High Interest in the Use of mHealth Platform for HIV Prevention among Men Who Have Sex with Men in Nepal.

Mobile technology growth in Nepal offers promising opportunities for using mobile health (mHealth) interventions to facilitate HIV prevention efforts. However, little is known about access and utilization of communication technology and their willingness to use mHealth for HIV prevention services in Nepal. We conducted a cross-sectional respondent-driven sampling survey of 250 MSM in Kathmandu Valley of Nepal from October to December 2022. We collected information on participant characteristics, HIV risk-related behaviors, ownership, or access to and frequency of use of communication technology (phones, tablets, laptops, and computers), and willingness to use mHealth to access HIV prevention services. Descriptive, bivariate, and multivariate linear regression analyses were performed. Almost all participants had smartphones with the internet (231/250, 92.4%) and accessed the internet daily (219/250, 87.6%) on the smartphone (236/250, 94.4%). The median score for willingness to use mHealth for HIV prevention was 10 (IQR: 3 to 17). Willingness to use mHealth was higher among those participants with a high school or above education (β = 0.223, p = < 0.001), had experienced violence (β = 0.231, p = 0.006), and had moderate to severe depressive symptoms (β = 0.223, p = < 0.001). However, monthly income above NPR 20,000 (USD 150) (β= -0.153, p = 0.008), disclosure of their sexual orientation to anyone (β= -0.159, p = < 0.007), and worry about being negatively judged by health care workers (β= -0.136, p = 0.023) were less willing to use mHealth strategies. The findings from this study suggest that there is a high willingness for utilizing mHealth interventions for HIV prevention in MSM population who are at higher risk of HIV acquisition

Knowledge of Cardiopulmonary Resuscitation Among Interns Working at Kathmandu Medical College

Background: Cardiac arrest is a substantial public health problem estimated to account for 15-20% of all death. Cardiac arrest is one of the most common emergencies within the emergency department leading to serious and life threatening results which can be managed if medical and paramedical personnel working in the emergency department have adequate knowledge about cardiopulmonary resuscitation (CPR) and if they are well trained to administer it effectively.  Objective: To assess the knowledge, attitude and practice regarding CPR amongst interns in tertiary medical center of Nepal and comprehend the depth of knowledge about CPR and practice regarding defibrillation used during CPR. Methodology: This is a cross-sectional study carried out in Kathmandu Medical College Teaching Hospital  using a semi structured pretested questionnaire. We requested interns to answer the questionnaire, which included 25 questions to assess the knowledge of  BLS. Similarly, subjects were inquired about  the  attitude level questionnaire by the researcher and scoring was done accordingly.  We analyzed the statistics through frequency, percentage, mean and mean percentw. Results:  Out of 150 interns , regarding knowledge, on an average 11.71 questions were correctly answered. Highest score of 22 was scored by five participants and lowest of 5 scored by seven participants. Eleven questions were rightly answered by more than 50%. All the participants  agreed that resuscitation training need to  be added in the curriculum . . Conclusion: The present study identified the  attitude score was good however, knowledge score of BLS  was poor among medical interns.  BLS training should be the part of the MBBS curriculum to solve this very critical issue. The unconsolidated knowledge about resuscitation among the  interns is not adequate. This study  emphasizes the necessity for standardized systemic resuscitation program in the undergraduate curriculum and effort should be made to introduce an appropriate, efficient and effective course design

Occupational Health Problems, Workplace Environment and Utilization of Personal Protective Equipment among Welders of Banepa Municipality, Nepal

Introduction: Welding is a hazardous occupation where welders expose to a variety of work-related hazards. These hazards might cause occupational health problems. This study aimed to identify the prevalence of occupational health problems, workplace environment and utilization of personal protective equipment among welders.Methods: A descriptive cross-sectional study design was used for the study. Data was collected from purposively selected 130 welders of 35 metal workshops in Banepa Municipality in May-June, 2019. An observational checklist was used to collect information on the workplace environment of selected metal workshops. Data was analyzed by using Statistical Package for Social Sciences (SPSS) version 20 and described by using descriptive and inferential statistical methods.Results: The study identified that 129 welders (99.2%) experienced accidents and injuries followed by eye and ear problems (128, 98.4%). Amongst all personal protective equipment, protective goggles were available in all 35 metal workshops and insulated gloves in 25 workshops (71.4%). Similarly, 118 welders (90.6%) always used safety goggles, 53 (41%) sometimes used facemasks and 85 (65.4%) never used helmets while working. Only 9 workshops (25.7%) had first aid kits available with no expired products and 4 (11.4%) had kept fire extinguishers in easily accessible locations. Among 35, 34 workshops (97.1%) did not have safety guidelines for their workers.Conclusion: Welders who worked in metal workshops experience different types of occupational health problems (OHP) and do not use all types of PPE for their protection. Hence, metal workshops should develop safety guidelines for their workers and strictly implement them to prevent OHP

Effect of Different Organic and Inorganic Fertilizers on Spring Rice Var. (Hardinath 1) Production in Rural Gorkha, Nepal

The effect of different organic and inorganic fertilizers had a significant effect on the yield of spring rice. A field experiment was carried out to determine the effects of different organic and inorganic fertilizers on the yield of spring rice var Hardinath-1 at Siranchowk rural municipality-4, Gorkha during the spring season of 2021 with four replications and five treatments: T1[Recommended inorganic fertilizer Nitrogen, Phosphorous, and Potassium (@100:30:30 kg/ha)], T2[75% recommended inorganic fertilizer + 25% recommended organic fertilizer: i.e. (Farm Yard Manure (6 ton /ha)], T3(50% recommended inorganic fertilizer + 50% recommended organic fertilizer), T4(25% recommended inorganic fertilizer + 75% recommended organic fertilizer ), and T5 (Recommended organic fertilizer) using simple Randomized Complete Block Design with 3*3 m of individual plot size. A biometrical observation like plant height (95.33 cm), and the number of tillers (340.75/ m2) were found significantly highest on T2. Similarly, yield attributing characteristics like the number of effective tillers (315.75/m2), several filled grains per panicle (150.25), and highest panicle length (25.06 cm) were also significantly highest on T2. The highest grain yield (8.27 ton/ha), straw yield (12.14 ton/ha), and harvest index (0.40) were also observed on T2. Total net return was found highest on T2: 287330 Nepalese Rupees(NPR) incurring the cost of fertilizer Rs NPR 18940 per hectare returning the gross return of NPR 268390 per hectare. In conclusion, T2 was the best combination of other biofertilizer combinations. So, the spring rice productivity can be enhanced via the adoption of 75% recommended inorganic fertilizer + 25% recommended organic fertilizer in fertilizer management practice at Chorkate, Gorkha

Ewing sarcoma genomics and recent therapeutic advancements

Ewing sarcomas are highly heterogenous mesenchymal tumors that develop in bone or soft tissue and primarily affect children, teenagers, and young adults. After osteosarcoma, it is the second most common malignant bone sarcoma. Ewing sarcoma, metastatic and relapsed, typically have a poor prognosis and recurrences are frequent, leading to high rates of morbidity and mortality. The ongoing inability to increase overall survival for patients with ewing sarcoma emphasizes the critical requirement for the quick translation of emerging therapy approaches. Targeting the EWR1/FLI1 fusion protein, which is the primary genetic anomaly and master regulator of ewing sarcoma and found in 80–90% of instances of ewing tumors, is the most crucial objective. This review offers new insights into the genomics and proteomics of ewing sarcoma signaling and how it influences the tumor microenvironment and disease progression. It also elucidates how recent technological advancements have explained some of the underlying oncogenic characteristics of ewing sarcoma. The current review examined existing and potential experimental therapies that, by enhancing patient survival and quality of life, target multiple signaling pathways involved in the progression of ewing sarcoma. These therapies may one day replace current regimens as the new standard of care for patients

Stigma as a barrier and sex work as a protective factor for HIV testing among trans women in Nepal.

Stigma towards trans women in Nepal creates individual and system-level risks for HIV. A critical protective factor is access to HIV prevention. Research is needed to determine the impact of stigma on HIV testing among trans women in Nepal. We conducted a secondary analysis of data collected using respondent driven sampling in 2019 on HIV risk among trans women in Nepal. Data analysis was restricted to trans women who were HIV negative at testing through the parent study. Descriptive statistics, tests for bivariable associations between HIV testing and stigma variables, and binomial Poisson regression were conducted to examine HIV testing outcomes. There were 173 participants who tested negative for HIV in our sample. The majority were under age 35 (59%) and most had a grade school education or less (64.7%). No trans women were homeless and most rented a room (70.5%) or owned their home (19.7%). The majority were currently sex workers (57.8%). Almost all HIV-negative trans women had ever been tested for HIV (90.8%), but only 53.5% in the last 3 months. The most frequently cited reason for not having been tested was thinking they were at low risk for HIV (40.9%) and being afraid of receiving a positive test result (22.7%). HIV and anti-trans stigma were high across most measures, including that almost all (94.2%) believed that most people in Nepal would discriminate against people with HIV. And most participants thought trans women were not accepted in Nepali Society (65.9%). Most participants also reported high social support (70.5%). Social cohesion among participants varied, with most experiencing medium (41.6%) or high (33.5%) social cohesion. Just over half had high social participation (55.5%). Participants who reported current sex work had lower prevalence of not testing for HIV in the last 3 months (prevalence ratio, PR = 0.54, 95% confidence interval, 95%CI = 0.32-0.92, p = 0.02). Every one-unit increase in social cohesion was associated with 1.05 times the prevalence of not testing for HIV in the last 3 months (95%CI = 1.01-1.09, p-value = 0.02). Trans women who did sex work were more likely to be HIV tested while those who were more socially connected to peers were less likely to have recently been tested for HIV. HIV stigma may result in fear of social rejection from peers if one tests positive. Interventions that focus on addressing stigma within trans women's social networks and strategies to mitigate HIV stigma in society may result in increased frequency of HIV testing among trans women in Nepal

Suicidal ideation, plan, and attempt among men who have sex with men in Nepal: Findings from a cross-sectional study.

Men who have sex with men (MSM) are at increased risk for suicide, with a much higher prevalence of suicidality than the general population. While there is a growing interest in the identification of risk factors for suicidal behaviors globally, the understanding of the prevalence and risk factors for suicidal behaviors among MSM in the context of low- and middle-income countries is almost non-existent. Therefore, this study aimed to investigate suicidal ideation, plan, and attempts, and related factors among MSM in Nepal. A cross-sectional respondent driven survey was conducted on 250 MSM between October and December 2022. Bivariate and multivariable logistic regression was used to evaluate independent correlates of suicidal behaviors of MSM. Overall, the lifetime prevalence of suicidal ideation, plans, and attempts among MSM in this study were 42.4%, 31.2%, and 21.6%, respectively. MSM with depressive symptoms (aOR = 5.7, 95% CI = 2.4-14.1), advanced education (higher secondary and above; aOR = 2.9, 95% CI = 1.4-6.1), and smoking habit (aOR = 2.5, 95% CI = 1.2-5.3) were at increased risk for suicidal ideation. Similarly, those with depressive symptoms (aOR = 2.2, 95% CI = 1.1-4.8) and advanced education (aOR = 2.7, 95% CI = 1.2-5.7) were more likely to plan suicide, whereas young MSM were significantly more prone to attempting suicide (aOR = 2.7, 95% CI = 1.3-5.8). Interestingly, MSM with moderate to severe food insecurity were 2-3 times more likely to think about, plan, or attempt suicide (ideation: aOR = 3.5, 95% CI = 1.6-7.7; plan: aOR = 3.7, 95% CI = 1.6-8.3; attempt: aOR = 2.2, 95% CI = 1.1-4.6). The results suggest the importance of early assessment of suicidal behaviors among MSM and the need for tailored interventions to simultaneously address mental health problems and food insecurity to reduce suicide-related problems among Nepalese MSM

Population-based HIV prevalence, stigma and HIV risk among trans women in Nepal

BackgroundTransgender women (trans women) in Nepal are underserved in the HIV response. Data are needed to determine the HIV prevalence disaggregated from other key populations and to identify the particular risks faced by this community. Trans women are marginalized around the world and research is also needed to determine the impact of stigma on HIV risk to inform trans-specific interventions.MethodsIn 2019, we conducted the first population-based HIV behavioral surveillance study of trans women disaggregated from other key populations using respondent driven sampling (RDS). We estimated the HIV prevalence for trans women, and bivariate and multivariate Poisson binomial regression models were constructed to examine the relationship between HIV risk and stigma.ResultsTrans women participants (N = 200) had a mean age of 33 years old (SD = 10.96). We found a weighted HIV prevalence of 11.3% (95% CI 6·82% - 18·13). We found that depression and anxiety (aPR 0.81; 95% CI 0.67-0.97; p = 0·02) and current engagement in sex work (aPR 1.31; 95% CI 1.01-1.71; p = 0·046) were significantly associated with greater prevalence of condomless receptive anal intercourse. We found that experienced stigma of ever being verbally abused due to gender identity was significantly associated with lower prevalence of depression and anxiety (aPR 0.42; 95% CI 0.20-0.87; p = 0·002). Feeling unaccepted in Nepali society and believing people thought they were a criminal because of their trans identity was significantly associated greater prevalence of current sex work (aPR 1.36; 95% CI 1.03-1.78; p = 0·03; aPR 1.45; 95% CI 1.03-2.07; p = 0.04). Every measure of experienced stigma assessed was significantly associated with greater prevalence of current engagement in sex work.ConclusionsTrans women are highly stigmatized in Nepal, leading to individual and systems factors that impact their risk for HIV. Interventions are needed that support the economic and mental wellbeing of trans women to prevent their heighted risk of HIV from stigma

Assessment of genetic diversity, population structure, and gene flow of tigers (Panthera tigris tigris) across Nepal's Terai Arc Landscape.

With fewer than 200 tigers (Panthera tigris tigris) left in Nepal, that are generally confined to five protected areas across the Terai Arc Landscape, genetic studies are needed to provide crucial information on diversity and connectivity for devising an effective country-wide tiger conservation strategy. As part of the Nepal Tiger Genome Project, we studied landscape change, genetic variation, population structure, and gene flow of tigers across the Terai Arc Landscape by conducting Nepal's first comprehensive and systematic scat-based, non-invasive genetic survey. Of the 770 scat samples collected opportunistically from five protected areas and six presumed corridors, 412 were tiger (57%). Out of ten microsatellite loci, we retain eight markers that were used in identifying 78 individual tigers. We used this dataset to examine population structure, genetic variation, contemporary gene flow, and potential population bottlenecks of tigers in Nepal. We detected three genetic clusters consistent with three demographic sub-populations and found moderate levels of genetic variation (He = 0.61, AR = 3.51) and genetic differentiation (FST = 0.14) across the landscape. We detected 3-7 migrants, confirming the potential for dispersal-mediated gene flow across the landscape. We found evidence of a bottleneck signature likely caused by large-scale land-use change documented in the last two centuries in the Terai forest. Securing tiger habitat including functional forest corridors is essential to enhance gene flow across the landscape and ensure long-term tiger survival. This requires cooperation among multiple stakeholders and careful conservation planning to prevent detrimental effects of anthropogenic activities on tigers

Surveillance of Influenza A Virus and Its Subtypes in Migratory Wild Birds of Nepal

Nepal boarders India and China and all three countries lie within the Central Asian Flyway for migratory birds. Novel influenza A H7N9 caused human fatalities in China in 2013. Subclinical infections of influenza A H7N9 in birds and the potential for virus dispersal by migratory birds prompted this study to assess avian H7N9 viral intrusion into Nepal. Surveillance of influenza A virus in migratory birds was implemented in early 2014 with assistance from the Food and Agricultural Organization (FAO). Of 1811 environmental fecal samples collected from seven wetland migratory bird roosting areas, influenza A H9N2 was found in one sample from a ruddy shelduck in Koshi Tappu Wildlife Reserve located in southern Nepal. Avian H7N9 and other highly pathogenic avian influenza viruses were not detected. This study provides baseline data on the status of avian influenza virus in migratory bird populations in Nepal