The African Surgical OutcomeS-2 (ASOS-2) Pilot Trial, a mixed-methods implementation study

Background: The African Surgical Outcomes Study (ASOS) showed that surgical patients in Africa have a mortality twice the global average. The working hypothesis is that patients die as a result of failure to rescue following complications in the postoperative period. The African Surgical OutcomeS-2 (ASOS-2) Trial plans to test the efficacy of increased postoperative surveillance in high risk patients for decreasing perioperative morbidity and mortality. This pilot trial aimed i) to evaluate the adequacy of data produced by the data collection strategies of the ASOS-2 Trial, ii) to evaluate the fidelity of implementation of the increased postoperative surveillance intervention, and iii) to understand the acceptability, appropriateness and feasibility of the intervention and the trial processes.Methods: The ASOS-2 Pilot Trial was a mixed-methods (quantitative-qualitative) implementation study focusing on the intervention arm of the proposed ASOS-2 Trial. The intervention is increased postoperative surveillance for high-risk surgical patients. The intervention protocol was implemented at all sites for a seven-day period. A post pilot trial survey was used to collect data on the implementation outcomes.Results: 803 patients were recruited from 16 hospitals in eight African countries. The sampling and data collection strategies provided 98% complete data collection. Seventy-three percent of respondents believed that they truly provided increased postoperative surveillance to high risk patients. In reality 83/125 (66%) of high-risk patients received some form of increased postoperative surveillance. However, the individual components of the increased postoperative surveillance intervention were implemented in less than 50% of high-risk patients (excepting increasing nursing observations). The components most frequently unavailable were the ability to provide care in a higher care ward (32.1%) and assigning the patient to a bed in view of the nurses’ station (28.4%). Failure to comply with available components of the intervention ranged from 27.5% to 54.3%. The post pilot survey had a response rate of 30/40 (75%). In Likert scale questions about acceptability, appropriateness, and feasibility of the ASOS-2 intervention, 63% to 87% of respondents indicated agreement. Respondents reported barriers related to resources, trial processes, teamwork and communication as reasons for disagreement.Conclusions: The proposed ASOS-2 Trial appears to be appropriate, acceptable and feasible in Africa. This pilot trial provides support for the proposed ASOS-2 Trial. It emphasises the need for establishing trial site teams which address the needs of all stakeholders during the trial. A concerted effort must be made to help participating hospitals to increase compliance with all the components of the proposed intervention of ‘increased postoperative surveillance’ during the ASOS-2 Trial.Keywords: Trial, cluster randomised, Trial, pilot, Implementation science, Mixed methods, Mortality, Surger

The SARAO MeerKAT 1.3 GHz Galactic Plane Survey

We present the SARAO MeerKAT Galactic Plane Survey (SMGPS), a 1.3 GHz continuum survey of almost half of the Galactic Plane (251○ ≤l ≤ 358○ and 2○ ≤l ≤ 61○ at |b| ≤ 1 5). SMGPS is the largest, most sensitive and highest angular resolution 1 GHz survey of the Plane yet carried out, with an angular resolution of 8″ and a broadband RMS sensitivity of ∼10–20 μJy beam−1. Here we describe the first publicly available data release from SMGPS which comprises data cubes of frequency-resolved images over 908–1656 MHz, power law fits to the images, and broadband zeroth moment integrated intensity images. A thorough assessment of the data quality and guidance for future usage of the data products are given. Finally, we discuss the tremendous potential of SMGPS by showcasing highlights of the Galactic and extragalactic science that it permits. These highlights include the discovery of a new population of non-thermal radio filaments; identification of new candidate supernova remnants, pulsar wind nebulae and planetary nebulae; improved radio/mid-IR classification of rare Luminous Blue Variables and discovery of associated extended radio nebulae; new radio stars identified by Bayesian cross-matching techniques; the realisation that many of the largest radio-quiet WISE H II region candidates are not true H II regions; and a large sample of previously undiscovered background H I galaxies in the Zone of Avoidance

The MeerKAT Galaxy Cluster Legacy Survey: I. Survey overview and highlights

Please abstract in the article.The South African Radio Astronomy Observatory (SARAO), the National Research Foundation (NRF), the National Radio Astronomy Observatory, US National Science Foundation, the South African Research Chairs Initiative of the DSI/NRF, the SARAO HCD programme, the South African Research Chairs Initiative of the Department of Science and Innovation.http://www.aanda.orghj2022Physic

Incorporating a water-logging routine into CERES-Maize, and some preliminary evaluations

The inability of CERES-Maize v3.0 to simulate a fluctuating water table has been identified as a major constraint in using this particular model in South Africa and in Kenya. Information regarding fluctuating water tables under specific conditions, and their influence on maize production, has been presented in South African literature. The objective of this study was to construct a simple water-logging subroutine based on these mechanisms, using the existing input data structure of CERES-Maize. Results indicate that it is possible to stimulate the impact of water logging on maize plants in this way. Further studies are needed to evaluate the assumptions made in this study and, if necessary, to make some refinements to the water-logging subroutine

Serum progesterone as an indicator of cyclic activity in post-partum goat does

The aim of this trial was to assess post-partum ovarian activity of the does of two South African goat breeds from their serum progesterone concentrations. Between seven and 100 days post-partum, does from the Boer goat breed and an indigenous rural goat type were allocated to two nutritional treatments within breed. One group per breed received a concentrated diet in an intensive feeding programme. The other group per breed was subjected to a low level of nutrition through the grazing of the natural pasture in an extensive (veld) grazing system. Blood samples were collected weekly from five does per breed per treatment. Serum progesterone concentrations were determined using a Gamma CoatTM [128] progesterone radioimmunoassay kit (Sorin Diagnostics, France). Large variations in serum progesterone concentrations were recorded within and between breeds and nutritional regimens. Irrespective of breed, in the extensive groups subjected to the low level of nutrition, mean peak serum progesterone concentrations never exceeded 0.2 ng/mL. This suggests that throughout the experimental period, ovarian activity remained low in the extensive groups. It was concluded that nutritional regimen plays a significant role in ensuring high ovarian activities. Furthermore, the higher mean serum progesterone levels in the Boer goat indicate an earlier and higher oestrous activity, compared to the indigenous does

Attacking Blood-Borne Parasites with Mathematics

Central carbon metabolism is important to cells as it supplies free energy in the form of ATP and the building blocks for new cells. Parasites harvest many of the components they require from their hosts, but they still have to generate ATP themselves, making the metabolic pathways that generate ATP essential to the parasites' survival and thereby potential target pathways for antiparasitic drugs. Metabolic networks often consist of many components that interact with each other via nonlinear kinetics.The behavior of the network arises from the interaction of the components within and outside the network. To understand network behavior, experimental measurements on the components should be integrated through computational approaches. In this chapter, we present an overview of how experiment-driven mathematical models have provided insights on important aspects of parasite metabolism and have aided in elucidating potent antiparasitic drug targets within metabolism