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Background: Resected rectal polyps with deep invasion into the submucosa (pT1b-sm2,3) or the muscle layer (pT2) are currently confronted with surgery due to non-curative resection. Aims: We evaluated the efficacy, safety, and locoregional control of adjuvant radiotherapy (RT) and/or chemotherapy (CT) following endoscopic KAR (knife-assisted resection) in patients with invasive early rectal cancers who are unwilling or unsuitable for additional surgical resection. Methods: Fifty-one patients with early rectal cancers, pT1b or pT2, underwent post-resection adjuvant RT and/or CT in 15 centers worldwide. "En bloc" macroscopic resection, R0 resection, recurrence rate, and adverse events following resection and adjuvant therapy were recorded in a multicenter retrospective cohort study. Results: Diagnostic staging (38/51, 75%) was the main reason for ELE. Macroscopic "en bloc" resection was demonstrated in 50/51 (98%), with an average follow-up of 20.6 months. Endoscopic recurrence occurred in 7/51 (13.7%) of patients, with mean time for diagnosis of recurrence at 8.9 months. Adjuvant therapy consisted of RT in 49.0% (25/51), CT in 11.8% (6/51), and combined CRT in 39.2% (20/51) of the cases. Perforation, severe post-procedural bleeding, and incontinence were the most frequent complications. The absence of superficial ulceration was associated with macroscopic complete resection, while the lesions with lower budding stage, clear lateral margins, lesion size < 40 mm, and needle-type knife used were associated with less endoscopic recurrencies. Conclusions: Our data investigated adjuvant RT and/or CT after endoscopic KAR of infiltrative rectal cancers (pT1bsm2,3-pT2) as being safe and effective for locoregional control and providing a non-surgical treatment option for patients with a non-curative resection. [ABSTRACT FROM AUTHOR]

Electric impulse drilling (EID) technology has great industrialization potential since it has unique advantages in crushing hard rocks of deep formation. To study the mechanism of dielectric breakdown is of great significance for accelerating the practical application of EID technology. In this paper, the dielectric breakdown damage model (DBDM) is established based on the heterogeneous granite model. On the basis of DBDM, the whole process of absolute dielectric breakdown (ADB) is studied, including the formation of the plasma channel and the variation of the electric field. Then, the mechanism of regional dielectric breakdown (RDB) development to ADB is studied, and the influence of peak voltage, electrode spacing and the parameters of a high-voltage electric pulse (HVEP) is discussed. Besides, the efficiency of two dielectric breakdown modes is evaluated. It is found that dielectric breakdown will only occur in the domain where the strength of the local electric field formed by HVEP exceeds the critical breakdown field strength of rock. RDB will occur when the pulse duration is too short or the peak voltage is too low. It is worth noting that RDB can be developed into ADB under multi-HVEPs. Moreover, under the same voltage, there is almost no difference between the failure volume caused by RDB under multi-HVEPs and ADB under a single HVEP. However, the energy consumption of the RDB under multi-HVEPs decreases exponentially with increasing voltage and is always higher than that of the ADB under a single HVEP. When designing the supporting tools and bits of EID technology, the life of insulation, the characteristics of formation, and energy utilization should be fully considered. The related research in this paper aims to provide reference and guidance for the application of EID technology in drilling engineering. Highlights: The variation of the electric field, the change of minerals and the generation of plasma channel in granite during dielectric breakdown is studied. The effect of the characteristics of high-voltage electric pulse (HVEP) on the dielectric breakdown in granite is studied. The mechanism and rock-breaking efficiency of absolute dielectric breakdown (ADB) and regional dielectric breakdown (RDB) are explored. [ABSTRACT FROM AUTHOR]

This research states that there is a process of involvement of colonial debt in Java, Indonesia in the typical economic characteristics of the loan and repayment cycle in the pawnshop system which is related to Eid al-Fitr, the Javanese months, and the climate of the planting season. This characteristic becomes an interesting study and very valuable knowledge for the development of socio-economic history in the area studied. The ability to understand the socio-economic conditions of society needs to be carried out in line with government programs to alleviate poverty. Therefore, understanding this article will help the government and society in choosing alternative solutions to their economic problems. This study focuses on the relationship between the lending cycle during Eid and the tendency to borrow during the planting climate. This research uses qualitative historical research methods. The practice of providing credit services using the pawnshop model was carried out based on the rules set by the colonial government. The process of borrowing and repaying loan funds is explained with the power of various analytical approaches. This problem will be explained using historical studies and other social sciences to enrich the explanation.

Information technologies and the entirely new digital world are experiencing significant development in the second and third decades of the twenty-first century. This development has led to the need to realize the concept of legal regulation of cyberspace, especially in the segment of digital identification. Digital identification is necessary to ensure security as well as the protection of personal data. Additionally, digital identification must guarantee the reliability and trust of signatories in the technologies used. The regulations adopted in previous years implied the existence of a PKI infrastructure and the storage of the private key by the signatory. However, the development of technologies and the widespread use of mobile and smart devices have generated the need for remote signing, cloud-based signing, and the creation of digital wallet techniques. It is precisely in this segment that the regulations have been amended. The paper presents EU regulations in this area and the situation in Bosnia and Herzegovina. It is particularly emphasized that the use of reliable legally grounded digital identification has not yet begun to be implemented in Bosnia and Herzegovina, and that it is necessary to establish practices and systems based on legal regulations that are aligned with the EU, as well as with the legal framework in Bosnia and Herzegovina. [ABSTRACT FROM AUTHOR]

This study explores the trend of Eid-related video advertisements in Malaysia on online streaming platforms like YouTube, as focusing on major corporate channels such as Petronas, TNB, Malaysia Airlines, and Telekom Malaysia. Thus, the aim of the study is to explore the trend of Eid advertisements and Malaysian audience engagement through corporate video on YouTube Channel. Notable differences emerged in how each company portrayed these values, showcasing unique approaches to brand representation. Despite the commonality in values, the varied portrayal methods indicated distinct brand identities for each organisation. The analysis was conducted using content analysis through viewing the Eid advertising video which emphasised the importance of crafting a brand image within the Eid-themed video content to resonate and be memorable among viewers. Findings shows that while companies align on shared values for Eid advertisements, the way these values are communicated plays a crucial role in shaping the brand's image and audience engagement. Consistent and respectful representation of shared values building trust towards the audiences. Meanwhile, broadcasters must ensure that the advertisements they air are culturally sensitive and align with the values of the audience. [ABSTRACT FROM AUTHOR]

This review aims to highlight the occurrences of several emerging and re-emerging infectious diseases, particularly 13 types under surveillance of Indonesia’s emerging contagious disease task force. These diseases are considered potentially epidemic, due to the nature of tropical climate and high humidity of Indonesia’s area. Several factors contribute to the emergence of these diseases: in conjunction with human behavior. Most of these diseases are zoonotic, specifically spread by viruses. The latest emerging infectious disease in Indonesia is monkeypox. Controlling the management of EID-REIDs presents a major obstacle for international health initiatives, particularly in Indonesia because of its extensive population, varied geographical landscape, and constrained resources. Overcoming these obstacles demands tactics like prioritizing Indonesian policies, bolstering disease monitoring systems, upgrading diagnostic capacities, fortifying public health facilities, fostering community involvement and education, and executing efficient prevention and management protocols. These strategies should be implemented in collaboration with international partners and organizations to effectively control and prevent the spread of emerging and re-emerging infectious diseases in Indonesia.

Despite the discovery of several closely related viruses in bats, the direct evolutionary progenitor of SARS-CoV-2 has not yet been identified. In this study, we investigated potential animal sources of SARS-related coronaviruses using archived specimens from Sunda pangolins (Manis javanica) and Chinese pangolins (Manis pentadactyla) confiscated from the illegal wildlife trade, and from common palm civets (Paradoxurus hermaphroditus) raised on wildlife farms in Viet Nam. A total of 696 pangolin and civet specimens were screened for the presence of viral RNA from five zoonotic viral families and from Sarbecoviruses using primers specifically designed for pangolin coronaviruses. We also performed a curated data collection of media reports of wildlife confiscation events involving pangolins in Viet Nam between January 2016 and December 2020, to illustrate the global pangolin supply chain in the context of Viet Nam where the trade confiscated pangolins were sampled for this study. All specimens from pangolins and civets sampled along the wildlife supply chains between February 2017 and July 2018, in Viet Nam and tested with conventional PCR assays designed to detect flavivirus, paramyxovirus, filovirus, coronavirus, and orthomyxovirus RNA were negative. Civet samples were also negative for Sarbecoviruses, but 12 specimens from seven live pangolins confiscated in Hung Yen province, northern Viet Nam, in 2018 were positive for Sarbecoviruses. Our phylogenetic trees based on two fragments of the RdRp gene revealed that the Sarbecoviruses identified in these pangolins were closely related to pangolin coronaviruses detected in pangolins confiscated from the illegal wildlife trade in Yunnan and Guangxi provinces, China. Our curated data collection of media reports of wildlife confiscation events involving pangolins in Viet Nam between January 2016 and December 2020, reflected what is known about pangolin trafficking globally. Pangolins confiscated in Viet Nam were largely in transit, moving toward downstream consumers in China. Confiscations included pangolin scales sourced originally from Africa (and African species of pangolins), or pangolin carcasses and live pangolins native to Southeast Asia (predominately the Sunda pangolin) sourced from neighboring range countries and moving through Viet Nam toward provinces bordering China.

Ophidiomyces ophidiicola (Oo) is a fungal pathogen and the causative agent of ophidiomycosis that has affected multiple snake taxa across the United States, Europe, and Asia. Ophidiomycosis has often been referred to as an emerging infectious disease (EID); however, its status as an EID has recently come under debate. Oo infections have been confirmed in wild snake populations in Texas; however, it is unknown if the pathogen is novel (i.e., invasive) or endemic to the state. To address this knowledge gap, we conducted surveys for Oo among preserved Nerodia deposited at three university museums in Texas. First, we visually assessed snakes for signs of infection (SOI), and if SOI were present, we sampled the affected area. We then used quantitative polymerase chain reaction to diagnose the presence of Oo DNA on areas with SOI and used these data to evaluate spatiotemporal patterns of Oo prevalence. We also tested for significant spatial clusters of Oo infenction using a Bernoulli probability model as implemented in the program SatScan. We found that the proportion of snakes exhibiting SOI was constant over time while the prevalence of Oo DNA among those SOI increased across space and time. Within these data, we detected an incidence pattern consistent with an introduction and then spread. We detected six spatial clusters of Oo infection, although only one was significant. Our results support the hypothesis that Oo is an emerging, novel pathogen to Texas snakes. These data narrow the knowledge gap regarding the history of Oo infections in Texas and establish a historical record of confirmed Oo detections in several counties across the state. Thus, our results will guide future research to those areas with evidence of past Oo infections but lacking confirmation in contemporary hosts. There is a considerable knowledge gap regarding the spatiotemporal dynamics of Ophidiomyces ophidiicola (Oo) infection among Texas snakes. To address this knowledge gap, we conducted surveys for signs of Oo infection (SOI) among preserved Nerodia deposited at three university museums in Texas. We used quantitative polymerase chain reaction to diagnose the presence of Oo DNA on snakes with SOI and then used spatiotemporal patterns in these data to evaluate the plausibility of novelty or endemism for Oo in this part of North America. [ABSTRACT FROM AUTHOR]

Copyright of HMD: Praxis der Wirtschaftsinformatik is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of HMD: Praxis der Wirtschaftsinformatik is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Maandblad voor Vermogensrecht is the property of Boom uitgevers Den Haag and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The transition to eGovernment creates challenges in terms of the confidentiality and security of sensitive data of citizens and organizations. Information systems require the implementation of appropriate security mechanisms to ensure the confidentiality, integrity and availability of data. Blockchain technology has the potential to transform public services, enabling administrations to organize processes and manipulate information in an innovative way. Blockchain’s high level of security is an advantage over other tools and technologies used in data processing. This study examines how blockchain technology can contribute to the development of the new generation of eGovernment services and proposes an ecosystem model based on SSI (Self-Sovereign Identity) authentication and Smart Contracts between citizens and administrations. The results can be a starting point for the development of national initiatives to use the blockchain as a platform for communications and transactions in the public sector. Blockchain based electronic services provide enhanced security for governments, citizens and businesses.

Introduction: Early infant diagnosis among human immunodeficiency virus (HIV)-exposed infants is a critical component of the prevention of mother-to-child transmission programs. The Kenya Ministry of Health recently revised their early infant diagnosis (EID) guidelines to include HIV DNA PCR testing at birth (pilot only), six weeks, six months, and 12 months postnatal and a final 18-month antibody test, to be in line with World Health guidelines on Management of HIV and treatment for infants. Despite these interventions to address barriers to IED, Kenya faces challenges in the uptake of EID. This study explored perceptions of caregivers and mothers of HIV positive infants in order to make recommendations to strengthen the provision of EID services in Kenya. Methods: We sought to understand the determinants of caregivers and or mothers of HIV positive infants seeking early infant Diagnosis services and treatment in six public health facilities located in six counties of Kenya. We conducted ten focus group discussions with mothers and caretakers of infants seeking Early Infant Diagnosis services and treatment in level four and level five public health facilities in six counties with high, medium, and low prevalence of HIV in Kenya. All Focus Group Discussions were audiotaped, transcribed, translated, and coded for analysis. Findings: Most respondents reported knowledge and awareness of EID services. However, respondents in rural counties reported less knowledge and awareness of EID compared to those from urban counties. Negative provider attitudes complicated respondents' pathway to seeking care in a stigma-free environment. Linkage by Community Health Volunteers to caregivers and mothers of an infant was noted as a critical component to care. While most respondents were satisfied with how they were treated by health providers while seeking services, most respondents complained about delays and long waiting times to receive services. At the community level, intimate partner violence is a key barrier to caretakers and mothers in seeking EID care. Conclusion & Recommendations: Mothers and caregivers of infants had higher levels of awareness (knowledge and understanding) of EID. Interventions to ensure that caregivers and mothers of infants are not stigmatized as well as addressing delays and long waiting times for the provision of services should be implemented while ensuring interventions to assist mothers and caregivers to address and cope with intimate partner violence initiated at facility and community level. [ABSTRACT FROM AUTHOR]

The current study intended to analyze the levels of joy in religious festivals. It involved 387 Pakistani Muslims including men (n=143) and women (n=282). Data was collected through a specifically developed questionnaire in Urdu. The findings revealed that Pakistani Muslims enjoy their festivals at a very low degree and the levels of joy in Eid-ul-Fitr and Eid-ul-Adha remains significantly lower than the levels of joy in weddings. The level of joy for Pakistanis during different festivals could not exceed 31 percent. The findings further revealed that, instead of being joyous, a little minority of the respondents felt sadness and tiredness while celebrating different festivals. Men had significantly higher levels of joy on Eid-Ul-Fitr and Eid-Ul-Adha as compared to women. Women had significantly higher levels of joy on close-relative’s wedding as compared to men. Unmarried had significantly higher levels of joy on friend’s wedding as compared to married. Kajian kali ini bertujuan untuk menganalisis tingkat keceriaan pada hari raya keagamaan. Ini melibatkan 387 Muslim Pakistan termasuk pria (n=143) dan wanita (n=282). Data dikumpulkan melalui kuesioner yang dikembangkan secara khusus dalam bahasa Urdu. Temuan mengungkapkan bahwa Muslim Pakistan menikmati festival mereka pada tingkat yang sangat rendah dan tingkat kegembiraan di Idul Fitri dan Idul Adha tetap jauh lebih rendah daripada tingkat kegembiraan dalam pernikahan. Tingkat kegembiraan orang Pakistan selama festival yang berbeda tidak bisa melebihi 31 persen. Temuan lebih lanjut mengungkapkan bahwa, alih-alih gembira, sebagian kecil responden merasakan kesedihan dan kelelahan saat merayakan festival yang berbeda. Pria memiliki tingkat kegembiraan yang jauh lebih tinggi pada Idul Fitri dan Idul Adha dibandingkan dengan wanita. Wanita memiliki tingkat kegembiraan yang jauh lebih tinggi pada pernikahan kerabat dekat dibandingkan dengan pria. Belum menikah memiliki tingkat kegembiraan yang jauh lebih tinggi pada pernikahan teman dibandingkan dengan menikah.

National digital identity management systems have gained traction as a critical tool for inclusion of citizens in the increasingly digitised public services. With the help of the World Bank, countries around the world are committing to building and promoting digital identification systems to improve development outcomes as part of the Identity for development initiative (ID4D). One of those countries is Nigeria, which is building a national ID management database for its over 100 million residents. However, there are privacy, security, human rights, ethics and socio-cultural implications associated with the design and scaling of such a system at a national level. Through a mixed method approach, this paper identifies some of these concerns and categorises which ones Nigerians are most worried about. It provides an empirically sound perspective around centralised national electronic identity (eID) management system, public trust and responsible data governance, and offers recommendations on enhancing privacy, security and trustworthiness of the digital infrastructure for identity management in Nigeria.

The Asian elephant (Elephas maximus), also known as Asiatic elephant is facing a significant decline in its wild populations due to habitat loss, fragmentation and degradation, leading to increased conflicts between humans and elephants. Preserving this iconic species is crucial, prompting researchers to explore various aspects of its biology, behavior, ecology and conservation efforts. In light of the profound importance of this subject, this study utilizes a descriptive systematic literature review (SLR) to examine global research trends on Asian elephants. Analyzing a dataset of 1780 articles spanning from 1914 to 2022, the study reveals a notable increase in publications, particularly since 2000, with 142 articles published in 2022 alone. This research provides a comprehensive overview of advancements in Asian elephant studies, promoting international collaboration and knowledge exchange among researchers. While research from leading scientific countries can aid in conservation efforts, there is a call for more inclusive, participatory and fair approaches. The study demonstrates a commitment to Equity, Inclusion and Diversity (EID) by adopting a multifaceted approach that considers the needs, perspectives and contributions of diverse stakeholders. By addressing disparities and advocating for social justice within elephant conservation, the study emphasizes the urgent need for collective action in conservation, welfare improvement, conflict resolution, ecosystem balance and overall enhancement of understanding about Asian elephants. Serving as a valuable resource for policymakers, conservation organizations and researchers, the study not only synthesizes existing literature but also identifies research gaps, highlights areas requiring immediate attention, and offers collaborative opportunities for global scientists to contribute to the well-being and preservation of this majestic species. [ABSTRACT FROM AUTHOR]

An extrinsic electron induced by a dielectric (EID) AlGaN/GaN MOS high-electron-mobility transistor (HEMT) on Si substrate was designed and investigated. The EID structure with SiO2 deposition and subsequent high-temperature annealing, which induces two-dimensional electron gases (2DEGs) on fully depleted AlGaN/GaN hetero-epitaxial layers with thin AlGaN barrier layer, was applied to access and drift regions in the HEMT. The fabricated HEMT exhibited enhancement-mode operation with a specific on-resistance of 7.6 mΩ cm2 and a breakdown voltage of over 1 kV. In addition, electron state analysis using hard X-ray photoelectron spectroscopy revealed that changes in the chemical states of Al and energy level lowering at the SiO2/AlGaN interface affect the induction of 2DEG in the EID structure. The proposed HEMTs should become a strong candidate for highly reliable high-power switching devices due to the damage-less fabrication without dry etching or fluorine plasma exposure processes on the semiconductor layers. [ABSTRACT FROM AUTHOR]

Background: Early diagnosis and confirmation of HIV infection in newborns is crucial for expedited initiation of antiretroviral therapy. Confirmatory testing must be done for all children with a reactive HIV PCR result. There is no comprehensive data on confirmatory testing and HIV PCR test request rejections at National Health Laboratory Service laboratories in South Africa. Objective: This study assessed the metrics of routine infant HIV PCR testing at the Tygerberg Hospital Virology Laboratory, Cape Town, Western Cape, South Africa, including the proportion of rejected test requests, turn-around time (TAT), and rate of confirmatory testing. Methods: We retrospectively reviewed laboratory-based data on all HIV PCR tests performed on children ≤ 24 months old (n = 43 346) and data on rejected HIV PCR requests (n = 1479) at the Tygerberg virology laboratory over two years (2017–2019). Data from sample collection to release of results were analysed to assess the TAT and follow-up patterns. Results: The proportion of rejected HIV PCR requests was 3.3%; 83.9% of these were rejected for various pre-analytical reasons. Most of the test results (89.2%) met the required 96-h TAT. Of the reactive initial test results, 53.5% had a follow-up sample tested, of which 93.1% were positive. Of the initial indeterminate results, 74.7% were negative on follow-up testing. Conclusion: A high proportion of HIV PCR requests were rejected for pre-analytical reasons. The high number of initial reactive tests without evidence of follow-up suggests that a shorter TAT is required to allow confirmatory testing before children are discharged.

Background: Human immunodeficiency virus (HIV) infection in pregnant women has an important role in its spread to the pediatric population through vertical transmission. Effective utilization of Prevention of Parent to Child Transmission (PPTCT) services can reduce this spread. This study aims to determine the vertical transmission of HIV, the seroprevalence of HIV in antenatal women, demographic factors of seropositive women, and utilization of PPTCT services to minimize the risk of mother-to-child transmission. Methods: This study was conducted to assess vertical transmission of HIV in the newborn of HIV pregnant women attending antenatal clinic (ANC) of a tertiary care hospital from August 2014 to December 2020. Pretest counseling, HIV testing, and posttest counseling were done as per National AIDS Control Organization (NACO) guidelines. Antiretroviral prophylaxis was given to seropositive women and their children. Analysis of demographic data of seropositive women and assessment of the utilization of PPTCT services were done according to available records. Results: In the study time, 139,619 new antenatal registrations were there, 68.21% of women attended pretest counseling and of them, 95.28% gave consent for HIV testing. Out of which, 0.14% were reported as HIV seropositive in PPTCT (tested according to NACO guidelines). In the study time, a total of 188 HIV-positive deliveries were conducted in our institute. Out of which, 144 (76.6%) were ANC-booked patients and 44 (23.4%) were unbooked patients and directly came in labor, deliveries were conducted according to NACO guidelines and all newborns were given nevirapine syrup. All newborns were followed up until 18 months and in study time, 78 dry blood samples (DBSs) were sent for DNA polymerase chain reaction (PCR) detection and all were reported negative by the reference laboratory at AIIMS, New Delhi. Conclusions: Adherence to testing, treatment, and follow-up in the antenatal and postnatal period can minimize the risk of HIV transmission from mother to child.

Background : Gastro-bronchial and gastro-colic fistulas (GB-GC) represent a rare, but serious complication after laparoscopic sleeve gastrectomy (LSG). The aim of this study is to evaluate the efficacy of endoscopic first-line approach with endoscopic internal drainage (EID) by inserting double pigtail stents (DPS) Methods: We retrospectively analyzed data from 40 consecutive patients referred at two tertiary centers for gastro-bronchial (N=30) and gastrocolic (N=10) fistulas following LSG. Nineteen patients previously experienced emergency surgical drainage. The mean interval between the index surgery and endoscopic fistula treatment was 265.6±521 days. Results: Healing of the fistulous tract was achieved in 19 patients (47.5%), with complete resolution at an average follow-up of 16 months. Mean time of treatment duration was 157.8±141 days with 5.0±2.9 endoscopic sessions. No major adverse events were registered. Conclusions: Despite complete fistula healing was achieved in less than 50% of our population, EID for GB/GC fistula after LSG still represents the most conservative approach with low complications rate. Previous surgical drainage seems to be a positive prognostic factor for endoscopic healing. While the longer the interval between the index surgery and endoscopic treatment, the lower was the rate of treatment success. [ABSTRACT FROM AUTHOR]

Abstract Background Early infant diagnosis (EID) of HIV-exposed and initiation of HIV-positive infants on anti-retroviral therapy (ART) requires a well-coordinated cascade of care. Loss-to-follow-up (LTFU) can occur at multiple steps and effective EID is impeded by human resource constraints, difficulty with patient tracking, and long waiting periods. The objective of this research was to conduct formative research to guide the development of an intervention to improve the pediatric HIV care cascade in central Mozambique. The study was conducted in Manica and Sofala Provinces where the adult HIV burden is higher than the national average. The research focused on 3 large clinics in each province, along the highly populated Beira corridor. Methods The research was conducted in 2014 over 3 months at six facilities and consisted of 1) patient flow mapping and collection of health systems data from postpartum, child-at-risk, and ART service registries, 2) measurement of clinic waiting times, and 3) patient and health worker focus groups. Results HIV testing and ART initiation coverage for mothers tends to be high, but EID and pediatric ART initiation are hampered by lack of patient tracking, long waiting times, and inadequate counseling to navigate the care cascade. About 76% of HIV-positive infants were LTFU and did not initiate ART. Conclusions Effective interventions to reduce LTFU in EID and improve pediatric ART initiation should focus on patient tracking, active follow-up of defaulting patients, reduction in EID turn-around times for PCR results, and initiation of ART by nurses in child-at-risk services. Trial registration Retrospectively registered, ISRCTN67747315 , July 24, 2019.

Background: Early diagnosis and confirmation of HIV infection in newborns is crucial for expedited initiation of antiretroviral therapy. Confirmatory testing must be done for all children with a reactive HIV PCR result. There is no comprehensive data on confirmatory testing and HIV PCR test request rejections at National Health Laboratory Service laboratories in South Africa. Objective: This study assessed the metrics of routine infant HIV PCR testing at the Tygerberg Hospital Virology Laboratory, Cape Town, Western Cape, South Africa, including the proportion of rejected test requests, turn-around time (TAT), and rate of confirmatory testing. Methods: We retrospectively reviewed laboratory-based data on all HIV PCR tests performed on children ≤ 24 months old (n = 43 346) and data on rejected HIV PCR requests (n = 1479) at the Tygerberg virology laboratory over two years (2017–2019). Data from sample collection to release of results were analysed to assess the TAT and follow-up patterns. Results: The proportion of rejected HIV PCR requests was 3.3%; 83.9% of these were rejected for various pre-analytical reasons. Most of the test results (89.2%) met the required 96-h TAT. Of the reactive initial test results, 53.5% had a follow-up sample tested, of which 93.1% were positive. Of the initial indeterminate results, 74.7% were negative on follow-up testing. Conclusion: A high proportion of HIV PCR requests were rejected for pre-analytical reasons. The high number of initial reactive tests without evidence of follow-up suggests that a shorter TAT is required to allow confirmatory testing before children are discharged. [ABSTRACT FROM AUTHOR]

Copyright of Romanian Journal of Information Technology & Automatic Control / Revista Română de Informatică și Automatică is the property of National Institute for Research & Development in Informatics - ICI Bucharest and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)