Prevalence of Subclinical Rheumatic Heart Disease in Eastern Nepal

Importance: Although rheumatic heart disease has been nearly eradicated in high-income countries, 3 in 4 children grow up in parts of the world where it is still endemic. Objectives: To determine the prevalence of clinically silent and manifest rheumatic heart disease as a function of age, sex, and socioeconomic status and to estimate age-specific incidence. Design, Setting, and Participants: In this school-based cross-sectional study with cluster sampling, 26 schools in the Sunsari district in Eastern Nepal with 5467 eligible children 5 to 15 years of age were randomly selected from 595 registered schools. After exclusion of 289 children, 5178 children were enrolled in the present study from December 12, 2012, through September 12, 2014. Data analysis was performed from October 1, 2014, to April 15, 2015. Exposures: Demographic and socioeconomic characteristics were acquired in a standardized interview by means of a questionnaire customized to the age of the children. A focused medical history was followed by a brief physical examination. Cardiac auscultation and transthoracic echocardiography were performed by 2 independent physicians. Main Outcomes and Measures: Rheumatic heart disease according to the World Heart Federation criteria. Results: The median age of the 5178 children enrolled in the study was 10 years (interquartile range, 8-13 years), and 2503 (48.3%) were female. The prevalence of borderline or definite rheumatic heart disease was 10.2 (95% CI, 7.5-13.0) per 1000 children and increased with advancing age from 5.5 (95% CI, 3.5-7.5) per 1000 children 5 years of age to 16.0 (95% CI, 14.9-17.0) in children 15 years of age, whereas the mean incidence remained stable at 1.1 per 1000 children per year. Children with rheumatic heart disease were older than children without rheumatic heart disease (median age [interquartile range], 11 [9-14] years vs 10 [8-13] years; P = .03), more commonly female (34 [64.2%] vs 2469 [48.2%]; P = .02), and more frequently went to governmental schools (40 [75.5%] vs 2792 [54.5%]; P = .002). Silent disease (n = 44) was 5 times more common than manifest disease (n = 9). Conclusions and Relevance: Rheumatic heart disease affects 1 in 100 schoolchildren in Eastern Nepal, is primarily clinically silent, and may be more common among girls. The overall prevalence and the ratio of manifest to subclinical disease increase with advancing age, whereas the incidence remains stable at 1.1 per 1000 children per year. Early detection of silent disease may help prevent progression to severe valvular damage.

Physical and Biological Controls on the Latitudinal Asymmetry of Surface Nutrients and pCO(2) in the Central and Eastern Equatorial Pacific

Surface nutrients and dissolved inorganic carbon (DIC) in the central (CEP) and eastern equatorial Pacific (EEP) show much higher concentrations to the south than to the north of the equator. In this study, the physical and biological controls on this asymmetry are investigated using a coupled physical-biogeochemical model. Two numerical experiments are conducted to examine the effects of asymmetrical photosynthetic efficiency (a) due to asymmetrical iron supply about the equator. The experiment with asymmetrical photosynthesis produces improved results as compared with historical observations. A nitrate budget analysis suggests that in the EEP the divergence of upwelling waters controls the surface nitrate asymmetry with additional contribution from the South Equatorial Current (SEC) carrying nutrient-rich Peru upwelling water. The changes of a affect the surface nitrate distribution but not the overall asymmetry. The SEC further carries excess nitrate to the west and thus extends the asymmetry in the east to the CEP. In the CEP, however, stronger northward than southward transport tends to reduce the nitrate asymmetry, while the asymmetrical photosynthesis would help to maintain it. Similar processes also control the distributions of surface silicate and DIC in the equatorial Pacific, which is also affected by the air-sea CO(2) exchange. The asymmetrical photosynthesis influences the distribution of surface DIC, pCO(2), and the air-sea CO(2) flux, by redistributing about 20% CO(2) flux from the north to the south of the equator. Owing to the adjustment of air-sea CO(2) flux, however, the net surface DIC change is smaller than the direct change associated with primary production.

Factors Related to Mental Health of Native Americans in Eastern Tribes

This paper is part of a five-year research project funded by the National Institute on Disability and Rehabilitation Research (NIDRR) that addresses the health, disability and service needs of Native Americans in eastern tribes. The Participatory Action Research model with a community-based approach was used to facilitate collaboration among the participating tribes. Native American research technicians conducted individual interviews with members of their tribes. Demographics, prevalence of disabilities, and various factors associated with health and mental health are presented. Of the 858 tribal members who responded to survey questions, the third most prominent health problem reported was mental illness.

Life, wanderings and labours in Eastern Africa : with an account of the first successful ascent of the equatorial snow mountain, Kilima Njaro, and remarks upon East African slavery

by Charles New, of the late Livingstone search and relief expedition

Travels and researches among the lakes and mountains of Eastern & Central Africa : from the journals of the late James Frederick Elton

from the journals of the late J. Frederick Elton, F.R.G.S., H.B.M. Consul at Mozambique ; edited and compiled by H.B. Cotterill

Na 1 Nachlass Max Horkheimer, 707 - "German Refugees from Eastern Zone" (p. IX 183.1-2 - IX 184.2-18)

"German Refugees from the Eastern Zone" 1952; 1. "Outline of a Pilot Study of German Refugees from the Eastern Zone Who are presently in Berlin" a) Typoskript, 4 Blatt; b) Typoskript, 3 Blatt; 2. "Budget for a Pilot Study of German Refugees from the Eastern Zone in Berlin" a) 2 Blatt; b) 1 Blatt; c) 1 Blatt; d) 1 Blatt; "Universität und Gesellschaft" 1952-1956; 1. "Universität und Gesellschaft" Teil III: Expertenbefragung. Forschungsbericht, 1953; als Typoskript vervielfältigt und gebunden, 77 Blatt; 2.-7. Allgemeine Darstellung der Untersuchungen; 2. "Einige wichtige Ergebnisse der Universitätsstudie", 1956. Als Typoskript vervielfältigt, 5 Blatt; 3. "Vorläufige Gliederung für den Bericht der Hochschul-Untersuchung" 2 Blatt; 4. "The German University of Today. Progress Report on a Research Project" 02.11.1955 a) Typoskirpt, 12 Blatt; b) Typoskript mit handschriftlichen Korrekturen, 12 Blatt; 5. "The German University of Today. A Progress Report on a Research Project" a) Typoskript, 7 Blatt; b) Typoskript mit handschriftlichen Korrekturen, 8 Blatt; c) Typoskirpt mit handschriftlichen Korrekturen, 12 Blatt; 6. "Funktion und Wirklichkeit der Universität heute. Zwischenbericht über drei Studien des Instituts für Sozialforschung an der Johann Wolfgang Goethe- Universität". Typoskript, 25 Blatt; 7. "Pläne einer Untersuchung über die Vorstellung von der Finktion der heutigen deutschen Universität bei bestimmten Personenkreisen" a) Typoskirpt, 11 Blatt; b) Typoskript, 11 Blatt; 8.-10. Studentenbefragung; 8. Fagebogen zur Umfrage "Warum studieren Studenten?", als Typoskript vervielfältigt, 19 Blatt; 9. "The Economic Situation of Students at the Johann Wolfgang Goethe- University in Frankfurt am Main" Resultate der Umfrage vom Winter 1952/43; Januar 1956; a) Typoskript, 43 Blatt; b) 43 Blatt; 10. "Students and Parentl Influence. Results of a Survey" a) Typoskript, 25 Blatt; b) Typoskript mit handschriftlichen Korrekturen von Frederick Pollock, 25 Blatt; 11.-14. Aktennotizen; 11. "Bericht über die Verhandlungen zwischen Herrn Professor Baumgarten, Tenbruck und Habermas am 12.12.1956 im Institut für vergleichende Sozialwissenschaften in Stuttgart. Betreff: Professorenstudie" 13.13.1956 vermutlich 13.03.1956. Typoskript, 2 Blatt; 12. Gembardt, Ulrich: Aktennotiz zur Hochschuluntersuchung. 23.05.1955, Typoskript, 3 Blatt; 13. Gembardt, Ulrich: Bemerkungen zur Aktennotiz vom 23.05.1955, Typoskript, 2 Blatt; 14. "Aktennotiz über die Hochschul-Forschungsprojekte des Göttinger Soziologischen Seminars und des Frankfurter Institut für Sozialforschung, die deim Hauptausschuß der Deutschen Forschungsgemeinschaft am 1. August 1953 zur Finanzierung vorgelegt werden" 20.07.1953. Typoskript, 2 Blatt; 15.-18. Briefe; 15. Löwenthal, Leo: 1 Brief mit Unterschrift an MAx Horkheimer, New York, 20.01.1955, 3 Blatt; 16. Horkheimer, Max [?]: 1 Brief an Chauncy D. Harris, ohne Ort, Januar 1955; a) Typoskirpt, 1 Blatt; b) Typoskirpt mit handschriftlichen Korrekturen, 1 Blatt; c) Typoskirpt mit handschriftlichen Korrekturen, 1 Blatt; d) Typoskirpt, 1 Blatt; 17. Horkheimer, Max: Drei gleichlautende Briefe an die Rektoren der Universität Bonn, Heidelberg und Koel, ohne Ort, 15.11.1953; a) Typoskript, 6 Blatt; b) Typoskript mit eigenhändigen KOrrekturen, 3 Blatt; 18. Plessner, Helmuth: 1 Brief mit Unterschrift mit Beilage an Max Horkheimer, Göttingen 02.07.1953, 4 Blatt;

Analyses of maternal and child mortality rates of five West African countries: Cote d'Ivoire, Guinea, Liberia, Senegal, Sierra Leone

After traveling to a small country in West Africa last summer, I became interested in learning more about the maternal, infant, and child death rates of that particular region of the continent. For the purposes of this paper I limited the number of countries that would be included in this research to five: Cote d'Ivoire, Guinea, Liberia, Senegal, and Sierra Leone. There are three hypotheses that were considered when conducting the research for this paper. The first was that there is no difference in the under five mortality rates for Cote d'Ivoire, Guinea, Liberia, Senegal, and Sierra Leone. The second hypothesis was that there is no difference in the female literacy rates for Cote d'Ivoire, Guinea, Liberia, Senegal, and Sierra Leone. The final hypothesis was that there is no difference in the male literacy rates for Cote d'Ivoire, Guinea, Liberia, Senegal, and Sierra Leone. The data used were collected from publicly available sources that include the CIA World Factbook, the WHO website, the UNICEF website, the Penn World Data table, and the World Bank website. The p-values that were calculated for all three hypotheses were found to be very significant, and all three of the null hypotheses were rejected. ^

Neogene calcareous nannofossils in the Caribbean and the eastern equatorial Pacific

Principal components analysis of nannofossil assemblages in five ODP sites in the Caribbean and the eastern equatorial Pacific was used to monitor Neogene surface water circulation changes. In 15.83-10.71 Ma, floral distributions clearly show the existence of the Circum-tropical Current between the Caribbean and the eastern equatorial Pacific and no surface water communication between the northern and southern Caribbean. In 10.71-9.36 Ma, the Circum-tropical Current weakened and the northward intra-Caribbean current had been initiated. Northern and southern Caribbean surface waters again became separated in 8.35-3.65 Ma and the Circum-tropical Current was regenerated. After 2.76 Ma, the northward intra-Caribbean current has completely been established and the Circum-tropical Current disappeared. This suggests that a barrier to the Circum-tropical Current had formed, indicating the final closure of the Isthmus of Panama.

(Table 1) Insoluble aerosol concentrations and vertical fluxes at the eastern shelf of the Black Sea during breeze circulation in October 1987

Amounts of aerosols transported to the shelf surface were calculated on the basis of in situ measurements of concentrations of eolian matter (insoluble aerosol fraction) and vertical fluxes of settling dust in five areas of the Black Sea shelf from the Danube delta to the Inguri River mouth. More than 8.3 mln t of eolian matter are annually transported from the land over the shelf of the former USSR. At the same time more than 5.4 mln t are supplied to the northwestern shelf area, 1.7 mln t are supplied to the Crimean area, about 0.8 mln t are supplied to the Kerch-Taman' area, and about 0.45 mln t are supplied to the Caucasian area.

The sapropel record of the eastern Mediterranean Sea

Research on sediments recovered during Ocean Drilling Leg 160 has concentrated on two issues: the first concerned the stratigraphy of sapropel formation, the second was oriented to clarify specific processes that explain sapropel origin. Progress has been made in the construction of stratigraphic composites out of sedimentary sequences from individual holes at each of the palaeoceanographic sites. On the composites, initial work has resulted in the establishment of high-resolution and intermediate-resolution stratigraphies for three sites (963, 964, 967); correlation of sedimentary cycles to astronomical (insolation) cycles extends the stratigraphies to Sites 969 and 966. The sapropel occurrences in the marine and land sequences over the entire Eastern Mediterranean are correlated; with the resolution that can be obtained from isotope studies, groups of sapropels occurred simultaneously over the entire basin. In detail, however, the temporal and facies patterns of sapropel sequences differ between individual sites and depositional basins. The differences may be related to effects of water depth, diagenesis, and post-depositional tectonic attenuation of sequences. Studies on the geochemistry and facies of sapropels agree that anoxic conditions favoured preservation of organic matter in sapropels, caused the enrichment of trace metals associated with sapropels, and helped to preserve primary sedimentary structures. Besides, all evidence is consistent with elevated fluxes of organic matter and associated elements during sapropel events.