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Gold nuggets occur predominantly in quartz veins, and the current paradigm posits that gold precipitates from dilute (<1 mg kg−1gold), hot, water ± carbon dioxide-rich fluids owing to changes in temperature, pressure and/or fluid chemistry. However, the widespread occurrence of large gold nuggets is at odds with the dilute nature of these fluids and the chemical inertness of quartz. Quartz is the only abundant piezoelectric mineral on Earth, and the cyclical nature of earthquake activity that drives orogenic gold deposit formation means that quartz crystals in veins will experience thousands of episodes of deviatoric stress. Here we use quartz deformation experiments and piezoelectric modelling to investigate whether piezoelectric discharge from quartz can explain the ubiquitous gold–quartz association and the formation of gold nuggets. We find that stress on quartz crystals can generate enough voltage to electrochemically deposit aqueous gold from solution as well as accumulate gold nanoparticles. Nucleation of gold via piezo-driven reactions is rate-limiting because quartz is an insulator; however, since gold is a conductor, our results show that existing gold grains are the focus of ongoing growth. We suggest this mechanism can help explain the creation of large nuggets and the commonly observed highly interconnected gold networks within quartz vein fractures.

In this paper we propose a novel document retrieval model in which text queries are augmented with multi-dimensional taxonomy restrictions. These restrictions may be relaxed at a cost to result quality. This new model may be applicable in many arenas, including multifaceted, product, and local search, where documents are augmented with hierarchical metadata such as topic or location. We present efficient algorithms for indexing and query processing in this new retrieval model. We decompose query processing into two sub-problems: first, an online search problem to determine the correct overall level of relaxation cost that must be incurred to generate the top kresults; and second, a budgeted relaxation search problem in which all results at a particular relaxation cost must be produced at minimal cost. We show the latter problem is solvable exactly in two hierarchical dimensions, is NP-hard in three or more dimensions, but admits efficient approximation algorithms with provable guarantees. We present experimental results evaluating our algorithms on both synthetic and real data, showing order of magnitude improvements over the baseline algorithm.

Background New late HIV diagnosis (CD4 count <350cells/mm3) are higher in North West England compared to the UK average. A Greater Manchester-wide audit into individuals diagnosed with late or very late HIV was conducted in 2016 and re-audited in 2019. Our aim was to gain intelligence into key demographics of late diagnosed individuals across Greater Manchester, review opportunities for earlier diagnosis and determine if key recommendations from the 2016 audit were followed.Methods Individuals were identified from locally kept data or HIV and AIDS Reporting System (HARS) data. A retrospective case note review was performed for each patient using data from local notes, General Practice summary of care records and relevant clinical letters. Data was collected for 2019 and compared to 2016 results.Results In 2016, nine departments contributed data and 104 individuals were identified as having been diagnosed late. In 2019, seven departments contributed data and 65 individuals were identified as having been diagnosed late. In both years, a greater proportion of males diagnosed late were White British and for females Black African. A greater proportion of late diagnosis occurred in men who have sex with men (MSM) and in heterosexual females. In 2019, a greater proportion of patients had an AIDS-defining illness at time of diagnosis. Whilst in 2016, most patients were asymptomatic. Over one third of patients had a clinical indicator disease in their past medical history, which is an increase in proportion from 2016. The proportion of cases where clinicians felt that there had been probable missed opportunities for earlier diagnosis also increased in 2019.Conclusions There are continued missed opportunities for earlier diagnosis. We recommend targeted interventions for groups at higher risk of late presentation, education in primary/secondary care regarding clinical indicator conditions, a formal review process for all late diagnosed cases, communication with primary/secondary care if missed opportunities are identified and broader HIV testing especially in high prevalence areas.

We report the case of a young man who has never had any sexual contact presenting with a large scrotal lump with secondary bacterial infection. He reported no prior warts – genital or cutaneous. On examination, he had a large pink cauliform mass on the scrotum with four smaller but similar satellite lesions. Appearances were thought to be consistent with giant condyloma of Buschke and Lowenstein. Once superinfection was treated with oral antibiotics, he had a trial of imiquimod without success and was then referred to urology. After surgical excision, pathology concluded it was an inflamed fibroepithelial polyp with no malignant changes. To our knowledge, this is the first case report of a giant scrotal fibroepithelial polyp with characteristic gross warty features in an adult.

NASA's strategy in exploring Mars has been to follow the water, because water is essential for life, and it has been found that there are many locations where there was once liquid water on the surface. Now perhaps, to narrow down the search for life on a barren basalt‐dominated surface, there needs to be a refocusing to a strategy of “follow the nutrients.” Here we model the entry of metallic micrometeoroids through the Martian atmosphere, and investigate variations in micrometeorite abundance at an analogue site on the Nullarbor Plain in Australia, to determine where the common limiting nutrients available in these (e.g., P, S, Fe) become concentrated on the surface of Mars. We find that dense micrometeorites are abundant in a range of desert environments, becoming concentrated by aeolian processes into specific sites that would be easily investigated by a robotic rover. Our modeling suggests that micrometeorites are currently far more abundant on the surface of Mars than on Earth, and given the far greater abundance of water and warmer conditions on Earth and thus much more active weather system, this was likely true throughout the history of Mars. Because micrometeorites contain a variety of redox sensitive minerals including FeNi alloys, sulfide and phosphide minerals, and organic compounds, the sites where these become concentrated are far more nutrient rich, and thus more compatible with chemolithotrophic life than most of the Martian surface. NASA's exploration program has allowed the scientific community to demonstrate clearly that Mars had a watery past, so the search for life needs to move on to identifying the places where water and nutrients coincided. We have investigated the relative abundance of micrometeorites on Mars compared to the Earth because these contain key nutrients that the earliest life forms on Earth used, and because their contained minerals can be used to investigate past atmospheric chemistry. We suggest that micrometeorites should be far more abundant on the Martian surface than on Earth's, and that wind‐driven modification of sediments is expected to concentrate micrometeorites, and their contained nutrients, in gravel beds and cracks in exposed bedrock. Micrometeorites are predicted to be far more abundant on Mars than on EarthMicrometeorites are concentrated in the residue of aeolian sediment removal, such as at bedrock cracks and gravel accumulationsMicrometeorite accumulation sites are enriched in key nutrients for primitive microbes: reduced phosphorus, sulfur, and iron

This paper describes the new mineral nataliyamalikite, the orthorhombic form of thallium iodide (TlI), from high-temperature fumaroles from the Avacha volcano, Kamchatka Peninsula, Russia. We also present some chemical analyses showing extreme enrichment of Tl in the volcanic gases at the Avacha volcano, and a review of thallium geochemistry that highlights the fascinating processes that led to the formation of nataliyamalikite.

Evidence in support of low atmospheric oxygen concentrations on early Earth relates to the composition of the lower Archaean atmosphere; now the composition of fossil micrometeorites preserved in 2.7-billion-year-old rocks in Australia suggests that they were oxidized in an oxygen-rich Archaean upper atmosphere.

ObjectiveTo determine the prevalence of asymptomatic neurosyphilis (ANS) in HIV-positive individuals after treatment of early syphilis with single-dose benzathine penicillin G (BPG) or oral antibiotic alternatives.MethodsPatients at high risk of neurosyphilis (defined by serum rapid plasma reagin (RPR) titre ≥1:32 and/or peripheral blood CD4 lymphocyte count ≤350/μL) underwent lumbar puncture (LP) at a median time of 8.2 months post treatment. ANS was diagnosed by a reactive cerebrospinal fluid (CSF) RPR test or CSF white blood cells (WBC) >20/μL plus a reactive CSF Treponema pallidumparticle agglutination (TPPA) ≥1:640.ResultsOf 133 eligible patients, all were men who have sex with men. Of these, 64 consented to LP. Full CSF results were available for 59 patients. Inclusion criteria were serum RPR (21/59), CD4 count (22/59) and combined RPR and CD4 (16/59). The LP patients were white British (82%), median age 40. Syphilis stages were primary (17%) secondary (43%) and early latent (41%). Syphilis was treated with BPG (47/59), doxycycline 100 mg two times per day for 14 days (10/59) and for 21 days (1/59). Azithromycin 500 mg one time per day for 10 days was given to 1/59. At the time of LP, 100% of patients had achieved serological cure, and 66% were taking antiretroviral treatment. Only 1/59 was diagnosed with ANS. The CSF showed: RPR non-reactive (59/59); TPPA non-reactive in 54/59; WBC ≤5/μL in 51/59.ConclusionsAlthough the number of patients in our study is modest, single-dose BPG appears to be highly effective even in patients at high risk of neurosyphilis.

Differences in religious faith-based viewpoints (controversies) on the sanctity of human life, acceptable behaviour, health-care technologies and health-care services contribute to the widespread variations in health care worldwide. Faith-linked controversies include family planning, child protection (especially child marriage, female genital mutilation, and immunisation), stigma and harm reduction, violence against women, sexual and reproductive health and HIV, gender, end-of-life issues, and faith activities including prayer. Buddhism, Christianity, Hinduism, Islam, Judaism, and traditional beliefs have similarities and differences in their viewpoints. Improved understanding by health-care providers of the heterogeneity of viewpoints, both within and between faiths, and their effect on health care is important for clinical medicine, public-health programmes, and health-care policy. Increased appreciation in faith leaders of the effect of their teachings on health care is also crucial. This Series paper outlines some faith-related controversies, describes how they influence health-care provision and uptake, and identifies opportunities for research and increased interaction between faith leaders and health-care providers to improve health care.

Abstract—Metal‐troilite textures are examined in metamorphosed and impact‐affected ordinary chondrites to examine the response of these phases to rapid changes in temperature. Complexly intergrown metal‐troilite textures are shown to form in response to three different impact‐related processes. (1) During impacts, immiscible melt emulsions form in response to spatially focused heating. (2) Immediately after impact events, re‐equilibration of heterogeneously distributed heat promotes metamorphism adjacent to zones of maximum impact heating. Where temperatures exceed ∼850 ° C, this post‐impact metamorphism results in melting of conjoined metal‐troilite grains in chondrites that were previously equilibrated through radiogenic metamorphism. When the resulting Fe‐Ni‐S melt domains crystallize, a finely intergrown mixture of troilite and metal forms, which can be zoned with kamacite‐rich margins and taenite‐rich cores. (3) At lower temperatures, post‐impact metamorphism can also cause liberation of sulfur from troilite, which migrates into adjacent Fe‐Ni metal, allowing formation of troilite and occasionally copper within the metal during cooling. Because impact events cause heating within a small volume, post‐impact metamorphism is a short duration event (days to years) compared with radiogenic metamorphism (>106years). The fast kinetics of metal‐sulfide reactions allows widespread textural changes in conjoined metal‐troilite grains during post‐impact metamorphism, whereas the slow rate of silicate reactions causes these to be either unaffected or only partially annealed, except in the largest impact events. Utilizing this knowledge, information can be gleaned as to whether a given meteorite has suffered a post‐impact thermal overprint, and some constraints can be placed on the temperatures reached and duration of heating.

Severe acute malnutrition affects 13 million children worldwide and causes 1–2 million deaths every year. Our aim was to assess the clinical and nutritional efficacy of a probiotic and prebiotic functional food for the treatment of severe acute malnutrition in a HIV-prevalent setting.

Background Although much is known about risk factors for low birthweight, an important cause of neonatal death, little is known about how to reduce or prevent low birthweight.Objective This study aimed to verify a low rate in the incidence of low birthweight reported in the Bhutanese refugee camps in Nepal and, if true, to try to understand how this came about.Methods Medical records from 1994 to 2001 were recovered for half of the refugee population, and birthweight and other maternal factors were analyzed. The adequacy of the food ration provided to the general population was assessed by comparing it with the nutrient requirements of pregnant women.Results The rates of low birthweight were indeed low in the refugee camps, averaging 11% in the years reviewed. Between 1996 and 1998, the mean rate of low birthweight fell from 16% to 8% and mean birthweight increased from 2.84 kg (SE, 2.80–2.87) to 3.0 kg (SE, 2.97–3.03). The increase in birthweight occurred following improvements in the micronutrient-to-energy ratios of the general ration.Conclusions Rates of low birthweight comparable to those in developed countries were achieved in an ethnic Nepali population within 5 years of settlement in refugee camps. These low rates were probably achieved because basic needs of mothers were met, including both the quantity and the micronutrient content of food, water and sanitation, antenatal care, and education. The improvement from 1996 to 1998 coincided with increased availability of micronutrients in the food ration. We hypothesize that increased periconceptional micronutrient intake may be responsible for the increase in birthweight.

The care of severely malnourished children in sub-Saharan Africa is challenging, especially in HIV-prevalent settings. Recent improvements to facility-based individual case management, and increased community-based management focusing on early identification and high programme coverage have led to reductions in mortality. Further interventions are urgently needed to address resistant mortality, mostly attributable to HIV. This paper explores strategies in three main areas to improve survival for children with severe acute malnutrition (SAM): identifying HIV and improving case management for HIV-infected children; strengthening existing strategies to improve outcomes for all children with SAM, regardless of HIV status; and improving early identification and increasing programme coverage. Although interventions to further improve survival among children with SAM in sub-Saharan Africa must firstly ensure best care for all children, HIV-infected children are at particular risks for mortality. Integration of specific interventions for HIV testing and treatment into SAM care is essential. International guidelines should reflect best evidence, and are in urgent need of updating and adapting to local country context. Effective interventions already exist that can improve survival in children with SAM in HIV-prevalent settings. The challenge is to implement what we know and to research what we do not.

Background: HIV-related pneumonia is the main cause of paediatric hospital admissions in southern Africa. We aimed to measure predictors of treatment failure and the cause of non-responsive pneumonia in children admitted to hospital with severe pneumonia in Durban, South Africa. Methods: We investigated 358 children aged 1-59 months who presented with WHO-defined severe or very severe pneumonia. Children were recruited irrespective of HIV status and started on a standard antimicrobial regimen of benzylpenicillin and gentamicin. All infants also received high-dose trimethoprim-sulfamethoxazole. The primary outcome measure was treatment failure at 48 h. Findings: 242 (68%) children were HIV infected, 41 (12%) HIV exposed, uninfected, and 75 (21%) HIV uninfected. Failure to respond by 48 h was predicted by age under 1 year (adjusted odds ratio 6.38, 95% CI 2.72-14.91, p<0.0001), very severe disease (2.47, 1.17-5.24, p=0.0181), HIV status (HIV infected 10.3, 3.26-32.51; HIV exposed, uninfected 6.02, 1.55-23.38; p=0.0003), and polymicrobial disease (one organism 2.06, 1.05-4.05; two organisms 10.75, 4.38-26.36; p<0.0001) on logistic regression analysis. All children with three organisms failed treatment. 72/110 treatment failures had at least two organisms isolated. Three of nine HIV-exposed, uninfected infants, 29/74 HIV-infected, but no HIV-uninfected infants who failed study therapy had Pneumocystis jirovecii pneumonia. Interpretation: For children younger than 1 year, the WHO guidelines are inadequate and need to be revised since both HIV-infected and HIV-exposed, uninfected infants had more treatment failures than did HIV-uninfected infants. Polymicrobial disease is an important reason for treatment failure, and we need to identify rapid low-cost diagnostic methods to assist clinicians.

In a longitudinal cohort study we investigated factors contributing to breast milk HIV RNA viral load among lactating women in Lusaka, Zambia. Detailed data from 135 HIV-infected women were collected by questionnaires concerning postpartum maternal and infant health and infant feeding practice. Maternal blood was collected during pregnancy and at 6 weeks postpartum. Milk samples collected from each breast at 10 days and 6 weeks postpartum plus a subset collected at other time points were analyzed for HIV RNA viral load. Increased milk viral load was associated in univariate analyses with maternal symptoms of poor health, raised plasma α1-acid glycoprotein (AGP) at week 6, raised milk sodium/potassium (Na/K) ratio, postpartum need for antibiotics, preterm delivery, and low birth weight infants. In a multiple regression 49% of variability in mean milk viral load was explained by milk Na/K ratio and need for antibiotics, with borderline contributions from plasma AGP and plasma viral load. Maternal blood hemoglobin or receipt of iron supplements and infant feeding variables such as changing the infant's diet by moving from exclusive to nonexclusive breastfeeding or adding solid foods were not associated with milk viral load. Thus maternal health was the main factor contributing to milk viral load. The lack of effect of feeding practices on milk viral load and the previously determined association of poor maternal health with reduced duration of exclusive breastfeeding in this cohort suggest the relation between exclusive breastfeeding and decreased HIV transmission may be secondary to poor maternal health.

Abstract We propose two new tools to address the evolution of hyperlinked corpora. First, we define time graphs to extend the traditional notion of an evolving directed graph, capturing link creation as a point phenomenon in time. Second, we develop definitions and algorithms for time-dense community tracking, to crystallize the notion of community evolution.

Plant-based complementary foods are the main source of nutrients for many young children in developing countries. They may, however, present problems in providing nutritionally adequate and safe diets for older infants and young children. The high starch content leads to low-nutrient diets that are bulky and dense, with high levels of antinutritive factors such as phytates, tannins, lectins, and enzyme inhibitors. Phytates impair mineral bioavailability, lectins interfere with intestinal structure, and enzyme inhibitors inhibit digestive enzymes. In addition, there is often microbial contamination, which leads to diarrhea, growth-faltering, and impaired development, and the presence of chemical contaminants may lead to neurological disease and goiter. The fact that some fruits containing carotenoids are only available seasonally contributes to the vulnerability of children receiving predominantly plant-based diets. Traditional household food technologies have been used for centuries to improve the quality and safety of complementary foods. These include dehulling, peeling, soaking, germination, fermentation, and drying. While modern communities tend to reject these technologies in favor of more convenient fast-food preparations, there is now a resurgence of interest in older technologies as a possible means of improving the quality and safety of complementary foods when the basic diet cannot be changed for economic reasons. This paper describes the biology, safety, practicability, and acceptability of these traditional processes at the household or community level, as well as the gaps in research, so that more effective policies and programs can be implemented to improve the quality and safety of complementary foods.

The role of trace elements in human health and environmental pollution has developed into an extensive field of research. This study describes a sampling and analytical strategy to determine the trace element content of primary (deciduous) teeth and to assess their use in environmental health and nutrition studies. Exfoliated and extracted primary teeth were collected from 21 Ugandan and 27 UK children. The crown and root of the teeth were separated and the former digested and analysed for several elements by inductively coupled plasma mass spectrometry. The influence of country, tooth type, age and gender were statistically investigated in addition to within-person variation. A principal components analysis (PCA) was used to treat the data in a multivariate fashion and facilitated the moderation of outliers. The results demonstrated that country of origin has an important influence on the elemental composition of teeth and that tooth type should be controlled in these types of studies. Given such a restriction, the age and gender of the donor should have no effect and do not need to be controlled. In addition, where country of domicile, age and gender were controlled, the concentrations of most elements within a single tooth type were representative of an individual and therefore may be indicative of health status.

A recommendation system tracks past actions of a group of users to make recommendations to individual members of the group. The growth of computer-mediated marketing and commerce has led to increased interest in such systems. We introduce a simple analytical framework for recommendation systems, including a basis for defining the utility of such a system. We perform probabilistic analyses of algorithms within this framework. These analyses yield insights into how much utility can be derived from knowledge of past user actions.

Vitamin A is important for protection against diarrhea, and supplements may benefit gut function of infants of HIV-infected mothers.

Vitamin A is important for protection against diarrhea, and supplements may benefit gut function of infants of HIV-infected mothers. We studied 238 infants of HIV-infected South African women participating in a randomized, double-blind, placebo-controlled trial of vitamin A during pregnancy (1.5 mg retinyl palmitate and 30 mg ß-carotene daily) plus 60 mg retinyl palmitate at delivery. The placebo group received identical placebo capsules at the same times. When infants were 1, 6, and 14 weeks of age, lactulose/mannitol dual sugar intestinal permeability tests were performed. Maternal vitamin A supplementation did not significantly affect infant gut permeability in the group as a whole at any time. By multiple regression analysis, HIV infection of the infant by 14 weeks was significantly associated with increased gut permeability at both 6 and 14 weeks. After controlling for birth weight, gestational age, current weight, feeding mode and recent morbidity, there was a trend toward an interaction between vitamin A supplementation and HIV infection (P= 0.086) at 14 weeks. Vitamin A made no difference to gut permeability of uninfected infants (lactulose/mannitol ratio for vitamin A group: 0.11, 95% confidence interval [CI] 0.08, 0.15, n= 73 and for placebo group: 0.09, 95% CI 0.06, 0.12, n= 76), but largely prevented the increase in the ratio of HIV-infected infants (vitamin A group: 0.17, 95% CI 0.13, 0.23, n= 23; placebo group: 0.50, 95% CI 0.37, 0.68, n= 20). The effects on the lactulose/mannitol ratio were related to changes in lactulose, not mannitol, excretion. Vitamin A supplementation was associated with significantly lower lactulose excretion at 1 and 14 weeks, suggesting the major effect of vitamin A was on maintaining the integrity of gut tight junctions. Vitamin A supplementation of HIV-infected pregnant women may prevent the deterioration in gut integrity in the subgroup of their infants who themselves become infected. Improving vitamin A status of HIV-infected infants may decrease their gastrointestinal morbidity.

It has been more than 70 years since vitamin A was first reported to play a role in the treatment of measles. the addition of vitamin A to the treatment of other common childhood illnesses remains controversial, with differing guidelines. This review analyzes the strength of the evidence for the role of vitamin A in six common childhood illnesses. We found no published papers on the use of vitamin A in chickenpox or malaria. There is strong published evidence for the use of adjuvant vitamin A in children requiring hospital admission for measles and some evidence for its use in acute shigellosis. the available evidence does not support a role for adjuvant vitamin A in acute lower respiratory tract infections or acute watery diarrhea. There is insufficient evidence on the role of vitamin A in the treatment of persistent diarrhea, acute measles not requiring admission, and protein-energy malnutrition to guide policy

The acute-phase response to infection alters the plasma concentrations of most biochemical measures of iron status, rendering assessment of status difficult. Soluble transferrin receptors (TfR) may be an exception but have not been examined longitudinally during the major metabolic and inflammatory changes which occur during clinical malaria. Blood samples were collected daily during hospitalization, and again at a follow-up 2–6 weeks after discharge, from adult, mainly European, patients (n= 49) who developed uncomplicated Plasmodium falciparummalaria following visits to endemic areas. Parasitaemia and plasma concentrations of ferritin, TfR, C-reactive protein (CRP), a1-acid glycoprotein (AGP) and a1-anti-chymotrypsin (ACT) were measured. The concentrations of CRP, AGP and ACT correlated highly (P< 0·001) with each other and with plasma ferritin, and were significantly higher (P< 0·05) at all time points in hospital compared to the follow-up. TfR concentration correlated negatively and significantly (P< 0·05) with AGP and CRP but not with ACT or ferritin, and was significantly lower (around 30%) at all time points in hospital compared to follow-up, although in only 1 subject did it ever fall outside the normal reference range. In areas where both iron deficiency and clinical episodes of malaria are common, plasma TfR values need to be interpreted cautiously as indicators of iron status.

Vitamin A has well-recognized benefits for prevention of diarrhea, but the impact of therapeutic doses given during diarrhea on biochemical and clinical outcomes is less clear. We investigated these potential therapeutic benefits within a study of the optimum time for vitamin A supplementation to promote vitamin A status.

This paper discuss topic distillation, an information retrieval problemthat is emerging as a critical task for the www. Algorithms for this problemmust distill a small number of high-quality documents addressing a broadtopic from a large set of candidates.We give a review of the literature, and compare the problem with relatedtasks such as classification, clustering, and indexing. We then describe ageneral approach to topic distillation with applications to searching andpartitioning, based on the algebraic properties of matrices derived fromparticular documents within the corpus. Our method – which we call special filtering– combines the use of terms, hyperlinks and anchor-textto improve retrieval performance. We give results for broad-topic querieson the www, and also give some anecdotal results applying the sametechniques to US Supreme Court law cases, US patents, and a set of WallStreet Journal newspaper articles.

The objective of this study was to compare the iron status of 356 mother-baby pairs who had intrauterine growth retardation (IUGR) with 356 mother-baby pairs who had appropriate weight for gestational age (AGA). Mothers were selected in 1991/92 from 4 hospitals in Campinas city, Brazil, where 95% of deliveries take place. Gestational age of the newborns was determined by the Capurro method. Newborns were classified as having IUGR according to the Lubchenco birthweight for gestational age standard. Haemoglobin (Hb), haematocrit (Ht) and ferritin were determined, respectively, by the cyanmethaemoglobin method, an haematocrit centrifuge, and an immunoenzymetric assay. Mean levels of Hb and Ht were higher in IUGR (16·4 g/dL; 51·7%) than in AGA babies (15·7 g/dL; 49·7%) (P< 0·001), as a consequence of intrauterine hypoxia. Higher maternal levels of ferritin (>50 µg/L) were more common in IUGR than in AGA mothers (P< 0·001). Forty-seven percent (335/712) of the IUGR and AGA mothers were anaemic (Hb ? 11·0 g/dL), but only 4·4% (31/356) of them had low levels of ferritin (?10 µg/L). We advise further large epidemiological studies involving IUGR and AGA mother-baby pairs, elucidating the mechanisms underlying the plasma-volume changes in pregnancy, and the prevalence of iron-deficiency anaemia assessed by different indicators, in view of the fact that ferritin can be affected by inflammation and infection, important risk factors for IUGR in developing countries.

The Ascaris lumbricoidesexpelled by 1765 people in a poor urban community in Bangladesh were recovered and counted after the subjects had been treated with pyrantel pamoate. The subjects were divided into 22 classes by age and sex (mean n= 80) to examine how prevalence, mean worm burdens and measures of aggregation of worms varied with age and between the sexes, and to see how a measure of aggregation, k, calculated in 3 ways (by maximum likelihood, from moments, or from the percentage uninfected) compared with an empirical aggregation index (the percentage of subjects who expelled an arbitrary 80% of all worms) and with the proportion who were moderately to heavily infected (defined as ? 15 worms). The prevalence of infection ranged from 64% to 95%, mean worm burdens ranged from 7 to 23 worms, and kranged from 0·3 to 1·2. There were significant differences between adult males and females in the prevalence of infection, mean worm burdens and measures of aggregation, differences which are probably driven more by behaviour than immunity. The parameter kwas better described in terms of the proportion who were moderately to heavily infected (linear; range 0·15–0·58) than by the empirical aggregation index (non-linear; range 0·30–0·49).

SummaryKerosene pneumonitis is usually self-limiting and secondary infection is rare. Long-term studies in developed countries have produced conflicting results about complications. The position in developing countries, where children are exposed to adverse environmental and nutritional factors, is unknown. The aim of the present work was to determine whether there is an increase in respiratory or other illnesses following kerosene pneumonitis and whether these changes could be related to the severity of the initial lung damage. Fifty-seven children with clinical signs of pneumonitis were examined on admission and after overnight observation. Clinical signs were assessed for their usefulness for predicting severity. Cases and matched neighbourhood controls were seen every 2 weeks for 3 months. The time to predict most reliably the severity of short-term ill effects was 12–24 hours after the initial insult. There was no significant difference in respiratory symptoms during the 3-month follow-up in cases compared with controls. However, mild diarrhoea and fever were reported significantly more often in cases than in controls. Morbidity after clinical recovery was not shown to be a problem, irrespective of the severity of the acute event.

Amylase from germinating cereal grains enables the preparation of porridge with a higher energy density than conventional weaning foods. This food can be combined with fermentation, which inhibits pathogen growth. These food technologies are inexpensive, can be implemented at the household level, and are therefore particularly appropriate for use in developing countries. In a controlled clinical trial, 75 children aged 6–25 months admitted to hospital with acute diarrhea were rehydrated and then randomly allocated to three corn porridge dietary groups: conventional, amylase-digested (AMD), and fermented and amylase-digested (FAD). The study diets were given ad libitum five times daily, and all intakes except breast milk were weighed. Mean daily energy intakes over 4 days in the conventional AMD, and FAD groups, respectively, were 32.4 (95 CI 28.7–36.6), 46.0 (CI 39.6–53.4), and 37.3 (CI 31.8–43.9) kcal/kg/day. The energy intake in the AMD group was 42 higher than the conventional group (p = 0.003). There were no significant differences between the groups for duration of diarrhea, frequency of stooling, or vomiting. Starch digestion using amylase from germination is an effective way of improving energy intake in children with acute diarrhea.

There is a strong relationship between diarrhoea, malnutrition, and intestinal integrity. To investigate the effect of different dietary treatment on intestinal permeability during acute diarrhoea, 87 Tanzanian children aged 6-25 months were recruited to this study when admitted to hospital.