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This article proposes a framework of linked software agents that continuously interact with an underlying knowledge graph to automatically assess the impacts of potential flooding events. It builds on the idea of connected digital twins based on the World Avatar dynamic knowledge graph to create a semantically rich asset of data, knowledge, and computational capabilities accessible to humans, applications, and artificial intelligence. We develop three new ontologies to describe and link environmental measurements and their respective reporting stations, flood events, and their potential impact on population and built infrastructure as well as the built environment of a city itself. These coupled ontologies are deployed to dynamically instantiate near real-time data from multiple fragmented sources into the World Avatar. Sequences of autonomous agents connected via the derived information framework automatically assess consequences of newly instantiated data, such as newly raised flood warnings, and cascade respective updates through the graph to ensure up-to-date insights into the number of people and building stock value at risk. Although we showcase the strength of this technology in the context of flooding, our findings suggest that this system-of-systems approach is a promising solution to build holistic digital twins for various other contexts and use cases to support truly interoperable and smart cities.

Carlos BM Monteiro,1 Geert JP Savelsbergh,2 Ana RP Smorenburg,3 Zodja Graciani,4 Camila Torriani-Pasin,5 Luiz Carlos de Abreu,6 Vitor E Valenti,7 Fernando Kok41School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, Brazil; 2MOVE Research Institute Amsterdam, Faculty of Human Movement Sciences, VU University, Amsterdam, the Netherlands; 3Burke-Cornell Medical Research Institute, White Plains, NY, USA; 4Department of Neurology, University of São Paulo, São Paulo, Brazil; 5Motor Behavior Laboratory, University of São Paulo, São Paulo, Brazil; 6Laboratory of Scientific Writing, Department of Morphology and Physiology, School of Medicine of ABC, Santo Andre, Brazil; 7Department of Speech Language and Hearing Therapy, Faculty of Philosophy and Sciences, UNESP, Marilia, BrazilAbstract: We aimed to evaluate the functional abilities of persons with Rett syndrome (RTT) in stages III and IV. The group consisted of 60 females who had been diagnosed with RTT: 38 in stage III, mean age (years) of 9.14, with a standard deviation of 5.84 (minimum 2.2/maximum 26.4); and 22 in stage IV, mean age of 12.45, with a standard deviation of 6.17 (minimum 5.3/maximum 26.9). The evaluation was made using the Pediatric ­Evaluation of Disability Inventory, which has 197 items in the areas of self-care, mobility, and social function. The results showed that in the area of self-care, stage III and stage IV RTT persons had a level of 24.12 and 18.36 (P=0.002), respectively. In the area of mobility, stage III had 37.22 and stage IV had 14.64 (P

This paper presents a knowledge graph-based approach for the dynamic control of a district heating network with integrated emission dispersion modelling. We propose an interoperable and extensible implementation to forecast the anticipated heat demand of a municipal heating network, minimise associated total generation cost based on a previously devised methodology, and couple it with dispersion simulations for induced airborne pollutants to provide automatic insights into air quality implications of various heat sourcing strategies. We create cross-domain interoperability in the nexus of energy and air quality via newly developed ontologies and semantic software agents, which can be chained together via The World Avatar dynamic knowledge graph to resemble the behaviour of complex systems. Furthermore, we integrate the City Energy Analyst into this ecosystem to provide building-level insights into energy demand and renewable generation potential to foster strategic analyses and scenario planning. Underlying calculations use building and weather data from the knowledge graph in place of inherent assumptions in the official software release, facilitating a more data-driven approach. All use cases are implemented for a mid-size town in Germany as a proof-of-concept, and a unified visualisation interface is provided, allowing for the examination of 3D buildings alongside their corresponding energy demand and supply time series, as well as emission dispersion data. With this work, we outline the potential of Semantic Web technologies to connect digital twins for holistic energy modelling in smart cities, thereby addressing the increasing complexity of interconnected energy systems.

Abstract The ability to integrate resources and share knowledge across organisations empowers scientists to expedite the scientific discovery process. This is especially crucial in addressing emerging global challenges that require global solutions. In this work, we develop an architecture for distributed self-driving laboratories within The World Avatar project, which seeks to create an all-encompassing digital twin based on a dynamic knowledge graph. We employ ontologies to capture data and material flows in design-make-test-analyse cycles, utilising autonomous agents as executable knowledge components to carry out the experimentation workflow. Data provenance is recorded to ensure its findability, accessibility, interoperability, and reusability. We demonstrate the practical application of our framework by linking two robots in Cambridge and Singapore for a collaborative closed-loop optimisation for a pharmaceutically-relevant aldol condensation reaction in real-time. The knowledge graph autonomously evolves toward the scientist’s research goals, with the two robots effectively generating a Pareto front for cost-yield optimisation in three days.

Abstract Background Pneumococcal disease caused by Streptococcus pneumoniae is an important cause of morbidity and mortality across all ages, particularly in younger children and older adults. Here, we describe pneumococcal disease hospitalizations at Ministry of Health (MoH) facilities in Malaysia between 2013 and 2015. Methods This was a retrospective databases analysis. Tabular data from the Malaysian Health Data Warehouse (MyHDW) were used to identify microbiologically confirmed, pneumococcal disease hospitalizations and deaths during hospitalization, using hospital-assigned ICD-10 codes (i.e., classified as meningitis, pneumonia, or non-meningitis non-pneumonia). Case counts, mortality counts, and case fatality rates were reported by patient age group and by Malaysian geographic region. Results A total of 683 pneumococcal disease hospitalizations were identified from the analysis: 53 pneumococcal meningitis hospitalizations (5 deaths and 48 discharges), 413 pneumococcal pneumonia hospitalizations (24 deaths and 389 discharges), and 205 non-meningitis non-pneumonia pneumococcal disease hospitalizations (58 deaths and 147 discharges). Most hospitalizations occurred in children aged

This paper explores the application of The World Avatar (TWA) dynamic knowledge graph to connect isolated data and assess the impact of rising sea levels in Singapore. Current sea level rise vulnerability assessment tools are often regional, narrow in scope (e.g., economic or cultural aspects only), and are inadequate in representing complex non-geospatial data consistently. We apply TWA to conduct a multi-perspective impact assessment of sea level rise in Singapore, evaluating vulnerable buildings, road networks, land plots, cultural sites, and populations. We introduce OntoSeaLevel, an ontology to describe sea level rise scenarios, and its impact on broader elements defined in other ontologies such as buildings (OntoBuiltEnv ontology), road networks (OpenStreetMap ontology), and land plots (Ontoplot and Ontozoning ontology). We deploy computational agents to synthesise data from government, industry, and other publicly accessible sources, enriching buildings with metadata such as property usage, estimated construction cost, number of floors, and gross floor area. An agent is applied to identify and instantiate the impacted sites using OntoSeaLevel. These sites include vulnerable buildings, land plots, cultural sites, and populations at risk. We showcase these sea level rise vulnerable elements in a unified visualisation, demonstrating TWA’s potential as a planning tool against sea level rise through vulnerability assessment, resource allocation, and integrated spatial planning.

Summary: Cancer immunotherapies have demonstrated remarkable success; however, the majority of patients do not respond or develop resistance. Here, we conduct epigenetic gene-targeted CRISPR-Cas9 screens to identify epigenomic factors that limit CD8+ T cell-mediated anti-tumor immunity. We identify that PRMT1 suppresses interferon gamma (Ifnγ)-induced MHC-I expression, thus dampening CD8+ T cell-mediated killing. Indeed, PRMT1 knockout or pharmacological targeting of type I PRMT with the clinical inhibitor GSK3368715 enhances Ifnγ-induced MHC-I expression through elevated STAT1 expression and activation, while re-introduction of PRMT1 in PRMT1-deficient cells reverses this effect. Importantly, loss of PRMT1 enhances the efficacy of anti-PD-1 immunotherapy, and The Cancer Genome Atlas analysis reveals that PRMT1 expression in human melanoma is inversely correlated with expression of human leukocyte antigen molecules, infiltration of CD8+ T cells, and overall survival. Taken together, we identify PRMT1 as a negative regulator of anti-tumor immunity, unveiling clinical type I PRMT inhibitors as immunotherapeutic agents or as adjuncts to existing immunotherapies.

Abstract Background Histoplasmosis is a fungal infection that commonly occurs in the lungs or in disseminated form. Primary laryngeal histoplasmosis is a very rare condition that can mimic laryngeal carcinoma or laryngeal tuberculosis. The purpose of this case report is to highlight the rare occurrence of primary laryngeal histoplasmosis with no involvement of other organs, especially the lungs, the diagnosis dilemma, and the antifungal protocol for this case. Case presentation We report a case of a 47-year-old male, who is a pigeon breeder, presented with chronic hoarseness. There were no signs of pulmonary or systemic involvement. Biopsy from laryngeal mucosa was confirmed as histoplasmosis, and he was started on intravenous (IV) amphotericin B for 2 weeks and oral itraconazole for 2 months. Conclusion Primary laryngeal histoplasmosis is considered a very rare occurrence. The laryngeal lesion may mimic conditions such as laryngeal carcinoma and laryngeal tuberculosis. Histopathology examination remains the gold standard, and antifungal treatment is the choice of therapy.

Abstract Background Optimizing efficiency has become increasingly critical with the growing demand for finite healthcare resources driven by population growth and an ageing society. Hence, policymakers are urgently finding more efficient ways to deliver health services. Thalassemia is a complex inherited blood disorder with significant prevalence in Malaysia. The high number of patients put substantial strain on the healthcare system. This study aims to evaluate the technical efficiency of thalassaemia care centres throughout Malaysia and the determinants that affect the efficiency. Method Data from 30 public hospitals with thalassaemia care centres were collected. A double bootstrap data envelopment analysis (DEA) approach is used with the assumption of input-oriented and variable-to-scale DEA models to generate technical efficiency scores. Bootstrap truncated regression was later conducted to identify the factors affecting the efficiency scores. Results The mean bias-corrected technical efficiency score has improved to 0.75 in 2017 from 0.71 in 2016. In both years, more than 50% of thalassaemia care centres showed good efficiency scores (0.8-1.0). Management factors that affect the efficiency scores include separation of patient management (β = 0.0653) and budget (β = 0.0843), where they are found to positively affect the efficiency scores. In contrast, having longer operating hours is found to inversely influence the performance levels (β = − 0.4023). Conclusions The study provides a pioneering framework to evaluate the technical efficiency of thalassaemia treatment centres in public healthcare settings and could provide a useful guide for policymaker and thalassaemia care centre managers to improve efficiency in service delivery to thalassaemia patients and their caregivers without compromising quality of care.

Abstract Background Policymakers are faced with the challenge of balancing patient’s access for effective and affordable medicines to sustain the rising healthcare costs. In a mixed healthcare market such as Malaysia, coverage decisions of new medicines are different: public funded health system has a formulary listing process whereas for private sector, which is a market-based economy, depends on patient’s willingness to pay and insurance coverage. There is little overlap between public and private healthcare service delivery with access to new innovative medicines, as differentiated by sources of funding. The objectives of this study were to examine the diffusion of New Chemical Entities (NCEs) into the public and private healthcare market between 2010 and 2014, and determine the factors explaining the diffusion. Methods We matched medicines from the product registration database by medicine formulation to medicines in IQVIA National Pharmaceutical Audit database for each year. The price per Defined Daily Dose (DDD), market concentration and generic utilization share variables were calculated. A panel fixed effect model was performed to measure diffusion of NCEs for each year and test possible determinants of diffusion of NCEs for overall market and sector specifics. Results The utilization of NCEs was larger in the private sector compared to the public sector but the speed of diffusion over time was higher in the public sector. Price per DDD was negatively associated with diffusion of NCEs, while generic utilization share was significantly regressive in the public sector. Market concentration was negatively associated with utilization of NCEs, however result tends to be mixed according to sector and Anatomical Therapeutic Chemical (ATC) category. Conclusions Understanding key aspects of sectoral variation in diffusion of NCEs are crucial to reduce the differences of access to new medicines within a country and ensure resources are used on cost effective treatments.

A growing number of studies have shown that γδ T cells play a pivotal role in mediating the clearance of tumors and pathogen-infected cells with their potent cytotoxic, cytolytic, and unique immune-modulating functions. Unlike the more abundant αβ T cells, γδ T cells can recognize a broad range of tumors and infected cells without the requirement of antigen presentation via major histocompatibility complex (MHC) molecules. Our group has recently demonstrated parts of the mechanisms of T-cell receptor (TCR)-dependent activation of Vγ9Vδ2+ T cells by tumors following the presentation of phosphoantigens, intermediates of the mevalonate pathway. This process is mediated through the B7 immunoglobulin family-like butyrophilin 2A1 (BTN2A1) and BTN3A1 complexes. Such recognition results in activation, a robust immunosurveillance process, and elicits rapid γδ T-cell immune responses. These include targeted cell killing, and the ability to produce copious quantities of cytokines and chemokines to exert immune-modulating properties and to interact with other immune cells. This immune cell network includes αβ T cells, B cells, dendritic cells, macrophages, monocytes, natural killer cells, and neutrophils, hence heavily influencing the outcome of immune responses. This key role in orchestrating immune cells and their natural tropism for tumor microenvironment makes γδ T cells an attractive target for cancer immunotherapy. Here, we review the current understanding of these important interactions and highlight the implications of the crosstalk between γδ T cells and other immune cells in the context of anti-tumor immunity.

Abstract Background The main objective of this study is to assess the performance of the global health system, emphasising the contribution of people’s happiness to health system efficiency across countries. Technical efficiency (TE) scores are estimated using the output-oriented variable returns to scale (VRS) data envelopment analysis (DEA) model based on the input measures: health expenditure, labour, hospital beds and education, and the output measures: healthy life expectancy and inverse mortality index. The efficiency scores are regressed against three explanatory variables: happiness index, population density, and healthcare share of gross domestic product (GDP). The analysis involved 121 selected countries using double bootstrap DEA as proposed by Simar, L., Wilson, P.W J Econ 136:1‑34, 2007. Results The bootstrap truncated regression indicates that happiness is one of the factors that contributes significantly to health system efficiency. The study also revealed that the selected health systems perform well, on average, in terms of population density and healthcare share of GDP. Conclusions In addition to improving the economic standard of living, policy-makers should also consider ways to increase the happiness and well-being of society. Policies focusing on well-being and happiness can lead to improved well-being and improved health outcomes, which may ultimately reduce the healthcare burden and enhance healthcare performance.

Human leukocyte antigen (HLA) presents peptides to activate T cells, but many aspects in the T cell receptor (TCR)/HLA interaction remain unclear. Here the authors show, via structural data, that two TCRs differentially recognize the same tumour peptide/HLA complex and induce contrasting conformation changes of the peptide.

Aqueous phase liquid (APLs) leakage and spillage into the subsurface system, leading to groundwater contamination is an issue that needs to be addressed. This paper aims to investigate the APLs migration characteristics in fractured non-isothermal double-porosity soil. A laboratory experiment was conducted to observe and monitor the characteristics of the soil structure and APLs migration in heated deformable double-porosity soil using digital image processing technique. The results show rapid liquid migration for the fractured soil samples. The time taken for the liquid to migrate under the application of heat is less for sample with low moisture content due to faster dry off and rapid evaporation. It can be concluded that APLs migration under vibration and non-isothermal effect is highly influenced by the soil sample structure, the soil fractured pattern, the soil water content, and the applied heat in the soil.

The use of hydraulic barriers in sanitary landfills has become an impeccable means of protecting the groundwater system from leachate. A question to be asked is, can these barriers continue to impede the migration of leachate over a long period? This paper investigates the phenomenon of leachate migration in compacted laterite soil used as liner in sanitary landfills. An experiment was carried out using laterite soil compacted at optimum moisture content using Standard Proctor energy. Leachate was poured on the compacted soil in an acrylic column and its migration was monitored using Digital Image Technique (DIT). The DIT capture photographic images at successive intervals of time which were fed through an image processing code to convert them to hue-saturation-intensity (HSI) format with the help of Surfer and Matlab computer softwares. Subsequently, PetraSim computer software was applied to predict the velocity behavior. The predicted velocity value shows that the laterite soil is compatible with the leachate and can be used as soil liner. The outcome of this study would enable designers to use non-destructive method to monitor and predict leachate migration in compacted soil liners to simulates leachate migration in waste containment applications.

Abstract Samples were taken from 100 camel sausages from the different retail markets in Aydin province in the south-west of Turkey and they were tested for the presence of Listeria spp by biochemical methods. Samples were enriched using Listeria Enrichment Broth and they were inoculated onto Listeria Selective Agar. Listeria monocytogenes was isolated from nine samples (9%), Listeria innocua from 14 samples (14%) and Listeria welshimeri from two samples(2%). A 701 bp fragment of listeriolysin O sequence for L. monocytogenes was amplified using specific primers by polymerase chain reaction (PCR) for confirmation of the identification. A random primer (OPA-11) was used in a random amplified polymorphic DNA (RAPD) assay. This detected five different band profiles amongst the L. monocytogenes isolates, indicating a relatively large amount of genetic heterogeneity amongst the nine isolates. The study has highlighted the need for improved strategies for food safety, in particular appropriate hygienic precautions to avoid contamination of sausage during the manufacturing process and appropriate preservation techniques during storage and transport, to prevent transmission of Listeria spp to consumers at home and abroad.

Abstract The etiology of mental retardation/developmental delay (MRDD) remains a challenge to geneticists and clinicians and can be correlated to environmental and genetic factors. Chromosomal aberrations are common causes of moderate to severe mental retardation and may represent 10% of these occurrences. Here we report the case of a boy with development delay, hypoplasia of corpus callosum, microcephaly, muscular hypotonia, and facial dysmorphisms. A deletion of 7q36.1 → 36.3 and duplication of 9p22.3 → 23 was detected as a result of an unbalanced translocation of paternal origin. Breakpoint delimitation was achieved with array comparative genomic hybridization assay. Additional multiplex ligation dependent probe amplification (MLPA) analyzes confirmed one copy loss of 7q36.3 region and one copy gain of 9p24.3 region. Patient resultant phenotype is consistent with the already described findings for both 7q deletion and 9p duplication syndromes.

Abstract Background This study aimed to investigate the relationship of anemia and body mass index among adult women in Jiangsu Province, China. Data were collected in a sub-national cross-sectional survey, and 1,537 women aged 20 years and above were included in the analyses. Subjects were classified by body mass index (BMI) categories as underweight, normal weight, overweight and obese according to the Chinese standard. Central obesity was defined as a waist circumference ≥ 80 cm. Anemia was defined as hemoglobin concentration Findings Overall, 31.1% of the Chinese women were anemic. The prevalence of overweight, obesity and central obesity was 34.2%, 5.8% and 36.2%, respectively. The obese group had the highest concentrations of hemoglobin compared with other BMI groups. After adjustment for confounders, overweight and obese women had a lower PR for anemia (PR: 0.72, 95% CI: 0.62-0.89; PR: 0.59, 95% CI: 0.43-0.79). Central obesity was inversely associated with anemia. Conclusion In this Chinese population, women with overweight/obesity or central obesity were less likely to be anemic as compared to normal weight women. No measures are required currently to target anemia specifically for overweight and obese people in China.

Abstract Background In developing countries, overweight prevalence is increasing while underweight prevalence is still high. This situation is known as the double nutrition burden. Both underweight and overweight are related to increased risk of chronic non-communicable diseases, reduced well-being and quality of life. This study aims to compare the prevalence of overweight and underweight among Vietnamese adults in 2000 and 2005. Methods The study was based on two nationally representative surveys, the National Nutrition Survey 2000 (14,452 subjects) and the National Adult Obesity Survey 2005 (17,213 subjects). Adults aged 25-64 years were sampled to be nationally representative. Multiple multinomial logistic regression analysis was used to investigate the association of underweight and overweight with socio-economic indicators. Results The distribution of BMI across the population and population groups indicated a shift towards higher BMI levels in 2005 as compared to 2000. The nationwide prevalence of overweight (BMI ≥ 25 kg/m2) and obesity (BMI ≥ 30 kg/m2) was 6.6% and 0.4% respectively in 2005, almost twice the rates of 2000 (3.5% and 0.2%). Using the Asian BMI cut-off of 23 kg/m2 the overweight prevalence was 16.3% in 2005 and 11.7% in 2000. In contrast, the underweight prevalence (BMI < 18.5 kg/m2) of 20.9% in 2005 was lower than the rate of 25.0% in 2000. Women were more likely to be both underweight and overweight as compared to men in both 2000 and 2005. Urban residents were more likely to be overweight and less likely to be underweight as compared to rural residents in both years. The shifts from underweight to overweight were clearer among the higher food expenditure levels. Conclusions The double nutrition burden was clearly present in Vietnam. The distribution of BMI across the population groups generally indicated a shift towards higher BMI levels in 2005 as compared to 2000. The prevalence of overweight was increased while the declined level of undernutrition was still high in 2005. The shifts of underweight to overweight were most obvious among population groups with higher food expenditure levels.

Abstract Background The increased prevalence of overweight and obesity warrants preventive actions, particularly among people in transitional stages associated with lifestyle changes, such as occupational retirement. The purpose is to investigate the effect of a one year low-intensity computer-tailored energy balance programme among recent retirees on waist circumference, body weight and body composition, blood pressure, physical activity and dietary intake. Methods A randomised controlled trial was conducted among recent retirees (N = 413; mean age 59.5 years). Outcome measures were assessed using anthropometry, bio-impedance, blood pressure measurement and questionnaires. Results Waist circumference, body weight and blood pressure decreased significantly in men of the intervention and control group, but no significant between-group-differences were observed at 12 or at 24-months follow-up. A significant effect of the programme was only observed on waist circumference (-1.56 cm (95%CI: -2.91 to -0.21)) at 12 month follow up among men with low education (n = 85). Physical activity and dietary behaviours improved in both the intervention and control group during the intervention period. Although, these behaviours changed more favourably in the intervention group, these between-group-differences were not statistically significant. Conclusions The multifaceted computer-tailored programme for recent retirees did not appear to be effective. Apparently the transition to occupational retirement and/or participation in the study had a greater impact than the intervention programme. Trial registration Clinical Trials NCT00122213.

Abstract Background Most children do not meet the recommended guidelines for fruit and vegetable intake. Since preference is an important predictor of intake, more knowledge is needed about children's preferences and about how these preferences develop. As most research about preferences has ignored cognitive development, this study was designed to explore the relation between children's perceptions and preferences for fruit and vegetables and their cognitive development. Methods The study population consisted of eight 4–5-year-old children, eight 7–8-year-old children and twelve 11–12-year-old children, recruited via a primary school in Wageningen, The Netherlands. Qualitative in-depth information was obtained by duo-interviews and focus group discussions. A structured guide with questions and game tasks was applied to address different domains in a consistent way. Results The developmental progress at the abstraction level was seen in children's reasoning across all domains. Children's preferences expanded and increased in complexity as they moved to a higher age bracket. The most important determinants for liking and disliking shifted from appearance and texture attributes in 4–5-year-olds towards taste attributes in 11–12-year-olds. Children's knowledge of basic tastes increased. Their understanding of health improved as they grew older. The emergence of social norms and perspectives of others as the children grew older was also seen in relation to fruit and vegetables. Child-reported parental strategies to stimulate healthy eating appeared to vary with age in line with cognitive development. Conclusion Cognitive development is paralleled by changes in the importance given to the attributes that determine whether a child likes or dislikes fruits and vegetables; children's understanding of and reasoning about health; and parental use of strategies. These developmental differences should be incorporated in programs designed to increase long-term fruit and vegetable intake in children.

Abstract Background People in transitional life stages, such as occupational retirement, are likely to gain weight and accumulate abdominal fat mass caused by changes in physical activity and diet. Hence, retirees are an important target group for weight gain prevention programmes, as described in the present paper. Methods/Design A systematic and stepwise approach (Intervention Mapping) is used to develop a low-intensity energy balance intervention programme for recent retirees. This one-year, low-intensity multifaceted programme aims to prevent accumulation of abdominal fat mass and general weight gain by increasing awareness of energy balance and influencing related behaviours of participants' preference. These behaviours are physical activity, fibre intake, portion size and fat consumption. The effectiveness of the intervention programme is tested in a cluster randomised controlled trial. Measurements of anthropometry, physical activity, energy intake, and related psychosocial determinants are performed at baseline and repeated at 6 months for intermediate effect, at 12 months to evaluate short-term intervention effects and at 24 months to test the sustainability of the effects. Discussion This intervention programme is unique in its focus on retirees and energy balance. It aims at increasing awareness and takes into account personal preferences of the users by offering several options for behaviour change. Moreover, the intervention programme is evaluated at short-term and long-term and includes consecutive outcome measures (determinants, behaviour and body composition).

Abstract The effect of iron fortification is generally assumed to be less than iron supplementation; however, the magnitude of difference in effects is not known. The present study aims to compare the efficacy of these two strategies on anaemia and iron status. After screening on low Hb, 425 anaemic children in six primary schools in Tam Nong district of Phu Tho province were included in a randomized, placebo-controlled trial comparing two groups receiving iron fortified instant noodles or iron supplementation for 6 months and a control group, with children in all groups having been dewormed. Blood samples were collected before and after intervention for haemoglobin, serum ferritin (SF), serum transferrin receptor (TfR), C-reactive protein (CRP), and haemoglobinopathies analysis. Regression analysis was used to assess the effect of iron fortification and iron supplementation on haemoglobin concentration, SF, TfR, body iron, and anaemic status as outcome variables. The improvement of haemoglobin, SF, and body iron level in the group receiving iron fortification was 42% (2.6 g/L versus 6.2 g/L), 20% (23.5 μg/L versus 117.3 μg/L), and 31.3% (1.4 mg/kg versus 4.4 mg/kg) of that in the iron supplementation group. The prevalence of anaemia dropped to 15.1% in the control group, with an additional reduction of anaemia of 8.5% in the iron supplementation group. The additional reduction due to iron fortification was 5.4%, which amounts to well over 50% of the impact of supplementation. In conclusion, the efficacy of iron fortification based on reduction of prevalence of anaemia, and on the change in haemoglobin level, is about half of the maximum impact of supplementation in case of optimal compliance. Thus, in a population of anaemic children with mild iron deficiency, iron fortification should be the preferred strategy to combat anaemia.