Barriers and enablers to integrating maternal and child health services to antenatal care in low and middle income countries.

UNLABELLED: Antenatal care (ANC) represents a delivery platform for a broad range of health services; however, these opportunities are insufficiently utilised. This review explores key barriers and enablers for successful integration of health s"ervices with ANC in different contexts. Data from peer-reviewed and grey literature were organised using the SURE checklist. We identified 46 reports focusing on integration of HIV, tuberculosis, malaria, syphilis or nutrition services with ANC from Asia, Africa and the Pacific. Perspectives of service users and providers, social and political factors, and health system characteristics (such as resource availability and organisational structures) affected ease of integration. TWEETABLE ABSTRACT: Health system factors, context and stakeholders must be considered for integrated antenatal care services.

Dynamic navigation-assisted bone ring technique for partially edentulous patients with severe vertical ridge defects.

The autogenous bone ring technique is among the approaches for vertical alveolar ridge augmentation, and this technique can enable simultaneous implantation. However, the outcomes can be compromised due to donor site morbidity, shifting of the bone ring graft positioning, and inaccurate implant placement. In recent decades, dynamic navigation systems have been introduced into the field of implantology, allowing the accuracy of outcomes to be improved. This Technical Note describes the use of dynamic navigation to guide bone ring surgery, which is expected to enable more precise and predictable bone augmentation and implantation procedures, reduce the risk of injuries to the adjacent anatomical structures, and achieve better treatment outcomes.

Effects of common dissolved anions on the reduction of para-chloronitrobenzene by zero-valent iron in groundwater.

Batch tests were conducted to evaluate the influences of several common dissolved anions in groundwater on the reduction of para-chloronitrobenzene (p-CNB) by zero-valent iron (ZVI). The results showed that p-CNB reduction was enhanced by both Cl(-) and SO(4)(2-). HCO(3)(-) could either improve or inhibit p-CNB reduction, depending on whether the mixing speed was intense enough to rapidly eliminate Fe-carbonate complex deposited on ZVI surface. Above a concentration of 100 mg L(-1), NO(3)(-) increased the p-CNB reduction rate. The reduction rate by ClO(4)(-) decreased because the ClO(4)(-) competed with p-CNB for electrons. The p-CNB reduction was inhibited by PO(4)(3-), SiO(3)(2-) and humic acid, in the order humic acid < PO(4)(3-) < SiO(3)(2-), since these ions could form inner-sphere complexes on iron surface. The reaction even ceased when the ion concentrations were greater than 4, 0.5, and 30 mg L(-1), respectively. The results indicated that common dissolved anions in groundwater should be taken into account when ZVI is applied for contaminated groundwater remediation.

Hospital-onset COVID-19 infection surveillance systems: a systematic review.

Hospital-onset COVID-19 infections (HOCIs) are associated with excess morbidity and mortality in patients and healthcare workers. The aim of this review was to explore and describe the current literature in HOCI surveillance. Medline, EMBASE, the Cochrane Database of Systematic Reviews, the Cochrane Register of Controlled Trials, and MedRxiv were searched up to 30 November 2020 using broad search criteria. Articles of HOCI surveillance systems were included. Data describing HOCI definitions, HOCI incidence, types of HOCI identification surveillance systems, and level of system implementation were extracted. A total of 292 citations were identified. Nine studies on HOCI surveillance were included. Six studies reported on the proportion of HOCI among hospitalized COVID-19 patients, which ranged from 0 to 15.2%. Six studies provided HOCI case definitions. Standardized national definitions provided by the UK and US governments were identified. Four studies included healthcare workers in the surveillance. One study articulated a multimodal strategy of infection prevention and control practices including HOCI surveillance. All identified HOCI surveillance systems were implemented at institutional level, with eight studies focusing on all hospital inpatients and one study focusing on patients in the emergency department. Multiple types of surveillance were identified. Four studies reported automated surveillance, of which one included real-time analysis, and one included genomic data. Overall, the study quality was limited by the observational nature with short follow-up periods. In conclusion, HOCI case definitions and surveillance methods were developed pragmatically. Whilst standardized case definitions and surveillance systems are ideal for integration with existing routine surveillance activities and adoption in different settings, we acknowledged the difficulties in establishing such standards in the short-term.