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Introduction: Reduction of maternal mortality ratio to achieve the target set for MMR for SDG is a global challenge. Maternal death has devastating impact on the newborn, family as well as in the society in long run. Most of the developing countries could not achieve the target MMR for MDG and are now far away from the target set for Sustainable Development Goal for maternal mortality ratio because of its gradual reduction. There are great differences in MMR in developed and developing countries as well as within the countries, states, districts depending upon the education ,socioeconomic status and provision of quality health care and its accessibility . This study was conducted to estimate the MMR , evaluate the causes of maternal deaths at Obstetrics and Gynaecology department of Assam Medical college and Hospital ,Dibrugarh Assam, India. Aim: To nd out the MMR and to evaluate the risk factors and causes of maternal deaths. Materials And Methods: A retrospective study of risk factors and causes of maternal deaths from 1st January 2019 to 31st December 2020 at Obstetrics and Gynaecology Department of Assam Medical College and Hospital Dibrugarh ,Assam ,India .The data were collected from Maternal Death Surveillance and Response Records ,Facility Based Maternal Death Review Form and Bed head tickets and analysis were made to nd out causes of death and MMR. MDSR meetings were conducted for all the maternal deaths at community , facility and CMO levels . The risk factors and causes responsible for maternal deaths were expressed in percentage Results: Results and Observations: There were 174 maternal deaths out of 22,209 live births resulting MMR of 783. Hypertensive disorders of pregnancy (37.93%) followed by Puerperal sepsis (12.64%) and Post partum haemorrhage (8.04%) were the leading direct causes and severe Anemia (10.92%) and Jaundice (5.17%) were the leading indirect causes of maternal death in our study. Conclusion:Reduction of maternal death is a global challenge to achieve the MMR target of SDG .Causes of maternal death are multifactorial .Though pregnancy and labour is a physiological condition, rapid deterioration occurs when complication arises. Targeted approach to the socioeconomically poorer section of the society is the need of the hour.

Supplemental material, sj-docx-1-jop-10.1177_02698811231171532 for Low-frequency monitoring for community clozapine initiations: A comparative study relative to standard frequency assessments by Yuya Mizuno, Devi L. Bridglal, Jack Coumbe, Hari McGrath, Ayush Adhikari, Emma Butler, Ilaria Bonoldi, David Taylor and Oliver D. Howes in Journal of Psychopharmacology

Supplemental material, sj-docx-1-jop-10.1177_02698811231171532 for Low-frequency monitoring for community clozapine initiations: A comparative study relative to standard frequency assessments by Yuya Mizuno, Devi L. Bridglal, Jack Coumbe, Hari McGrath, Ayush Adhikari, Emma Butler, Ilaria Bonoldi, David Taylor and Oliver D. Howes in Journal of Psychopharmacology

BACKGROUND Breast cancer is the most common cancer in women worldwide and has surpassed cervical cancer in India. As a result of regular mammography screening programs and public awareness, early-stage breast cancer with better prognosis has occurred. Immunohistochemistry (IHC) is now a common practice in tumour evaluation which are of importance in diagnosis as well as for deciding the treatment and of prediction of prognosis in breast cancer. The present study was undertaken in view of correlating the histopathology of the tumour and IHC profile with respect to oestrogen receptor (ER), progesterone receptor (PR) and HER2 / neu. METHODS The study is a cross-sectional prospective analysis of patients with primary carcinoma of breast who are undergoing surgery over a period of 2 years from September 2017 to August 2019. All specimens were processed and stained with haematoxylin and eosin and immunohistochemistry was done for oestrogen and progesterone receptors and HER 2neu. RESULTS A total of 20 cases of breast carcinoma specimens were studied, whose age ranged from 24 - 72 years of age. All the 20 cases occurred in females. Infiltrating duct carcinoma was the most histological subtype noted in this study comprising 85 % (17 / 20) of cases. In the study 50 % (10/20) of the cases showed ER / PR positivity with negative HER2 / neu while 15 % (3/15) of cases were negative for ER / PR and HER2 / neu and only one case showed positivity for all three markers. 10 cases (50 %) had lymph node metastases in this study. CONCLUSIONS Breast cancer is the most commonly diagnosed malignancy in Indian women and is also the leading cause of cancer death in women worldwide. Assessment of receptor (ER, PR and HER – 2 / neu) status along with histopathological grading and staging will guide the clinicians to impart a correct treatment protocols to the patients. It will also be of great help in assessing the prognosis. KEYWORDS Breast Cancer, Histopathology, Immunohistochemistry

In this work a new law of varying deceleration parameter of third degree have been proposed. The solutions of the modified field equations have been derived under the newly proposed law of the deceleration parameter. Model exhibits the Big-bang singularity at cosmic time ($t=0$) and shows Big Rip at ($t=n$) then it re-enter the phase of initial singularity at $t=2n$ and ends its cyclic behavior at $t=3n$. The evolution of the physical and dynamical parameters of the Universe have been studied and the graphical representation has also been shown. Further $Om(z)$ diagnostic parameter and the energy conditions have also been studied together with their graphical representations.

In this work, the Renyi holographic dark energy (RHDE)and its behaviour has been explored with the anisotropic and spatially homogeneous Bianchi type-I Universe in the framework of $f(G)$ gravity. We use IR cutoff as the Hubble and Granda-Oliveros (GO) horizons. To find a consistent solutions of the field equations of the models, it is assumed that the deceleration parameter is defined in terms of function of Hubble parameter $H$. With reference to current cosmological data, the behaviors of the cosmological parameters relating to the dark energy model are evaluated and their physical significance is examined. It is observed that for both the models, the equation of state parameter approaches to $-1$ at late times. However, the RHDE model with the Hubble horizon exhibits stability from the squared sound speed, but the RHDE model with the GO horizon exhibits instability. In both the models, deceleration parameter and statefinder diagnostic confirm the accelerated expansion of the Universe and also correspond to the $\Lambda$CDM model at late times.

Adolescents are developmentally vulnerable to sleep problems due to their transitional stage. According to the literature, recent lifestyle changes and poor sleep hygiene have increased the prevalence of sleep disorders. A quantitative approach with a pre-test and post-test control group design is used to assess the effectiveness of sleep hygiene strategies on sleep quality and the level of stress among adolescents. Sixty-four adolescents (51% male) in grade 9 are recruited using a probability-computerized simple random sampling technique and divided into experimental and control groups. The validity and reliability of the tool are established using Cronbach's alpha test. The experimental group received an online intervention on sleep hygiene strategies for 5 days, including Surya Namaskar and deep breathing exercises, while the control group received standard interventions per institute policy. The data is gathered using an online structured questionnaire that includes demographic variables, the sleep quality scale, and a stress scale at baseline (T0), immediately following the intervention (T1), and at the 1-week follow-up (T2). Both groups have kept an online sleep hygiene diary for the last 2 weeks. The findings showed that post-intervention sleep quality (T1 and T2) and stress levels (T2) are significantly (P < 0.05) higher than baseline (T0) levels in the experimental group. The result demonstrates that participants in the experimental group adhered to the recommendations made in the sleep hygiene diary. Hence, it was concluded that early detection of poor sleep hygiene and stress in adolescents is required for timely intervention. The implementation of sleep hygiene strategies is a novel approach to addressing a prevalent problem and can help motivate adolescents to adopt healthy sleeping habits.

Healthcare is one of the fastest growing sectors of the US economy, employing over 12 million workers with women representing about 80% of the healthcare workforce. Rates of occupational injury to healthcare workers have risen over the past decade. Safety issues facing by the organizations include back injuries, slips and falls, laser hazards, chemical exposures, biological hazards, workplace violence, and community safety issues. A cause of accident is a result of hazard. A careless or uncontrolled hazard results in a major accident or a minor hazard. Now- a- days; orientation, training, education has been dine as a record for documentation. This kind of activity results in poor knowledge in job and hazard. The objective of this paper is to know about the responsibility of an individual based on leadership approach to be carried out in an organization, their work practice of effective management along with hazard control analysis and job hazard analysis (JHA), also called a job safety analysis (JSA), a technique to identify the dangers of specific tasks in order to reduce the risk of injury to workers. This promotes to know what the hazards are; reduce or eliminate them before anyone gets hurt. Also impacts on both overt and covert cultures of organization. This helps the organization to maintain revenues, minimize losses, serve communities and meet regularities and accreditation requirements.

We report a novel type of Mg-doped ZnO nanoparticles prepared on solvothermal route nanoparticles at different concentrations (2%,4%,6%, and 8%) and used Mg-ZnO as photoanode for dye-sensitized solar cells (DSSC) fabrication. DSSC using Mg-doped ZnO as a semiconductor material and natural dyes Terminalia cattappa as sensitizer were successfully produced. The structural, optical spectra of Mg-ZnO nanopowder were studied using XRD, FESEM-EDX, TEM, SAED patterns, and UV-Visible Spectra, Fourier Transform Infrared (FT-IR). The XRD results show that the crystal size also increases by increasing the dopant concentration of the Mg-doped ZnO sample. The optical spectra show the absorption of the samples increases with the increases of concentration using the UV-Visible analysis and the bandgap energy is calculated by Tauc plot. Mg-doped ZnO nanoparticles prepared at different concentrations were used for the fabrication of DSSC. Furthermore, from the J-V graph, 8% concentration is more effective than other concentrations.

Background Abnormal fetal movements are implicated in joint pathologies such as arthrogryposis and developmental dysplasia of the hip (DDH). Experimentally induced paralysis disrupts joint cavitation and morphogenesis leading to postnatal abnormalities. However, the developmental window(s) most sensitive to immobility-and therefore the best time for intervention-have never been identified. Here, we systematically vary the timing and duration of paralysis during early chick hip joint development. We then test whether external manipulation of immobilized limbs can mitigate the effects of immobility. Results Timing of paralysis affected the level of disruption to joints, with paralysis periods between embryonic days 4 and 7 most detrimental. Longer paralysis periods produced greater disruption in terms of failed cavitation and abnormal femoral and acetabular geometry. External manipulation of an immobilized limb led to more normal morphogenesis and cavitation compared to un-manipulated limbs. Conclusions Temporary paralysis is detrimental to joint development, particularly during days 4 to 7. Developmental processes in the very early stages of joint development may be critical to DDH, arthrogryposis, and other joint pathologies. The developing limb has the potential to recover from periods of immobility, and external manipulation provides an innovative avenue for prevention and treatment of developmental joint pathologies.

Due to openness of the deployed environment and transmission medium, Wireless Sensor Networks (WSNs) suffers from various types of security attacks including Denial of service, Sinkhole, Tampering etc. Securing WSN is achieved a greater research interest and this paper proposes a new secure routing strategy for WSNs based on trust model. In this model, initially the sensor nodes of the network are formulated as clusters. Further a trust evaluation mechanism was accomplished for every sensor node at Cluster Head level to build a secure route for data transmission from sensor node to base station. Here the trust evaluation is carried out only at cluster head and also the cluster head is chosen in such a way the node having rich resources availability. The trust evaluation is a composition of the social trust and data trust. Simulation experiments are conducted over the proposed approach and the performance is measured through the performance metrics such as network lifetime, and Malicious Detection Rate. The obtained performance metrics shows the outstanding performance of proposed approach even in the increased malicious behavior of network.

The effect of background derivatization on the signal enhancement of pesticide residues extracted from edible oil samples was studied by GC with negative chemical ionization MS. The analytes were extracted by a solvent extraction process, and the extract was subjected to rapid low-temperature fat precipitation. The residual fatty acids were silylated by derivatization with N,O-bis(trimethylsilyl)trifluoroacetamide. The chromatograms obtained from the derivatized samples showed higher signal intensity and lower detection levels when compared to the direct analysis without derivatization. The sensitivity levels of the method are either better or comparable to that of previously reported methodologies. The LODs of the analyzed organochlorine, organophosphorus, and synthetic pyrethroid residues in sunflower, rice bran, and ground oil samples were in the range of 0.02–0.5 ng/g, and the LOQs were in the range of 0.1–2 ng/g. The intraday and interday accuracies were in the range of 81–116% with RSDs less than 14%. The recoveries obtained were in the range of 53–89% with the RSD values less than 13% for all the studied pesticide residues.

This paper depicts the findings of the survey research covering 65 engineering institutions which are recognised as research centres in the state of Karnataka, India. Responses have been sought from research supervisors and research scholars as to the extent of the use of obsolete grey collections. Opinions have also been captured from the chief librarians of the 65 research institutions as regards the ways of managing the obsolete grey literature. The following are the areas covered in the study in respect of obsolete grey resources available in these 65 research libraries. - Demand for GL in engineering sciences and technology - Grey Literature collection in English and Foreign languages - Process of weeding-out of obsolete grey literature - Reasons for weeding out of old GL collections - Extent of the use of old GL collections - Weeding-out vis-à-vis Relegation of obsolete GL collections. The study was undertaken during 2007-2010 with the objective of understanding the pattern of obsolescence and the method followed in the libraries to manage the old GL collections in the engineering research institutions. The findings also project the practical methods followed by various libraries as to the weeding out process. Importance of old collections of GL for research vis-à-vis weeding out process adopted by the libraries have been depicted in the study based on the opinions exposed by 1270 researchers, which account for 84.6% of the total population. The summary or core of findings eventually shows that 66.4% of the research supervisors and research scholars hold the view that old collection of GL is of vital source for their research and has to be retained along with active collection in the libraries.

Cornual ectopic gestation is one of the causes of “Maternal near miss” cases. In the modern era of IVF treatments and better imaging techniques, more number of cases of cornual ectopic pregnancies is being diagnosed and treated both by conservative and radical methods. Here, we report a case of a recurrent cornual ectopic pregnancy in the early second trimester, which was managed by hysterectomy due to uncontrolled haemorrhage. Thirty five year old Mrs. S, Gravida 4, para2, with one previous ectopic pregnancy presented to the obstetric casualty with acute abdominal pain at 15 weeks +2 days of gestation. On vaginal examination, there was right fornicial fullness and both the fornices were tender. Cervical motion tenderness was also present. On review of her previous records, dating scan done at 8 to 9 weeks showed normal intrauterine pregnancy. An emergency scan was carried out which revealed an empty uterine cavity with gestational sac measuring 3.6×4.4×4.6 cms seen outside the uterus just above the fundus with absent cardiac activity. There was evidence of haemoperitoneum, therefore she was diagnosed with recurrent ruptured ectopic pregnancy.

Opiate analgesics are widely used in the treatment of severe pain. Because of their importance in therapy, different strategies have been considered for making opiates more effective while curbing their liability to be abused. Although most opiates exert their analgesic effects primarily via mu opioid receptors, a number of studies have shown that delta receptor-selective drugs can enhance their potency. The molecular basis for these findings has not been elucidated previously. In the present study, we examined whether heterodimerization of mu and delta receptors could account for the cross-modulation previously observed between these two receptors. We find that co-expression of mu and delta receptors in heterologous cells followed by selective immunoprecipitation results in the isolation of mu-delta heterodimers. Treatment of these cells with extremely low doses of certain delta-selective ligands results in a significant increase in the binding of a mu receptor agonist. Similarly, treatment with mu-selective ligands results in a significant increase in the binding of a delta receptor agonist. This robust increase is also seen in SKNSH cells that endogenously express both mu and delta receptors. Furthermore, we find that a delta receptor antagonist enhances both the potency and efficacy of the mu receptor signaling; likewise a mu antagonist enhances the potency and efficacy of the delta receptor signaling. A combination of agonists (mu and delta receptor selective) also synergistically binds and potentiates signaling by activating the mu-delta heterodimer. Taken together, these studies show that heterodimers exhibit distinct ligand binding and signaling characteristics. These findings have important clinical ramifications and may provide new foundations for more effective therapies.

This article 'Efficiency of Modified Urea Granules in Transplanted Rice' appeared in the International Rice Research Newsletter series, created by the International Rice Research Institute (IRRI). The primary objective of this publication was to expedite communication among scientists concerned with the development of improved technology for rice and for rice based cropping systems. This publication will report what scientists are doing to increase the production of rice in as much as this crop feeds the most densely populated and land scarce nations in the world.

This article 'Rice Grassy Stunt Disease in Kerala, India' appeared in the International Rice Research Newsletter series, created by the International Rice Research Institute (IRRI). The primary objective of this publication was to expedite communication among scientists concerned with the development of improved technology for rice and for rice based cropping systems. This publication will report what scientists are doing to increase the production of rice in as much as this crop feeds the most densely populated and land scarce nations in the world.