomorph somatotype (49.1%), while the smallest group was of the ectomorph somatotype (6.3%).Comparing the results of anaerobic tests in the young males from the mountainous and lowland regions of Zakarpattia, regardless of body composition and somatotype, we observed that the WAnT 10 result was significantly higher in the mountain youth by 11.4%, and the WAnT 30 by 17.3% respectively (p<0.01). For the relative PPO value, no statistically significant differences were found between the young males from the mountainous and lowland regions (p>0.05).It was established that young males of different somatotypes significantly differ in the development of the anaerobic energy supply mode for muscular activity. Among the young males, regardless of the region of residence, those with the mesomorph and mesoectomorph somatotypes showed the highest levels of aerobic performance in terms of relative WAnT 10, WAnT 30, and PPO. These individuals had a morphological type with a predominance of muscle component and a relative deficiency in the fat component.Conclusions. It was established that anaerobic performance in young males of different morphological types from the mountainous and lowland regions of Zakarpattia significantly differs. The data indicate that the power of the anaerobic alactate and lactate energy supply systems is better developed in young men of those somatotypes where the muscle component predominates. The lowest values in anaerobic test results were observed in young endomesomorphs from both lowland and mountainous regions, where the fat component predominates. We associate these low values with the fact that a significant fat component acts as a ballast during physical exertion in hypoxic conditions.

<p>Drought-affected regions often contain high densities of small reservoirs, usually informally built, as drought-coping mechanism. These structures influence socio-hydrological dynamics and have the potential to alter hydrological processes relevant to drought emergence and development. This study aimed to analyze the influence of a high concentration of small reservoirs on the intensification and evolution of drought events. We present an innovative method, which we call “Drought Cycle Analysis”, that tracks the concomitance of precipitation and water storage deficit and associates this with four drought stages: Wet Period, Meteorological drought, Hydro-meteorological drought and Hydrological drought period. The methodology was tested for the Riacho do Sangue River watershed located in the semi-arid region of northeast Brazil. We used a combination of satellite imagery (Landsat 5, 7 and 8) and an empirical equation to estimate the volume stored in the dense network of small reservoirs. Using the Drought Cycle Analysis, we show that the unmonitored small reservoirs induced and modified drought events, extending the duration of hydrological drought on average by 30%. Furthermore, this extension can double for specific drought events. The Drought Cycle Analysis method proved useful for monitoring and comparing the evolution of different drought events, in addition to being applicable as an auxiliary tool in the improvement of water resources management of large reservoirs. This study demonstrates the importance of considering small reservoirs in water resource management strategy development for drought-prone regions.</p>

There is growing interest in using a reduced rate of mineral fertilizer along with water-saving superabsorbent polymer (WSAP) for field crop production in arid and semiarid regions of the world. The overall objective of this study was to evaluate the effects of hydrogel applications on the phosphorus fertilizer efficiency parameter, yield, and selected physiological properties of corn (Zea mays L.) grown at different levels of water deficiency in greenhouse conditions. The experimental design consisted of 3 completely randomized blocks in a factorial arrangement, with 9 hydrogel doses (0%, 0.01%, 0.02%, 0.04%, 0.08%, 0.12%, 0.2%, 0.4%, and 0.6%), 4 phosphorus fertilizer doses (0, 80, 160, and 240 kg ha-1), and 4 water deficiency levels (50%, 65%, 80%, and 100%). Overall, 432 pots were used in this study. We found that the irrigation interval of 0.0% WSAP (control) application treatment at water deficient conditions (WDC 50%) was 6 days, although this value could be increased to 11 days with 0.4% WSAP application treatment. The highest yield was obtained from 0.40% WSAP with 240 kg ha-1 P application dose at 35% deficient irrigation conditions according to leaf relative water content, the chlorophyll reading value of corn plants, and P fertilizer efficiency parameters such as agronomic efficiency, physiological efficiency, use efficiency, and apparent recovery efficiency values. These findings suggest that the application of 0.40% WSAP with 240 kg ha-1 P and economic soil management practice could provide an efficient corn production operation in drought-affected regions such as eastern Turkey and other areas with similar ecologies.

An explosive epidemic of dengue occurred in Fiji between January and July 1975. All laboratory evidence indicated that type 1 dengue was the only prevalent dengue virus. This type had probably not been in Fiji for 30 years and over 70% of the population was susceptible. Aedes aegypti appeared to be the major vector in urban areas, but circumstantial evidence indicated that Aedes rotumae was a vector in at least one remote area. All forms of the clinical spectrum of dengue were seen and reported in all age groups. Overt clinical symptoms tended to be less frequent among children under age 10 and adults over age 30. Approximately 16% of persons reporting dengue-like illness had some type of bleeding associated with their disease with little difference by age, sex, or ethnic group. Epistaxis and gingival bleeding were the most commonly reported and observed hemorrhagic manifestations, but internal bleeding was reported in about 25% of hemorrhagic cases. The proportion of hemorrhagic cases was the same among primary and secondary dengue-infected persons. These and other epidemiologic observations did not support the hypothesis that the hemorrhagic complications seen with dengue occur only in secondary infections.

Motor neuron disease (MND) is a systemic disease of broad clinical spectrum. It is characterized by primary involvement of the lower or upper motor neuron, or both simultaneously represented by the most common form, amyotrophic lateral sclerosis (ALS). ALS is a rare and fatal disease that causes the individual death between three and five years, on average, after the onset of symptoms, due to respiratory failure. Other forms of MND have already been described, such as primary lateral sclerosis, progressive muscle atrophy, progressive bulbar paralysis, as well as atypical presentations of the disease, affecting a single segment as it occurs in pure bulbar form and brachial and leg amyotrophic diplegia. Each of these forms presents with symptomatology and evolution own, which corroborates the importance of the diagnosis of each specific form. This study has as objective to evaluate predictors factors for the diagnosis of ALS in the first neurological consultation in the ambulatory of neuromuscular diseases at Antonio Pedro Hospital University, as well as to describe the epidemiological, clinical and electrophysiological findings of MND. This is an observational, descriptive and retrospective study conducted from the analysis of the database, of this ambulatory, from which the variables were collected and submitted to statistical analysis: Mann-Whitney test and Fisher's exact test. Correlating clinical, epidemiological and electrophysiological findings of patients with ALS and non-ALS showed that the variables: age at onset of symptoms (P=0,02), presence of bulbar symptoms (P<0,001), hyperreflexia (P=0,001), pathological reflexes (P=0,001) and presence of fasciculation on electromyography (P=0,001), presented significant predictor value for the diagnosis of ALS. We conclude that, despite the small sample size, our study was able to demonstrate that these variables are independent predictors for the diagnosis of ALS in the first neurological evaluation in patients with NDM. These findings reinforce the importance of a well-done and directed neurological examination in the first evaluation of patients with suspected NDM

Therapeutic recommendations in this report are based heavily on evidence from controlled clinical trials. Nonetheless, randomized clinical trials have not been carried out to address all therapeutic questions pertaining to all age groups, both sexes, and different racial/ethnic groups. Consequently, ATP III recommendations for various groups often must be made by combining what has been learned from clinical trials with other lines of evidence such as epidemiological findings. Fortunately, a large number of clinical trials have produced a very large set of consistent results that allow for considerable confidence in projections of benefits and drawbacks of cholesterol-lowering therapy in groups that have not been subject to clinical trials. In the discussion to follow, the ATP III panel has crafted its recommendations for different population groups from general evidence statements and general recommendations developed in previous sections. No attempt will be made to grade the category and strength of evidence for all recommendations made in this section. Men of middle-age (35-65 years) are at increasing risk for CHD as they progressively age. Up to one-third of all new CHD events and about one-fourth of all CHD deaths occur in middle-aged men.1017 Most of the excess risk for CHD morbidity and mortality in middle-aged men can be explained by the major risk factors—cholesterol disorders, hypertension, and cigarette smoking.10,11 Men are predisposed to abdominal obesity, which makes them particularly susceptible to the metabolic syndrome. Consequently, metabolic risk factors (elevated cholesterol and triglycerides, low HDL cholesterol, and elevated blood pressure) appear earlier in men than women. Table VIII.1-1 summarizes factors to consider when applying ATP III guidelines to middle-aged men. View this table: Table VIII.1-1. Special Considerations for Cholesterol Management in Middle-Aged Men CHD is a major cause of death in women as well as men and it ultimately kills as many women as men.1017 However, …

BackgroundDuring 2022, a new public health threat emerged when cases of paediatric acute hepatitis of unknown aetiology (HUA) were identified in children aged under 16 years old in the United Kingdom (UK). At the time, the epidemiology and extent of cases was based upon limited and non-standardised reporting from hospitals and liver units. We aimed to adapt existing real-time syndromic surveillance systems to support the epidemiological investigation of cases of HUA presenting to emergency departments (EDs) in England.MethodsSyndromic surveillance is generally based on the collection of patient symptoms or chief complaints, which are collected using automated routines in near real-time. Here, we used an existing ED syndromic surveillance system monitoring daily patient attendances across a network of approximately 150 EDs in England. Clinical diagnosis codes related to the potential symptoms associated with the HUA incident were selected and attendance data monitored retrospectively and prospectively during the incident.ResultsFrom 2 April 2018 to 31 December 2021, there were small sporadic numbers of daily ED attendances for ‘liver conditions’ in children with no observed secular trends or seasonality across the 1 to 4 and 5 to 14 years age groups. The period 2 April to 29 July was compared across each year included in the analysis. Mean daily HUA attendances during 2018 to 2021 was 0.05 and 0.22 for 1 to 4 and 5 to 14 years respectively, however in 2022 there were 0.26 and 0.42 mean daily attendances. This represented an increase of 377% and 94% in the 1 to 4 and 5 to 14 years age groups, respectively. From June 2022, daily syndromic ‘liver condition’ attendances appeared to decrease and the rate of increase in cumulative attendances slowed.ConclusionsWe demonstrate how syndromic surveillance provided support to the HUA outbreak using an existing syndromic surveillance framework to develop new indicators based on the newly emerging clinical symptoms. The outputs from the syndromic tool matched clinical and epidemiological findings with respect to trends in other HUA-related data, including clinical and laboratory reports, over time. This work demonstrates the potential for syndromic surveillance supporting the epidemiological surveillance of hepatitis and providing a valuable tool for the real-time management of future unknown health threats.

Background and Aims Stroke is one of the leading causes of death and disability in adults, accounting for a high number of hospitalizations worldwide.This study aims to evaluate the epidemiology of hospitalizations for stroke in Brazil during 2019 and 2020. Methods Cross-sectional, descriptive and retrospective study, which evaluated the epidemiology of hospital admissions for stroke in the Brazilian National Health System in the years 2019 and 2020.Hospital admissions were evaluated by sex, race and age group using the national database (DATASUS – Department of Informatics of the Unified Health System). The official classification of race/skin color in Brazil is composed of five categories: White, Brown [Pardo], Black,Yellow and Indigenous. Results During this time period, there was a total of 316,859 hospitalizations for stroke in the Brazilian National Health System, with 163,120 (51.5%) hospital admissions in 2019 and 153,739 (48.5%) in 2020. Also, 166,178 (52.4%) patients were male and 150,681 (47.6%) were female. Regarding race (n=250,446); 106,998 (42.7%) patients considered themselves white, 116,601 (46.6%) brown, 17,085 (6.8%) black and 9,762 (3.9%) others. Regarding age groups; 64,939 (20.5%) were &gt;80 years old, 163,114 (51.5%) were 60-79, 74,605 (23.5%) were 40-59 and 14,201 (4.5%) were &lt;40. Conclusions The majority of patients hospitalized for stroke were 60-79 years old and white or brown. The similar number of hospital admissions in 2019 and 2020 may suggest that hospitalizations for stroke were not significantly impacted by hospital’s oversaturation by the COVID-19 pandemic.

The purpose of this investigation was at first to clarify the clinico-epidemological characteristics of hypertension in Tochigi Prefecture, especially in Ishibashi Town, second to examine the usefulness of echocardiography in a community survey on cardiovascular diseases. The results were as follows: 1. The trends of mortality of hypertensive heart disease in Tochigi Prefecture. 1) The mortality of hypertensive heart disease in Tochigi Prefecture showed a tendency to decrease for these ten years. It was higher in Tochigi Prefecture than in all over the country. 2) The survey of National Health Insurance records in Ishibashi Town revealed that 56.6% of the patients with cardiovascular disease accompanied with hypertension. 2. The epidemiological findings on cardiovascular diseases in Tochigi Prefecture as compared with those all over the country. 1) The averages of systolic and diastolic blood pressure were lower. 2) The incidence of left ventricular highvoltage and ST-T change in electrocardiography was higher. 3) The incidence of myocardial infarction and angina pectoris was lower. 4) The incidence of silent myocardial ischemia was higher. 5) There was no difference of hypertensive heart disease between in Tochigi Prefecture and all over the country. 3. The multivariate analysis of findings of the community survey on cardiovascular disease (mainly ischemic heart disease and hypertensive heart disease) in Ishibshi Town. 1) Severity of hypertension, anamnesis of hypertension and subjective symptom of heart in relation with ischemic heart disease. 2) Anamnesis of hypertension and abnormality of electrocardiography in relation with hypertensive heart disease. These factors above mentioned were suggested to have strong relation with ischemic heart disease and hypertensive heart disease, by application of the quantification method of Hayashi's second type to data of a community survey on cardiovascualr diseases in Ishibashi Town. 4. The relation between echocardiography and blood perssure level. 1) There was a significantly clear relation between thicknes of intervascular septum and blood perssure level (p<0.01), and also between thickness of postrior wall and blood pressure level. 2) Diastolic descent rate of mitral valve made a clear decrease adversely to the level of blood pressure. 3) Partial correlation coefficient of examination items in the community survey with the level of blood pressure was the highest (0.42) in thickness of intervascular septum of echocardiography, secondly higher (0.33) in anamnesis of hypertension and thirdly higher (0.14) in age factor. 4) Examination of pertial correlation coefficient of those factors by age revealed that in age group from 30 to 59, thickness of intervascular septum of echocardiography had the highest correlation (0.46) with blood pressure level and in age group more than 60 anamnesis of hypertension had the highest correlation (0.60). Findings above mentioned are likely to suggest the usefulnes of echocardiography in community survey on cardiovascular diseases, as well electrocardiography and other methods of examinaiton.

This chapter provides a synthesis of the main study findings. It offers further considerations and recommendations for policy and research. The study used remote-sensing and perception analysis to assess causes and consequences of land-use change in the Lowland region (Chaps. 4 and 5). A theoretical framework proposed in Chap. 2, and refined in Chap. 6 set the conceptual basis for the study. Within this context, the analysis’ findings were tested vis-a-vis the study hypothesis, challenging commonly-held views about land-use change in the Lowland region, and Lesotho in general. This chapter provides a summary of the main findings. These findings aim to contribute to improved understanding and knowledge about the causes and consequences of land-use change in the Lowland region of Lesotho in particular, and by implication, shed light on plausible explanations of similar occurrences in Lesotho and perhaps in other similar semi-arid regions in sub-Sahara Africa. Human wellbeing, health, access to food and nutrition, the environment on which we depend for our survival, institutions and our socio-economies, are critical factors, some of which cause, and/or are effected by changes in land-use.

There are two common forms of NRH-quinone oxidoreductase 2 (NQO2) in the human population resulting from SNP rs1143684. One has phenylalanine at position 47 (NQO2-F47) and the other leucine (NQO2-L47). Using recombinant proteins, we show that these variants have similar steady state kinetic parameters, although NQO2-L47 has a slightly lower specificity constant. NQO2-L47 is less stable towards proteolytic digestion and thermal denaturation than NQO2-F47. Both forms are inhibited by resveratrol, but NQO2-F47 shows negative cooperativity with this inhibitor. Thus these data demonstrate, for the first time, clear biochemical differences between the variants which help explain previous biomedical and epidemiological findings.

Ethiopia is a country that is highly vulnerable to climate change and often faces extreme weather events, creating great challenges related to food security, water resources, and socio-economic development. This study investigates the spatial-temporal characteristics of extreme rainfall (>30 mm∙day−1) over Ethiopia during June-September (JJAS) from 1981 to 2022 and their possible mechanisms. It is found that the climatological extreme rainfall frequency exceeds 10 - 12 days∙yr−1 in the Ethiopian highlands but falls below 1 day∙yr−1 in lowland regions, highlighting the important role of orography and monsoon dynamics. Trend analysis shows a clear dipole pattern, with significant increases in the western and southwestern regions (p = 0.001) and decreases in northern and northeastern areas of Ethiopia (p = 0.003 to 0.036). EOF analysis reveals a major highland-wide uniform mode (EOF1; 23% of variance) and a secondary north-south dipole mode (EOF2; 9%), which both exhibit evident interannual-to-interdecadal variabilities. While the EOF1 is closely linked to ENSO with a significant negative correlation (R = −0.42), PC2 shows a prominent upward trend with large-scale warming. After removing this trend, the interannual variability of PC2 is significantly associated with the preceding FMAM North Atlantic Tripole (NAT; R = 0.35) and the concurrent JJAS Indian Ocean Dipole (IOD; R = 0.30). Further analyses show that La Niña events can enhance the Somali low-level jet, strengthening southwesterly wind anomalies that transport abundant moisture and favor the occurrence of precipitation extremes. In contrast, the NATI and IOD induce anticyclonic circulations over eastern and northeastern Africa, respectively. These atmospheric responses lead to moisture convergence in southern Ethiopia and divergence in the north. This promotes precipitation extremes, primarily in the southern part of the country. Our results highlight the importance of incorporating the three basin-scale air-sea coupled modes into early warning and seasonal forecasting systems, thereby enhancing adaptation strategies and flood-risk management for precipitation extremes.

ISEE-558 Objectives: To describe the frequency of certain diseases (otitis, congiuntivitis, faringitis, cutaneous infections, gastroenteritis, respiratory tract infections) and to estimate the risk of their occurrence with bathing activity in the Adriatic Sea. Methods: A prevalence study was conducted in 4 areas (Veneto, Emilia-Romagna, Abruzzo and Puglia regions) of the Italian Adriatic coast (July 1st-August 31st 1998). Subjects were enrolled that were present in the study areas for at least 3 days. Who had any bathing activity was defined as exposed, the others as unexposed. We used an ad hoc questionnaire to collect personal, risk factors, and clinical information. Data management was performed using Epi Info 2002. Results: We recruited 6536 persons, 55.2% were females, mean age 29 years old, 82.3% had any bathing activity. Overall, 16.1% was affected by at least one target disease (cutaneous infection 33.2%, faringitis 17.5%, otitis 13.8%, conjunctivitis 8.9%, respiratory tract infections 6.6%, gastroenteritis 5.1%). Females and children were significantly more susceptible (OR=1.36, p<0.01, OR=3, p<0.01, respectively) to diseases than the other study participants. A statistically significant higher occurrence of diseases was observed in Emilia-Romagna (23.4%) than in Abruzzo (14.2%), Veneto (13.3%) and Puglia (10%), P<0.01. In the univariate analysis, “bathing” represents a risk factor (OR=1.53, p<0.01) but it does not in the multivariate (OR=1.08, p=0.45). Faringitis and gastroenteritis, too, were significantly associated with bathing in the univariate analysis, but were not associated with ingestion of sea water when age group was included in the multivariate analysis (crude RR=1.95, 1.12<RR<3.38 vs adjusted RRMH=1.55, 0.79<RR<3.01). Bathing was a risk factor for cutaneous infections (OR=2.58, p<0.01) and conjunctivitis (OR=2.4, p=0.038) in multivariate analysis. Discussion: Bathing is not a risk factor for serious diseases (ie gastroenteritis), but is associated with other, less serious ones (conjunctivitis, cutaneous infections). Age and sex act as confounding factors in the association between “bathing” and “diseases”, as they are also associated with any diseases. Epidemiologic findings should be supplemented by microbiological analyses of the relevant recreational waters. Although our results are in concordance with some studies and in discordance with others, this is the first, large-scale, population-based epidemiologic study that analyses the correlation between infectious diseases and bathing in marine waters (in our instance the Adriatic Sea).

Granular cell tumor is rare tumors from Schwann cells with clinicopathological feature results, which may be showed in both benign and malignant tumor. Several tumors commonly appear in the oral cavity, gastrointestinal tract and skin. This must be appropriately treated to avoid repetition or metastatic cancer lesions. The aim study is to search clinicopathological aspects of granular cell tumor diagnosed at different general hospitals in Iraq and to compare these findings with epidemiological findings from different governorates positions. The data was collected from different Iraq governorates in mouth and tongue area from 2010 to 2020 years. Different parameters were displayed like age group, gender, topography, morphology and distribution of annual patients of the tumor. According to the available of the all information about these characteristics was revealed the inclusion criteria. The factors frequencies were calculated from descriptive analysis of the data. The total (101) cases of granular cell tumor in mouth and tongue location were found. (17) cases was the maximum value in 2015 year and it followed by (15) cases in 2019 year as compared to other years. Baghdad governorate (95) cases has a greatly patients than other governorates. (59) Cases with (58.40 %) of female gender and (42) cases with (41.60) of male and the female to male ratio was (1.38:1).

Childhood falls and their complications are a serious public health concern worldwide. However, very few programs have been developed to address the problem because of the lack of convincing data,...