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Pre-exposure prophylaxis (PrEP) is highly effective at reducing HIV acquisition. We aimed to estimate usage of oral-PrEP, and factors associated with adherence among female sex workers (FSWs) in Nairobi, Kenya, using a novel point-of-care urine tenofovir lateral flow assay (LFA). The Maisha Fiti study randomly selected FSWs from Sex Worker Outreach Program clinics in Nairobi. Data were collected from 1003 FSWs from June-October 2019, including surveys on self-reported oral-PrEP adherence. Adherence was also measured using the LFA for HIV-negative FSWs currently taking oral-PrEP. Informed by a social-ecological theoretical framework, we used hierarchical multivariable logistic regression models to estimate associations between individual, interpersonal/community, and structural/institutional-level factors and either self-reported or LFA-assessed adherence. Overall, 746 HIV-negative FSWs aged 18-40 participated in the study, of whom 180 (24.1%) self-reported currently taking oral-PrEP. Of these, 56 (31.1%) were adherent to oral-PrEP as measured by LFA. In the multivariable analyses, associations with currently taking oral-PrEP included having completed secondary education, high alcohol/substance use, feeling empowered to use PrEP, current intimate partner, no recent intimate partner violence, having support from sex worker organisations, experiencing sex work-related stigma, and seeking healthcare services despite stigma. Associations with oral-PrEP LFA-measured adherence measured included having only primary education, experience of childhood emotional violence, belonging to a higher wealth tertile, and being nulliparous. Oral-PrEP adherence, measured by self-report or objectively, is low among FSWs in Nairobi. Programs to improve oral-PrEP usage among FSWs should work to mitigate social and structural barriers and involve collaboration between FSWs, healthcare providers and policymakers.

Fibroelastolytic papulosis (FEP) is an acquired cutaneous disorder of elastin that encompasses both white fibrous papulosis of the neck (WFPN) and pseudoxanthoma elasticum (PXE)-like papillary dermal elastolysis (PDE). Although FEP is a benign acquired disorder, it shares overlapping clinical features with pseudoxanthoma elasticum (PXE), a genetic disorder with systemic manifestations. We report two cases of FEP, including the WFPN and PXE-like PDE variants, in elderly women. In one case, a woman in her 70s with hyperlipidemia and chronic kidney disease presented with white-to-yellow, smooth, monomorphic papules coalescing into plaques on the posterior neck and bilateral antecubital fossa. A punch biopsy and elastic stain revealed a loss of elastic fibers in the papillary dermis. Based on these findings, we diagnosed our patient with PXE-like PDE. In another case, a woman in her 60s with no significant medical history similarly presented with skin-colored, smooth monomorphic papules on the posterior and anterior neck. A punch biopsy was also performed and an elastic stain showed a loss of elastic fibers in the papillary dermis, confirming the diagnosis of WFPN. Although rare, FEP is an important entity for dermatologists to recognize and differentiate from PXE given the potential for systemic complications in PXE.

Accurate and efficient detection of ships from aerial images is an intriguing and difficult task of extreme societal importance due to their implication and association with maritime infractions, and other suspicious actions. Having an automated system with the required capabilities indicates a substantial reduction in the related man-hours of characterization and the overall underlying processes. With the advent of various image processing techniques and advancements in the field of machine learning and deep learning, specialized methodologies can be created for the said task. An intuition for the enhancement of existing methodologies would be a study on attention-based cognition and the development of improved neural architectures with the available attention modules. This paper offers a novel study and empirical analysis of the utility of various attention modules with U-Net and other subsidiary architectures as a backbone for the task of computationally efficient and accurate ship detection. The best performing models are depicted and explained thoroughly, while considering their temporal performance.

Background: Tuberculosis (TB), as a communicable disease, is an ongoing global epidemic that accounts for a high burden of global mortality and morbidity. Drug-resistant TB strains are one of the hurdles in controlling TB problem. TB is the most common opportunistic infection in people living with human immunodeficiency viruses (PLHIV). To accelerate progress toward the goal of ending TB by 2035, it is imperative to outline the incidence and mortality trends of TB in India. Aims and Objectives: This study aims to provide deep insights into the recent trends of TB incidence and mortality in India from 2018 to 2023. Materials and Methods: This is a cross-sectional type of observational study done, over a period of 6 years from 2018 to 2023. It included 21,223 suspected samples tested for TB and rifampicin (rif) resistance with GeneXpert CBNAAT (cepheid) for infection of Mycobacterium tuberculosis (MTB). Results: Out of total 21,223 samples tested, 17.97% of samples were positive for MTB. From the year 2018 to 2023, 9.5% decline was seen in overall TB cases. However, the diagnosis of rif resistance is in similar range for all the study years. New patients show slight decline, but previous patients show higher rif resistance. There is decreased TB incidence in PLHIV. Conclusion: Overall, the incidence of TB has decreased in the past 6 years. The acquired drug resistance was seen in 32.6% cases. The study found an overall decrease in the incidence of TB in PLHIV. [ABSTRACT FROM AUTHOR]

: Introduction: Street‐connected young people (SCY) experience structural and social barriers to engaging in the HIV prevention‐care continuum. We sought to elicit recommendations for interventions that may improve SCY's engagement along the HIV prevention‐care continuum from healthcare providers, policymakers, community members and SCY in Kenya. Methods: This qualitative study was conducted in Uasin Gishu, Trans Nzoia, Bungoma, Nakuru and Kitale counties in Kenya between May 2017 and September 2018 to explore and describe the public perceptions of, and proposed and existing responses to, the phenomenon of SCY. This secondary analysis focuses on a subset of data interviews that investigated SCY's healthcare needs in relation to HIV prevention and care. We conducted 41 in‐depth interviews and seven focus group discussions with 100 participants, of which 43 were SCY. In total, 48 participants were women and 52 men. Results: Our analysis resulted in four major themes corresponding to stages in the HIV prevention‐care continuum for key populations. We identified the need for an array of strategies to engage SCY in HIV prevention and testing services that are patient‐centred and responsive to the diversity of their circumstances. The use of pre‐exposure prophylaxis was a biomedical prevention strategy that SCY and healthcare providers alike stressed the need to raise awareness around and access to for SCY. Several healthcare providers suggested peer‐based approaches for engaging SCY throughout the continuum. However, SCY heavily debated the appropriateness of using peer‐based methods. Structural interventions, such as the provision of food and housing, were suggested as strategies to improve antiretroviral therapy adherence. Conclusions: This study identified contextually relevant interventions that should be adapted and piloted for use with SCY. Education and sensitization of SCY and healthcare providers alike were identified as possible strategies, along with affordable housing and anti‐poverty strategies as cash transfers and provision of food. Peer‐based interventions are a clear option but require SCY‐specific adaptation to be implemented effectively., INTRODUCTION Young people aged 10–24 years, particularly adolescent girls and young women (AGYW) and other young key populations (YKPs), are still disproportionately acquiring HIV in sub‐Saharan Africa (SSA) [1]. In [...]

Introduction: This review summarizes the evolving use, indications, success rate, and post-operative complications of trabeculectomy versus tube shunt surgery for the treatment of open-angle glaucoma (POAG). Trabeculectomy leads to significantly sustained reductions in IOP and therefore remains the gold standard of care for advanced POAG. While tube shunt surgeries have been historically reserved as second-line procedures for glaucoma, they have been used with increasing frequency in recent years as effective alternatives to trabeculectomy. Areas covered: This review discusses major clinical trials and studies on tube shunt surgery and trabeculectomy for the treatment of POAG, encompassing studies published between 1961 and 2024. A PubMed-based search protocol was conducted using the following keywords: 'advanced open-angle glaucoma,' 'Ahmed,' 'Baerveldt,' 'trabeculectomy,' 'trabeculectomy versus tube shunt,' 'surgical failure,' 'IOP,' and 'complications.' Studies included were experimental or observational, involving eyes with various stages of POAG with or without prior glaucoma operations that underwent trabeculectomy or tube shunt surgery. Expert opinion: Tube shunt surgeries represent an effective method for lowering IOP with a reduced rate of complications compared with trabeculectomy. However, since trabeculectomy achieves optimal IOP reduction and remains the superior surgical option for certain patient populations, trabeculectomy must remain a tool that is learned and practiced by glaucoma surgeons. [ABSTRACT FROM AUTHOR]

Background: Supraclavicular brachial plexus blockade (SBPB) is commonly performed regional anesthetic technique for forearm and hand surgeries, and its blockage provides good surgical anesthesia. Aim: Considering the efficacy of adjuvant for ropivacaine in SBPBs, we designed a double-blind randomized control study to compare the characteristics and side effects of ropivacaine along with dexamethasone versus dexmedetomidine in SBPBs in patients scheduled for upper limb surgeries. Material and Methods: Present study was single-center, prospective, randomised, double blind study, conducted patients aged 18-70 years, belonging to American Society of Anaesthesiologists physical status (ASA) of I or II, scheduled for Upper limb surgeries under SBPB. Results: In present study, 108 patients were studied, 54 patients received 20 ml 0.5% Ropivacaine with 50 mcg Dexamethasone (Group A, n=54), while other 54 patients received 20 ml 0.5% Ropivacaine with 50 mcg Dexmedetomidine (Group B, n=54). Age, weight, gender, ASA grade & duration of surgery were comparable in both groups. Dexamethasone group has earlier onset of sensory block, earlier onset of motor block, prolonged duration of sensory block & prolonged duration of motor block as compared to dexmedetomidine group & difference was statistically significant (p< 0.05). Dexamethasone group duration of analgesia, delayed first rescue analgesic requirement & less doses of rescue analgesia required as compared to dexmedetomidine group & difference was statistically significant (p< 0.05). Conclusion: Dexamethasone is a better alternative than dexmedetomidine since it shortens the onset of sensory and motor block, prolongs the duration of sensory and motor block and prolongs the duration of analgesia. [ABSTRACT FROM AUTHOR]

There has been surge in the usage of Internet as well as social media platforms which has led to rise in online hate speech targeted on individual or group. In the recent years, hate speech has resulted in one of the challenging problems that can unfurl at a fast pace on digital platforms leading to various issues such as prejudice, violence and even genocide. Considering the acceptance of Artificial Intelligence (AI) and Natural Language Processing (NLP) techniques in varied application domains, it would be intriguing to consider these techniques for automated hate speech detection. In literature, there have been efforts to recognize and categorize hate speech using varied Machine Learning (ML) and Deep Learning (DL) techniques. Hence, considering the need and provocations for hate speech detection we aim to present a comprehensive review that discusses fundamental taxonomy as well as recent advances in the field of online hate speech identification. There is a significant amount of literature related to the initial phases of hate speech detection. The background section provides a detailed explanation of the previous research. The subsequent section that follows is dedicated to examining the recent literature published from the year 2020 onwards. The paper presents some of the hate speech datasets considered for hate speech detection. Furthermore, the paper discusses different data modalities, namely, textual hate speech detection, multi‐modal hate speech detection and multilingual hate speech detection. Apart from systematic review on hate speech detection, the paper also implement several multi‐label models to compare the performance of hate speech detection by employing classic ML technique namely, Logistic Regression and DL technique namely, Long Short‐Term Memory (LSTM) and a multiclass multi‐label architecture. In the implemented architecture, we have derived two new elements to quantify the hatefulness and intensity of hatred to improve the results for hate speech detection using Indonesian tweet dataset. Empirical Analysis of the model reveals that the implemented approach outperforms and is able to achieve improved results for the underlying dataset. [ABSTRACT FROM AUTHOR]