Antenatal dexamethasone for early preterm birth in low-resource countries

BACKGROUND: The safety and efficacy of antenatal glucocorticoids in women in low-resource countries who are at risk for preterm birth are uncertain. METHODS: We conducted a multicountry, randomized trial involving pregnant women between 26 weeks 0 days and 33 weeks 6 days of gestation who were at risk for preterm birth. The participants were assigned to intramuscular dexamethasone or identical placebo. The primary outcomes were neonatal death alone, stillbirth or neonatal death, and possible maternal bacterial infection; neonatal death alone and stillbirth or neonatal death were evaluated with superiority analyses, and possible maternal bacterial infection was evaluated with a noninferiority analysis with the use of a prespecified margin of 1.25 on the relative scale. RESULTS: A total of 2852 women (and their 3070 fetuses) from 29 secondary- and tertiary-level hospitals across Bangladesh, India, Kenya, Nigeria, and Pakistan underwent randomization. The trial was stopped for benefit at the second interim analysis. Neonatal death occurred in 278 of 1417 infants (19.6%) in the dexamethasone group and in 331 of 1406 infants (23.5%) in the placebo group (relative risk, 0.84; 95% confidence interval [CI], 0.72 to 0.97; P=0.03). Stillbirth or neonatal death occurred in 393 of 1532 fetuses and infants (25.7%) and in 444 of 1519 fetuses and infants (29.2%), respectively (relative risk, 0.88; 95% CI, 0.78 to 0.99; P=0.04); the incidence of possible maternal bacterial infection was 4.8% and 6.3%, respectively (relative risk, 0.76; 95% CI, 0.56 to 1.03). There was no significant between-group difference in the incidence of adverse events. CONCLUSIONS: Among women in low-resource countries who were at risk for early preterm birth, the use of dexamethasone resulted in significantly lower risks of neonatal death alone and stillbirth or neonatal death than the use of placebo, without an increase in the incidence of possible maternal bacterial infection.Fil: Oladapo, Olufemi T.. Organizacion Mundial de la Salud; ArgentinaFil: Vogel, Joshua P.. Organizacion Mundial de la Salud; ArgentinaFil: Piaggio, Gilda. Organizacion Mundial de la Salud; ArgentinaFil: Nguyen, My-Huong. Organizacion Mundial de la Salud; ArgentinaFil: Althabe, Fernando. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; ArgentinaFil: Metin Gülmezoglu, A.. Organizacion Mundial de la Salud; ArgentinaFil: Bahl, Rajiv. Organizacion Mundial de la Salud; ArgentinaFil: Rao, Suman P.N.. Organizacion Mundial de la Salud; ArgentinaFil: de Costa, Ayesha. Organizacion Mundial de la Salud; ArgentinaFil: Gupta, Shuchita. Organizacion Mundial de la Salud; ArgentinaFil: Shahidullah, Mohammod. No especifíca;Fil: Chowdhury, Saleha B.. No especifíca;Fil: Ara, Gulshan. No especifíca;Fil: Akter, Shaheen. No especifíca;Fil: Akhter, Nasreen. No especifíca;Fil: Dey, Probhat R.. No especifíca;Fil: Abdus Sabur, M.. No especifíca;Fil: Azad, Mohammad T.. No especifíca;Fil: Choudhury, Shahana F.. No especifíca;Fil: Matin, M.A.. No especifíca;Fil: Goudar, Shivaprasad S.. No especifíca;Fil: Dhaded, Sangappa M.. No especifíca;Fil: Metgud, Mrityunjay C.. No especifíca;Fil: Pujar, Yeshita V.. No especifíca;Fil: Somannavar, Manjunath S.. No especifíca;Fil: Vernekar, Sunil S.. No especifíca;Fil: Herekar, Veena R.. No especifíca;Fil: Bidri, Shailaja R.. No especifíca;Fil: Mathapati, Sangamesh S.. No especifíca;Fil: Patil, Preeti G.. No especifíca;Fil: Patil, Mallanagouda M.. No especifíca;Fil: Gudadinni, Muttappa R.. No especifíca;Fil: Bijapure, Hidaytullah R.. No especifíca;Fil: Mallapur, Ashalata A.. No especifíca;Fil: Katageri, Geetanjali M.. No especifíca;Fil: Chikkamath, Sumangala B.. No especifíca;Fil: Yelamali, Bhuvaneshwari C.. No especifíca;Fil: Pol, Ramesh R.. No especifíca;Fil: Misra, Sujata S.. No especifíca;Fil: Das, Leena. No especifíca

Grass Buffer Strips Improve Soil Health and Mitigate Greenhouse Gas Emissions in Center-Pivot Irrigated Cropping Systems

Declining water resources and soil degradation have significantly affected agricultural sustainability across the world. In the southern High Plains of USA, buffer strips of perennial grasses alternating with cultivated corn strips were introduced in center-pivot irrigated crop fields to increase agronomic production and ecosystem services. A study was conducted to evaluate soil carbon (C) and nitrogen (N) dynamics, greenhouse gas (GHG) emissions, and soil health benefits of integrating circular grass buffer strips in the center-pivot irrigated corn production system. Multiple parameters were assessed in the grass buffer strips, and at distances of 1.52, 4.57, and 9.14 m away from the edges of grass strips in corn strips. While grasses in the buffer strips depleted N compared to corn strips, potential C mineralization (PCM) was 52.5% to 99.9% more in grass strips than in corn strips. Soil microbial biomass C (MBC) content was 36.7% to 52.5% greater in grass strips than in corn strips. Grass buffer also reduced carbon dioxide (CO2) and nitrous oxide (N2O) emissions from corn strips. Grass buffer strips can improve soil health and sustainability in center-pivot irrigated cropping systems by increasing soil C components and reducing GHG emissions

Non-extraction treatment of skeletal class II malocclusion

Introduction: Every orthodontist at some point in his clinical practice has faced the dilemma of how ′best′ to manage a mild to moderate Class II malocclusion. Aims and Objectives: To demonstrate the efficacy of Forsus™ Fatigue Resistant Device in the management of Class II malocclusion. Materials and Method: A patient having Class II division 1 malocclusion with functional jaw retrusion was treated using MBT 0.022" prescription and Forsus FRD appliance. Pre- and post-treatment photographs and lateral cephalograms were taken. Cephalometric analysis was done, and results were superimposed. Result: 7-8 months of Forsus wear obtained stable and successful results with improvement in facial profile, skeletal jaw relationship, and mild increase in IMPA. Discussion and Conclusion: Greater forward displacement of the mandible was the predominant factor for successful treatment Class II patient. Forsus gives good results for class II management, and it would be wise to consider treating such cases by non-extraction approach rather than contemplating extractions

Simulation and Analysis of IPFC in power studies

Development of electrical power transmission systems follows closely the increasing demand on electrical energy. With the increasing size and complexity of the transmission networks, the performance of the power systems decreases due to problems associated with load flow, power oscillations and voltage quality. Flexible ac transmission systems (FACTS) and High-voltage direct current (HVDC) technologies offer some effective schemes to meet these demands. In recent years, FACTS technology has been considered as one of feasible solutions, to increase power grid delivery capability and remove identified network bottlenecks. An attempt is made in this paper to discuss the developments, types of FACTS and simulation of IPFC, using SIMULINK is carried out for comparing issues relating to power transmissio

Management of Ureteric Calculi in Dhule City of North-western Maharashtra

Background: Urolithiasis, usually affecting people in the prime of life, causes significant morbidity and loss of productivity. Uretericstones account for 2/3rd of all urinary calculi brought to attention of doctors. The damaging effects of the calculi may result in obstruction with dilatation of the urinary tract, leading to stasis and severe infection. Aims and Objectives: To evaluate patients with urinary stones with regards to the incidence, age, sex,clinical presentation, site, size, side, management and their complications. Material and Methods:It was a prospective study carried out by Department of Surgery at Annasaheb Chudaman Patil Memorial Medical College, and Hospital Dhule for a period of two years. Patients were selected after they were diagnosed as having ureteric calculi. The patients were treated by conservative or surgical methods, and the outcome was monitored. Statistical analysis of the data was done for obtaining results.Result: The majority of the patients were males with peak age group in the second and third decade. Pain in abdomen or loin tenderness was the most common presenting symptom. Most of the patients were treated by conservative medical management. Endourological procedures were the most commonly performed surgical intervention. Conclusion: Most of the patients with ureteric calculi present with painin abdomen and majority can be treated by medical management. With the availability of better facilities the requirement for open surgery is decreasing and endourological procedures are becoming the means of surgical intervention.Complications are minimal with surgical expertise for endourological procedures

New gravity balancing technique and hybrid actuation for spatial serial manipulators

The problem of gravity balancing of robotic systems has been investigated for a long time. A big amount of different designs has been developed so far, but with several limitations: applicability only to planar kinematics or some particular spatial ones, encumbrance and reduced workspace of the robot, complication of both theoretical and practical implementation. This chapter deepens a new simple technique for gravity balancing any spatial serial manipulator with rotational joints, using a number of springs less or equal to the number of degrees of freedom of the manipulator. Then, such technique is extended to a concept of actuation for robotic systems. Given a robotic manipulator and a force to exert at the level of the end effector, there is no energy consumption regardless of the configuration of the system (like in passive systems), as long as magnitude and orientation of the required force are fixed. Changes in magnitude and/or orientation of the exerted force require some energy to be achieved (like in active systems). Such combined features make an hybrid system with several benefits: low energy consumptions, simplified control and intrinsic safety of the system, with wide prospects in robotics

Seed Yield and Water Productivity of Irrigated Winter Canola (Brassica napus L.) under Semiarid Climate and High Elevation

Canola is a cash crop produced for its highly-valued seed, and as a protein source for animal feed. While winter canola is produced mainly in the high plains, it is expanding to new environments, and is greatly incorporated into crop systems with advantages in terms of increasing crop yield and improving soil health. The objectives of this study were to evaluate eight winter canola genotypes for seed yield, and to determine their water productivity under semiarid climates and high elevations in the Four Corners region at Farmington, New Mexico. A field experiment was conducted at the New Mexico State Agricultural Science Center at Farmington for five growing seasons. Eight genotypes of winter canola (Baldur, Flash, Safran, Sitro, Virginia, Visby, Wichita, and Sumner) were arranged into the randomized complete block design. The field was fully irrigated with a center pivot irrigation system. Results showed that winter canola seed yield was dependent on genotype, varying from 2393 to 5717 kg/ha. The highest yield was achieved by Sitro, and the lowest yield by Sumner. There was inter-annual variation in canola nitrogen-use efficiency (NUE), irrigation water-use efficiency (IWUE), and crop water-use efficiency (CWUE). NUE varied from 12.9 to 50.4 kg seed/kg N, with the highest NUE achieved by Sitro, and the lowest by Sumner. IWUE varied from 0.34 to 0.80 kg/m3, and canola CWUE from 0.28 to 0.69 kg/m3. The highest water productivity was achieved by Sitro. The results of this study showed full assessment of canola production under the semiarid climate in the Four Corners region, and could improve crop productivity and profitability