Frequency and management of maternal infection in health facilities in 52 countries (GLOSS): a 1-week inception cohort study

Background: Maternal infections are an important cause of maternal mortality and severe maternal morbidity. We report the main findings of the WHO Global Maternal Sepsis Study, which aimed to assess the frequency of maternal infections in health facilities, according to maternal characteristics and outcomes, and coverage of core practices for early identification and management. Methods: We did a facility-based, prospective, 1-week inception cohort study in 713 health facilities providing obstetric, midwifery, or abortion care, or where women could be admitted because of complications of pregnancy, childbirth, post-partum, or post-abortion, in 52 low-income and middle-income countries (LMICs) and high-income countries (HICs). We obtained data from hospital records for all pregnant or recently pregnant women hospitalised with suspected or confirmed infection. We calculated ratios of infection and infection-related severe maternal outcomes (ie, death or near-miss) per 1000 livebirths and the proportion of intrahospital fatalities across country income groups, as well as the distribution of demographic, obstetric, clinical characteristics and outcomes, and coverage of a set of core practices for identification and management across infection severity groups. Findings: Between Nov 28, 2017, and Dec 4, 2017, of 2965 women assessed for eligibility, 2850 pregnant or recently pregnant women with suspected or confirmed infection were included. 70·4 (95% CI 67·7–73·1) hospitalised women per 1000 livebirths had a maternal infection, and 10·9 (9·8–12·0) women per 1000 livebirths presented with infection-related (underlying or contributing cause) severe maternal outcomes. Highest ratios were observed in LMICs and the lowest in HICs. The proportion of intrahospital fatalities was 6·8% among women with severe maternal outcomes, with the highest proportion in low-income countries. Infection-related maternal deaths represented more than half of the intrahospital deaths. Around two-thirds (63·9%, n=1821) of the women had a complete set of vital signs recorded, or received antimicrobials the day of suspicion or diagnosis of the infection (70·2%, n=1875), without marked differences across severity groups. Interpretation: The frequency of maternal infections requiring management in health facilities is high. Our results suggest that contribution of direct (obstetric) and indirect (non-obstetric) infections to overall maternal deaths is greater than previously thought. Improvement of early identification is urgently needed, as well as prompt management of women with infections in health facilities by implementing effective evidence-based practices. Funding: UNDP–UNFPA–UNICEF–WHO–World Bank Special Programme of Research, Development and Research Training in Human Reproduction, WHO, Merck for Mothers, and United States Agency for International Development

Formation of intermediate SiCN interlayer during deposition of CNx on a-Si : H or a-SiC : H thin films

Thin films of carbon nitride have been realized in a downstream RF plasma beam discharge generated in argon/nitrogen with carbon electrodes. The deposition has been performed on the top of a-Si:H or a-SiC:H layers previously deposited in diode type CVD reactor from methane and silane. The surface topography produced by the deposition procedures has been studied by atomic force microscopy (AFM) technique. The obtained samples have been investigated by secondary ions mass spectrometry (SIMS), Fourier transform infrared spectroscopy (FTIR) and UV-Vis optical absorption. It is shown that the formation of SiC and SiCN interlayers occurs, which is promoted by the reactions of plasma C, N, and CN gaseous species with the silicon atoms from the base film. (C) 2001 Published by Elsevier Science B.V

OPSE metrology system onboard of the PROBA3 mission of ESA

In recent years, ESA has assessed several mission involving formation flying (FF). The great interest in this topics is mainly driven by the need for moving from ground to space the location of next generation astronomical telescopes overcoming most of the critical problems, as example the construction of huge baselines for interferometry. In this scenario, metrology systems play a critical role. PROBA3 is an ESA technology mission devoted to in-orbit demonstration of the FF technique, with two satellites, an occulter and a main satellite housing a coronagraph named ASPIICS, kept at an average inter-distance by about 144m, with micron scale accuracy. The guiding proposal is to test several metrology solution for spacecraft alignment, with the important scientific return of having observation of Corona at never reached before angular field. The Shadow Position Sensors (SPS), and the Optical Position Emitters Sensors (OPSE) are two of the systems used for FF fine tracking. The SPS are finalized to monitor the position of the two spacecraft with respect to the Sun and are discussed in dedicated papers presented in this conference. The OPSE will monitor the relative position of the two satellites and consists of 3 emitters positioned on the rear surface of the occulter, that will be observed by the coronagraph itself. By following the evolution of the emitters images at the focal plane the alignment of the two spacecrafts is retrieved via dedicated centroiding algoritm. We present an overview of the OPSE system and of the centroiding approach

Frequency and management of maternal infection in health facilities in 52 countries (GLOSS): a 1-week inception cohort study

Background Maternal infections are an important cause of maternal mortality and severe maternal morbidity. We report the main findings of the WHO Global Maternal Sepsis Study, which aimed to assess the frequency of maternal infections in health facilities, according to maternal characteristics and outcomes, and coverage of core practices for early identification and management. Methods We did a facility-based, prospective, 1-week inception cohort study in 713 health facilities providing obstetric, midwifery, or abortion care, or where women could be admitted because of complications of pregnancy, childbirth, post-partum, or post-abortion, in 52 low-income and middle-income countries (LMICs) and high-income countries (HICs). We obtained data from hospital records for all pregnant or recently pregnant women hospitalised with suspected or confirmed infection. We calculated ratios of infection and infection-related severe maternal outcomes (ie, death or near-miss) per 1000 livebirths and the proportion of intrahospital fatalities across country income groups, as well as the distribution of demographic, obstetric, clinical characteristics and outcomes, and coverage of a set of core practices for identification and management across infection severity groups. Findings Between Nov 28, 2017, and Dec 4, 2017, of 2965 women assessed for eligibility, 2850 pregnant or recently pregnant women with suspected or confirmed infection were included. 70·4 (95% CI 67·7–73·1) hospitalised women per 1000 livebirths had a maternal infection, and 10·9 (9·8–12·0) women per 1000 livebirths presented with infection-related (underlying or contributing cause) severe maternal outcomes. Highest ratios were observed in LMICs and the lowest in HICs. The proportion of intrahospital fatalities was 6·8% among women with severe maternal outcomes, with the highest proportion in low-income countries. Infection-related maternal deaths represented more than half of the intrahospital deaths. Around two-thirds (63·9%, n=1821) of the women had a complete set of vital signs recorded, or received antimicrobials the day of suspicion or diagnosis of the infection (70·2%, n=1875), without marked differences across severity groups. Interpretation The frequency of maternal infections requiring management in health facilities is high. Our results suggest that contribution of direct (obstetric) and indirect (non-obstetric) infections to overall maternal deaths is greater than previously thought. Improvement of early identification is urgently needed, as well as prompt management of women with infections in health facilities by implementing effective evidence-based practices