Developing a portable field unit to improve well-child care

BACKGROUND: Pediatric growth tracking has been identified as a top priority by international health agencies to assess the severity of malnutrition and stunting. However, remote low-resource settings often lack the necessary infrastructure for longitudinal analysis of growth for the purposes of early identification and immediate intervention of stunting.METHODS: To address this gap, we developed a portable field unit (PFU) capable of identifying a child over the course of multiple visits, each time adding new anthropomorphic measurements. We conducted a preliminary field evaluation of the PFU by using the unit on two distinct visits to three schools in the area surrounding a medical clinic in rural San Jose, Honduras. The unit was used to assess children at each school as part of the community outreach.RESULTS: Community outreaches to three schools were conducted by two distinct teams, where they used the device to assess 210 children. Of the 180 children registered during the first visit, 112 were re-identified and assessed on the subsequent visit. Twenty-four instances of moderate-to-severe malnutrition were identified and referred for further evaluation to the central clinic.CONCLUSION: This initial assessment suggests that the PFU could be an effective means of identifying at-risk children.

Exploring the Effects on Student Learning and Engagement of COVID-19: an Innovative and Interdisciplinary Approach

Educators are tasked with developing new pedagogical, communication, and assessment strategies to ensure the delivery of quality instruction to students. The nexus that exists between student engagement and teaching methods has been a sustained and distinct focus for higher education institutions. However, the emergence of the COVID-19 pandemic has forced institutions to adjust to distinct functionalities. With the shift to fully online models, there exists an opportunity to engage both faculty and students in innovative teaching-learning assessments and processes. Despite the myriad of challenges that COVID-19 introduces, our paper presents effective strategies, namely, the pedagogical community's focus on opportunities for student ownership in the learning process, the chance to engage students using an innovative social media strategy discussion format, and the formulation of syllabi that incorporate interdisciplinary strategies. Models that actively engage both sides of the educational spectrum will be catalysts for reform. We propose an educational structure that fosters inclusivity in the context of five focused domains: preassessments, prospective socioeconomic gaps, pedagogy, psychological health of students and faculty, and pandemic assessment.

Complex poly(lactic acid)-based biomaterial for urinary catheters: II. Biocompatibility

The present paper is focused on the surface and bulk characterization of poly(lactic acid) (PLA)-based composites that contain hydrolyzed collagen as a biological polymer, silver nanoparticles and vitamin E and epoxidized soybean oil as a plasticizer. The bionanocomposites were obtained by melt processing and evaluated for structural and surface characteristics, biocompatibility, functional properties such as antimicrobial and antioxidant activity and hydrolytic degradation behavior. It has been established that the optimal composition to impart functional properties to the PLA matrix is a formulation containing 15% epoxidized soybean oil, 15% hydrolyzed collagen, 5% Pluronic, 5% vitamin E and 0·3% silver nanoparticles. This bionanocomposite inhibits the growth of both Gram-positive bacteria, Escherichia coli and Salmonella typhimurium, and Gram-negative bacteria, Listeria monocytogenes, and reaches 100% radical-scavenging activity. The PLA-based biomaterials obtained in this study are stable in biological media in the short and medium terms and therefore are recommended as multifunctional biomaterials for the manufacture of medical devices, such as urinary catheters.

Lactoferrin-Immobilized Surfaces onto Functionalized PLA Assisted by the Gamma-Rays and Nitrogen Plasma to Create Materials with Multifunctional Properties

Both cold nitrogen radiofrequency plasma and gamma irradiation have been applied to activate and functionalize the polylactic acid (PLA) surface and the subsequent lactoferrin immobilization. Modified films were comparatively characterized with respect to the procedure of activation and also with unmodified sample by water contact angle measurements, mass loss, X-ray photoelectron spectroscopy (XPS), attenuated total reflectance-Fourier transform infrared spectroscopy (ATR-FTIR), atomic force microscopy (AFM), and chemiluminescence measurements. All modified samples exhibit enhanced surface properties mainly those concerning biocompatibility, antimicrobial, and antioxidant properties, and furthermore, they are biodegradable and environmentally friendly. Lactoferrin deposited layer by covalent coupling using carbodiimide chemistry showed a good stability. It was found that the lactoferrin-modified PLA materials present significantly increased oxidative stability. Gamma-irradiated samples and lactoferrin-functionalized samples show higher antioxidant, antimicrobial, and cell proliferation activity than plasma-activated and lactoferrin-functionalized ones. The multifunctional materials thus obtained could find application as biomaterials or as bioactive packaging films.

Is transcription of data on antiretroviral treatment from electronic to paper-based registers reliable in Malawi?

SETTING

Antiretroviral treatment (ART) clinics at one central hospital, three district hospitals and one mission hospital in the central and southern regions of Malawi.

OBJECTIVE

To measure the extent of inaccuracies in the transcription of case registration and recorded deaths between electronic medical data (EMR) and paper registers. This was done to inform the Ministry of Health on the reliability of the paper-based system as backup in case of EMR failure.

DESIGN

Retrospective analysis of routine programme data.

RESULTS

A total of 31 763 registrations and 2922 deaths in the EMR were compared with those in the paper registers. In one hospital, up to 24% of overall case registrations were missing from the paper registers. At other sites, the differences were minor and included duplicate patients who should have been classified as 'transfer in' patients in the paper register. There were major differences in the number of registered deaths in two of the five facilities.

CONCLUSION

There are varying degrees of agreement between the EMR and paper registers which compromise the use of the latter as a backup solution in case of EMR failure. The reasons for this unreliability and ways forward to address the problem are discussed.

Plasma-activated fibrinogen coatings onto poly(vinylidene fluoride) surface for improving biocompatibility with tissues

CO2, N2, and N2/H2 radiofrequency plasma exposure was used for functionalization of poly(vinylidene fluoride) surface aiming the fibrinogen immobilization. Fibrinogen was immobilized onto poly(vinylidene fluoride) surface using both simple plasma activation and covalent coupling. The modified surfaces have been characterized by X-ray photoelectron spectroscopy, attenuated total reflectance–Fourier transform infrared spectroscopy, near infrared–chemical imaging, atomic force microscopy, and wettability measurements, and the obtained materials were tested as supports for fibroblast cell cultures. The plasma type and the immobilization procedure have influenced the fibrinogen attachment onto the poly(vinylidene fluoride) surface, which was achieved mainly through amide bonds when using coupling agents. Covalent immobilization of fibrinogen onto poly(vinylidene fluoride) surface leads to a more stable protein-modified polymer surface. Non-cytotoxic plasma-based coating technology has the ability to covalently immobilize bioactive molecules for surface modification of some biomaterials that mainly could be achieved by the immobilization of proteins such as fibrinogen that triggers desirable cellular responses. The fibrinogen-modified poly(vinylidene fluoride) materials showed increased cell viability of fibroblasts. Cell viability was enhanced by plasma-activated fibrinogen coatings onto poly(vinylidene fluoride) surface, this being more significant if coating was linked further by a coupling reaction. Hence, they could be good candidates for biomedical applications.

Measurement of the cosmic microwave background polarization lensing power spectrum with the POLARBEAR experiment

Gravitational lensing due to the large-scale distribution of matter in the cosmos distorts the primordial cosmic microwave background (CMB) and thereby induces new, small-scale B-mode polarization. This signal carries detailed information about the distribution of all the gravitating matter between the observer and CMB last scattering surface. We report the first direct evidence for polarization lensing based on purely CMB information, from using the four-point correlations of even- and odd-parity E- and B-mode polarization mapped over ∼30 square degrees of the sky measured by the POLARBEAR experiment. These data were analyzed using a blind analysis framework and checked for spurious systematic contamination using null tests and simulations. Evidence for the signal of polarization lensing and lensing B modes is found at 4.2σ (stat+sys) significance. The amplitude of matter fluctuations is measured with a precision of 27%, and is found to be consistent with the Lambda cold dark matter cosmological model. This measurement demonstrates a new technique, capable of mapping all gravitating matter in the Universe, sensitive to the sum of neutrino masses, and essential for cleaning the lensing B-mode signal in searches for primordial gravitational waves.

Evidence for gravitational lensing of the cosmic microwave background polarization from cross-correlation with the cosmic infrared background

We reconstruct the gravitational lensing convergence signal from cosmic microwave background (CMB) polarization data taken by the Polarbear experiment and cross-correlate it with cosmic infrared background maps from the Herschel satellite. From the cross spectra, we obtain evidence for gravitational lensing of the CMB polarization at a statistical significance of 4.0σ and indication of the presence of a lensing B-mode signal at a significance of 2.3σ. We demonstrate that our results are not biased by instrumental and astrophysical systematic errors by performing null tests, checks with simulated and real data, and analytical calculations. This measurement of polarization lensing, made via the robust cross-correlation channel, not only reinforces POLARBEAR auto-correlation measurements, but also represents one of the early steps towards establishing CMB polarization lensing as a powerful new probe of cosmology and astrophysics.

In vitro biocompatibility testing of some synthetic polymers used for the achievement of nervous conduits

Biocompatible synthetic polymers are largely used in the bio-medical domain, tissue engineering and in controlled release of medicines. Polymers can be used in the achievement of cardiac and vascular devices, mammary implants, eye lenses, surgical threads, nervous conduits, adhesives, blood substitutes, etc. Our study was axed on the development of cytotoxicity tests for 3 synthetic polymers, namely polyvinyl alcohol, polyethylene glycol and polyvinyl chloride. These tests targeted to determine the viability and morphology of cells (fibroblasts) that were in indirect contact with the studied polymers. Cell viability achieved for all the studied synthetic polymers allowed their frame in biocompatible material category. Cell morphology did not significantly change, thus accomplishing a new biocompatibility criterion. The degree of biocompatibility of the studied polymers varied. Polyvinyl alcohol presented the highest grade of biocompatibility and polyvinyl chloride placed itself at the lowest limit of biocompatibility. The results achieved allowed the selection of those polymers that (by enhancing their degrees of biocompatibility due to the association with various biopolymers) will be used in the development of new biocompatible materials, useful in nervous conduits manufacture.

HIV testing coverage of family members of adult antiretroviral therapy patients in Malawi

Many children in sub-Saharan Africa die from AIDS, not having accessed HIV testing and care. Children of adult antiretroviral therapy (ART) patients are a target group for HIV testing in order to increase access to care, but the HIV test coverage of this group in Malawi is unknown. In a cross-sectional survey of 832 patients at a large urban ART clinic in Blantyre, we found that 81.2% of 1223 children and 37.7% of 488 spouses of adult ART patients were reportedly not HIV tested. Wives of male patients were significantly less frequently HIV tested than husbands of female patients (53.0% vs. 72.4%, p<0.0001). Children under the age of 8 years (adjusted odds ratios [aOR] 2.76), children of female patients (aOR 2.53) and of patients whose partner had been HIV tested (aOR 2.87) were significantly more likely to have been tested for HIV. More attention needs to be given to provider initiated testing of children and spouses of ART patients.

Antifungal properties of lectin and new chitinases from potato tubers

We have purified from potato tubers, the lectin STA devoid of chitinase activity and two chitinases devoid of lectin activity. Both enzymes are 16 kDa glycoproteins, and probably belong to a new family of plant chitinases. The respective antifungal properties of lectin and chitinases were studied by following their effects against early developmental stages of Fusarium oxysporum, a fungal potato pathogen. Here we demonstrate that: (1) lectin does not inhibit mycelial growth but irreversibly inhibits conidia germination and alters the germ tubes; and (2) chitinases block mycelial growth as well as conidia germination and lyse germ tubes.