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The focus of this study has been to understand the evolutionary relationships and taxonomy of a widely distributed parapatric species pair of wild silk moths in Europe: Saturnia pavonia and Saturnia pavoniella (Lepidoptera: Saturniidae). To address species delimitation in these parapatric taxa, target enrichment and mtDNA sequencing was employed alongside phylogenetic, admixture, introgression, and species delimitation analyses. The dataset included individuals from both species close to and farther away from the contact zone as well as two hybrids generated in the lab. Nuclear markers strongly supported both S. pavonia and S. pavoniella as two distinct species, with hybrids forming a sister group to S. pavoniella. However, the Maximum Likelihood (ML) tree generated from mtDNA sequencing data presented a different picture, showing both taxa to be phylogenetically intermixed. This inconsistency is likely attributable to mitonuclear discordance, which can arise from biological factors (e.g., introgressive hybridization and/or incomplete lineage sorting). Our analyses indicate that past introgressions have taken place, but that there is no evidence to suggest an ongoing admixture between the two species, demonstrating that the taxa have reached full postzygotic reproductive isolation and hence represent two distinct biological species. Finally, we discuss our results from an evolutionary point of view taking into consideration the past climatic oscillations that have likely shaped the present dynamics between the two species. Overall, our study demonstrates the effectiveness of the target enrichment approach in resolving shallow phylogenetic relationships under complex evolutionary circumstances and that this approach is useful in establishing robust and well‐informed taxonomic delimitations involving parapatric taxa. [ABSTRACT FROM AUTHOR]

Objective: The number of extremely drug-resistant (XDR) Salmonella typhi isolates is growing in the northwest of Pakistan, where health-care facilities are already under strain due to the coronavirus disease 2019 (COVID-19) issue. In Khyber Pakhtunkhwa, Pakistan, we currently describe the first widespread appearance of an XDR Salmonella typhi epidemic during the COVID-19 pandemic. This strain of Salmonella typhi is resistant to all first- and second-line drugs and even the third-generation cephalosporin. Methods: Salmonella species isolated from pediatric blood samples shown a high level of resistance to the various antibiotic classes evaluated between November and December 2020. Gender, age, address, and clinical symptoms were among the demographic information that was recorded. A total of 562 blood cultures from symptomatic patients have been collected by the Pathology Laboratory at a tertiary care institution of Rehman Medical Institute, Peshawar. All samples have been processed in accordance with regulatory requirements and incubated in BacT/ALERT 3D. Results: Of the 562 blood samples, 71 included Salmonella typhi, of which 66 (92.9%) and 5 (7%) were multidrug resistant (MDR) and XDR, respectively. Ciprofloxacin (100%), chloramphenicol (100%), ceftriaxone (100%), ampicillin (100%), and cotrimoxazole (93%) were completely resistant to all isolates. Azithromycin and carbapenems were effective against every Salmonella typhi isolate that was MDR or XDR. Males (76%) were more commonly affected than females (24%), and the frequency was substantially higher in children under 15 years of age (88%) than in adults (P = 0.0016). Conclusion: The emergence of XDR Salmonella typhi with a high level of resistance is in fact alarming. Due to the lack of viable treatment alternatives, the current situation necessitates the immediate implementation of efficient preventive measures, such as campaigns for typhoid vaccination and food and water safety. [ABSTRACT FROM AUTHOR]

Introduction: Cerebral venous thrombosis (CVT) associated with pregnancy and puerperium has long been recognized, with poor information in terms of functional outcomes. Our objective was to analyze risk factors, clinical, imaging, and laboratory variables to predict functional outcome and death in this population. Methods: CVT registries from three referral centers from Pakistan, Turkey, and Mexico, recruiting prospective cases, were combined for CVT associated with pregnancy or puerperium. Datasets and variables were standardized. Demographic characteristics, presentation, risk factors, and functional outcomes in pregnancy/puerperium-related CVT were analyzed. Binary logistic regression was used to assess predictors of outcome. The main outcome was modified Rankin score >2 at 30 days and mortality at 30 days. Results: Five hundred fifty-three cases (median age 28 years [IQR 23–34]) of CVT associated with pregnancy and puerperium were included; 439 cases (79.4%) happened in the puerperium and 20.6% during pregnancy (53.5% occurred during the first trimester). Anemia (36.7%) and dehydration (22.9%) were the commonest obstetric risk factors identified. Predictors of poor outcome (mRS >2) were encephalopathy (OR 12.8, p < 0.001), cases from Mexican origin (OR 3.1, p = 0.004), fever/puerperal infection (OR 2.7, p = 0.02), and anemia (OR 2.2, p = 0.01). Cases from Mexican origin (OR 12.0, p = 0.003) and Encephalopathy (OR 7.7, p < 0.001), presented with the highest mortality association in the final adjusted model. Discussion/Conclusion: In CVT associated with pregnancy and puerperium, encephalopathy, fever/puerperal infection, and anemia are associated with bad functional outcomes, meanwhile encephalopathy and cases from Mexican origin with higher mortality in the acute (30-days) of CVT onset. Anemia and infection are potential reversible predictors of poor outcome that clinicians should be aware of in order to prevent poor outcomes in these patients. [ABSTRACT FROM AUTHOR]

Objective: To determine the frequencies of different cytogenetic abnormalities in patients of Acute Myeloid Leukemia and Acute Lymphoblastic Leukemia in Northern Pakistan. Methods: It was descriptive cross-sectional study conducted in Hematology Department of a Tertiary care referral institute from June 2015 to July 2017. All newly diagnosed cases of Acute Leukemia were analyzed. Cytogenetic analysis was performed on bone marrow aspirate samples using Giemsa-trypsin banding technique. Karyotypes were identified and interpreted according to ISCN criteria. Results: A total of 355 newly diagnosed patients of Acute Leukemia were analyzed. Out of these, 180 patients had AML and 175 had ALL. In Acute Myeloid Leukemia chromosomal abnormalities were detected in 28.2 % cases. Of these the common ones included t(8;21),t(15;17),+8, Inversion 16 and Monosomy 7. Other abnormalities included Complex karyotype, Down’s syndrome related AML, Hyperdiploidy, del 16q,-8,+Y and t(3p;17q)del 10. In Acute Lymphoblastic Leukemia chromosomal abnormalities were detected in 40% cases. Common ones included Hyperdiploidy, Tetraploidy and t(9;22). Other abnormalities included t(1;19) and t(2;8)t(8;14). Conclusion: Cytogenetically favorable abnormalities are commonest occurring chromosomal defects in both Acute Myeloid Leukemia and Acute Lymphoblastic Leukemia in Northern Pakistan, i.e., t(8;21) in AML and Hyperdiploidy in ALL. [ABSTRACT FROM AUTHOR]

Suzuki coupling reaction is one of the useful methods for carbon‐carbon bond formation. In the present study, the aforementioned method is used to expand an aryl appendage on the indolenine nucleus of diastereomeric syn‐ and anti‐6‐bromo‐4a‐isopropyl‐2‐methyl‐2,3,4,4a‐tetrahydro‐1H‐carbazole analogs. Therefore, two sets of new diastereomeric Suzuki‐coupled products (16 compounds) were prepared. For this, diastereomeric syn‐ and anti‐6‐bromo‐4a‐isopropyl‐2‐methyl‐2,3,4,4a‐tetrahydro‐1H‐carbazole analogs were treated with arylboronic acids in the presence of palladium catalyst under thermal catalysis. Structures of synthesized compounds were inferred using spectroscopic studies. DFT‐based quantum chemical calculations were used to decipher structural attributes and stability of diastereomeric bromo‐2,3,4,4a‐tetrahydro‐1H‐carbazoles and their Suzuki‐coupled products, which revealed chair conformation for methylcyclohexane ring of syn‐compound while twist‐boat conformation for diastereomeric anti‐compound. syn‐Compound was found more stable than its anti‐isomer based on DFT‐calculations. Also, results demonstrated agreement between experimental and theoretical chemical shift values in NMR spectra with some deviations. Thus, structural elucidation based on computational advances in combination with the spectroscopic method can provide a powerful method for studying and comparing the structural attributes of diastereomeric compounds. [ABSTRACT FROM AUTHOR]

Objectives The literature on health and disease during Ramadan fasting (RF) is widely spread in many journals making it not readily accessible to those interested in the subject. Here, we provide an overview of the research on the interplay of RF with various aspects of well-being published in 2022. Materials and Methods A narrative, nonsystematic review of the international literature from a single major medical online database, PubMed, in one calendar year (2022) was conducted. The search term "Ramadan fasting" was used to retrieve the appropriate records. The relevant literature with substantial data-based content was presented in a concise thematic account, excluding those concerned with diabetes. Results Themes that emerged from the review included the pathophysiology of metabolic changes during RF, nutritional aspects including body composition and energy metabolism, cardiovascular disease and risk factors, renal function and structure, endocrinology (mainly thyroid), neurological disorders, mental health, pregnancy and fetal life, and infections (including COVID). Some miscellaneous clinical themes were identified, such as patients' and professional perspectives. Conclusions In 2022, the medical interest in RF was again widely spread across specialties. Cardiovascular disease and risk factors attract the most interest in terms of original articles and professional guidelines. We hope with this review to present a concise summary of the scholarly work on the subject in this year. [ABSTRACT FROM AUTHOR]

Background: Drug overdose mortality is rising precipitously among Black people who use drugs. In NYC, the overdose mortality rate is now highest in Black (38.2 per 100,000) followed by the Latinx (33.6 per 100,000) and white (32.7 per 100,000) residents. Improved understanding of access to harm reduction including naloxone across racial/ethnic groups is warranted. Methods: Using data from an ongoing study of people who use illicit opioids in NYC (N = 575), we quantified racial/ethnic differences in the naloxone care cascade. Results: We observed gaps across the cascade overall in the cohort, including in naloxone training (66%), current possession (53%) daily access during using and non-using days (21%), 100% access during opioid use (20%), and complete protection (having naloxone and someone who could administer it present during 100% of opioid use events; 12%). Naloxone coverage was greater in white (training: 79%, possession: 62%, daily access: 33%, access during use: 27%, and complete protection: 13%, respectively) and Latinx (training: 67%, possession: 54%, daily access: 22%, access during use: 24%, and complete protection: 16%, respectively) versus Black (training: 59%, possession: 48%, daily access:13%, access during use: 12%, and complete protection: 8%, respectively) participants. Black participants, versus white participants, had disproportionately low odds of naloxone training (OR 0.40, 95% CI 0.22–0.72). Among participants aged 51 years or older, Black race (versus white, the referent) was strongly associated with lower levels of being trained in naloxone use (OR 0.20, 95% CI 0.07–0.63) and having 100% naloxone access during use (OR 0.34, 95% CI 0.13–0.91). Compared to white women, Black women had 0.27 times the odds of being trained in naloxone use (95% CI 0.10–0.72). Conclusions: There is insufficient protection by naloxone during opioid use, with disproportionately low access among Black people who use drugs, and a heightened disparity among older Black people and Black women. [ABSTRACT FROM AUTHOR]

Abstract Nanobiotechnology is the study of small biological structures ranging in size of 1-100nm. Zinc oxide (ZnO) is a versatile inorganic molecule having strong antimicrobial, disinfecting and drying properties, useful in production of medicines. ZnO nanoparticles (ZnO-NPs) are metallic nano-particles with high catalytic, biological and UV-blockage properties. Aim of this study is to synthesize cost-effective and eco-friendly ZnO-NPs by using zinc-acetate-dihydrate and Lallemantia royleana seed-extract as reducing, stabilizing and capping agent. Biosynthesized ZnO-NPs were characterized by various analytical techniques. The characteristic peak of ZnO-NPs was measured at ∼382nm. FT-IR analysis revealed polysaccharide nature of L. royleana-extract and their functional group’s interaction with ZnO-NPs responsible for reduction and stabilization. SEM and XRD results revealed hexagonal-wurtzite structure of ZnO-NPs with average size of 18.26 nm. These ZnO-NPs possess strong anti-hemolytic and catalytic potentials. Our study showed that ZnO-NPs degrade organic pollutants effectively and can be useful for the purification of industrial effluents in future. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to determine medical students' perceptions of their clinical teachers as role models during the clinical years of a medical program. Materials and Methods: In this cross-sectional study, a pre-validated questionnaire, Role Modeling Apperception Tool was used and completed by Final year medical students selected from affiliated medical institutions of Khyber Medical University, Peshawar i.e. four graduating cohorts, comprising about 600 students. Participants were selected following universal sampling and data was analyzed for descriptive and inferential statistics. Results: The response rate to Role Modeling Apperception Tool was 75.1% n=451. The total number of students participating in this study from Private sector medical colleges was 157 34.8% and Public Government was 294 65.2%. The mean age of the students was 23.71 years SD=0.77, Range=22-26. Male respondents comprised 42.4% n=191 and females were n=260 57.6% of the study sample. Altogether, 92.9% of students experienced positive role models while 72% had negative role models among academic staff in their medical colleges. Mostly, medical students perceived male clinical teachers as their role models in comparison to their female counterparts. Moreover, clinical teachers were more considered positive role models than basic sciences teachers. Private-sector medical college students rated their clinical teachers higher among all domains Clinical, Personal, and Teaching in comparison to Public sector medical college students. A strong positive correlation was noted among domains tested on Role Modeling Apperception Tool. Conclusion: Clinical instructors are inveterately considered by students as their role models in medical colleges and significance are conferred on their position. Altogether, doctors with teaching roles must be cognizant of their responsibilities and their influence on the professional growth and performance of students. Eventually, components related to Personal, Clinical, and Teaching attributes were suggested as major traits perceived in role models. [ABSTRACT FROM AUTHOR]

Traveling in search of healing is quite common in Pakistan, where people gravitate toward large urban tertiary-care centers. In this article the authors explore psychodynamic aspects of the therapeutic journey, with respect to the traveler, the healer, and other symbolic aspects of the doctor-patient relationship in the multicultural nation of Pakistan. [ABSTRACT FROM AUTHOR]

This article brings Muhammad Iqbal's Persian book of poetry, Javid Nama , into dialogue with Gotthold Ephraim Lessing's drama Nathan the Wise. In conversation with Islam's early history, narrative traditions, and debates over the status of revelation and reason, both authors, we argue, envision religious truth as an irreducible experience that no single doctrine can lay exclusivist claims to. We demonstrate that intuition, reason, and revelation coexist as different paths toward spiritual insights in their fictional works. In different yet comparable ways, they create a fresh ontological ground for negotiating questions of divine truth and move the searching subject centre stage. Focused on deeds and actions, their reform projects promote an ethical conduct of life and acceptance among different religious groups that could not contrast more profoundly with the political reality in most Islamic countries today. [ABSTRACT FROM AUTHOR]

The plant Caralluma edulis is traditionally used against diabetes and inflammatory conditions in Pakistan. This study was designed to provide scientific validation of the traditional use of Caralluma edulis. Phytochemicals were extracted from the plant by different solvents (distilled water, methanol, ethanol, and acetone) using the Soxhlet's extraction method. Bioactive compounds were detected by gas chromatography–mass spectrometry (GC-MS). The in vitro anti-inflammatory activities (albumin denaturation, membrane stabilization, and proteinase inhibition) and antioxidant capacity (DPPH scavenging activity, FRAP reducing activity) of different extracts from Caralluma edulis were assessed. The antidiabetic potential of Caralluma edulis plant extracts was determined in acute and subacute diabetic rabbit models. Oxidative stress and enzymatic antioxidant status were also estimated in MDA, CAT, and SOD levels. Results showed that the methanol extract yielded the highest contents of phenolics, flavonoids, alkaloids, and terpenoids. The in vitro anti-inflammatory activity and antioxidant potential of the methanol extract were the highest among the tested solvents. The tested extracts did not show any remarkable antidiabetic activity in the acute diabetic model. However, all tested extracts demonstrated antidiabetic potential in the subacute diabetic model. No adverse effect was observed at the tested dose (200 mg/kg) of Caralluma edulis extracts in experimental animals. It is concluded that methanol is the key solvent for extracting bioactive compounds from Caralluma edulis. The plant can be used against inflammatory disorders and may prove a potential candidate for drug development. Long-term use of Caralluma edulis at the tested dose (200 mg/kg) showed antidiabetic properties in the animal model. [ABSTRACT FROM AUTHOR]

Objective: To analyze internal quality control of blood components, including red cell concentrates, fresh frozen plasma, cryoprecipitate and random donor platelets, to measure our blood bank performance. Study Design: Cross-sectional study. Place and Duration of Study: Armed Forces Institute of Transfusion (AFIT), Rawalpindi Pakistan from Jul to Dec 2021. Methodology: Whole blood units were separated into red cell concentrates, fresh frozen plasma and random platelets by the platelet-rich plasma method. Cryoprecipitates were prepared from FFPs. Quality control was done on representative components. For red cell concentrates, hematocrit was measured. For platelet concentrates, pH and platelet yield were measured. For fresh frozen plasma, Factor-VIII assay and for cryoprecipitate, Factor VIII and fibrinogen assays were done. The blood components were also tested for bacterial cultures. Results: A total of 1130 units were analyzed for quality control, including 360 red cell concentrates, fresh frozen plasma, random donor platelets each and 50 cryoprecipitates. Red cell concentrates had a mean hematocrit of 68.5±3.7%. Random donor platelets had a yield of 10.1±1.4* 1010 / unit and a mean pH of 6.7±0.2. Fresh frozen plasma had a Factor VIII level of 2.2±0.98 IU/ml. Cryoprecipitate had a mean fibrinogen level of 202.8±27.8 mg/unit and Factor VIII132.5±54.1IU/unit. All blood components met internal quality control standards. Blood cultures were negative in 99.2% of random donor platelets tested. Conclusion: The internal quality control of blood products was in concordance with the national and international standards for quality control in blood banks. [ABSTRACT FROM AUTHOR]

Antigen based rapid diagnostic tests possesses a potential to be utilized along with Gold standard methods to detect Covid-19 infection to cope with the demand of testing. The aim of this study was to determine diagnostic accuracy of electrochemiluminescence based automated antigen detection immunoassay comparing with molecular based test RT-PCR (Covid-19). It was a cross-sectional study conducted in RMI Peshawar, from 1st April 2021 till 30th April 2021. The study comprised 170 individuals who were suspected of having Covid-19. Nasopharyngeal samples taken from suspected individuals were analyzed by RT-PCR and automated antigen test (Elecsys SARS-CoV-2 Antigen) simultaneously. The correlation of SARS-CoV-2 antigen with PCR positive and negative cases was analyzed for specificity, sensitivity respectively. The ECLIA based Elecsys antigen test (Roche) revealed overall sensitivity 72%, specificity 95% and accuracy of 94.9%. Sensitivity of antigen test progressively declined from 94.3% in Ct <25 to 70.8% in Ct 26–29 and then to 47.2% in Ct 30–35. Based on the findings of our study we conclude that automated antigen testing (Elecsys SARS-CoV-2 Antigen) cannot replace molecular based testing like RT PCR. Elecsys SARS-CoV-2 Ag test should be used complementary to RT-PCR in testing algorithms. Frequent testing strategy should be adopted while using automated antigen testing to overcome its limitation in individuals with low viral loads. [ABSTRACT FROM AUTHOR]

Background: Chronic obstructive pulmonary disease (COPD) is slowly progressing respiratory disease that leads to alveoli blockage and difficulty in breathing. The objective of this study was to determine the association of 1359 G/A polymorphism of central cannabinoid receptor 1 (CNR1) gene and chronic obstructive pulmonary disease in Pakistani population. Materials & Methods: We investigated CNR1 single nucleotide polymorphism at the location 1359 G/A (p.Thr453Th; rs1049353) in 180 COPD patients and 194 healthy individuals In Department of Biology, Virtual University, Lahore, Pakistan in 2014-2015. DNA samples were extracted from venous leukocytes by using standard method, amplified (PCR) and digested (RFLP). Restriction digests were evaluated by 8% polyacrylamide gel. Frequencies of homozygous and heterozygous variants of 1359 G/A polymorphism were analyzed. Results: Genotype distribution AA, GG, GA of CNR1 gene in COPD patients was 1.1%, 68.3% and 30.5% versus controls 3.1%, 56.0% and 40.8% respectively. The heterozygous genotype distribution (GA) was observed higher in patients 68.3% than controls 56%. Allele frequencies A and G of CNR1 gene were 0.311 and 0.688 in controls versus 0.353 and 0.646 in patients respectively. The A allele variant frequency was higher in patients 35.3% than controls 31.1%. Results indicated that polymorphism of CNR1 gene located at 1359 may have association with COPD disease. Conclusions: Our study gave clue for association of COPD with 1359 G/A polymorphism of central cannabinoid receptor 1 (CNR1) gene in Pakistani population. Further studies are needed to elucidate the relationship of CNR1 gene to COPD by larger sample sizes. [ABSTRACT FROM AUTHOR]

Objectives: To assess appropriate antibiotics use in neonatal sepsis and to highlight the need for developing an Antibiotic stewardship program at local levels. Methods: A clinical audit was conducted in the neonatal ward of the tertiary care hospital of Lahore for one year from May 2019 to May 2020. Reports of blood culture and drugs susceptibility were gathered from the microbiology department, and clinical records were evaluated about the choice of the antimicrobials, dosage, frequency, and clinical prognosis. The statistics were applied using SPSS software. Results: Eighty five neonates with the mean age of five days were treated in tertiary care hospital for septicemia. Every patient received more than one antibiotic empirically. The most prescribed drug combination (90.6%) was Cefotaxime and Amikacin. Optimum antibiotics dose was prescribed in only 70.2% of cases. Blood isolates showed gram-negative bacilli in 69 (81.2%) cases, gram positive cocci in 14 (16.5%) cases, two (2.3%) culture susceptibility reports showed growth of candida. Gram negative organisms were most susceptible to Imipenem (54%), Piperacillin-Tazobactam (48%) and Gentamicin (48%). Gram-positive organisms showed the most susceptibility to Vancomycin (100%), Amikacin (92%), and Co-amoxiclav (85%). Meropenem (39%), Linezolid (28%), and Vancomycin (27%) were the most commonly given alternate antibiotics. All the patients (n=10, 11.8%) whose culture sensitivity reporting showed susceptibility to empirical therapy survived. Conclusion: Due to poor availability of latest data about local antibacterial resistance pattern and lack of knowledge among pediatricians about latest antibiotic prescribing protocols, many inconsistencies were noted in the use of antibiotics in neonatal sepsis which resulted in a poor outcome hence, reflecting in international key health indicators (neonatal mortality rate) of country. Concerning the change in the resistance pattern of microorganisms to antimicrobials, it is high time to collect local data about antibacterial susceptibility and develop an antibiotic stewardship program to stop inappropriate use of antibiotics. [ABSTRACT FROM AUTHOR]

Objective: To ascertain the vaginal birth rate following the trial of uterine scar and its outcomes. Study Design: Cross-sectional Observational study. Setting: Department of Gynecology Bakhtawar Amin Trust Teaching Hospital Multan. Period: 6th August 2020 to 6th August 2021. Material & Methods: After passing through selection criteria, all enrolled women underwent serial ultrasound including pelvis ultrasound to access scar thickness up to thirty-six gestation weeks. All women were evaluated for baseline investigations, clinical history, and underwent cardiotocography (CTG) which was then followed by a trial of labor (TOL). Women who experienced spontaneous labor after TOL were observed through partogram and intrapartum CTG. All maternal and fetal outcomes were observed. Results: Out of these 80 women, 51 (63.7%) had successfully given birth through the vaginal route while 29 (36.2%) underwent emergency CS following TOL. The majority of enrolled women, 62 (77.5%) had age less than 35 years, 45 (56.2%) had parity 1-4, and 74 (92.5%) had gestation age >36 weeks. 3 (5.8%) women had a history of VBAC and all had parity >4. Among the women with successful VBAC, the majority were younger than 35 years (88.2%), parity less than 4 (62.7%), and all were positive for previous successful VBAC. Postpartum hemorrhage was the most reported maternal complication (3.9%). Three (4.4%) experienced intra-uterine deaths which were the major fetal complications. Conclusion: Trial of vaginal birth following cesarean section could be a preferable option given its association with low fetal and maternal complications and considerable success rate. [ABSTRACT FROM AUTHOR]

Background: Black sexual minority men (BSMM) and Black transgender women face a disproportionate risk of incarceration and sexually transmitted infection (STI)/HIV, yet research on the longitudinal association between incarceration and STI/HIV risk in these groups is limited.Methods: We used data from the HIV Prevention Trials Network (HPTN) 061 study conducted among BSMM and Black transgender women in Atlanta, Boston, Los Angeles, New York City, San Francisco, and Washington, DC, restricting analyses to those who returned for the 6-month follow-up visit when recent incarceration was measured (n = 1169). Using inverse probability of treatment weighting, we measured associations between incarceration and next 6-month multiple partnerships; selling or buying sex; condomless anal intercourse; and incident chlamydia, gonorrhea, syphilis, and HIV. We explored differences by study city, and among BSMM who had sex with men only, BSMM who had sex with men and women, and Black transgender women.Results: Approximately 14% reported past 6-month incarceration. Incarceration was associated with next 6-month selling sex (adjusted risk ratio [ARR], 1.80; 95% confidence interval [CI], 1.12-2.87) in the overall sample and multiple partnerships among BSMM who had sex with men and women (ARR, 1.34; 95% CI, 1.10-1.63) and transgender women (ARR, 1.77; 95% CI, 1.22-2.57). There is evidence suggesting that incarceration may predict gonorrhea (ARR, 2.35; 95% CI, 0.95-5.77), with particularly strong associations observed in Los Angeles (ARR, 6.48; 95% CI, 1.48-28.38).Conclusions: Incarceration may increase STI/HIV risk among BSMM and Black transgender women. Additional mixed-methods research is needed to validate associations and understand pathways. [ABSTRACT FROM AUTHOR]

It is necessary to understand the emergence and history of coronavirus due to which the whole world has been badly affected. The design of the study was survey in nature. The population of the study consisted of administration management, faculty and students of KP Universities. The target population of the study comprised of students in which the numbers of (n = 1000) students including males and females were taken as sample of the study throughout the selected 20 public section universities of KP by applying snowball and convenient sampling techniques. Quantitative approached was preferred. The key objectives of the study were: 1) To know the impact of COVID-19 on universities students. 2) To examine the coping strategies of KP Universities regarding COVID-19. 3) To determine the responses of universities students’ about e-teaching and learning during COVID-19. Data were collected online through self-developed questionnaire of 5-Points Likert scale with options “Strongly Agree to Strongly Disagree” and interview by using electronic resources like email and whatsapp to know public perceptions regarding COVID-19 and its impact on students’ learning. Data were delimited to the public sector universities of KP. The collected data were statistically analyzed through descriptive statistics. Results and conclusions were drawn by probing that COVID-19 badly effected students’ learning. Some recommendations were given at the end regarding the control and proper solution of pandemic COVID-19 along with technology usage for e-teaching and e- learning at university level. [ABSTRACT FROM AUTHOR]

Background. Venous thromboembolism (VTE) is referred to as formation of clots in a deep vein or lodging of thrombus towards the lungs which could be fatal yet preventable. The risk of developing VTE can be increased by various factors. Where there are innumerable acquired causes, the possibility of inherited thrombophilia cannot be ignored. In view of this, we have evaluated all patients with venous thromboembolism for inherited thrombophilia. Objective. To evaluate the frequencies of antithrombin (AT) deficiency, protein C and S deficiencies, Factor V Leiden, and prothrombin gene mutations in patients harboring venous thromboembolism. Materials and Methods. A study comprising of 880 patients who were presented with manifestations of venous thromboembolism was conducted from July 2016 to June 2017. A blood sample collected from patients was screened for thrombophilia defects encompassing AT, protein C and S deficiencies, Factor V Leiden, and prothrombin gene mutations. All acquired causes of thrombosis were excluded. Results. Of 880 patients who underwent screening for thrombophilia, 182 patients demonstrated VTE history. Their age ranged from 1 to 58 years. Males constituted a predominant group. About 45 (24.7%) patients had evidence of heritable thrombophilia. Of these, 20 (10.9%) had AT deficiency, 9 (4.9%) had Factor V Leiden mutation, 6 (3.2%) had protein C deficiency, whereas protein S deficiency and prothrombin gene mutation both were found in 5 (2.7%) patients. Conclusion. Our study illustrated the highest frequency of antithrombin deficiency among other investigated thrombophilia defects. [ABSTRACT FROM AUTHOR]

α‐Glucosidase inhibition is one of the key targets for controlling diabetes. In consideration of that, new L‐valinol derived fluorinated sultam triazoles were synthesized as α‐glucosidase inhibitors, and their activities were further compared with the precursor molecules (sulfonamides, sultams, and N‐propargyl sultams). Primarily, all the synthesized sultam triazoles and precursor compounds (sulfonamides, sultams, and N‐propargyl sultams) were evaluated for different biological activities, including cytotoxicity, anti‐inflammatory, and α‐glucosidase inhibitory activities. Results revealed that only sultam triazoles exhibited inhibition against α‐glucosidase enzyme (IC50 values: 173 to 194 μM) using acarbose (IC50: 875.85 ± 2.03 μM) as the standard drug. These sultam triazoles were prepared after few steps, starting from enantiopure L‐valinol, which differ electronically (due to the position of fluorine atom and different positions on aromatic ring). Structures of all the compounds were evaluated using different spectroscopic techniques. Kinetics of active compounds were also investigated to find their mode of inhibition. [ABSTRACT FROM AUTHOR]

Transition from detention to the community for Black men who have sex with men with criminal justice involvement (BMSM-CJI) represents a particularly vulnerable period for HIV acquisition and transmission. We examined levels of HIV PrEP awareness among BMSM-CJI. PrEP awareness among BMSM-CJI was low (7.9%) with evidence of lower awareness levels among those with STI. There was evidence that HIV testing history was associated with higher PrEP awareness. Study findings highlight needs for further assessment of PrEP knowledge among BMSM-CJI. The strong association between HIV testing and PrEP awareness underscores an opportunity to integrate PrEP education within HIV/STI testing services [ABSTRACT FROM AUTHOR]

Although racial/ethnic disparities in police contact are well documented, less is known about other dimensions of inequity in policing. Sexual minority groups may face disproportionate police contact. We used data from the P18 Cohort Study (Version 2), a study conducted to measure determinants of inequity in STI/HIV risk among young sexual minority men (YSMM) in New York City, to measure across-time trends, racial/ethnic disparities, and correlates of self-reported stop-and-frisk experience over the cohort follow-up (2014–2019). Over the study period, 43% reported stop-and-frisk with higher levels reported among Black (47%) and Hispanic/Latinx (45%) than White (38%) participants. Stop-and-frisk levels declined over follow-up for each racial/ethnic group. The per capita rates among P18 participants calculated based on self-reported stop-and-frisk were much higher than rates calculated based on New York City Police Department official counts. We stratified respondents' ZIP codes of residence into tertiles of per capita stop rates and observed pronounced disparities in Black versus White stop-and-frisk rates, particularly in neighborhoods with low or moderate levels of stop-and-frisk activity. YSMM facing the greatest economic vulnerability and mental disorder symptoms were most likely to report stop-and-frisk. Among White respondents levels of past year stop-and-frisk were markedly higher among those who reported past 30 day marijuana use (41%) versus those reporting no use (17%) while among Black and Hispanic/Latinx respondents stop-and-frisk levels were comparable among those reporting marijuana use (38%) versus those reporting no use (31%). These findings suggest inequity in policing is observed not only among racial/ethnic but also sexual minority groups and that racial/ethnic YSMM, who are at the intersection of multiple minority statuses, face disproportionate risk. Because the most socially vulnerable experience disproportionate stop-and-frisk risk, we need to reach YSMM with community resources to promote health and wellbeing as an alternative to targeting this group with stressful and stigmatizing police exposure. [ABSTRACT FROM AUTHOR]

Background: Quitting smoking may lead to improvement in substance use, psychiatric symptoms, and pain, especially among high-risk populations who are more likely to experience comorbid conditions. However, causal inferences regarding smoking cessation and its subsequent benefits have been limited. Methods: We emulated a hypothetical open-label randomized control trial of smoking cessation using longitudinal observational data of HIV-positive and HIV-negative US veterans from 2003–2015 in the Veterans Aging Cohort Study. We followed individuals from the first time they self-reported current cigarette smoking (baseline). We categorized participants as quitters or non-quitters at the first follow-up visit (approximately 1 year after baseline). Using inverse probability weighting to adjust for confounding and selection bias, we estimated odds ratios for improvement of co-occurring conditions (unhealthy alcohol use, cannabis use, illicit opioid use, cocaine use, depressive symptoms, anxiety symptoms, and pain symptoms) at second follow-up (approximately 2 years after baseline) for those who quit smoking compared to those who did not, among individuals who had the condition at baseline. Results: Of 4,165 eligible individuals (i.e., current smokers at baseline), 419 reported no current smoking and 2,330 reported current smoking at the first follow-up. Adjusted odds ratios (95% confidence intervals) for associations between quitting smoking and improvement of each condition at second follow-up were: 2.10 (1.01, 4.35) for unhealthy alcohol use, 1.75 (1.00, 3.06) for cannabis use, 1.10 (0.58, 2.08) for illicit opioid use, and 2.25 (1.20, 4.24) for cocaine use, 0.78 (0.44, 1.38) for depressive symptoms, 0.93 (0.58, 1.49) for anxiety symptoms, and 1.31 (0.84, 2.06) for pain symptoms. Conclusions: While a causal interpretation of our findings may not be warranted, we found evidence for decreased substance use among veterans who quit cigarette smoking but none for the resolution of psychiatric conditions or pain symptoms. Findings suggest the need for additional resources combined with smoking cessation to reduce psychiatric and pain symptoms for high-risk populations. [ABSTRACT FROM AUTHOR]

Background: Children with intellectual disabilities are at heightened risk for traumatization, though underserved due to silos of care, diagnostic overshadowing, and lack of adapted treatment. Trauma‐Focused Cognitive Behavioural Therapy (TF‐CBT), an evidence‐based childhood trauma therapy, is described with recommended adaptations for use with children who have intellectual disabilities. Method: We present a suggested theoretical and clinical guide for treating children with mild to moderate intellectual disabilities. We explicate key functional domains of intellectual disabilities—comprehension, executive functions, and generalization—as the basis for tailoring the treatment model. Results: Therapy recommendations are organized into a heuristic 'matrix' of resources and adaptations to TF‐CBT components, based on clinical experience and research literature, illustrated with composite case vignettes. Conclusion: Children with intellectual disabilities are a uniquely vulnerable population historically excluded from clinical trauma interventions and research but can respond to adapted care. Considerations for future research and dissemination are discussed. [ABSTRACT FROM AUTHOR]

Development and sharing of model approaches to national science policies can enable States Parties to effectively raise awareness about the security dimensions of life science research and to promote research integrity and the responsible use of science, as well as enhancing accountability practices among practitioners and fostering access to emerging capabilities in science and technology. It is also important to incorporate convergent domains of scientific endeavors in biological and particularly computer and information sciences, upon which the life sciences increasingly depend. Indeed, the rapid development of science and technology may be outpacing necessary ethical and regulatory practices. Thus, governments and civil society often struggle to anticipate emerging capabilities and to identify and implement appropriate oversight mechanisms, particularly for activities that occur outside the direct oversight of government programs. However, these efforts are critical for public health and serve as an extremely powerful action to counter the use of biological weapons. [ABSTRACT FROM AUTHOR]

Black sexual minority men (BSMM) and Black transgender women (BTW) have disproportionately high HIV prevalence, making HIV testing critical for treatment and prevention. Racism and homophobia may be barriers to testing among BSMM/BTW, particularly in the context of previous incarceration. We analyzed a subsample (n = 655) of HIV-negative, previously incarcerated BSMM/BTW in the HIV Prevention Trials Network 061 study, generating prevalence ratios and interaction terms testing associations between experienced racism and homophobia with past-year HIV testing. Both racism (aPR = 0.83, 95% CI [0.70, 0.98]) and homophobia (aPR: 0.68, 95% CI [0.48, 0.98]) were associated with lower testing, although their interaction was associated with unexpectedly higher testing (Interaction aPR = 1.77, 95% CI [1.25, 2.49]). Among BSMM/BTW with a history of incarceration, racism and homophobia are barriers to HIV testing. Positive interactions between racism and homophobia could be explained by numerous factors (e.g., resilience, coping) and warrants further study. [ABSTRACT FROM AUTHOR]

Background. There is clinical importance to investigate the disease progression through potential biomarkers of SARS-CoV-2 infection. In the present study, we aim to evaluate the significance of inflammatory markers in different categories of COVID-19 in admitted patients. Methods. In a single-center, observational study of 50 in-hospital patients who were diagnosed with COVID-19 and admitted to the intensive care unit of a tertiary care hospital in Peshawar, infection biomarkers, including hs-CRP, serum ferritin, serum creatinine, ALT, ALP, cardiac troponin-I, and IL-6 were analyzed. Results. The median age was 61.3 years. 70% (35) were male while 30% (15) were female. We noted significantly increased hs-CRP (9.32 mg/dL ± 10.03) and ferritin levels (982.3 ng/ml ± 601.9). A noteworthy increase was observed in neutrophil count (11.05 × 109/L) and a decrease was observed in lymphocyte count (0.27 × 109/L) (P < 0.05), and the platelet count was borderline decreased (244.1 × 109/L). IL-6 levels were markedly increased in all admitted patients (100.2 pg/ml ± 122.2 pg/ml). Conclusion. The serum levels of CRP, troponin-I, ALP, ALT, serum creatinine, and ferritin are markedly increased in COVID-19 patients. Increased CRP and ferritin levels were also associated with secondary bacterial infection and poor clinical outcomes. [ABSTRACT FROM AUTHOR]

Background: Despite evidence of socio-demographic disparities in outcomes of COVID-19, little is known about characteristics and clinical outcomes of patients admitted to public hospitals during the COVID-19 outbreak. Objective: To assess demographics, comorbid conditions, and clinical factors associated with critical illness and mortality among patients diagnosed with COVID-19 at a public hospital in New York City (NYC) during the first month of the COVID-19 outbreak. Design: Retrospective chart review of patients diagnosed with COVID-19 admitted to NYC Health + Hospitals / Bellevue Hospital from March 9th to April 8th, 2020. Results: A total of 337 patients were diagnosed with COVID-19 during the study period. Primary analyses were conducted among those requiring supplemental oxygen (n = 270); half of these patients (135) were admitted to the intensive care unit (ICU). A majority were male (67.4%) and the median age was 58 years. Approximately one-third (32.6%) of hypoxic patients managed outside the ICU required non-rebreather or non-invasive ventilation. Requirement of renal replacement therapy occurred in 42.3% of ICU patients without baseline end-stage renal disease. Overall, 30-day mortality among hypoxic patients was 28.9% (53.3% in the ICU, 4.4% outside the ICU). In adjusted analyses, risk factors associated with mortality included dementia (adjusted risk ratio (aRR) 2.11 95%CI 1.50–2.96), age 65 or older (aRR 1.97, 95%CI 1.31–2.95), obesity (aRR 1.37, 95%CI 1.07–1.74), and male sex (aRR 1.32, 95%CI 1.04–1.70). Conclusion: COVID-19 demonstrated severe morbidity and mortality in critically ill patients. Modifications in care delivery outside the ICU allowed the hospital to effectively care for a surge of critically ill and severely hypoxic patients. [ABSTRACT FROM AUTHOR]

This study focuses on the production of cellulase from a thermophilic bacterium Brevibacillus sp. MT5 and prospects of utilizing the enzyme preparation for the saccharification of sugarcane bagasse (SB). The data revealed that cellulase produced at 70 °C expressed an IFPU (international filter paper unit) of 1.776 when assayed at 60 °C and showed good activity towards SB. Consequently, the conditions affecting saccharification of SB were studied by employing a Plackett–Burman design and reducing sugars were determined by dinitrosalicylic acid method and glucose oxidase kit. The analysis of the design highlighted that the factors affecting the hydrolysis process varies in terms of their significance with respect to the duration of the reaction, however, agitation remained a consistent significant factor throughout the process. Gravimetric analysis displayed a reduction of 49.7 and 22.6% in cellulose content after saccharification of SB from an industry and SB from a fruit juice vendor, respectively. The effect of enzyme action on SB was further visualized by scanning electron microscopy and Fourier transform infra-red spectroscopy that showed increased porosity and a diminished peak for cellulose, indicating degradation of the substrate by the enzyme preparation. [ABSTRACT FROM AUTHOR]

Background: As the number of indications for labour induction continue to increase, the focus has shifted to performing these procedures in an outpatient setting. This study aims to systematically review published data from randomized controlled trials that compare outpatient with inpatient labour induction, to ascertain the role of outpatient labour induction for low-risk pregnancies.Methods: We conducted a systematic review wherein we searched MEDLINE, EMBASE, Biosis Previews®, and International Pharmaceutical Abstracts from inception to January 2020 to identify randomized controlled trials that reported on maternal, fetal and resource-related outcomes following outpatient versus inpatient labour induction. Pooled incidences and mean differences were calculated using random-effects meta-analysis. Risk-of-bias was assessed using the Cochrane Risk of Bias tool. Subgroup analysis was conducted based on the method of induction.Results: Of the 588 records identified, 12 publications, representing nine independent randomized controlled trials conducted in Australia, Europe and North America, were included. These reported on 2615 cases of labour induction (1320 outpatients versus 1295 inpatients). Overall, apart from a higher number of suspicious fetal heart rate tracings [RR = 1.43 (1.10, 1.86)] and a shorter mean length of hospital stay [MD = 282.48 min (160.23, 404.73) shorter] in the outpatient group, there were no differences in delivery method, adverse outcomes or resource-use between the two arms. On subgroup analysis, when comparing the use of balloon catheters in both arms, those induced as outpatients had fewer caesarean deliveries [RR = 0.52 (0.30, 0.90)], a shorter admission-to-delivery interval [MD = 370.86 min (19.19, 722.54) shorter], and a shorter induction to delivery interval [MD = 330.42 min (120.13, 540.71) shorter].Conclusion: Outpatient labour induction in resource-rich settings is at least as effective and safe, in carefully selected patient populations, when compared with inpatient labour induction. Whether outpatient labour induction results in lower rates of caesarean deliveries needs to be explored further.Trial Registration: This systematic review was prospectively registered in Prospero ( CRD42019118049 ). [ABSTRACT FROM AUTHOR]

Introduction: Sympathetic renal denervation (RD) can potentially reduce blood pressure (BP) in people with resistant hypertension (RH) and uncontrolled hypertension (UH). While a large sham-controlled trial (SCT) showed similar outcomes of RD vs. sham control, in the recent trials, RD was effective in reducing BP in hypertensive people. We performed a meta-analysis of SCTs of RD vs. sham in hypertensive patients.Methods: Multiple electronic databases were searched since inception through September 2018 for SCTs that compared RD vs. sham. Change in 24-hour, daytime and nighttime ambulatory and office BP were efficacy outcomes. Various adverse events were safety outcomes.Results: A total of 7 SCTs were included in the analysis. RD vs. sham significantly reduced 24-hour ambulatory SBP by 3.45 mmHg [95% CI (-5.01, -1.88); P < 0.0001] and DBP by 1.87 mmHg [(-3.59, -0.15); P = 0.01], office DBP by 2.97 mmHg [(-4.76, -1.18); P = 0.001] and daytime ambulatory SBP by 4.03 mmHg [(-6.37, -1.68); P = 0.0008] and DBP by 1.53 mmHg [(-2.69, -0.37); P = 0.01]. RD vs. sham caused non-significant reduction in office SBP by 3.99 mmHg [(-8.10, 0.11); P = 0.06] and nighttime ambulatory SBP by 3.05 mmHg [(-6.86, 0.75), P = 0.12] and DBP by 1.03 mmHg [(-3.01, 0.96); P = 0.31]. There was no difference in the risk of hypertensive crisis/emergency [0.62; 0.24-1.60; P = 0.33] between the two strategies.Conclusions: Current meta-analysis shows that RD reduces ambulatory BP and office DBP in patients with hypertension. Future trials with longer follow-up should confirm these findings. [ABSTRACT FROM AUTHOR]

Objective: To evaluate and compare the performance of Ziehl Neelsen (ZN) smearing, Lowenstein--Jensen (LJ) culture and real-time PCR analysis to detect Mycobacterium tuberculosis in pulmonary and extra-pulmonary specimens. Materials and Methods: A descriptive study conducted from January 2016 through December 2018, on a total of 293 clinical samples of patients suspected with pulmonary and extra-pulmonary tuberculosis at a tertiary hospital of Peshawar, Pakistan. Specimens were processed by ZN smearing, LJ culture and Real-time PCR technique for the detection of M.tuberculosis. The target for the amplification was a segment of IS6110 in the M.tuberculosis chromosome. Specificity and sensitivity were derived for each test and Fishers exact test was performed to examine significance of association between specimen types and each test. Results: Of the 293 samples, 165(56.3%) were from males and 128(43.7%) females. Mean age was 44 years (2-85 years). Specimen types included: CSF (30.4%), pleural fluid (4.1%), sputum (15%), urine (2.4%), synovial fluid (2.4%), other fluids (33.1%) and biopsies (12.6%). Using PCR as gold standard, ZN microscopy correctly identified 20.5% of total M.TB positive specimens and LJ culture detected 47.7%.Certain specimen types showed higher positivity rates of M.TB detection: synovial fluid (42.9%), pleural fluid (41.7%)by PCR analysis. ZN microscopy was associated with the low positivity rates for all specimens, the highest being 18.2% for sputum samples. Conclusion: Tuberculosis PCR is a more rapid and reliable test in the diagnosis and management of tuberculosis. Both Pulmonary and extra-pulmonary specimens exhibit greater positivity rates by PCR analysis than by LJ culture and ZN smearing. [ABSTRACT FROM AUTHOR]

Therapeutic alliance (TA), or the collaborative relationship between a therapist and client, has been shown to be an important component of intervention success. The objective of this study was to examine the psychometric properties of the Therapy Process Observational Coding System–Alliance Scale (TPOCS‐A). The sample consisted of 20 children (19 males) ages 8 to 12 years with autism and their parents (15 mothers, 5 fathers), who completed a cognitive–behavioural intervention designed to improve children's emotion regulation skills. Two trained coders rated early, middle, and late parent and child alliance using the TPOCS‐A after watching video recorded therapy sessions. Therapist‐reported child involvement, alliance, and adherence were also assessed. Psychometric findings revealed that the TPOCS‐A is a reliable and valid measure of therapeutic alliance for children with autism. The implications of examining TA in empirically supported treatments for this population are discussed. [ABSTRACT FROM AUTHOR]

Carbazole analogs 3 and 4 and a new library of bicarbazole-linked triazoles 6–11 were prepared via new synthetic methodology. Metal-catalyzed oxidative coupling reaction was utilized for the synthesis of bicarbazole acetylene 4 and different metals (Zn+2, Co+2, Fe+3, Ni+2, Cu+2, Mn+2) as catalyst were screened. Only Fe-catalyzed reaction was found to be excellent and gave homocoupled product 4. Cu-catalyzed 1,3-dipolar cycloaddition was also utilized to install triazole moiety for the synthesis of hybrid molecules 6–11. Based on reported anti-inflammatory activity of carbazole and triazole scaffolds, all compounds were screened for their reactive oxygen species (ROS) inhibitory potential. Results from these studies revealed triazole 9 as most active compound (IC50 value of 7.6 ± 0.1 µg/mL on human whole blood and 2.7 ± 0.09 µg/mL on isolated neutrophils) using ibuprofen as a standard. Therefore, class described herein can serve as attractive structural element for further studies on ROS inhibition. [ABSTRACT FROM AUTHOR]

The present study describes the synthesis, and evaluation of β‐glucuronidase inhibitory potential of metronidazole analogues. Twenty‐four metronidazole‐tethered benzamide triazoles (28‐51) were synthesized using copper‐catalyzed Huisgen alkyne‐azide cycloaddition reaction, and characterized by using different spectroscopic techniques. All of them were identified as new compounds. Compounds 28–51 demonstrated weak to excellent in vitro β‐glucuronidase inhibitory activity with no toxicity against 3T3 mouse fibroblast cell lines. Compound 51 (IC50=12.41 ± 0.58 μM) was found to be the most active β‐glucuronidase inhibitor among the series, with an activity ∼4 times higher than the standard inhibitor, D‐saccharic acid‐1,4‐lactone (IC50=45.75 ± 2.16 μM). [ABSTRACT FROM AUTHOR]

Incarceration is thought to influence HIV transmission by disrupting partnerships that provide support and protect against sex risk-taking. Current correctional facility-based family-strengthening programs focus on marital partnerships, a minority of inmates' partnerships. Research on the sex partnerships of incarcerated African-American men and the types of partnerships most likely to protect against HIV-related sex risk is limited. Improved understanding can inform expansion of correctional facility-based family-strengthening programs to a greater proportion of protective partnerships and HIV risk reduction programs to partnerships vulnerable to sex risk. Project DISRUPT is a cohort study of African-American men being released from prison in North Carolina who were in committed heterosexual partnerships at prison entry. Using baseline survey data (N = 189), we conducted latent class analysis (LCA) to identify subgroups of participants with distinct relationship profiles and measured associations between relationship characteristics and multiple partnerships of inmates and their partners in the six months before incarceration. LCA indicated a two-class solution, with relationships distinguished by satisfaction/stability (satisfied/stable class: 58.0%; dissatisfied/unstable class: 42.0%); each class had comparable relationship length and levels of marriage and cohabitation. Dissatisfied/unstable relationships were associated with multiple partnerships among participants (AOR 2.93, 95% CI 1.50, 5.72) and partners (AOR 4.95, 95% CI 1.68, 14.58). Satisfaction indicators-versus length, marriage, or cohabitation-were the strongest independent correlates of inmates' and partners' multiple partnerships. Pre-incarceration economic deprivation, mental disorder symptoms, substance use, and violence in relationships were associated with dissatisfaction/instability. Prison-based programs designed to maintain healthy partnerships, strengthen relationship skills, and reduce HIV risk-taking and violence in relationships are warranted and should be targeted to both marital and nonmarital partnerships. Programming also should address the poverty, mental illness, and substance use factors that threaten relationship satisfaction/stability and increase HIV risk. [ABSTRACT FROM AUTHOR]

Given that young children of mothers with adverse childhood experiences (ACEs) exhibit increased risk for maladaptive outcomes (including being maltreated by their caregivers), this study investigated a comprehensive model for predicting children's emotional and behavioral problems in the context of mothers' ACEs. A community sample of 146 mothers with children aged one and onehalf to five years provided ratings of their ACEs, depressive symptoms, parenting characteristics, mother–young child attachment, and young children's internalizing and externalizing problems. Mothers' ACEs and depressive symptoms predicted uniquely young children's internalizing problems. In contrast, mothers' ACEs, depressive symptoms, and punitive parenting behaviors predicted uniquely young children's externalizing problems. These results suggested the importance of trauma-informed interventions for high-risk mothers who may be involved with child welfare systems and for their young children who are likely to exhibit emotional and behavioral problems as child custody decisions are made. [ABSTRACT FROM AUTHOR]

Objective: To analyze bacterial susceptibility of Escherichia coli isolated from urine samples of hospitalized diabetic patients to fluoroquinolones. Material and Methods: A total of four hundred and ten (410) isolates of Escherichia coli were studied from May-October 2018 at two teaching hospitals of Peshawar. Urine samples from Diabetic patients were generally enlist from internal medicine, surgical wards and intensive care divisions. Primary susceptibility testing was performed in accordance with Clinical and Laboratory Standard Institute (CLSI) guidelines. Results were interpreted as norfloxacin resistant if zone diameter is ≤ 12 mm andciprofloxacin resistant for zone diameter ≤ 15 mm. Results: Out of 410 isolates of Escherichia coli, 373(91%) were fluoroquinolones resistant and 37(9%) were fluoroquinolones sensitive. Conclusions: Fluoroquinolones resistance in Escherichia coli causing UTI is prevalent in our setup due to irrational use of antibiotics. Appropriate antibiotic management strategies are needed to curtail the spread of this form of resistance. [ABSTRACT FROM AUTHOR]

Three quarters of new HIV infections in the US are among men who have sex with men (MSM). In other populations, incarceration is a social determinant of elevations in viral load and HIV-related substance use and sex risk behavior. There has been limited research on incarceration and these HIV transmission risk determinants in HIV-positive MSM. We used the Veterans Aging Cohort Study (VACS) 2011-2012 follow-up survey to measure associations between past year and prior (more than one year ago) incarceration and HIV viral load and substance use and sex risk behavior among HIV-positive MSM (N = 532). Approximately 40% had ever been incarcerated, including 9% in the past year. In analyses adjusting for sociodemographic factors, past year and prior incarceration were strongly associated with detectable viral load (HIV-1 RNA >500 copies/mL) (past year adjusted odds ratio (AOR): 3.50 95% confidence interval (CI): 1.59, 7.71; prior AOR: 2.48 95% CI: 1.44, 4.29) and past 12 month injection drug use (AORs > 6), multiple sex partnerships (AORs > 1.8), and condomless sex in the context of substance use (AORs > 3). Past year incarceration also was strongly associated with alcohol and non-injection drug use (AOR > 2.5). Less than one in five HIV-positive MSM recently released from incarceration took advantage of a jail/prison re-entry health care program available to veterans. We need to reach HIV-positive MSM leaving jails and prisons to improve linkage to care and clinical outcomes and reduce transmission risk upon release. [ABSTRACT FROM AUTHOR]

Although research has suggested that mothers who experienced childhood maltreatment tend to exhibit heightened risk for attachment difficulties with their young children, less is known about the mechanisms underlying this association. Thus, this study examined mothers' symptoms of depression as a mediator in the relationship between mothers' childhood maltreatment experiences and patterns of insecure (i.e., anxious, avoidant, and disorganized) mother-young child attachment. Mothers (N = 146) with children aged 1½-to 5-years provided ratings of their childhood maltreatment experiences, attachment with their young children, and symptoms of depression. Mothers' symptoms of depression mediated significantly the relationship between mothers' childhood maltreatment experiences and patterns of insecure mother-young child attachment. These findings suggested that symptoms of depression in the context of mothers' childhood maltreatment may be related more directly to mother-young child attachment than childhood maltreatment experiences alone. These results demonstrated the importance of promoting trauma-informed parenting interventions for facilitating secure emotional connections between mothers and their young children. [ABSTRACT FROM AUTHOR]

This case study outlines the treatment of a 5-year-old Caucasian male who presented with symptoms of selective mutism (SM) along with significant impairment related to comorbid anxiety and speech difficulties. To address these symptoms, Integrated Behavior Therapy for Selective Mutism (IBTSM) was utilized for the treatment of this young boy’s SM and comorbid anxiety. An attachment focus was incorporated as a framework for conceptualizing his SM symptoms. As the treatment of this young boy’s symptoms proceeded, it became clear that his underlying speech difficulties needed to be addressed as well, as these difficulties were preventing expected progress to occur. Thus, this young boy’s treatment was individualized to fit his unique difficulties. In shifting the treatment focus to “being brave like a superhero,” significant decreases were achieved in this young boy’s overall internalizing and Diagnostic and Statistical Manual of Mental Disorders (DSM)-related anxiety symptoms, facilitating a successful transition to speech and language therapy. This case study is distinctive in its description of the complexities that may come along with treating symptoms that appear consistent with SM along with other comorbid conditions and nuanced circumstances. [ABSTRACT FROM AUTHOR]

Background: Black men who have sex with men (BMSM) and some who also have sex with women (BMSMW) account for over 70% of new HIV infections in the United States representing an elevated HIV risk in this group, also informing risks of HIV transmission to other BMSM and female sexual partners. Settings: We examined trajectories of self-reported substance use, HIV-related sexual risk behaviors, and psychosocial vulnerabilities among BMSMW versus BMSM over a 1-year study period. Methods: We analyzed baseline, 6-, and 12-month follow-up data from the HIV Prevention Trials Network "BROTHERS" Study (HPTN 061; n = 1126). Categorizing participants by sexual partner type across 3 time points: (1) BMSMO: having male and no female partners across assessments and (2) BMSMW: having sex with male and one or more female partners at least at 1 time point. Using generalized estimating equations, we estimated associations between being BMSMW (versus BMSMO) and changes in psychosocial vulnerability, substance use, and HIV-related sexual risk behaviors. Results: Generalized estimating equation models controlling for sociodemographics, time-varying effects, and intervention status showed that BMSMW versus BMSMO had 50% increased odds of crack use, 71% increased odds of alcohol use during condomless anal intercourse (CAI), 51% greater odds of using drugs at last CAI, and twice the odds of receiving goods at last CAI. Conclusions: Findings show stable and comparatively elevated illicit drugs, alcohol, and exchange sex during last CAI among BMSMW. Future intervention research should focus on ways to address changes in substance-related HIV-transmission behaviors over time in this population of men. [ABSTRACT FROM AUTHOR]

Incarceration is strongly associated with post-release STI/HIV risk. One pathway linking incarceration and STI/HIV risk may be incarceration-related dissolution of protective network ties. Among African American men released from prison who were in committed partnerships with women at the time of incarceration (N = 207), we measured the association between committed partnership dissolution during incarceration and STI/HIV risk in the 4 weeks after release. Over one-quarter (28%) experienced incarceration-related partnership dissolution. In adjusted analyses, incarceration-related partnership dissolution was strongly associated with post-release binge drinking (adjusted odds ratio (AOR) 4.2, 95% confidence interval (CI); 1.4-15.5). Those who experienced incarceration-related partnership dissolution were much more likely to engage in multiple/concurrent partnerships or sex trade defined as buying or selling sex (64%) than those who returned to the partner (12%; AOR 20.1, 95% CI 3.4-175.6). Policies that promote maintenance of relationships during incarceration may be important for protecting health. [ABSTRACT FROM AUTHOR]

Objective: To find out the experience and expression of academic stressors in college students and to develop a reliable and valid measure. Methodology: A sample of 244 college students with age range 15-20 (M = 17.38, SD = 1.22) were selected through the convenient sampling technique. Both boys and girls living in intact families, having no physical or psychological disorder studying in different government and private institutes of city Lahore were included in the study. A three-step model (item generation, expert validation, and pilot study) was used to develop the scale. Results: Descriptive statistics revealed n=97(39%) 1st year and 147 (61%) 2nd year students with highest number living in nuclear family system (n=150(61%). Exploratory factor analysis using Principal Component factor analysis revealed two factors: sustaining performance and psychosocial stressors. The value of Kaiser-Meyer-Olkin was .87 and the Bartlett test was 929.90 with p=0.000. Student Problem Checklist was used to establish the concurrent validity of the scale and was found to be r=.92. The internal consistency was 0.92 (p<0.001) and the test-retest reliability of ASS was r=.67 (p<0.001). Girls experienced more academic stressor (M=35.53, SD=19.43, p<0.001) as compared to boys (M=31.72, SD=13.45). Conclusion: The Academic Stressor Scale is an indigenous scale with established psychometrics that provides a depiction of academic stressors faced by Students in Pakistani culture. [ABSTRACT FROM AUTHOR]

Objectives: To correlate the screening ability of ultrasound-based TIRADS with the FNAC-based Bethesda system when the latter is kept as a gold standard. Material and methods: A cross-sectional study was conducted in the Histopathology department, Rehman Medical Institute, Peshawar 15th June 2022-14th June 2023. A total of 363 patients from any age group of either gender diagnosed with thyroid nodules were included in the trial. All the participants underwent ultrasound followed by ultrasound-guided fine needle aspiration of thyroid nodules. TIRADS and Bethesda grading was done for each participant. Demographics and grading scores were recorded. Keeping Bethesda scoring as gold standard diagnostic performance of TIRADS grading was calculated. Results: Mean age of the patients was 46.68 ± 12.28 years with a female-to-male ratio of 2.3:1. TIRADS grading revealed 210 (69.8%) from TIRADS 2 while 70(82.4%), 12(50%), and 09(23.7%) patients were from TIRADS 3, 4 and 5 categories respectively. Bethesda grades were 301(82.9%), 21(5.8%), 09(2.5%), 28(7.7%), and 04(1.1%) from Bethesda 2, 3, 4, 5, and 6 categories respectively. The sensitivity of the TIRADS was 93.8%, specificity 89.1%, positive predictive value 45%, negative predictive value 99.3%, and a diagnostic accuracy of 89.5%. Conclusion: TIRADS grading has a high diagnostic ability when Bethesda scoring is kept as the gold standard. It can be used effectively in segregating benign from malignant nodules and is recommended for screening patients presenting with thyroid nodules. [ABSTRACT FROM AUTHOR]

Neurological diseases like Alzheimer's disease, epilepsy, parkinsonism, depression, Huntington's disease and amyotrophic lateral sclerosis prevailing globally are considered to be deeply influenced by oxidative stressbased changes in the biochemical settings of the organs. The excess oxygen concentration triggers the production of reactive oxygen species, and even the intrinsic antioxidant enzyme system, i.e. SOD, CAT and GSHPx, fails to manage their levels and keep them under desirable limits. This consequently leads to oxidation of protein, lipids and nucleic acids in the brain resulting in apoptosis, proteopathy, proteasomes and mitochondrion dysfunction, glial cell activation as well as neuroinflammation. The present exploration deals with the evidence-based mechanism of oxidative stress towards development of key neurological diseases along with the involved biomechanistics and biomaterials. [ABSTRACT FROM AUTHOR]

Background: We measured associations between parental incarceration and STI/HIV-related drug use and sex risk, assessing differences by race, age at first parental incarceration, and potential mediators of the relationship.Methods: We used Waves I (adolescence), III (young adulthood), and IV (adulthood) of the National Longitudinal Study of Adolescent to Adult Health (n = 11,884) to measure associations between age of parental incarceration (never; <8; 8-17; ≥18 years old) and marijuana and cocaine use, multiple partnerships, and STI in adolescence and adulthood among white, Black, and Hispanic participants and assessed mediation by sexual and physical abuse, mental disorder symptoms, and drug use.Results: By Wave IV, approximately one in six had experienced a parental incarceration; higher prevalence observed among black (26%) and Hispanic (20%) versus white (15%) respondents (p < 0.0001). Parental incarceration at any age was moderately to strongly associated with STI/HIV risk outcomes. In multivariable models, parental incarceration at age <8 years old (versus never) remained strongly associated with STI/HIV risk in both adolescence and adulthood, with strongest associations among non-whites. Among black participants, parental incarceration at <8 years old was associated with over double the odds of adulthood use of marijuana (adjusted odds ratio (AOR): 2.53, 95% confidence interval: 1.62, 3.95) and cocaine (AOR: 4.41, 95% CI: 2.05, 9.48). Delinquency, drug use, and mood disorders appeared to partially mediate the relationship.Conclusions: Children impacted by parental incarceration constitute priority populations for substance use and STI/HIV prevention and treatment. The unintended consequences of incarceration for children should be considered in decarceration discussions. [ABSTRACT FROM AUTHOR]