A study on cardiotocography for predicting fetal prognosis in high-risk pregnancy

Background: The admission cardiotocography (CTG) in high-risk obstetrics patients for continuous monitoring of fetal heart rate (FHR) has become crucial in the modern obstetric practice. It is not only a good screening and inexpensive test but also non-invasive, easily performed and interpreted. Methods: This was a prospective observational study conducted in department of obstetrics and gynaecology, Pannadhay Rajkiya Mahila Chikitsalaya at RNT medical college, Udaipur from April 2022 to September 2022. A total of 100 high risk obstetrics patients were subjected to cardiotocography (CTG). The Women eligible for the study were those who had gestational age ≥32 weeks with cephalic presentation in first stage of labour with singleton fetus in vertex presentation and categorised as high-risk during the time of admission. Results: A total of 100 high risk obstetric patients were subjected to CTG. Out of these common high-risk factors in our study consisted of postdated pregnancy (21%) followed by pre-eclampsia (19%), oligohydramnios (16%) cord around neck (13%). Majority of them (47%) fall under 20-25 years and constituted by primigravida (59%).  CTG was reactive in (65%), non-reactive in 25% of cases and 10% patients had suspicious tracings. The incidence of neonatal intensive care unit (NICU) admission, fetal distress and APGAR score less than 7 was significantly higher with suspicious and nonreactive CTG than reactive CTG. Conclusions: CTG test is a simple, non-invasive screening test should be used in high risk pregnancy as admission test. The heavy load of constant monitoring and adverse perinatal outcome can be reduced by CTG monitoring in high-risk obstetrics patients

A Positive Deviance Inquiry on Effective Communicative Practices of Rural Indian Women Entrepreneurs

Why do some rural women entrepreneurs in India succeed despite low levels of literacy, staggering household responsibility, unsupportive social structures, and oppressive cultural practices? The present article employed the Positive Deviance (PD) approach to identify the effective communication practices of rural women entrepreneurs in Uttar Pradesh, India, who succeed against overwhelming odds. Starting with an initial pool of 21,024 rural Indian women who received microloans for income-generation, and through several sieving rounds of focus group conversations with over 1,100 women, 24 PD women entrepreneurs were identified. A variety of participatory processes and liberating structures—Discovery and Action Dialogues (DADs), improvisational theater and prototyping, personal storytelling, and card-sorting games—were employed to identify the highly uncommon practices of PD entrepreneurs. These uncommon practices included micro interpersonal behaviours to connect deeply with customers, personalised branding of their businesses, daily diary jottings to monitor sales and profits, reframing value propositions to persuade customers, and others.publishedVersio

Impact of an International Nosocomial Infection Control Consortium multidimensional approach on central line-associated bloodstream infection rates in adult intensive care units in eight cities in India

SummaryObjectiveTo evaluate the impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional infection control approach on central line-associated bloodstream infection (CLABSI) rates in eight cities of India.MethodsThis was a prospective, before-and-after cohort study of 35650 patients hospitalized in 16 adult intensive care units of 11 hospitals. During the baseline period, outcome surveillance of CLABSI was performed, applying the definitions of the CDC/NHSN (US Centers for Disease Control and Prevention/National Healthcare Safety Network). During the intervention, the INICC approach was implemented, which included a bundle of interventions, education, outcome surveillance, process surveillance, feedback on CLABSI rates and consequences, and performance feedback. Random effects Poisson regression was used for clustering of CLABSI rates across time periods.ResultsDuring the baseline period, 9472 central line (CL)-days and 61 CLABSIs were recorded; during the intervention period, 80898 CL-days and 404 CLABSIs were recorded. The baseline rate was 6.4 CLABSIs per 1000 CL-days, which was reduced to 3.9 CLABSIs per 1000 CL-days in the second year and maintained for 36 months of follow-up, accounting for a 53% CLABSI rate reduction (incidence rate ratio 0.47, 95% confidence interval 0.31–0.70; p=0.0001).ConclusionsImplementing the six components of the INICC approach simultaneously was associated with a significant reduction in the CLABSI rate in India, which remained stable during 36 months of follow-up

Hot-hole extraction from quantum dot to molecular adsorbate

Ultrafast thermalized and hot-hole-transfer processes have been investigated in CdSe quantum dot (QD)/catechol composite systems in which hole transfer from photoexcited QDs to the catechols is thermodynamically favorable. A series of catechol derivatives were selected with different electron-donating and -withdrawing groups, and the effect of these groups on hole transfer and charge recombination (CR) dynamics has been investigated. The hole-transfer time was determined using the fluorescence upconversion technique and found to be 2–10 ps depending on the molecular structure of the catechol derivatives. The hot-hole-transfer process was followed after monitoring 2S luminescence of CdSe QDs. Interestingly, hot-hole extraction was observed only in the CdSe/3-methoxycatechol (3-OCH₃) composite system owing to the higher electron-donating property of the 3-methoxy group. To confirm the extraction of the hot hole and to monitor the CR reaction in CdSe QD/catechol composite systems, ultrafast transient absorption studies have been carried out. Ultrafast transient-absorption studies show that the bleach recovery kinetics of CdSe QD at the 2S excitonic position is much faster in the presence of 3-OCH₃. This faster bleach recovery at the 2S position in CdSe/3-OCH₃ suggests hot-hole transfer from CdSe QD to 3-OCH₃. CR dynamics in CdSe QD/catechol composite systems was followed by monitoring the excitonic bleach at the 1S position and was found to decrease with free energy of the CR reaction

Ultrafast hole/electron transfer dynamics in a CdSe quantum dot sensitized by pyrogallol red: a super-sensitization system

To find a suitable hole-transporting adsorbate for CdSe quantum dots (QDs), a pyrogallol red (PGR) molecule was chosen where PGR also can sensitize CdSe QDs. Energy level diagrams suggest that the photoexcited hole can be transferred to PGR and photoexcited PGR can inject an electron into CdSe QDs. Steady-state and time-resolved emission studies suggest that the photoexcited hole is transferred to PGR; however, the process is too fast to monitor with the subnanosecond time-resolution spectroscopic technique. Femtosecond transient absorption spectroscopy has been employed to monitor the charge-transfer behavior of the above system in an early time scale. Photoexcitation of pure PGR and CdSe QDs at 400 nm laser light gives the transient absorption due to the photoexcited singlet state of PGR and charge carriers (electron/hole) in CdSe QDs, respectively, in the visible/near-IR region of the absorption spectra. However, on photoexcitation of the CdSe/PGR composite at 400 nm, the PGR cation radical and electron in the CdSe QD were detected in the transient absorption spectra. Hole transfer time from the photoexcited CdSe QD to PGR is found to be 500 fs. The transient signal due to the PGR cation and electron in the CdSe QD also contributed to photoexcitation of PGR on the CdSe QD, where electron injection is found to be <150 fs. Charge recombination dynamics were found to be very slow with time constants of 4 ps (15%) and >200 ps (85%) confirming a grand charge-separated state in the CdSe/PGR composite system

Ultrafast excited state dynamics of S2 and S1 states of triphenylmethane dyes

Excited state dynamics of S2 and S1 states for a series of TPM dyes, pyrogallol red (PGR), bromopyrogallol red (Br-PGR) and aurin tricarboxylic acid (ATC), have been monitored by using ultrafast transient absorption and fluorescence up-conversion techniques. Optical absorption studies indicate that all the TPM dyes exist as keto–enol tautomers depending upon the pH of the solution. Interestingly, all the TPM dyes give S2 emission (major emitting state) in addition to weak S1 emission. S2 emission lifetimes as fast as ∼150–300 fs and S1 emission lifetimes of 2–5 ns were observed depending upon the molecular structure of the dyes. Femtosecond transient absorption studies suggest the presence of an ultrafast non-radiative decay channel from the S2 state in addition to S2 luminescence. The vibrational relaxation time from hot S1 state is found to be 2–6 ps. The heavy atom effect has been observed in ultrafast relaxation dynamics of Br-PG

Ultrafast Hole/Electron Transfer Dynamics in a CdSe Quantum Dot Sensitized by Pyrogallol Red: A Super-Sensitization System

To find a suitable hole-transporting adsorbate for CdSe quantum dots (QDs), a pyrogallol red (PGR) molecule was chosen where PGR also can sensitize CdSe QDs. Energy level diagrams suggest that the photoexcited hole can be transferred to PGR and photoexcited PGR can inject an electron into CdSe QDs. Steady-state and time-resolved emission studies suggest that the photoexcited hole is transferred to PGR; however, the process is too fast to monitor with the subnanosecond time-resolution spectroscopic technique. Femtosecond transient absorption spectroscopy has been employed to monitor the charge-transfer behavior of the above system in an early time scale. Photoexcitation of pure PGR and CdSe QDs at 400 nm laser light gives the transient absorption due to the photoexcited singlet state of PGR and charge carriers (electron/hole) in CdSe QDs, respectively, in the visible/near-IR region of the absorption spectra. However, on photoexcitation of the CdSe/PGR composite at 400 nm, the PGR cation radical and electron in the CdSe QD were detected in the transient absorption spectra. Hole transfer time from the photoexcited CdSe QD to PGR is found to be 500 fs. The transient signal due to the PGR cation and electron in the CdSe QD also contributed to photoexcitation of PGR on the CdSe QD, where electron injection is found to be <150 fs. Charge recombination dynamics were found to be very slow with time constants of 4 ps (15%) and >200 ps (85%) confirming a grand charge-separated state in the CdSe/PGR composite system

Spectroscopy and femtosecond dynamics of water soluble type I CdSe/ZnS core–shell quantum dot

Thiol-capped type I CdSe/ZnS core–shell quantum dot nanostructures have been synthesized at low temperature in water; and then characterized by steady-state absorption and photoluminescence (PL) studies and high resolution TEM (HRTEM) measurements. On excitation of CdSe quantum dot predominantly surface state emission was detected, however on ZnS shell formation prominent exciton emission of CdSe with much higher overall quantum yield was observed. Femtosecond up-conversion measurements reveal that exciton emission found to decay much faster as compared to that of surface state emission. Lifetime of CdSe exciton emission found to increases with ZnS shell thickness. Femtosecond transient absorption studies have been carried out on these QD and core–shell material at 400 nm laser light and monitored the transients in the visible region to study charge carrier dynamics in ultrafast time scale. On laser excitation electron–hole pairs are generated which are detected by induced absorption signal for the charge carriers in visible region and immediate bleach at excitonic position for both QD and QD core–shell. Carrier quenching studies has been carried out for both CdSe and CdSe/ZnS by using benzoquinone (BQ, electron quencher) and pyridine (Py, hole quencher) suggest that although CdSe/ZnS form type I core–shell, still both electron and hole found to be leaked through ZnS shell from CdSe core

A Positive Deviance Inquiry on Effective Communicative Practices of Rural Indian Women Entrepreneurs

Why do some rural women entrepreneurs in India succeed despite low levels of literacy, staggering household responsibility, unsupportive social structures, and oppressive cultural practices? The present article employed the Positive Deviance (PD) approach to identify the effective communication practices of rural women entrepreneurs in Uttar Pradesh, India, who succeed against overwhelming odds. Starting with an initial pool of 21,024 rural Indian women who received microloans for income-generation, and through several sieving rounds of focus group conversations with over 1,100 women, 24 PD women entrepreneurs were identified. A variety of participatory processes and liberating structures—Discovery and Action Dialogues (DADs), improvisational theater and prototyping, personal storytelling, and card-sorting games—were employed to identify the highly uncommon practices of PD entrepreneurs. These uncommon practices included micro interpersonal behaviours to connect deeply with customers, personalised branding of their businesses, daily diary jottings to monitor sales and profits, reframing value propositions to persuade customers, and others