Telephone or video? A review of telemedicine consultations during the COVID-19 pandemic in a spinal MSK service

A service evaluation of the move to virtual appointments during the COVID-19 pandemic

a systematic review protocol

Introduction Varicella zoster virus (VZV) causes varicella (chicken pox) and herpes zoster (shingles). Worldwide, these diseases are associated with significant morbidity. Most of the epidemiological data on VZV come from high income countries. There are few data on VZV in Africa, where tropical climates and high HIV/AIDS prevalence rates are expected to impact the epidemiology of VZV. Safe and effective vaccinations for both varicella and herpes zoster exist, but are not routinely used in Africa. There are very few data available on VZV disease burden in Africa to guide the introduction of these vaccines on the continent. Our aim is to conduct a systematic review of the VZV-associated morbidity and mortality in Africa, which will provide critical information that could be used to develop vaccination policies against these diseases in Africa. Methods and analysis Electronic databases will be searched and all studies published after 1974 that meet predefined criteria will be assessed. The primary outcomes for the study are VZV incidence/prevalence, hospitalisation rates and total death rates. The secondary outcome for this study is the proportion of VZV hospitalisations and/or deaths associated with HIV/AIDS. Two reviewers will screen the titles and abstracts, and then independently review the full texts, to determine if studies are eligible for inclusion. A risk of bias and quality assessment tool will be used to score all included studies. Following standardised data extraction, a trend analysis using R-programming software will be conducted to investigate the trend of VZV. Depending on the characteristics of included studies, subgroup analyses will be performed. This review will be reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Ethics and dissemination As this is a protocol for a systematic review, which will use already published data, no ethics approval is required. Findings will be disseminated in peer-reviewed journals. Trial registration number CRD4201502614

The effect of direct thermal method, temperature and time on microstructure of a cast aluminum alloy

The direct thermal method is used for the creation of globular microstructures suitable for semi-solid metal forming. In this paper both simulation and experimental results using direct thermal method are presented. ProCAST® software was used to estimate temperature distribution inside the aluminium billet. In validation work, molten aluminium A356 was poured into metallic copper tube moulds and cooled down to the semi-solid temperature before being quenched in water at room temperature. The effect of pouring temperatures of 630°C, 650°C, 665°C, 680°C and holding times of 45s and 60s on the microstructure of aluminium A356 alloy were investigated. The simulation results showed that the average temperature rate within the copper mould, from initial pouring temperature to just before quenching, was approximately 1°C/s. Examination of the solidified microstructures showed that the microstructure was more spherical when lower pouring temperatures and holding periods were used. From the micrographs it was found that the most globular and smallest structures were achieved at processing parameters of 630°C and 45s

Neutron Radiography of Fluid Flow for Geothermal Energy Research

AbstractEnhanced geothermal systems seek to expand the potential for geothermal energy by engineering heat exchange systems within the earth. A neutron radiography imaging method has been developed for the study of fluid flow through rock under environmental conditions found in enhanced geothermal energy systems. For this method, a pressure vessel suitable for neutron radiography was designed and fabricated, modifications to imaging instrument setups were tested, multiple contrast agents were tested, and algorithms developed for tracking of flow. The method has shown success for tracking of single phase flow through a manufactured crack in a 3.81cm (1.5 inch) diameter core within a pressure vessel capable of confinement up to 69 MPa (10,000 psi) using a particle tracking approach with bubbles of fluorocarbon-based fluid as the “particles” and imaging with 10 ms exposures

Lessons learnt during the national introduction of human papillomavirus (HPV) vaccination programmes in 6 African countries: Stakeholders’ perspectives

Background. Infection with human papillomavirus (HPV) significantly increases the risk of developing cervical cancer later in life. Therefore, globally, HPV vaccines targeted to pre-adolescent and adolescent girls have been on the rise since the licensure in 2006. However, the introduction of HPV vaccines has been relatively slow in Africa. At the end of 2016, only 8 of the 54 countries in Africa were reported to have introduced HPV vaccination at a national level. By 2019, the number of countries had grown marginally to 11.Objectives. To investigate stakeholders’ perspectives on the experiences, challenges and lessons learnt during national HPV vaccine introduction in Africa.Methods. A questionnaire was administered to selected participants from 8 African countries. These countries had successfully introduced HPV vaccination at a national level by the end of 2016. We used in-depth interviews and self-administered online questionnaires for data collection and analysis. Data are presented without naming the country or participants; therefore, readers will not be able to identify the results that are specific to individual countries. Narrative and thematic reporting were used to describe the results.Results. We obtained results from 6 of the 8 targeted countries. The challenges reported during HPV vaccination programmes were: identifying the target population, using a school-based vaccine-delivery strategy, obtaining political support, the need to integrate HPV vaccination with existing school health programmes and engaging multiple stakeholders. These challenges were similar in all 6 countries. The lessons learnt were that a school-based delivery strategy is a successful approach for national HPV vaccination, and that identifying girls for vaccination at schools was less challenging if implemented through a class-based instead of an age-based approach.Conclusions. Most African countries do not have established platforms to deliver vaccines to pre-adolescent and adolescent populations. The successful introduction of the HPV vaccine through school-based vaccination strategies in African countries may have created a platform to deliver other adolescent vaccines. The similarity of the study findings across the 6 participating countries further strengthens the need to document and disseminate the challenges and lessons learnt during HPV vaccine introduction in Africa. Documentation and dissemination of the challenges and lessons learnt are useful to other countries in Africa that plan to introduce an HPV vaccination programme, and possibly other adolescent vaccines.

Modelling and observation of transionospheric propagation results from ISIS II in preparation for ePOP

The enhanced Polar Outflow Probe (ePOP) is scheduled to be launched as part of the Cascade Demonstrator Small-Sat and Ionospheric Polar Explorer (CASSIOPE) satellite in early 2008. A Radio Receiver Instrument (RRI) on ePOP will receive HF transmissions from various ground-based transmitters. In preparation for the ePOP mission, data from a similar transionospheric experiment performed by the International Satellites for Ionospheric Studies (ISIS) II satellite has been studied. Prominent features in the received 9.303-MHz signal were periodic Faraday fading of signal intensity at rates up to 13 Hz and a time of arrival delay between the O- and X-modes of up to 0.8 ms. Both features occurred when the satellite was above or south of the Ottawa transmitter. Ionospheric models for ray tracing were constructed using both International Reference Ionosphere (IRI) profiles and local peak electron density values from ISIS ionograms. Values for fade rate and differential mode delay were computed and compared to the values observed in the ISIS II data. The computed values showed very good agreement to the observed values of both received signal parameters when the topside sounding <I>fo</I>F2 values were used to scale IRI profiles, but not when strictly modelled IRI profiles were used. It was determined that the primary modifier of the received signal parameters was the <I>fo</I>F2 density and not the shape of the profile. This dependence was due to refraction, at the 9.303-MHz signal frequency, causing the rays to travel larger distances near the peak density where essentially all the mode splitting occurred. This study should assist in interpretation of ePOP RRI data when they are available

Epidemiology of post-neonatal bacterial meningitis in Cape Town children

CITATION: Hussey, G. 1997. Epidemiology of post-neonatal bacterial meningitis in Cape Town children. South African Medical Journal, 87(1):51-56.The original publication is available at http://www.samj.org.zaBacterial meningitis is a major cause of childhood morbidity and mortality in South Africa. However, comprehensive regional or national epidemiological data, essential for rational public health interventions, are lacking. The purpose of this 1-year prospective study, from 1 August 1991 to 31 July 1992, was to define the magnitude of the problem of childhood bacterial meningitis in Cape Town. The study group consisted of all children, aged > 1 month to < 74 years, who presented with proven bacterial meningitis at all the hospitals in the Cape Town metropolitan area. During the year 201 cases were identified: 101 (50.2%) were due to Neisseria meningitidis, 74 (36.8%) were due to Haemophilus influenzae and 26 (12.9%) were due to Streptococcus pneumoniae. The overall incidence rate (95% confidence interval) for children less than 14 years, 5 years and 1 year was 34 (30 - 40), 76 (65 - 88) and 257 (213 - 309) per 100 000 children, respectively. The rate was highest in black infants, 416 (316 - 545)/100 000. This was 2 times greater than the rate in coloured infants and about 4.5 times greater than the rate in white infants. The median age of all the children was 10 months. The ages of children with haemophilus and pneumococcal meningitis were similar, 9 and 7.5 months respectively (P = 0.43), while children with meningococcal meningitis were significantly cider (22 months) than the others (P < 0.01). The overall case fatality rate was 5%, and 12.9% of survivors had significant neurological sequelae (disability) on discharge.Publisher’s versio