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Background: Point-of-care ultrasound (POCUS) implemented through task shifting to nontraditional users has potential as a diagnostic adjuvant to enhance acute obstetrical care in resource-constrained environments with limited access to physician providers. Objective: This study evaluated acute obstetrical needs and the potential role for POCUS programming in the North East region of Haiti. Methods: Data was collected on all women presenting to the obstetrical departments of two Ministry of Public Health and Population (MSPP)-affiliated public hospitals in the North East region of Haiti: Fort Liberté Hospital and Centre Medicosocial de Ouanaminthe. Data was obtained via retrospective review of hospital records from January 1 through March 31, 2016. Trained personnel gathered data on demographics, obstetrical history, diagnoses, clinical care and outcomes using a standardized tool. Diagnoses a priori, defined as those diagnoses whose detection could be assisted with POCUS, included multi-gestations, non-vertex presentation, cephalopelvic disproportion, placental abruption, placenta previa, spontaneous abortions, retained products and ectopic pregnancy. Results: Data were collected from 589 patients during the study period. Median maternal age was 26 years and median gestational age was 38 weeks. The most common reason for seeking care was pelvic pain (85.2%). Sixty-seven (11.5%) women were transferred to other facilities for higher-level care. Among cases not transferred, post-partum hemorrhage, infant mortality and maternal mortality occurred in 2.4%, 3.0% and 0.6% of cases, respectively. There were 69 cases with diagnoses that could have benefited from POCUS use. Between sites, significantly more cases had the potential for improved diagnostics with POCUS at Fort Liberté Hospital (19.8%) than Centre Medicosocial de Ouanaminthe (8.2%) (p < 0.001). Conclusion: Acute obstetrical care is common and POCUS has the potential to impact the care of obstetrical patients in the North East region of Haiti. Future programs evaluating the feasibility of task shifting and the sustainable impacts of acute obstetric POCUS in Haiti will be important.

As we expand the search for life beyond Earth, a water-dominated planet, we turn our eyes to other aquatic worlds. Microbial life found in Earth’s many extreme habitats are considered useful analogs to life forms we are likely to find in extraterrestrial bodies of water. Modern-day benthic microbial mats inhabiting the low-oxygen, high-sulfur submerged sinkholes of temperate Lake Huron (Michigan, USA) and microbialites inhabiting the shallow, high-carbonate waters of subtropical Laguna Bacalar (Yucatan Peninsula, Mexico) serve as potential working models for exploration of extraterrestrial life. In Lake Huron, delicate mats comprising motile filaments of purple-pigmented cyanobacteria capable of oxygenic and anoxygenic photosynthesis and pigment-free chemosynthetic sulfur-oxidizing bacteria lie atop soft, organic-rich sediments. In Laguna Bacalar, lithification by cyanobacteria forms massive carbonate reef structures along the shoreline. Herein, we document studies of these two distinct earthly microbial mat ecosystems and ponder how similar or modified methods of study (e.g., robotics) would be applicable to prospective mat worlds in other planets and their moons (e.g., subsurface Mars and under-ice oceans of Europa). Further studies of modern-day microbial mat and microbialite ecosystems can add to the knowledge of Earth’s biodiversity and guide the search for life in extraterrestrial hydrospheres.

Objective: The present study evaluates the concurrent and predictive validity of the Seguin Form Board Test (SFBT) as an intelligence tool for children in low- and middle-income countries. Methods: In a cohort of normal children, followed up in South India, two cross-sectional analyses were done at 3 and 7 years of age on 95 children. The SFBT and Vineland Social Maturity Scale (VSMS) were done at 3 years of age and Malin’s Intelligence Scale for Indian Children (MISIC) and the VSMS were done at 7 years of age, and the results were compared for concurrent and predictive validity for the SFBT. Results: Intelligence quotient and social quotient had positive correlations at 3 years of age, indicating fair concurrent validity. The SFBT done at around 3 years of age had good positive correlation with MISIC at 7 years of age, indicating good predictive validity. Conclusion: This study shows the utility of the SFBT as a community-based intelligence tool with acceptable concurrent and predictive validity.

Context: Gait termination time (GTT) has been used to predict falls in older adults but has not been explored in the sport rehabilitation setting. The incorporation of a concurrent cognitive task as a complex measure of gait in this clinical population could lead to better health-related outcomes. Objective: To compare the effect of planned and unplanned gait termination with and without a concurrent cognitive task on reaction time (RT), gait velocity, and GTT. Design: Cross-sectional. Setting: Laboratory. Participants: Twenty young adults (females 60.0%, age 20.1 [0.9] y, height 169.5 [8.8] cm, mass 67.4 [10.8] kg). Intervention: Participants completed 6 planned and 6 unplanned gait termination trials on an instrumented gait mat with and without a cognitive task. Main Outcome Measures: The authors measured RT (s), gait velocity (m/s), GTT (s), and normalized GTT (s2/m). A 2 (motor) × 2 (cognitive) repeated-measures analysis of variance (α =.05) was used; significant interaction effects were explored using Bonferroni-corrected t tests (α <.008). Results: Participants walked more slowly during dual-task trials compared with single-task trials (F1,19 = 4.401, P =.050). Participants walked significantly more slowly with a cognitive task during planned (P <.001, mean difference = −0.184 m/s, 95% CI, −0.256 to −0.111) and unplanned (P =.001, mean difference = −0.111 m/s, 95% CI, −0.173 to −0.050) gait termination. Participants walked significantly more slowly (P <.001, mean difference = −0.142 m/s, 95% CI, −0.210 to −0.075) when performing the most difficult task, unplanned termination with a cognitive task, than when performing the least difficult task, planned termination with no cognitive task. We observed a cognitive task main effect such that adding a cognitive task increased RT (F1,19 = 16.375, P =.001, mean difference = −0.118 s, 95% CI, −0.178 to −0.057) and slowed normalized GTT (F1,19 = 5.655, P =.028, mean difference = −0.167 s2/m, 95% CI, −0.314 to −0.020). Conclusions: Overall, participants displayed more conservative gait strategies and slower RT, normalized GTT, and gait velocity as task difficulty increased. More investigation is needed to truly understand the clinical meaningfulness of these measures in athletic injuries. [ABSTRACT FROM AUTHOR]

Evaluates abnormal liver function test results in asymptomatic patients. Causes of asymptomatic liver disease; Routine liver function tests not always specific for liver disease; Effect of cellular injury on alanine transaminase and aspartate transaminase; Specific etiologies of abnormal liver function test results; Drugs and other substances that may cause abnormal liver function test results; History and physical examination of liver diseases.