Seismicity of the central Afar rift and implications for Tendaho dam hazards

Temporary broadband seismic networks deployed from 2007 to 2011 around the Afar triple junction of the East African Rift System provide insights into seismicity patterns of the actively deforming crust around the 1.86 km3 impounded lake system behind the Tendaho dam. The observed seismicity correlates well with the active magmatic centres around central Afar. The area around the dam site is characterized by a network of intersecting NNE- and NW-trending faults. Seismicity clusters observed in the specified time interval indicate that both fault sets are active and are potential sources of seismogenic hazards. The dam neighbourhood is naturally active and it is a challenge to associate the observed seismic activity to either a change in magmato-tectonic conditions or attribute it to the influence of reservoir load. It is evident that the dam region experi- ences high levels of seismic and volcano-tectonic unrest, regardless of the origin of the activity. The spatial overlap of narrow zones of crustal seismicity and upper mantle low velocity zones observed in S-wave tomography models suggests that melt production zones guide the distribution of strain during continental rupture. Given its volcanically and seismically active setting, the Tendaho dam site and the surrounding region require continuous monitoring for the safety of downstream popu- lations and development infrastructures in the Afar National Regional State of Ethiopia

A multidisciplinary study of the final episode of the Manda Hararo dyke sequence, Ethiopia, and implications for trends in volcanism during the rifting cycle

The sequence of dyke intrusions between 2005 and 2010 in the Manda Hararo rift segment, Ethiopia, provided an opportunity to test conceptual models of continental rifting. Based on trends up to dyke 13 in the sequence, it was anticipated that, should magma supply continue, dykes would shorten in length and eruptions would increase in size and decrease in distance from the segment centre as extensional stress was progressively released. In this paper we revisit these predictions by presenting a comprehensive overview of the May 2010 dyke and fissure eruption, the 14th and last in the sequence, from InSAR, seismicity, satellite thermal data, ultra violet SO2 retrievals, and multiple LiDAR surveys. We find the dyke is longer than other eruptive dykes in the sequence, propagating in two directions from the segment centre, but otherwise fairly typical in terms of opening, propagation speed and geodetic and seismic moment. However, though the eruption is located closer to the segment centre, it is much smaller than previous events. We interpret this as indicating that either the Manda Hararo rifting event was magma limited, or that extensional stress varies north and south of the segment centre

Calcium deficiency and causation of rickets in Ethiopian children

Objective: To assess the role of calcium in the development of clinical rickets among Ethiopian children coming to Jimma Specialised Hospital outpatient, department. Design: Case control study. Settings: Jimma Specialised Teaching Hospital and surrounding urban and rural community in the catchment area. Subjects: One hundred and thirty five under five year old children (30 cases of rickets and 104 non-rachitic cases) who came for paediatric service in Jimma hospital. Results: The mean (±SD) level of calcium intake for cases and controls was 664.5 (± 102.7) mg and 645.8(± 144.4) mg, respectively. There was no statistically significance difference between the two groups in the mean level of calcium intake (t=0.659, P>0.05). Generally, in both cases and controls the majority of the study participants were taking calcium below the recommended daily calcium requirement of 800 mg for age group according to Food and Nutrition Board of the National Research Council. When adjusted for different co-variates including age, sex, breast feeding history, history of diarrhoea lasting longer than 14 days and 24 hours calcium intake children and religion, occupation, educational status and residence the mothers/care givers using logistic regression model, frequency of exposure to sunlight ( OR=1.55, 95%CI: 1.2, 2.0), being from rural areas(OR= 5.0, 95% CI: 1.1, 23.3) and age 12-23 months (OR= 4.5, 95%CI: 1.2, 16.5) were significantly associated with rickets(

Cross-Sectional and Longitudinal Associations between Household Food Security and Child Anthropometry at Ages 5 and 8 Years in Ethiopia, India, Peru, and Vietnam

En: Journal of Nutrition, No. 145, pp. 1924-1933. doi:10.3945/jn.115.210229Background: Poor childhood nutritional status has lifetime effects and food insecurity is associated with dietary practices that can impair nutritional status. Objectives: We assessed concurrent and subsequent associations between food insecurity and height-for-age z scores (HAZs) and body mass index–for-age z scores (BMI-Zs); evaluated associations with transitory and chronic food insecurity; and tested whether dietary diversity mediates associations between food insecurity and nutritional status. Methods: We used data from the Young Lives younger cohort composed of children in Ethiopia (n = 1757), India (n =1825), Peru (n = 1844), and Vietnam (n = 1828) recruited in 2002 (round 1) at ;1 y old, with subsequent data collection at 5 y in 2006 (round 2) and 8 y in 2009 (round 3). Results: Children from food-insecure households had significantly lower HAZs in all countries at 5 y (Ethiopia, 20.33; India, 20.53; Peru, 20.31; and Vietnam, 20.68 HAZ; all P < 0.001), although results were attenuated after controlling for potential confounders (Ethiopia, 20.21; India, 20.32; Peru, 20.14; and Vietnam, 20.27 HAZ; P < 0.01). Age 5 y food insecurity predicted the age 8 y HAZ, but did not add predictive power beyond HAZ at age 5 y in Ethiopia, India, or Peru. Age 5 y food insecurity predicted the age 8 y BMI-Z even after controlling for the 5 y BMI-Z, although associations were not significant after the inclusion of additional confounding variables (Ethiopia, P = 0.12; India, P = 0.29; Peru, P = 0.16; and Vietnam, P = 0.51). Chronically food-insecure households had significantly lower HAZs than households that were consistently food-secure, although BMI-Zs did not differ by chronic food-insecurity status. Dietary diversity mediated 18.8–30.5% of the association between food security and anthropometry in Vietnam, but mediated to a lesser degree (8.4–19.3%) in other countries. Conclusions: In 4 countries, food insecurity at 5 y of age was associated with both HAZ and BMI-Z at age 8 y, although the association was attenuated after adjusting for other household factors and anthropometry at age 5 y, and remained significant only for the HAZ in Vietnam

Children with Moderate Acute Malnutrition with No Access to Supplementary Feeding Programmes Experience High Rates of Deterioration and No Improvement: Results from a Prospective Cohort Study in Rural Ethiopia

Background: Children with moderate acute malnutrition (MAM) have an increased risk of mortality, infections and impaired physical and cognitive development compared to well-nourished children. In parts of Ethiopia not considered chronically food insecure there are no supplementary feeding programmes (SFPs) for treating MAM. The short-term outcomes of children who have MAM in such areas are not currently described, and there remains an urgent need for evidence-based policy recommendations. Methods: We defined MAM as mid-upper arm circumference (MUAC) of ≥11.0cm and <12.5cm with no bilateral pitting oedema to include Ethiopian government and World Health Organisation cut-offs. We prospectively surveyed 884 children aged 6–59 months living with MAM in a rural area of Ethiopia not eligible for a supplementary feeding programme. Weekly home visits were made for seven months (28 weeks), covering the end of peak malnutrition through to the post-harvest period (the most food secure window), collecting anthropometric, socio-demographic and food security data. Results: By the end of the study follow up, 32.5% (287/884) remained with MAM, 9.3% (82/884) experienced at least one episode of SAM (MUAC <11cm and/or bilateral pitting oedema), and 0.9% (8/884) died. Only 54.2% of the children recovered with no episode of SAM by the end of the study. Of those who developed SAM half still had MAM at the end of the follow up period. The median (interquartile range) time to recovery was 9 (4–15) weeks. Children with the lowest MUAC at enrolment had a significantly higher risk of remaining with MAM and a lower chance of recovering. Conclusions: Children with MAM during the post-harvest season in an area not eligible for SFP experience an extremely high incidence of SAM and a low recovery rate. Not having a targeted nutrition-specific intervention to address MAM in this context places children with MAM at excessive risk of adverse outcomes. Further preventive and curative approaches should urgently be considered

Comparison of the hemodynamic changes between preeclamptic and normotensive parturients who underwent cesarean section under spinal anesthesia at North Showa zone public hospitals, Oromia region, Ethiopia, 2022: a prospective cohort study

BackgroundSpinal anaesthesia complicates maternal hemodynamic and may expose the parturient to dangerous cardiovascular problems Up to 7 to 89 2 of pregnant women can suffer from spinal anaesthesia related hypotension The aim of this study to compare the hemodynamic changes between preeclamptic and normotensive parturients who underwent caesarean section under spinal anaesthesia at North Showa Zone Public Hospitals Oromia Region from February 15 to May 15 2022 MethodsA prospective cohort study was conducted on a total of 140 parturients 70 in each group who underwent cesarean delivery under spinal anesthesia The study participants were chosen using a consecutive sampling technique Data were collected from patient charts and intraoperative observations and entered into the Epi Data software version 4 6 and exported to the Statistical Package for the Social Sciences version 25 software Hemodynamic change baseline value current value baseline value 100 The independent t test Mann Whitney U test two ways mixed ANOVA chi square and Fisher s exact test was used to analyze the data as appropriate A P 0 05 was statistically significant ResultsThe mean percentage change in SBP DBP and MAP after spinal anaesthesia was a statistically significant difference between the normotensive and preeclamptic groups except MAP at 15 min was comparable between the two groups with p 0 638 The proportion of preeclamptic parturients who develop hypotension was 47 compared to 74 of normotensive parturients and the RR of developing hypotension if participants were preeclamptic was 0 63 with a 95 confidence interval of 0 412 to 0 978 and a p 0 039 The mean change in heart rate during the first 15 min was comparable between the groups ConclusionIn contrast to normotensive parturients undergoing caesarean section under spinal anaesthesia our study found that the hemodynamic change was lower in preeclamptic parturients The proportion of preeclamptic women who develop hypotension was 47 compared t

Is multiple sclerosis a length-dependent central axonopathy? The case for therapeutic lag and the asynchronous progressive MS hypotheses

Trials of anti-inflammatory therapies in non-relapsing progressive multiple sclerosis (MS) have been stubbornly negative except recently for an anti-CD20 therapy in primary progressive MS and a S1P modulator siponimod in secondary progressive MS. We argue that this might be because trials have been too short and have focused on assessing neuronal pathways, with insufficient reserve capacity, as the core component of the primary outcome. Delayed neuroaxonal degeneration primed by prior inflammation is not expected to respond to disease-modifying therapies targeting MS-specific mechanisms. However, anti-inflammatory therapies may modify these damaged pathways, but with a therapeutic lag that may take years to manifest. Based on these observations we propose that clinically apparent neurodegenerative components of progressive MS may occur in a length-dependent manner and asynchronously. If this hypothesis is confirmed it may have major implications for the future design of progressive MS trials

Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017 : a systematic analysis for the Global Burden of Disease Study 2017

Background: The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk outcome pairs, and new data on risk exposure levels and risk outcome associations. Methods: We used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs by decomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risks; and (6) changes due to all other factors, approximated as the risk-deleted death and DALY rates, where the risk-deleted rate is the rate that would be observed had we reduced the exposure levels to the TMREL for all risk factors included in GBD 2017. Findings: In 2017,34.1 million (95% uncertainty interval [UI] 33.3-35.0) deaths and 121 billion (144-1.28) DALYs were attributable to GBD risk factors. Globally, 61.0% (59.6-62.4) of deaths and 48.3% (46.3-50.2) of DALYs were attributed to the GBD 2017 risk factors. When ranked by risk-attributable DALYs, high systolic blood pressure (SBP) was the leading risk factor, accounting for 10.4 million (9.39-11.5) deaths and 218 million (198-237) DALYs, followed by smoking (7.10 million [6.83-7.37] deaths and 182 million [173-193] DALYs), high fasting plasma glucose (6.53 million [5.23-8.23] deaths and 171 million [144-201] DALYs), high body-mass index (BMI; 4.72 million [2.99-6.70] deaths and 148 million [98.6-202] DALYs), and short gestation for birthweight (1.43 million [1.36-1.51] deaths and 139 million [131-147] DALYs). In total, risk-attributable DALYs declined by 4.9% (3.3-6.5) between 2007 and 2017. In the absence of demographic changes (ie, population growth and ageing), changes in risk exposure and risk-deleted DALYs would have led to a 23.5% decline in DALYs during that period. Conversely, in the absence of changes in risk exposure and risk-deleted DALYs, demographic changes would have led to an 18.6% increase in DALYs during that period. The ratios of observed risk exposure levels to exposure levels expected based on SDI (O/E ratios) increased globally for unsafe drinking water and household air pollution between 1990 and 2017. This result suggests that development is occurring more rapidly than are changes in the underlying risk structure in a population. Conversely, nearly universal declines in O/E ratios for smoking and alcohol use indicate that, for a given SDI, exposure to these risks is declining. In 2017, the leading Level 4 risk factor for age-standardised DALY rates was high SBP in four super-regions: central Europe, eastern Europe, and central Asia; north Africa and Middle East; south Asia; and southeast Asia, east Asia, and Oceania. The leading risk factor in the high-income super-region was smoking, in Latin America and Caribbean was high BMI, and in sub-Saharan Africa was unsafe sex. O/E ratios for unsafe sex in sub-Saharan Africa were notably high, and those for alcohol use in north Africa and the Middle East were notably low. Interpretation: By quantifying levels and trends in exposures to risk factors and the resulting disease burden, this assessment offers insight into where past policy and programme efforts might have been successful and highlights current priorities for public health action. Decreases in behavioural, environmental, and occupational risks have largely offset the effects of population growth and ageing, in relation to trends in absolute burden. Conversely, the combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in non-communicable diseases at the global level, which presents both a public health challenge and opportunity. We see considerable spatiotemporal heterogeneity in levels of risk exposure and risk-attributable burden. Although levels of development underlie some of this heterogeneity, O/E ratios show risks for which countries are overperforming or underperforming relative to their level of development. As such, these ratios provide a benchmarking tool to help to focus local decision making. Our findings reinforce the importance of both risk exposure monitoring and epidemiological research to assess causal connections between risks and health outcomes, and they highlight the usefulness of the GBD study in synthesising data to draw comprehensive and robust conclusions that help to inform good policy and strategic health planning

A framework for human microbiome research

A variety of microbial communities and their genes (the microbiome) exist throughout the human body, with fundamental roles in human health and disease. The National Institutes of Health (NIH)-funded Human Microbiome Project Consortium has established a population-scale framework to develop metagenomic protocols, resulting in a broad range of quality-controlled resources and data including standardized methods for creating, processing and interpreting distinct types of high-throughput metagenomic data available to the scientific community. Here we present resources from a population of 242 healthy adults sampled at 15 or 18 body sites up to three times, which have generated 5,177 microbial taxonomic profiles from 16S ribosomal RNA genes and over 3.5 terabases of metagenomic sequence so far. In parallel, approximately 800 reference strains isolated from the human body have been sequenced. Collectively, these data represent the largest resource describing the abundance and variety of the human microbiome, while providing a framework for current and future studies