Seasonal variability of women's dietary diversity and food supply: a cohort study in rural Burkina Faso.

OBJECTIVE: To investigate the seasonal variations of women's dietary diversity (WDD) (items consumed and food supply) and its linkages with agriculture, market and wild resources. DESIGN: A cohort of 300 women was followed-up over a year to investigate WDD and food sources (production, purchase or foraging). Monthly qualitative 24 h recalls allowed computing WDD Scores from a standard 10-food groups (FG) classification (WDDS-10). Associations between farm/women's characteristics and WDDS-10 were investigated using multivariate mixed models including interaction terms factor*months. SETTING: Tuy province, Burkina Faso. PARTICIPANTS: 300 women of reproductive age. RESULTS: Both dietary diversity and food sources were seasonal. The mean WDDS-10 was relatively stable from August to January (ranging from 3·1 to 3·5 FG) when farm production predominated. The WDDS-10 gradually increased from February, concomitantly with an increase in food purchases (onions, tomatoes, mangoes) and reached its highest levels (>4 FG) from March to June, when food purchases were still relatively high and when more women consumed foraged fruits (shea plums and wild grapes). Women living on farms owning > 3 plough oxen and different animal species had significantly higher WDDS-10 than others (+0·28 and +0·35 FG, respectively). Women who practiced off-farm activities also had higher WDDS-10 than those who did not (+0·21 FG, P < 0·05). Other factors, for example, the number of foraged edible species, provided advantages in terms of dietary diversity only during certain seasons (October - January, P for interaction < 0·01). CONCLUSIONS: Diversifying women's diets throughout the year requires complementary interventions aimed at diversifying production, promoting foraging and increasing income-generating activities to enable food purchasing.

Ex vivo simulation of cardiopulmonary bypass with human blood for hemocompatibility testing.

OBJECT: Experimental circuits for biomaterial surface testing are frequently limited by the tested blood volume, composition of the circuit, flow conditions and the use of animal blood. This report describes an ex vivo set-up for simulated cardiopulmonary bypass with human blood perfusion. We investigated the clinical generalizability of the observed effects on hematological and metabolic parameters and the hemocompatibility of the system. METHODS: The simulated cardiopulmonary bypass circuit consisted of a heparin-coated tubing system connected to an oxygenator and a venous reservoir. Normothermic flow of blood obtained from healthy donors was maintained at 2.4 L/min/m(2) by a roller pump. Heparin was dosed to obtain a target activated clotting time (ACT) ⩾500 s. Blood was drawn at baseline and 0, 10, 60 and 120 minutes following the initiation of blood flow to determine hematological and metabolic parameters and the hemocompatibility of the extracorporeal system. Data were analyzed using repeated measures ANOVA. RESULTS: Two hours of blood perfusion resulted in a small, but clinically unimportant reduction in hematocrit, whereas hemoglobin levels and red blood cell, platelet and leukocyte counts remained stable. There was a significant increase in ACT throughout the experiment. While pO2 levels and the pH remained unaltered during the experiment, pCO2 values decreased from 51 ± 6 mmHg at T0 to 41 ± 3 mmHg at T120 (p<0.001). Simulated cardiopulmonary bypass induced a two-fold increase in C3a (p=0.001) while tissue factor was decreased from 44 ± 14 pg/mL at T0 to 38 ± 13 pg/mL at T120 (p=0.009). Levels of CD40L, prothrombin fragment 1+2, ß-thromboglobulin and factor VIIa remained stable over time. CONCLUSION: The ex vivo set-up for simulated cardiopulmonary bypass mimicked the clinical cardiosurgical setting. Exposure of fresh donor blood to the extracorporeal circuit showed a good hemocompatibility, indicated by maintained hematological parameters and a mild immune response.

An ex vivo evaluation of blood coagulation and thromboresistance of two extracorporeal circuit coatings with reduced and full heparin dose.

OBJECTIVES: Bioactive Carmeda® heparin-coated extracorporeal circuits (ECCs) have been shown to reduce contact phase and coagulation activation during cardiopulmonary bypass (CPB). Heparin coating is therefore effective in safely reducing coagulation during routine CPB. Balance® Biosurface is a new, recently developed biopassive coating containing negatively charged sulphonated polymers. This study sought to compare the clotting activation and thromboresistance of the Balance® (B) circuit with that of the Carmeda® (C) with full-dose systemic heparin (FDH) and reduced-dose systemic heparin (RDH). METHODS: This ex vivo study set-up comprising 40 experiments consisted of simplified ECC and circulation of freshly donated human blood. RDH and FDH regimens were obtained with 0.5 IU/ml and 1 IU/ml heparin administered to reach target activated clotting times (ACTs) of 250 and 500 s, respectively. The study design comprised four groups: FDH-C, FDH-B, RDH-C and RDH-B (all n = 10). Blood was sampled prior to and during the 2-h CPB. Coagulation activation was assessed (FXIIa, F1.2) and electron microscope scan imaging of oxygenators enabled determination of adhesion scores. RESULTS: With a biopassive compared with bioactive surface, mean ACT was lower, regardless of the heparin regimen applied (P < 0.001), whereas the total heparin dose required to maintain ACT was above target level (P < 0.001). However, FXIIa and F1.2 values were similar in all groups throughout, as were pressure gradients among oxygenators. All groups demonstrated similar adhesion scores following ultrastructural oxygenator assessment. CONCLUSIONS: In the absence of surgical-related haemostatic disturbances and based on target ACT levels under reduced- or full-dose heparin, the clotting process was similar to heparin-coated and new sulphonated polymer-coated ECC, both demonstrating similar thromboresistance.