Months In Area Research Articles

A robust decision-making approach for designing coastal groundwater quality monitoring networks.

This paper presents a new approach to the spatiotemporal design of groundwater quality monitoring networks for coastal aquifers. A fusion model combines the outputs of several developed simulation models to make estimates more accurate. A modified GALDIT method is used to incorporate the aquifer vulnerability to saltwater intrusion. The value of information (VOI) theory is applied to determine sufficient monitoring wells. The groundwater quality monitoring network is designed by employing a robust decision-making (RDM) approach under different management strategies and economic considerations. This approach incorporates the deep uncertainties of some critical variables, including water level and total dissolved solids (TDS) concentration at the coastline and pumping flow rates of agricultural wells. The new methodology is implemented in the coastal Qom-Kahak aquifer, Iran. The results illustrate that the combination model has significantly improved evaluation criteria compared to individual prediction models. The fusion model results indicate that thirty monitoring wells would be ideal. The RDM-based analyses in the Qom-Kahak aquifer showed that an optimal network with 30 monitoring wells outperforms the current network regarding various criteria, such as VOI and variance of estimation error. The new well configuration also demonstrates a suitable spatial distribution. Given that the current sampling frequencies are unsuitable for areas with varying vulnerabilities, we recommend sampling every 3months in areas with moderate vulnerabilities and once every three seasons in areas with low vulnerabilities, based on the information transfer index. Finally, a management strategy in which the pumping rate should be less than 60% of the current rate is suggested to prevent saltwater intrusion into the aquifer.

Electromagnetic Short-Term to Imminent Forecast Indices for M ≥ 5.5 Earthquakes in the Gansu–Qinghai–Sichuan Region of China

Electromagnetic indices play a potential role in the forecast of short-term to imminent M ≥ 5.5 earthquakes and have good application prospects. However, despite possible progress in earthquake forecasting, concerns remain because it is difficult to obtain accurate epicenter forecasts based on different forecast indices, and the forecast time span is as large as months in areas with multiple earthquakes. In this study, based on the actual demand for short-term earthquake forecasts in the Gansu–Qinghai–Sichuan region of western China, we refined the construction of earthquake forecast indicators in view of the abundant electromagnetic anomalies before moderate and strong earthquakes. We revealed the advantageous forecast indicators of each method for the three primary earthquake elements (time, epicenter, magnitude) and the spatiotemporal evolution characteristics of the anomalies. The correlations between the magnitude, time, intensity, and electromagnetic anomalies of different M ≥ 5.5 earthquakes indicate that the combination of short-term electromagnetic indices is pivotal in earthquake forecasting.

Impact of seasonal malaria chemoprevention based on the number of medicines doses received on malaria burden among children aged 3-59 months in Nigeria: A propensity score-matched analysis.

Seasonal malaria chemoprevention using sulfadoxine-pyrimethamine plus amodiaquine (sulfadoxine-pyrimethamine plus amodiaquine on Day 1 and amodiaquine on both Day 2 and Day 3) is delivered to children aged 3-59 months in areas of highly season malaria transmission. While the overall population-level impact of seasonal malaria chemoprevention on malaria control has been documented in various countries and time periods, there is no clear evidence regarding seasonal malaria chemoprevention impact based on the number of medicine doses children receive in one cycle in routine programmatic conditions. Data were extracted from Nigeria's routinely collected seasonal malaria chemoprevention end-of-round coverage surveys (2021, 2022). We matched seasonal malaria chemoprevention-targeted children who received specific numbers of seasonal malaria chemoprevention medicines with those who did not receive any doses of seasonal malaria chemoprevention medicines (non-sulfadoxine-pyrimethamine plus amodiaquine) using multiple sets of propensity score matches. We performed multilevel logistic regression for each matched group to evaluate the association between the number of doses of seasonal malaria chemoprevention medicines and monthly confirmed malaria cases (caregiver-reported malaria infection diagnosed by rapid diagnostic test at a health facility following the penultimate cycle of seasonal malaria chemoprevention). Among 21,621 SMC-targeted children, 9.7% received non-sulfadoxine-pyrimethamine plus amodiaquine, 0.5% received only Day 1 sulfadoxine-pyrimethamine plus amodiaquine, 1.0% received Day 1 sulfadoxine-pyrimethamine plus amodiaquine and either Day 2 amodiaquine or Day 3 amodiaquine (sulfadoxine-pyrimethamine plus amodiaquine + amodiaquine), and 88.8% received Day 1 sulfadoxine-pyrimethamine plus amodiaquine and both Day 2 and Day 3 amodiaquine (sulfadoxine-pyrimethamine plus amodiaquine + amodiaquine + amodiaquine). Children receiving only Day 1 sulfadoxine-pyrimethamine plus amodiaquine did not have significant lower odds of rapid diagnostic tests-confirmed malaria than those receiving non-sulfadoxine-pyrimethamine plus amodiaquine (OR 0.77, 0.42-1.42). However, children receiving sulfadoxine-pyrimethamine plus amodiaquine + amodiaquine had significantly lower odds of rapid diagnostic tests-confirmed malaria than those receiving non-sulfadoxine-pyrimethamine plus amodiaquine (OR 0.42, 95% CI 0.28-0.63). Similarly, children receiving sulfadoxine-pyrimethamine plus amodiaquine + amodiaquine + amodiaquine also had significantly lower odds of rapid diagnostic test-confirmed malaria than those receiving non-sulfadoxine-pyrimethamine plus amodiaquine (OR 0.54, 95% CI 0.47-0.62). Adherence to at least one daily dose of amodiaquine administration following receipt of Day 1 sulfadoxine-pyrimethamine plus amodiaquine by eligible children is crucial to ensure the effectiveness of seasonal malaria chemoprevention. This demonstrates the importance of enhancing caregiver awareness regarding the importance of amodiaquine and identifying barriers toward amodiaquine administration at the community level.

Malaria vaccines: a new tool for elimination?

A malaria vaccine represents an essential complementary tool to curb the stagnation, or even increase, in malaria cases observed over the last decade due to the emergence of resistance to insecticides impregnated on mosquito nets, wars and internal conflicts, as well as global warming. In October 2021, WHO recommended the use of the RTS,S/ASO1 vaccine for children aged 5-17 months in areas of moderate to high transmission. In October 2023, a second vaccine received WHO approval for deployment in the same population, following demonstration of around 70 % efficacy in protecting young children against malaria for one year. Given their partial efficacy, however, these vaccines are not generally recommended for travelers to endemic countries.

OUTCOME OF DEVELOPMENTAL THERAPY IN CHILDREN WITH CEREBRAL PALSY CHILDREN: A PROSPECTIVE COHORT

Introduction: Cerebral palsy (CP) is the non-progressive disorder of motor and posture with associated delayed development in areas of cognition, perception, behavior and sensation, due to insult to immature brain. Improvement in all developmental domains of CP patients depends upon early institution of rehabilitation programs involving all multidisciplinary approach. The portage early education program (PEEP) is a worldwide, effective and early interventional method, for developmentally delayed children. Objective: To determine the outcome of developmental therapy in children with CP by using PEEP. Study Design: Experimental research design (within group) Settings: The children hospital and the institute of child health Multan. Methodology: 156 patients of 2 to 10 years of age, both gender from January 2020 to December 2020, diagnosed as CP were enrolled for this study. All children were assessed by using PEEP and GMFM (Gross Motor Function Measure) twice 6 months apart. A trained clinical psychologist administered PEEP to all the children. All the Patients were advised regular weekly sessions at hospital by multidisciplinary team and at least 2 hours per day for continuation of these therapies at home. At the end of 6 months we found that all families had not followed this. The patient who visited >2times/month were considered compliant and those visited <2times/month were considered non-compliant. Data was analyzed by using SSPS version 16. Paired t test was used to compare the developmental outcome of compliant and non-compliant groups. Results: Out of 156 participants, 58(37%) were in compliant and 98(63%) non-compliant. Male subjects were prominent 42(72.41%) and 67(68.37%) respectively. Most of the participants belonged to 3-6 years of age in both groups28(48.29%) and 51(52.04%) respectively. Spastic quadriplegia (26(44.83%), 57 (58.16%)), and level 5 on GMFM 24(42.86) and 52(53.06%) respectively was commonly presents in both patient groups. The mean comparison of DQ of Compliant CP Children at initial stage and after six months in areas of GM, C, SH, S, L and GMFM was found statistically significant. Conclusion: CP children should be on regular follow up for developmental therapy for long time for better outcome. PEEP is an excellent system for the assessment, training and rehabilitation of children with delayed development.

Seismic noise to public health signal: investigating the effects of pandemic guidance in Mexico

ABSTRACT Understanding public activities and developing thoughtful public health strategies are key goals in efforts to manage the COVID-19 pandemic. This paper explores how seismic noise data can be used as part of such efforts. We show that the fluctuation of seismic noise levels has the capacity to demonstrate aggregate human movement. When considered in relation to major public health efforts, these data can help us evaluate the effectiveness of public health communication strategies that seek to limit social activity. We show evidence that, broadly speaking, Mexican national efforts to encourage “lockdown” worked for a few months in areas around seismic stations, and broke down as time went on. Further, we suggest that changes in the levels of human activity detected in seismic noise can be read alongside social data that provide some clues as to why people respond or not to health recommendations. Our findings have implications for both efforts to understand the nature and effects of public trust in the Mexican state and also the practicalities of using seismic noise data in this manner. An interdisciplinary analysis allows us to address these data and their possible use in a way that takes seriously the opportunities and challenges that emerge in the context of contemporary biopolitics and emerging configurations of surveillance technologies. Analyzing anthropogenic seismic activity opens up new opportunities for ethical data collection and use.

Impact of Circular, Waste-Heat Reuse Pathways on PM2.5-Air Quality, CO2 Emissions, and Human Health in India: Comparison with Material Exchange Potential.

India is home to 1.3 billion people who are exposed to some of the highest levels of ambient air pollution in the world. In addition, India is one of the fastest-growing carbon-emitting countries. Here, we assess how two strategies to reuse waste-heat from coal-fired power plants and other large sources would impact PM2.5-air quality, human health, and CO2 emissions in 2015 and a future year, 2050, using varying levels of policy adoption (current regulations, proposed single-sector policies, and ambitious single-sector strategies). We find that power plant and industrial waste-heat reuse as input to district heating systems (DHSs), a novel, multisector strategy to reduce local biomass burning for heating emissions, can offset 71.3–85.2% of residential heating demand in communities near a power plant (9.3–12.4% of the nationwide heating demand) with the highest benefits observed during winter months in areas with collocated industrial activity and higher residential heating demands (e.g., New Delhi). Utilizing waste-heat to generate electricity via organic Rankine cycles (ORCs) can generate an additional 22 (11% of total coal-fired generating capacity), 41 (8%), 32 (13%), and 6 (5%) GW of electricity capacity in the 2015, 2050-current regulations, 2050-single-sector, and 2050-ambitious-single-sector scenarios, respectively. Emission estimates utilizing these strategies were input to the GEOS-Chem model, and population-weighted, simulated PM2.5 showed small improvements in the DHS (0.2–0.4%) and ORC (0.3–3.4%) scenarios, where the minimal DHS PM2.5-benefit is attributed to the small contribution of biomass burning for heating to nationwide PM2.5 emissions (much of the biomass burning activity is for cooking). The PM2.5 reductions lead to ∼130–36,000 mortalities per year avoided among the scenarios, with the largest health benefits observed in the ORC scenarios. Nationwide CO2 emissions reduced <0.04% by DHSs but showed larger reductions using ORCs (1.9–7.4%). Coal fly-ash as material exchange in cement and brick production was assessed, and capacity exists to completely reutilize unused fly-ash toward cement and brick production in each of the scenarios.

Impact of seasonal malaria chemoprevention on prevalence of malaria infection in malaria indicator surveys in Burkina Faso and Nigeria

BackgroundIn 2012, the WHO issued a policy recommendation for the use of seasonal malaria chemoprevention (SMC) to children 3–59 months in areas of highly seasonal malaria transmission. Clinical trials have...

Extending Delivery of Seasonal Malaria Chemoprevention to Children Aged 5-10 Years in Chad: A Mixed-Methods Study.

To prevent malaria among children aged 3-59 months in areas with high seasonal transmission, seasonal malaria chemoprevention (SMC) is recommended. In Chad, there is evidence of SMC administration to children aged older than 5 years (referred to as "leakage"). This study aimed to understand the reasons for leakage and explore the feasibility and acceptability of extending the delivery of SMC to children aged 5-10 years in Chad. We conducted a mixed-methods study in Massaguet health district with a cross-sectional survey to determine SMC coverage for children aged up to 10 years after SMC cycles 1 and 3 (n=90 and n=100 caregivers surveyed, respectively) and at the end of cycle 4 (n=101 caregivers surveyed). We conducted 14 key informant interviews at the national and district level and 8 focus group discussions with community distributors and caregivers. In the compounds surveyed, there were no children aged 5-10 years in cycle 1. In cycles 3 (n=1 children) and 4 (n=16 children), there was 100% (95% confidence interval [CI]=2.5, 100.0) and 62.5% (95% CI=35.4, 84.8) coverage of SMC in children aged 5-10 years, respectively. Extension of SMC to older children was considered acceptable, but there were concerns about feasibility and ensuring the sustainability of the current program in children aged 3-59 months. Key informants acknowledged the need to secure additional funding to pilot SMC in older age groups and were uncertain about the impact of the current SMC program at scale. Key informants considered extending SMC to children aged 5-10 years acceptable but did not deem it a current priority. They expressed an urgent need to address leakage and reinforce both the sustainability and quality of the current SMC program.

Seasonal malaria chemoprevention in older children: magnitude, consequences and opportunities

Seasonal malaria chemoprevention is tailored for children 3 to 59 months in areas of high transmission of malaria between July and October. However, SMC was administrated to children outside the pre-defined age range. This study aims to evaluate to which extent the treatment was given to these children. The authors carried out a cross sectional survey in November 2018 in eight (8) health regions. Sampled of 944 household where mothers of children under the age of 10 were interviewed about SMC coverage. They used a structured questionnaire to mothers/tutors including child’s age, the history of SMC administration including the adherence to the three daily doses, the possession or not of SMC cards, use of bed nets, and finally episodes of illnesses during the SMC period. Proportion of treated children included proportions captured both during mother/tutor’s interview or card inspection. A total of 1191 children between the age of 5 years and over were identified. According to mother’s declaration, 19.65% (234/1191) children received at least one dose of SMC; only 150 children had SMC card, of whom 146 (97.33%) have received at least one dose of SMC. Despite the well-known age target of SMC, older children were treated; however reduced, this deserves further attention. Key words: SMC coverage, children over 59 months, Burkina Faso.

Variations in Morphology and Anatomy of Breadfruit (Artocarpus altilis) Based on Differences in Altitude

Background: Breadfruit [Artocarpus altilis (Parkinson ex F.A.Zorn) Fosberg] is a versatile plant that can be used by humans. Breadfruit has morphological variations that are thought to be related to anatomical variations that are formed as an adaptation mechanism to survive in a different area. This plant has the ability to live in different altitude ranges, from coastal areas to upland areas. This research was conducted for eight months in areas with altitude ranges of &lt;350 masl, 350-700 masl, and &gt;700 masl in Banyumas, Purbalingga, and Cilacap Regencies. Sampling of plants was carried out randomly selected (purposive random sampling), then described their morphological characteristics. Furthermore, the leaves are made for anatomical preservation to determine the anatomical character. Breadfruit plants that grow at an altitude of less than 350 m above sea level have the characteristics of a higher, larger diameter stem, have a tighter branching, more sap production, a higher number of fruit and have a larger fruit size. The anatomical characteristics of breadfruit plants that grow at an altitude of less than 350 masl have stomata characters that are wider and longer than those of 350-700 masl and &gt; 700 masl. The highest stomata and trichomata density at an altitude &gt; 700 masl. The highest mean cuticle thickness, epidermis, palisade ratio and mesophyll thickness were highest in breadfruit leaves at altitudes &lt;350 masl.

Seasonal malaria chemoprevention in the Sahel subregion of Africa: a cost-effectiveness and cost-savings analysis

The intermittent administration of seasonal malaria chemoprevention (SMC) is recommended to prevent malaria among children aged 3-59 months in areas of the Sahel subregion in Africa. However, the cost-effectiveness and cost savings of SMC have not previously been evaluated in large-scale studies. We did a cost-effectiveness and cost-savings analysis of a large-scale, multi-country SMC campaign with sulfadoxine-pyrimethamine plus amodiaquine for children younger than 5 years in seven countries in the Sahel subregion (Burkina Faso, Chad, Guinea, Mali, Niger, Nigeria, and The Gambia) in 2016. The financial and economic costs were analysed from the programmatic perspective and are reported in 2016 US$ for each country. The estimated numbers of averted malaria cases, deaths, and disability-adjusted life-years (DALYs) were based on numbers of SMC treatments administered and modelled malaria transmission. Cost savings were calculated from a programmatic perspective corresponding to the diagnostic and treatment costs for malaria cases averted. The total cost of SMC for all seven countries was $22·8 million, and the weighted average economic cost of administering four monthly SMC cycles was $3·63 per child (ranging from $2·71 in Niger to $8·20 in The Gambia). Based on 80% modelled effectiveness of SMC, the incremental economic cost per malaria case averted ranged from $2·91 in Niger to $30·73 in The Gambia; the cost per severe case averted ranged from $119·63 in Niger to $506·00 in The Gambia; the cost per death averted ranged from $533·56 in Niger to $2256·92 in The Gambia; and the cost per DALY averted (discounted by 3%) ranged from $18·66 in Niger to $78·91 in The Gambia. The estimated total economic cost savings to the health systems in all seven countries were US$66·0 million and the total net economic cost savings were US$43·2 million. SMC is a low-cost and highly cost-effective intervention that contributes to substantial cost savings by reducing malaria diagnostic and treatment costs among children. Unitaid.

Ways to increase stress resistance of grapes in conditions of moisture deficit

For optimal conditions of grapevine development, a relatively uniform distribution of precipitation is needed during all phases of active plant growth. However, often there are dry periods in summer months in areas of unstable moistening. At the present time, in intensive technologies of grape cultivation, foliar treatments with agrochemicals are widely used to increase stress resistance of plants to moisture deficit with the goal to protect and increase cropping capacity and gain optimal conditions of viticultural products. Our research, carried out in the conditions of Crimea, have shown that using of the studied systems of mineral nutrition with micronutrient fertilizers of the Wuxal group in conditions of air and soil drought contributed to an increase in the average bunch weight by 17.4-51.9 g and an cropping capacity of grapes by 9.5-35, 3% (1-1.5 t / ha). It was experimentally proven that test treatments have led to a significant increase (by 4.7-15.5%) in the growth of green matter of bushes and in the structure index of table grape bunch by 19.1-37.8%. Against the background of using the studied systems of nutrition, an increase in the content of sugars and phenolic substances in the must of ‘Saperavi’ grape variety by 8.5% and 70.4%, respectively, was observed in comparison with the control.

Focused action is required to protect ethnic minority populations from COVID-19 post-lockdown.

Since the association between COVID-19 and ethnicity was first noted in April 2020,1 numerous large-scale national datasets have been analysed.2–6 The evidence is clear — ethnicity is a key risk factor for adverse COVID-19 outcome, alongside age, male sex, obesity, deprivation, and comorbidities.7 There are significant ethnic inequalities in the risk of admission to hospital and risk of death from COVID-19. Black and South Asian ethnic groups are at greatest risk, although most ethnic minorities have been shown to have increased risk when compared with white populations.7 Beyond admission to hospital and mortality risk, there is also concern over longer-term impacts, that is, post-acute COVID-19,8 which could significantly impact ethnic minority populations. As a result, Public Health England (PHE) released two evidence reviews and recommendations to address the disparities in COVID-19 outcomes in ethnic minority populations.9,10 PHE made only seven recommendations and these were lacking in detail, featuring issues that were already well articulated in minority health literature. The recommendations gave limited attention to the wider determinants of health that underpin ethnic disparities in COVID-19 outcomes, and gave no indication of timeframes for delivery or methods of implementation.10 In addition, the recommendations did not address how ethnic minority populations could best protect themselves during the pandemic. This was a significant oversight because personal and community responsibilities are imperative social determinants to protecting the health and wellbeing of ethnic minority communities when national (and regional) lockdown is eased. Subsequent to the PHE report there was an inevitable resurgence in COVID-19 cases over the summer months in areas with a high density of ethnic minorities such as Leicester,11 Blackburn, and Oldham. From mid-September, local COVID-19 restrictions were introduced across parts of the North West, North East, Midlands, and West Yorkshire. …

Four new species of Isepeolini (Hymenoptera; Apidae) from northern Chile

BackgroundCleptoparasitic bees are less commonly collected than their hosts and often more difficult to identify and additional descriptions and treatment of diagnostic characteristics are needed.ResultsFour new species of Isepeolini are described from northern Chile: Isepeolus mankalunthata Packer & Graham, new species; Melectoides licancabur Packer & Graham, new species, M. desiccata Packer & Graham new species and M. glaucodontus Packer & Graham new species. Putative host information is provided where possible, comments on the habitats of these bees are made and additional records of the tribe from Chile are listed.ConclusionUsing traps left out for weeks to months in areas where bees are sparse is proving a useful technique to catch rare and undescribed species.

Initial Experience With Autologous Skin Cell Suspension for Treatment of Deep Partial-Thickness Facial Burns.

Facial burns present a challenge in burn care, as hypertrophic scarring and dyspigmentation can interfere with patients' personal identities, ocular and oral functional outcomes, and have long-term deleterious effects. The purpose of this study is to evaluate our initial experience with non-cultured, autologous skin cell suspension (ASCS) for the treatment of deep partial-thickness (DPT) facial burns. Patients were enrolled at a single burn center during a multicenter, prospective, single-arm, observational study involving the compassionate use of ASCS for the treatment of large total BSA (TBSA) burns. Treatment decisions concerning facial burns were made by the senior author. Facial burns were initially excised and treated with allograft. The timing of ASCS application was influenced by an individual's clinical status; however, all patients were treated within 30 days of injury. Outcomes included subjective cosmetic parameters and the number of reoperations within 3 months. Five patients (4 males, 1 female) were treated with ASCS for DPT facial burns. Age ranged from 2.1 to 40.7 years (mean 18.2 ± 17.3 years). Average follow-up was 231.2 ± 173.1 days (range 63-424 days). Two patients required reoperation for partial graft loss within 3 months in areas of full-thickness injury. There were no major complications and one superficial hematoma. Healing and cosmetic outcomes were equivalent to, and sometimes substantially better than, outcomes typical of split-thickness autografting. Non-cultured, ASCS was successfully used to treat DPT facial burns containing confluent dermis with remarkable cosmetic outcomes. Treatment of DPT burns with ASCS may be an alternative to current treatments, particularly in patients prone to dyspigmentation, scarring sequelae, and with limited donor sites.

Poor Dietary Diversity Is Associated with Stunting among Children 6-23 Months in Area of Mergangsan Public Health Center, Yogyakarta.

The period of pregnancy and the first two years of children are called the golden period so that the adequacy intake of macro and micronutrients must be fulfilled. Stunting is a chronic undernutrition condition as a result of inadequate quality and quantity of complementary foods with or without infectious diseases. Quality and quantity of complementary foods can affect linear growth. To analyzed the association between dietary diversity and stunting among children aged 6-23 mo in the area of Mergangsan public health center, Yogyakarta. Method: Study was an analytic observational study with a cross-sectional design. The population was children aged 6-23 mo from 60 integrated health service centers in the area of Mergangsan public health center with a total population of 343 children. The sample size was 135 children. Samples were selected using simple random sampling. Data were analyzed using univariate (descriptive), bivariate (chi-square test), and multivariate analysis (multiple logistic regression). The result of bivariate analysis showed that there was a significant association between dietary diversity of complementary foods (p=0.012; RP=2.87; CI: 1.23-6.68) and father's height (p=0.03; RP=2.58; CI: 1.06-6.30) with stunting. The result of the multivariate analysis showed that there was a significant association between dietary diversity of complementary foods and stunting while there was no association between the father's height and stunting. Poor dietary diversity of complementary foods was a risk factor of stunting among children aged 6-23 mo.

Neuroanatomical correlates of sensory deficits in children with neonatal arterial ischemic stroke.

Our aim was to characterize the sensory processing outcome following neonatal arterial ischemic stroke (NAIS) and identify neuroanatomical correlates of abnormal sensory processing. We evaluated children with NAIS longitudinally at 12 months, 18 months, and/or 30 months in areas of cognitive, motor, and language development. We gathered sensory processing data using the Sensory Profile-2 Caregiver Questionnaire. These data were analyzed against early magnetic resonance imaging using a voxel-based approach. Eighteen children (10 males, 8 females) with NAIS were evaluated longitudinally, of which six exhibited atypical sensory processing. Children with sensory processing deficits had lower overall developmental scores in motor, cognitive, and language domains. Neuroanatomical correlates were identified in the posterior periventricular white matter extending superiorly into the supramarginal gyrus, and inferiorly into the fusiform and inferior temporal gyri. Our results provide new evidence that children with NAIS may experience difficulty processing sensory information, which is most likely associated with injuries in the posterior periventricular white matter, supramarginal gyrus, fusiform gyrus, and posterior thalamic radiation. Atypical sensory processing is common in children with neonatal arterial ischemic stroke (NAIS). NAIS territories in sensory areas were correlated with atypical sensory processing behaviors. Children with NAIS may benefit from early interventions targeted toward sensory processing. Future research mapping NAIS injuries using early magnetic resonance imaging may predict long-term outcomes.

Drought, conflict and children’s undernutrition in Ethiopia 2000–2013: a meta-analysis

ObjectiveTo estimate the prevalence of childhood wasting and to investigate the effects of drought and conflict on wasting in crisis-affected areas within Ethiopia.MethodsWe searched the Complex Emergency Database for nutrition surveys carried out in Ethiopia over the period 2000–2013. We extracted data on the prevalence of wasting (weight-for-height z-scores below –2) among children aged 6–59 months for areas of Ethiopia that had sufficient data available. Data on any conflict events (irrespective of magnitude or impact) and episodes of seasonal drought affecting the survey areas were extracted from publicly available data sources. Random-effects Bayesian meta-analysis was used to synthesize the evidence from 231 small-scale surveys.FindingsFrom the total sample of 175 607 children analysed, the pooled number of children wasted was 21 709. The posterior median prevalence of wasting was 11.0% (95% credible interval, CrI: 10.3–11.7) over the 14-year period. Compared with areas unaffected by drought, the estimated prevalence of wasting was higher in areas affected by moderate levels of drought (posterior odds ratio, OR: 1.34; 95% CrI: 1.05–1.72) but similar in severe drought-affected areas (OR: 0.96; 95% CrI: 0.68–1.35). Although the pooled prevalence of wasting was higher in conflict-affected than unaffected areas, the difference was not plausible (OR: 1.02; 95% CrI: 0.82–1.26).ConclusionDespite an overall declining trend, a wasting problem persists among children in Ethiopia. Conflict events did not have a major impact on childhood wasting. Nutrition interventions should go beyond severe drought-prone areas to incorporate areas where moderate droughts occur.

Environmental contamination with Toxocara eggs: a quantitative approach to estimate the relative contributions of dogs, cats and foxes, and to assess the efficacy of advised interventions in dogs.

BackgroundEnvironmental contamination with Toxocara eggs is considered the main source of human toxocariasis. The contribution of different groups of hosts to this contamination is largely unknown. Current deworming advices focus mainly on dogs. However, controversy exists about blind deworming regimens for >6-month-old dogs, as most of them do not actually shed Toxocara eggs. We aim to estimate the contribution of different non-juvenile hosts to the environmental Toxocara egg contamination and to assess the effects of different Toxocara-reducing interventions for dogs.MethodsA stochastic model was developed to quantify the relative contribution to the environmental contamination with Toxocara eggs of household dogs, household cats, stray cats, and foxes, all older than 6 months in areas with varying urbanization degrees. The model was built upon an existing model developed by Morgan et al. (2013). We used both original and published data on host density, prevalence and intensity of infection, coprophagic behaviour, faeces disposal by owners, and cats’ outdoor access. Scenario analyses were performed to assess the expected reduction in dogs’ egg output according to different deworming regimens and faeces clean-up compliances. Estimates referred to the Netherlands, a country free of stray dogs.ResultsHousehold dogs accounted for 39 % of the overall egg output of >6-month-old hosts in the Netherlands, followed by stray cats (27 %), household cats (19 %), and foxes (15 %). In urban areas, egg output was dominated by stray cats (81 %). Intervention scenarios revealed that only with a high compliance (90 %) to the four times a year deworming advice, dogs’ contribution would drop from 39 to 28 %. Alternatively, when 50 % of owners would always remove their dogs’ faeces, dogs’ contribution would drop to 20 %.ConclusionAmong final hosts of Toxocara older than 6 months, dogs are the main contributors to the environmental egg contamination, though cats in total (i.e. both owned and stray) transcend this contribution. A higher than expected compliance to deworming advice is necessary to reduce dogs’ egg output meaningfully. Actions focusing solely on household dogs and cats are unlikely to sufficiently reduce environmental contamination with eggs, as stray cats and foxes are also important contributors.