Assessing the mediating role of organizational justice between the responsible leadership and employee turnover intention in health-care sector.

PURPOSE: The aim of this study is to investigate the extent to which organizational justice (OJ) mediates between responsible leadership (RL) and employee turnover intention (TI). DESIGN/METHODOLOGY/APPROACH: Both online and offline questionnaire was used to collect the data from 387 Indian health-care employees, and the data were analyzed using partial least squares structural equation modeling (PLS-SEM) with the help of SmartPLS 4. FINDINGS: The study's findings demonstrated a significant positive association between RL and OJ and a negative association between OJ and employee TI. Furthermore, results also confirmed the mediating role of OJ between RI and TI. RESEARCH LIMITATIONS/IMPLICATIONS: The generalizability of the study's data collection is limited because it is based on the responses of Indian health-care sector employees to an online and offline survey. The authors propose that the health-care sector uses RL as an approach that takes a broad view of the parties with a stake and focuses on creating fairness in acts and justice at the workplace to address the major issue of employee turnover. ORIGINALITY/VALUE: This study expanded on previous research by demonstrating that the influence of responsible leadership on employee TI is mediated by OJ in the context of India's health-care sector. It also contributes to the literature regarding RI, OJ and TI. The study also enriched the body of knowledge about using the PLS-SEM approach to predict employee TI.

Endogenous Interfacial Mo-C/N-Mo-S Bonding Regulates the Active Mo Sites for Maximized Li+ Storage Areal Capacity.

Active sites, mass loading, and Li-ion diffusion coefficient are the benchmarks for boosting the areal capacity and storage capability of electrode materials for lithium-ion batteries. However, simultaneously modulating these criteria to achieve high areal capacity in LIBs remains challenging. Herein, MoS2 is considered as a suitable electroactive host material for reversible Li-ion storage and establish an endogenous multi-heterojunction strategy with interfacial Mo-C/N-Mo-S coordination bonding that enables the concurrent regulation of these benchmarks. This strategy involves architecting 3D integrated conductive nanostructured frameworks composed of Mo2 C-MoN@MoS2 on carbon cloth (denoted as C/MMMS) and refining the sluggish kinetics in the MoS2 -based anodes. Benefiting from the rich hetero-interface active sites, optimized Li adsorption energy, and low diffusion barrier, C/MMMS reaches a mass loading of 12.11 mg cm-2 and showcases high areal capacity and remarkable rate capability of 9.6 mAh cm-2 @0.4 mA cm-2 and 2.7 mAh cm-2 @6.0 mA cm-2 , respectively, alongside excellent stability after 500 electrochemical cycles. Moreover, this work not only affirms the outstanding performance of the optimized C/MMMS as an anode material for supercapacitors, underscoring its bifunctionality but also offers valuable insight into developing endogenous transition metal compound electrodes with high mass loading for the next-generation high areal capacity energy storage devices.

Unlatching the Additional Zinc Storage Ability of Vanadium Nitride Nanocrystallites.

Vanadium-based materials, due to their diverse valence states and open-framework lattice, are promising cathodes for aqueous zinc ion batteries (AZIBs), but encounters the major challenges of in situ electrochemical activation process, potent polarity of the aqueous electrolyte and periodic expansion/contraction for efficient Zn2+ storage. Herein, architecting vanadium nitride (VN) nanosheets over titanium-based hollow nanoarrays skeletal host (denoted VNTONC) can simultaneously modulate address those challenges by creating multiple interfaces and maintaining the (1 1 1) phase of VN, which optimizes the Zn2+ storage and the stability of VN. Benefiting from the modulated crystalline thermodynamics during the electrochemical activation of VN, two outcomes are achieved; I) the cathode transforms into a nanocrystalline structure with increased active sites and higher conductivity and; II) a significant portion of the (1 1 1) crystal facets is retained in the process leading to the additional Zn2+ storage capacity. As a result, the as-prepared VNTONC electrode demonstrates remarkable discharge capacities of 802.5 and 331.8 mAh g-1 @ 0.5 and 6.0 A g-1 , respectively, due to the enhanced kinetics as validated by theoretical calculations. The assembled VNTONC||Zn flexible ZIB demonstrates excellent Zn storage properties up to 405.6 mAh g-1 , and remarkable robustness against extreme operating conditions.

Monolithic Microparticles Facilitated Flower-Like TiO2 Nanowires for High Areal Capacity Flexible Li-Ion Batteries.

Flexible lithium-ion batteries (FLIBs) are intensively studied using free-standing transition metal oxides (TMOs)-based anode materials. However, achieving high areal capacity TMO-based anode materials is yet to be effectively elucidated owing to the poor adhesion of the active materials to the flexible substrate resulting in low active mass loading, and hence low areal capacity is realized. Herein, a novel monolithic rutile TiO2 microparticles on carbon cloth (ATO/CC) that facilitate the flower-like arrangement of TiO2 nanowires (denoted ATO/CC/OTO) is demonstrated as high areal capacity anode for FLIBs. The optimized ATO/CC/OTO anode exhibits high areal capacity (5.02 mAh cm-2@0.4 mA cm-2) excellent rate capability (1.17 mAh cm-2@5.0 mA cm-2) and remarkable cyclic stability (over 500 cycles). A series of morphological, kinetic, electrochemical, in situ Raman, and theoretical analyses reveal that the rational phase boundaries between the microparticles and nanowires contribute to promoting the Li storage activity. Furthermore, a 16.0 cm2 all-FLIB pouch cell assembled based on the ATO/CC/OTO anode and LiNiCoMnO2 cathode coated on ATO/CC (ATO/CC/LNCM) exhibits impressive flexibility under different folding conditions, creating opportunity for the development of high areal capacity anodes in future flexible energy storage devices.

Efficient Hydrogen Evolution on Antiperovskite CuNCo3 Nanowires by Mo Incorporation and its Trifunctionality for Zn Air Batteries and Overall Water Splitting.

The current development of single electrocatalyst with multifunctional applications in overall water splitting (OWS) and zinc-air batteries (ZABs) is crucial for sustainable energy conversion and storage systems. However, exploring new and efficient low-cost trifunctional electrocatalysts is still a significant challenge. Herein, the antiperovskite CuNCo3 prototype, that is proved to be highly efficient in oxygen evolution reaction but severe hydrogen evolution reaction (HER) performance, is endowed with optimum HER catalytic properties by in situ-derived interfacial engineering via incorporation of molybdenum (Mo). The as-prepared Mo-CuNCo3 @CoN nanowires achieve a low HER overpotential of 58 mV@10 mA cm-2 , which is significantly higher than the pristine CuNCo3 . The assembled CuNCo3 -antiperovskite-based OWS not only entails a low overall voltage of 1.56 V@10 mA cm-2 , comparable to most recently reported metal-nitride-based OWS, but also exhibits excellent ZAB cyclic stability up to 310 h, specific capacity of 819.2 mAh g-1 , and maximum power density of 102 mW cm-2 . The as-designed antiperovskite-based ZAB could self-power the OWS system generating a high hydrogen rate, and creating opportunity for developing integrated portable multifunctional energy devices.

Prediction of complications of pre-eclampsia using the fullPIERS high risk predictive model.

OBJECTIVE: To determine the predicted probability percentage of complications in women with pre-eclampsia using the Pre-eclampsia Integrated Estimate of Risk (fullPIERS) model within the first 24 h after admission and assess the model's predictive value for complications of pre-eclampsia. METHODS: This was a prospective cohort study in which the fullPIERS model was applied to 256 pregnant women with pre-eclampsia within the first 24 h after admission. These women were then followed for 48 h to 7 days for maternal and fetal complications. Reciever operating characteristics (ROC) curves were generated to assess the performance of the fullPIERS model for adverse outcomes of pre-eclampsia. RESULTS: Of the 256 women enrolled in the study, 101 women (39.5%) developed maternal complications, 120 women (46.9%) developed fetal complications, and 159 women (62.1%) developed both. With an area under the ROC curve of 0.843 (95% confidence interval 0.789-0.897), the fullPIERS model had good discriminating ability to predict complications at any time point between 48 h and 7 days after admission. The sensitivity and specificity of the model at a ≥5.9% cut-off value for predicting adverse maternal outcomes were 60% and 97%, respectively; they were 44% and 96%, respectively, for predicting combined fetomaternal complications with a cut-off value of 4.9%. CONCLUSIONS: The fullPIERS model performs reasonably well in predicting adverse maternal and fetal outcomes in women with pre-eclampsia.

Laparoscopic approach in postpartum pyoperitoneum: A guide to early rehabilitation.

Sepsis is a leading cause of maternal mortality and morbidity worldwide. Pyoperitoneum is a grave and life-threatening manifestation of puerperal sepsis. Administration of broad-spectrum antibiotics and drainage of pus by laparotomy has long been the cornerstone of treatment for pyoperitoneum in a parturient. In this series of six cases, the successful laparoscopic management of postpartum pyoperitoneum is discussed. The latter offers the advantage of a magnified view of the surgical field, thorough lavage and drainage, and avoidance of long incisions to explore the abdomen, resulting in faster recovery, less pain, greater patient satisfaction, and lower economic burden.

Impact of WHO Labor Care Guide on reducing cesarean sections at a tertiary center: an open-label randomized controlled trial.

BACKGROUND: The World Health Organization Labor Care Guide was introduced in December 2020 to implement World Health Organization (WHO) guidelines on intrapartum care for a positive childbirth experience. OBJECTIVE: This study aimed to determine the effect of the WHO Labor Care Guide on labor outcomes, especially in reducing primary cesarean deliveries, and its acceptability by healthcare providers. STUDY DESIGN: This open-label randomized control trial was conducted from September 2021 to December 2021 on 280 low-risk antenatal women admitted for delivery at a busy tertiary care institute in North India. After informed consent, women were allocated into the study and control groups. Labor monitoring was performed using the WHO Labor Care Guide in the study group and the World Health Organization-modified partograph in the control group. Women who had a cesarean delivery in the latent phase of labor were excluded from the study. The primary outcome was mode of delivery, whereas the secondary outcomes were duration of active labor, maternal complications (postpartum hemorrhage and puerperal sepsis), duration of hospital stay, Apgar score at 5 minutes, and neonatal intensive care unit admission. The labor outcomes in both groups were compared. In the study group, the acceptability, difficulty, and satisfaction levels of the users were assessed using a 5-point Likert scale. The "learning curve" for the use of the Labor Care Guide (LCG) was determined. SPSS software (version 21.0; IBM Corporation, Chicago, IL) was used for statistical analysis. RESULTS: After excluding women who underwent cesarean delivery in the latent phase, 136 women in the study group and 135 women in the control group were observed for labor outcomes. The cesarean delivery rate was 1.5% in the study group vs 17.8% in the control group (P=.0001). The duration of the active phase of labor was significantly shorter in the study group than in the control group (P<.001). The 2 groups were similar in terms of maternal complications, duration of hospital stay, and Apgar score. The learning curve took average levels of 6.50 and 2.25 Labor Care Guide plots to shift from "very difficult" to "neutral" and "neutral" to "easy," respectively. After an initial learning curve, acceptability and satisfaction levels were found to be high in the WHO Labor Care Guide users. CONCLUSION: The WHO Labor Care Guide is a simple labor monitoring tool for the reducing primary cesarean delivery rate without increasing the duration of hospital stay and fetomaternal complications.

Weather Classification by Utilizing Synthetic Data.

Weather prediction from real-world images can be termed a complex task when targeting classification using neural networks. Moreover, the number of images throughout the available datasets can contain a huge amount of variance when comparing locations with the weather those images are representing. In this article, the capabilities of a custom built driver simulator are explored specifically to simulate a wide range of weather conditions. Moreover, the performance of a new synthetic dataset generated by the above simulator is also assessed. The results indicate that the use of synthetic datasets in conjunction with real-world datasets can increase the training efficiency of the CNNs by as much as 74%. The article paves a way forward to tackle the persistent problem of bias in vision-based datasets.

Does the Addition of Serum PAPP-A and ß-hCG Improve the Predictive Value of Uterine Artery Pulsatility Index for Preeclampsia at 11-14 Weeks of Gestation? A Prospective Observational Study.

PURPOSE OF STUDY: To study the role of uterine artery Doppler pulsatility index (UtA-PI), serum pregnancy-associated plasma protein-A (PAPP-A) and free beta human chorionic gonadotropin (fß-hCG) levels, individually and in combination with each other, at 11-14 weeks of gestation for prediction of preeclampsia (PE). METHODS: In a prospective observational study, a total of 100 low-risk gravid females were recruited at 11-14-weeks of gestation. UtA-PI, PAPP-A and fß-hCG levels were estimated. These women were followed up until delivery for the development of PE and gestational hypertension (GH). RESULTS: The best individual marker for screening PE and GH was UtA-PI with ROC AUC (± standard error) = 0.934 ± 0.028, p < 0.0001. UtA-PI at a cutoff value of ≥ 2.8 (95th percentile) had 77.8% sensitivity, 98.9% specificity, 97.8% NPV and 87.5% PPV in detecting PE. PAPP-A (MoM) at a cutoff value of ≤ 0.27 (5th percentile) demonstrated 44.4% sensitivity, 95.6% specificity, 94.5% NPV and 50% PPV. fß-hCG (MoM) at a cutoff value of ≤ 0.5 (5th percentile) had a specificity of 94.5%. Among the combined markers, UtA-PI along with PAPP-A estimation served best with a sensitivity and specificity of 44% and 100%, respectively. Addition of fß-hCG to either UtA-PI or PAPP-A levels was not found sensitive for detecting PE but yielded 100% specificity and 96% NPV. CONCLUSION: UtA-PI as a stand-alone test was found most useful for the prediction of PE. Addition of either or both of PAPP-A and fß-hCG to UtA-PI did not improve the sensitivity of combined test with only a slight improvement in specificity and NPV. Their routine addition to UtA-PI studies is not recommended for prediction of PE at 11-14 weeks of gestation in low- and lower-middle-income countries (LMIC).

Infectious crystalline keratitis induced by Citrobacter.

Background: Microbial keratitis is an important cause of ocular morbidity, with emerging organisms and drug resistance posing a real threat to vision of patients. Case presentation: A 30-year-old female presented with infective keratitis in the left eye. She had been using rose nectar as home remedy for her ailment. With no improvement in her symptoms, she presented to the eye emergency department, where she was started on empirical therapy with moxifloxacin, which was shifted to levofloxacin eye drops after the antimicrobial susceptibility test results came in. Microbiological examination revealed infection with rare gram-negative bacilli Citrobacter koseri. The patient responded well to the treatment with 1.5% levofloxacin eye drops and her vision improved from 20/120 to 20/30 over a course of 3 months. Conclusion: Treatment of microbial keratitis with those antibiotics that the organism is most sensitive to is of paramount importance today, where we often find patients on a cocktail of eye drops, which leads to further resistance and vision deterioration. Culturing of cornea scrapings and antimicrobial susceptibility testing of the isolated organism is now the standard guideline to be followed in the investigation of microbial keratitis.

Progression of the first stage of labour, in low risk nulliparas in a South Asian population: a prospective observational study.

We compared the labour pattern in the active phase of labour, defined at 4 cm versus 6 cm cervical dilatation, in a South Asian population. This was a prospective observational study where 500 low risk nulliparous women were recruited. Our aim was to study, the average labour pattern curve of all parturients. Mean duration of the active phase from 4 to 10 cm was 5.12 ± 2.10 hours and from 6 to 10 cm was 2.79 ± 1.72 hours. The 95th percentile values suggests that it takes 5-6 hours to progress from 4 to 6 cm and again 5-6 hours from 6 to 10 cm. The minimum labour progression rate can be as low as 0.5 cm/hour with vaginal delivery (VD) still being achieved. The slope of labour curve steepens after 6 cm, suggesting 6 cm as the onset of the active phase. Allowing labour to continue for a longer period before 6 cm of cervical dilation may reduce the rate of unnecessary intrapartum intervention and caesarean section (CS) for labour dystocia.Impact StatementWhat is already known on this subject? Friedman's definitions of normal labour and abnormal labour are widely accepted in current obstetric practises. Friedman's normal dilatation rate of 1 cm/h that is universally accepted is becoming questionable in our current obstetric population because of escalating rates of unnecessary labour interventions like oxytocin augmentation and CS.What the results of this study add? The rule of 1 cm/hour of labour progression cannot be applied to every woman and inappropriate interventions should be withheld until labour progression does falls below 0.5 cm/hour.What the implications are of these findings for clinical practice and/or further research? Six centimetres rather than 4 cm of cervical dilatation is a more appropriate landmark for the start of the active phase. Allowing labour to continue for a longer period before 6 cm of cervical dilation may reduce the rate of unnecessary intrapartum interventions and CS for labour dystocia.

Flexible Antifreeze Zn-Ion Hybrid Supercapacitor Based on Gel Electrolyte with Graphene Electrodes.

Zn-ion energy storage devices employing hydrogel electrolytes are considered as promising candidates for flexible and wearable electronics applications. This is because of their safe nature, low cost, and good mechanical characteristics. However, conventional hydrogel electrolytes face limitation at subzero temperatures. Herein, we report an antifreezing, safe, and nontoxic gel electrolyte based on the poly(vinyl alcohol) (PVA)/Zn/ethylene glycol system. The optimal gel electrolyte membrane exhibits a high ionic conductivity (15.03 mS cm-1 at room temperature) and promising antifreezing performance (9.05 mS cm-1 at -20 °C and 3.53 mS cm-1 at -40 °C). Moreover, the antifreezing gel electrolyte can suppress the growth of Zn dendrites to display a uniform Zn plating/stripping behavior. Also, a flexible antifreezing Zn-ion hybrid supercapacitor fabricated with the optimum antifreezing gel electrolyte membrane exhibits excellent electrochemical properties. The supercapacitor possesses a high specific capacity of 247.7 F g-1 at room temperature under a high working voltage of 2 V. It also displays an outstanding cyclic stability at room temperature. Moreover, the supercapacitor shows an extraordinary electrochemical behavior and cyclic stability over up to 30 000 cycles at -20 °C under a current load of 5 A g-1, demonstrating its outstanding low-temperature electrochemical performance. Besides, the antifreezing supercapacitor device also offers high flexibility under different deformation conditions. Therefore, it is believed that this work provides a simplistic method of realizing the application of flexible antifreezing Zn-ion energy storage devices in a subzero-temperature environment.

Prognosticating Fetomaternal ICU Outcomes.

Although no scoring system is as yet fully validated for predicting maternal outcomes in critically ill obstetric patients, prognostication may be done objectively using severity predicting models. General critical care scoring systems which have been studied in obstetric patients are outcome prediction models (Acute Physiology and Chronic Health Evaluation [APACHE] I-IV, Simplified Acute Physiology Score [SAPS] I-III, Mortality Probability Model [MPM] I-IV) and organ dysfunction scores (Multiple Organ Dysfunction Score [MODS], Logistic Organ Dysfunction Score [LODS], Sequential Organ Failure Assessment [SOFA]). General critical care scoring systems may overpredict mortality rates in obstetric patients secondary to an altered physiology of organ systems during pregnancy. Obstetric prediction models were developed keeping in mind the physiological characteristics of obstetric population. They are Modified Early Obstetric Warning System (MEOWS), Obstetric Early Warning Score (OEWS), Maternal Early Warning Trigger (MEWT), and disease-specific obstetric scoring systems. The APACHE II model and MPM II are most often used scoring systems for predicting maternal mortality. The SOFA model is the best predictive model for sepsis in obstetrics. APACHE II and SAPS are more useful for nonobstetric population. Recent studies have also underscored the applicability of the OEWS in intensive care unit (ICU) settings with results comparable to the more elaborate APACHE II and SOFA scores. The Early Warning System helps in identifying acutely deteriorating pregnant and postpartum women in non-ICU settings who may require critical care. Fetal outcomes are largely dependent upon maternal outcomes. Prognostic systems applied to mothers may help in estimation of perinatal mortality and morbidity. How to cite this article: Suri J, Khanam Z. Prognosticating Fetomaternal ICU Outcomes. Indian J Crit Care Med 2021;25(Suppl 3):S206-S222.

Ionic Liquid-Incorporated Zn-Ion Conducting Polymer Electrolyte Membranes.

In this study, novel ionic liquid-incorporated Zn-ion conducting polymer electrolyte membranes containing polymer matrix poly (vinylidene fluoride-hexafluoropropylene) (PVdF-HFP) and 1-ethyl-3-methylimidazolium trifluoromethanesulfonate (EMITf), along with zinc trifluoromethanesulfonate Zn(Tf)2, are prepared and investigated. It is ascertained that the optimal membrane ILPE-Zn-4 (the mass ratio of EMITf:Zn(Tf)2:PVDF-HFP is 0.4:0.4:1), with abundant nanopores, exhibits a high amorphousness. At room temperature, the optimized electrolyte membrane offers a good value of ionic conductivity (~1.44 × 10-4 S cm-1), with a wide electrochemical stability window (~4.14 V). Moreover, the electrolyte membrane can sustain a high thermal decomposition temperature (~305 °C), and thus its mechanical performance is sufficient for practical applications. Accordingly, the ionic liquid-incorporated Zn-ion conducting polymer electrolyte could be a potential candidate for Zn-based energy storage applications.