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BACKGROUND: This research aimed to identify the clinical profile and risk factors of retinopathy of prematurity (ROP) among "at-risk" newborns treated at a sick newborn care unit (SNCU) located at high altitude in North India, with the intention of contributing to formulate regional and national ROP screening guidelines. MATERIALS AND METHODS: In a prospective observational study from 2021 to 2022, outborn and inborn babies eligible for ROP screening were screened. RESULTS: Total 39/122 screened neonates had laser for Type 1 ROP, and 22/39 (56.4%) had aggressive ROP (AROP). The average birth weight (BW) was 1803.87 g, and the average gestational age was 34 weeks. Respiratory distress, bronchopulmonary dysplasia, sepsis, and apnea were present in 57.3%, 13%, 52.5%, and 25.4%, respectively. Sight-threatening ROP was present in 50% below 28+6 weeks, 27% between 29 and 30+6 weeks, 52% between 31 and 33+6 weeks, and 15% with gestation >34 weeks. Two babies with Type 1 ROP weighed >2 kg and one had AROP. Upon regression analysis, BW <1500 g, gestation <32 weeks, oxygen >48 h, clinical sepsis, total SNCU stay >14 days, continuous positive airway pressure support with oxygen >50%, and >10 days to achieve full feeds were associated with severe ROP. Caffeine to treat apnea and kangaroo mother care reduced ROP. None had short-term unfavorable outcome. CONCLUSION: With similar infrastructure and work force shortage in most SNCUs, these findings can be generalized. The burden of Type 1 and AROP is increasing, as seen in higher gestation and BWs. This needs revision of ROP screening criteria at local and national level. It is crucial to emphasize on the importance of pediatrician and ophthalmologist collaboration, early ROP screening, diagnosis, and treatment to stop disease progression to severe ROP.

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OBJECTIVES: To evaluate the impact of hybrid support (tele-mentoring and conventional support) on adverse outcome among neonates admitted to 10 special newborn care units (SNCUs) in Chhattisgarh. METHODS: This before-and-after study was conducted at 10 SNCUs in Chhattisgarh in 2022. Conventional support was given earlier and later, that was supplemented with tele-rounds which were carried out using Skype technology. The principal investigator (PI) visited each unit for one day per month to kickstart quality improvement (QI) projects and provide guidance. Patient outcome data were collected on clinical sepsis proportion, IV fluid usage, antibiotic usage, length of stay, referral and mortality. RESULTS: A total of 2807 babies across 10 units were assessed. This was retrospectively correlated with 5169 babies in these units in the year before the intervention was started. The percentage of clinical neonatal sepsis cases decreased from 53.4% to 29.4% (P < 0.05). IV fluid usage dropped from 40% to 22.2% (P < 0.05). The initiation and continuation of kangaroo mother care (KMC) increased from 55.5% to 93.8% (P < 0.05). The average length of stay decreased from 5.5 ± 0.97 d to 4 ± 0.2 d (P < 0.05). Oxygen utilization decreased from 39.3% to 33.6% (P < 0.05). The proportion of antibiotic usage decreased from 50.2% to 39.7% (P < 0.05). The mortality rate decreased from 8.18% to 6.99% (P < 0.05). Referral rate decreased from 13.12% to 11.93% (P < 0.05). CONCLUSIONS: The implementation of a QI package through hybrid support, which includes tele-mentoring, supportive supervision visits, and local QI project advocacy, proves to be an effective approach in enhancing newborn intensive care.

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In antiquity, Pb was a common element added in the production of large bronze artifacts, especially large statues, to impart fluidity to the casting process. As Pb does not form a solid solution with pure Cu or with the Sn-Cu alloy phases, it is normally observed in the metal matrix as globular droplets embedded within or in interstitial positions among the crystals of Sn-bronze (normally the α phase) as the last crystallizing phase during the cooling process of the Cu-Sn-Pb ternary melt. The disequilibrium Sn content of the Pb droplets has recently been suggested as a viable parameter to detect modern materials [Shilstein, Berner, Feldman, Shalev & Rosenberg (2019). STAR Sci. Tech. Archaeol. Res. 5, 29-35]. The application assumes a time-dependent process, with a timescale of hundreds of years, estimated on the basis of the diffusion coefficient of Sn in Pb over a length of a few micrometres [Oberschmidt, Kim & Gupta (1982). J. Appl. Phys. 53, 5672-5677]. Therefore, Pb inclusions in recent Sn-bronze artifacts are actually a metastable solid solution of Pb-Sn containing ∼3% atomic Sn. In contrast, in ancient artifacts, unmixing processes and diffusion of Sn from the micro- and nano-inclusions of Pb to the matrix occur, resulting in the Pb inclusions containing a substantially lower or negligible amount of Sn. The Sn content in the Pb inclusions relies on accurate measurement of the lattice parameter of the phase in the Pb-Sn solid solution, since for low Sn values it closely follows Vegard's law. Here, several new measurements on modern and ancient samples are presented and discussed in order to verify the applicability of the method to the detection of modern artwork pretending to be ancient.

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The electrochemical synthesis of syngas (CO and H2) has garnered considerable attention in the context of Fischer-Tropsch (FT) synthesis employing thermal catalysts. Nonetheless, the need for a novel, cost-effective technique persists. In this investigation, we introduce a direct electrochemical (dEC) approach for FT synthesis that functions under ambient conditions by utilizing a p-block element (Sn and In) overlaid Cu electrode. Surface *CO and H* species were obtained in an electrolytic medium through the CO2 + H+ + e- → HOOCad → *CO (or direct CO adsorption) and H+ + e- → H* reactions, respectively. We have observed C2-7 long-chain hydrocarbons with a CnH2n+2/CnH2n ratio of 1-3, and this observation can be explained through the process of C-C coupling chain growth of the conventional FT synthesis, based on the linearity of the Anderson-Schulz-Flory equation plots. Thick Sn and In overlayers resulted in the dominant production of formate, while CO and C2H4 production were found to be proportional and inversely correlated to H2, C2H6, and C3-7 hydrocarbon production. The EC CO2/CO reduction used in dEC FT synthesis offers valuable insights into the mechanism of C2+ production and holds promise as an eco-friendly approach to producing long-chain hydrocarbons for energy and environmental purposes.

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With the increasing power density of electronic devices, solder joints are prone to electromigration under high currents, which results in a significant threat to reliability. In this study, the molecular dynamics method is used to study the diffusion mechanism of the Cu3Sn/Cu interface under the action of electrothermal coupling. The results show that the diffusion activation energy decreases with an increase in electric field intensity, accelerating the diffusion of the Cu3Sn/Cu interface. Furthermore, it is noted that the abrupt change in the vacancy-time curve lags behind that of the mean square displacement curve, which depicts that the responses of the vacancies are driven by the electric field. The vacancy-responsive diffusion mechanism of the Cu3Sn/Cu interface is proposed. The atoms around the interface in the electric field get rid of the shackles of the neighboring atoms easily. The vacancy concentration increases as the atoms leave the equilibrium position, which accelerates the movement of vacancies and enhances the diffusion of the Cu3Sn/Cu interface.

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To alleviate kinetics imbalance and capacity insufficiency simultaneously, a novel hierarchical structure (SnCu2Se4/d-Ti3C2Tx/NPC) composed of delaminated Ti3C2Tx, SnCu2Se4 nanoparticles, and N-doped porous carbon layers is designed as a battery-type anode for lithium/sodium ion hybrid capacitor (LIC/SIC). The combination of SnCu2Se4 nanoparticles with high specific capacity, d-Ti3C2Tx with accelerated ion diffusion path, and NPC with enhanced electronic conductivity makes the SnCu2Se4/d-Ti3C2Tx/NPC composite possess excellent cycling stabilities in half-cell lithium-ion and sodium-ion batteries (LIB and SIB), with capacities of 114 mAh g-1 after 6000 cycles at 10 A g-1 for LIB and 296 mAh g-1 after 900 cycles at 1.0 A g-1 for SIB. The rate performance is also outstanding, with recovered capacity of 738 mAh g-1 at 0.1 A g-1 after cycles at current densities up to 50 A g-1 for LIB. Subsequently, LIC and SIC based on the SnCu2Se4/d-Ti3C2Tx/NPC anode and activated carbon cathode exhibit high energy densities of 147.9 and 158.6 Wh kg-1 at a power density of 100 W kg-1, respectively. They also possess distinctive long lifespans with capacity retentions of 78 and 81% after 10,000 cycles at 1.0 A g-1, respectively, demonstrating the feasibility of SnCu2Se4/d-Ti3C2Tx/NPC toward energy devices requiring high energy density, power density, and long-term stability.

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INTRODUCTION: Nearly one-third of neonatal mortality in India is due to neonatal sepsis and death occurs in 30% of culture-positive neonates. Pathogens such as Klebsiella pneumoniae and Escherichia coli are the most common bacteria responsible for neonatal sepsis in India and South Asia. MATERIALS AND METHODS: It was an observational study, conducted in special newborn care units (SNCUs) of Capital Hospital in Bhubaneswar, Odisha from May 2017 to October 2019. All neonates (<28 days of life) with blood culture-positive sepsis were included in this study. Blood cultures were sent in all the babies with features of clinical sepsis. The demographic profile of neonates, clinical presentations, isolated organisms, and their sensitive patterns was recorded for analysis. RESULTS: Blood culture was sent in 445 suspected neonates with clinical sepsis out of which 115 blood culture positive organisms were isolated. Among the isolated organisms, 42 (35.6%) cases were Staphylococcus aureus followed by Coagulase negative Staphylococcus (CONS) (20.8%), E. coli (19.1%), K. pneumoniae (10.4%), Acinetobacter baumannii (2.7%), Enterobacter spp.(4.3%), Enterococcus spp. (4.3%), and Pseudomonas aeruginosa (2.7%). S. aureus was the predominant organism found in both early and late-onset sepsis. All Gram-negative bacilli (GNB) are resistant to ampicillin whereas cephalosporin resistance was found in 68% of cases. Mortality due to sepsis was 8%. CONCLUSION:  S. aureus followed by CONS was found to be the most common cause of sepsis in SNCU. A high degree of resistance of organisms to penicillins and cephalosporins calls for a re-evaluation of antibiotic policy and protocols for empirical treatment in neonatal sepsis.

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COVID-19 has impacted children's immunization rates, putting the lives of children at risk. The present study assesses the impact of phone-call counseling, on immunization uptake during the pandemic. Families of babies discharged from the SNCUs in six government centers in three South Indian states were recruited. Calls were made 10 days after the immunization due date. Missed vaccinees were counseled and followed up on 7 and 15 days. Of 2313 contacted, 2097 completed the survey. Respondents were mostly mothers (88.2%), poor (67.5%), and had secondary level education (37.4%). Vaccinations were missed due to the baby's poor health (64.1%), COVID-19 related concerns (32.6%), and lack of awareness (16.8%). At the end of the intervention, the immunization uptake increased from 65.2% to 88.2%. Phone-call intervention can safely support immunization and lower the burden on health workers.

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Nanosoldering can bond various nanomaterials together or connect them with electrodes to form electrical contacts, thus assembling these nanomaterials into functional nanodevices; it is believed to be a promising interconnection technique due to its flexibility, controllability and crucial advantage of avoiding detrimental effects on the nano-objects. In this technique, molten solder as a filler material is introduced between the objects to be joined to form a reliable bond, in which the nanosolder reflow melting is a crucial prerequisite for successful nanosoldering. This work focuses on studying the melting characteristics of one-dimensional 97Sn3Cu nanosolder with low-cost, prominent electrical property and high mechanical reliability, aiming to promote its applications in nanosoldering. The reflow melting of an individual nanosolder has been dynamically observed byin situheating holder in transmission electron microscopy, where the obtained reflow temperature (530 °C) is much higher than its melting temperature (220.4 °C) because of the external oxide layer confinement. Furthermore, the size-dependent melting temperature of nanosolders with various diameters (20-300 nm) has been investigated by both differential scanning calorimetry and theoretical calculation, revealing that the melting temperature decreases as the diameter goes down, especially for the nanosolders in the sub 80 nm range, where the value decreases significantly. The experimental results are in good agreement with the theoretical predictions. These results pointed out here can be readily extended to other nanosolders.

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Cost-effectiveness analysis (CEA) provides information on how much extra do we need to spend per unit gain in health outcomes with introduction of any new healthcare intervention or treatment as compared to the alternative. This information is crucial to make decision regarding funding any new drug, diagnostic test or determining standard treatment protocol. It becomes even more important to consider this evidence in resource constrained low-income and middle-income country settings. Generating evidence on costs and consequences of a treatment or intervention could be performed in the setting of a randomized controlled trial, which is the perfect platform to evaluate efficacy or effectiveness. However, we argue that randomized controlled trial (RCT) offers an incomplete setting to generate comprehensive data on all costs and consequences for the purpose of a CEA. Hence, it is needed to use a decision model, either in combination with the evidence from RCT or alone. In this article, we demonstrate the application of decision model-based economic evaluation using 2 separate techniques - a decision tree and a Markov model. We argue that application of a decision model allows computation of health benefits in terms of utility-based measure such as a quality-adjusted life year or disability-adjusted life year which is preferred for a CEA, measure distal costs and consequences which are much more downstream to the application of intervention, allows comparison with multiple intervention and comparators, and provides opportunity of making use of evidence from multiple sources rather than a single RCT which may have limited generalizability. This makes the use of such evidence much more acceptable for clinical use and policy relevant.

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To acquire the synergy effects between Sn and Cu for the jointly high Faradaic efficiency and current density, we develop a novel strategy to design the Sn-Cu alloy catalyst via a decorated co-electrodeposition method for CO2 electroreduction to formate. The Sn-Cu alloy shows high formate Faradaic efficiency of 82.3% ± 2.1% and total C1 products Faradaic efficiency of 90.0% ± 2.7% at -1.14 V vs. reversible hydrogen electrode (RHE). The current density and mass activity of formate reach as high as (79.0 ± 0.4) mA cm-2 and (1490.6 ± 7.5) mA mg-1 at -1.14 V vs. RHE. Theoretical calculations suggest that Sn-Cu alloy can obtain high Faradaic efficiency for CO2 electroreduction by suppressing the competitive hydrogen evolution reaction and that the formate formation follows the path of CO2 â†’ HCOO* â†’ HCOOH. The stepped (2 1 1) surface of Sn-Cu alloy is beneficial towards selective formate production.

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With the development of lead-free solders in electronic packaging, Sn-Cu lead-free solder has attracted wide attention due to its excellent comprehensive performance and low cost. In this article, we present recent developments in Sn-Cu lead-free solder alloys. From the microstructure and interfacial structure, the evolution law of the internal structure of solder alloy/solder joint was analysed, and the model and theory describing the formation/growth mechanism of interfacial IMC were introduced. In addition, the effects of alloying, particle strengthening and process methods on the properties of Sn-Cu lead-free solders, including wettability, melting and mechanical properties, were described. Finally, we outline the issues that need to be resolved in the future research.

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BACKGROUND: Maternal and child mortality and morbidity continue to be high despite existence of various national health programmes in India. Annually 41% of all Under 5 mortality is comprised of neonates, 3/4 of who die within the first week of life. Even though effective programmes are existing, optimum utilization is still a question. So the present study was planned to assess utilisation of maternal and neonatal health services and its influence on neonatal health. OBJECTIVES: 1. To assess the utilization of MCH services before admission to SNCU. 2. To analyse the process of implementation of IMNCI before referral and during the admission. 3. To observe the impact on neonatal health and give necessary recommendations. METHODOLOGY: The information regarding utilization of MCH services was obtained by conducting in depth interviews with the responsible adults accompanying the sick neonate. The Pre-treatment and referral slips were verified and compared with that of the prescribed guidelines laid down by the IMNCI for young infants (0-2 months) at SNCU. RESULTS AND DISCUSSION: Some of the important observations were mentioned here. 100% women had TT immunization whereas 72% had the full ANC, 58.7% had full course of IFA, 76% had utilized JSY benefits and 48.34% had their PNC. 84% neonates had required immunization, 59.01% were on exclusive breast feeding. 38.9% were paid home visits, only 42% had an idea about the danger signs of neonatal period. 23% sick babies were treated under IMNCI guideline. Among them 98% given initial treatment, only 34% given proper diagnosis/classification, 56% were given adequate advice.

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For negating the impact of early adversities on the development and ensuring a healthy, dynamic future for all children, Ministry of Health and Family Welfare in 2013 launched a programme for child health screening and early intervention services as Rashtriya Bal Swasthya Karyakram (RBSK) which aims to improve the quality of life with special focus on improving cognition and survival outcomes for "at risk" children. It has a systemic approach of prevention, early identification and management of 30 health conditions distributed under 4Ds: Defects at birth, Diseases, Deficiencies and Developmental delays including Disabilities spread over birth to 18 y of age in a holistic manner. There is a dedicated 4 member Mobile Health team for community screening and a dedicated 14 member team at District Early Intervention Center (DEIC) for comprehensive management. Existing health infrastructure and personnel are also integrated and utilized in this endeavor. Defects at birth are screened at Delivery points, home visits by accredited social health activist (ASHA), Anganwadi centers and at schools. Developmental delays are evaluated at DEIC through a multidisciplinary team with interdisciplinary approach. Five thousand four hundred eighteen dedicated Mobile Health teams have screened a total of 12.19 crore children till Dec.14. From April to Dec. 2014, 4.20 crore children were screened, of which birth to 6-y-old children were 2.13 crore while 2.07 crore were from 6 to 18 y. 17.7 lakh children were referred to tertiary centers and 6.2 lakh availed tertiary care. 50.7 lakhs were found positive for 4Ds; 1.35 lakhs were birth defects. RBSK is a step towards universal health care for free assured services.

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