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Abstract Introduction Adolescent girls and young women (AGYW) in Nepal have disproportionately poor reproductive and maternal health outcomes. In response, Save the Children, the Nepal government, and local partners designed and implemented Healthy Transitions for Nepali Youth, a multi-level integrated intervention. The intervention aimed to improve reproductive, maternal, and newborn health knowledge, attitudes, and behaviors among AGYW, and address gender attitudes and norms in four districts of Karnali Province, Nepal. Methods Married and unmarried AGYW aged 15–24 were engaged in a small group, curriculum-based intervention; husbands and families received home visits, using short videos to catalyze discussion; communities were engaged through dialogue-based activities; and the health system was made more adolescent-responsive through quality assessments, training, and supervision. An external organization conducted a quantitative survey with a sample of 786 AGYW intervention participants at baseline and 565 of the same AGYW at endline. Pooled linear regressions were estimated for each indicator to assess the statistical significance of differences between baseline and endline. Focus group discussions and key informant interviews were conducted with AGYW, husbands, families, community leadership, and program implementers. Data analysis was done through STATA 14th version and NVivo. Results The percentage of AGYW currently using a modern contraceptive method increased significantly, and more AGYW believed that their family was supportive of delaying marriage and motherhood at the endline. Young women’s knowledge of danger signs during labor increased, and there was a significant improvement in essential newborn care practices immediately after birth. AGYW reported shifts towards more gender equitable attitudes and behaviors, including related to decision-making about reproductive and maternal health. Conclusion Positive shifts in reproductive, maternal, and newborn health and gender knowledge, attitudes, and behavior were observed among AGYW, their male partners, and families. The results can inform the design of future interventions to effectively reach this critical population. Trail registration Not applicable.

Background: A prospective study was conducted to find distribution of the left ventricular mass in normal adult Nepalese population in order to establish the upper reference limit. Materials and Methods: A total of 100 consecutive male and 100 female participants of age 18 years and above visiting for cardiac checkup were enrolled prospectively in this study. Participants with hypertension, diabetes, obesity and significant cardiovascular disease were excluded. Results: Mean age of study population was 43 years. Mean left ventricular mass in total, male and female population was 127.45±29 gm, 136.48±30.64gm and 118.43±24.24 gm respectively. Mean left ventricular mass index (LVMI) in total, male and female population was 74.52±15.78 gm/m2, 80.04±16.5 gm/m2 and 69.17±13.05 gm/m2 respectively. Left ventricular mass and left ventricular mass index increased with age, Body Mass Index, Systolic and Diastolic Blood Pressure, and were statistically significant (p-value

Abstract Background Adolescent girls and young women (AGYW) often experience early childbearing and have poor utilization of reproductive, maternal, and neonatal health (RMNH) services in Nepal. Involving men in such services has been increasingly recognized globally to improve gender-equitable reproductive health behaviour in husbands. This qualitative study assessed the implementation of Healthy Transitions’ male engagement interventions in Karnali Province, Nepal which were implemented to improve gender-equitable attitudes, and supportive RMNH care-seeking behaviors among the husbands of young women. Methods We conducted a summative qualitative study that included in-depth interviews with 12 AGYW as primary beneficiaries and their husbands (N = 12) and in-laws (N = 8). In addition, key informant interviews were conducted with health workers (N = 8), local government representatives (N = 4), members of Health Facility Operation and Management Committee (N = 8) and project implementers (N = 12). Due to COVID-19-related travel restrictions and lockdowns, all interviews were conducted via phone calls and online consultation. Data were analyzed using multistage coding and thematic content analysis. Results AGYW, their husbands, in-laws and health workers were receptive to the Healthy transitions’ male engagement initiatives. They perceived that the project contributed a momentum to facilitate men’s gender-responsive behaviour. Many participants reported that male engagement interventions, including home visits, community dialogues, and social events improved husbands’ support for their wives during menstruation, pregnancy, and childbirth. The activities also facilitated spousal communication and improved the couple’s decision-making for family planning use. Women reported that improved support from their husbands increased their self-confidence. Conclusions This study sheds light on the role of male engagement strategies to improve RMNH in a context where inequitable gender norms and roles are highly prevalent. Our findings highlight the potential to improve RMNH by addressing barriers to male engagement.

This work investigates the cumulative dose 60Co gamma ( $\gamma$ ) – ray irradiation effects on enhancement mode HEMT devices inheriting 3D – Electron and Hole Gases for dosimeter applications. The devices are irradiated through a 60Co source and demonstrate the enhancement in the drain current metrics. To elucidate, the said devices were irradiated through different mechanisms and the Compton effect was investigated through contour plots via TCAD simulations. The degradation of Schottky Gate contact and insulator charging affects the 2D – Hole Gas at the GaN cap and thereby affects the bottleneck at the 3DEG sheet. This significantly affects the OFF – state leakage components of the said device and can therefore be exploited for potential use in sensing and dosimeter applications. The leakage components can be exploited further to improve the linearity of the dosimeter by considering different grading profiles of the AlGaN layer. In this regard, a workflow for optimizing the sensitivity and linearity of the dosimeter through different graded profiles is also presented. Amongst all, gaussian graded profiles have been identified as the best – case scenario considering the sensitivity and exhibiting a linear operation.

Introduction: Frozen shoulder is one of the common musculoskeletal disorders characterized by pain and restriction of motion of the shoulder joint. It is also considered a common self-limiting regional skeletal problem. This study aimed to evaluate related risk factors for frozen shoulders. Methods: This was a hospital-based comparative study involving 60 patients with a diagnosed frozen shoulder in the out-patient department as cases and 60 patients hospitalized during the same period with non-shoulder-related complaints as controls. A face-to-face interview was taken. Univariate and multivariate logistic regression analyses were performed. Results: A total of 120 consecutive subjects (60 patients with frozen shoulders and 60 controls) were taken. The mean age of cases was 54.7±3.21 years and that of controls was 42.08±2.74 years. Among the frozen shoulder patients, 33.3% had diabetes and 15% had a history of thyroid disorder. Multivariate logistic regression analysis showed age, diabetes mellitus, and thyroid dysfunction as independent risk factors for frozen shoulder (p

BackgroundContraceptive use can prevent unintended pregnancies, early childbearing, and abortion-related deaths. Despite these benefits, the use of modern contraceptives remains low among adolescent girls and young women (AGYW) in Nepal. To address this gap, the Healthy Transitions Project was implemented in Karnali Province, Nepal from February 2019 to September 2021. This study aimed at measuring the effect of Healthy Transitions' intervention on improving knowledge and use of modern family planning methods among AGYW in Nepal.MethodsWe used a pre- and post-intervention study design to assess the effect of Healthy Transitions project. A quantitative survey was conducted at baseline and after the first cohort of AGYW had completed the intervention (1 year later). The baseline survey was conducted in 2019 with a cohort of 786 married and unmarried AGYW aged 15-24 years. An end line survey was conducted in 2020 with 565 AGYW who were interviewed at baseline. Data analysis was done using STATA version 15.1. The exact McNemar significance probability value was used to decide the significance of difference between baseline and endline.ResultsThe knowledge and uptake of modern family planning methods have increased in the endline compared to the baseline. AGYW recognised 10 out of the ten modern methods at endline, a significant increase from 7 at baseline (pConclusionOur results show that multilevel demand and supply-side interventions, targeting adolescents and young women, their families, community, and health system helped to improve knowledge and use of modern family planning methods among AGYW. The study suggests that these intervention approaches can be adopted to improve family planning use among adolescents and young women in other similar settings.

BackgroundUptake of family planning (FP) services could prevent many unwanted pregnancies, and unsafe abortions and avert maternal deaths. However, women, especially from ethnic and religious minorities, have a low practice of contraceptives in Nepal. This study examined the knowledge and practices of modern contraceptive methods among Muslim women in Nepal.MethodsA cross-sectional study was conducted among 400 Muslim women in the Khajura Rural Municipality of Banke district. Data were collected using face to face structured interviews. Two outcome variables included i) knowledge of and ii) practices of contraceptives. Knowledge and practice scores were estimated using the list of questions. Using median as a cut-off point, scores were categorised into two categories for each outcome variable (e.g., good knowledge and poor knowledge). Independent variables were several sociodemographic factors. The study employed logistic regression analysis, and odds ratios (OR) were reported with 95% confidence intervals (CIs) at a significance level of pResultsAlmost two-thirds (69.2%) of respondents had good knowledge of modern contraceptive methods, but only 47.3% practised these methods. Women of nuclear family (adjusted odds ratio (aOR) = 0.60; 95% CI: 0.38,0.95), and who work in agricultural sector (aOR = 0.38; 95% CI: 0.22, 0.64) were less likely to have good knowledge on modern contraceptives. Women with primary (aOR = 2.59; 95% CI: 1.43, 4.72), secondary and above education (aOR = 4.41; 95% CI:2.02,9.63), women with good knowledge of modern contraceptives (aOR = 2.73; 95% CI: 1.66, 4.51), who ever visited a health facility for FP counselling (aOR = 4.40; 95% CI: 2.58, 7.50) had higher odds of modern contraceptives practices.ConclusionMuslim women had low use of modern contraceptive methods despite having satisfactory knowledge about them. There is a need for more equitable and focused high-quality FP practices. Targeted interventions are needed to increase the knowledge and practices of contraceptives in the Muslim community. The study highlights the need to target FP interventions among socially disadvantaged women, those living in a nuclear family, and those with poor knowledge of modern contraceptives.

This article reports an experimental approach to analyze the kink effect phenomenon which is usually observed during the GaN high electron mobility transistor (HEMT) operation. De-trapping of charge carriers is one of the prominent reasons behind the kink effect. The commonly observed non-monotonic behavior of kink pattern is analyzed under two different device operating conditions and it is found that two different de-trapping mechanisms are responsible for a particular kink behavior. These different de-trapping mechanisms are investigated through a time delay analysis which shows the presence of traps with different time constants. Further voltage sweep and temperature analysis corroborates the finding that different de-trapping mechanisms play a role in kink behavior under different device operating conditions.

Background Acute kidney injury (AKI) is a global problem and it is encountered both in community and in-hospital patients. AKI has caused very significant damage to the health sector with high morbidity and mortality rates as well as a financial burden to the family. AKI contributes to a 3% incidence of end-stage renal disease (ESRD). Sepsis and hypovolemia-associated ischemia is the most common cause of AKI. AKI has various risk factors, modes of presentation and outcomes. Also, the prevalence varies across the different populations. There is a paucity of data about the clinical profile of AKI in the eastern part of Nepal. This study aims to assess the age, comorbid conditions, the severity of AKI, mode of treatment, and outcome of patients with AKI admitted to the Nobel Medical College and Teaching Hospital, Biratnagar, Nepal. Methods This is a cross-sectional analytical study conducted at a Nobel Medical College Teaching Hospital, Biratnagar, Nepal from July 2018 to June 2019 AD. Results In this study, 192 patients diagnosed with AKI were included. Male patients accounted for 52.7%. The mean age was 48.6±18.73 years. Most of the patients (74.5%) were below Conclusions We observed that early diagnosis, avoidance of nephrotoxic agents, and early, aggressive, and appropriate interventions result in improved patient outcomes. However late presentations of AKI have a higher hospital mortality rate.

This study aims to analyse tourism and disability research from a longitudinal perspective (2000–2019). One hundred and five seminal articles from the Scopus database were systematically selected and bibliometrically analysed. The state-of-the-art tool – bibliometrix was used to analyse and visualize tourism and disability research. The main analysis was divided into four sub-analyses (descriptive analysis, reference publication year spectroscopy, network analysis, and co-word analysis) to comprehensively demonstrate the trends and patterns, historical origin, and intellectual and conceptual structure in disability and tourism research. Findings indicate that although the publications related to tourism and disability have significantly increased, it is mostly dominated by few contributors. The proposed study provides a powerful insight into tourism and disability research for theoretical and practical developments. [ABSTRACT FROM AUTHOR]

INTRODUCTION This prospective and observational hospital based study was carried out in Orthopedics Department of Universal College of Medical Sciences-Teaching Hospital (UCMS-TH) from October 2021 to September 2023. All patients with proximal humerus fractures who fulfilled the inclusion criteria and who underwent open reduction and internal fixation by PHILOS plate were enrolled in the study. Functional outcome was assessed according to Constant murley scoring system and Visual analogue score. Post-operatively patients were regularly followed at 6 weeks, 3 months and 6 months. MATERIAL AND METHODS In this study of 60 cases, the mean age group was 55.38±11.40 years and male patients outnumbered female patients (39 males and 21 females). 36 cases (60%) were of right side and 24 (40%) were of left side. Majority of the fractures were due to fall injury (57%) followed by road traffic accident (35%). The mean Constant Murley Score was 78.15±5.620 and VAS (visual analogue score) was 1.88±0.865. RESULTS Open reduction and internal fixation by PHILOS plate is an effective procedure providing good anatomical restoration and early mobilization in proximal humerus fracture thus providing good functional outcome. [ABSTRACT FROM AUTHOR]

Background: Contraceptive use can prevent unintended pregnancies, early childbearing, and abortion-related deaths. Despite these benefits, the use of modern contraceptives remains low among adolescent girls and young women (AGYW) in Nepal. To address this gap, the Healthy Transitions Project was implemented in Karnali Province, Nepal from February 2019 to September 2021. This study aimed at measuring the effect of Healthy Transitions' intervention on improving knowledge and use of modern family planning methods among AGYW in Nepal. Methods: We used a pre- and post-intervention study design to assess the effect of Healthy Transitions project. A quantitative survey was conducted at baseline and after the first cohort of AGYW had completed the intervention (1 year later). The baseline survey was conducted in 2019 with a cohort of 786 married and unmarried AGYW aged 15–24 years. An end line survey was conducted in 2020 with 565 AGYW who were interviewed at baseline. Data analysis was done using STATA version 15.1. The exact McNemar significance probability value was used to decide the significance of difference between baseline and endline. Results: The knowledge and uptake of modern family planning methods have increased in the endline compared to the baseline. AGYW recognised 10 out of the ten modern methods at endline, a significant increase from 7 at baseline (p<0.001). Among AGYW, 99% were aware of sources to obtain family planning methods, compared with 92% at baseline (p< 0.001). The proportion of married AGYW using modern contraceptive methods was significantly higher at the endline 33%, than baseline (26%) (p<0.001). Conclusion: Our results show that multilevel demand and supply-side interventions, targeting adolescents and young women, their families, community, and health system helped to improve knowledge and use of modern family planning methods among AGYW. The study suggests that these intervention approaches can be adopted to improve family planning use among adolescents and young women in other similar settings. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Proximal humerus fractures are usually sustained from trivial fall in elderly. These fractures are usually associated with severe degree of comminution and deformity. Therefore, anatomical reduction of fracture fragments, and early mobilization are key factors for optimal outcomes of involved limb. This study was intended to evaluate the functional outcomes of proximal humerus fractures in adults managed by closed reduction and percutaneous pinning (CRPP). MATERIAL AND METHODS: This prospective and observational hospital based study was carried out in Orthopedics Department, Universal College of medical Sciences-Teaching Hospital (UCMS-TH) from July 2021 to June 2023. All patients with proximal humerus fractures who fulfilled the inclusion criteria and who underwent closed reduction and percutaneous pinning were enrolled in the study and functional outcome was assessed according to Constant murley scoring system and Visual analogue score. Post-operatively patients were regularly followed at 6 weeks, 3 months and 6 months. RESULTS: In this study of 60 cases, the mean age group was 53.08±13.10 years and male patients outnumbered female patients (37 males and 23 females). Forty one cases (68.3%) were of right side and 19 (31.7%) were of the left side. Majority of the fractures were due to fall injury (53.3%), followed by road traffic accident (40%). The mean Constant Murley Score was 76.95 ± 5.53 and VAS (visual analogue score) was 1.97 ± 0.97. CONCLUSION: Closed reduction and percutaneous pinning is simple, less invasive and effective procedure for proximal humerus fracture providing good functional outcome. [ABSTRACT FROM AUTHOR]

Herein, a high‐pressure sensor based on freestanding high‐electron‐mobility transistor (HEMT)‐inspired optical waveguide comprising AlGaN/GaN/AlN layers on silicon carbide (SiC) substrate is proposed and studied for harsh environment applications using finite element method (FEM). The working principle of the sensor is based on the change in birefringence due to applied pressure. Further, the transmission spectra for different wavelengths are evaluated. For the best possible outcomes, the dip wavelengths under different values of pressure are tracked and studied for different gallium nitride (GaN) core thicknesses. After optimizing GaN core thickness and AlGaN ratio, the sensor displays a good linear response within the pressure range of 90–150 MPa. The two dip wavelength shifts demonstrate maximum spectral sensitivities of −209.6 and 180 pm MPa−1, respectively, for the pressure range of 90–150 MPa within the communication wavelength regime of 1500–1600 nm. By considering the features such as cost‐effectiveness, portability, simple design, and easy detection process, the proposed pressure sensor is optimum for harsh environment measurements and studies. [ABSTRACT FROM AUTHOR]