Poor power quality is a major barrier to providing optimal care in special neonatal care units (SNCU) in Central India [version 1; peer review: 2 approved]

Background: Approximately 25% of all neonatal deaths worldwide occur in India. The Indian Government has established Special Neonatal Care Units (SNCUs) in district and sub-district level hospitals to reduce neonatal mortality, but mortality rates have stagnated. Reasons include lack of personnel and training and sub-optimal quality of care. The role of medical equipment is critical for the care of babies, but its role in improving neonatal outcomes has not been well studied.  Methods: In a qualitative study, we conducted seven focus group discussions with SNCU nurses and pediatric residents and thirty-five key informant interviews and with pediatricians, residents, nurses, annual equipment maintenance contractors, equipment manufacturers, and Ministry of Health personnel in Maharashtra between December 2019 and November 2020. The goal of the study was to understand challenges to SNCU care. In this paper, we focus on current gaps and future needs for SNCU equipment, quality of the power supply, and use of SNCU equipment. Results: Respondents described a range of issues but highlighted poor power quality as an important cause of equipment malfunction. Other concerns were lack of timely repair that resulted in needed equipment being unavailable for neonatal care. Participants recommended procuring uninterrupted power supply (UPS) to protect equipment, improving quality/durability of equipment to withstand constant use, ensuring regular proactive maintenance for SNCU equipment, and conducting local power audits to discern and address the causes of power fluctuations. Conclusions: Poor power quality and its negative impact on equipment function are major unaddressed concerns of those responsible for the care and safety of babies in SNCUs in Central India. Further research on the power supply and protection of neonatal equipment is needed to determine a cost-effective way to improve access to supportive care in SNCUs and desired improvements in neonatal mortality rates

Proton events at geostationary altitude during 2005, their relationship to solar wind and IMF parameters, and their 'geoeffectiveness'

Solar wind and IMF parameters from the ACE satellite at the Earth's dayside Lagrangian point LI, are examined during solar proton events of 2005 for 'shock' structures. The GOES-10 satellite at geostationary orbit (G) sees proton events in the 10-30 MeV energy range only when the flux of these particles exceeds (5 x 10(-1)) protons/cm(2).sec.sr. (also known as pfu). Such events are invariably followed at G by REE (Relativistic Electron Events) which commence with an RED (Relative Electron Dropout). During REE, the enhanced flux of > 2 MeV electrons can exceed (> 5 x 104) pfu, and can cause operational anomalies on geostationary satellite instruments. Such large proton events also trigger off at Earth (E), ssc type of storms with typical signatures in the geomagnetic indices Dst and Kp, and large Forbush decreases in the Cosmic Ray Neutron Monitor (CRNM) Count. Relationships between the various Space Weather parameters recorded at L1, G and E during Proton events, assume special importance from the point of view of Satellite Anomaly predictions

Differences between CME associated and CH associated RED events during 2005

As part of study of RED (Relativistic Electron Dropout) events at Geostationary orbit, we have classified them on the basis of their solar causes. We find that the solar causes associated with RED events are Interplanetary (IP) Shocks, Coronal Mass Ejection (CME), Flares, Magnetic Clouds and Corotating Interaction Regions (CIR) followed by Coronal Hole (CH) stream. Here we have taken CME and CH associated RED events during 2005. We have studied Interplanetary parameters (IP) (i.e. solar wind Velocity (Vsw), solar wind Ion density (Nsw), solar wind dynamic pressure (P,,), total Interplanetary magnetic field B along with its north-south component, Bz), Radiation belt (RB) parameters at geostationary orbit (i.e. electron flux >2 MeV, Hp component (i.e. the component of magnetic field parallel to the spin axis of the satellite) and dayside magnetopause distance (MP)) and the geomagnetic indices (i.e. Dst and Kp) and Cosmic Ray Neutron Monitor (CRNM) count. The parameters which show significant differences between CME and CH events are Vsw, Psw, B, Bz, Dst and Kp, with Vsw and Dst showing the largest differences. As typical examples, in the case of the CME of 22 January, 2005, Vsw touches over 975 km s(-1) and Dst is Sudden Storm Commencement (SSC) type with minimum Dst being -110 nT. In the case of the CH of 05 April, Vsw is only 650 km s-1 and Dst is of Gradual Commencement (GC) type with minimum Dst of -80 nT. In this paper we present differences observed in the above mentioned parameters for several RED events associated with CME and CH during 2005

Energy dependence of near-relativistic electron spectrum at geostationary orbit during the SEP events of 2005

In view of the renewed interest in the study of energetic particles in the outer radiation belt of the earth, we feel it will be helpful in looking for the energy dependence of the electron energy spectrum at geostationary orbit. This may give us some insight into how we can safeguard geostationary satellites from functional anomalies of the deep dielectric charging type, which are caused by charge accumulation and subsequent discharge of relativistic electrons. In this study we examine whether there is any energy dependence in relativistic electron enhancements at geosynchronous altitudes during solar energetic proton events of 2005

Hypoglycemic effects of gypsophila paniculata (Baby\u27s Breath) root extract on Streptozocin-induced diabetes in Sprague Dawley rats

The study used an experimental design. A total of 25 Sprague Dawley rats were used for this study. The rats were administered with Streptocozin to induce diabetes. The rats were divided into 5 groups of 5 rats each. Group 1 was treated with metformin, Group 3,4,5 was treated with different concentration of Baby\u27s Breath extract, 100 mg/kg, 150 mg/kg and 200 mg/kg respectively. Group 1 served as the negative control group and was administered with only Normal Saline Solution. Fasting Blood Glucose was determined every three (3) days for six (6) days. Based on the results, the rats treated with 200 mg/kg of Baby\u27s Breath extract possess a hypoglycemic effect. It was concluded that the Baby\u27s breath extract posses a hypoglycemic effect by decreasing the blood glucose level of the rats

Barriers to optimal care for babies in newborn care units that highlight the impact of Covid-19.

Barriers to optimal care for babies in newborn care units that highlight the impact of Covid-19.</p

Consolidated criteria for reporting qualitative studies (COREQ): 32-item checklist.

Consolidated criteria for reporting qualitative studies (COREQ): 32-item checklist.</p

Participants in key informant interviews and focus groups by facility type.

Participants in key informant interviews and focus groups by facility type.</p

Inclusivity in global research.

Nearly one quarter (600,000) of all neonatal deaths worldwide per year occur in India. To reduce neonatal mortality, the Indian Ministry of Health and Family Welfare established neonatal care units, including neonatal intensive care units and specialized neonatal care units to provide immediate care at birth, resuscitation for asphyxiation, postnatal care, follow up for high-risk newborns, immunization, and referral for additional or complex healthcare services. Despite these efforts, neonatal mortality remains high, and measures taken to reduce mortality have been severely challenged by multiple problems caused by the Covid-19 pandemic. In this qualitative study, we conducted seven focus group discussions with newborn care unit nurses and pediatric residents and 35 key informant interviews with pediatricians, residents, nurses, annual equipment maintenance contractors, equipment manufacturers, and Ministry personnel in the Vidarbha region of Maharashtra between December 2019 and November 2020. The goal of the study was to understand barriers and facilitators to providing optimal care to neonates, including the challenges imposed by the Covid-19 pandemic. Covid-19 exacerbated existing barriers to providing optimal care to neonates in these newborn care units. As a result of Covid-19, we found the units were even more short-staffed than usual, with trained pediatric nurses and essential equipment diverted from newborn care to attend to patients with Covid-19. Regular training of neonatal nursing staff was also disrupted due to Covid-19, leaving many staff without the skills to provide optimate care to neonates. Infection control was also exacerbated by Covid-19. This study highlights the barriers to providing optimal care for neonates were made even more challenging during Covid-19 because of the diversion of critically important neonatal equipment and staff trained to use that equipment to Covid-19 wards. The barriers at the individual, facility, and systems levels will remain challenging as the Covid-19 pandemic continues.</div