Adjunctive misoprostol for prevention of post-partum haemorrhage: a pragmatic strategy of selective sequential administration

Background: To evaluate the effect of adjunctive misoprostol in preventing postpartum haemorrhage (PPH) by selective administration above threshold bleeding in order to reduce its side effects in comparison with primary prevention with oxytocin alone.Methods: It was a prospective observational cohort study conducted at Government medical College of central India. Population included 500 low risk women delivering vaginally. After having received oxytocin as primary prevention, women were monitored for bleeding by quantitative assessment of blood loss (QBL) using an innovative drape (kept prepared at the point of care) and once bleeding crossed 350 ml mark, alternate women were given 800 µg misoprostol sublingually as an adjuvant (study group) and compared with those who did not receive adjuvant misoprostol (control group). Main outcome measure: Comparing the incidence of PPH and side effects between study and control group.Results: 150 women had blood loss >350 ml which constituted 76 women in study and control group each. Incidence of PPH was significantly less in the study group (10.52 versus 22.36%, p<0.05, RR 0.470 95% CI= 0.216-1.024). Though side effects were more (38.15%) in study group but these were mild in nature and when the number was extrapolated to all recruited women, the incidence came down to 11.6%.Conclusions: Sequential adjuvant misoprostol at 350 ml blood loss after primary prevention with oxytocin is an effective and pragmatic strategy for preventing PPH when compared to oxytocin alone but with reduced overall side effects owing to less number of women receiving misoprostol

Design of Timer for Application in ATM using FPGA and VHDL

A watchdog timer is a computer hardware timing device that triggers a system reset if the main program, due to some fault condition, such as a hang, neglects to regularly service the watchdog (writing a “service pulse” to it, also referred to as “petting the dog”). The intention is to bring the system back from the hung state into normal operation. Such a timer has got various important applications, one of them being in ATMs (Automated Teller Machine) which we have studied and designed in our project

Visual estimation of blood loss versus quantification of blood loss after vaginal birth using an innovative drape: a prospective study

Background: This study was done to compare the accuracy of visual estimation of blood loss (EBL) and quantitative assessment of blood loss (QBL, sum of volumetric and gravimetric assessment) against a reference standard i.e. calculated QBL (C-QBL) and also with each other after vaginal birth.Methods: Prospective observational cohort study conducted at Pt. JNM medical College Raipur, Chhattisgarh, India and involved 101 low risk women after vaginal birth. Women were allocated alternately to EBL or QBL group (volumetric component of measured blood loss was done with an innovative low cost drape prepared with a plastic apron at the point of care. Gravimetric component was measured by weight difference of the mops and pads before and after use). C-QBL was calculated for each case with a standard formula. Main outcome measure was comparing the correlation coefficient of EBL and QBL each with C-QBL.Results: The mean blood loss in 51 women of EBL group and 50 women of QBL group was 275.29 ml and 380 ml respectively. Pearson’s correlation coefficient (r) of EBL with C-QBL was 0.4984 (weak correlation) compared to that of QBL with C-QBL (r=0.9093, strong positive correlation). The error of underestimation by EBL compared to QBL was 28% (mean=104.71 ml p500 ml by EBL method was 5 (95% CI .605-41.3).Conclusions: Visual EBL should be replaced with QBL for measurement of postpartum blood loss. Using innovative under-buttock low cost drape greatly helps in routine QBL

Hypervascular retained products of conception: dilemma of diagnosis and management

Retained products of conception (RPOC) are a partial retention of placental tissue after dilation and curettage (D&C) procedures or vaginal deliveries. Ultrasound scan reports sometimes mention the presence of increased endometrial / sub‐endometrial vascularity in the context of retained products of conception. This raises the possibility of serious intra‐operative haemorrhage because of the possibility of arterio‐venous malformation. The aim of this article is to discuss the diagnosis and management options of retained products of conception (RPOC) with increased vascularity where simple dilatation and curettage may lead to life threatening haemorrhage and endanger the life of the patient and to enlighten the importance of evaluation of vascularity in all cases of RPOC prior to dilatation and curettage in order to avoid the dreaded complication of massive haemorrhage

Network Design on Undirected Series-Parallel Graphs

We study the single pair capacitated network design problem and the budget constrained max flow problem on undirected series-parallel graphs. These problems were well studied on directed series-parallel graphs, but little is known in the context of undirected graphs. The major difference between the cases is that the source and sink of the problem instance do not necessarily coincide with the terminals of the underlying series-parallel graph in the undirected case, thus creating certain complications. We provide pseudopolynomial time algorithms to solve both of the problems and provide an FPTAS for the budget constrained max flow problem. We also provide some extensions, arguing important cases when the problems are polynomial-time solvable, and describing a series-parallel gadget that captures an edge upgrade version of the problems

Evaluation of micronucleus frequency in oral exfoliated buccal mucosa cells of smokers and tobacco chewers: a comparative study

Background: Oral cancer is one of the tenth most common cancers in the world and constitutes the third most important group of malignancies in India. Majority of these cancers are diagnosed at an advanced stage resulting in poor prognosis and survival rates among patients. Hence early diagnosis of oral cancers seems to be the need of the hour. Analysis of exfoliated buccal cell micronuclei (MN) is a sensitive method of monitoring genetic damage. The present study aims to compare the frequency of micronucleus in tobacco chewers and smokers and thus evaluate the genotoxic potential of these habits.Methods: The study was conducted on 60 subjects, divided into 3 groups each of 20 subjects. Group 1: with history of chewing tobacco, group 2: with history of chewing tobacco and smoking, group 3: healthy subjects without any habits as controls. Oral exfoliated cells were obtained from buccal mucosa of the subjects, 2 slides were prepared from each subject stained with Giemsa and H&E stain respectively. Atleast 1000 cells were examined for each subject and micronuclei frequency was scored according to criteria of Tolbert et al.Results: The mean number of micronuclei was 18.5±9.5 in tobacco chewers, 19.1±9.2 in chewers with smoking habit and 8.2±5.6 in controls. Bonferroni multiple comparisons amongst these three groups showed the mean difference of micronuclei to be highly significant when chewers and chewers with smoking habit were compared to controls. Similarly based on the duration of addiction, a highly significant difference was noted in no. of micronucleated cells in subjects addicted to tobacco for more than 15 years.Conclusions: Tobacco can cause and increase the rate of nuclear anomalies in both smoking and smokeless forms. Thus oral mucosal micronuclei frequency can be used as a marker of epithelial carcinogenic progression.

A comparison of platelet count in severe preeclampsia, mild preeclampsia and normal pregnancy

Background: Preeclampsia, the most common of hypertensive disorders of pregnancy is an idiopathic multisystem disorder affecting 2 – 10% of all pregnancies and together they form one member of the deadly triad, along with hemorrhage and infection that contribute greatly to the maternal morbidity and mortality rates. The identification of this clinical entity and effective management play a significant role in the outcome of pregnancy. Platelet count is emphasized to play a significant role in hemostasis mechanism of preeclampsia and the degree of thrombocytopenia increases with severity of preeclampsia. This study was conducted to find correlation of platelet count in severe preeclampsia, mild preeclampsia and normal subjects.Methods: Total 140 subjects, 70 control and 70 cases were enrolled in the study. Samples for platelet count were collected and estimation was carried out by the auto-analyzers. The statistical evaluation is done using SPSS version 22 along with Anova and student t-test.Results: The mean platelet count was significantly lower (p <0.05) in mild and severe preeclampsia than that in the normal pregnancy. Decreased platelet count in severe preeclampsia was significant compared to that in mild preeclampsia.Conclusions: The frequency of thrombocytopenia was found to be directly related with the severity of disease, so platelet count can be used as a simple and cost effective tool to monitor the progression of preeclampsia, thereby preventing complications to develop during the gestational period

FACTIFY3M: A Benchmark for Multimodal Fact Verification with Explainability through 5W Question-Answering

Combating disinformation is one of the burning societal crises -- about 67% of the American population believes that disinformation produces a lot of uncertainty, and 10% of them knowingly propagate disinformation. Evidence shows that disinformation can manipulate democratic processes and public opinion, causing disruption in the share market, panic and anxiety in society, and even death during crises. Therefore, disinformation should be identified promptly and, if possible, mitigated. With approximately 3.2 billion images and 720,000 hours of video shared online daily on social media platforms, scalable detection of multimodal disinformation requires efficient fact verification. Despite progress in automatic text-based fact verification (e.g., FEVER, LIAR), the research community lacks substantial effort in multimodal fact verification. To address this gap, we introduce FACTIFY 3M, a dataset of 3 million samples that pushes the boundaries of the domain of fact verification via a multimodal fake news dataset, in addition to offering explainability through the concept of 5W question-answering. Salient features of the dataset include: (i) textual claims, (ii) ChatGPT-generated paraphrased claims, (iii) associated images, (iv) stable diffusion-generated additional images (i.e., visual paraphrases), (v) pixel-level image heatmap to foster image-text explainability of the claim, (vi) 5W QA pairs, and (vii) adversarial fake news stories.Comment: arXiv admin note: text overlap with arXiv:2305.0432

Improving Undergraduate Astronomy Students' Skills with Research Literature via Accessible Summaries: A Case Study with Astrobites-based Lesson Plans

Undergraduate physics and astronomy students are expected to engage with scientific literature as they begin their research careers, but reading comprehension skills are rarely explicitly taught in major courses. We seek to determine the efficacy of lesson plans designed to improve undergraduate astronomy (or related) majors' perceived ability to engage with research literature by using accessible summaries of current research written by experts in the field. During the 2022-2023 academic year, twelve faculty members incorporated lesson plans using accessible summaries from Astrobites into their undergraduate astronomy major courses, surveyed their students before and after the activities, and participated in follow-up interviews with our research team. Quantitative and qualitative survey data clearly show that students' perceptions of their abilities with jargon, identifying main takeaways of a paper, conceptual understanding of physics and astronomy, and communicating scientific results all improved with use of the tested lesson plans. Additionally, students show evidence of increased confidence of their abilities within astronomy after exposure to these lessons, and instructors valued a ready-to-use resource to incorporate reading comprehension in their pedagogy. This case study with Astrobites-based lesson plans suggests that incorporating current research in the undergraduate classroom through accessible literature summaries may increase students' confidence and ability to engage with research literature, as well as their preparation for participation in research and applied careers.Comment: Submitted to PRPE

Providing new constraints on Europa's surface composition

243 pagesEuropa, one of the four Galilean moons of Jupiter, is one of the most fascinating planetary bodies in our solar system. A salty, liquid water ocean beneath its surface is a promising environment to explore in order to answer one of the fundamental questions in science for us Earthlings: Are we alone? Has life evolved independently elsewhere? While the path forward in the exploration of Europa should hopefully reach a stage where we can explore the ocean directly using deep sea explorers, akin to oceanography on Earth, in these early stages of exploring Europa we rely on remote sensing to study this icy moon and constrain its habitability. Europa's surface is young, with few craters and geological evidence of surface-ocean exchange. Hence the surface composition of Europa provides a window to its subsurface ocean's composition. Of special interest therefore, are regions on Europa's surface where the surface material is likely 'endogenic': fresh deposits of material that have extruded onto the surface and yet to be fully altered by the intense, high-energy irradiation environment of Jupiter. The problem of characterizing the composition of these surface deposits, especially trace species of interest to the question of habitability, like organics, is challenging. Many candidate species have been proposed to explain the bulk composition of Europa's surface, but ambiguity remains over exact identification. Europa's low reflectance in the near-infrared wavelength regime, especially beyond ~ 2 microns, complicates the identification and characterization of species like organics which, despite being spectroscopically rich in this wavelength region, are expected to have inherently weak signals in the reflectance spectra due to trace abundances. Finally, the spectroscopic features of surface species can be affected by other factors apart from abundance, like the average grain-size and porosity of the planetary regolith, and the observation geometry, and degeneracies between these parameters cannot be ignored. This thesis paves a new way forward for spectroscopic characterization of Europa's surface, introducing a framework that can help answer two fundamental questions about the surface composition: 1) Is there significant evidence for a species in the presence of all possible candidates, allowing for the effects of non-abundance parameters? 2) If there is significant evidence for the presence of a species, then what is its abundance and what are the confidence intervals on that value? A systematic approach that uses these two questions as guide stones for spectroscopic data analysis can help resolve fundamental debates about composition and confidently detect weak signals of trace species on Europa surface. In this thesis, I introduce such a framework, called FROSTIE, and demonstrate its capabilities in three chapters. Firstly, FROSTIE was used to get the first estimate of abundances of amorphous and crystalline forms of water ice on Europa's surface from data collected by the Juno spacecraft, which is of immense consequence as overabundance of crystalline ice is a potential marker for fresh deposits on Europa's surface. Next, FROSTIE permitted a revisit of Galileo spectra of Europa, in their most comprehensive analysis of yet that included the first use of an empirical parameter to account for irradiation-induced spectroscopic shift, demonstrating that there is still a lot to be learned from the Galileo data. Finally, FROSTIE was also applied to assess the feasibility of the promises that the Europa Clipper mission holds, especially when it comes to detecting and characterizing trace organics via remote sensing. The novel framework presented to carry out this assessment can be immensely useful in planning future observations and instruments for exploration of planetary surfaces in the solar system. A fundamental goal that was decided upon as the development of FROSTIE started was to ensure its availability and accessibility to the wider planetary science community. To that end, FROSTIE will be released as an open-source research software package, extensively documented and driven by tutorials, so that many more can participate in accelerating our understanding of Europa's surface composition and habitability