Addressing Domestic Violence in Antenatal Care Environments in Nepal (ADVANCE) - study protocol for a randomized controlled trial evaluating a video intervention on domestic violence among pregnant women.

BACKGROUND: Domestic violence (DV) prior to, and during pregnancy is associated with increased risks for morbidity and mortality. As pregnant women routinely attend antenatal care this environment can be used to offer support to women experiencing DV. We have developed a video intervention that focuses on the use of behavioral coping strategies, particularly regarding disclosure of DV experiences. The effectiveness of this intervention will be evaluated through a randomized controlled trial (RCT) and a concurrent process evaluation. METHODS: All pregnant women between 12-22 weeks of gestation attending routine antenatal care at two tertiary level hospitals in Nepal are invited to participate. DV is measured using the Nepalese version of the Abuse Assessment Screen (N-AAS). Additionally, we measure participants' mental health, use of coping strategies, physical activity, and food security through a Color-coded Audio Computer Assisted Self Interview (C-ACASI). Irrespective of DV status, women are randomized into the intervention or control arm using a computer-generated randomization program. The intervention arm views a short video providing information on DV, safety improving actions women can take with an emphasis on disclosing the violence to a trusted person along with utilizing helplines available in Nepal. The control group watches a video on maintaining a healthy pregnancy and when to seek healthcare. The primary outcome is the proportion of women disclosing their DV status to someone. Secondary outcomes are symptoms of anxiety and depression, coping strategies, the use of safety measures and attitudes towards acceptance of abuse. Follow-up is conducted after 32 weeks of gestation, where both the intervention and control group participants view the intervention video after completing the follow-up questionnaire. Additionally, a mixed methods process evaluation of the intervention will be carried out to explore factors influencing the acceptability of the intervention and the disclosure of DV, including a review of project documents, individual interviews, and focus group discussions with members of the research team, healthcare providers, and participants. DISCUSSION: This study will provide evidence on whether pregnant women attending regular antenatal visits can enhance their safety by disclosing their experiences of violence to a trusted person after receiving a video intervention. TRIAL REGISTRATION: The study is registered in ClinicalTrial.gov with identifier NCT05199935.

Gaming Disorder among Medical College Students during COVID-19 Pandemic Lockdown.

Background The frequent lockdown in Nepal during COVID-19 pandemic had brought various kinds of complexities such as stress among college students. This situation had created uncertainty of future academic career of undergraduate students in medical colleges. Some previously published literature showed gaming as a coping mechanism against stress. Objective To assess the gaming behavior of Medical college students during lockdown in COVID-19 pandemic. Method A cross-sectional study was conducted during lockdown period of July to August 2020. A total of 412 college students were enrolled. Online Google forms were shared to all the eligible students through email, viber and messenger with the help of class representative. Collected data were analyzed in SPSS version 20.0. Result The prevalence of gaming disorder was 8.5% among 260 internet gaming users. About 69.2% of the participants reported that their gaming behavior had increased due to stress of COVID-19 pandemic. Gender and spending more time online per day showed significant associations with greater scores on the internet gaming disorder. Conclusion During lockdown period of COVID-19 pandemic, the gaming behavior of medical college students has increased.

Twin-beam sub-shot-noise raster-scanning microscope.

By exploiting the quantised nature of light, we demonstrate a sub-shot-noise scanning optical transmittance microscope. Our microscope demonstrates, with micron scale resolution, a factor of improvement in precision of 1.76(9) in transmittance estimation gained per probe photon relative to the theoretical model, a shot-noise-limited source of light, in an equivalent single-pass classical version of the same experiment using the same number of photons detected with a 90% efficient detector. This would allow us to observe photosensitive samples with nearly twice the precision, without sacrificing image resolution or increasing optical power to improve signal-to-noise ratio. Our setup uses correlated twin-beams produced by parametric down-conversion, and a hybrid detection scheme comprising photon-counting-based feed-forward and a highly efficient CCD camera.

The Prevalence of Gender Inequalities and Violence in the Eastern Nepal.

Background Gender inequality and gender based violence is more established in societies with stratification and stronger gender norms. Objective To determine prevalence of gender violence, perception on gender issues and awareness on sexual trafficking and rights among men and women in Morang district of Nepal. Method This cross sectional study was conducted among 810 men and 1190 women in twenty different VDCs of Morang district using self-administered computer based self-interview methods during October-November 2016. Result Male in comparison to female reported more physical abuse during their lifetime. Females (n=259, 21.7%) reported more severe lifetime emotional abuse (n=148, 18.2%) compared to the males. Lifetime severe sexual abuse was reported by a close to five percent (n=95) of both sexes. The severe forms of partner violence include choking, threat or use of weapon and setting on fire was identified to be perpetrated by both the sexes. More than 50% (n=1095) of the respondents had known someone using physical violence against their partner in the community. The involvement of female in key economic decision-making was reported by less than 12%. Nearly 72% (n=1441) were aware of occurrence of sexual trafficking from Nepal while only 46% (n=918) were aware of sexual trafficking occurring from their vicinity. Conclusion The study confirms that despite awareness on gender equality and sexual trafficking, the prevalence of violence and adherence to stronger gender stereotypes, stigmas and roles indicates much need of awareness for establishing equalities and reducing gender violence.

Screening for Hypertension and Obesity in Rural Population of Nepal.

Background Hypertension is a major non-communicable disease and obesity is a risk factor for non-communicable diseases around the globe. The prevalence of hypertension and obesity is gradually increasing in Nepal. Most cases in the rural population of Nepal remain undiagnosed due to lack of routine screening and awareness. Objective To screen the cases of hypertension and obesity in a rural population of Nepal and also to depict the association between them. Method A cross sectional study was used to collect data on age, sex, height, weight and blood pressure through a screening health camp. Only the respondents who were not already taking antihypertensive drugs were included in this study. The measurement of blood pressure and body mass index was done using standard instruments. Joint National Committee VII classification was used to classify hypertension and World Health Organization classification was used for Body Mass Index. Analysis was done in IBM SPSS version 20. Result Out of the total respondents, 69.8% were female and 30.2% were male, and mean age was 48.73 (±16.25) years. Among them, 375 (30.17%) respondents were found to be hypertensive and 137 (11.02%) were pre-hypertensive. Similarly, 27% male participants and 72 % female participants were obese. Almost three-fifths of the obese participants were hypertensive. Conclusion Pre-hypertension and hypertension were seen in 11.02% and 30.17% of the study population respectively. As routine screening of hypertension and obesity is not done in our country, most of them remain undiagnosed.

Epidemiology of Work-Related Musculoskeletal Symptoms and Illnesses among Brick Kiln Workers in Kathmandu Valley, Nepal.

Background Workers in the brick manufacturing industries require to carry heavy loads, do repetitive work and remain in awkward postures for extended periods of time. These activities may cause them to develop work-related musculoskeletal symptoms and disorders. Objective To investigate the epidemiology of musculoskeletal symptoms and disorders among brick manufacturing workers as well as similar exposure groups among brick kiln workers. Method An analytical cross-sectional study was conducted during February - March 2015 in the Kathmandu Valley. From 16 brick kilns, 400 interviewees involving green brick molding, green brick stacking/carrying, red brick loading/carrying, coal crushing/ carrying and firing were recruited. An unmatched equal size of reference group of grocery workers was maintained for comparison. Prevalence of all musculoskeletal symptoms and disorders were computed and compared among brick workers and grocery workers as well as similar exposure groups among brick kiln workers. Result The musculoskeletal symptoms and disorders were prevalent in 90.5% of the exposed and 82.2% of the reference group. Brick kiln workers were about two times more likely to experience musculoskeletal symptoms and disorders compared to the reference group. When the associations among similar exposure groups were evaluated, there were significantly high prevalence of musculoskeletal symptoms and disorders among green brick molders, red brick loaders/carriers and coal crushers/ carriers in comparison to firemen. Conclusion This study showed a high prevalence of musculoskeletal symptoms and disorders among brick kilns workers. Among all similar exposure groups, coal crushing/carrying task significantly elevated with all types of musculoskeletal symptoms and disorders.

Airborne Particulate Matter and Health Condition in Brick Kiln Workers in Kathmandu Valley, Nepal.

Background Air quality monitoring in brick kilns indicates very high concentrations of airborne particulate matter. Air pollution from brick kilns poses an enhanced threat to the environment and to human health. Objective To evaluate airborne particulate matter concentration and health status of brick kiln workers. Method A cross-sectional comparative study was conducted in the Kathmandu valley targeting all brick industries and their workers during January - March 2015 and March - April 2016. A total of 16 brick kilns and 800 participants (400 brick workers as exposed and 400 grocery workers as referent) were selected for study. A direct-reading, Dusttrak model 8533 was used for air sampling. Nepali version questionnaire was applied to obtain epidemiological data. SPSS version 16 was used to perform statistical analysis. Median, mean, range and proportion were calculated and Mann-Whitney U test, Kruskal-Wallis test and chi square (c2) test were applied to test significance. Result Mean values of particulate matter concentrations for brickfields were as follows: Total Suspended Particulate Matter (TSPM): 5.179 mg/m3, PM10: 4.958 mg/m3, respirable suspended particulate matter (RSPM): 4.140 mg/m3, PM2.5: 3.965 mg/m3, and PM1: 3.954 mg/m3. The mean concentrations for grocery workers were; TSPM: 0.089 mg/ m3, PM10: 0.089 mg/m3, RSPM: 0.085 mg/m3, PM2.5: 0.082 mg/m3 and PM1: 0.082 mg/m3. Among brickfield workers, red and green brick loading zones had results that exceeded the ACGIH Threshold Limit Values for TSPM and RSPM. Workers complaints of injury were 52% and 44.2%, and illnesses were 88.5% and 82.2%, respectively among exposed and referent. The occurrence of injuries/illnesses during work showed significant association between exposed and the referent groups at 0.05 level. Conclusion The high level of airborne particulate matter in the brick fields requires action for the protection of workers. The availability of health services within brick industries needs to be enhanced.

Label-Free Field Effect Transistors (FETs) for Fabrication of Point-of-Care (POC) Biomedical Detection Probes.

Field effect transistors (FETs)-based detection probes are powerful platforms for quantification in biological media due to their sensitivity, ease of miniaturization, and ability to function in biological media. Especially, FET-based platforms have been utilized as promising probes for label-free detections with the potential for use in real-time monitoring. The integration of new materials in the FET-based probe enhances the analytical performance of the developed probes by increasing the active surface area, rejecting interfering agents, and providing the possibility for surface modification. Furthermore, the use of new materials eliminates the need for traditional labeling techniques, providing rapid and cost-effective detection of biological analytes. This review discusses the application of materials in the development of FET-based label-free systems for point-of-care (POC) analysis of different biomedical analytes from 2018 to 2024. The mechanism of action of the reported probes is discussed, as well as their pros and cons were also investigated. Also, the possible challenges and potential for the fabrication of commercial devices or methods for use in clinics were discussed.

Fluorescence Resonance Energy Transfer (FRET)-Based Sensor for Detection of Foodborne Pathogenic Bacteria: A Review.

Sensitive and rapid determination of foodborne pathogenic bacteria is of practical importance for the control and prevention of foodborne illnesses. Nowadays, with the prosperous development of fluorescence assays, fluorescence resonance energy transfer (FRET)-derived diagnostic strategies are extensively employed in quantitative analysis of different pathogenic bacteria in food-related matrices, which displays a rapid, simple, stable, reliable, cost-effective, selective, sensitive, and real-time way. Considering the extensive efforts that have been made in this field so far, we here discuss the up-to-date developments of FRET-based diagnostic approaches for the determination of key foodborne pathogens like Staphylococcus aureus, Escherichia coli, Vibrio parahaemolyticus, Salmonella spp., Campylobacter spp., and Bacillus cereus in complex food-related matrices. Moreover, the principle of this technology, the choosing standards of acceptor-donor pairs, and the fluorescence properties are also profiled. Finally, the current prospects and challenges in this field are also put forward.

LncRNA-miRNA interaction is involved in colorectal cancer pathogenesis by modulating diverse signaling pathways.

LncRNAs function as molecular sponges for miRNAs to control their availability for targeting mRNA molecules. This procedure indirectly regulates the expression of cancer-related genes. Some lncRNAs also directly interact with miRNAs, leading to their degradation or sequestration, which can negatively impact gene expression. miRNAs, on the other hand, play a critical role in controlling the expression of genes, including oncogenes and tumor suppressor genes. Multiple types of cancer have been linked to the onset and progression of miRNA dysregulation. Even though there is a lot of potential for treating CRC by targeting the LncRNA-miRNA axis, several challenges remain to be overcome. The specificity of the targeting approach, delivery methods, resistance, safety, and cost-effectiveness are critical research areas that must be addressed to advance this field and improve treatment outcomes for people with CRC.

Exosomes derived from adipose stem cells in combination with hyaluronic acid promote diabetic wound healing.

Diabetic wound is one of the main challenges in dermatology. Although stem cell-based treatment has therapeutic benefits in wound repair, the clinical application is still limited. Herein we investigated whether adipose stem cells -derived exosomes (Exo) loaded on hyaluronic acid (HA) could promote healing in diabetic rats. Sixty diabetic rats were randomly planned into the control group, Exo group, HA group, and HA+Exo group. On days 7, 14, and 21, five rats from each group were sampled for stereological, molecular, and tensiometrical assessments. Our results indicated that the wound closure rate, the total volumes of new epidermis and dermis, the numerical densities of fibroblasts, the length density blood vessels, collagen density as well as tensiometrical parameters of the healed wounds were significantly higher in the treated groups than in the control group, and these changes were more obvious in the HA+Exo ones. Furthermore, the expression of TGF-ß and VEGF genes were meaningfully upregulated in all treated groups compared to the control group and were greater in the HA+Exo group. This is while expression of TNF-α and IL-1ß, as well as numerical densities of neutrophils decreased more considerably in the HA+Exo group in comparison to the other groups. Generally, it was found that using both HA injection and exosomes has more effect on diabetic wound healing.

A way forward for fundamental physics in space.

Space-based research can provide a major leap forward in the study of key open questions in the fundamental physics domain. They include the validity of Einstein's Equivalence principle, the origin and the nature of dark matter and dark energy, decoherence and collapse models in quantum mechanics, and the physics of quantum many-body systems. Cold-atom sensors and quantum technologies have drastically changed the approach to precision measurements. Atomic clocks and atom interferometers as well as classical and quantum links can be used to measure tiny variations of the space-time metric, elusive accelerations, and faint forces to test our knowledge of the physical laws ruling the Universe. In space, such instruments can benefit from unique conditions that allow improving both their precision and the signal to be measured. In this paper, we discuss the scientific priorities of a space-based research program in fundamental physics.

Conditional vascular cell adhesion molecule 1 deletion in mice: impaired lymphocyte migration to bone marrow.

We generated vascular cell adhesion molecule (VCAM)-1 "knock-in" mice and Cre recombinase transgenic mice to delete the VCAM-1 gene (vcam-1) in whole mice, thereby overcoming the embryonic lethality seen with conventional vcam-1-deficient mice. vcam-1 knock-in mice expressed normal levels of VCAM-1 but showed loss of VCAM-1 on endothelial and hematopoietic cells when interbred with a "TIE2Cre" transgene. Analysis of peripheral blood from conditional vcam-1-deficient mice revealed mild leukocytosis, including elevated immature B cell numbers. Conversely, the bone marrow (BM) had reduced immature B cell numbers, but normal numbers of pro-B cells. vcam-1-deficient mice also had reduced mature IgD+ B and T cells in BM and a greatly reduced capacity to support short-term migration of transferred B cells, CD4+ T cells, CD8+ T cells, and preactivated CD4+ T cells to the BM. Thus, we report an until now unappreciated dominant role for VCAM-1 in lymphocyte homing to BM.

Congenital syngnathia: case report and review of literature.

Congenital bony fusion of the maxilla and mandible, especially as an isolated occurrence, is a very rare condition. The very few cases reported in the literature are mostly inadequate in description and confusing in nomenclature. An isolated case of syngnathia in a 60-year-old female patient with unilateral bony fusion (synostosis) of the maxilla and mandible associated with fibrous adhesions (synechiae) of the opposite site is reported. The existent literature is also reviewed.

Diabetes mellitus: a review of its associations with different environmental factors.

Diabetes Mellitus is a global health problem with a worldwide prevalence of 2.8% in 2000. Type 1 diabetes mellitus is an auto immune disorder genetically mediated, while type 2 is more of a life style induced disorder although the role of genetic susceptibility, infections are also equally strong. Many studies have backed up these statements. However, there have been very few researches that show association of diabetes with environmental factors like pollution, exposure to chemicals e.g. mercury, arsenic, psychological condition e.g. depression, stress, and socio-economic conditions e.g. occupation, earnings etc. Recently, the role of these factors in causation and progression of diabetes have received much attention. Thus, this review has been designed to explore more on association of diabetes with physical, socio-economic and psychological environment.

Economic and social burden due to injuries and violence in Nepal: a cross-sectional study.

BACKGROUND: Injury and violence cause five million deaths annually in the world which is around 9% of the global mortality. Eight out of fifteen leading causes of deaths in the age group 15-25 years are injury related. OBJECTIVE: The objective of this study was to assess the incidence, severity and socio-economic burden of injuries and violence in two cities of Nepal. MATERIALS AND METHODS: Relevant data was collected from 17th August 2008 to 16th September 2008 from injured patients attending emergency departments at six health centres in two cities. RESULTS: In total, 505 injury cases were reported. 42.5% of the injuries occurred in roads and 34.1% at home. 65% of road traffic injuries involved motorcycles. The majority (60%) of the injured subjects were economically active. A single injury case cost 126.2 US$ including all the expenses and the loss due to inability to work. CONCLUSION: The high incidence of injuries, especially road traffic injuries, adds a huge economic burden to nation.

Asymptomatic throat carriage rate and antimicrobial resistance pattern of Streptococcus pyogenes in Nepalese school children.

BACKGROUND: Streptococcus pyogenes or Group A streptococcus (GAS) causes several suppurative and non suppurative infections. In addition to pharyngitis and skin infections, GAS are also the causative agent of post-streptococcal infection syndromes such as acute rheumatic fever (ARF) and post-streptococcal glumerulonephritis (PSG). GAS frequently colonises in the throat of an asymptomatic person. Pharyngeal carriage rates of GAS among healthy school children vary with geographical location and seasons. OBJECTIVES: We carried out this preliminary study to determine the throat carriage rate and antimicrobial resistance trend of Streptococcus pyogenes or Group A streptococcus (GAS) among the Nepalese school children. MATERIALS AND METHODS: Four schools situated at different locations of Kathmandu valley were included in the study. Throat swabs from 350 students of age group 5-15 years were collected, immediately transported to the laboratory and were processed for S. pyogenes following standard microbiological procedures. Antimicrobial susceptibility testing of the isolates was performed by Kirby Bauer disc diffusion method following CLSI guidelines. RESULTS: S. pyogenes was isolated from 10.9% (38/350) of the screened children. The GAS colonisation rate was statistically insignificant (P>0.05) with sex and age sub-groups, although the rate was slightly higher among girls and age sub-group 9-12 years. No significant difference in carrier rate was observed among different schools (P>0.05). All isolates were susceptible to azithromycin. No resistance was detected for penicillin and its derivative antibiotic ampicillin. Highest resistance rate was observed for cotrimoxazole (71.0%) followed by chloramphenicol (7.8%), ciprofloxacin (5.2%) and erythromycin (5.2%). CONCLUSION: Antibiotic resistant GAS isolated from asymptomatic Nepalese school children is a public health concern. When screened and appropriately treated with antibiotics, carriers can be prevented from spreading of streptococcal infections in the school environment and the community. Preventing cross infections would ultimately reduce the incidence of life-threatening sequelae which are debilitating and difficult to treat. It is recommended to conduct regular screening and GAS surveillance in schools, and maintain rational use of antibiotics to minimise GAS carriage/infections and resistance.