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Mette Frahm Olsen,1 Markos Tesfaye,2 Pernille Kæstel,1 Henrik Friis,1 Lotte Holm3 1Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark; 2Department of Psychiatry, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia; 3Department of Food and Resource Economics, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark Objectives: Ready-to-use supplementary foods (RUSF) are used increasingly in human immunodeficiency virus (HIV) programs, but little is known about how it is used and viewed by patients. We used qualitative methods to explore the use, perceptions, and acceptability of RUSF among adult HIV patients in Jimma, Ethiopia. Methods: The study obtained data from direct observations and 24 in-depth interviews with HIV patients receiving RUSF. Results: Participants were generally very motivated to take RUSF and viewed it as beneficial. RUSF was described as a means to fill a nutritional gap, to “rebuild the body,” and protect it from harmful effects of antiretroviral treatment (ART). Many experienced nausea and vomiting when starting the supplement. This caused some to stop supplementation, but the majority adapted to RUSF. The supplement was eaten separately from meal situations and only had a little influence on household food practices. RUSF was described as food with “medicinal qualities,” which meant that many social and religious conventions related to food did not apply to it. The main concerns about RUSF related to the risk of HIV disclosure and its social consequences. Conclusion: HIV patients view RUSF in a context of competing livelihood needs. RUSF intake was motivated by a strong wish to get well, while the risk of HIV disclosure caused concerns. Despite the motivation for improving health, the preservation of social networks was prioritized, and nondisclosure was often a necessary strategy. Food sharing and religious fasting practices were not barriers to the acceptability of RUSF. This study highlights the importance of ensuring that supplementation strategies, like other HIV services, are compatible with the sociocultural context of patients. Keywords: Africa, nutritional supplementation, qualitative research, adherence

The boron isotopic composition of tourmaline and hambergite (Be2BO3[OH,F]) from peraluminous (n = 12), peralkaline (n = 1), and peralkaline nepheline syenite (n = 16) pegmatites has been measured by secondary ion mass spectrometry, for which a new hambergite reference material was developed. The focus of this study is on nepheline syenite pegmatites from the Larvik Plutonic Complex (Norway) and one peralkaline pegmatite related to the nearby Eikeren-Skrim Complex (Norway), where we investigate the source of boron as being from magmatic vs. external fluids. Tourmaline-hambergite mineral pairs were also analysed from peraluminous pegmatite localities (Russia, Tajikistan, and Pakistan) to test for systematic B-isotope fractionation between these two minerals. Tourmaline and hambergite from peraluminous granitic pegmatites have light boron ratios (δ11B = −12.9to −1.0‰) associated with S-type granites, whereas peralkaline granitic and nepheline syenite pegmatites have boron ratios (δ11B = −1.7 to 11.8‰), which we interpret is a result of heavy‑boron enrichment from external fluids. Our data show that hambergite tracks isotope variations of its geochemical setting and could therefore be used as a proxy mineral in place of tourmaline when geochemical stability favours hambergite. The results suggest a slight but consistent partitioning of B-isotopes between tourmaline and hambergite, with Δ11B = δ11Btourmaline−δ11Bhambergite in the range of approximately −3‰ to −5‰. Boron is in trigonal coordination with oxygen in both of these mineral phases as verified by NMR. Single crystal XRD analyses of tourmaline and hambergite reveal consistent longer distances of tourmaline relative to hambergite. We attribute the boron isotopic fractionation to the longer bond-lengths in tourmaline compared with hambergite.

Niobium is usually considered to be one of the least mobile elements during alteration of rocks in geological processes and is thought to only be mobile at elevated temperatures and/or pressures. Since niobium is assumed to be unaffected by weathering it can be used in geochemical-evolution calculations to estimate the loss of material from the weathering of rocks. There are roughly a hundred niobium-bearing minerals, including those in the pyrochlore group, which comprises the main ores for Nb and Ta. Furthermore, pyrochlores are identified as potential hosts for nuclear waste because of their resistance to weathering. Here we show that niobium can be highly mobile even at near-surface geochemical conditions as a soluble and unreactive polyoxometalate ion. Discovery of the first natural hexaniobate minerals, all formed at near-surface conditions, provides evidence that niobium is being actively leached out of nearby primary minerals and easily transported as polyoxometalate ions. In addition, we show how Nb and Ta can be fractionated during low-temperature processes.

Background/Objectives: Birth weight (BW), independent of socioeconomic status, has been identified as a predictor for childhood cognitive development. However, it is not known whether this relation is related to low BW per se or particularly related to a deficit in fat mass (FM) or fat-free mass (FFM) at birth. This study therefore aimed at investigating the relation between body composition at birth and child development at 2 years of age. Subjects/Methods: An Ethiopian birth cohort was followed up at 2 years. Body composition was measured within 48 h of birth using infant air-displacement plethysmography. Child development was assessed at 2 years of age using Denver developmental screening test. Associations between body composition at birth and development at 2 years of age were tested using linear regression analysis. Results: FFM but not FM at birth was positively associated with higher global developmental score at 2 years of age ([beta]=2.48, 95% confidence interval (CI) 0.17; 4.79) adjusted for neonatal, postnatal and parental characteristics. This association was attributable to the association with the language developmental domain ([beta]=1.61, 95 CI 0.33; 2.90). Conclusions: Among Ethiopian children, FFM at birth but not FM predicted better global and language development at 2 years of age. Higher FFM at birth might have exerted a positive effect on the growth and differentiation of the brain and neuronal circuits for better development. This study therefore highlights the need to improve mother's nutritional status during pregnancy in ways that stimulate fetal FFM growth., Author(s): M Abera [sup.1] [sup.2] , M Tesfaye [sup.1] [sup.2] , T Girma [sup.3] , C Hanlon [sup.4] [sup.5] , G S Andersen [sup.6] , J C Wells [sup.7] , [...]

BACKGROUND/OBJECTIVES: The effects of inflammation on nutritional rehabilitation after starting antiretroviral therapy (ART) are not well understood. We assessed the relationship between inflammation and body composition among patients enrolled in the Nutritional Support for African Adults Starting Antiretroviral therapy (NUSTART) trial in Tanzania and Zambia from 2011 to 2013. SUBJECTS/METHODS: HIV-infected, ART-eligible adults with body mass index (BMI) of < 18.5 kg/[m.sup.2] enrolled in the NUSTART trial were eligible for this study. Anthropometric and body composition data were collected at recruitment and 6 and 12 weeks post ART and C-reactive protein (CRP) was measured at recruitment and 6 weeks. The relationships between CRP and body composition were assessed using multiple regression. RESULTS: Of the 1815 trial participants, 838 (46%) had baseline and 6-week CRP measurements. Median age was 36 years, 55% were females and median CD4 count was 135 cells/µl. A one-log reduction in CRP at 6 weeks was associated with increased mid-upper arm circumference (0.45 cm; 95% CI: 0.30, 0.61), calf circumference (0.38 cm; 0.23, 0.54), waist circumference (0.98 cm; 0.59, 1.37), BMI (0.37 kg/[m.sup.2]; 0.24, 0.50) and fat-free mass (0.58 kg; 0.26, 0.91), but not with fat mass (0.09 kg; -0.17, 0.34). Fat-free mass gains persisted at 12 weeks and were more closely associated with 6-week CRP values than with baseline values. CONCLUSIONS: Reduction in CRP shortly after ART initiation was associated with higher fat-free mass gains. Further studies are warranted to determine whether interventions to reduce systemic inflammation will enhance gains in fat-free mass. European Journal of Clinical Nutrition (2016) 70, 499-504; doi: 10.1038/ejcn.2015.221; published online 20 January 2016, This article has been corrected since Advance Online Publication and a corrigendum is also printed in this issue INTRODUCTION Infection with HIV continues to be a major public health problem [...]

BACKGROUND/OBJECTIVES: Assessment of infant body composition (BC) is crucial to understand the consequences of suboptimal nutritional status and postnatal growth, and the effects of public health interventions. Bioelectrical impedance analysis (BIA) is a feasible, relatively inexpensive and noninvasive method for assessing BC. However, very little research has been conducted in lowand middle-income populations, where efforts to prevent or treat malnutrition in early life are a public health priority. We aimed to develop equations for predicting fat-free mass (FFM) and fat mass (FM) based on BIA in 0- to 6-month-old Ethiopian infants. SUBJECTS/METHODS: The study comprised a total of 186 BC assessments performed in 101 healthy infants, delivered at Jimma University Specialized Hospital. Infant air-displacement plethysmography (IADP) was the criterion method, whereas weight, length, sex, age and an impedance index ([L.sup.2]/[Z.sub.50]) were predictors. Prediction equations were developed using stepwise multiple linear regression and the accuracy was evaluated with a 10-fold cross-validation approach. RESULTS: A linear regression model based on body weight, age and sex predicted FFM, estimated by IADP, with an adjusted [R.sup.2] and root mean square error (RMSE) of 0.94 and 200 g, respectively. Adding impedance index to the model resulted in a significantly improved model fit ([R.sup.2] = 0.95;RMSE = 181 g). For infants below 3 months of age, inclusion of impedance index did not contribute to an improved model fit for predicting FFM compared with a model already comprising weight, sex and age. CONCLUSIONS: The derived equations predicted FFM with acceptable accuracy and may be used in future field surveys, epidemiological studies and clinical trials conducted in similar sub-Saharan African population groups aged 0-6 months. doi:10.1038/ejcn.2015.51; published online 1 April 2015, INTRODUCTION High prevalence of low birth weight and infant malnutrition, combined with increasing rates of obesity, make sub-Saharan African countries prone to nutrition-related diseases. (1-3) Assessment of body composition (BC), [...]

BACKGROUND/OBJECTIVES: Gains in fat mass and lean mass during tuberculosis (TB) treatment may determine functional recovery and survival;yet, data are scarce. We aimed to assess predictors of fat and fat-free mass during 2 months of intensive TB treatment in a cohort in Mwanza, Tanzania. SUBJECTS/METHODS: Fat and fat-free mass were determined at the start of TB treatment and repeated after 2 months using the deuterium dilution technique. Gains in fat and fat-free mass were determined and predictors assessed using regression analysis. RESULTS: Data for 116 patients were available at baseline and during follow-up. Of these, 38.8% were females, mean age was 37.3 (s.d. 13.5) years, 69% (81) had sputum-positive TB, 45.7% (53) were HIV infected and 25% (29) were current smokers. The mean weight gain was 3.3 kg (95% confidence interval: 2.7;3.8), and it did not differ by sex. However, compared with females, males had 1.0 (0.4;1.6) kg/[m.sup.2] lower fat mass but 0.7 (0.2;1.3) kg/[m.sup.2] higher fat-free mass gain. Current smoking was associated with higher fat mass (0.7 kg/[m.sup.2], 0.04;1.4) but lower fat-free mass (-0.5 kg/[m.sup.2],-1.2;0.07) gain. Among HIV-infected patients, antiretroviral therapy (ART) led to a lower fat gain (- 1.2 kg/[m.sup.2],-2.2;-0.2) but to a higher fat-free mass among sputum-negative (2.9 kg/[m.sup.2], 0.8;5.1) but not sputum-positive patients. CONCLUSIONS: During intensive phase of TB treatment, sex, smoking and ART were predictors of body composition. Larger studies are needed to further understand predictors of body composition during recovery, to help design interventions to improve treatment outcomes. doi:10.1038/ejcn.2015.37; published online 1 April 2015, INTRODUCTION Severe nutritional deficit is common among tuberculosis (TB) patients (1) and may be associated with slow clinical and functional recovery (2) and increased risk of mortality. (3,4) Although treatment [...]

Schistosoma infection, age, C-reactive protein, and fever are good indicators of retinol concentration in the rural schoolchildren of Zimbabwe. S. mansoni infection decreases the retinol level and can cause vitamin A deficiency in children with marginal vitamin A status. The decrease is probably due to the malabsorption of vitamin A, increased consumption of retinol, or a decrease in retinol-binding protein synthesis, rather than metabolic changes. Serum retinol studies are helpful in age and metabolic responses to infections.