Changing priorities in maternal and perinatal health in Gert Sibande District, South Africa

Gert Sibande District is a predominantly rural district in Mpumalanga Province, South Africa (SA), with a population of just over 1.1 million. It has a high prevalence of HIV infection and pregnancy-related hypertensive disease. In 2010 the district was one of the worst-performing health districts in SA, with a maternal mortality ratio of 328.0 per 100 000 births. Various programmes were introduced between 2010 and 2017 to address major causes of maternal and perinatal morbidity and mortality in the district. The focus has been on HIV-related morbidity, the direct obstetric causes of maternal and perinatal morbidity and mortality, and health systems strengthening. During the period 2010 - 2017, there was a steady decline in institutional maternal mortality with a drop of 71% in maternal deaths over a period of 6 years, from 328.0 per 100 000 births to 95.0. However, the ratio levelled off in 2016 and 2017, mainly as a result of a changing disease profile. The stillbirth rate showed a decline of 24.4% over a period of 8 years. With perseverance, rapid response and evidence-based strategies it was possible to more than halve the institutional maternal mortality ratio within 6 years. However, with the changing disease profile, conditions such as hypertensive disease in pregnancy should be prioritised and new strategies developed to further reduce maternal and perinatal mortality and morbidity

Body weight and the medial longitudinal foot arch : high-arched foot, a hidden problem?

This study had two objectives. First, to determine the prevalence of hollow (high-arched) and flat foot among primary school children in Cracow (Poland). Second, to evaluate the relationship between the type of medial longitudinal arch (MLA; determined by the Clarke’s angle) and degree of fatness. The prevalence of underweight, overweight, and obesity was determined by means of IOTF cut-offs with respect to age and gender. A sample of 1,115 children (564 boys and 551 girls) aged between 3 and 13 years was analyzed. In all age groups, regardless of gender, high-arched foot was diagnosed in the majority of children. A distinct increase in the number of children with high-arched foot was observed between 7- and 8-year olds. Regardless of the gender, high-arched foot was more common among underweight children. In the group of obese children, the biggest differences were attributed to gender. High-arched foot was the most frequently observed among boys. In all gender and obesity level groups, the flat foot was more common among boys than among girls. Conclusions: High-arched foot is the most common foot defect among children 3–13 years old regardless of gender. Flat foot is least frequently observed in children 3–13 years old. A statistic correlation between MLA and adiposity is observed. Stronger correlation is observed among girls

First Report of ‘CandidatusLiberibacter asiaticus’ Associated with Huanglongbing in Sweet Orange in Ethiopia

Huanglongbing (HLB) is a serious disease of citrus worldwide. Three different ‘Candidatus Liberibacter’ species are associated with HLB: ‘Ca. Liberibacter asiaticus’, ‘Ca. L. africanus’, and ‘Ca. L. americanus’ (1). ‘Ca. L. africanus’ and its vector, Trioza erytreae, are both heat sensitive, and when present, occur in citrus when temperatures remain below 30 to 32°C. In Africa, ‘Ca. L. africanus’ and T. erytreae have been reported in South Africa, Zimbabwe, Malawi, Burundi, Kenya, Somalia, Ethiopia, Cameroon, and Madagascar (1). Inspection of citrus trees in orchards and budwood sources in nurseries located in the warmer citrus-growing areas of Tigray and North Wollo in northern Ethiopia revealed nearly 100 trees with symptoms of leaf yellowing with a blotchy mottle pattern, dead branches, and decreased fruit quality and yield. Two symptomatic sweet orange budwood trees and three symptomatic orchard plants were sampled in April 2009, along with three healthy-looking sweet orange plants. DNA was extracted from 200 mg of desiccated leaf midribs using the CTAB method (4) and subjected to conventional PCR using the primer pairs A2/J5 (2) and OI2/23S1 (3) that amplify the ribosomal protein gene in the rplKAJL-rpoBC operon and the 16S/23S ribosomal intergenic regions, respectively, of ‘Ca. L. africanus’ and ‘Ca. L. asiaticus’. Positive PCR reactions were obtained for all five symptomatic samples with both primer pairs. PCR amplicons of 703 bp (A2/J5) and 892 bp (OI2/23S) recovered from two of these samples were purified, cloned, and sequenced. BLAST analysis revealed that the nucleotide sequences we obtained for the ribosomal protein (GenBank Accessions Nos. GQ890155 and GQ890156) shared 100% identity with each other and 99% identity with sequences of ‘Ca. L. asiaticus’ from Brazil (DQ471904), Indonesia (AB480161), China (DQ157277), and Florida (CP001677). Similarly, the 16S/23S ribosomal intergenic sequences (GU296538 and GU296539) shared 100% identity with each other and 99% identity with homologous ‘Ca. L. asiaticus’ sequences from Brazil (DQ471903), Indonesia (AB480102), China (DQ778016), and Florida (CP001677) and contained two tRNA genes as occurs in ‘Ca. L. asiaticus’ but not in ‘Ca. L. africanus’ (3). To our knowledge, this is the first report of ‘Ca. L. asiaticus’ in Africa. The presence of ‘Ca. L. asiaticus’ is a threat for warmer citrus-growing areas of Africa that are less favorable for ‘Ca. L. africanus’ and T. erytreae. In areas where ‘Ca. L. asiaticus’ was confirmed, symptomatic trees must be promptly eradicated and surveys to determine spread of the disease and its vectors are necessary

Development of the Nebraska Department of Transportation Winter Severity Index

Adverse weather conditions are responsible for millions of vehicular crashes, thousands of vehicular deaths and billions of dollars in economic and congestion costs. Many transportation agencies utilize a performance or mobility metric to assess how well they are maintaining road access. This research focuses on the development of a winter severity index for the State of Nebraska (NEWINS). NEWINS is an event-driven index that was derived for the Nebraska Department of Transportation (NDOT) and its districts across the state. The NEWINS framework includes a categorical storm classification framework and climatological aspect to capture atmospheric conditions more accurately across the diverse spatial regions of Nebraska. A ten-year (2006-2016) winter season database of meteorological variables for Nebraska was obtained from the National Centers for Environmental Information. Meteorological parameters were grouped into categories that subsequently provided a storm classification database. The NEWINS is based on a weighted linear combination to the collected database to measure severity statewide and across NDOT individual districts. The NEWINS results were compared to other meteorological variables, many used in other agencies’ winter severity indices. This comparison verified the NEWINS robustness for the observed events for the ten year period. For example, an assessment of the difference between days with observed snowfall versus days with accumulated snowfall revealed a 39% average reduction in days. Furthermore, the NEWINS results highlight the greater number of events during the 2009-2010 winter season, and the lack of events during the 2011-2012 drought year. The NEWINS also shows strong differences monthly and among NDOT districts across the state with a general decrease in events from the western to eastern NDOT districts. In addition, NEWINS storm classifications were compared to NDOT winter maintenance operations performance data for a sample winter season. Last, the 2016-17 winter season was computed to provide a testbed for the NEWINS procedure. It is expected that the NEWINS could help transportation personnel to efficiently allocate resources during adverse weather events, while balancing safety, mobility, and available budget. Further, the theoretical and practical contributions provided by the NEWINS can be used by other agencies to assess their weather sensitivity

Development of the Nebraska Department of Transportation Winter Severity Index

Adverse weather conditions are responsible for millions of vehicular crashes, thousands of vehicular deaths and billions of dollars in economic and congestion costs. Many transportation agencies utilize a performance or mobility metric to assess how well they are maintaining road access. This research focuses on the development of a winter severity index for the State of Nebraska (NEWINS). NEWINS is an event-driven index that was derived for the Nebraska Department of Transportation (NDOT) and its districts across the state. The NEWINS framework includes a categorical storm classification framework and climatological aspect to capture atmospheric conditions more accurately across the diverse spatial regions of Nebraska. A ten-year (2006-2016) winter season database of meteorological variables for Nebraska was obtained from the National Centers for Environmental Information. Meteorological parameters were grouped into categories that subsequently provided a storm classification database. The NEWINS is based on a weighted linear combination to the collected database to measure severity statewide and across NDOT individual districts. The NEWINS results were compared to other meteorological variables, many used in other agencies’ winter severity indices. This comparison verified the NEWINS robustness for the observed events for the ten year period. For example, an assessment of the difference between days with observed snowfall versus days with accumulated snowfall revealed a 39% average reduction in days. Furthermore, the NEWINS results highlight the greater number of events during the 2009-2010 winter season, and the lack of events during the 2011-2012 drought year. The NEWINS also shows strong differences monthly and among NDOT districts across the state with a general decrease in events from the western to eastern NDOT districts. In addition, NEWINS storm classifications were compared to NDOT winter maintenance operations performance data for a sample winter season. Last, the 2016-17 winter season was computed to provide a testbed for the NEWINS procedure. It is expected that the NEWINS could help transportation personnel to efficiently allocate resources during adverse weather events, while balancing safety, mobility, and available budget. Further, the theoretical and practical contributions provided by the NEWINS can be used by other agencies to assess their weather sensitivity

The growth of zeolites A, X and mordenite in space

Zeolites are a class of crystalline aluminosilicate materials that form the backbone of the chemical process industry worldwide. They are used primarily as adsorbents and catalysts and support to a significant extent the positive balance of trade realized by the chemical industry in the United States (around $19 billion in 1991). The magnitude of their efforts can be appreciated when one realizes that since their introduction as 'cracking catalysts' in the early 1960's, they have saved the equivalent of 60 percent of the total oil production from Alaska's North Slope. Thus the performance of zeolite catalysts can have a profound effect on the U.S. economy. It is estimated that a 1 percent increase in yield of the gasoline fraction per barrel of oil would represent a savings of 22 million barrels of crude oil per year, representing a reduction of$400 million in the United States' balance of payments. Thus any activity that results in improvement in zeolite catalyst performance is of significant scientific and industrial interest. In addition, due to their 'stability,' uniformity, and, within limits, their 'engineerable' structures, zeolites are being tested as potential adsorbents to purify gases and liquids at the parts-per-billion levels needed in today's electronic, biomedical, and biotechnology industries and for the environment. Other exotic applications, such as host materials for quantum-confined semiconductor atomic arrays, are also being investigated. Because of the importance of this class of material, extensive efforts have been made to characterize their structures and to understand their nucleation and growth mechanisms, so as to be able to custom-make zeolites for a desired application. To date, both the nucleation mechanics and chemistry (such as what are the 'key' nutrients) are, as yet, still unknown for many, if not all, systems. The problem is compounded because there is usually a 'gel' phase present that is assumed to control the degree of supersaturation, and this gel undergoes a continuous 'polymerization' type reaction during nucleation and growth. Generally, for structure characterization and diffusion studies, which are useful in evaluating zeolites for improving yield in petroleum refining as well as for many of the proposed new applications (e.g., catalytic membranes, molecular electronics, chemical sensors) large zeolites (greater than 100 to 1000 times normal size) with minimum lattice defects are desired. Presently, the lack of understanding of zeolite nucleation and growth precludes the custom design of zeolites for these or other uses. It was hypothesized that the microgravity levels achieved in an orbiting spacecraft could help to isolate the possible effects of natural convection (which affects defect formation) and minimize sedimentation, which occurs since zeolites are twice as dense as the solution from which they are formed. This was expected to promote larger crystals by allowing growing crystals a longer residence time in a high-concentration nutrient field. Thus it was hypothesized that the microgravity environment of Earth orbit would allow the growth of large, more defect-free zeolite crystals in high yield