The infant-feeding practices of mothers enrolled in the prevention of mother-to-child transmission of HIV programme at a primary health care clinic in the Mpumalanga province, South Africa

Purpose: To determine whether mothers attending a primary health care (PHC) clinic in the Mpumalanga province, South Africa for post-deliveryprevention of mother-to-child transmission (PMTCT) of the Human Immunodeficiency Virus (HIV) follow-up care were adhering to the recommendationof exclusive infant-feeding practices, and to identify possible areas for improvement of the PMTCT of HIV services at the clinic.Setting: A municipal PHC clinic in White River, a semi-urban town in Mpumalanga, South Africa.Design: A cross-sectional descriptive study using a structured infant-feeding questionnaire.Subjects: All mothers attending the clinic for post-delivery PMTCT of HIV follow-up care during a four-month period from 1 November 2007 to29 February 2008.Results: A total of 33 mothers with infants attended the clinic during the period. All 33 mothers took part in the questionnaire study. Thirtyquestionnaires were subsequently found suitable for analysis. The mothers were predominantly rural, with low levels of education and no formalemployment. Their ages ranged from 22 to 42 years, with a mean of 30.7 years. Fifteen (50%) of the 30 mothers practised exclusive replacementfeeding (ERF), 8 (27%) practised exclusive breast-feeding (EBF), and 7 (23%) practised mixed feeding.Conclusion: More than three-quarters of the mothers practised the recommended exclusive infant-feeding methods for PMTCT of HIV, with ERF asthe most popular choice. However, the infant-feeding practices could not be generalised as the attendance of mothers for post-delivery follow-upcare at the clinic was very poor during the study period. This poor attendance was attributed to frequent non-availability of free formula milk for theprogramme. Better quality counselling is needed to further increase the adherence to exclusive infant-feeding practices, and to improve the uptakeof post-delivery follow-up care

OH yields from the CH3CO+O-2 reaction using an internal standard

Laser flash photolysis of CH3C(O)OH at 248 nm was used to create equal zero time yields of CH3CO and OH. The absolute OH yield from the CH3CO + O2 (+M) reaction was determined by following the OH temporal profile using the zero time OH concentration as an internal standard. The OH yield from CH3CO + O2 (+M) was observed to decrease with increasing pressure with an extrapolated zero pressure yield close to unity (1.1 ± 0.2, quoted uncertainties correspond to 95% confidence limits). The results are in quantitative agreement with those obtained from 248 nm acetone photolysis in the presence of O2

The Distances of SNR W41 and overlapping HII regions

New HI images from the VLA Galactic Plane Survey show prominent absorption features associated with the supernovae remnant G23.3-0.3 (SNR W41). We highlight the HI absorption spectra and the $^{13}$CO emission spectra of eight small regions on the face of W41, including four HII regions, three non-thermal emission regions and one unclassified region. The maximum velocity of absorption for W41 is 78$\pm$2 km/s and the CO cloud at radial velocity 95$\pm$5 km/s is behind W41. Because an extended TeV source, a diffuse X-ray enhancement and a large molecular cloud at radial velocity 77$\pm$5 km/s are also projected at the center of W41, these yield the kinematic distance of 3.9 to 4.5 kpc for W41. For HII regions, our analyses reveal that both G23.42-0.21 and G23.07+0.25 are at the far kinematic distances ($\sim$9.9 kpc and $\sim$ 10.6 kpc respectively) of their recombination-line velocities (103$\pm$0.5 km/s and 89.6$\pm$2.1 km/s respectively), G23.07-0.37 is at the near kinematic distance (4.4$\pm$0.3 kpc) of its recombination-line velocity (82.7$\pm$2.0 km/s), and G23.27-0.27 is probably at the near kinematic distance (4.1$\pm$0.3 kpc) of its recombination-line velocity (76.1$\pm$0.6 km/s).Comment: 11 pages, 3 figs., 2 tables, accepted by A

A Magellanic Origin for the Warp of the Galaxy

We show that a Magellanic Cloud origin for the warp of the Milky Way can explain most quantitative features of the outer HI layer recently identified by Levine, Blitz & Heiles (2005). We construct a model similar to that of Weinberg (1998) that produces distortions in the dark matter halo, and we calculate the combined effect of these dark-halo distortions and the direct tidal forcing by the Magellanic Clouds on the disk warp in the linear regime. The interaction of the dark matter halo with the disk and resonances between the orbit of the Clouds and the disk account for the large amplitudes observed for the vertical m=0,1,2 harmonics. The observations lead to six constraints on warp forcing mechanisms and our model reasonably approximates all six. The disk is shown to be very dynamic, constantly changing its shape as the Clouds proceed along their orbit. We discuss the challenges to MOND placed by the observations.Comment: 4 pages, 3 figures, submitted to ApJ Letters. Additional graphics, 3d visualizations and movies available at http://www.astro.umass.edu/~weinberg/lm

Use of External Cephalic Version and Amnioreduction in the Delivery of a Fetal Demise with Macrocephaly Secondary to Massive Intracranial Teratoma

Introduction Congenital intracranial tumors are rare and often incidentally diagnosed on routine ultrasound. We report a case of a fetal demise with a massive intracranial teratoma at 25 weeks of gestation and the management of her delivery in the setting of macrocephaly, breech presentation, and polyhydramnios. Case A 31-year-old G3P1011 woman at 25 weeks\u27 gestation presented with a recent fetal demise and a fetal intracranial tumor first identified at 16 weeks\u27 gestational age. The patient had declined termination of pregnancy. Biometry was consistent with 24 weeks\u27 gestation, except for a head circumference of 394.4 mm consistent with 39 weeks\u27 gestation. The fetus was in a breech presentation. An external cephalic version (ECV) was successfully performed under epidural anesthesia and an amnioreduction was then performed to stabilize the fetal position. Immediate induction of labor and vaginal delivery followed. Discussion ECV and amnioreduction may help facilitate delivery in cases of fetal demise complicated by macrocephaly, malpresentation, and polyhydramnios

Is There a Fundamental Line for Disk Galaxies?

We show that there are strong local correlations between metallicity, surface brightness, and dynamical mass-to-light ratio within M33, analogous to the fundamental line of dwarf galaxies identified by Prada & Burkert (2002). Using near-infrared imaging from 2MASS, the published rotation curve of M33, and literature measurements of the metallicities of HII regions and supergiant stars, we demonstrate that these correlations hold for points at radial distances between 140 pc and 6.2 kpc from the center of the galaxy. At a given metallicity or surface brightness, M33 has a mass-to-light ratio approximately four times as large as the Local Group dwarf galaxies; other than this constant offset, we see broad agreement between the M33 and dwarf galaxy data. We use analytical arguments to show that at least two of the three fundamental line correlations are basic properties of disk galaxies that can be derived from very general assumptions. We investigate the effect of supernova feedback on the fundamental line with numerical models and conclude that while feedback clearly controls the scatter in the fundamental line, it is not needed to create the fundamental line itself, in agreement with our analytical calculations. We also compare the M33 data with measurements of a simulated disk galaxy, finding that the simulation reproduces the trends in the data correctly and matches the fundamental line, although the metallicity of the simulated galaxy is too high, and the surface brightness is lower than that of M33.Comment: 14 pages, 14 figures (5 in color). Accepted for publication in Ap

High-Resolution Measurements of the Dark Matter Halo of NGC 2976: Evidence for a Shallow Density Profile

We have obtained two-dimensional velocity fields of the dwarf spiral galaxy NGC 2976 in Halpha and CO. The high spatial (~75 pc) and spectral (13 km/s and 2 km/s, respectively) resolution of these observations, along with our multicolor optical and near-infrared imaging, allow us to measure the shape of the density profile of the dark matter halo with good precision. We find that the total (baryonic plus dark matter) mass distribution of NGC 2976 follows a rho_tot ~ r^(-0.27 +/- 0.09) power law out to a radius of 1.8 kpc, assuming that the observed radial motions provide no support. The density profile attributed to the dark halo is even shallower, consistent with a nearly constant density of dark matter over the entire observed region. A maximal disk fit yields an upper limit to the K-band stellar mass-to-light ratio (M*/L_K) of 0.09^{+0.15}_{-0.08} M_sun/L_sun,K (including systematic uncertainties), with the caveat that for M*/L_K > 0.19 M_sun/L_sun,K the dark matter density increases with radius, which is unphysical. Assuming 0.10 M_sun/L_sun,K < M*/L_K < 0.19 M_sun/L_sun,K, the dark matter density profile lies between rho_dm ~ r^-0.17 and rho_dm ~ r^-0.01. Therefore, independent of any assumptions about the stellar disk or the functional form of the density profile, NGC 2976 does not contain a cuspy dark matter halo. We also investigate some of the systematic effects that can hamper rotation curve studies, and show that 1) longslit rotation curves are far more vulnerable to systematic errors than two-dimensional velocity fields, 2) NGC 2976 contains large radial motions at small radii, and 3) the Halpha and CO velocity fields of NGC 2976 agree within their uncertainties. [slightly abridged]Comment: 30 pages, 4 tables, 13 figures (7 in color; Figures 1 and 3 are low-resolution to save space). Accepted for publication in ApJ. Version with full-resolution figures available at http://astro.berkeley.edu/~bolatto/ngc2976rotation.ps (46 MB

Adherence and Acceptability of Telehealth Appointments for High Risk Obstetrical Patients During the COVID-19 Pandemic.

Background:Telehealth has been successfully implemented for the delivery of obstetrical care. However, little is known regarding the attitudes and acceptability of patients and providers in high risk obstetrics and if implementation improves access to care in non-rural settings. Objective:The study aims to: 1) Describe patient and provider attitudes toward telehealth for delivery of high risk obstetrical care in a large health care system with both urban and suburban settings. 2) Determine if implementation of a telehealth model improves patient adherence to scheduled appointments in this patient population.Study DesignTwo self-administered surveys were designed. The first survey was sent to all high-risk obstetrical patients who received a telehealth visit between March 1, 2020 and May 30, 2020. The second survey was designed for providers who participated in these visits. We also compared the attended, cancelled and no show visit rates before (March 1-May 30, 2019) and after (March 1-May 30, 2020) telehealth implementation, as well as telehealth versus in person visits in 2020. We reviewed scheduled high-risk prenatal care appointments, diabetes education sessions, and genetic counseling and Maternal- Fetal Medicine consultations. Results:A total of 91 patient surveys and 33 provider surveys were analyzed. Overall, 86.9% of patients were satisfied with the care they received and 78.3% would recommend telehealth visits to others. 87.8% of providers reported having a positive experience using telehealth, and 90.9% believed that telehealth improved patients\u27 access to care. When comparing patient and provider preference regarding future obstetrical care after experiencing telehealth, 73.8% of patients desired a combination of in person and telehealth visits during their pregnancy. However, a significantly higher rate of providers preferred in-person visits (56% vs 23% respectively). When comparing visits between 2019 and 2020, there was a significantly lower rate of no-show appointments, patient-cancelled appointments, and patient same-day cancellations with the implementation of telehealth. There was also a significantly lower rate of patient-cancelled appointments, and patient same-day cancellations with those receiving telehealth visits compared to in person visits in 2020. Conclusion:Implementation of telehealth in high risk obstetrics has the potential to improve access to high risk obstetrical care, by reducing the rate of missed appointments. Both patients and providers surveyed expressed a high rate of satisfaction with telehealth visits and a desire to integrate telehealth into the traditional model of high risk obstetrical care