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Introduction Over 265 000 women are living with HIV in the USA, but limited research has investigated the physical, mental and behavioural health outcomes among women living with HIV of reproductive age. Health status during the reproductive years before, during and after pregnancy affects pregnancy outcomes and long-term health. Understanding health outcomes among women living with HIV of reproductive age is of substantial public health importance, regardless of whether they experience pregnancy. The Health Outcomes around Pregnancy and Exposure to HIV/Antiretrovirals (HOPE) study is a prospective observational cohort study designed to investigate physical and mental health outcomes of young women living with HIV as they age, including HIV disease course, engagement in care, reproductive health and choices and cardiometabolic health. We describe the HOPE study design, and characteristics of the first 437 participants enrolled as of 1 January 2024.Methods and analysis The HOPE study seeks to enrol and follow 1630 women living with HIV of reproductive age, including those with perinatally-acquired HIV, at 12 clinical sites across 9 US states and Puerto Rico. HOPE studies multilevel dynamic determinants influencing physical, mental and social well-being and behaviours of women living with HIV across the reproductive life course (preconception, pregnancy, post partum, not or never-pregnant), informed by the socioecological model. Key research areas include the clinical course of HIV, relationship of HIV and antiretroviral medications to reproductive health, pregnancy outcomes and comorbidities and the influence of racism and social determinants of health. HOPE began enrolling in April 2022.Ethics and dissemination The HOPE study received approval from the Harvard Longwood Campus Institutional Review Board, the single institutional review board of record for all HOPE sites. Results will be disseminated through conference presentations, peer-reviewed journals and lay summaries.

Unremitting decline in crop productivity and nutrient recovery are resulted due to dearth of need based fertilizer recommendation over blanket application apart from nitrogen pollution in several means. An advance nutrient management tactic, GreenSeeker (GS) has developed and used in many field crops following the principle of four "R" (right source, right amount at right time, and place) nutrients stewardship technologies. But no studies have been conducted for evaluation of GS in mustard for improving productivity, profitability and nutrient use efficiency (NUE) while minimizing environmental risks. With this objective, a study was planned to conduct an experiment in rabi season of 2021-22 and 2022-23 to assess optical sensor based nitrogen management in mustard over blanket recommendation. The experiment was comprised of ten N treatments including control in randomized block design in triplicates. Research findings indicated that application of GreenSeeker based N significantly improved all growth traits and yield parameters in Brassica juncea L. Per cent enhancement in seed yield, net monetary returns and benefit-cost ratio was higher as 19.3 and 64.5%, 125.1 & 36.2% and 58.8 & 24.4%, respectively under GS based multi split N application over RDF and control. Further, real time N management with GS acquired higher crop production efficiency (CPE) (19.9 kg/day) with lesser cost/kg production (Rs 15.7/kg). Split application of N using GS increased oil yield by 79.9 and 26% over control and recommended dose of fertilizer (RDF) with maximum oil content (42.3%), and increases soil organic carbon (SOC) content by 16.1% from its initial value. Moreover, GS crop sensor could be the probable solution to minimize the crop nitrogen requirement by 15-20% with a yield enhancement of about 18.7% over RDF.

ObjectiveTo assess functional outcomes and classify postoperative complications of augmentation cystoplasty by the Clavien-Dindo classification system. MethodsA total of 197 adult patients undergoing augmentation cystoplasty between January 2016 and December 2020 at the Department of Urology, Sindh Institute of Urology and Transplantation (SIUT), were included in the study after obtaining approval from the ethics review committee. Patients’ records were reviewed for assessment of complications up to 3 months of follow-up. Functional outcomes were assessed by comparing preoperative video urodynamics study (VUDS) findings with follow-up VUDS findings at 1 year. IBM SPSS v23 was used to record and analyze all the complications, treatments, and pre- and postoperative VUDS data. ResultsOf the 197 patients included in this study, 127 (64.5%) were male and 70 (35.5%) were female. The mean age of the patients was 38.4 ± 9.92 years. Eighty-seven patients (44.2%) remained complication-free, 64 patients (32.5%) had grade I-II complications, 44 patients (22.3%) had grade III and IV complications, and only 2 patients (1%) had grade V complications. Stomal stenosis was the most frequent complication, occurring in 14.7% of patients, followed by renal function deterioration and high-grade fever, each noted in 13.7% of patients. Mean preoperative bladder capacity was 144.3 ± 63.09 mL, mean preoperative filling pressure was 43.34 ± 26.92 cm3 H2O, while mean postoperative bladder capacity was 460.83 ± 70.69 mL and mean postoperative filling pressure was 7.47 ± 5.79 cm3 H2O. ConclusionAugmentation cystoplasty can increase bladder capacity and improve bladder function. Because of the potential for complications, it is essential to carefully choose patients for surgery and provide proper preoperative counseling. Additionally, it is crucial to give proactive postoperative care.

الملخص: أهداف البحث: لتحديد دور الأشعة السينية المحمولة التسلسلية في التشخيص والتقدير الكمي لمرضى كوفيد-19 المؤكدين المنومين في مستشفى الرعاية الثالثية. طرق البحث: تم إجراء دراسة استعادية في معهد داو للأشعة، جامعة داو للعلوم الصحية. تمت دراسة الحالات الإيجابية المؤكدة لكوفيد-19 من نوفمبر 2020 إلى يناير 2021 بدراسة استعادية. تم استرداد معلومات البيانات حول التركيبة السكانية للمرضى والخصائص السريرية ونتائج الأشعة السينية على الصدر والنتائج من خلال السجل الطبي الإلكتروني. تمت مقارنة خط الأساس ونتائج الأشعة السينية للصدر للمتابعة باستخدام درجة شدة الأشعة السينية على الصدر. تم استخدام الانحدار اللوجستي متعدد المتغيرات لتقييم العلاقة بين خصائص المرضى ونتائج المرضى. النتائج: اشتملت الدراسة على 329 مريضا بمتوسط عمر 56.43 ± 13.10 سنة (المدى 16-85 سنة). كان الدمج المحيطي وعتامة الزجاج الأرضي (89.4٪) أكثر نتائج الأشعة السينية شيوعا تليها مشاركة الرئة الثنائية (79.0٪) والاندماج المحيط/عتامة الزجاج الأرضي (69.9٪). من بين المرضى الذين تم إدخالهم، خرج 61.4 ٪ من المرضى، و 49.5 ٪ من المرضى لديهم مدة إقامة مطولة ≥10 أيام، وتوفي 37.7 ٪ من المرضى. بعد تعديل خصائص جميع المرضى، أظهر النموذج متعدد المتغيرات عدم وجود فرق كبير في درجة شدة الأشعة السينية للصدر فيما يتعلق بنتائج المريض. ارتبط المرضى الذين تم إدخالهم في وحدة العناية المركزة، ودعم العلاج بالأكسجين، وضغط إيجابي ثنائي المستوى في المسالك الهوائية، وجهاز التنفس الصناعي بشكل كبير بنتيجة الخروج من المستشفى، والإقامة المطولة في المستشفى، والوفاة. الاستنتاجات: كان الاستصحاف المحيطي وعتامة الزجاج الأرضي أكثر اكتشافات الأشعة السينية للصدر شيوعا في مرضى كوفيد-19 المقبولين. لم يلاحظ أي اختلاف كبير في درجة شدة الأشعة السينية للصدر في النتيجة الأولية للخروج، والإقامة المطولة في المستشفى، والوفاة. ليس هناك حاجة لإجراء أشعة سينية يومية للصدر في المرضى في المستشفى حتى يتم طلبها في حالة تفاقم الأعراض أو التدخل الهام مثل التنبيب الرغامي. Abstract: Objective: To determine the role of the serial portable chest X-ray in the diagnosis and quantification of patients with confirmed COVID-19 admitted to a tertiary care hospital. Methods: A retrospective study was conducted at Dow Institute of Radiology, Dow University of Health Sciences. Confirmed positive cases of COVID-19 from November 2020 to January 2021 were retrospectively studied. Patients' demographics and clinical characteristics, chest X-ray findings, and outcomes were retrieved through electronic medical records. Baseline and final follow-up chest X-rays findings were compared by using chest X-ray severity score. Multivariable logistic regression was used to evaluate the relationship between patients’ characteristics and patient outcomes. Results: The study included 329 patients with a mean age of 56.43 ± 13.10 years (range 16–85 years). Peripheral consolidation and ground glass opacities (89.4%) were the most common X-ray findings followed by bilateral lung involvement (79.0%) and perihilar consolidation/ground glass opacities (69.9%). Among the patients who were admitted, 61.4% were discharged, 49.5% had prolonged length of stay ≥10 days, and 37.7% died. After adjustment of all patients' characteristics, the multivariate model showed no significant difference in chest X-ray severity score in relation to the patient's outcome. Patients who were admitted to the intensive care unit, and received oxygen support, bilevel positive airway pressure, and a ventilator were significantly associated with the outcome of being discharged, prolonged hospital stay, and death. Conclusion: Peripheral consolidation and ground glass opacities were the most common chest X-ray findings in admitted COVID-19 patients. No significant difference in chest X-ray severity score was noted in the primary outcome of being discharged, prolonged hospital stay, and death. There is no requirement for daily chest X-rays in hospitalized patients until required in the condition of worsening symptoms or significant intervention such as endotracheal intubation.

Background and Aims: The aim of this study was to review a large series of cases with hepatoportal sclerosis (HPS) as a pathologically recognizable entity in liver tissue specimens and describe the associated clinical and radiographic manifestations, along with the outcomes of this entity. Methods: Data were collected through a retrospective chart review. Results: Twenty-eight patients were identified that had pathologically defined HPS. All patients had a significant past medical history and signs and symptoms of portal hypertension. The most consistent laboratory finding was an elevated alkaline phosphatase. Radiographically, 9 patients were mistakenly identified as having advanced fibrosis/cirrhosis. The initial histologic diagnosis was made on biopsy in 20 patients and after transplant in 8 patients. The severity of symptoms was variable and required transplantation in 11 patients, 3 were treated with transjugular intrahepatic portosystemic shunt, and the remaining patients were treated symptomatically. Conclusion: HPS is associated with past medical history that may be causal in nature. Signs and symptoms may be severe enough to require liver transplantation. A significant proportion of patients are radiographically misdiagnosed as cirrhosis. In this small series, overall outcomes for transplanted patients are acceptable.

Objective: To determine the factors associated with renal function recovery in individuals with kidney failure due to obstruction in the urinary tract. Method: The prospective, descriptive study was conducted July 2020 to August 2021 at the Department of Urology, Sindh Institute of Urology and Transplantation, Karachi, and comprised adult patients of either gender who had renal failure secondary to obstructive urinary tract. Baseline data regarding patients’ variables, including age, gender, duration of symptoms (25 days or 25 days), haemoglobin (9.85g/dl or 9.85g/dl), serum creatinine and renal cortical thickness (16.5mm or 16.5 mm), was noted on a proforma. The variables were stratified to assess impact on renal recovery. Data was analysed using SPSS 23. Results: Of the 126 patients, 43(34.13%) were males and 83(65.87%) were females. The overall mean age was 44.13±14.18 years. Renal recovery occurred in 67(78.8%) patients having duration of symptoms 25 days, and in 13(31.7%) patients with duration of symptoms 25 days (p 0.001). Renal recovery occurred in 41(58.6%) patients having haemoglobin 9.85g/dL and in 39(69.6%) patients having haemoglobin 9.85g/dL (p=0.2). Renal recovery occurred in 26(37.7%) patients with parenchymal thickness 16.5mm and in 54(94.7%) patients with renal cortical thickness 16.5mm (p 0.001). Conclusion: Symptom duration 25 days, and renal parenchymal thickness 16.5mm were found to be predictive factors of good recovery in renal failure cases secondary to obstructive uropathy. Key Words: Urinary obstruction, Obstructive nephropathy, Percutaneous nephrostomy, Renal failure.

Abstract Monkeypox (MPX) has emerged as a threatening outbreak in recent months. The understanding of disease pathogenesis and its systemic involvement has evolved with time. Both the virus and its vaccine, like other members of the Orthopoxvirus family, were always expected to have neuropsychiatric consequences. Several neurological complications have been reported with MPX and its vaccines that include but not limited to headaches, myalgia, encephalitis, and coma. Psychiatric complications like anxiety and depression have also been reported; however, we lack evidence to present a direct causality. We conducted a literature review to compile recent evidence on neuropsychiatric manifestations and underline the importance of evolving aspects and complications of MPX. We advocate for better reporting of cases and adverse events, to enhance our understanding of the disease, aiding physicians to make more informed decisions, thus facilitating timely diagnosis and treatment.

Abstract We explore the shifted $$f(R) (\propto R^{1+\delta })$$ f ( R ) ( ∝ R 1 + δ ) model with $${\delta }$$ δ as a distinguishing physical parameter for the study of constraints at local scales. The corresponding dynamics confronted with different geodesics (null and non-null) along with their conformal analog are investigated. For null geodesics, we discuss the light deflection angle, whereas, for non-null geodesics under the weak field limit, we investigate the perihelion advance of the Mercury orbit in f(R) Schwarzschild background, respectively. The extent of an additional force, appearing for non-null geodesics, depends on $$\delta $$ δ . Such phenomenological investigations allow us to strictly constrain $$\delta $$ δ to be approximately $${\mathcal {O}}(10^{-6})$$ O ( 10 - 6 ) with a difference of unity in orders at galactic and planetary scales and seem to provide a unique f(R) at local scales. Our results suggest that the present form of the model is suitable for the alternative explanation of dark matter-like effects at local scales.

Introduction: Adolescents living with HIV are subject to multiple co-morbidities, including growth retardation and immunodeficiency. We describe growth and CD4 evolution during adolescence using data from the Collaborative Initiative for Paediatric HIV Education and Research (CIPHER) globalproject. Methods: Data were collected between 1994 and 2015 from 11 CIPHER networks worldwide. Adolescents with perinatally acquired HIV infection (APH) who initiated antiretroviral therapy (ART) before age 10 years, with at least one height or CD4 count measurement while aged 10-17 years, were included. Growth was measured using height-for-age Z-scores (HAZ, stunting if Results: A total of 20,939 and 19,557 APH were included for the growth and CD4 analyses, respectively. Half were females, two-thirds lived in East and Southern Africa, and median age at ART initiation ranged from 7 years in sub-Saharan African regions. At age 10, stunting ranged from 6% in North America and Europe to 39% in the Asia-Pacific; 19% overall had CD4 counts Conclusions: Growth patterns during adolescence differed substantially by sex and region, while CD4 patterns were similar, with an observed CD4 decline that needs further investigation. Early diagnosis and timely initiation of treatment in early childhood to prevent growth retardation and immunodeficiency are critical to improving APH growth and CD4 outcomes by the time they reach adulthood. Keywords: adolescent; CD4; cohort studies; growth; HIV; perinatally acquired Additional information may be found under the Supporting Information tab of this article., 1 | INTRODUCTION In 2019, an estimated 1.7 million adolescents aged 10-19 years were living with HIV worldwide, with 90% of them in sub-Saharan Africa, and 8% in Asia and [...]

A novel, natural, and effective antimicrobial intervention is in demand for improving the microbial safety of vegetable seeds/sprouts. This study assessed the efficacy of ascaroside treatment in the control of Salmonella enterica on alfalfa and fenugreek sprouts. Sanitized commercial seeds were treated with 1 mM or 1 µM ascaroside (ascr)#18, a plant immunity modulator (PIM) and dried for an hour before being inoculated with lyophilized S. Cubana or S. Stanley cells in sandy soil (104 CFU/g). Treated and untreated seeds were spouted on 1% water agar at 25°C in the dark. Seed or sprout samples were collected on days 0, 1, 3, 5, and 7, and the population of Salmonella was determined. Data were fit into the general linear arrangement, and means were separated using Fisher’s least significant difference test. Seed type, strain type, treatment type, and sprouting time were significant factors (P ≤ 0.05) influencing Salmonella growth on sprouts. The populations of Salmonella were significantly higher on fenugreek than on alfalfa sprouts. S. Stanley had a significantly higher population than S. Cubana. The population of Salmonella increased from day 0 to day 3 and reached the peak population on Day 5. Treatments with both concentrations of ascaroside significantly decreased the populations of Salmonella compared to the controls. The mean Salmonella population reduction was ca. 4 or 1 log CFU/g by treatment with 1 mM and 1 µM of the PIM, respectively. Treatment with the PIM could be potentially used to improve the microbial safety of vegetable seeds and sprouts.

This manuscript introduces a novel miniaturized super wideband (SWB) hexagonal fractal spatial diversity 2-element multiple-input-multiple-output (MIMO) antenna for broadband applications, as a compact wideband antenna is required for military radio and space communication devices. The designed antenna includes two hexagonal ( $1^{st}$ modified Koch iteration) Koch fractal radiators with two linear tapered feedlines (TLTF) and a step tapered slotted ground plane (STSGP) that provides the broad impedance characteristic with miniaturized size in the operating band of 1.78-30 GHz. Moreover, the STSGP is also accountable for enabling the isolation ( $S_{12/21}$ ) better than 10 dB. To further meet the isolation higher than 22 dB, a meander line is protruded from the ground plane while maintaining a 6 mm edge-to-edge distance between two antenna elements. Typically, the MIMO antenna with high isolation is beneficial for high-speed data transmission. The experimental outcomes represent that the proposed MIMO antenna is with the advantages of reasonably good diversity gain (nearly 10 dB), stable radiation patterns, high peak gain (almost 6.6 dBi), and moderate radiation efficiency (around 85%) across -10 dB impedance bandwidth. The total active reflection coefficient (TARC) and envelop correlation coefficient (ECC) are less than −25 dB and 0.1 respectively. Due to all these attributes, the proposed 2-element MIMO antenna array can be a potential candidate for military radio, spectrum sensing for cognitive radio, and space communication applications.

Background Tenofovir disoproxil fumarate (TDF) is often used in treating pregnant women living with HIV. Third-trimester TDF exposure is associated with a 12% reduction in bone mineral content in HIV-exposed uninfected (HEU) neonates. The potential mechanisms underlying this observation are unknown. Methods The TDF study enrolled newborns of gestational age ≥36 weeks from the Surveillance Monitoring for Antiretroviral Therapy and Toxicities study based on in utero TDF exposure (TDF use ≥8 weeks in the third trimester vs none). Blood and urine samples were collected cross-sectionally within 30 days of birth to assess renal function (serum creatinine, serum phosphate, eGFR, percent tubular reabsorption of phosphate [PTRP]), and bone turnover (serum parathyroid hormone, 25-OH vitamin D [25(OH)D], and urinary cross-linked N-telopeptide of type 1 collagen). For each biomarker, a LOESS plot was fit using values at age at specimen collection; regression lines over age were fit among samples collected from 4 to 30 days, to compare slopes by TDF exposure. Results Among 141 neonates, 77 were TDF-exposed and 64 TDF-unexposed. Between age 4 and 30 days, PTRP decreased more rapidly in the TDF-exposed compared to the unexposed group with slopes of −0.58 vs −0.08/day (difference −0.50/day [95% CI −0.88, −0.11]). Slopes for 25(OH)D were similar in both groups, but serum levels were lower in TDF-exposed neonates (median [IQR]: 22 [19, 29] vs 26 [22, 37] ng/mL). No differences were observed for other biomarkers. Conclusions Third-trimester in utero exposure to TDF is associated with increased urinary loss of phosphate and lower serum concentrations of 25(OH)D in HEU neonates. [ABSTRACT FROM AUTHOR]