Impact of the Syrian refugee crisis on land use and transboundary freshwater resources.

Since 2013, hundreds of thousands of refugees have migrated southward to Jordan to escape the Syrian civil war that began in mid-2011. Evaluating impacts of conflict and migration on land use and transboundary water resources in an active war zone remains a challenge. However, spatial and statistical analyses of satellite imagery for the recent period of Syrian refugee mass migration provide evidence of rapid changes in land use, water use, and water management in the Yarmouk-Jordan river watershed shared by Syria, Jordan, and Israel. Conflict and consequent migration caused ∼50% decreases in both irrigated agriculture in Syria and retention of winter rainfall in Syrian dams, which gave rise to unexpected additional stream flow to downstream Jordan during the refugee migration period. Comparing premigration and postmigration periods, Syrian abandonment of irrigated agriculture accounts for half of the stream flow increase, with the other half attributable to recovery from a severe drought. Despite this increase, the Yarmouk River flow into Jordan is still substantially below the volume that was expected by Jordan under the 1953, 1987, and 2001 bilateral agreements with Syria.

Effects of artichoke (Cynara scolymus) leaf and bloom head extracts on chemically induced DNA lesions in Drosophila melanogaster.

The genotoxicity of bloom head (BHE) and leaf (LE) extracts from artichoke (Cynara scolymus L.), and their ability to modulate the mutagenicity and recombinogenicity of two alkylating agents (ethyl methanesulfonate - EMS and mitomycin C - MMC) and the intercalating agent bleomycin (BLM), were examined using the somatic mutation and recombination test (SMART) in Drosophila melanogaster. Neither the mutagenicity nor the recombinogenicity of BLM or MMC was modified by co- or post-treatment with BHE or LE. In contrast, co-treatment with BHE significantly enhanced the EMS-induced genotoxicity involving mutagenic and/or recombinant events. Co-treatment with LE did not alter the genotoxicity of EMS whereas post-treatment with the highest dose of LE significantly increased this genotoxicity. This enhancement included a synergistic increase restricted to somatic recombination. These results show that artichoke extracts promote homologous recombination in proliferative cells of D. melanogaster.

Does health aid matter to financial risk protection? A regression analysis across 159 household surveys, 2000-2016.

INTRODUCTION: Universal Health Coverage (UHC) is a widely accepted objective among entities providing development assistance for health (DAH) and DAH recipient governments. One key metric to assess progress with UHC is financial risk protection, but empirical evidence on the extent to which DAH is associated to financial risk protection (and hence UHC) is scarce. METHODS: Our sample is comprised of 65 countries whose DAH per capita is above the population -weighted average DAH per capita across all countries. The sample comprises of 1.7 million household observations, for the period 2000-2016. We run country and year fixed effects regressions, and pseudo-panel models, to assess the association between DAH and three measures of financial risk protection: catastrophic health expenditure (i.e., out-of-pocket health expenditures larger than 10% of total household expenditures ['CHE10%']), out-of-pocket health expenditure as a share of total expenditure ('OOP%'), and impoverishment due to health expenditures, at the 1.90US$ per day poverty line ('IMP190'). RESULTS: on average, DAH investment does not appear to be significantly associated with financial risk protection outcomes. However, we find suggestive evidence that a 1 US$ increase in DAH per capita is negatively associated (i.e., an improvement) with at least one financial risk protection outcome for the poorest household quintile within countries (in fixed effects models, IMP190: 0.05 percentage points, p < 0.1; in pseudo-panel models, CHE10%: 0.12 percentage points, p < 0.01). DAH is also negatively associated (i.e., an improvement) with most financial risk protection outcomes when it is largely channelled via government systems (i.e., when it is "on-budget") (CHE10%: 0.68 percentage points, p < 0.05). Several robustness checks confirm these results. DISCUSSION: DAH investments require careful planning to improve financial risk protection. For example, positive DAH effects for the poorest quintiles of the population might be driven by DAH targeting poorer populations and doing so effectively. Our results also suggest that channelling more resources via governments might be a promising avenue to enhance the impact of DAH on financial risk protection.

Evaluation of the mutagenicity and genotoxicity of Arrabidaea chica Verlot (Bignoneaceae), an Amazon plant with medicinal properties.

Arrabidaea chica Verlot (Bignoniaceae) is an important folk medicine plant native to the Amazon region and used to treat anemia, hemorrhage, inflammation, intestinal colic, hepatitis, and skin affections. Although studies showed its therapeutic properties, little knowledge regarding genotoxic properties of this plant is available. The aim of this study was to determine the potential mutagenic and genotoxic/antigenotoxic effects of an A. chica chloroformic fraction (Ac-CF) obtained from leaves containing bioactive metabolites. The mutagenic effects were evaluated using the Salmonella mutagenicity assay, with TA98, TA97a, TA100, TA102, and TA1535 strains, with and without metabolic activation. In vivo mutagenic and genotoxic/antigenotoxic effects were investigated using the micronucleus (MN) test in bone marrow and alkaline comet assay in blood and liver after administration of 100, 500, or 1000 mg/kg Ac-CF in CF-1 mice by gavage (once a day for 3 d). In vitro antioxidant potential was evaluated using DPPH and xanthine/hypoxanthine assays. Ac-CF was not mutagenic in any of the Salmonella typhimurium strains tested and showed negative responses for mutagenicity and genotoxicity in mice. Further, Ac-CF displayed antigenotoxic effects by decreasing the oxidative DNA damage induced by hydrogen peroxide by greater than 50% in blood and liver. The antioxidant action detected in the in vitro assays demonstrated IC50 of 0.838 mg/ml in the xanthine/hypoxanthine assay and IC50 of 28.17 µg/ml in the DPPH assay. In conclusion, Ac-CF did not induce mutagenic and genotoxic effects and was able to protect DNA against oxidative damage in vivo, suggesting that this fraction may not pose genetic risks, although further toxicology assays are necessary.

Homologous recombination induced by doxazosin mesylate and saw palmetto in the Drosophila wing-spot test.

Benign prostatic hyperplasia (BPH) is the most common tumor in men over 40 years of age. Acute urinary retention (AUR) is regarded as the most serious hazard of untreated BPH. α-Blockers, such as doxazosin mesylate, and 5-α reductase inhibitors, such as finasteride, are frequently used because they decrease both AUR and the need for BPH-related surgery. An extract of the fruit from American saw palmetto plant has also been used as an alternative treatment for BPH. The paucity of information available concerning the genotoxic action of these compounds led us to assess their activity as inducers of different types of DNA lesions using the somatic mutation and recombination test in Drosophila melanogaster. Finasteride did not induce gene mutation, chromosomal mutation or mitotic recombination, which means it was nongenotoxic in our experimental conditions. On the other hand, doxazosin mesylate and saw palmetto induced significant increases in spot frequencies in trans-heterozygous flies. In order to establish the actual role played by mitotic recombination and by mutation in the genotoxicity observed, the balancer-heterozygous flies were also analyzed, showing no increment in the total spot frequencies in relation to the negative control, for both drugs. Doxazosin mesylate and saw palmetto were classified as specific inducers of homologous recombination in Drosophila proliferative cells, an event linked to the loss of heterozygosity.

Genotoxic and antigenotoxic activity of acerola (Malpighia glabra L.) extract in relation to the geographic origin.

Malpighia glabra L, popularly known as acerola, is considered a functional fruit and therefore is taken to prevent disease or as adjuvant to treatment strategies, since the fruit is an undeniable source of vitamin C, carotenoids, and flavonoids. Acerola is a natural source of vitamin C, flavonoids, and carotenoids. Its chemical composition is affected by genetic uniformity of the orchards and environmental factors. Considering the extensive growth of the culture of acerola in Brazil as well as its widespread use, this study evaluates the genotoxic and antigenotoxic activity of acerola in relation to geographical origin using the comet assay in mice blood cells in vitro. No acerola samples showed potential to induce DNA damage, independently of origin. Also, for antigenotoxicity activity, only the acerola sample from São Paulo reduced DNA damage induced by hydrogen peroxide (by about 56%). The sample from Ceará showed good antioxidant activity by the 2,2-diphenyl-1-picrylhydrazyl assay, in agreement with its higher rutin, quercetin, and vitamin C levels. Additional studies with other treatment regimens are necessary to better understand the impact of the complex mixture of acerola on genomic stability.

Degradation Measurement and Modelling under Ageing in a 16 nm FinFET FPGA.

Most of the latest generation of integrated circuits use FinFET transistors for their performance, but what about their reliability? Does the architectural evolution from planar MOSFET to FinFET transistor have any effect on the integrated circuit reliability? In this article, we present a test bench we have developed to age and measure the degradation of 5103 ring oscillators (ROs) implemented in nine FPGAs with 16nm FinFET under different temperature and voltage conditions (Vnom≤Vstress≤1.3Vnom and 25°C≤Tstress≤115°C) close to operational conditions in order to predict reliability regarding degradation mechanisms at the transistor scale (BTI, HCI and TDDB) as realistically as possible. By comparing our initial RO measurements and the data extracted from Vivado, we will show that the performance of the nine FPGAs is between 50% and 70% of the best performance expected by Vivado. After 8000 h of ageing, we will see that the relative degradations of the RO are a maximum of 1%, which is a first indicator proving the FPGAs' good reliability. By comparing our results with similar studies on 28 nm MOSFET FPGAs, we will reveal that 16 nm FinFET FPGAs are more reliable. To be implemented in an FPGA, an RO uses logic resources (LUT) and routing resources. We will show that degradation in the two types of resources is different. For this reason, we will present a method for separating degradations in logical and routing resources based on RO degradation measures. Finally, we will model rising and falling edge propagation time degradations in an FPGA as a function of time, temperature, voltage, signal duty cycle and resources used in the FPGA.

Treatment with aqueous extract from Croton cajucara Benth reduces hepatic oxidative stress in streptozotocin-diabetic rats.

Croton cajucara Benth is a plant found in Amazonia, Brazil and the bark and leaf infusion of this plant have been popularly used to treat diabetes and hepatic disorders. The present study was designed to evaluate the oxidative stress as well as the therapeutic effect of Croton cajucara Benth (1.5 mL of the C. cajucara extract i.g.) in rats with streptozotocin-induced diabetes. Croton cajucara Benth was tested as an aqueous extract for its phytochemical composition, and its antioxidant activity in vitro was also evaluated. Lipid peroxidation and superoxide dismutase, catalase, and glutathione reductase activities were measured in the hepatic tissue, as well as the presence activation of p65 (NF-κB), through western blot. Phytochemical screening of Croton cajucara Benth detected the presence of flavonoids, coumarins and alkaloids. The extract exhibited a significant antioxidant activity in the DPPH-scavenging and the hypoxanthine/xanthine oxidase assays. Liver lipid peroxidation increased in diabetic animals followed by a reduction in the Croton-cajucara-Benth-treated group. There was activation of p65 nuclear expression in the diabetic animals, which was attenuated in the animals receiving the Croton cajucara Benth aqueous extract. The liver tissue in diabetic rats showed oxidative alterations related to the streptozotocin treatment. In conclusion the Croton cajucara Benth aqueus extract treatment effectively reduced the oxidative stress and contributed to tissue recovery.

Characterization of lung tumors motion baseline using cone-beam computed tomography.

PURPOSE: To characterize the interfractional variability in lung tumor volume, position, and tumor boundaries. METHODS: Cone-beam computed tomography (CBCT) scans were acquired weekly during the course of treatment for 34 lung cancer patients (1-20 scans) with large tumors. Spatial registration based on bones was performed between contoured planning CT and CBCT. Gross tumor volume (GTV) on each CBCT was then contoured. Tumor volume, centroid, and boundaries variability were quantified. A commercial deformable registration software was tested and results were compared to manual contours. RESULTS: Mean volume reduction was 41 ± 32% (p < 0.001) after an average time of 51 days. Tumor centroid drifts were 0.03, 0.14, and -0.13 cm in right-left (RL), anterior-posterior (AP), and superior-inferior (SI) directions with standard deviations of 0.55, 0.50, and 0.51 cm. GTV boundaries displacements were -0.27, -0.14, and -0.16 cm with standard deviations of 0.64, 0.57, and 0.59 cm in RL, AP, and SI directions. Relative error between deformed and manual contours with the commercial deformable registration software rose up exponentially with the GTV decrease. CONCLUSIONS: GTV size changes for large lung tumors are similar to those for standard tumors. Magnitude absolute values of displacement vector for centroid and boundaries shifts show that there is not a preferred direction for the drifts but shrinkage.

Household Consumption and Expenditures Surveys (HCES): a primer for food and nutrition analysts in low- and middle-income countries.

BACKGROUND: The dearth of 24-hour recall and observed-weighed food record data--what most nutritionists regard as the gold standard source of food consumption data-has long been an obstacle to evidence-based food and nutrition policy. There have been a steadily growing number of studies using household food acquisition and consumption data from a variety of multipurpose, nationally representative household surveys as a proxy measure to overcome this fundamental information gap. OBJECTIVE: To describe the key characteristics of these increasingly available Household Consumption and Expenditures Surveys (HCES) in order to help familiarize food and nutrition analysts with the strengths and shortcomings of these data and thus encourage their use in low- and middle-income countries; and to identify common shortcomings that can be readily addressed in the near term in a country-by-country approach, as new HCES are fielded, thereby beginning a process of improving the potential of these surveys as sources of useful data for better understanding food- and nutrition-related issues. METHODS: Common characteristics of key food and nutrition information that is available in HCES and some basic common steps in processing HCES data for food and nutrition analyses are described. RESULTS: The common characteristics of these surveys are documented, and their usefulness in addressing major food and nutrition issues, as well as their shortcomings, is demonstrated. CONCLUSIONS: Despite their limitations, the use of HCES data constitutes a generally unexploited opportunity to address the food consumption information gap by using survey data that most countries are already routinely collecting.

Estimating micronutrient intakes from Household Consumption and Expenditures Surveys (HCES): an example from Bangladesh.

BACKGROUND: Globally, there is a scarcity of national food consumption data that could help to assess food patterns and nutrient intakes of population groups. Estimates of food consumption patterns and apparent intakes of energy and nutrients could be obtained from national Household Consumption and Expenditures Surveys (HCES). OBJECTIVE: To use the HCES conducted in Bangladesh in 2005 (HIES2005) to estimate apparent intakes of vitamin A, iron, and zinc. METHODS: Food acquisition data from HIES2005, which surveyed 10,080 households, were transformed into standard measurement units. Intrahousehold food and nutrient distribution was estimated with Adult Male Equivalent (AME) units. Adequacy of intake was assessed by comparing individual nutrient intakes with requirements and was then aggregated by households. RESULTS: The weighted mean energy intake for the population was 2,151 kcal/person/day, with a range among divisions from 1,950 in Barisal to 2,195 in Dhaka division. The apparent intakes of vitamin A and iron were insufficient to satisfy the recommended intakes for more than 80% of the population in Bangladesh, while apparent intakes of zinc, adjusted by bioavailability, satisfied the requirements of approximately 60% of the population. CONCLUSIONS: Using the HIES2005, we were able to produce estimates of apparent food consumption and intakes of some key micronutrients for the Bangladeshi population and observed wide differences among divisions. However, the methodological approaches reported here, although feasible and promising, need to be validated with other dietary intake methods.

Indian social safety net programs as platforms for introducing wheat flour fortification: a case study of Gujarat, India.

BACKGROUND: Micronutrient deficiencies exact an enormous health burden on India. The release of the National Family Health Survey results--showing the relatively wealthy state of Gujarat having deficiency levels exceeding national averages--prompted Gujarat officials to introduce fortified wheat flour in their social safety net programs (SSNPs). OBJECTIVE: To provide a case study of the introduction of fortified wheat flour in Gujarat's Public Distribution System (PDS), Integrated Child Development Scheme (ICDS), and Mid-Day Meal (MDM) Programme to assess the coverage, costs, impact, and cost-effectiveness of the initiative. METHODS: India's 2004/05 National Sample Survey data were used to identify beneficiaries of each of Gujarat's three SSNPs and to estimate usual intake levels of vitamin A, iron, and zinc. Comparing age- and sex-specific usual intakes to Estimated Average Requirements, the proportion of the population with inadequate intakes was estimated. Postfortification intake levels and reductions in inadequate intake were estimated. The incremental cost of fortifying wheat flour and the cost-effectiveness of each program were estimated. RESULTS: When each program was assessed independently, the proportion of the population with inadequate vitamin A intakes was reduced by 34% and 74% among MDM and ICDS beneficiaries, respectively. Both programs effectively eliminated inadequate intakes of both iron and zinc. Among PDS beneficiaries, the proportion with inadequate iron intakes was reduced by 94%. CONCLUSIONS. Gujarat's substitution of fortified wheat flour for wheat grain is dramatically increasing the intake of micronutrients among its SSNP beneficiaries. The incremental cost of introducing fortification in each of the programs is low, and, according to World Health Organization criteria, each program is "highly cost-effective." The introduction of similar reforms throughout India would largely eliminate the inadequate iron intake among persons participating in any of the three SSNPs and would have a significant impact on the global prevalence rate of inadequate iron intake.

Pharmacological evaluation of Copaifera multijuga oil in rats.

CONTEXT: Copaiba oil is an oleoresin made up of resin acids and volatile compounds, and it is obtained by tapping the trunks of trees that are members of the Copaifera L. (Leguminoseae) genus and are found in tropical parts of Latin America. OBJECTIVE: This study analyzed the chemical composition of Copaifera multijuga Hayne oil and conducted preclinical trials to investigate anti-inflammatory effects and any action it may have on the central nervous system (CNS) of rats. MATERIALS AND METHODS: The chemical analysis was carried out using gas chromatography with mass spectroscopy. Anti-inflammatory activity was measured by leucocytes mobilization, by chemotaxis assay in Boyden's chamber, and by pleurisy model in rats. CNS effect was determined by plus maze and open-field assays. The statistical test applied was analysis of variance (ANOVA) followed by Tukey's test or ANOVA followed by Duncan's test. RESULTS: The oil was composed of sesquiterpenes with the predominance of ß-caryophyllene (36.0%), followed by α-copaene (18.8%), ß-bisabolene (8.5%), and α-trans-bergamotene (7.0%). Data demonstrated that at 100 and 200 mg/kg doses and at a concentration of 200 µl/ml copaiba essential oil presented anti-inflammatory effects both in vivo and in vitro based on reduced leukocyte migration to the rats' pleural cavity and to the chemotactic agent lipopolysaccharide solution, respectively. During the experiments investigating CNS effects, locomotive and exploratory activities were reduced and the animals' anxiety increased at 100 and 200 mg/kg. CONCLUSION: The results obtained suggest that copaiba oil has an interesting anti-inflammatory effect and important effect on the CNS.

Antigenotoxicity and antioxidant activity of Acerola fruit (Malpighia glabra L.) at two stages of ripeness.

Genotoxic and antigenotoxic effects of acerola fruit at two stages of ripeness were investigated using mice blood cells. The results show that no ripeness stage of acerola extracts presented any genotoxic potential to damage DNA (Comet assay) or cytotoxicity (MTT assay). When antigenotoxic activity was analyzed, unripe fruit presented higher DNA protection than ripe fruit (red color) extract. The antioxidant capacity of substances also showed that unripe samples inhibit the free radical DPPH more significantly than the ripe ones. The results about determination of compounds made using HPLC showed that unripe acerola presents higher levels of vitamin C as compared to ripe acerola. Thus, vitamin C and the complex mixture of nutrients of Malpighia glabra L., and especially its ripeness stages, influenced the interaction of the fruit extract with the DNA. Acerola is usually consumed when ripe (red fruit), although it is the green fruit (unripe) that has higher potential as beneficial to DNA, protecting it against oxidative stress.

Financial Protection in Health among the Elderly - A Global Stocktake.

Universal Health Coverage is one of the key targets of the Sustainable Development Goals and it implies that everyone can access the healthcare they need without suffering financial hardship. In this paper, we use a large set of household surveys to examine if older populations are facing different degrees of financial hardship compared to younger populations. We find that while differences in average age structures between countries are not systematically associated with higher financial risk related to out-of-pocket health expenditures, there are large differences in financial hardship between younger and older households within countries. Households with more elderly members are more likely to face catastrophic and impoverishing out-of-pocket health payments compared to younger households, and this age gradient is stronger for the poorest segments of the population. Making progress toward Universal Health Coverage will require extension and improved targeting of benefit packages and financial protection to meet the health needs of older adults, and especially the poorest and most vulnerable segments of elderly populations.

Reliability of infrared ear thermometry in the prediction of rectal temperature in older inpatients.

AIMS AND OBJECTIVES: To assess the capability of infrared ear thermometry accurately to predict rectal temperature in older patients. BACKGROUND: Infrared ear thermometry is now commonly used for predicting body temperature in older patients. However, ear thermometry has been insufficiently evaluated in geriatric patients. DESIGN: Prospective, convenience sample, unblinded study. METHODS: All patients (or their guardians) gave informed consent. Patients hospitalised in a geriatric unit underwent sequential ear and rectal temperatures measurements using two different models of infrared ear thermometers (ThermoScan and Genius) and a rectal probe, respectively. After a brief otoscopic examination, ear temperatures were measured twice at both ears with each thermometer, the highest of four measurements being retained for analysis. The rectal temperature was the reference standard. RESULTS: Hundred patients (31 males), aged 81 (SD 7) years completed the study. The mean rectal temperature was 37.3 degrees C (SD 0.7) degrees C (range 36.3-40.7 degrees C). Eighteen patients were febrile (rectal temperature >or= 37.8 degrees C). The mean bias between rectal and ear temperatures as measured with the ThermoScan was -0.20 degrees C (SD 0.32) degrees C and the 95% limits of agreement were -0.83 degrees C and 0.42 degrees C (95% CI, -0.88-0.48 degrees C). Using the Genius, the corresponding figures were -0.56 degrees C (SD 0.39) degrees C, -1.32 degrees C and 0.20 degrees C (95% CI, -1.39-0.27 degrees C). After correction for bias, the ThermoScan predicted the level of fever with a maximum error of 0.7 degrees C (mean error 0.3 degrees C). Using the Genius, the maximum error and the mean error were 1.6 degrees C and 0.4 degrees C, respectively. CONCLUSIONS: Infrared ear thermometry can predict rectal temperature in normothermic and in febrile inpatients with an acceptable level of accuracy. However, the predictive accuracy depends on both operator technique and quality of instrumentation. RELEVANCE TO CLINICAL PRACTICE: Proper technique (measuring in both ears) and optimal instrumentation (model of ear thermometer) are essential for accuracy.

Pressurized liquid extraction of vitamin E from Brazilian grape seed oil.

The goal of this paper is to optimize the pressurized liquid extraction (PLE) of vitamin E from grape seed oil from residues of the wine industry. For this purpose an experimental planning to optimize the extraction of Brazilian grape seed oil by means of PLE with hexane as solvent was applied and the results are compared with conventional methods (Soxhlet and mechanical press extraction). Vitamin E was separated and analyzed using HPLC with UV detection. This study demonstrates the ability of the PLE in extracting grape seed oil rich in vitamin E.

Antioxidant and antimutagenic properties of the monoterpene indole alkaloid psychollatine and the crude foliar extract of Psychotria umbellata Vell.

Psychollatine is a monoterpene indole alkaloid produced and accumulated by Psychotria umbellata Vell. (Rubiaceae) leaves in relatively high amounts (approximately 3% of the dry weight). The alkaloid has been shown to display opioid-like analgesic, anxiolytic, antidepressive and antipsychotic activities in rodents. In vitro assays suggested a protective role for this molecule in plant oxidative stress responses. This work reports antioxidant properties of psychollatine and the crude foliar extract from P. umbellata in strains of Saccharomyces cerevisiae proficient and deficient in antioxidant defenses exposed to H2O2 and paraquat. The antimutagenic activity of P. umbellata and its main alkaloid were assayed in S. cerevisiae N123 strain in presence of H2O2. Moreover, the antioxidant capacity of these substances on the hydroxyl radical (OH.) was investigated, using the hypoxanthine/xanthine oxidase assay. Psychollatine and the crude foliar extract of P. umbellata showed protective effect against oxidative stress in yeast, acting both as antioxidant and antimutagenic agents.

Household income and expenditure surveys: a tool for accelerating the development of evidence-based fortification programs.

BACKGROUND: One-third of the world's population suffers from micronutrient deficiencies due primarily to inadequate dietary intake. Food fortification is often touted as the most promising short- to medium-term strategy for combating these deficiencies. Despite its appealing characteristics, progress in fortification has been slow. OBJECTIVE: To assess the potential of household food-purchase data to fill the food-consumption information gap, which has been an important factor contributing to the slow growth of fortification programs. METHODS: Household income and expenditure survey (HIES) data about: (a) a population's distribution of apparent household consumption, which are essential to setting safe fortification levels, (b) the proportion of households purchasing "fortifiable" food, and (c) the quantity of food being purchased were used to proxy food-consumption data and develop suggested fortification levels. RESULTS: The usefulness of the approach in addressing several common fortification program design issues is demonstrated. HIES-based suggested fortification levels are juxtaposed with ones developed using the most common current approach, which relies upon Food and Agriculture Organization (FAO) Food Balance Sheets. CONCLUSIONS: Despite its limitations, the use of HIES data constitutes a generally unexploited opportunity to address the food-consumption information gap by using survey data that nearly every country of the world is already routinely collecting. HIES data enable the design of fortification programs to become more based on country-specific data and less on general rules of thumb. The more routine use of HIES data constitutes a first step in improving the precision of fortification feasibility analyses and improving estimates of the coverage, costs, and impact of fortification programs.