RESUMEN
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. (Funded by the Bill and Melinda Gates Foundation and the World Health Organization; Australian and New Zealand Clinical Trials Registry number, ACTRN12617000476336; Clinical Trials Registry-India number, CTRI/2017/04/008326.).
Asunto(s)
Dexametasona/administración & dosificación , Glucocorticoides/administración & dosificación , Enfermedades del Prematuro/prevención & control , Muerte Perinatal/prevención & control , Atención Prenatal , Adulto , Países en Desarrollo , Femenino , Humanos , Recién Nacido de Bajo Peso , Recién Nacido , Recien Nacido Prematuro , Enfermedades del Prematuro/epidemiología , Inyecciones Intramusculares , Embarazo , Nacimiento Prematuro , Riesgo , Mortinato/epidemiologíaRESUMEN
This study reports the formation of Er-doped nanocrystalline cobalt ferrite with the formula CoFe2-x Er x O4 (0.0 ≤ x ≤ 0.10) from nontoxic metal precursors Co(NO3)2·6H2O, Fe(NO3)3·9H2O, and Er(NO3)3·5H2O through an easy and economical sol-gel route in which citric acid is served as the chelating agent. The as-prepared powder was annealed at 700 °C for 3 h in ambient air to get the required spinel structure. The annealed samples were subjected to structural and magnetic characterization. The X-ray diffraction (XRD) data of the samples confirmed the cubic spinel structure formation. The average crystallite size evaluated from XRD data increased from 21 to 34 nm with the substitution of Er due to the larger atomic size of Er3+ than Fe3+. Moreover, the crystallite size obtained from XRD data are well matched with the particle size measured from transmission electron microscopy images. The lattice parameters obtained from XRD data agree well with the values estimated from theoretical cation distribution and Rietveld refinement calculation. The hysteresis curve exhibits the particles are soft ferromagnetic and the coercivity increased from 54.7 to 76.6 kA/m with maximum saturation magnetization, M s = 61 emug-1 for 0.10 Er content. The squareness ratios were found to be less than 0.5, which indicates the single-domain nature of our particles. The blocking temperature measured from field cooled-zero field cooled curves is T B > 350 K for all the samples, which is much higher than the room temperature (300 K). The enhancement of saturation magnetization and coercivity has been explained based on the crystallite size, anisotropy constant, and cation distribution. Thus, the structural and magnetic properties of CoFe2O4 nanoparticles (NPs) can be tuned by Er incorporation and these NPs can be applied in different soft magnetic devices.
RESUMEN
Nano-fiber structure of ZnO and Ni doped ZnO (Ni:ZnO) transparent thin films have been deposited on glass substrate at 350 °C at an ambient atmosphere via spray pyrolysis technique. The structural, surface morphological and opto-electrical properties of ZnO and Ni doped ZnO thin films have been investigated. The XRD patterns show that the films are of polycrystalline in nature having preferential orientation (0 0 2) plane for ZnO changes to (1 0 1) by Ni doping in ZnO matrix. Optical study exhibits red shifting in band gap energy with Ni doping due to sp-d hybridization and display high absorption coefficient of the order of 107 m-1. The photoluminescence (PL) spectra indicate blue emissions in all samples. Electrical measurement confirms the resistivity of the film decreases remarkably with Ni doping and electrical transport is mainly thermally activated. From Hall Effect study, it is confirmed that all the samples are n-type having carrier concentration of the order of 1018 cm-3. Both mobility and carrier concentrations of the films became higher than ZnO sample with the increase of Ni concentration.