Development Research Foundation Research Articles

Towards green evolution in urban Egypt: assessing Al Rehab City through LEED-ND and BREEAM-communities frameworks

This article provides a comprehensive analysis of the application of green neighborhood rating systems, specifically Leadership in Energy and Environmental Design-Neighborhood Development (LEED-ND) and Building Research Foundation Environmental Assessment Method (BREEAM)-Communities, in the context of Cairo, Egypt, focusing on Al Rehab City, a prominent urban area in New Cairo. The study begins by providing a background on Al-Rehab City, explaining its strategic planning, urban design, and demographic dynamics. It then delves into the current state of sustainable urban planning in Egypt, highlighting the challenges and opportunities that exist in this rapidly urbanizing context. The core of the article includes a comparative analysis of LEED-ND and BREEAM communities, assessing their adaptability and relevance to the Egyptian urban landscape, especially Al Rehab City. It explores many sustainability issues such as smart location, neighborhood pattern and design, green infrastructure, sustainable transportation, energy efficiency, water conservation, waste management, and community engagement. The discussion extends to examine how each of these aspects of sustainability applies to Al Rehab City, complemented by case studies and examples of current sustainable practices in Cairo. Furthermore, the article identifies specific local challenges in implementing these assessment systems, such as economic constraints, policy constraints, and cultural factors. It also suggests opportunities for improvement, including the potential for public–private partnerships, policy reforms, community engagement, technological innovation, and sustainable urban development modeling. In conclusion, the article provides insight into the future prospects of green urban planning in Cairo. The potential impact of adopting comprehensive assessment systems is discussed, with an emphasis on the role of Al Rehab City as a potential model for sustainable urban development in Egypt and the wider MENA region. The article aims to contribute to the discourse on sustainable urban planning, and provide a roadmap for integrating global sustainability standards into the unique context of Egyptian cities.

The assessment of immunological parameters (Anti- Thyroid peroxidase antibody and Anti-Thyroglobin antibody) in premenopausal thyroid women patients

Background: Thyroid diseases may be complicated by anti-thyroglobin and anti-thyroid peroxidase antibodies. Objective: This research examined thyroid diseases and serum Anti-TPO Ab and Anti-Tg Ab levels. Methods: Al-Fadel foundation for training and development (research foundation) in Babylon province conducted this cross-sectional study. The research comprised 90 patients aged 15–45, separated into three groups: 60 patients with thyriodism, 30 healthy participants as a control group, and all patients (n=60) into two groups: hypothyroidism and hyperthyroidism. Results: Hyperthyroidism and hypothyroidism patients and healthy controls had similar mean Anti TPO levels. Compared to healthy controls, hypothyroidism and hyperthyroidism patient groups increased significantly. Hypothyroidism and hyperthyroidism patients had higher Anti Tg levels than the health control group. Conclusion: Anti-TOP Ab and Anti-Tg Ab vary significantly between Hyperthyroidism, Hypothyroidism, and control. Clinical labs should evaluate thyroidism patients for potential consequences using these biomarkers.

Vikaspur Knowledge Centre: Micro-Politics in a Community-Based Organization

The knowledge centres (KC) established by Development Research Foundation (DRF) were part of an ambitious project to disseminate valuable information to the rural masses. The KCs purpose was to bridge the digital divide, which was supposed to be run by the local community. The Vikaspur KC initiative had a lot of potentials, but due to local politics and conflict among a few stakeholders, it faced many problems. The differences among the volunteers were the core issues that ultimately led to the lockout of the KC. There was a lack of proper managerial structure at the ground level. The local village dynamics also influenced this issue. The political structures and dynamics also influenced the conflict at the Vikaspur KC at the micro-level (village level) and the meso-level (provincial level).

​Production Performance and Economics of Forage Cropping Systems under Irrigated Condition of Western Maharashtra

Background: Green forages have important role in livestock sector as they are the main source of nutrition. Even then there is always deficit in green fodder supply as against the demand. Out of the total cultivated land at national level, area under fodder crops is about 4%. Under these circumstances the only way is to increase the productivity of fodder crops by adopting best forage cropping system. Growing of cereal-legume fodder crops, as intercrop, mixed crop and sequence crop increase the fodder production and also help to meet the balanced diet for livestock. Methods: A field study was conducted at Central Research Station of BAIF Development Research Foundation, Urulikanchan in three successive years from 2013-14 to 2015-16. The experiment was laid in a randomized block design with four replications and six different forage cropping systems. The experiment was conducted in light gravel soil. Result: Among the six different cropping systems studied, significantly higher green fodder yield of 792 q/ha/year, net monetary returns of Rs. 92891/ha/year and benefit-cost ratio of 1.92 was recorded in intercropping sequence of maize + cowpea (kharif), oat + berseem (rabi) and bajra + cowpea (summer). This cropping system has confirmed more fodder production from the cereal and legume inter crops with further additional benefits of provision of high quality fodder and net monetary returns.

Improving psychosocial distress for young adolescents in rural schools of Pakistan: study protocol of a cluster randomised controlled trial

IntroductionEmotional problems are leading contributors to health burden among adolescents worldwide. There is an urgent need for evidence-based psychological interventions for young people. This study aims to evaluate the effectiveness...

A Novel Sutureless Integrated Stented (SIS) Graft Prosthesis for Type A Aortic Dissection: A Pilot Study for a Prospective, Singer Arm, Multi-Center Clinical Trial

Background: Various kinds of surgical strategies and prostheses have been advocated to improve short-term and long-term outcomes in type A aortic dissection (TAAD). Large-extent repair of pathological aorta with satisfactory outcomes is hard to achieve. The aim of this study was to investigate effectiveness and safety of a novel Sutureless Integrated Stented (SIS) graft prosthesis on TAAD patients undergoing total arch replacement (TAR) combined with frozen elephant trunk (FET) surgeries. Methods: All patients admitted to Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College were screened according to inclusion and exclusion criteria after signing written informed consent. Urgent or scheduled surgery was arranged for eligible patients. Before operation, candidate size of the SIS graft prosthesis was chosen comprehensively according to aortic diameter on different levels measured on aortic computed tomography angiography (CTA). During operation, final appropriate-sized SIS graft prosthesis was implanted under direct vision. The primary endpoint was operative mortality. Secondary endpoints included postoperative rate of stroke, spinal cord injury, unexpected aortic reoperation and so on. All variables related to this study were collected prospectively and classified into preoperative, intraoperative, postoperative and follow-up data. Discharged patients were contacted by telephone 1 month after surgery and were asked to return to hospital 3 months, 6 months and 12 months after surgery. Inquiry, physical examination, aortic computed tomography angiography (CTA) examinations and transthoracic echocardiography (TTE) were performed on the occasion of the return visit. Effectiveness and safety analyses were done in these patients. Findings: Between Aug 1 and Sep 3, 2020, 10 TAAD patients were enrolled in this study. The SIS graft prostheses were successfully implanted in all patients. The median (IQR) age was 56.50 (43.75, 66.75) years (range from 31 to 75), and 7 patients were male (70.0%). All patients were performed with ascending aorta replacement + TAR + FET. Concomitant procedure included Bentall procedure, David procedure, adventitial inversion technique and ascending aorta-femoral artery bypass. The median (IQR) operation time, CPB time and cross clamp time were 270.50 (218.50, 312.50), 110.00 (88.00, 125.75), 69.50 (51.25, 82.75) min, respectively. Of note, the median (IQR) CA time was 9.00 (8.00, 9.00) min (range from 4 to 12). The median (IQR) lowest nasopharynx temperature was 26.75 (25.98, 27.67) °C. The median (IQR) platelets transfusion was 1.00 (1.00, 1.00) U. The median (IQR) platelets transfusion was 0.00 (0.00, 0.00) U. The median (IQR) platelets transfusion was 0.00 (0.00, 0.00) mL. No patients died after surgery and no severe postoperative complications occurred. Follow-up was 100% completed. Survival rate at 1-year follow-up was 100%. No patients have ever experienced any major organ complication. Freedom from prosthesis related adverse events and aortic reintervention was both 100%. Interpretation: The SIS graft prosthesis could be implanted in a novel sutureless way, which simplified surgery procedure, reduced CA time and avoided DHCA. The preliminary clinical outcomes and follow-up outcomes were satisfactory and with 0 death, 0 severe complication and 0 reintervention until 1 year postoperatively, which demonstrated effectiveness and safety of this prosthesis. Large-sample size trial has been conducted to further identify our findings. Trial Registration: This study was registered with Chinese Clinical Trial Registry, ChiCTR2000032264. Funding: Beijing Science and Technology Program (Z191100007619042), Capital Health Development and Scientific Research Foundation (2018-2-4035), CAMS Initiative for Innovative Medicine (2016-I2M-1-016), Special Subject Development Foundation of Fuwai Hospital (2015-FWTS01). Declaration of Interest: We declare no competing interests. Ethical Approval: This study was approved by Ethic Committee of Fuwai Hospital, Chinese Academy of Medical Sciences.

Performance of Ber (Zizyphus mauritiana lamk.) Varieties under Two Irrigation Scheduling of Saline Water in Central Gujarat Conditions in India

The field experimentation was carried out at Instructional Farm, BAIF Development Research Foundation, Nanodara of Ahmadabad district during 2014 to 2018 with an objective to evaluate the response of the two ber varieties (Seb and Gola) to number of irrigations on the growth and yield of ber crop. It was also intended to understand effect of saline irrigation water on soil status as irrigation water of the study location is slightly saline in nature. The study was conducted in Split Plot Design with six replications. Treatments consisted of two irrigation schedule; normal irrigation at 15 days interval and life saving irrigation at 30 days interval and two varieties (Seb and Gola). Soil and irrigation water of the study location was analyzed using standard procedures for initial and yearly status, respectively. Two ways ANOVA was carried out using R Studio Statistics Rx 64 software. Significance levels were tested at p≤0.05. The highest plant height (326.87 cm), girth size (60.75 cm), number of secondary branches per plant (7.24), dry leaf biomass per plant (3.96 kg), dry shoot weight per plant (16.65) as well as fruits per plant (337.58), fruit weight (56.96 g), fruit yield per plant (19.43 kg) and fruit yield per ha (5400 kg) were increased significantly with normal irrigation treatment (irrigations at 15 days interval) which was significantly superior over life saving irrigation. In case of varieties, all the parameters of the growth and yield of the crop were maximum for Gola variety compared to Seb. The pH, EC and SAR were comparatively lower in soil under life saving than normal irrigation.

Cognitive–behavioral therapy-based intervention to treat symptoms of anxiety in pregnancy in a prenatal clinic using non-specialist providers in Pakistan: design of a randomised trial

IntroductionPrenatal anxiety is a prevalent condition that is harmful for women and a strong predictor of postpartum depression. This trial assesses an intervention initiated in early pregnancy to mid pregnancy...

Grandmother Involvement in Rural Pakistan: An Observational Study on Child Growth and Development

Background: Early childhood interventions primarily focus on the mother-child relationship, but grandmothers are often critical in childcare in low-resource settings. We examined the role of grandmother involvement on child growth and development cross-sectionally and longitudinally in rural Pakistan. Methods: Maternally reported grandmother involvement was collected at 3 and 12 months postpartum about daily instrumental and non-instrumental caregiving and categorized into non-involved, low, and high. Outcomes included 12- and 24-month child growth, 12-month Bayley Scales of Infant and Toddler Development, and 24-month Ages and Stages Questionnaire-Socioemotional. We used adjusted linear mixed models to estimate mean differences (MD) on 699 households with complete data. Findings: The majority of grandmothers were involved in caregiving at 3 and 12 months. High 3-month grandmother involvement (vs. non-involved) was associated with higher 12-month weight-for-length z-scores (MD=0·33, 95% CI: 0·07, 0·59); however, 12-month grandmother involvement was associated with lower 24-month weight-for-length z-scores (MD= -0·21, 95% CI: -0·42, -0·01). High 12-month grandmother involvement was associated with improved 12—month cognitive (MD=0·48, 95% CI: 0·10, 0·87) and fine motor (MD=0·42, 95% CI: 0·09, 0·76) skills and 24-month socioemotional development (MD= -15·52, 95% CI: -25·27, -5·76). Interpretation: Early grandmother involvement had positive associations with child weight, but became negative as children aged. Grandmother involvement was positively associated with cognitive, fine motor, and socioemotional development. Understanding how grandmother involvement affects child outcomes in early life is necessary to inform caregiving interventions. Funding: National Institute of Child Health and Human Development, National Institute of Mental Health, Carolina Population Center. Declaration of Interest: The authors have no conflicts of interest to disclose. Ethical Approval: This study was approved by institutional review boards at the Human Development Research Foundation (HDRF), the University of North Carolina at Chapel Hill, and Duke University.

Grandmother Involvement on Child Growth and Development in Rural Pakistan

Background: Early childhood interventions have primarily focused on the mother-child relationship, but grandmothers are often critical in childcare. Prior research is mixed on how grandmother involvement influences child outcomes. There is a paucity of research on grandmother caregiving in low- and middle-income countries. We described maternally-reported grandmother caregiving activities and examined the role of grandmother involvement on child growth and development cross-sectionally and longitudinally. Methods: We utilized the Bachpan study, a birth cohort in rural Pakistan. Grandmother involvement was based on maternal report at 3 and 12 months postpartum of 20 items related to daily instrumental and non-instrumental caregiving. A summed score was created and categorized into non-involved, low, and high. Outcomes included 12- and 24-month child growth, Bayley Scales of Infant and Toddler Development at 12 months, and Ages and Stages Questionnaire-Socioemotional at 24 months. Complete data were available for 699 households. We used adjusted linear mixed models to estimate mean differences (MD). Findings: The majority of grandmothers were involved in caregiving at 3 and 12 months. Children with highly involved grandmothers at 3 months (vs. non-involved) had higher 12-month weight-for-length z-scores (MD=0·33, 95% CI: 0·07, 0·59); however, 12-month grandmother involvement was associated with lower 24-month weight-for-length z-scores (MD= -0·21, 95% CI: -0·42, -0·01). Twelve-month high grandmother involvement (vs. non-involved) was associated with improved cognitive (MD=0·48, 95% CI: 0·10, 0·87) and fine motor (MD=0·42, 95% CI: 0·09, 0·76) at 12 months and socioemotional development (MD= -15·52, 95% CI: -25·27, -5·76) at 24 months. Interpretation: Early grandmother involvement had positive associations on child weight, but this association became negative as the child grew older. Grandmother involvement was positively associated with cognitive, fine motor, and socioemotional development. Understanding how grandmother involvement affects child outcomes in early life is necessary to inform how to best incorporate grandmothers into caregiver interventions. Trial Registration: NCT02111915 (https://clinicaltrials.gov/ct2/show/NCT02111915); NCT02658994 (https://clinicaltrials.gov/ct2/show/NCT02658994). Trials were prospectively registered. Funding Statement: The Bachpan cohort study was supported by NICHD [R01 HD075875] and NIMH [U19MH95687]. We are grateful to the Carolina Population Center for training support [T32 HD091058] and for general support [P2C HD050924]. Declaration of Interests: The authors have no conflicts of interest to disclose. Ethics Approval Statement: This study was approved by institutional review boards at the Human Development Research Foundation (HDRF), the University of North Carolina at Chapel Hill, and Duke University.

Assessment of cactus (Opuntia ficus-indica L. Mill) accessions for growth, yield and nutritional parameters under pot culture

A pot experiment was conducted at BAIF Development Research Foundation, Urulikanchan, Pune, India during 2014-2016 to study the biomass production performance of four cactus accessions as a source of fodder for livestock. Single matured cladodes of individual accessions were planted in plastic pots during August 2014 and were harvested 18 months after planting. The growth and yield observations were recorded during harvesting and fresh cladodes were analyzed for nutritional parameters in the laboratory. The study revealed that the highest green biomass yield per plant was recorded in accession 1270 (1.74 kg) followed by 1271 (1.45 kg), 1280 (1.39 kg) and the lowest was in accession 1308 (1.36 kg). The maximum fresh weight per cladode was observed in accession 1280 (448.84 g) followed by 1270 (436.75 g), 1271 (394.73 g) and the minimum was in accession 1308 (150.69 g). The more number of cladodes (9.0) were found in accession 1308 followed by 1270 (4.0), 1271 (3.69) and the least (3.10) was in accession 1280. The maximum cladodes area of 333.14 cm2 was recorded in accession 1270 followed by 1280 (310.84 cm2) and the lowest was in accession 1308 (95.61 cm2). The nutritional evaluation of fresh cladodes revealed dry matter in the range of 8.24 to 11.15 %, crude protein 4.00 to 6.03% and crude fiber 7.06 to 8.15%.

Comprehensive Analysis of Immunity to Pituitary Adenomas: Implications of Immunotherapeutic Approaches for Pituitary Adenomas

Background: Immunotherapy is a promising therapeutic approach for cancers. However, the immune background and the interactions between pituitary adenomas (PAs) and the host immune system remain unclear. Methods: Poly-A enriched RNA sequencing was performed on 115 snap frozen PA samples. Estimating the Proportion of Immune and Cancer cells (EPIC) was used to detect all the main cell types (B cells, CD8+ T cells, CD4+ T cells, macrophages and NK cells) in a tumor sample from the expression of genes. Immunohistochemical (IHC) staining was used to validate the main findings. Findings: In RNA sequencing data, PA samples showed immune infiltration, including B cells, CD8+ T cells, CD4+ T cells, macrophages and NK cells. The results were further validated by IHC. Meanwhile, pathway analysis showed that TNFR superfamily (TNFRSF), IL-10 family and TGF beta (TGFβ) family were the potential mechanisms of immune infiltration in PAs. In order to search how tumor making progression with high infiltration of immune cells, gene-expression data revealed that tumor progression was related to increased expression of PD-1/PD-L1 and was associated with higher infiltration of CD8+ T cells. Besides, pathway enrichment analysis showed that regulation of death/apoptosis processes and the JAK-STAT pathway were found to be significantly enriched in samples with higher immune infiltration. At last, analysis of cancer-testis antigens (CTAs) expression in CD8+ T cells suggested that CTAG2 and TSPYL6 were potential immunotherapeutic targets in GH and non-functioning PAs, respectively. Interpretation: Our work provides new angles for understanding tumor-infiltrating immune cells. The results may inform effective checkpoint blockade and cancer vaccine therapies and make it possible to take immunotherapy into invasive functioning PAs. Funding Statement: This work was supported by the National Natural Science Foundation of China under Grant number 81471229; Capital Medical Development Research Foundation under Grant number 201811071. Declaration of Interests: No potential conflicts of interest are declared. Ethics Approval Statement: The PA tissue collection was approved by the Institutional Review Board of Beijing Tiantan Hospital, Capital Medical University. All procedures involving human participants conformed to the ethical standards of the national research committee and the 2013 Helsinki Declaration, which were approved by the Institutional Review Board of Beijing Tiantan Hospital, Capital Medical University. Informed consent was obtained from all patients prior to their enrollments in this study.

Maternal Depression in Rural Pakistan: The Protective Associations with Cultural Postpartum Practices

Background: Traditional postpartum practices intend to provide care to mothers, but there is mixed evidence concerning their impact on postpartum depression (PPD). It remains unknown if there is a unique impact of postpartum practices on PPD separately from other social support, or if practices differentially affect those with prenatal depression. This study aims to understand if chilla (چ له), a postpartum practice in Pakistan defined by receiving relief from household work, familial support, supplemental food, protects against PPD independent of other support and whether this varies by prenatal depression. Methods: Data come from the Bachpan cohort study in Pakistan. Chilla participation and social support were assessed at three months postpartum. Women were assessed for major depressive episodes (MDE) and depression symptom severity in their third trimester and at six months postpartum. Adjusted linear mixed models were used to assess the relationship between chilla participation and PPD. Findings: Eighty-nine percent of women (N=786) participated in chilla. In adjusted models, chilla participation was inversely related to MDE (OR=0·56;95%CI=0·31,1·03) and symptom severity (Mean Difference (MD)=-1·54;95%CI: -2·94,-0·14). Chilla participation was associated with lower odds of MDE (OR=0·44;95%CI=0·20,0·97) among those not prenatally depressed and with lower symptom severity among those prenatally depressed (MD=-2·05;95%CI:-3·81,-0·49). Interpretation: Chilla is inversely associated with MDE and symptom severity at six months postpartum. Interventions aimed at preventing and treating PPD should consider the potential benefits of chilla and similar postpartum practices. Funding: NICHD (R01-HD075875) and NIMH (U19MH95687) supported this study. The Carolina Population Center provided training (T32-HD091058) and general support (P2C-HD050924). Declaration of Interest: The authors have no conflicts of interest to disclose. Ethical Approval: This study was approved by institutional review boards at the Human Development Research Foundation (HDRF), the University of North Carolina at Chapel Hill, and Duke University.

Long-term effects of China’s One Village One Preschool program on elementary academic achievement

One Village One Preschool (OVOP) project is a government-supported public intervention launched by the China Development Research Foundation, which provided disadvantaged rural and minority children in central and western rural China with access to early childhood education (ECE). OVOP has established about 2300 centers in ten provinces, enrolling over 170,000 3–6-year olds, free of charge for all. We analyzed longitudinal data collected from a sample of 1962 children in Ledu county of Qinghai Province (comparing OVOP attendees to children who had experienced no ECE, private ECE, or public ECE), using an inverse probability weighted longitudinal growth modeling approach to reduce selection bias in evaluating the effects of OVOP on children’s academic achievement during the first 5 years of elementary school. We found that children who attended OVOP centers attained higher scores in elementary grades than children who had received no ECE or who had attended private township ECE. However, OVOP children scored lower than children who went to well-resourced public township ECE centers, despite showing growth rates that were similar. Both OVOP and public ECE groups improved more quickly than children in the no-ECE or private-ECE group. We conclude that providing low-cost ECE to rural children in China has educational and social value.

Delivering the Thinking Healthy Programme for Perinatal Depression Through Volunteer Peers: A Cluster Randomised Controlled Trial in Pakistan

Background: The Thinking Healthy Programme (THP), endorsed by WHO, is an evidence-based intervention for perinatal depression. We adapted THP for delivery by volunteer peers (THPP) - lay women from the community - and assessed its effectiveness and cost-effectiveness in Rawalpindi, Pakistan. Methods: In this cluster randomised controlled trial, 40 village-clusters were equally randomised to intervention (THPP plus Enhanced Usual Care (EUC)) or to EUC-alone. Consenting pregnant women aged ≥18 years who scored >10 on the nine-item Patient Health Questionnaire (PHQ-9) were eligible. Follow-up visits were at 3 and 6 months post childbirth. Primary outcomes were depressive symptoms score and remission at 6 months post-childbirth. Secondary outcomes included recovery from depression, levels of disability and perceived social support and child outcomes. All assessors were masked, and analyses were modified intention-to-treat. The trial was registered with ClinicalTrials.gov (NCT02111915). Findings: Of the 570 women enrolled between 15th October 2014 and 25th February 2016, 227/283 (80%) and 226/287 (79%) women in the THPP plus EUC and EUC-alone groups, respectively, contributed primary outcome data. Overall, 90 (16%) woman had at least one serious adverse event, evenly distributed between groups. Compared to women in the EUC-alone group, those in the THPP plus EUC group had significantly lower PHQ-9 scores at 3 months (standardised mean difference, SMD=-0.30, 95% CI -0.48 to -0.11, p=<0.001) although not at 6 months (SMD=-0.13, 95% CI -0.31 to 0.06, p=0.07) and higher probability of remission at 3 months (50% vs 44%; prevalence ratio, PR=1.18 95% CI 1.06 to 1.29, p=0.002) although not at 6 months (49% vs 45%; PR=1.12, 95% CI 0.95 to 1.29, p=0.14). Repeated measures analyses over the 6 months post childbirth showed intervention effects on both PHQ-9 scores (SMD=-0.22, 95%CI -0.35 to -0.09, p=<0.001) and remission (PR=1.15 95% CI 1.02 to 1.28, p=0.02), disability scores (SMD=-0.12, 95% CI -0.25 to 0.01, p=0.03) and perceived social support scores (SMD=0.16, 95%CI 0.03 to 0.29, p=0.01). There was evidence for sustained effects of the intervention, with higher prevalence of recovery (proportion not depressed at both 3 and 6 months) (35% vs 26%, p=0.002) and response I (≥50% reduction in symptoms from baseline) (53% vs 40%, p=0.003). However, no effects were observed on child outcomes. THPP was associated with slightly higher costs than EUC-alone but significantly better outcome, thereby rendering it a cost-effective intervention; total societal cost per unit improvement on PHQ-9 was US$ 2.65 (95% CI 1.82 to 3.49) at 3 months post childbirth, US$ 1.17 (95% CI -0.53 to 2.88) for the 3-6-month post-childbirth period and US$ 15.50 (95% CI 9.59 to 21.61) over the study period as a whole. Interpretation: THPP showed moderate to strong effects on symptom severity and remission at 3 months postnatal in women caring for infants and was cost-effective. Intervention benefits waned by 6 months, possibly due to spontaneous remission of participants in the EUC group, a common occurrence in depression trials. Informed Consent: Both trials will obtain informed written consent at screening and baseline, followed by re-affirmation of consent at the 3- and 6-month postnatal follow-ups. Informed written consent will be obtained by trained research teams, who will ensure it is taken appropriately. A copy of the information sheets and consent forms will be left with the participants. A record of age, depression score and reasons for refusal will be maintained for those who do not consent. Separate consent will be taken, by trained research teams, for participation in the qualitative sub-study and for the audio recording of intervention sessions to monitor therapy quality. Refusals at all stages will be documented. Trial registration: Pakistan Trial: ClinicalTrials.gov Identifier: NCT02111915 (9 April 2014) India Trial: ClinicalTrials.gov Identifier: NCT02104232 (1 April 2014) Funding: National Institute of Mental Health, USA, through 1U19MH095687 Declaration of Interests: Authors declare no competing interests. Ethics Approval Statement: Ethical approval was obtained from the Institutional Review Boards (IRBs) at the University of Liverpool, the London School of Hygiene and Tropical Medicine (LSHTM), and the Human Development Research Foundation (the trial-implementing institution in Pakistan).

The effectiveness of the peer delivered Thinking Healthy Plus (THPP+) Programme for maternal depression and child socio-emotional development in Pakistan: study protocol for a three-year cluster randomized controlled trial.

BackgroundThe negative effects of perinatal depression on the mother and child start early and persist throughout the lifecourse (Lancet 369(9556):145–57, 2007; Am J Psychiatry 159(1):43-7, 2002; Arch Dis Child 77(2):99–101, 1997; J Pak Med Assoc 60(4):329; J Psychosoma Res 49(3):207–16, 2000; Clin Child Fam Psychol Rev 14(1):1–27, 2011). Given that 10–35 % of children worldwide are exposed to perinatal depression in their first year of life (Int Rev Psychiatry 8(1):37–54, 1996), mitigating this intergenerational risk is a global public health priority (Perspect Public Health 129(5):221–7, 2009; Trop Med Int Health 13(4):579–83, 2008; Br Med Bull 101(1):57–79, 2012). However, it is not clear whether intervention with depressed women can have long-term benefits for the mother and/or her child. We describe a study of the effectiveness of a peer-delivered depression intervention delivered through 36 postnatal months, the Thinking Healthy Program Peer-delivered PLUS (THPP+) for women and their children in rural Pakistan.Methods/designThe THPP+ study aims are: (1) to evaluate the effects of an extended 36-month perinatal depression intervention on maternal and index child outcomes using a cluster randomized controlled trial (c-RCT) and (2) to determine whether outcomes among index children of perinatally depressed women in the intervention arm converge with those of index children born to perinatally nondepressed women. The trial is designed to recruit 560 pregnant women who screened positive for perinatal depression (PHQ-9 score ≥10) from 40 village clusters, of which 20 receive the THPP+ intervention. An additional reference group consists of 560 perinatally nondepressed women from the same 40 clusters as the THPP+ trial. The women in the nondepressed group are not targeted to receive the THPP+ intervention; but, by recruiting pregnant women from both intervention and control clusters, we are able to evaluate any carryover effects of the THPP+ intervention on the women and their children. Perinatally depressed women in the THPP+ intervention arm receive bimonthly group-based sessions. Primary outcomes are 3-year maternal depression and 3-year child development indicators. Analyses are intention-to-treat and account for the clustered design.DiscussionThis trial, together with the reference group, has the potential to further our understanding of the early developmental lifecourse of children of both perinatally depressed and perinatally nondepressed women in rural Pakistan and to determine whether intervening with women’s depression in the perinatal period can mitigate the negative effects of maternal depression on 36-month child development.Trial registrationTHPP-P ClinicalTrials.gov Identifier: NCT02111915 (registered on 9 April 2014).THPP+ ClinicalTrials.gov Identifier: NCT02658994 (registered on 21 January 2016).Sponsor: Human Development Research Foundation (HDRF).Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-016-1530-y) contains supplementary material, which is available to authorized users.

Leguminous blocks: Nutritional values and economics

Present study was conducted at Central Research Station of BAIF Development Research Foundation, Urulikanchan, Pune during 2013 to 2015 with an objective to determining the nutritive values and keeping quality of legume blocks. Leaf meals were prepared from sun dried leaves and chaffed twigs of subabul (Leucaena leucocephala), desmanthus (Desmanthus vergatus), sesbania (Sesbania sesban) and lucerne (Medicago sativa). Five blocks were prepared by adding molasses, corn flour, mineral mixture and salt. Chemical composition such as dry matter (DM), crude protein (CP), crude fibre (CF), ether extract (EE), ash and silica content were determined according to standard analytical procedures. The chemical composition was more or less similar in fresh and stored legume blocks in all the recipes and did not vary much during storage. Further, no deterioration in colour, odour or texture was observed in storage, or any apparent contamination with mould. Among the five leguminous blocks, highest nutritive values in terms of CP, CF, EE, ash and silica were observed in sesbania legume block (22.17, 12.14, 3.52, 10.71 and 0.52%) followed by blocks of subabul (20.52, 10.61, 3.42, 10.72 and 0.81%) respectively. The cost of per kg production of leguminous block of subabul and sesbania was low as compared to lucerne blocks, which were Rs. 20, 21 and 29 correspondingly. All the goats offered legume blocks accepted them readily. All the blocks were offered to difeerent five goats for feeding and their acceptance and the intake was 100 per cent. Hence, the leguminous blocks prepared from sesbania and subabul leaf meal were selected as the best leguminous blocks as goat feed.

Improved routing strategy based on gravitational field theory**Project supported by the Technology and Development Research Project of China Railway Corporation (Grant No. 2012X007-D) and the Key Program of Technology and Development Research Foundation of China Railway Corporation (Grant No. 2012X003-A).

Routing and path selection are crucial for many communication and logistic applications. We study the interaction between nodes and packets and establish a simple model for describing the attraction of the node to the packet in transmission process by using the gravitational field theory, considering the real and potential congestion of the nodes. On the basis of this model, we propose a gravitational field routing strategy that considers the attractions of all of the nodes on the travel path to the packet. In order to illustrate the efficiency of proposed routing algorithm, we introduce the order parameter to measure the throughput of the network by the critical value of phase transition from a free flow phase to a congested phase, and study the distribution of betweenness centrality and traffic jam. Simulations show that, compared with the shortest path routing strategy, the gravitational field routing strategy considerably enhances the throughput of the network and balances the traffic load, and nearly all of the nodes are used efficiently.

Investigation of the project leaders' cognition to Capital Medical Development Research Foundation

Objective To investigate the cognition of persons who lead the programmes of Capital Medical Development Research Foundation (referred to Capital Fund).Method We formed electronic questionnaires mainly by the Expert Meeting Law,and investigated the cognition of the project leader of Capital Fund,relying on the special work notice of Beijing Municipal Health Bureau.We evaluated reliability by Cronbach's alpha coefficient,evaluated validity by content validity,and analyzed the project leader's cognition of the function,satisfaction,purpose and influence of Capital Fund.Result The satisfaction index with method of the foundation's management and the cognition index to the foundation are both over 95％,the objective and the impact of Capital Fund are popular,showing that the Capital Fund promoted the development of medicine.Conclusion The project leader of Capital Fund have positive cognition and satisfaction,and also showed their expectation to the foundation. Key words: Capital medical development research foundation; Project leader; Cognition

Adult mortality estimates for small areas in Brazil, 1980–2010: a methodological approach

BackgroundIn recent decades, life expectancy and health status have improved considerably in Brazil. Life expectancy at birth has risen from 48 years in 1960 to over 73 years in 2010. However, the country is marked by large regional and socioeconomic inequality. Due to data limitations, incomplete coverage of vital registration systems, and errors in age declaration for both population and death counts, little is known about the level and trends in adult mortality for sub-national areas. This study aimed to study the evolution of adult mortality in small areas in Brazil from 1980 to 2010, using 45q15 as a summary measure of adult mortality across small areas in Brazil. MethodsData were obtained from the mortality database available from Datasus, a vital statistics database organised by the Brazilian Ministry of Health that contains information on deaths by age, sex, and cause from 1979 to 2010. Population censuses were used to acquire the population by age and sex for 137 comparable small areas in Brazil, as defined by the National Statistics Office, for the years 1980 to 2010. We combined traditional formal demography methods, called death distribution methods, with indirect standardisation and Bayesian statistics to produce more reliable estimates of adult mortality for the 137 small areas. FindingsThe results show that data quality has improved considerably across Brazil during the period of analysis, but regional variation persists. On average, completeness of death counts increased from 80% (range 50–100) in 1980–91, to 95% (73–100) in 2000–10. Estimates of adult mortality show that more developed regions in the south and southeast parts of the country have lower mortality levels than the northeast, but there is a clear convergence process. InterpretationThis study indicates that the combination of traditional demographic methods to Bayesian statistics is a successful alternative to produce mortality estimates for small areas in Brazil. We also found a large improvement in the quality of mortality data in Brazil since 1980. Finally, we observe a convergence process on health status. FundingBrazilian National Counsel of Technological and Scientific Development (CNPq) and Minas Gerais Research Foundation (Fapemig).