Background: In India, 20-30% pregnancies fall under high-risk category, contributing to 75% of perinatal mortality and morbidity. An effective approach to reduce maternal and neonatal mortality/morbidity is early identification, effective management, and timely referral of high-risk pregnancies (HRPs). The Integrated High-Risk Pregnancy Tracking and Management (IHRPTM) program aims to enhance capacity of auxiliary nurse midwives (ANMs), medical officers (MOs), and specialist gynaecologists by: i. providing algorithmic, color-coded, detailed (yet simple) #Protocols for six HRP conditions, customized for each role, ii. offering live training, iii. delivering #Digital training and hand-holding, and iv. facilitating tracking pregnancies and management of HRPs. Equipping health workers (HWs) on these interventions facilitates early identification, effective management, and timely referrals, ultimately improving primary care and satisfaction of mothers with HRPs. Stated interventions are implemented in the intervention arm for 18 months, while during this period, HWs of intervention and control arms will receive routine training through state and national programs, ensuring pregnant women have equal access to routine maternity services. Objective: At the system level, the program evaluates the impact on improvement in the knowledge and skills of HWs in diagnosing and managing HRPs. At the community level, it assesses the translation of this knowledge into practice, in terms of early diagnosis and effective management, among women with HRPs. Methods: The program will be implemented in two intervention districts (Sambhal and Shravasti) and two matched control districts (Baduan and Gonda) of Uttar Pradesh, on six HRPs. #Study uses a ‘quasi-experimental, before-and after trial design’, with intervention and control arms. However, impact of program will be assessed only on three HRPs: moderate/severe anaemia, pregnancy-induced hypertension, and antepartum haemorrhage (APH), including placenta previa/abruptio placenta. System level impacts will be assessed through qualitative data collected from district officials, specialist gynaecologists, MOs and ANMs, at baseline and endline. Community level outcomes will be measured quantitatively using baseline and endline data from recently delivered women (RDW), using difference-in-difference (DiD) technique. Results: The impact evaluation #Protocol was approved by ARMMAN’s Scientific Review Board and Sigma’s Institutional Review Board. The #Protocols for six HRP-conditions were vetted by the government of Uttar Pradesh. By November 2024, all the ANMs, MOs, specialist gynaecologists, staff nurses, and community health officers in two intervention districts were trained on six HRP-#Protocols. #Digital learning tool and WhatsApp support system was also introduced to facilitate continued learning and handholding of ANMs in managing HRPs and/or to clear doubts. Pre-intervention/baseline data was collected from two arms, during June-October 2024. Conclusions: This trial will provide valuable insights into the feasibility and effectiveness of the program, at system and community levels, in a low resource setting like Uttar Pradesh. If successful, these insights can feed into capacitating HWs, at scale, in all the districts and expansion to other HRPs, with significant potential for improving maternal and neonatal outcomes of the state.

Medication adherence is critical for optimal glycaemic management and the prevention of complications in type 2 diabetes mellitus. Despite its importance, non-adherence remains a prevalent issue, with...

arXiv abstract link

Naguszewski et al., (2025). BraWl: Simulating the thermodynamics and phase stability of multicomponent alloys using conventional and enhanced sampling techniques. Journal of Open Source Software, 10(1...

A one-pot reaction on a diiron platform yields the first isolable series of ferrabenzene compounds. X-ray, NMR, and DFT studies confirm their aromatic character. Selected derivatives display favorable physicochemical prerequisites for biological applications and exhibit a promising in vitro cytotoxicity profile, linked to disruption of mitochondrial activity. Abstract Despite extensive research on metallabenzenes, ferrabenzenes have remained elusive, with only a single example reported to date, discovered accidentally. In this work, we present a reproducible, room-temperature reaction on a diiron bis-cyclopentadienyl platform, providing access to a class of four substituted ferrabenzenes (5a-c), stabilized by η6-coordination to a second iron fragment. This synthesis involves a one-pot double C─C coupling of iminium, carbene (from a diazo compound), and carbon monoxide moieties, yielding ferra-cyclohexadienone derivatives (4a-c), followed by O-alkylation with alkyl triflates. Experimental and computational studies enabled the proposal of a plausible reaction mechanism. Combined X-ray crystallography, nuclear magnetic resonance (NMR), and computational data support the aromatic character of the ferrabenzene ring in compounds 5a-c and, to a lesser extent, in their precursors 4a-c. Complexes 4a-c and 5a-c were further characterized by IR spectroscopy, mass spectrometry, and IR spectroelectrochemistry. A selection of ferrabenzenes (5a, 5b, 5aEt) revealed physicochemical properties suitable for biological applications, including permanent air stability, adequate aqueous solubility and stability, and balanced hydrophilic/lipophilic profile. These compounds exhibited potent cytotoxicity in vitro against three cancer cell lines, with 5aEt standing out for its pronounced activity, attributed to disruption of cell redox homeostasis, and marked selectivity compared to two noncancerous cell lines.

A 2-year multicomponent lifestyle intervention previously shown to improve cognition in at-risk adults also enhances blood pressure regulation, reduces sleep

This study evaluated the effectiveness of FIBROWALK multicomponent intervention, delivered online (FIBRO-On) or outdoors (FIBRO-Out), compared to treatment as usual (TAU) in reducing fibromyalgia…

Lepenies, Laura K.; Seidling, Hanna M.; Pabst, Alexander; et al. British journal of clinical pharmacology Vol. 91, no. 12, p. 3489 - 3500

Effectiveness of inspiratory muscle training and multicomponent physical training in patients with post-COVID conditions: a systematic review and meta-analysis https://link.springer.com/article/10.118...