Cradling disparities: A descriptive qualitative study of maternal experiences of mothers from low-socioeconomic status in the first month postpartum.

AIM: To explore the experiences, expectations and needs of mothers from low-socioeconomic status at 1 month postpartum. DESIGN: Descriptive qualitative. METHODS: Mothers from low-socioeconomic status and irrespective of their parity were invited to participate in one-to-one interviews at 1 month postpartum. Semi-structured interviews were conducted until data saturation. Interviews were audio recorded, transcribed verbatim and analysed thematically. Written informed consent was obtained. RESULTS: Twenty mothers participated and six themes were identified: (1) No choice but to find meaning; (2) Father as a major pillar of support; (3) 'Kampung' Spirit; (4) Trials and Tribulations of Transition to Motherhood; (5) Shame, guilt and internalized stigma and (6) Reclaiming the power. CONCLUSION: This study reflected the unique struggles of mothers from low-socioeconomic status with pregnancy, childbirth and early postpartum and the wider health inequities within Singapore's maternal health system. To provide much-needed support and improved care, the stakeholders within government, healthcare providers and social organizations should consider the niche needs of this community. IMPLICATIONS FOR PATIENT CARE: Nurses need to reflect on their own biases and ensure consistent care delivery regardless of socioeconomic status. When delivering patient education, patient-centred and sincere advice rooted in personal experience can help to establish rapport. IMPACT: This study is the first to explore the experiences of mothers from low-socioeconomic status in the Singapore context. Low-socioeconomic status mothers experienced less autonomy over their health, the care they received and their childcare options. As mothers adjusted to their new roles, they struggled to cope. However, as they were wary of the stigma surrounding poverty and their guilt of not being a 'good mother', they preferred to seek informal support from their family, friends and self-help through learning from social media, as compared to formal, external help. REPORTING METHOD: COREQ checklist. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Wastewater surveillance to infer COVID-19 transmission: A systematic review.

Successful detection of SARS-COV-2 in wastewater suggests the potential utility of wastewater-based epidemiology (WBE) for COVID-19 community surveillance. This systematic review aims to assess the performance of wastewater surveillance as early warning system of COVID-19 community transmission. A systematic search was conducted in PubMed, Medline, Embase and the WBE Consortium Registry according to PRISMA guidelines for relevant articles published until 31st July 2021. Relevant data were extracted and summarized. Quality of each paper was assessed using an assessment tool adapted from Bilotta et al.'s tool for environmental science. Of 763 studies identified, 92 studies distributed across 34 countries were shortlisted for qualitative synthesis. A total of 26,197 samples were collected between January 2020 and May 2021 from various locations serving population ranging from 321 to 11,400,000 inhabitants. Overall sample positivity was moderate at 29.2% in all examined settings with the spike (S) gene having maximum rate of positive detections and nucleocapsid (N) gene being the most targeted. Wastewater signals preceded confirmed cases by up to 63 days, with 13 studies reporting sample positivity before the first cases were detected in the community. At least 50 studies reported an association of viral load with community cases. While wastewater surveillance cannot replace large-scale diagnostic testing, it can complement clinical surveillance by providing early signs of potential transmission for more active public health responses. However, more studies using standardized and validated methods are required along with risk analysis and modelling to understand the dynamics of viral outbreaks.

Mutations in atpG2 may confer resistance to gentamicin in Listeria monocytogenes.

Introduction Listeriosis, a foodborne infection caused by Listeria monocytogenes, could lead to febrile listerial gastroenteritis and a more invasive form which is often associated with a high mortality and hospitalisation rate. Gentamicin, used as an adjunct therapy with ampicillin, remains the treatment of choice for this life-threatening and invasive infection.Gap statement Nevertheless, there is little data on gentamicin resistance determinants in L. monocytogenes.Aim In this study, we selected and characterised B2b, a gentamicin-resistant mutant derived from L. monocytogenes ATCC 19115 to determine the target(s) of resistance in L. monocytogenes after exposure to gentamicin.Methodology Whole-genome sequencing was carried out to identify the mutation site(s) and possible mechanism(s) of resistance. The mutant was characterised using antimicrobial susceptibility testing and PCR. For biological verifications, complementation and allelic exchange mutagenesis were carried out.Results We found that the gentamicin resistance in B2b was caused by a 10 bp deletion in atpG2 which encodes a gamma subunit of the ATP synthase in L. monocytogenes. Using atpG2 PCR, various other mutations were identified in other gentamicin resistant mutants derived from ATCC 19115. In addition, the mutation from B2b, when introduced into L. ivanovii, also caused gentamicin resistance in this Listeria species.Conclusion Hence, atpG2 mutations appear to be important determinants of gentamicin resistance not only in L. monocytogenes but possibly also in other Listeria species.

Definition of the hypothalamic GnRH pulse generator in mice.

The pulsatile release of luteinizing hormone (LH) is critical for mammalian fertility. However, despite several decades of investigation, the identity of the neuronal network generating pulsatile reproductive hormone secretion remains unproven. We use here a variety of optogenetic approaches in freely behaving mice to evaluate the role of the arcuate nucleus kisspeptin (ARNKISS) neurons in LH pulse generation. Using GCaMP6 fiber photometry, we find that the ARNKISS neuron population exhibits brief (∼1 min) synchronized episodes of calcium activity occurring as frequently as every 9 min in gonadectomized mice. These ARNKISS population events were found to be near-perfectly correlated with pulsatile LH secretion. The selective optogenetic activation of ARNKISS neurons for 1 min generated pulses of LH in freely behaving mice, whereas inhibition with archaerhodopsin for 30 min suppressed LH pulsatility. Experiments aimed at resetting the activity of the ARNKISS neuron population with halorhodopsin were found to reset ongoing LH pulsatility. These observations indicate the ARNKISS neurons as the long-elusive hypothalamic pulse generator driving fertility.

Intraocular pressure spikes after a sequential laser peripheral iridotomy for angle closure.

OBJECTIVE: To determine the incidence of intraocular pressure (IOP) spikes within the first 30 minutes after sequential argon-Nd:YAG laser peripheral iridotomy (LPI) in patients with angle closure and to explore risk factors for their occurrence. METHODS: A total of 428 consecutive eyes of 298 patients who had undergone LPI at the Singapore National Eye Centre between June 2011 and August 2011 were reviewed retrospectively. There were 238 primary angle closure suspect eyes, 85 primary angle closure eyes, 92 primary angle closure glaucoma eyes, and 13 acute primary angle closure (APAC) eyes. The pre-LPI IOP and post-LPI IOP, gonioscopic findings, medications, laser parameters, and the need for acute IOP-lowering treatment were recorded. RESULTS: The proportion of patients with a post-LPI IOP elevation ≥8 mm Hg was 10.7% (n=46) and those with a significant IOP spike of ≥30 mm Hg was 31 (7.2%). There were no significant differences between those with or without a post-LPI IOP elevation ≥8 mm Hg and those with or without a post-LPI IOP of ≥30 mm Hg, in terms of age, gender, race, total laser energy used, and seniority of the physician performing the procedure. Patients who experienced IOP spike ≥8 mm Hg were on fewer pre-LPI medications (P=0.009). On logistic regression, patients with APAC had a significantly higher probability of an IOP spike (P=0.003). CONCLUSIONS: The incidence of postsequential LPI IOP elevation ≥8 mm Hg was 10.7%. The primary diagnosis of APAC was a risk factor, and using preprocedure ocular hypotensives can potentially reduce their occurrence.

Personality of social robots perceived through the appearance.

Past research showed that people are able to perceive the personality of others at zero acquaintances. There are two main ways, verbal and non-verbal methods, which play an important role for one in perceiving personality of others. Extensive research was conducted in relating personality with verbal, paralinguistic and gestures cues. However, there are not much research, to our knowledge, that relates the appearance and perceived personality of robots. The main objective of this research is to relate individual design features with big five perceived personality of the robots. We used the results of rated perceptions across 100 pictorial images of robots and relate the results with the 40 individual design features using General Linear Model (GLM). The initial results of the GLM analysis showed that participants' rating of personality of robot fell along the dimension of perceived friendliness which is a common rotation of extroversion and agreeableness. Some relationships were found between humanlike design features and perceived friendliness of robots. Since participants are more familiar with humans, participants perceived robots with humanlike features friendlier than the others. Some other findings such as color and surface material were found related with participants' perceived friendliness as well. In the future, we will work on the analysis of the main and interaction effects of individual features on user's perceived friendliness.

Pediatric Orbital Blow-Out Fractures: Surgical Outcomes.

PURPOSE: The objective of this study was to evaluate the features, timing of intervention, complications, and outcomes of patients who underwent surgery for pediatric orbital blow-out fractures. DESIGN: This was a retrospective case review studying all cases of pediatric orbital blow-out fractures that underwent surgical intervention from 2000 to 2009 in a tertiary ophthalmic center in Singapore. METHODS: Case notes review of all cases of pediatric orbital blow-out fractures repaired surgically was carried out for demographics, time to intervention, and outcome. How the various factors may affect the outcome was statistically analyzed. RESULTS: A total of 23 patients were reviewed. There were 21 patients (91.3%) with floor fractures, 1 (4.3%) with medial wall fracture, and 1 (4.3%) with combined medial wall and floor fracture. Of the 21 cases of floor fracture, 20 cases had radiological images available for review, 17 (85%) were linear, and 3 (15%) were open. Patients with open fractures were older with a mean age of 14.0 years as compared with 12.6 years in those with linear fractures. The mean duration from injury to intervention was 13.0 days. Preoperatively, 14 (60.9%) had diplopia, but only 4 cases (17.4%) had diplopia in extreme gaze at the last follow-up after surgery (18 months). Outcome was not affected by age, duration between injury and intervention, type of fracture, and nature of implants used. CONCLUSIONS: Our study demonstrated that pediatric orbital blow-out fractures had good outcomes. It might also suggest the possibility of not having to manage all linear fractures as a surgical emergency.

Central corneal thickness in Chinese subjects with primary angle closure glaucoma.

PURPOSE: To characterize central corneal thickness (CCT) in Chinese eyes with primary angle closure glaucoma (PACG). METHODS: CCT was measured by ultrasound pachymetry in PACG eyes and compared with primary open-angle glaucoma (POAG) eyes. POAG eyes were further subdivided into high-tension glaucoma (HTG) and normal-tension glaucoma (NTG) for analysis. PACG eyes had glaucomatous optic neuropathy and visual field loss, an angle in which at least 180 degrees of angle in which the posterior trabecular meshwork was not visible, and raised intraocular pressure (IOP) and/or peripheral anterior synechiae. Both HTG (IOP >21 mm Hg) and NTG (IOP consistently <21 mm Hg) eyes had glaucomatous optic neuropathy with compatible visual field defects and open angles. Further comparison was made with CCT data of 1067 normal subjects previously enrolled in a population-based study. RESULTS: We enrolled 154 patients with PACG and 300 with POAG. Mean age of PACG patients was 68.1±8.3 years compared with 71.1±12.4 years in POAG patients (P=0.002). There was no difference in mean CCT of PACG eyes (541.28±33.95 µm) and POAG eyes (539.28±34.84 µm, P=0.56) or normal eyes of control subjects (536.74±31.08 µm) (P=0.07). However, mean CCT of NTG eyes (535.23±36.10 µm) was significantly lower than that of HTG eyes (543.44±33.10 µm, P=0.04), and HTG eyes had thicker CCT than normal eyes (P=0.01). CONCLUSIONS: PACG eyes had similar CCT as those with POAG or normal eyes in Chinese subjects.