Preconception nutrition intervention improved birth length and reduced stunting and wasting in newborns in south Asia: The women first randomized controlled trial

South Asia has \u3e50% of the global burden of low birth weight (LBW). The objective was to determine the extent to which maternal nutrition interventions commenced before conception or in the 1st trimester improved fetal growth in this region. This was a secondary analysis of combined newborn anthropometric data for the South Asian sites (India and Pakistan) in the Women First Preconception Maternal Nutrition Trial. Participants were 972 newborn of mothers who were poor, rural, unselected on basis of nutritional status, and had been randomized to receive a daily lipid-based micronutrient supplement commencing ≥3 months prior to conception (Arm 1), in the 1st trimester (Arm 2), or not at all (Arm 3). An additional protein-energy supplement was provided if BMI/m2 or gestational weight gain was less than guidelines. Gestational age was established in the 1st trimester and newborn anthropometry obtaine

Challenges of implementing an individual randomized controlled trial (women first: Preconception maternal nutrition study) in a rural study site: A case study from Pakistan

Persistent global disparities in maternal and neonatal outcomes associated with poor maternal nutrition provided the genesis of the Women First (WF) study, an individually randomized controlled trial on preconceptional maternal nutrition. This article describes the challenges that arose in implementing this trial related to nutrition or diet of the mother, in District Thatta-Pakistan. During different phases of the study, we encountered problems in identifying the eligible participants, taking consent from couples, randomizing participants in different arms, conducting biweekly follow-up visits on time, ensuring compliance to the intervention, and measuring the primary outcome within the 24 hours of birth. Each challenge was itself an opportunity for the research team to address the same through effective coordination and teamwork. Moreover, with adequate resources and dedicated staff with diverse backgrounds, it was possible to implement the WF study across the widely scattered geographic clusters of District Thatta. In addition, there are some broad strategies that could be applied to other studies such as very close contact either in person or at least by talking to mothers via phones and rapport with the study participants, the study leadership of country coordinator and the field supervisors to build trust between those on front lines and the study leadership. Moreover, continuous monitoring and supervision with frequent training and refreshers were also found to be more important to assure the data quality and to meet the study targets. Community meetings were also found to be very helpful and effective to follow the participants for a long time. Researchers conducting a similar type of studies particularly in rural areas can learn many lessons from such experiences. Thus, the process of implementing the study in one of the rural areas of Pakistan provides an insight into where and how similar individual randomized trials might be deployed

Use of smokeless tobacco before conception and its relationship with maternal and fetal outcomes of pregnancy in Thatta, Pakistan: Findings from women first study

Introduction: Smokeless tobacco (SLT) consumption during pregnancy has adverse consequences for the mother and fetus. We aimed to investigate the effects of maternal pre-pregnancy SLT consumption on maternal and fetal outcomes in the district of Thatta, Pakistan.Methods: We conducted a secondary data analysis of an individual randomized controlled trial of preconception maternal nutrition. Study participants were women of reproductive age residing in the district of Thatta, Pakistan. Participants were asked questions regarding the usage of commonly consumed SLT known as gutka (exposure variable). Study outcomes included maternal anemia, miscarriage, preterm births, stillbirths, and low birth weight. We performed a cox-regression analysis by controlling for confounders such as maternal age, education, parity, working status, body mass index, and geographic clusters.Results: The study revealed that 71.5% of the women reported using gutka, with a higher proportion residing in rural areas as compared to urban areas in the district of Thatta, Pakistan. In the multivariable analysis, we did not find a statistically significant association between gutka usage and anemia [(RR: 1.04, 95% CI (0.92-1.16)]; miscarriage [(RR: 1.08, 95% CI (0.75-1.54)]; preterm birth [(RR: 1.37, 95% CI (0.64-2.93)]; stillbirth [(RR: 1.02, 95% CI (0.39-2.61)] and low birth weight [(RR: 0.96, 95% CI (0.72-1.28)].Conclusion: The study did not find an association between gutka usage before pregnancy and adverse maternal and fetal outcomes. In the future, robust epidemiological studies are required to detect true differences with a dose-response relationship between gutka usage both before and during pregnancy and adverse feto-maternal outcomes.Implications: While most epidemiological studies conducted in Pakistan have focused on smoking and its adverse outcomes among males, none of the studies have measured the burden of SLT among women of reproductive age (WRA) and its associated adverse outcomes. In addition, previously conducted studies have primarily assessed the effect of SLT usage during pregnancy rather than before pregnancy on adverse fetal and maternal outcomes. The current study is unique because it provides an insight into the usage of SLT among WRA before pregnancy and investigated the association between pre-pregnancy SLT usage and its adverse feto-maternal outcomes in rural Pakistan

Pregnant women in four low-middle income countries have a high prevalence of inadequate dietary intakes that are improved by dietary diversity

Background: Up-to-date dietary data are required to understand the diverse nutritional challenges of pregnant women living in low-middle income countries (LMIC). To that end, dietary data were collected from 1st trimester pregnant women in rural areas of Guatemala, India, Pakistan, and Democratic Republic of the Congo (DRC) participating in a maternal lipid-based nutrient supplement (LNS) Randomized Controlled Trial to examine dietary diversity (DD), usual group energy and nutrient intakes, and prevalence of inadequate dietary intakes.Methods: Two 24-h dietary recalls were conducted in ~240 pregnant women/site (total n = 966) prior to 12-week gestation. Adequate DD was assessed, i.e., ≥5 major food groups consumed within the past 24 h. Median, Q1, Q3 intakes (without LNS) of energy, macronutrients, 12 micronutrients, and phytate were examined. The at risk prevalence of inadequate intakes were based on international guidelines for pregnant women.Results: Dietary patterns varied widely among sites, with adequate DD reported: 20% (Pakistan), 25% (DRC), 50% (Guatemala), and 70% (India). Significantly higher intakes of most key nutrients were observed in participants with adequate DD. More than 80% of women in all sites had inadequate intakes of folate, vitamin B12, and choline, and \u3e80% of women in India and DRC also had inadequate intakes of calcium, thiamine, riboflavin, and vitamin B6.Conclusions: Our data highlight the likely need for micronutrient supplementation in pregnancy, specifically multi-micronutrient interventions, and support the value of increasing DD as part of sustainable long-term nutrition programs for women of reproductive age in these poor rural settings in LMIC

Blinded, multi-centre evaluation of drug-induced changes in contractility using human induced pluripotent stem cell-derived cardiomyocytes

Animal models are 78% accurate in determining whether drugs will alter contractility of the human heart. To evaluate the suitability of human-induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) for predictive safety pharmacology, we quantified changes in contractility, voltage, and/or Ca2+ handling in 2D monolayers or 3D engineered heart tissues (EHTs). Protocols were unified via a drug training set, allowing subsequent blinded multicenter evaluation of drugs with known positive, negative, or neutral inotropic effects. Accuracy ranged from 44% to 85% across the platform-cell configurations, indicating the need to refine test conditions. This was achieved by adopting approaches to reduce signal-to-noise ratio, reduce spontaneous beat rate to ≤ 1 Hz or enable chronic testing, improving accuracy to 85% for monolayers and 93% for EHTs. Contraction amplitude was a good predictor of negative inotropes across all the platform-cell configurations and of positive inotropes in the 3D EHTs. Although contraction- and relaxation-time provided confirmatory readouts forpositive inotropes in 3D EHTs, these parameters typically served as the primary source of predictivity in 2D. The reliance of these “secondary” parameters to inotropy in the 2D systems was not automatically intuitive and may be a quirk of hiPSC-CMs, hence require adaptations in interpreting the data from this model system. Of the platform-cell configurations, responses in EHTs aligned most closely to the free therapeutic plasma concentration. This study adds to the notion that hiPSC-CMs could add value to drug safety evaluation

Harvested Energy Prediction Schemes for Wireless Sensor Networks: Performance Evaluation and Enhancements

We review harvested energy prediction schemes to be used in wireless sensor networks and explore the relative merits of landmark solutions. We propose enhancements to the well-known Profile-Energy (Pro-Energy) model, the so-called Improved Profile-Energy (IPro-Energy), and compare its performance with Accurate Solar Irradiance Prediction Model (ASIM), Pro-Energy, and Weather Conditioned Moving Average (WCMA). The performance metrics considered are the prediction accuracy and the execution time which measure the implementation complexity. In addition, the effectiveness of the considered models, when integrated in an energy management scheme, is also investigated in terms of the achieved throughput and the energy consumption. Both solar irradiance and wind power datasets are used for the evaluation study. Our results indicate that the proposed IPro-Energy scheme outperforms the other candidate models in terms of the prediction accuracy achieved by up to 78% for short term predictions and 50% for medium term prediction horizons. For long term predictions, its prediction accuracy is comparable to the Pro-Energy model but outperforms the other models by up to 64%. In addition, the IPro scheme is able to achieve the highest throughput when integrated in the developed energy management scheme. Finally, the ASIM scheme reports the smallest implementation complexity

COVID-19 Pandemic: A Remedial Measure Through Convalescent Serum

An acute respiratory syndrome Corona Virus 2 has affected humanity throughout the world. Scientifically, Corona Virus 2 is known as SARS-COV-2 which is abbreviated as COVID-2019. China was the first victim of this outbreaks in December 2019 [1] which was later recognized as pandemic on March 11, 2020 by World Health Organization (WHO) [2,3]. At the time of this writing, about 8.75 million individuals of 188 countries [4] have been effected by COVID resulting in 463000 deaths primarily, corona virus communicates from one body to another body through close contacts via droplets produced by sneezing, coughing or taking by infected badly within a buffer zone of 3 to 6 feet [5,6,7]. These droplets fall onto a surface and can survive up to 72 hours [8]. Various studies have proved that droplets may travel up to 37 feet by an uncovered cough [9,10,11]. Corona virus is not an airborne, however it may transport through respiratory droplets during talking and breathing [12]. Full Tex

Analysis and characterization of opto-electronic properties of iron oxide (Fe2O3) with transition metals (Co, Ni) for the use in the photodetector application

There are several uses for ultraviolet photodetectors, including in the scientific, military, and industrial sectors. In this sense, UV photodetectors must have high responsiveness, be insensitive to visible light, and be inexpensive to produce. For this purpose, we report the development of Co and Ni based iron oxide nanoparticles via the cost effective low temperature sol–gel auto-combustion process. XRD study approves the cubic crystal structure of iron oxide (Fe2O3) with predominant orientation along (311) direction. A sharp and strong peak is obtained at 583 cm−1 and 594 cm−1 for both samples in FT-IR spectra assigned to metal oxide Fe–O network system which approves the formation of iron oxide. Raman spectroscopy analysis reveals the presence of two A1g and five Eg phonon modes in the case of both samples. Absorption study exhibits the strong absorption peaks for the iron oxide sample doped with cobalt and nickel, while poor absorption was noticed from the pure iron oxide nanoparticles. The large and low energy band gap values are found to be 2.77 eV and 1.68 eV for pure Fe2O3 and cobalt and nickel doped Fe2O3 nanoparticles, respectively. Stone and cloud-like shape morphology was observed from SEM analysis. The EDX spectra reveal the presence of essential elements, like Fe and O in the case of pure iron oxide while Fe, O, Co and Ni in the case of transition metals doped iron oxide nanoparticles. The photoluminescence (PL) spectroscopy technique was recorded the luminescent properties which reveals the decrease in PL intensity that confirms the decline in electron–hole recombination. Therefore, I–V characterization analysis reveals that electrical conductivity increases with the addition of metals due to decrease in electron–hole recombination with the co-doping of metals. These modified opto-electronic properties of the developed Fe2O3 by metals co-doping make it suitable candidate for the use in photodetector application

Case report on very early afterdepolarizations in HiPSC-cardiomyocytes: an artifact by big conductance calcium activated potassium current (Ibk,Ca)

publishedVersionPeer reviewe

Author Correction: Differentiation of cardiomyocytes and generation of human engineered heart tissue (Nature Protocols, (2017), 12, 6, (1177-1197), 10.1038/nprot.2017.033)

Please note that since the original publication of this paper, the author David Letuffe-Brenière has changed his name to David Brenière-Letuff