The role of nutrition in the pathophysiology and management of sickle cell disease among children: A review of literature

ABSTRACT

Sickle cell disease (SCD) is one of the common inherited blood disorders in humans and has been associated with decreased dietary intake which results in poor nutritional status and impaired growth. Nutrition is one of the most important but often forgotten aspect of care of patients with chronic disorders and there have been emerging concern in literature on increased nutritional needs of SCD patients. This paper sought to review the available literature on the roles of individual nutrients in the pathophysiology and management of SCD among children. Children with SCD have been shown to exhibit suboptimal status with respect to both macronutrients and micronutrients. Thus, nutrition could play an important role in the management of SCD. However, there is paucity of evidence coming from trials with large sample sizes to support the suggestion that supplementation with various nutrients that have been considered in this review will be helpful.     

The relationship between self-reported tobacco exposure and cotinines in urine and blood for pregnant women

To explore the relationship of self-reported exposure to tobacco smoke and the cotinine levels in the urine and blood over the follow-up period for pregnant women. Three hundred ninety-eight pregnant women undergoing prenatal care were interviewed in different trimesters at three hospitals in central Taiwan using a structured questionnaire. Based on their self-reported smoking experience, the participants were classified into three groups (25 smokers, 191 passive smokers, and 182 non-smokers) and were tracked in this study up to the time of delivery. Cotinine levels were tested for the maternal blood and urine at the end of each trimester and for the umbilical cord-blood of the newborns. All specimens were measured using a sensitive high-performance liquid chromatographic (HPLC) technique. In general, urinary cotinine levels were higher in subjects who smoked (including current- and ex-smokers) than those who never smoked. The pattern of distribution of cotinine levels among smoking/ETS exposure group in the urine sample was similar to that in the blood sample. The umbilical cord-blood cotinine levels was found to be highest in the active smoking group, followed by the ETS group exposed to ETS both at home and in the workplace. Over the course of the pregnancies, there was an increase in cotinine levels in urine and maternal blood for each of 3 exposure groups. Exposure to smoking by self-reported information in pregnant women has been found to be directly related to the levels of cotinine in the umbilical cord-blood of the fetus. Cotinine is a sensitive measure of ETS exposure, but if biochemical analysis is not available or convenient for a pregnant woman, then self-reported exposure to ETS can provide a good estimate if the information is gathered by a well-trained interviewer in a structured way.     

Predictive mapping of powerful owl (Ninox strenua) breeding sites using Geographical Information Systems (GIS) in urban Melbourne, Australia

Urban expansion is a principal process threatening biodiversity globally. It is predicted that over half of the world's population will reside in urban centres by 2010. If we are to conserve biodiversity, a shift in perspective from traditional ecological studies based in natural environments, to studies based in less natural environments is paramount. To effectively conserve species which occur in urban environments, comprehensive analysis is necessary to determine the processes that are driving this urban usage. Geographical Information Systems (GIS) technology provides a valuable tool for efficient spatial analysis and predictive mapping of species distributions.This study used GIS to analyze current breeding sites for the powerful owl, a vulnerable top order predator in urban Melbourne, Australia. GIS analysis suggests that a number of ecological attributes were influencing powerful owl usage of urban environments. Using these ecological attributes, predictive mapping was undertaken, which identified a number of potential breeding sites for powerful owls within urbanized Melbourne.Urban environments are traditionally perceived as “the wastelands” of natural environments, however, this study demonstrates that they have the potential to support apex predators, an important finding for the management of rare and threatened species.     

The influence of clearance on friction, lubrication and squeaking in large diameter metal-on-metal hip replacements

Large diameter metal-on-metal bearings (MOM) are becoming increasingly popular, addressing the needs of young and more active patients. Clinical data has shown excellent short-to-mid-term results, though incidences of transient squeaking have been noted between implantation and up to 2 years post-operative. Geometric design features, such as clearance, have been significant in influencing the performance of the bearings. Sets of MOM bearings with different clearances were investigated in this study using a hip friction simulator to examine the influence of clearance on friction, lubrication and squeaking. The friction factor was found to be highest in the largest clearance bearings under all test conditions. The incidence of squeaking was also highest in the large clearance bearings, with all bearings in this group squeaking throughout the study. A very low incidence of squeaking was observed in the other two clearance groups. The measured lubricating film was found to be lowest in the large clearance bearings. This study suggests that increasing the bearing clearance results in reduced lubricant film thickness, increased friction and an increased incidence of squeaking.     

Co‐tier downlink interference management in dense femtocell networks

With the adoption of long‐term evolution standard for 4G mobile communications, the deployment of femtocell base stations (FBSs) to cope with the surging traffic in mobile wireless communication is becoming increasingly popular. However, with the random installation of FBSs, the problem of interference among FBSs is still a challenge. In this paper, assuming the presence of a femtocell management system that can control and coordinate the densely deployed FBSs, a novel power backoff scheme is proposed that determines the appropriate transmit power of each FBS so that the interference is reduced. Simulation results for randomly deployed FBSs in an environment with shadowing using MATLAB are provided, showing that our proposed methods can effectively mitigate the co‐tier downlink interference while improving the system capacity in a densely deployed femtocell network with shared spectrum use. Quantitatively, the average interference is reduced by roughly 90% to 100% of dBm, and the average capacity is increased by more than 80%. These results attest to the effectiveness of the proposed scheme.     

Acute renal failure and chronic kidney disease following liver transplantation

Acute renal failure (ARF) and chronic kidney disease (CKD) are common complications after liver transplantation (LTx). The incidence of ARF post-LTx varies between 48% and 94%; 8% to 17% of patients require renal replacement therapy (RRT). The most common cause of ARF early after LTx is ischemic acute tubular necrosis, followed later by cyclosporine toxicity and sepsis. Preoperative serum creatinine >1.5 mg/dL and early hepatic allograft dysfunction are risk factors for the occurrence of postoperative ARF. Of patients with ARF due to the hepatorenal syndrome, approximately two-thirds will recover, although recovery may be delayed 3 months or longer after LTx. Mortality after LTx is affected modestly by the presence of ARF pretransplant (<2-fold increase), but increases markedly (up to 8-fold) in the face of ARF posttransplant. Mortality does not appear to be influenced by the mode of RRT used. The risk of CKD after LTx is approximately 18% at 5 years and increases to approximately 25% by 10 years after transplantation. Calcineurin inhibitor toxicity is the most common cause. Specific prognosticators for predicting CKD after LTx are presently lacking. The occurrence of CKD after LTx markedly impairs long-term survival.     

Non Uniform Multiresolution Method for Optical Flow and Phase Portrait Models: Environmental Applications

In this paper we define a complete framework for processing large image sequences for a global monitoring of short range oceanographic and atmospheric processes. This framework is based on the use of a non quadratic regularization technique for optical flow computation that preserves flow discontinuities. We also show that using an appropriate tessellation of the image according to an estimate of the motion field can improve optical flow accuracy and yields more reliable flows. This method defines a non uniform multiresolution approach for coarse to fine grid generation. It allows to locally increase the resolution of the grid according to the studied problem. Each added node refines the grid in a region of interest and increases the numerical accuracy of the solution in this region. We make use of such a method for solving the optical flow equation with a non quadratic regularization scheme allowing the computation of optical flow field while preserving its discontinuities. The second part of the paper deals with the interpretation of the obtained displacement field. For this purpose a phase portrait model used along with a new formulation of the approximation of an oriented flow field allowing to consider arbitrary polynomial phase portrait models for characterizing salient flow features. This new framework is used for processing oceanographic and atmospheric image sequences and presents an alternative to complex physical modeling techniques.     

Isotope Studies of the CMR Compounds La1−xCaxMnO3+δ

Oxygen isotope effect studies of the ferromagnetic Curie temperature T _c of La_1?x Ca _x MnO₃ are presented. The isotope exponent α₀=?ΔlnT _c/Δlnm ₀ changes from 0.4 to 0.14 in the range 0.2<x<0.43. The isotope exponent decreases strongly with increasing tolerance factor, or decreasing lattice distortion. Above Tc the conductivity is characteristic of small polarons. Raman scattering shows a prominent peak at 230 cm?1. The peak width could be related to site-dependent Jahn–Teller distortions above T _c, becoming significantly smaller at and below T _c. IR reflectivity data show a much larger zero frequency IR conductivity than dc conductivity. The IR peaks are independent of temperature between 150 and 295 K.