Time Of Birth Research Articles

Prediction of Possible Adverse Effects of Gestational Diabetes Mellitus on Maternal and Fetal Glomeruli by Urine and Amniotic Fluid Podocyte Degradation Products

Objectives: To compare the levels of podocyte damage markers nephrin and podocalyxin in urine samples taken at the time of gestational diabetes mellitus (GDM) diagnosis and at birth. Amniotic fluid podocalyxin (pdx) and nephrin levels were also analyzed to determine whether GDM had an impact on fetal glomeruli. Methods: A total of 50 patients, including 24 patients diagnosed with gestational diabetes and 26 healthy pregnant women whose gestational weeks were matched, were included in the study. GDM was diagnosed with a 75 g oral glucose tolerance test (OGTT). Fresh morning urine samples from patients diagnosed with GDM were collected. The second urine sample was collected with the help of a catheter during birth. Amniotic fluid samples were taken from patients who gave birth by cesarean section. The urinary podocalyxin and nephrin levels were measured via the quantitative sandwich enzyme immunoassay. Albumin–creatinine ratio (uACR) was also calculated in urine samples. Results: Urinary nephrin and pdx levels on the day of GDM diagnosis were similar in the GDM and control groups. Microalbuminuria was detected in only one patient from each group at the time of GDM diagnosis. In the urine samples taken from the time of birth, pdx and nephrin levels of the GDM group were significantly higher than the control group (p < 0.001 for each). While microalbuminuria was detected in five patients (20.8%) at the time of birth in the GDM group, it was detected in only two patients (7.7%) in the control group. In the GDM group, a significant increase was detected between the urine pdx and nephrin levels measured at diagnosis and those measured at birth. In the control group, measurements at baseline and at birth were similar. There was no significant difference between the GDM and control groups in terms of amniotic fluid pdx and nephrin levels. A positive and significant correlation was detected between urinary pdx, nephrin, SBP, and uACR. Conclusions: While GDM triggers podocyte damage in maternal glomeruli, it does not cause significant change in fetal glomeruli.

Self and body representation among women survivors of childhood abuse and its relation to their infant's temperament.

Studies have suggested that women's history of childhood abuse is associated with the temperament of their children, as indicated by increased negative emotionality and decreased regulatory capacity. The aim of this study was to examine a model according to which the association between maternal childhood abuse and infant temperament would be mediated by women's self-objectification and sense of disrupted body boundaries. Four hundred forty women were recruited on a maternity ward within 48 hr of giving birth (Time 1). Of them, 295 (67.05%) participated in the second assessment, 3 months postpartum (Time 2). Participants' self-objectification and sense of body boundaries were assessed at Time 1. Maternal history of childhood abuse and infant temperament were assessed at Time 2. Structural equation modeling yielded two significant mediation effects: (a) the association between maternal history of childhood abuse and infant's negative emotionality was mediated by self-objectification, and (b) the association between maternal history of childhood abuse and infant's orienting/regulatory capacity was mediated by a sense of disrupted body boundaries. This study highlights the significant influence of maternal self and body representations on infant temperament, suggesting that these factors may be relevant for clinical interventions with mothers with a history of childhood abuse to support their children's well-being. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Prevalence, type, and risk factors of intracranial hemorrhage in term neonates: a systematic review and meta-analysis.

Intracranial hemorrhage in the newborn poses a significant challenge to their well-being and subsequent development. In pre-term neonates, germinal matrix hemorrhage is the most common cause of intracranial hemorrhage with the prevalence varying from 20 to 59%. However, in term neonates, the prevalence and type of intracranial hemorrhage have not been well elucidated. The type of hemorrhage occurring in term neonates differs from those occurring in pre-term neonates. We conducted a systematic review to assess the prevalence, type, and risk factors of intracranial hemorrhage occurring in term neonates. We conducted a systematic review and meta-analysis by searching the PubMed and Embase databases. Inclusion criteria were studies reporting intracranial hemorrhage in term neonates (37weeks or more gestational age at the time of birth). Exclusion criteria were as follows: (1) studies which examined only a specific type of hemorrhage, (2) studies which examined only a single risk factor, (3) sample size < 20, (4) not in English language, and (5) full text not accessible/available. The studies which met the eligibility criteria were assessed and evaluated by two authors, and data was extracted using a predesigned template. The risk of bias in the included studies was assessed using the Joanna Briggs Institute bias assessment tool. The meta-analysis for prevalence, type of hemorrhage, and risk factor was conducted using MetaXL extension for Microsoft Excel. A total of 1226 records were identified in a database search of PubMed and Embase. After screening, 20 studies were included in the final analysis. The overall prevalence of intracranial hemorrhage in term neonates was 9.3% (95% CI, 4.9-14.9%). The prevalence of intracranial hemorrhage in asymptomatic patients was 5.8% (95% CI, 2.5-10.2%) and in symptomatic patients was 29.3% (95% CI, 15.3-44.8%). Sub-group analysis of the modality of detection shows that the prevalence of hemorrhage detection was higher with computed tomography/magnetic resonance imaging (CT/MRI) than with ultrasonography (USG). Extra-axial hemorrhage was the most common type of hemorrhage detected, comprising about 32.4% of the overall. The odds of having an intracranial hemorrhage was significantly higher with an instrumental delivery (OR = 3.75, 95% CI, 1.4-10.02). The present study shows that the prevalence of intracranial hemorrhage is relatively high in symptomatic and asymptomatic patients with extra-axial hemorrhage being the most common type of hemorrhage. The prevalence of hemorrhage varied according to the type of imaging used for detection and ideal imaging modality for evaluation, and the consequences of intracranial hemorrhage in term infants on development remain to be determined.

Determining optimal timing of birth for women with chronic or gestational hypertension at term: The WILL (When to Induce Labour to Limit risk in pregnancy hypertension) randomised trial.

Chronic or gestational hypertension complicates approximately 7% of pregnancies, half of which reach 37 weeks' gestation. Early term birth (at 37 to 38 weeks) may reduce maternal complications, cesareans, stillbirths, and costs but may increase neonatal morbidity. In the WILL Trial (When to Induce Labour to Limit risk in pregnancy hypertension), we aimed to establish optimal timing of birth for women with chronic or gestational hypertension who reach term and remain well. This 50-centre, open-label, randomised trial in the United Kingdom included an economic analysis. WILL randomised women with chronic or gestational hypertension at 36 to 37 weeks and a singleton fetus, and who provided documented informed consent to "Planned early term birth at 38+0-3 weeks" (intervention) or "usual care at term" (control). The coprimary outcomes were "poor maternal outcome" (composite of severe hypertension, maternal death, or maternal morbidity; superiority hypothesis) and "neonatal care unit admission for ≥4 hours" (noninferiority hypothesis). The key secondary was cesarean. Follow-up was to 6 weeks postpartum. The planned sample size was 540/group. Analysis was by intention-to-treat. A total of 403 participants (37.3% of target) were randomised to the intervention (n = 201) or control group (n = 202), from 3 June 2019 to 19 December 2022, when the funder stopped the trial for delayed recruitment. In the intervention (versus control) group, losses to follow-up were 18/201 (9%) versus 15/202 (7%). In each group, maternal age was about 30 years, about one-fifth of women were from ethnic minorities, over half had obesity, approximately half had chronic hypertension, and most were on antihypertensives with normal blood pressure. In the intervention (versus control) group, birth was a median of 0.9 weeks earlier (38.4 [38.3 to 38.6] versus 39.3 [38.7 to 39.9] weeks). There was no evidence of a difference in "poor maternal outcome" (27/201 [13%] versus 24/202 [12%], respectively; adjusted risk ratio [aRR] 1.16, 95% confidence interval [CI] 0.72 to 1.87). For "neonatal care unit admission for ≥4 hours," the intervention was considered noninferior to the control as the adjusted risk difference (aRD) 95% CI upper bound did not cross the 8% prespecified noninferiority margin (14/201 [7%] versus 14/202 [7%], respectively; aRD 0.003, 95% CI -0.05 to +0.06), although event rates were lower-than-estimated. The intervention (versus control) was associated with no difference in cesarean (58/201 [29%] versus 72/202 [36%], respectively; aRR 0.81, 95% CI 0.61 to 1.08. There were no serious adverse events. Limitations include our smaller-than-planned sample size, and lower-than-anticipated event rates, so the findings may not be generalisable to where hypertension is not treated with antihypertensive therapy. In this study, we observed that most women with chronic or gestational hypertension required labour induction, and planned birth at 38+0-3 weeks (versus usual care) resulted in birth an average of 6 days earlier, and no differences in poor maternal outcome or neonatal morbidity. Our findings provide reassurance about planned birth at 38+0-3 weeks as a clinical option for these women. isrctn.com ISRCTN77258279.

Predictive model for congenital heart disease in children of Pakistan by using structural equation modeling

BackgroundThe structural abnormality of the heart and its blood vessels at the time of birth is known as congenital heart disease. Every year in Pakistan, sixty thousand children are born with CHD, and 44 in 1000 die before they are a month old. Various studies used different techniques to estimate the risk factors of congenital heart disease, but these techniques suffer from a deficiency of capacity to present human understanding and a deficiency of adequate data. The current study provided an innovative approach by defining the latent variables to handle this issue and building a reasonable model.MethodData used in this study has been collected from mothers and hospital records of the children. The dataset contains information on 3900 children who visited the OPD of the Chaudry Pervaiz Elahi Institute of Cardiology (CPEIC) Multan, Pakistan from October 2021 to September 2022. The latent variables were defined from the data and structural equation modeling was used to model them.ResultThe results show that there are 53.6% of males have acyanotic CHD and 54.5% have cyanotic CHD. There are 46.4% of females have acyanotic CHD and 45.5% have cyanotic CHD. The children who have no diabetes in the family are 64.0% and children who have diabetes in the family are 36.0% in acyanotic CHD, the children who have no diabetes in the family are 59.7% and children have diabetes in the family are 40.3% in cyanotic CHD. The value of standardized root mean residual is 0.087 is less than 0.089 which shows that the model is a good fit. The value of root mean square error of approximation is 0.113 is less than 0.20 which also shows the good fit of the model.ConclusionIt was concluded that the model is a good fit. Also, the latent variables, socioeconomic factors, and environmental factors of mothers during pregnancy have a significant effect in causing cyanotic while poor general health factor increases the risk of Acyanotic congenital heart disease.

Diagnostic Utility of Cord Thyroid-Stimulating Hormone (TSH) in Congenital Hypothyroidism and Its Association With Perinatal Factors: A Study From a Tertiary Referral Centre in Hyderabad, India.

Introduction Congenital hypothyroidism (CH) is one of the most common, easily treatable, causes of long-term neurodevelopmental complications in children. The prevalence of CH in India is much higher compared to other countries. Although developed countries have well-established neonatal screening programs, a uniform nationwide screening program at birth is still not established in India. Cord blood thyroid-stimulating hormone (TSH) screening is crucial in diagnosing congenital hypothyroidism even with advancements in expanded newborn screening programs. The aim of this study was to determine the prevalenceof elevated cord blood TSH levels and factors associated with it among newborns and to analyze the false positive rates ofelevated cord blood TSH levels among the study population and factors associated with it. Methods This retrospective cross-sectional studywas conducted among 51,251 live newborn babies born at Fernandez Hospital, Hyderabad, India, over a period of five years from January 2019 to December 2023.The data of all the mothers and newborns was retrieved from medical records and details of maternal age, parity, co-morbidities, mode of delivery, gestational age of the newborn at delivery, gender, number of babies, APGAR score, and birth weight were obtained. As per hospital policy, 5 ml of cord blood sampleof all newborn babies was collected from the umbilical cord at the time of birth. Samples were analysed for cord TSH batchwise by the enzyme-linked immunosorbent assay (ELISA) method. As per the manufacturer, the normal biological reference intervals are <20 uIU/mL. All the cord TSH values > 20 uIU/ mL were considered abnormaland advised a repeat serum TSH test within 14 days of life. Cord TSH values that were higher than the biological reference range after retesting were considered positive for CH. All the initial and repeat results were retrieved from the neonatal digital database. Results Out of 51,251 live newborn babies, 71 (0.14%) were confirmed with a diagnosis of congenital hypothyroidism.The prevalenceof CH in our study population was 1.4 per 1000 live births. Anaemia was found to be a statistically significant predictor of true positive cases (p<0.05).In our study, while evaluating risk factors for elevated cord TSH levels, we found that the babies born by vaginal delivery had higher cord TSH levels than babies born by lower segment caesarean section (LSCS) (p<0.001). The other variables considered in the study which include maternal age, BMI, parity of mother, gender of the baby, birth weight, gestation age and APGAR score were not statistically significant for CH. Conclusion The prevalence of congenital hypothyroidism was 1.4 in 1000 in our study. Mode of delivery and maternal anaemia had an impact on elevated cord TSH levels. These factors should be considered while interpreting cord TSH values.Cord TSH testing is an effective screening tool for CH.It helps in the early detection of thyroid dysfunction in newborns, enabling timely intervention and treatment to prevent developmental delays and other complications. This study presents evidence supporting the inclusion of cord blood TSH as a predictive factor in CH screening programs.

Sub-attosecond time delays of photoemission from asymmetric cores of molecules

We theoretically study the extreme ultraviolet (XUV) photoemission of the asymmetric molecular ion HeH2+ beyond the dipole approximation. Based on the double-slit interference of the photoelectron emitted from two atomic cores, we propose a scheme to obtain the XUV photoemission time delays originated from different physical mechanisms. In our study, two types of sub-attosecond photoemission time delays are identified and extracted from the observable photoelectron momentum distributions. One is the so-called birth time delay, originated from the travel time of the photon across the molecule, and the other is the escaping time delay of the photoelectron from two different cores. The present study shows the observable evidence demonstrating that in single-photon ionization, it takes more time for the photoelectron escaping from the helium nucleus than that from the proton. Published by the American Physical Society 2024

Differences in Time of Birth between Spontaneous and Operative Vaginal Births.

Previous studies have identified an association between obstetric interventions and the time of day in which they are performed; however, they do not account for granular variations in the temporality of delivery interventions, which is influenced by both health care providers and resource availability. We sought to assess differences in time of birth among spontaneous vaginal births (SVBs) versus operative (forceps- and vacuum-assisted) vaginal births (OVBs). This cross-sectional study used birth certificate data from the National Vital Statistics System from 2016 to 2021, which includes the time of birth and delivery method for recorded U.S. births. The number of SVBs and OVBs at each minute was normalized relative to the total births within each delivery group to facilitate balanced comparisons between groups. Logistic regression analysis assessed the odds of OVBs per time of day. A total of 15,412,129 subjects who underwent vaginal birth were included in this analysis, 690,905 (4.5%) of whom underwent OVBs. Compared to births at other time intervals, those between 4:30 and 7:30 p.m. were more likely to be OVBs (odds ratio [OR] = 1.13, 95% confidence interval [CI]: 1.12-1.14). Conversely, births between 3:00 and 6:00 a.m. were less likely to be OVBs (OR = 0.87, 95% CI: 0.86-0.88). After adjusting for adjusting for maternal age, gestational age, and induction of labor, births between 4:30 and 7:30 p.m. remained more likely to be OVBs (adjusted odds ratio [aOR] = 1.09, 95% CI: 1.08-1.10) and births between 3:00 and 6:00 a.m. remained less likely to be OVBs (aOR = 0.91, 95% CI: 0.90-0.92). In this population-based study, we identified temporal differences between SVBs and OVBs with increased use of instrumentation during the late afternoon and reduced use in the early morning. These findings prompt further investigation into the indications for OVBs and root causes of these temporal variations, which are likely multifactorial and involve provider and resource availability. · This study identifies temporal differences between SVBs and OVBs.. · Compared to SVBs, operative births are more likely in the late afternoon.. · OVBs are also less likely in the early morning.. · These temporal trends suggest the influence of provider and resource availability..

The interplay of body mass index, gestational weight gain, and birthweight over 3800 g in vaginal breech birth: A retrospective study.

Optimal counseling of women for vaginal breech birth requires consideration of both established and emerging risk factors for adverse perinatal outcomes. Currently, rising prevalences of maternal obesity and impaired glucose tolerance challenge obstetric care. We aimed to investigate the effects of these parameters on the outcome of vaginal breech birth to improve counseling practices. A total of 361 women (without previous vaginal births) attending vaginal birth of a singleton fetus in breech presesntation between 01/2015 and 11/2021 were included in this retrospective single-center study. Data were derived from the hospital data base. We analyzed the effect of the maternal body mass index (BMI) at birth (compared to pre-pregnancy BMI), excessive weight gain, gestational diabetes, and neonatal birthweight on obstetrical and neonatal short-term outcomes (intrapartum cesarean delivery, performance of obstetric maneuvers (Løvset-, Bracht-, Veit-Smellie maneuver and Bickenbach's arm delivery), admission to the neonatal unit, Apgar score after 5 minutes<7, and arterial cord pH-value <7.10). Multivariable logistic regression was used for analysis and adjustment of variables. Overall, 246 women (68.1%) had a successful vaginal birth. Intrapartum cesarean delivery (n = 115/361; 31.9%) was independently associated with maternal BMI at birth (p = 0.0283, aOR = 1.87 (1.19-3.97)) if birthweight was ≥3800 g. The rate of intrapartum cesarean delivery was also higher in women with gestational diabetes (p = 0.0030, aOR = 10.83 (2.41-60.84)). A significantly higher risk of neonatal acidosis (arterial pH-value <7.10) was observed in women with BMI at birth ≥30 kg/m2 (p = 0.0345, aOR = 1.84 (1.04-3.22)) without affecting other outcomes. Pre-pregnancy BMI, gestational weight gain and BMI-gain did not significantly affect the obstetrical and neonatal birth outcomes. When neonatal birthweight is ≥3800 g, maternal BMI at birth (p = 0.0283; aOR = 1.87 (1.19-3.97)) is independently associated with the rate of intrapartum cesarean delivery. However, pre-pregnancy BMI and BMI-gain during pregnancy were not associated with the need for intrapartum cesarean delivery or other adverse outcomes. Consequently, BMI at the time of birth could be more informative than pre-pregnancy BMI and may improve counseling of women attempting vaginal breech birth.

Most common congenital syndromes with facial asymmetry: A narrative review.

Symmetry is present in various aspects of everyday life. A symmetrical face is considered attractive, whereas a lack of facial symmetry is regarded as a source of functional and aesthetic problems. Most of the people exhibit slight asymmetries, but some of them reveal severe asymmetries. Among patients presenting with severe facial asymmetries, there may be those with congenital defects. Congenital defects may manifest at the time of birth or be a result of birth trauma.One of the most prevalent asymmetrical birth defects is cleft lip and/or cleft palate. Other congenital defects include craniofacial syndromes, such as Treacher Collins syndrome (TCS) and Goldenhar syndrome. Among the rare syndromes with facial asymmetries, Klippel-Feil syndrome (KFS), PHACE (posterior fossa brain malformation, hemangiomas, arterial anomalies, cardiac anomalies, and eye abnormalities) syndrome, plagiocephaly, and Parry-Romberg syndrome are worth noticing. The majority of craniofacial asymmetries require surgery to improve the patient's facial appearance. The treatment is multidisciplinary and long, and the most common procedures involve reparative and regenerative surgeries. The aim of this review was to present the most common congenital defects with facial asymmetry.

Haemorrhagic and thromboembolic outcomes in pregnant patients with mechanical heart valves who undergo interruption of anticoagulation for birth - A case series.

Anticoagulant therapy prevents thrombosis and thromboembolic events in patients with mechanical heart valves. Bridging anticoagulation around the time of birth represents a unique challenge. Few retrospective reviews or case series exist examining peripartum outcomes with bridging anticoagulation. Review of peripartum and postpartum anticoagulation management, with a focus on postpartum complications. Design: case series, single centre. Royal Brisbane and Women's Hospital, Australia between 1 January, 2000, and 1 August, 2022. all pregnant women with mechanical heart valves (any type) who birthed. intrapartum and postpartum haemorrhage, thrombosis, thromboembolic complications, cardiac events, readmission, and maternal death. There were 18 women, with 23 births. Sixteen births were via caesarean section (70%). Fourteen women (61%) experienced at least one significant haemorrhagic complication, one woman required a peripartum hysterectomy, one woman experienced atrial fibrillation, and one had a valvular thromboembolic complication. No maternal cerebral thromboses or maternal deaths were recorded. Women with mechanical heart valves who undergo bridging anticoagulation are associated with significant maternal morbidity. Most postpartum haemorrhagic complications were associated with bridging unfractionated heparin infusions in the first postnatal week. Bridging anticoagulation practices varied widely. Ongoing pooled data are required to inform evidence-based guidelines for postpartum anticoagulation management.

Hearing loss in newborn infants with hypoxic ischaemic encephalopathy: protocol for a case–control study

IntroductionHypoxic ischaemic encephalopathy (HIE), a condition where the brain does not receive enough oxygen and/or blood flow around the time of birth, is associated with significant morbidity and mortality. Systemic...

Association of toll-like receptors with the airway-intestinal microbiota and pneumonia development in preterm infants - A case control study

BackgroundThe prevention and treatment of pneumonia and lung injury in preterm infants are major challenges for pediatricians worldwide. Few studies have analyzed the composition of bacterial colonies in the airway and intestine and their relationship with toll-like receptors (TLRs) as it relates to pneumonia in preterm infants. MethodsThis study included 70 infants born at 32–35 weeks gestation. Oral-tracheal aspirates at the time of birth, first-pass meconium, and serum specimens were collected. Bacterial deoxyribonucleic acid (DNA) was extracted from the Oral-tracheal aspirates and meconium, and 16S ribosomal ribonucleic acid (rRNA) genes were amplified and sequenced. The levels of TLR2 and TLR4 were analyzed using an enzyme-linked immunosorbent assay. Preterm infants were classified into non-pneumonia (A) and pneumonia (B) groups according to their clinical manifestations. ResultsSignificant differences in the alpha and beta diversities were observed between the two groups. Infants with pneumonia had less bacterial diversity in the airways and intestinal flora at birth than those without pneumonia. The three most predominant phyla in the airways at birth were Proteobacteria, Firmicutes, and Actinobacteria. The levels of TLR2 and TLR4 in oral-tracheal aspirates were higher in infants with pneumonia than in those without pneumonia, although serum TLR2 and TLR4 levels did not differ between the groups. Streptococcus in the oral tracheal aspirate was negatively correlated with TLR2 and TLR4 levels, and Ureaplasma in the oral-tracheal aspirate was negatively correlated with TLR4 levels in the airway. ConclusionReduced perinatal microbiota diversity is associated with the levels of TLR2 and TLR4, and may also have a significant impact on the development of pneumonia.

Maternal and infant outcomes for women experiencing homelessness, prior to and during pregnancy, in England: a retrospective cohort study

BackgroundSafe, secure, healthy housing is a crucial determinant of health. The aim of this study was to determine whether women that experienced homelessness (WEH) in England prior to or during pregnancy, are at greater risk of adverse pregnancy outcomes than women that are housed. MethodsA retrospective nationwide population study was conducted using English national Hospital Episode Statistics Admitted Patient Care database. The population included one randomly selected singleton birth with a gestational age >24 weeks’ per women, in hospital, between the 1st January 2013 and 31st March 2023. WEH were identified as having at least one homeless code (“no fixed abode”, “registered with a homeless-exclusive GP practice”, “clinical diagnosis of homelessness”) at the time of birth. Logistic regression was used to estimate the odds ratios of severe maternal morbidity (SMM), preterm birth (<37 weeks’) and low birthweight (<2500 g) for WEH compared to housed women overall and those in the most deprived areas. Results were adjusted for age, ethnicity, parity, year of birth and pre-existing medical conditions. FindingsThe study population comprised 3 349 601 births from 2013–23. 3301 (0·1%) births were from WEH. Homelessness increased the risk of SMM, preterm birth and low birthweight, with fully adjusted odds ratios (aOR) of 1·28 (95% CI 1·02–1·60), 2·02 (95% CI 1·81–2·25) and 2·16 (95% CI 1·94–2·40) respectively compared to housed women. This remained significant when compared to women living in the most deprived areas: aOR 1·24 (95% CI 0·99–1·55), 1·94 (95% CI 1·62–2·34), 1·87 (95% CI 1·69–2·08) respectively. InterpretationThese results highlight the need for prioritisation in policy to improve housing prior to and during pregnancy. Quality research that investigates not just dichotomous homelessness, but the impact of frequent moves during pregnancy, housing quality and overcrowding is required, which necessitates the collection of detailed housing information through pregnancy and the postnatal period. FundingNV is funded by a clinical research fellowship from Nuffield Department of Population Health and Academy of Medical Sciences Starter Grant for Clinical Lecturers.

Vedic astrological factors for human immunodeficiency virus transmission within male individuals with sexual orientation as homosexual

Background: For almost more than 70 years, the modern science had labeled homosexuality as a mental disorder and was part of DSM (Diagnostic and Statistical Manual of Mental Disorders) until the fifth edition was released in the year 2013 and homosexuality was removed from the mental disorder list. Despite of the removal of homosexuality along with all kind of sexual orientation from mental disorder, it is still being considered taboo in the society. From Sanatana Dharma perspective, homosexuality is very well mentioned in multiple scriptures. In Vedic Astrology as well, this homosexuality along with diseases due to sexual intercourse is being described. In this modern era, one of the most common disease due to sexual intercourse is HIV. Although, HIV is considered relatively new transmission due to its first scientific mention in the late twentieth century, the symptoms and overall nature of this disease is clearly described in Vedic Astrology. Finding: This research paper is an extension of the existing research paper in the field of Vedic Astrology especially in the field of Vedic Astrology focusing on HIV transmission. A total of 314 HIV positive samples was collected from 18 countries selected from Asia, Europe, North America, South America, Africa as well as Australia in order to have a coverage of all the continents. All these HIV positive people belong to LGBT community, to be very specific Gay (homosexuals) and have been identified as HIV transmission due to anal intercourse with another Gay partner. The Astrological Natal Chart were analyzed for all these 314 samples against the KIRAN sutra (5 thumb rules) to find the possibility of HIV based on the sutras i.e. rules. Out of 314 samples, 310 charts fit the criteria (KIRA sutra) mentioned in the KIRAN sutra for HIV transmission. 4 samples were not checked against the criteria (N) due to insufficient Nakshatra-Pada i.e. Constellation-Phase coverage along with the complex nature of the Nakshatra sutra i.e. N sutra of KIRAN sutra. The result indicates that the KIRAN sutra is very effective sutra even to identify the HIV transmission from male-to-male partner with an accuracy of 98.73% (310 cases out of 314 cases) using only 4 sutras i.e. KIRA. Conclusion: The research is an effort to raise awareness and to help males with homosexual orientation to identify whether they are highly prone to HIV or not using their Vedic Astrological Natal Chart so that they can take preventive action. A new yoga i.e. Samalaingika Yauna Sankramaṇa Yoga is being introduced in the field of Medical Astrology focusing on males with sexual orientation as homosexual, commonly known as Gay in LGBT community in order to support Gays living a HIV free life without judging their sexual orientation. Novelty/Originality of this article: This study introduces the application of the KIRAN sutra from Vedic Astrology as a predictive method for assessing HIV transmission risk in homosexual men, achieving an accuracy rate of 98.73%, along with the introduction of a new configuration, Samalaingika Yauna Sankramaṇa Yoga.

Influence of male targeted short message service on uptake of family planning among spouses in Marsabit County, Kenya

Background: Family planning helps in regulating the number of children and determine healthy spacing and timing of births between pregnancies. The global contraceptive prevalence stands at 49.0%, Sub-Saharan Africa at 29.0%, Kenya at 56.9% while in Marsabit County at 5.6%. Male spouse involvement on matters of family planning deserves attention. This study aimed at establishing the influence of male targeted short message service on uptake of family planning among female spouses in Marsabit County, Kenya. Methods: A pre-test and post-test quasi experimental study design was adopted involving randomly selected 220 couples from Laisamis and Moyale sub-counties. Intervention of male targeted short message service was offered to male spouses from Moyale sub-county for a period of 4 months. A questionnaire was used to collect data. Quantitative data analysis was done using SPSS. All the required ethical and logistical considerations followed. Results: At baseline level of uptake was overall 14.3%, control 13.2% and intervention 15.4% while at endline overall 30.2%, control 20.4% and intervention 39.5%. Further results revealed that uptake of family planning was increased by use of short message service. Conclusions: The study concluded that the level of uptake was low but with SMS intervention uptake significantly increased. The Ministry of Health should consider integrating male targeted short message service intervention in provision of family planning services to increase uptake.

Arrhythmia burden in patients with congenital heart disease

Abstract Background The prevalence of congenital heart defects (CHD) is rising. Many patients experience arrhythmias either due to the defect itself or necessary intervention. Sudden onset of arrhythmia poses grave risks such as heart failure, stroke, or cardiac death. Research gaps exist regarding high-risk defects, age susceptibility, and prognostic implications of arrhythmia. Purpose Delineate the burden of arrhythmias in patients with CHD. Methods Patients born in the period 1970-2017 and diagnosed with CHD were identified in Swedish nationwide medical registries. Each patient was matched by birthyear and sex with ten controls from the general population. Cox proportional hazard regression model and Fine-Gray regression model with death as competing risk were used to compute risk (hazard ratio [HR]) and cumulative incidence of arrhythmias (supraventricular and ventricular arrhythmias). Estimates were compared with the matched controls. Follow-up started at time of birth. Results We included 63,559 patients and 583,205 matched controls with median follow-up of 12.8 years. Almost two-thirds of the total CHD population were born after year 2000 and 89% (n=56,564) had a simple lesion (defined as atrial or ventricular septal defect, coarctation of the aorta or malformation of the heart valves). During follow-up, 1,632 events of arrhythmia (90% of supraventricular origin) were registered in the population of patients with CHD, yielding an incidence rate of 16.4 per 10,000 person-years (versus 1.6 in the control population). The cumulative incidence of arrhythmias in the total CHD population was slightly increased during childhood compared with the control population, but rose significantly hereafter, illustrated in Figure 1, yielding an overall risk of 10.5 (CI 95%: 9.8-11.2). Stratified by lesion severity, the risk for arrhythmias was 8.7 (CI 95%: 7.6-8.7) and 30.4 (CI 95%: 26.2-35.2) in patients with simple and complex lesions, respectively. Patients with simple CHD lesions displayed a risk of 7.7 (95% CI: 7.1-8.4) for supraventricular arrhythmias and 11.5 (95% CI: 9.2-14.5) for ventricular arrhythmias. Correspondingly, patients with complex CHD lesions displayed risks of 66.7 (95% CI: 42.7-104.2) and 28.9 (95% CI: 24.8-33.6). Conclusion Arrhythmias, irrespective of origin, are common in patients with CHD and correlate with lesion severity. The overall burden of arrhythmias increased significantly after childhood. Meticulous follow-up is vital in order to prevent, detect and treat arrhythmias as it might trigger clinical deterioration and even sudden cardiac death in patients with CHD.

Research on multi-stage rocket debris localization and recovery based on three-sphere localization

Advances in modern rocket technology have created challenges in the field of spaceflight with regard to the localization and recovery of rocket debris. In particular, in multi-stage rocket structures, transonic sonic booms are generated after the separation of the next stage or booster, which increases the difficulty of wreckage recovery. To solve this problem, a mathematical model based on multi-sensor data and three-sphere localization technique is proposed for accurately determining the location of the sonic boom point. The theoretical equations were constructed from monitoring equipment data and transformed into an optimization problem for numerical solution, and the longitude, latitude, altitude and time of the sonic boom birth were successfully determined. In addition, the localization and differentiation methods of multiple wrecks are studied, and the alignment and repeated verification strategies are used to improve the localization accuracy and reliability. Finally, the model validation is carried out by adding random perturbations, and the results show that the new model can still effectively locate the wreckage under a small range of perturbations, which provides an important support for the development of rocket wreckage recovery technology.

Evaluating Autism Risk Factors and Their Impact on Children in Thi-Qar, Iraq.

Background Autism is a neurodevelopmental disorder marked by difficulties in social communication, language, restricted interests, and repetitive behaviors. Aim This study aims to identify potential risk factors for autism among children and assess their effects on early developmental skills. Methods A case-control study was conducted from September 2022 to September 2023, involving 298 children with autism (265 boys, 33 girls) aged four to 12 from the Thi-Qar Autistic Children Center and private clinics in Iraq. A control group of 300 children (150 boys, 150 girls) was also included. Data were collected through a specialized questionnaire covering demographics, neonatal history (e.g., jaundice, birth asphyxia), parental age, and developmental skills (motor milestones, speech, handwriting). Results Among the 298 children with autism enrolled, 265 (89%) were boys and 33 (11%) were girls. Children with autism had a positive family history of autism in 207 (69%) compared to 15 (5%) in the control group (p < 0.001). Paternal age over 35 years at the time of birth was noted in 159 (53%) versus 75 (25%) for the control group (p < 0.001). Maternal age over 35 showed no significant difference (p = 0.23). Hypoxia at birth was present in 153 (51%) children with autism compared to 45 (15%) in the control group (p = 0.001). Significant developmental delays were observed, including speech defects in 210 (70%) children with autism versus 15 (5%) in controls (p < 0.001). In terms of handwriting, 240 (80%) children with autism demonstrated acceptable handwriting skills, while 60 (20%) did not, compared to 264 (88%) in the control group who achieved handwriting skills, resulting in a p-value of 0.23. Conclusions The findings indicate that boys are more affected than girls, with significant risk factors including family history, paternal age, and neonatal birth asphyxia. Children with autism demonstrated marked delays in motor skills and speech defects, emphasizing the need for early detection and intervention.

Fokker-Planck equation for the crystal-size probability density in progressive nucleation and growth with application to lognormal, Gaussian and gamma distributions

The Fokker Planck (FP) equation for the probability density function (PDF) of crystal size in phase transformations ruled by progressive nucleation and growth, has been derived. Crystals are grouped in sub-sets, we refer to as τ-crystals, where τ is the birth time of the set. It is shown that the size PDF is the superposition of the PDF of the crystal sub-sets (τ-PDFs), with weight given by the nucleation rate. The growth and diffusion coefficients entering the FP equations are estimated as a function of both τ-PDFs and nucleation rate. The functional form of these coefficients is studied for solutions of the FP equation for τ-crystals given by the lognormal, Gaussian and gamma distributions. For the first two distributions, the effect of fluctuations, nucleation rate and growth rate, on the shape of the distribution has been investigated. It is shown that for an exponential decay of the fluctuation term, the shape of the PDF is mainly governed by both the time constant for nucleation and the strength of the fluctuation. It is found that τ-PDFs given by the one-parameter gamma distributions are suitable to deal with KJMA (Kolmogorov Johnson Mehl Avrami) compliant phase transformations, where the fluctuation term is proportional to crystal size. The connection between the FP equation for the size PDF and the evolution equation for the density of crystal populations is also discussed.