The use of a mobile obstetric emergency system to improve obstetric referrals in Bong County, Liberia: A pre-post study.

Objective: Liberia experiences an unmet need for cesarean section with about 5% population coverage, lower than 9%-19% coverage associated with improved maternal and newborn outcomes. Delays in the referral process for comprehensive emergency obstetric and newborn care (CEmONC) services due to ineffective communication between a rural health facility (RHF) and a district hospital contribute to the low CS rate. This study examined the association between mobile obstetric emergency system (MORES) implementation and referral time for obstetric emergencies as well as maternal/newborn outcomes.

Monomer Choice Influences -Acryloyl Amino Acid Grafter Conversion via Protease Catalysis.

End-capped peptides modified with reactive functional groups on the N-terminus provide a route to prepare peptide-polymer conjugates for a broad range of applications. Unfortunately, current chemical methods to construct modified peptides rely largely on solid-phase peptide synthesis (SPPS), which lacks green preparative characteristics and is costly, thus limiting its applicability to specialty applications such as regenerative medicine. This work evaluates N-terminally modified -acryloyl-glutamic acid diethyl ester, -acryloyl-leucine ethyl ester, and -acryloyl-alanine ethyl ester as grafters and papain as the protease for the direct addition of amino acid ethyl ester (AA-OEt) monomers via protease-catalyzed peptide synthesis (PCPS) and the corresponding formation of -acryloyl-functionalized oligopeptides in a one-pot aqueous reaction.

A spectral three-dimensional color space model of tree crown health.

Protecting the future of forests in the United States and other countries depends in part on our ability to monitor and map forest health conditions in a timely fashion to facilitate management of emerging threats and disturbances over a multitude of spatial scales. Remote sensing data and technologies have contributed to our ability to meet these needs, but existing methods relying on supervised classification are often limited to specific areas by the availability of imagery or training data, as well as model transferability. Scaling up and operationalizing these methods for general broadscale monitoring and mapping may be promoted by using simple models that are easily trained and projected across space and time with widely available imagery.

Evaluation of independent self-collected blood specimens for COVID-19 antibody detection among the US veteran population.

Feasibility of home blood sample collection methods for the presence of SARS-CoV-2 antibodies from VA Million Veteran Program (MVP) participants was tested to determine COVID-19 infection or vaccination status. Participants (n = 312) were randomly assigned to self-collect blood specimens using the Neoteryx Mitra Clamshell (n = 136) or Tasso-SST (n = 176) and asked to rate their experience. Mitra tip blood was eluted and Tasso tubes were centrifuged.

Emergent Approaches to Efficient and Sustainable Polyhydroxyalkanoate Production.

Petroleum-derived plastics dominate currently used plastic materials. These plastics are derived from finite fossil carbon sources and were not designed for recycling or biodegradation. With the ever-increasing quantities of plastic wastes entering landfills and polluting our environment, there is an urgent need for fundamental change.

Rapid Synthesis of Silk-Like Polymers Facilitated by Microwave Irradiation and Click Chemistry.

Silk is a natural fiber that surpasses most man-made polymers in its combination of strength and toughness. Silk fibroin, the primary protein component of silk, can be synthetically mimicked by a linear copolymer with alternating rigid and soft segments. Strategies for chemical synthesis of such silk-like polymers have persistently resulted in poor sequence control, long reaction times, and low molecular weights.

Combined ACL-PCL-Medial and Lateral Side Injuries (Global Laxity).

The multiple ligament injured knee is a complex problem in orthopedic surgery. These injuries may or may not present as acute knee dislocations, and careful assessment of the extremity vascular and neurological status is essential because of the possibility of arterial and/or venous compromise, and nerve injury. These complex injuries require a systematic approach to evaluation and treatment.

Horizontal HIV transmission to children of HIV-uninfected mothers: A case series and review of the global literature.

Background: Vertical transmission is the predominant route for acquisition of HIV infection in children, either in utero, intrapartum or postnatally through breast feeding. Less frequently, children may acquire HIV by horizontal transmission. Horizontal transmission may be healthcare-associated (infusion of HIV-contaminated blood products, use of contaminated needles, syringes and medical equipment, or through ingestion of HIV in expressed breastmilk).

Effect of mixed maize-legume silages on milk quality and quantity from lactating smallholder dairy cows.

The study investigated the effect of the following maize:legume (70:30) mixed crop silages: maize:cowpea, maize:velvet bean, and maize:lablab on milk production during the 2016 dry season. Using a 5 × 5 double Latin square design, five Holstein-Friesian crossbred cows in early lactation (30 ± 15 days) and five Jersey crossbred cows in early lactation (25 ± 10 days) were given the supplementary mixed crop silage diets at 0.5 kg/l of milk produced over 105 days.

Service evaluation of a digital behavioural change programme.

The purpose of this service evaluation was to analyse the -efficacy of OurPath, a UK-based digital behavioural change programme, based on real-world data gathered in a commercial setting. In total, 98 potential participants with a mean body mass index of 31 kg/m (obese) paid money to enrol on OurPath, a digital behavioural change programme that combines a private online social network, daily structured educational content, health coaching, wireless scales and an activity tracker. Participants underwent a core 6-week intensive lifestyle change intervention and moved onto OurPath's Sustain programme, with follow-ups after 3 and 6 months.

Next generation sequencing improves detection of drug resistance mutations in infants after PMTCT failure.

Background: Next generation sequencing (NGS) allows the detection of minor variant HIV drug resistance mutations (DRMs). However data from new NGS platforms after Prevention-of-Mother-to-Child-Transmission (PMTCT) regimen failure are limited.

Objective: To compare major and minor variant HIV DRMs with Illumina MiSeq and Life Technologies Ion Personal Genome Machine (PGM) in infants infected despite a PMTCT regimen.

Combined anterior cruciate ligament and posterolateral reconstruction of the knee using allograft tissue in chronic knee injuries.

Combined anterior cruciate ligament (ACL) and posterolateral injury of the knee can result in significant functional instability for the affected individual. Both components of the instability must be treated to maximize the probability of success for the surgical procedure. Higher failure rates of the ACL reconstruction have been reported when the posterolateral instability has been left untreated.

Long-term followup of surgically treated knee dislocations: stability restored, but arthritis is common.

Background: Surgical treatment of knee dislocations is intended to correct the anatomic injury and restore knee stability and patient function. Several studies have shown successful results with surgical treatment of knee dislocations with up to 10 years of followup, but longer-term studies are uncommon.

Questions/purposes: We evaluated patients treated surgically for knee dislocations at 10-year followup to assess (1) knee stability; (2) return to preinjury level of function; (3) development of arthrosis; and (4) range of motion (ROM) loss.

Are lopinavir and efavirenz serum concentrations in HIV-infected children in the therapeutic range in clinical practice?

Background: In antiretroviral treatment the role of therapeutic drug monitoring via measurement of serum levels remains unclear, especially in children.

Aim: To quantify exposure to LPV and EFV in children receiving therapy in a routine clinical setting in order to identify risk factors associated with inadequate drug exposure.

Method: A prospective study was conducted in a routine clinical setting in Tygerberg Children's Hospital, South Africa.

Biceps skin-fold thickness may detect and predict early lipoatrophy in HIV-infected children.

Background: The prevalence of potentially stigmatizing lipoatrophy in children receiving antiretroviral therapy in Southern Africa is high, affecting around a third of children. Early diagnosis of lipoatrophy is essential for effective intervention to arrest progression.

Methods: Prepubertal children receiving antiretroviral therapy were recruited from a hospital-based family HIV clinic in Cape Town and followed up prospectively.

High prevalence of lipoatrophy in pre-pubertal South African children on antiretroviral therapy: a cross-sectional study.

Background: Despite changes in WHO guidelines, stavudine is still used extensively for treatment of pediatric HIV in the developing world. Lipoatrophy in sub-Saharan African children can be stigmatizing and have far-reaching consequences. The severity and extent of lipoatrophy in pre-pubertal children living in sub-Saharan Africa is unknown.

Surgical treatment of combined PCL-ACL medial and lateral side injuries (global laxity): surgical technique and 2- to 18-year results.

The multiple ligament injured knee is a severe injury that may also involve neurovascular injuries, fractures, and other systemic injuries. Surgical treatment offers good functional results documented in the literature by physical examination, arthrometer testing, stress radiography, and knee ligament rating scales. Mechanical tensioning devices are helpful with cruciate ligament tensioning.

Single compared to double-bundle PCL reconstruction using allograft tissue.

This study compares the results of arthroscopic transtibial tunnel single-bundle and double-bundle posterior cruciate ligament (PCL) reconstructions using allograft tissue in PCL-based multiple ligament injured knees. Ninety consecutive PCL reconstructions are evaluated: 45 single-bundle and 45 double-bundle reconstructions. All PCL reconstructions were performed using the arthroscopically assisted transtibial tunnel PCL reconstruction technique using fresh frozen allograft tissue from the same tissue bank.

Rehabilitation after multiple-ligament reconstruction of the knee.

Diagnosis and management of multiple-ligament knee injuries has evolved over the years, and now treatment often includes surgical intervention. Rehabilitation after multiple-knee ligament reconstruction requires a precarious balance between restoring range of motion and function to the knee without compromising the static stability and integrity of the grafted tissues. It is imperative that the patient is aware of the time commitment, restrictions, and the fact that the entire rehabilitation process will likely take a full year before returning to unrestricted activity.

Combined PCL-ACL lateral and medial side injuries: treatment and results.

The multiple ligament-injured knee is a complex problem in orthopedic surgery. These injuries may or may not present as acute knee dislocations, and careful assessment of the extremity vascular and neurologic status is essential because of the possibility of arterial and/or venous compromise, and nerve injury. These complex injuries require a systematic approach to evaluation and treatment.

Arthroscopic double-bundle posterior cruciate ligament reconstruction surgical technique.

The keys to successful posterior cruciate ligament (PCL) reconstruction are to identify and treat all pathology, use strong graft material, accurately place tunnels in anatomic insertion sites, minimize graft bending, use a mechanical graft tensioning device, use primary and back-up graft fixation, and use the appropriate postoperative rehabilitation program. Adherence to these technical principles results in successful single-bundle and double-bundle arthroscopic transtibial tunnel PCL reconstruction based on stress radiography, arthrometer, knee ligament rating scales, and patient satisfaction measurements.

Current concepts review: the posterior cruciate ligament.

Injuries to the posterior cruciate ligament (PCL) and methods of treatment of the injured PCL have historically been surrounded by controversy in the orthopedic community. The infrequent occurrence of PCL injuries and PCL-based, multiple ligament knee injuries has led to limitations in clinical studies and a subsequent lag in basic science and clinical research compared with that for other ligamentous injuries. In recent years, new studies have elucidated the biomechanical function and complex anatomy of the PCL leading to an increased interest in research, understanding, and treatment of these complex injuries.

Postoperative rehabilitation of the posterior cruciate ligament.

Diagnosis and management of posterior cruciate ligament injuries has evolved, and now the treatment often includes surgical intervention. The purpose of this paper is to define the current approach to postsurgical management after the posterior cruciate ligament reconstruction, review conservative management, and discuss surgical outcomes using a specified program.