BACKGROUND Acute respiratory infections(ARI)and diarrhoea are among the leading causes of infant and under-five mortality worldwide.Zinc,the second most abundant trace element in the human body,is widely used in the t...BACKGROUND Acute respiratory infections(ARI)and diarrhoea are among the leading causes of infant and under-five mortality worldwide.Zinc,the second most abundant trace element in the human body,is widely used in the treatment of both conditions.It mitigates diarrhoea by restoring mucosal integrity and enhancing enterocyte brush border enzyme activity.In ARI,zinc boosts immune function,promotes epithelial regeneration,and inhibits the replication of respiratory viruses.AIM To assess the effectiveness of prophylactic intermittent zinc supplementation in preventing acute diarrhoea and ARI in infants.METHODS This open-label,randomized controlled trial with a 1:1 allocation ratio was conducted over 15 months(October 2022 to December 2023)at a tertiary care hospital in Eastern India.A total of 320 infants attending the outpatient department for routine vaccinations were enrolled and randomly assigned to intervention and control groups.The intervention group received zinc drops for two weeks,with the regimen repeated one month later and again at six months during subsequent vaccination visits.The control group received no placebo or alternative treatment.Outcomes were assessed after the final follow-up at nine months.RESULTS The mean annual incidence of ARI and diarrhoea was significantly lower in the zinc group than in the control group[ARI:0.25±0.61 vs 0.92±1.22;mean difference=-0.67(95%CI:-0.88 to-0.45),P<0.001,Cohen’s d=-0.69]and[diarrhoea:1.04±1.30 vs 2.07±2.09;mean difference=-1.03(95%CI:-1.42 to-0.65),P<0.001,Cohen's d=-0.59],respectively.Additionally,the zinc group showed significantly greater gains in length[10±0.6 cm vs 8.6±0.4 cm;mean difference=1.4(95%CI:1.3-1.5),P<0.001,Cohen’s d=2.74]and weight[3150±108 g vs 2818±76 g;mean difference=332(95%CI:310-352),P<0.001,Cohen's d=3.56].CONCLUSION Prophylactic intermittent zinc supplementation administered alongside routine immunization substantially reduces the incidence of ARI and diarrhoea in infants and promotes improved growth.This affordable strategy holds promise for reducing infant morbidity and mortality without increasing healthcare burdens.展开更多
Restoration of forests poses a major challenge globally, particularly in the tropics, as the forests in these regions are more vulnerable to land-use change. We studied land-use change from natural forest(NF) to degra...Restoration of forests poses a major challenge globally, particularly in the tropics, as the forests in these regions are more vulnerable to land-use change. We studied land-use change from natural forest(NF) to degraded forest(DF), and subsequently to either Jatropha curcas plantation(JP) or agroecosystem(AG), in the dry tropics of Uttar Pradesh, India, with respect to its impacts on soil microbial community composition as indicated by phospholipid fatty acid(PLFA) biomarkers and soil organic carbon(SOC) content. The trend of bacterial PLFAs across all land-use types was in the order: NF > JP > DF> AG. In NF, there was dominance of gram-negative bacterial(G^-) PLFAs over the corresponding gram-positive bacterial(G^+) PLFAs. The levels of G^- PLFAs in AG and JP differed significantly from those in DF, whereas those of G^+ PLFAs were relatively similar in these three land-use types. Fungal PLFAs,however, followed a different trend: NF > JP > DF = AG. Total PLFAs, fungal/bacterial(F/B) PLFA ratio, and SOC content followed trends similar to that of bacterial PLFAs. Across all land-use types, there were strong positive relationships between SOC content and G-, bacterial, fungal, and total microbial PLFAs and F/B PLFA ratio. Compared with bacterial PLFAs, fungal PLFAs appeared to be more responsive to land-use change. The F/B PLFA ratio, fungal PLFAs, and bacterial PLFAs explained 91%, 94%,and 73% of the variability in SOC content, respectively. The higher F/B PLFA ratio in JP favored more soil C storage, leading to faster ecosystem recovery compared to either AG or DF. The F/B PLFA ratio could be used as an early indicator of ecosystem recovery in response to disturbance, particularly in relation to land-use change.展开更多
文摘BACKGROUND Acute respiratory infections(ARI)and diarrhoea are among the leading causes of infant and under-five mortality worldwide.Zinc,the second most abundant trace element in the human body,is widely used in the treatment of both conditions.It mitigates diarrhoea by restoring mucosal integrity and enhancing enterocyte brush border enzyme activity.In ARI,zinc boosts immune function,promotes epithelial regeneration,and inhibits the replication of respiratory viruses.AIM To assess the effectiveness of prophylactic intermittent zinc supplementation in preventing acute diarrhoea and ARI in infants.METHODS This open-label,randomized controlled trial with a 1:1 allocation ratio was conducted over 15 months(October 2022 to December 2023)at a tertiary care hospital in Eastern India.A total of 320 infants attending the outpatient department for routine vaccinations were enrolled and randomly assigned to intervention and control groups.The intervention group received zinc drops for two weeks,with the regimen repeated one month later and again at six months during subsequent vaccination visits.The control group received no placebo or alternative treatment.Outcomes were assessed after the final follow-up at nine months.RESULTS The mean annual incidence of ARI and diarrhoea was significantly lower in the zinc group than in the control group[ARI:0.25±0.61 vs 0.92±1.22;mean difference=-0.67(95%CI:-0.88 to-0.45),P<0.001,Cohen’s d=-0.69]and[diarrhoea:1.04±1.30 vs 2.07±2.09;mean difference=-1.03(95%CI:-1.42 to-0.65),P<0.001,Cohen's d=-0.59],respectively.Additionally,the zinc group showed significantly greater gains in length[10±0.6 cm vs 8.6±0.4 cm;mean difference=1.4(95%CI:1.3-1.5),P<0.001,Cohen’s d=2.74]and weight[3150±108 g vs 2818±76 g;mean difference=332(95%CI:310-352),P<0.001,Cohen's d=3.56].CONCLUSION Prophylactic intermittent zinc supplementation administered alongside routine immunization substantially reduces the incidence of ARI and diarrhoea in infants and promotes improved growth.This affordable strategy holds promise for reducing infant morbidity and mortality without increasing healthcare burdens.
基金The University Grants Commission, New Delhi, India, provided financial support in the form of a University CRET and CAS Fellowship to Mr. Chandra Mohan Kumar (No.Bot/2012-2013/CAS-JRF/262)
文摘Restoration of forests poses a major challenge globally, particularly in the tropics, as the forests in these regions are more vulnerable to land-use change. We studied land-use change from natural forest(NF) to degraded forest(DF), and subsequently to either Jatropha curcas plantation(JP) or agroecosystem(AG), in the dry tropics of Uttar Pradesh, India, with respect to its impacts on soil microbial community composition as indicated by phospholipid fatty acid(PLFA) biomarkers and soil organic carbon(SOC) content. The trend of bacterial PLFAs across all land-use types was in the order: NF > JP > DF> AG. In NF, there was dominance of gram-negative bacterial(G^-) PLFAs over the corresponding gram-positive bacterial(G^+) PLFAs. The levels of G^- PLFAs in AG and JP differed significantly from those in DF, whereas those of G^+ PLFAs were relatively similar in these three land-use types. Fungal PLFAs,however, followed a different trend: NF > JP > DF = AG. Total PLFAs, fungal/bacterial(F/B) PLFA ratio, and SOC content followed trends similar to that of bacterial PLFAs. Across all land-use types, there were strong positive relationships between SOC content and G-, bacterial, fungal, and total microbial PLFAs and F/B PLFA ratio. Compared with bacterial PLFAs, fungal PLFAs appeared to be more responsive to land-use change. The F/B PLFA ratio, fungal PLFAs, and bacterial PLFAs explained 91%, 94%,and 73% of the variability in SOC content, respectively. The higher F/B PLFA ratio in JP favored more soil C storage, leading to faster ecosystem recovery compared to either AG or DF. The F/B PLFA ratio could be used as an early indicator of ecosystem recovery in response to disturbance, particularly in relation to land-use change.
