Effects of breastfeeding and naturally acquired immunity on infection with {\it Giardia lamblia}: A study in a cohort of Mexican infants

Giardia lamblia is one of the most common causes of gastrointestinal tract infection among young children worldwide. Yet host protection against this parasite and the effect of infection with Giardia on infant growth are poorly understood. It was hypothesized that among young children, protection against infection with Giardia is afforded by breastfeeding and previous infection with the parasite and further, that infection with Giardia decreases growth velocity. From 4/88 to 4/90, 197 infants in a poor area of Mexico City were followed from 0 to 18 months of age, with stool specimens, symptoms and feeding status data collected weekly. A total of 6,031 stool specimens were tested for Giardia antigen by enzyme-linked immunosorbent assay. There were 1.0 Giardia infections per child-year; 25% were symptomatic and 54% lasted more than 1 month; 94 infants had 1, and 33 had 2 or more infections. Breastfeeding status was coded and analyzed for each child-week of follow up. 91% of study infants were breastfed from birth, 57% at 6 months and 38% at 12 months of age. Rate ratios for non-breastfeeding adjusted for confounding factors were calculated from stratified analyses and the Cox proportional hazards model. Not breastfeeding was a significant risk factor for first infection with Giardia vs. any breastfeeding (adjusted RR = 1.8; 1.1, 2.8) at all ages; a dose response was demonstrated by degree of breastfeeding. The adjusted rate ratio for non-breastfeeding vs. partial breastfeeding was 1.6 (1.03, 2.6) and for non-breastfeeding vs. complete breastfeeding was 4.7 (1.4, 15.9). Among Giardia infected infants, breastfeeding did not protect against diarrheal symptoms or shorten the duration of carriage. First and repeat infections with Giardia did not differ in duration or the percent symptomatic. The analysis of growth and Giardia infection was inconclusive but suggested that a history of Giardia infection might be associated with decreased weight velocity, while an immediate chronic infection might be associated with increased weight velocity. In summary, these data indicate that breastfeeding protects infants against infection with Giardia; provide no evidence of protection against repeat infections resulting from a prior infection and suggest but do not establish that a history of Giardia infection might be associated with decreased growth in young children. ^

Systematic literature review on internet-based interventions to prevent HIV transmission

Objective. To perform a systematic review of the internet based HIV prevention interventions.^ Data Source. Data resources including Ovid Medline, CINAHL (EBSCOhost and Psycinfo) were searched for the relevant articles. Study Selection: Studies were selected if the entire article was in English, Randomized control trial performed after 1998 till current, internet based aimed towards HIV/AIDS prevention. ^ Data Extraction. Each relevant article was coded using a code sheet which consisted of background information, study characteristics, study population information, program details, intervention and results. Data Synthesis: Total of seven relevant articles were coded and the information obtained was incorporated into the evidence tables for comparison.^ Conclusion. Overall the internet based HIV prevention studies have been very successful in recruiting large number of people but has not been able to show effective results due to high attrition. More research needs to be done in the area.^

Baseline evaluation of environmental physical activity and nutrition support of Texas Medical Center hospital worksites

Background: Obesity is a major health problem in the United States that has reached epidemic proportions. With most U.S adults spending the majority of their waking hours at work, the influence of the workplace environment on obesity is gaining in importance. Recent research implicates worksites as providing an 'obesogenic' environment as they encourage overeating and reduce the opportunity for physical activity. Objective: The aim of this study is to describe the nutrition and physical activity environment of Texas Medical Center (TMC) hospitals participating in the Shape Up Houston evaluation study to develop a scoring system to quantify the environmental data collected using the Environmental Assessment Tool (EAT) survey and to assess the inter-observer reliability of using the EAT survey. Methods: A survey instrument that was adapted from the Environmental Assessment Tool (EAT) developed by Dejoy DM et al in 2008 to measure the hospital environmental support for nutrition and physical activity was used for this study. The inter-observer reliability of using the EAT survey was measured and total percent agreement scores were computed. Most responses on the EAT survey are dichotomous (Yes and No) and these responses were coded with a '0' for a 'no' response and a '1' for a 'yes' response. A summative scoring system was developed to quantify these responses. Each hospital was given a score for each scale and subscale on the EAT survey in addition to a total score. All analyses were conducted using Stata 11 software. Results: High inter-observer reliability is observed using EAT. The percentage agreement scores ranged from 94.4%–100%. Only 2 of the 5 hospitals had a fitness facility onsite and scores for exercise programs and outdoor facilities available for hospital employees ranged from 0–62% and 0–37.5%, respectively. The healthy eating percentage for hospital cafeterias range from 42%–92% across the different hospitals while the healthy vending scores were 0%–40%. The total TMC 'healthy hospital' score was 49%. Conclusion: The EAT survey is a reliable instrument for measuring the physical activity and nutrition support environment of hospital worksites. The study results showed a large variability among the TMC hospitals in the existing physical activity and nutrition support environment. This study proposes cost effective policy changes that can increase environmental support to healthy eating and active living among TMC hospital employees.^

An evaluation of the centers for Medicare & Medicaid Services' Hospital Acquired Conditions and Present on Admission Indicator Reporting program

Objective: This dissertation evaluated three aspects of the Centers for Medicare and Medicaid Services' Hospital Acquired Conditions and Present on Admission Indicator Reporting program (HACPOA program) to produce three journal articles for publication. ^ Methods: All payer admission records from state inpatient databases from Arizona, New Jersey and Washington states were analyzed for the year 2008. However some analyses required a sample of adult only Medicare patients in the first two studies. California's inpatient data (2004 – 2010) was also analyzed in the third study to examine the reporting and non-payment program elements' impact on the incidence of hospital acquired conditions. ^ Results: Majority diagnoses reported in inpatient prospective payment systems hospitals were present on admission. However, some diagnoses are still coded as "not present on admission" and "insufficient documentation to determine whether or not conditions are present on admission or not". This is important because it reveals that hospital complications still occur in hospitals. Hospital fall and trauma injuries were the most common hospital acquired conditions observed in this study. Predictors of hospital fall injuries include age, gender, number of diagnoses, number of procedures, number of chronic conditions while predictors of hospital trauma injuries include number of e-codes, number of diagnoses and the presence of chronic conditions on a patient's admission records. Finally, the implementation of the present on admission reporting requirement increased reports of certain hospital acquired conditions while the non-payment policy element in the Hospital Acquired Conditions program reduced the incidence of hospital fall and trauma injuries in particular. ^ Conclusion: The implementation of the Hospital Acquired Conditions and Present on Admission Indicator Reporting program has made the state inpatient database a more useful source of data capable of now identifying hospital complications. The reporting and nonpayment program elements in the HACPOA program have also impacted the incidence of hospital acquired conditions. ^

Something real: A social marketing approach to smoking prevention among Montevideo youth

Uruguay has some of the strictest tobacco-control laws in Latin America. Despite this, youth smoking rates in Uruguay are amongst the highest in South America. Thus, it is important to identify strategies to prevent youth smoking in Uruguay. The current qualitative research study sought to identify intrapersonal and socioenvironmental factors that are associated with smoking among middle school youth in Uruguay. It also sought to develop potential prevention strategies and media messages that would resonate with youth for a social media campaign. The study was grounded in social cognitive theory and the theory of reasoned action/planned behavior, among other behavioral science theories; anthropological perspectives were also considered. To achieve these goals, 29 group and individual structured interviews were conducted in two private middle schools catering to lower and higher SES youth in Montevideo, Uruguay during the summer of 2012. One hundred and three study participants, including students, parents, and teachers, were interviewed. The structured interviews were recorded, transcribed, translated, back translated, coded and analyzed. The study findings show that positive attitudes towards smoking (i.e. to be seen, to increase status, to ensure women's equality, to looking old, and to service as a rite of passage), delinquent behavior (i.e. transgression/deviant behavior), social norms that support smoking (i.e. peer pressure and modeling, group membership/sense of belonging, parental modeling, and family support), easy access and availability to tobacco (i.e. retails stores) were factors associated with youth smoking. Potential protective factors may include parental support, negative attitudes towards smoking, sports/music, and smoke-free environments. Because study participants are accustomed to government-sponsored strong countermarketing graphic imaging, study participants selected even stronger images and messages as the preferred way to receive tobacco prevention messages. Something Real ("Algo Real") was a theme that resonated with the participants and chosen as the name for the proposed campaign. This campaign was designed as a multiple component intervention that included mass, school base, and family based strategies to prevent tobacco use. Some intervention materials specific to these intervention components were developed to target relevant intrapersonal and socioenvironmental factors identified above. These materials will be tested in future pilot studies and larger scale evaluation with this population, outside the scope of this dissertation. ^

Distribution of siphonophores in the upwelling area off NW Africa

Using a Bongo-Net equipped with a multiple coded closing device, the vertical distribution of siphonophores has been observed in 100 m depth intervals at 13 stations off Cap Mirik (19°N) (from 0-500 m depth). This distributional pattern of the 15 siphonophores species found is discussed in relationship to the hydrography of this upwelling region. The following main features have been observed in comparision with the warmer oceanic water offshore: (1) a lower diversity, (2) a shallower distribution of some of the deep living species die to the lower temperature in the upper 300 m an a lower transparency, (3) no contribution to acoustic scattering by physonect siphonophores.

Swath sonar bathymetry during SONNE cruise SO196 with links to multibeam raw data files

Multibeam data were measured during R/V Sonne cruise SO-196 (2008-03-02 to 2008-03-27) along survey profiles, transits and during stationary work. Data were achieved at the Okiwana Trough, particularly in the area of Yonaguni Knoll and Hatoma Knoll. The multibeam sonar system Kongsberg EM120 was operated using 191 beams and up to 150 deg aperture angle. The refraction correction was achieved using CTD profiles measured during this cruise. The quality of data might be reduced during bad weather periods. The dataset contains raw data that are not processed and thus may contain errors and blunders in depth and position.

Documentation of sediment cores during SONNE Expedition SO228 from the western tropical Pacific

The core descriptions (chapter 7) summarize the most important results of the analysis of each sediment core following procedures applied during ODP/IODP expeditions. All cores were opened, described, and color-scanned. In the core descriptions the first column displays the lithological data that are based on visual analysis of the core and are supplemented by information from binocular and smear slide analyses. The sediment classification largely follows ODP/IODP convention. Lithological names consist of a principal name based on composition, degree of lithification, and/or texture as determined from visual description and microscopic observations. In the structure column the intensity of bioturbation together with individual or special features (turbidites, volcanic ash layers, plant debris, shell fragments, etc.) is shown. The hue and chroma attributes of color were determined by comparison with the Munsell soil color charts and are given in the color column in the Munsell notation. A GretagMacbethTM Spectrolino spectrophotometer was used to measure percent reflectance values of sediment color at 36 wavelength channels over the visible light range (380-730 nm) on all of the cores. The digital reflectance data of the spectrophotometer readings were routinely obtained from the surface (measured in 1 cm steps) of the split cores (archive half). The Spectrolino is equipped with a measuring aperture with folding mechanism allowing an exact positioning on the split core and is connected to a portable computer. The data are directly displayed within the software package Excel and can be controlled simultaneously. From all the color measurements, for each core the red/blue ratio (700 nm/450 nm) and the lightness are shown together with the visual core description. The reflectance of individual wavelengths is often significantly affected by the presence of minor amounts of oxyhydroxides or sulphides. To eliminate these effects, we used the red/blue ratio and lightness.

Radiolarian faunal turnover across the Oligocene/Miocene boundary in the equatorial Pacific Ocean

The global warming trend of the latest Oligocene was interrupted by several cooling events associated with Antarctic glaciations. These cooling events affected surface water productivity and plankton assemblages. Well-preserved radiolarians were obtained from upper Oligocene to lower Miocene sediments at Ocean Drilling Program (ODP) Leg 199 Sites 1218 and 1219 in the equatorial Pacific, and 110 radiolarian species were identified. Four episodes of significant radiolarian faunal changes were identified: middle late Oligocene (27.5 to 27.3 Ma), latest Oligocene (24.4 Ma), earliest Miocene (23.3 Ma), and middle early Miocene (21.6 Ma). These four episodes approximately coincide with increases and decreases of biogenic silica accumulation rates and increases in delta18O values coded as "Oi" and "Mi" events. These data indicate that Antarctic glaciations were associated with change of siliceous sedimentation patterns and faunal changes in the equatorial Pacific. Radiolarian fauna was divided into three assemblages based on variations in radiolarian productivity, species richness and the composition of dominant species: a late Oligocene assemblage (27.6 to 24.4 Ma), a transitional assemblage (24.4 to 23.3 Ma) and an early Miocene assemblage (23.3 to 21.2 Ma). The late Oligocene assemblage is characterized by relatively high productivity, low species richness and four dominant species of Tholospyris anthophora, Stichocorys subligata, Lophocyrtis nomas and Lithelius spp. The transitional assemblage represents relatively low values of productivity and species richness, and consists of three dominant species of T. anthophora, S. subligata and L. nomas. The characteristics of the early Miocene assemblage are relatively low productivity, but high species richness. The two dominant species present in this assemblage are T. anthophora and Cyrtocapsella tetrapera. The most significant faunal turnover of radiolarians is marked at the boundary between the transitional/early Miocene assemblages.

Stable isotope and Mg/Ca record of Globigerinoides ruger morphotypes

Tests of the planktonic foraminifer Globigerinoides ruber (white; d'Orbigny) have become a standard tool for reconstructing past oceanic environments. Paleoceanographers often utilize the Mg/Ca ratios of the foraminiferal tests for reconstructing low-latitude ocean glacial-interglacial changes in sea surface temperatures (SST). We report herein a comparison of Mg/Ca measurements on sample pairs (n = 20) of two G. ruber (white) morphotypes (G. ruber sensu stricto (s.s.) and G. ruber sensu lato (s.l.)) from surface and downcore samples of the western Pacific and Indian Oceans. G. ruber s.s. refers to specimens with spherical chambers sitting symmetrically over previous sutures with a wide, high arched aperture, whereas G. ruber s.l. refers to a more compact test with a diminutive final chamber and small aperture. The G. ruber s.s. specimens generally show significantly higher Mg/Ca ratios compared to G. ruber s.l. Our results from the Mg/Ca ratio analysis suggest that G. ruber s.l. specimens precipitated their shells in slightly colder surface waters than G. ruber s.s. specimens. This conclusion is supported by the differences in delta18O and delta13C values between the two morphotypes. Although it is still unclear if these two morphotypes represent phenotypic variants or sibling species, our findings seem to support the hypothesis of depth and/or seasonal allopatry within a single morphospecies.

The SUGAR Toolbox

The SUGAR Toolbox contains scripts coded in MATLAB for calculating various thermodynamic, kinetic, and geologic properties of substances occurring in the marine environment, particularly gas hydrate and seep systems. Brief descriptions of the toolbox scripts and some notes on the underlying basic theory as well as tables of additional property values can be found in the accompanying documentation.

(Table 1) Basin area, average late-summer speedup, number of sinks and runoff of West Greenland Ice Sheet catchments

We use interferometric synthetic aperture radar observations recorded in a land-terminating sector of western Greenland to characterise the ice sheet surface hydrology and to quantify spatial variations in the seasonality of ice sheet flow. Our data reveal a non-uniform pattern of late-summer ice speedup that, in places, extends over 100 km inland. We show that the degree of late-summer speedup is positively correlated with modelled runoff within the 10 glacier catchments of our survey, and that the pattern of late-summer speedup follows that of water routed at the ice sheet surface. In late-summer, ice within the largest catchment flows on average 48% faster than during winter, whereas changes in smaller catchments are less pronounced. Our observations show that the routing of seasonal runoff at the ice sheet surface plays an important role in shaping the magnitude and extent of seasonal ice sheet speedup.

Digital elevation model (DEM) of the ice sheet in western Dronning Maud Land, Antarctica

In this paper, a new digital elevation model (DEM) is derived for the ice sheet in western Dronning Maud Land, Antarctica. It is based on differential interferometric synthetic aperture radar (SAR) from the European Remote Sensing 1/2 (ERS-1/2) satellites, in combination with ICESat's Geoscience Laser Altimeter System (GLAS). A DEM mosaic is compiled out of 116 scenes from the ERS-1 ice phase in 1994 and the ERS-1/2 tandem mission between 1996 and 1997 with the GLAS data acquired in 2003 that served as ground control. Using three different SAR processors, uncertainties in phase stability and baseline model, resulting in height errors of up to 20 m, are exemplified. Atmospheric influences at the same order of magnitude are demonstrated, and corresponding scenes are excluded. For validation of the DEM mosaic, covering an area of about 130,000 km**2 on a 50-m grid, independent ICESat heights (2004-2007), ground-based kinematic GPS (2005), and airborne laser scanner data (ALS, 2007) are used. Excluding small areas with low phase coherence, the DEM differs in mean and standard deviation by 0.5 +/- 10.1, 1.1 +/- 6.4, and 3.1 +/- 4.0 m from ICESat, GPS, and ALS, respectively. The excluded data points may deviate by more than 50 m. In order to suppress the spatially variable noise below a 5-m threshold, 18% of the DEM area is selectively averaged to a final product at varying horizontal spatial resolution. Apart from mountainous areas, the new DEM outperforms other currently available DEMs and may serve as a benchmark for future elevation models such as from the TanDEM-X mission to spatially monitor ice sheet elevation.

(Table 1) Accumulation and ice discharge of West Antarctic glaciers draining into the Amundsen Sea between 1974 and 2007

The Advanced Land Observation System (ALOS) Phased-Array Synthetic-Aperture Radar (PALSAR) is an L-band frequency (1.27 GHz) radar capable of continental-scale interferometric observations of ice sheet motion. Here, we show that PALSAR data yield excellent measurements of ice motion compared to C-band (5.6 GHz) radar data because of greater temporal coherence over snow and firn. We compare PALSAR velocities from year 2006 in Pine Island Bay, West Antarctica with those spanning years 1974 to 2007. Between 1996 and 2007, Pine Island Glacier sped up 42% and ungrounded over most of its ice plain. Smith Glacier accelerated 83% and ungrounded as well. Their largest speed up are recorded in 2007. Thwaites Glacier is not accelerating but widening with time and its eastern ice shelf doubled its speed. Total ice discharge from these glaciers increased 30% in 12 yr and the net mass loss increased 170% from 39 ± 15 Gt/yr to 105 ± 27 Gt/yr. Longer-term velocity changes suggest only a moderate loss in the 1970s. As the glaciers unground into the deeper, smoother beds inland, the mass loss from this region will grow considerably larger in years to come.

Ice thickness measurements in the Lincoln Sea and adjacent Arctic Ocean

Results of helicopter-borne electromagnetic measurements of total (ice plus snow) sea-ice thickness performed in May 2004 and 2005 in the Lincoln Sea and adjacent Arctic Ocean up to 86° N are presented. Thickness distributions south of 84° N are dominated by multi-year ice with modal thicknesses of 3.9 m in 2004 and 4.2 m in 2005 (mean thicknesses 4.67 and 5.18 m, respectively). Modal and mean snow thickness on multi-year ice amounted to 0.18 and 0.30 m in 2004, and 0.28 and 0.35 m in 2005. There are also considerable amounts of 0.9-2.2 m thick first-year ice (modal thickness), mostly representing ice formed in the recurring, refrozen Lincoln Polynya. Results are in good agreement with ground-based electromagnetic thickness measurements and with ice types demarcated in satellite synthetic aperture radar imagery. Four drifting buoys deployed in 2004 between 86° N and 84.5° N show a similar pattern of a mean southward drift of the ice pack of 83 ± 18 km between May 2004 and April 2005, towards the coast of Ellesmere Island and Nares Strait. The resulting area decrease of 26% between the buoys and the coast is larger than the observed thickness increase south of 84° N. This points to the importance of shear in a narrow band along the coast, and of ice export through Nares Strait in removing ice from the study region.