Hyperspectral cathodoluminescence imaging and analysis extending from ultraviolet to near infrared.

The measurement of near-infrared (NIR) cathodoluminescence (CL) with sufficient sensitivity to allow full spectral mapping has been investigated through the application of optimized grating spectrometers that allow the ultraviolet (UV), visible, and NIR CL spectra to be measured simultaneously. Two optical spectrometers have been integrated into an electron microprobe, allowing simultaneous collection of hyperspectral CL (UV-NIR), characteristic X-rays, and electron signals. Combined hyperspectral CL spectra collected from two natural apatite (Ca5[PO4]3[OH,F]) samples from Wilberforce (Ontario, Canada) and Durango (Mexico) were qualitatively analyzed to identify the emission centers and then deconvoluted pixel-by-pixel using least-squares fitting to produce a series of ion-resolved CL intensity maps. Preliminary investigation of apatite has shown strong NIR emissions associated primarily with the rare-earth element Nd. Details of growth and alteration were revealed in the NIR that were not discernable with electron-induced X-ray mapping. Intense emission centers from Nd3+ and Sm3+ were observed in the spectra from both apatites, along with minor emissions from other 3+ rare-earth elements. Quantitative electron probe microanalysis was performed on points within the mapped area of the Durango apatite to produce a calibration line relating cathodoluminescent intensity of the fitted peak centered at 1,073 nm (1.156 eV) to the Nd concentration.

Structure of the amorphous titania precursor phase of N-doped photocatalysts.

Amorphous titania samples prepared by ammonia solution neutralization of titanyl sulphate have been characterized by chemical and thermal analyses, and with reciprocal-space and real-space fitting of wide-angle synchrotron X-ray scattering data. A model that fits both the chemical and structural data comprises small segments of lepidocrocite-type layer that are offset by corner-sharing as in the monoclinic titanic acids H2Ti n O2n+1·mH2O. The amorphous phase composition that best fits the combined chemical and scattering data is [(NH4)3H21Ti20O52]·14H2O, where the formula within the brackets is the cluster composition and the H2O outside the brackets is physically adsorbed. The NH4 + cations are an integral part of the clusters and are bonded to layer anions at the corners of the offset layers, as occurs in the alkali metal stepped-layer titanates. The stepped-layer model is shown to give a consistent mechanism for the reaction of aqueous ammonia with solid hydrated titanyl sulphate, in which the amorphous product retains the exact size and shape of the reacting titanyl sulphate crystals.

Waist-to-height ratios in relation to BMI z-scores in three ethnic groups from a representative sample of New Zealand children aged 5-14 years.

Waist-to-height ratio (WHtR) is purported to offer a simpler index of health risk than body mass index (BMI) in children as it requires no adjustment for age or sex. Little is known regarding the usefulness of WHtR in different ethnic groups. The aim of this study was to compare the WHtR cutpoints associated with BMI definitions of overweight and obesity in a nationally representative sample of New Zealand children. Height, weight and waist circumference were measured in 3006 children (51.5% male) aged 5-14 years (n=1107 Maori, n=985 Pacific and n=924 New Zealand European and Others (NZEO)). A WHtR >0.5 was more common in Pacific (43.4%) and Maori (33.1%) children than in NZEO children (20.8%, P<0.001), with 25.6% of children overall being above this cutoff. Although ethnicity influenced the relationship between BMI and WHtR (P<0.01), differences were clinically insignificant as illustrated by the similarity in WHtR values for a given BMI (WHtR of 0.47 in Maori, 0.46 in Pacific and 0.48 in European boys at the 85th BMI percentile). The present results suggest that having WHtR values >0.5 should be equally useful in evaluating cardiovascular health risks in groups of Maori, Pacific and NZEO children.

Neuromuscular characterisation in Cerebral Palsy using hybrid Hill-type models on isometric contractions.

BACKGROUND: Muscles of individuals with Cerebral Palsy (CP) undergo structural changes over their lifespan including an increase in muscle stiffness, decreased strength and coordination. Being able to identify these changes non-invasively would be beneficial to improve understanding of CP and assess therapy effectiveness over time. This study aims to adapt an existing EMG-driven Hill-type muscle model for neuromuscular characterisation during isometric contractions of the elbow joint. METHODS: Participants with (n = 2) and without CP (n = 8) performed isometric force ramps with contraction levels ranging between 15 and 70% of their maximum torque. During these contractions, high-density EMG data were collected from the M. Biceps and Triceps brachii with 64 electrodes on each muscle. The EMG-driven Hill-type muscle model was used to predict torques around the elbow joint, and muscle characterisation was performed by applying a genetic algorithm that tuned individuals' parameters to reduce the RMS error between observed and predicted torque data. RESULTS: Observed torques could be predicted accurately with an overall mean error of 1.24Nm ± 0.53Nm when modelling individual force ramps. The first four parameters of the model could be identified relatively reliably across different experimental protocols with a full-scale variation of below 20%. CONCLUSION: An HD-EMG muscle modelling approach to evaluating neuromuscular properties in participants with and without CP has been presented. This pilot study confirms the feasibility of the experimental protocol and demonstrates some parameters can be identified robustly using the isometric contraction force ramps.

Cost-utility analysis of LED fluorescence microscopy in the diagnosis of pulmonary tuberculosis in Indian settings.

BACKGROUND: With support from the Stop TB Partnership's TB REACH Wave 2 Grant, diagnostic microscopy services for tuberculosis (TB) were upgraded from conventional Ziehl-Neelsen (ZN) based sputum microscopy to light emitting diode technology-based fluorescence microscopy (LED FM) in 200 high-workload microscopy centres in India as a pilot intervention. OBJECTIVE: To evaluate the cost-effectiveness of LED-FM over conventional ZN microscopy to inform further scale-up. METHODS: A decision-tree model was constructed to assess the cost utility of LED FM over ZN microscopy. The results were summarised using incremental cost-effectiveness ratio (ICER); one-way and probabilistic sensitivity analyses were also conducted to address uncertainty within the model. Data were analysed from 200 medical colleges in 2011 and 2012, before and after the introduction of LED microscopes. A full costing analysis was carried out from the perspective of a national TB programme. RESULTS: The ICER was calculated at US$14.64 per disability-adjusted life-year, with an 82% probability of being cost-effective at a willingness-to-pay threshold equivalent to Indian gross domestic product per capita. CONCLUSIONS: LED FM is a cost-effective intervention for detecting TB cases in India at high-workload medical college settings.

Work-heat tolerance of distance runners.

Physical training in a cool environment by subjects not previously trained improves their work-heat tolerance, but can not replace heat acclimatization to the standard heat stress conditions employed by a variety of investigators. This is attributed to the inability of these subjects to sustain prolonged work at high metabolic rates. Thus, they are not maintaining high core body temperatures long enough to bring about an adaptive change to heat. On the other hand, the intense and prolonged (years) training of long distance runners in a temperature environment at high metabolic rates has acclimatized them for at least 4 hours of mild work (MR 160 kcal/m2-hr) in both hot dry (50/27 C db/wb) and hot wet (36.7/33.1 C db/wb) environments, but not for work at high energy expenditures (MR 540 kcal/m2-hr) in a less severe thermal stress (35/21 C db/wb). These highly trained athletes can improve their work-heat tolerance at high metabolic rates in a warm climate by training at competitive speeds in a cool environment dressed in sweat clothing or by training at near competitive speeds in the heat. In either of these situations the athlete is cautioned to consume water at frequent intervals to offset the dehydration associated with excessive sweating under these conditions.

Influence of EGTA on an exercise-induced elevation in the colonic temperature of the rat.

The purpose of this study was to determine if an exercise-induced rise in body temperature could be affected by the chelation of Ca++ in the extracellular fluid surrounding the hypothalamus of the rat. Following the implantation of a guide tube above the hypothalamus, each animal was familiarized with exercising on a motor-driven treadmill. In random order, on separate days, a solution containing 3.6 mM EGTA, 26 mM Ca++ or an artificial cerebrospinal fluid (ACSF) solution was perfused through the guide tube while the animal was running. Colonic (Tc) and tail-skin (Tt) temperatures were monitored continuously. The perfusion of EGTA produced a significant increase in Tc when compared with the perfusion of the ACSF solution. The perfusion of excess Ca++ produced a significant decrease in Tc. These results suggest that Ca++ may play an important role in the mediation of heat dissipation during exercise.

Methodology of the 1997 New Zealand National Nutrition Survey.

AIMS: To describe the development and use of the methodologies in the 1997 New Zealand National Nutrition Survey (NNS97). METHODS: NNS97 was a voluntary cross-sectional population survey conducted over a twelve month period on 4,636 non-institutionalized urban and rural New Zealand residents aged fifteen years and older. Survey data were collected in the participants' home and included: a self-administered qualitative food frequency questionnaire, including questions on food preparation habits; a three-pass 24-hour diet recall; interviewer-administered questions on diet supplement use, barriers to dietary change and participant perception of household food security; physical measurements including weight, height, three circumferences, two skinfolds and elbow breadth; blood pressure; and a blood sample to determine cholesterol and iron status. RESULTS: New methodologies developed for NNS97 included a computer based interview system, probability analyses for estimating prevalence of inadequate intake of selected nutrients, determination of iron status by both dietary and biochemical assessment, assessments of dietary supplement use and food security. A full range of quality control procedures at each stage of the data collection were also initiated. CONCLUSION: NNS97 has improved on previous New Zealand national nutrition survey methodologies, particularly with direct data capture and rigorous quality control procedures used in the collection of survey data.

Obesity and body fat distribution in the New Zealand population.

AIMS: To report the prevalence of obesity and body fat distribution in the New Zealand population and to determine if there is a trend to increasing obesity and changes in body fat distribution. METHODS: Body weight, height, two skinfolds (triceps and subscapular), and waist and hip circumferences were measured on 4,420 New Zealanders as part of the 1997 National Nutrition Survey (NNS97). These results are compared with data from the 1977 National Heart Foundation Survey (n=1,800) and the 1989 Life in New Zealand Survey (LINZ89) (n=3,300). RESULTS: 35% of the population (40.4% males, 30.1% females) were classified as overweight and a further 17% as obese (14.7% males, 19.2% females) in NNS97 compared to 32% overweight and 11% obese in LINZ89. Body weight and body mass index have increased in the last two decades. In addition, there has been an increasing trend towards central obesity as estimated by waist to hip ratio and subscapular to triceps ratio. CONCLUSIONS: The increase in body weight, obesity, central obesity, and the proportion of the population likely to exhibit health risk indicators presents an increasing health problem in New Zealand.

Attaining optimal bone status: lessons from the 1997 National Nutrition Survey.

AIMS: To examine the adequacy of calcium intake in relation to current recommendations, demographic differences in calcium intake and dietary sources in the New Zealand population. METHODS: 24-hour diet recall and qualitative food frequency data from the 1997 New Zealand National Nutrition Survey (NNS97) were used. RESULTS: No age-gender subgroups had median intakes meeting the latest (1998) US recommendations. Women's median intakes failed to meet even the considerably lower 1990 Australian recommendations. 20% of New Zealanders and one in four women had intakes below the UK Estimated Average Requirements for calcium. Intakes below the UK Lower Reference Nutrient Intake (the level at which the risk of deficiency is virtually 100%) were common (15-20%) among women aged 15-18 years, those living in the most deprived areas or Maori. Milk and milk products were the major sources of the nation's calcium intake. CONCLUSION: Although other factors such as genetics, hormonal status, vitamin D status and exercise influence skeletal health, adequate calcium intakes are important in minimizing bone loss. A reduction in the proportion of New Zealanders with inadequate calcium intakes will most readily be achieved if more people meet the milk products Dietary Guideline (minimum of two servings daily). Health professionals can play an important role in raising perceptions of the benefits of adequate calcium intakes, promoting the milk products Dietary Guideline, and emphasising that lower fat diets can include adequate calcium through use of reduced fat milk products.

Declining levels of total serum cholesterol in adult New Zealanders.

AIM: To measure the average serum concentration of total cholesterol and high density lipoprotein cholesterol in a representative sample of New Zealanders. METHODS: Serum total and high density lipoprotein cholesterol levels were measured in a representative sample of 1,412 men and 1,741 :women aged 15 years or older who participated in the National Nutrition Survey (1997) of New Zealanders. RESULTS: The average serum total cholesterol concentration in men was the same as in women (5.7 mmol/L); however, younger women (44 years and under) tended to have lower levels and older women (55 years and over) higher levels of total cholesterol than men. Women in all age groups had higher average levels of high density lipoprotein cholesterol (1.4 mmol/L) than men (1.2 mmol/L). Ethnic differences were apparent with Maori men having significantly higher average levels of total cholesterol than their New Zealand European counterparts. CONCLUSIONS: Mean serum total cholesterol concentration in women has declined by 0.3 mmol/L from 6.0 mmol/L (p<0.05) since the previous representative survey of New Zealanders (Life in New Zealand Survey, 1989), but by only 0.1 mmol/L in men, despite a similar reduction amongst men and women in the proportion of dietary energy derived from total and saturated fat. It is possible that weight gain in men and women during the last nine years is having a differential effect on serum cholesterol concentrations.

Food security: is New Zealand a land of plenty?

AIM: To explore the concept of food security (when there is enough, appropriate and acceptable food available) in the adult New Zealand population using the National Nutrition Survey (NNS97). METHODS: The stepwise development of indicators of food security included a literature search and focus groups with low income women and men. Key issues surrounding the procurement and provision of food were determined and eight indicator statements prepared for inclusion in NNS97, to be addressed by each participant on behalf of their household. RESULTS: Prevalence was significantly higher (p<0.05) for females compared to males for the majority of indicator statements among New Zealand European & Others and Maori. New Zealand European & Others reported the most food security; Pacific people reported the least and Maori fell between the two. There was a significant increasing linear trend of food security with age (p<0.001), after adjusting for gender. "Food runs out in my/our household due to lack of money" was cited more often by female compared to male New Zealand European & Others in NZDep96 quartiles III and IV. CONCLUSION: The issue of 'not having enough food' may be more prevalent in New Zealand than US or Australia. Among New Zealand European & Others the higher prevalence of insufficient food due to lack of money among females from NZDep96 quartiles III and IV suggests that males may be protected from this by their female partners. Food security needs to be improved among young adults, women, Maori and Pacific people in order to prevent longer term nutritional health consequences.

Blood lipid levels in New Zealand.

OBJECTIVES: the study aimed to determine age and gender specific levels of lipids and lipoproteins in New Zealanders. Participants were randomly selected from 20 general electoral roles, and from a sample of 15-18 year olds. METHODS: plasma cholesterol, LDL cholesterol, HDL cholesterol and triglyceride levels were measured in 2941 men and women aged 15-99 years. RESULTS: mean (SD) plasma cholesterol was 6.0 (1.3) mmol/L in men and 6.1 (1.3) mmol/L in women. There was a marked variation in total cholesterol and calculated LDL cholesterol with age, and the pattern was different in men and women. There was also a considerable regional variation; levels tending to increase from north to south. Overall mean cholesterol levels adjusted for age and geographical distribution were 5.8 and 6.0 mmol/L for men and women respectively. CONCLUSION: the fact that approximately a third of the adult population in New Zealand under 65 years have cholesterol levels greater than 6.5 mmol/L indicates the need for effective diet and lifestyle changes to reduce the high rates of CHD.

Dietary iron intakes and biochemical iron status of 15-49 year old women in New Zealand: is there a cause for concern?

AIM: To assess dietary iron intakes and biochemical iron status of a nationally representative sample of nonpregnant 15-49 year old women (n=1,751) in New Zealand. METHODS: A cross-sectional national survey was conducted in 1996/97. Women were selected via a multistage stratified cluster sampling procedure with increased sampling of Maori and Pacific women. Dietary iron intakes were estimated using a 24-hour diet recall. Biochemical iron status was assessed on a non-fasting venipuncture blood sample (n=1,047) via haemoglobin, mean cell volume, erythrocyte zinc protoporphyrin, transferrin receptors and serum ferritin. RESULTS: Average daily dietary iron intakes ranged from 9.6 mg/day among Pacific women to 10.5 mg/day among Maori women; 41% of 20-49 year olds and 45% of adolescents were at risk of low dietary iron intakes. The estimated percentage of 15-49 year old women with iron deficiency anaemia ranged from 1.4-5.5%, and for iron deficiency without anaemia from 0.7-12.6% depending on the age group and criteria used. CONCLUSIONS: The overall estimated prevalence of suboptimal biochemical iron status among 15-49 year old women in New Zealand ranged from 7-13%, which compared favourably with premenopausal women living in other western countries. This situation is, however, a public health concern given the potential negative functional consequences associated with even mild iron deficiency.

Operational research leading to rapid national policy change: tuberculosis-diabetes collaboration in India.

In 2011, bi-directional screening for tuberculosis (TB) and diabetes mellitus (DM) was recommended by the World Health Organization (WHO), although how best to implement the activity was not clear. In India, with early engagement of national programme managers and all important stakeholders, a countrywide, multicentre operational research (OR) project was designed in October 2011 and completed in 2012. The results led to a rapid national policy decision to routinely screen all TB patients for DM in September 2012. The process, experience and enablers of implementing this unique and successful collaborative model of operational research are presented.

En 2011, un double dépistage de la tuberculose (TB) et du diabète (DM) a été recommandé par l'Organisation Mondiale de la Santé (OMS), mais il n'a pas été précisé clairement comment mettre en œuvre au mieux cette activité. En Inde, grâce à l'engagement précoce des directeurs de programmes nationaux et de tous les partenaires importants, un projet national de recherche opérationnelle (OR) multicentrique a été conçu en octobre 2011 et achevé en 2012. Les résultats ont rapidement amené à une décision politique nationale de dépister en routine tous les patients TB à la recherche de DM en septembre 2012. Cet article présente la procedure et l'expérience de ceux qui ont mis en œuvre ce modèle collaboratif de recherche opérationnelle assez unique et fructueux.

En el 2011, la Organización Mundial de la Salud recomendó la detección bidireccional de la tuberculosis (TB) y la diabetes sacarina (DM), aunque no fue claro cuál sería el mejor mecanismo de ejecución de la iniciativa. En la India, con la participación temprana de los gestores del programa nacional y todos los principales interesados directos, se formuló un proyecto multicéntrico de investigación operativa de ámbito nacional en octubre del 2011 y se completó en el 2012. Los resultados llevaron a una rápida decisión política de alcance nacional en septiembre del 2012, de practicar la detección sistemática de la DM en todos los pacientes con diagnóstico de TB. En el presente artículo se describe el proceso, las experiencias y los factores facilitadores de la ejecución de este excepcional y eficaz modelo colaborativo de investigación operativa.

Health-care seeking among people with cough of 2 weeks or more in India. Is passive TB case finding sufficient?

SETTING: Thirty districts of India. OBJECTIVES: To estimate 1) the proportion of people with cough of ≥2 weeks, 2) those who did not seek care from a health care provider for cough, and 3) their characteristics. METHODOLOGY: A cross-sectional community-based survey in which 4562 people (aged ≥18 years) were interviewed. RESULTS: Of the 4562 individuals interviewed, 437 (9.5%, 95%CI 7.2-11.8) had cough ≥2 weeks; this was more frequent in those >55 years of age (14%) and in those from districts in eastern (12%) and northern (11%) states of India. Of those with cough, 300 (69%, 95%CI 60-77) had not sought care from any health care provider. Not seeking care was more frequent in people residing in rural areas (73%) compared with urban areas (53%), and in the districts of eastern (82%) and northern (74%) states compared to districts from the southern (46%) and western (54%) states. CONCLUSIONS: Nearly a tenth of those interviewed aged ≥18 years had cough of ≥2 weeks. About two thirds, especially those from rural areas, had not visited a health care provider for the cough. This finding has huge implications for India's current mostly passive case-finding strategy for detecting and controlling tuberculosis.

Compliance surveys: an effective tool to validate smoke-free public places in four jurisdictions in India.

Smoke-free initiatives have gained significant momentum since India enacted comprehensive smoke-free legislation in October 2008. The International Union Against Tuberculosis and Lung Disease has actively supported various levels of government, legislators, civil society, and communities across the country to implement smoke-free public places and comply with the law. On World No Tobacco Day 2010, four jurisdictions demonstrated that public places within their jurisdictions were smoke-free. These jurisdictions cover a wide spectrum of demographic and geographic variation and include an entire state. The demonstration of being 'smoke-free' in these jurisdictions was supported by a simple survey that documented compliance with the smoke-free law in the country.

Tuberculosis 'retreatment others': profile and treatment outcomes in the state of Andhra Pradesh, India.

SETTING: The Government of India's Revised National Tuberculosis Control Programme (RNTCP), Andhra Pradesh, South India. OBJECTIVES: To study the basic characteristics and treatment outcomes of tuberculosis (TB) patients classified as 'retreatment others' and compare their treatment outcomes with smear-positive retreatment TB cases (relapse, failure, and treatment after default [TAD]). DESIGN: Retrospective record and report review of a patient cohort (n = 1237) registered as 'retreatment others' under the RNTCP from July to September 2008. RESULTS: Of 1009 patient records of 'retreatment others' reviewed, 674 (67%) were males, 892 (88%) were aged 15-64 years, 847 (84%) were pulmonary sputum smear-negative, 843 (84%) had unknown human immunodeficiency virus (HIV) status and 55 (5.5%) were HIV-positive. All patients were treated with the RNTCP intermittent (thrice weekly) retreatment regimen. Eighty per cent were successfully treated (cured plus treatment completed). Successful outcomes were higher in females (84%), in patients with extra-pulmonary TB (87%) and in HIV-negative patients (87%). The treatment outcomes were significantly better for 'retreatment others' (P < 0.05) than among the sputum smear-positive retreatment cases (78% for relapses, 59% for failures and 73% for TAD). CONCLUSIONS: 'Retreatment others' were predominantly sputum smear-negative TB, with significantly better treatment outcomes than among smear-positive retreatment patients. Future studies may assess the accuracy of the diagnoses and factors contributing to the occurrence of 'retreatment others'.

Did successfully treated pulmonary tuberculosis patients undergo all follow-up sputum smear examinations?

To assess response to anti-tuberculosis treatment as per national guidelines, a retrospective record review was undertaken in four districts of Andhra Pradesh, India, in December 2009 to determine whether pulmonary tuberculosis (PTB) patients reported as successfully treated (cured or treatment completed) underwent all scheduled follow-up sputum smear examinations. In a quarterly cohort of 3000 PTB patients reported as successfully treated, 1847 (61.5%) underwent all follow-up sputum examinations, with a higher proportion of new cases (65%) than retreatment cases (45%). The mid-continuation phase follow-up sputum examinations were commonly missed, and 11% patients had not undergone end-of-treatment follow-up sputum examinations.

On a entrepris en décembre 2009 une revue rétrospective des enregistrements dans quatre districts d'Andhra Pradesh en Inde afin de déterminer dans quelle mesure les patients atteints de tuberculose pulmonaire (TBP) signalés comme traités avec succès (guérison ou achèvement du traitement) avaient subi tous les examens de frottis de crachats prévus dans le suivi pour évaluer la réponse au traitement TB conformément aux directives nationales. Dans une cohorte trimestrielle de 3000 patients TBP signalés comme traités avec succès, 1847 (61,5%) avaient subi des examens de crachats du suivi, la proportion étant plus élevée parmi les nouveaux cas (65%) que parmi les retraitements (45%). Les examens de crachats du suivi au milieu de la phase de continuation ont manqué régulièrement et l'examen de crachats du suivi à la fin du traitement n'a pas été appliqué chez 11% des patients.

En diciembre 2009 se llevó a cabo una revisión retrospectiva de los registros de tuberculosis (TB) en cuatro distritos de Andhra Pradesh en la India, con el fin de determinar si todos los pacientes con TB pulmonar (TBP) cuyo desenlace terapéutico se había notificado como exitoso (curación o tratamiento completo) habían cumplido con las baciloscopias de seguimiento programadas para evaluar la respuesta al tratamiento antituberculoso de conformidad con lo estipulado en las directrices nacionales. En una cohorte trimestral de 3000 pacientes con TBP cuyo tratamiento se registró como exitoso, 1847 pacientes (61,5%) contaban con todas las baciloscopias de seguimiento; esta proporción fue más alta en los casos nuevos (65%) que en los casos de retratamiento (45%). Con frecuencia faltaron las baciloscopias previstas en la mitad de la fase de continuación y 11% de los pacientes carecía del examen de esputo correspondiente a la finalización del tratamiento.