Before and after study of a national complementary and supplementary feeding programme in Rwanda, 2017-2021.

To address high rates of malnutrition among children from vulnerable households in Rwanda, the government initiated a national food supplementation programme. A before and after evaluation, using repeat cross-sectional surveys in randomly selected villages was conducted; aimed at assessing the effectiveness of providing fortified blended food (FBF) to children 18-23 months of age, pregnant and lactating women in the lowest tier of Rwanda's social support system. Data were collected in 2017, 2018 and 2021 through interviews with caregivers; anthropometric measurements and a capillary blood sample were obtained from children. The primary statistical analysis compared the nutritional status of children before and after the introduction of FBF. We enroled 724 children during each survey. The prevalence of stunting declined from 47% to 35% between 2017 and 2021; in 2018, the prevalence of stunting was 43%. Children had a 42% reduction in the odds of being stunted (adjusted odds ratio [AOR]: 0.58, 95% confidence interval [CI]: 0.47-0.74, p < 0.001) from 2017 to 2021 even after adjusting for inherent, distal, proximal, and intermediate covariates. The reduction in stunting observed within the first year of the programme was not statistically significant (AOR: 0.83, 95% CI: 0.67-1.03, p < 0.091). We observed meaningful reductions in the prevalence of stunting among children which coincided with the introduction of Government-led initiative to reduce malnutrition. The Rwandan Government has committed to improving the living conditions of vulnerable households and has made strong investments in reducing malnutrition. The impact of these investments can be seen in the overall trend towards improved nutritional status highlighted in this evaluation.

Carboxymethyl hydroxypropyl guar gum physicochemical properties in dilute aqueous media.

We investigate carboxymethyl hydroxypropyl guar gum (CMHPG) solution properties in water and NaCl, KCl, and CaCl2 aqueous solutions. The Huggins, Kraemer, and Rao models were applied by fitting specific and relative viscosity of CMHPG/water and CMHPG/salt/water to determine the intrinsic viscosity [η]. The Rao models yielded better results (R2 = 0.779-0.999) than Huggins and Kraemer equations. [η] decreased up to 84% in salt solution over the range 0.9-100 mM compared to water. Salt effects screened the CMHPG charged side groups chains leading to a compacted structure. In 0.9 mM NaCl(aq), the hydrodynamic coil radius (Rcoil) was 28% smaller and 45% smaller in 100 mM NaCl solution relative to water. Similar decreases were seen in KCl and CaCl2 solutions. KCl and CaCl2 were more effective than NaCl. CMHPG is salt-tolerant and shows comparatively less viscosity change than native guar gum, with modest reduced viscosity increases with CMHPG dilution at all salt concentrations. The electrostatic interactions were effective up to 100 mM salt. The activation energy of viscous flow for CMHPG solutions was computed and compared to measured xanthan gum and several literature values. These data show that the barrier to CMHPG flow is higher than for xanthan gum.

Geographic Representation of Authorship in Ophthalmic Research from Low- and Middle-Income Countries.

PURPOSE: Low- and middle-income countries (LMICs) are underrepresented in ophthalmic research, despite carrying the highest burden of visual impairment. To assess the representation of local authors in global ophthalmic research, this cross-sectional, bibliometric analysis measured the proportion of LMIC-affiliated authorship in LMIC-based ophthalmic research. METHODS: We sampled original, primary research conducted in LMICs and published in 1 of 7 high-impact ophthalmic journals between 2017 and 2021. For each article, we extracted the number and name of country study site(s), country affiliation(s) of first and last author, proportion of LMIC-affiliated authors, funding sources, and study design. RESULTS: Of the 1,333 studies exclusively conducted in LMICs, 89.4% of first authors and 80.6% of last authors were exclusively LMIC-affiliated. Representation of LMIC-affiliated first authors were lower in studies based in low-income countries (25.0%) or in sub-Saharan Africa (26.5%), published in journals with higher impact factors (68.0% in Ophthalmology), funded by high-income countries (HICs) (41.4%), or conducted in both LMICs and HICs (27.1%). The United States, United Kingdom, and Australia had the 3rd, 6th, and 8th largest shares of last authors. There were only 12 single-country studies conducted in low-income countries, namely Ethiopia, the Gambia, Guinea, Liberia, the Niger, and Sierra Leone. Of these countries, only three held first authorship and one held last authorship. CONCLUSIONS: Although LMIC-based ophthalmic research has demonstrated higher local authorship representation compared to other fields, underrepresentation can be exacerbated by country income level, journal "prestige," and degree of HIC involvement. These discrepancies highlight the need for more equitable data ownership in global ophthalmic research.

Glioblastoma simulating an arteriovenous malformation: a case report.

Glioblastoma is the most common primary malignant brain tumor in adults. It is enhanced by the abnormal proliferation of central nervous system cells called astrocytes. Microvascular endothelial proliferation is one of the criteria for a histological diagnosis. Hypervascular glioblastoma simulating an arteriovenous malformation is an involuntary manifestation and constitutes a rare entity. Case presentation: The authors report a case of a 44-year-old patient with no history followed. Symptoms began 6 months ago with the gradual onset of headaches without vomiting or seizures associated with a drop in normal visual acuity without neurological deficit. Cerebral imaging including cerebral angiography concluding with a right parieto-occipital cerebral process probably associated with an arteriovenous malformation. Clinical discussion: The management was surgical by biopsy after a right parieto-occipital bone flap concluding in glioblastoma. The patient needs chemotherapy and radiotherapy sessions with good clinical evolution. Conclusion: The coexistence of an arteriovenous malformation and glioblastoma remains an association whose pathophysiology still remains to be explored.

Salt and Temperature Effects on Xanthan Gum Polysaccharide in Aqueous Solutions.

Xanthan gum (XG) is a carbohydrate polymer with anionic properties that is widely used as a rheology modifier in various applications, including foods and petroleum extraction. The aim was to investigate the effect of Na+, K+, and Ca2+ on the physicochemical properties of XG in an aqueous solution as a function of temperature. Huggins, Kraemer, and Rao models were applied to determine intrinsic viscosity, [η], by fitting the relative viscosity (ηrel) or specific viscosity (ηsp) of XG/water and XG/salt/water solutions. With increasing temperature in water, Rao 1 gave [η] the closest to the Huggins and Kraemer values. In water, [η] was more sensitive to temperature increase (~30% increase in [η], 20-50 °C) compared to salt solutions (~15-25% increase). At a constant temperature, salt counterions screened the XG side-chain-charged groups and decreased [η] by up to 60% over 0.05-100 mM salt. Overall, Ca2+ was much more effective than the monovalent cations in screening charge. As the salt valency and concentration increased, the XG coil radius decreased, making evident the effect of shielding the intramolecular and intermolecular XG anionic charge. The reduction in repulsive forces caused XG structural contraction. Further, higher temperatures led to chain expansion that facilitated increased intermolecular interactions, which worked against the salt effect.

Xanthan gum in aqueous solutions: Fundamentals and applications.

Xanthan gum is a naturally occurring polysaccharide obtained from Xanthomonas campestris. The xanthan gum backbone consists of ß-d-glucose linked like in cellulose. The trisaccharide ß-d-mannose-(1-4)-α-d-glucuronic acid-(1-2)-α-d-mannose is linked to O(3) position of every other glucose residue. Ketal bonds link pyruvic acid residues to approximately half of the terminal mannose residues. The terminal mannose residues also carry acetate groups. Xanthan gum is used as a thickening, stabilizing, or suspending agent in various applications, e.g., food, pharmaceutical, cosmetic, and petroleum extraction. The performance of xanthan gum is based on its macromolecular conformation and association in solution and at interfaces. In water, xanthan gum undergoes conformational transitions from helix to random coil, in response to stimuli such as pH, ionic strength, temperature, and shear. This review presents fundamental information on the behavior of xanthan gum in aqueous media, at conditions and in the presence of additives which are of interest to applications that benefit from viscosity changes such as in oil and gas extraction. Effects on xanthan gum aqueous solutions of pH, electrolytes, changes in temperature, and added natural polysaccharides or synthetic polymers are highlighted. Such information is useful in the formulation of products and the design of processes involving xanthan gum and related polysaccharide polymers.