Summary Background Stillbirths are a major public health issue and a sensitive marker of the quality of care around pregnancy and birth. The UN Global Strategy for Women's, Children's and Adolescents’ Health (2016–30) and the Every Newborn Action Plan (led by UNICEF and WHO) call for an end to preventable stillbirths. A first step to prevent stillbirths is obtaining standardised measurement of stillbirth rates across countries. We estimated stillbirth rates and their trends for 195 countries from 2000 to 2019 and assessed progress over time. Methods For a systematic assessment, we created a dataset of 2833 country-year datapoints from 171 countries relevant to stillbirth rates, including data from registration and health information systems, household-based surveys, and population-based studies. After data quality assessment and exclusions, we used 1531 datapoints to estimate country-specific stillbirth rates for 195 countries from 2000 to 2019 using a Bayesian hierarchical temporal sparse regression model, according to a definition of stillbirth of at least 28 weeks’ gestational age. Our model combined covariates with a temporal smoothing process such that estimates were informed by data for country-periods with high quality data, while being based on covariates for country-periods with little or no data on stillbirth rates. Bias and additional uncertainty associated with observations based on alternative stillbirth definitions and source types, and observations that were subject to non-sampling errors, were included in the model. We compared the estimated stillbirth rates and trends to previously reported mortality estimates in children younger than 5 years. Findings Globally in 2019, an estimated 2·0 million babies (90% uncertainty interval [UI] 1·9–2·2) were stillborn at 28 weeks or more of gestation, with a global stillbirth rate of 13·9 stillbirths (90% UI 13·5–15·4) per 1000 total births. Stillbirth rates in 2019 varied widely across regions, from 22·8 stillbirths (19·8–27·7) per 1000 total births in west and central Africa to 2·9 (2·7–3·0) in western Europe. After west and central Africa, eastern and southern Africa and south Asia had the second and third highest stillbirth rates in 2019. The global annual rate of reduction in stillbirth rate was estimated at 2·3% (90% UI 1·7–2·7) from 2000 to 2019, which was lower than the 2·9% (2·5–3·2) annual rate of reduction in neonatal mortality rate (for neonates aged <28 days) and the 4·3% (3·8–4·7) annual rate of reduction in mortality rate among children aged 1–59 months during the same period. Based on the lower bound of the 90% UIs, 114 countries had an estimated decrease in stillbirth rate since 2000, with four countries having a decrease of at least 50·0%, 28 having a decrease of 25·0–49·9%, 50 having a decrease of 10·0–24·9%, and 32 having a decrease of less than 10·0%. For the remaining 81 countries, we found no decrease in stillbirth rate since 2000. Of these countries...

A recent analysis from South Africa reported no association between age-disparate relationships and HIV-1 acquisition. We assessed the association between male partner age and HIV-1 acquisition among South African women participating in the VOICE trial. Of 4,077 women enrolled, 3,789 had complete data; 26% and 5% reported having a partner >5 and >10 years older at enrollment, respectively. Reporting a partner >5 years older (HR=1.00; 95% CI 0.74, 1.35) or >10 older (HR=0.92; 95% CI 0.49, 1.74) was not associated with HIV-1 acquisition. These data corroborate recent reports and may suggest a shift in local epidemiology of heterosexual HIV-1 transmission.

Intramolecular C–N heterocyclization and C–C bond formation under visible light irradiation at room temperature was accomplished with a metal-free photoredox catalyst.

Stillbirths are a public health issue as well as an example of the inequality of care during pregnancy and birth. Groups such as the UN Global Strategy for Women's, Children's, and Adolescents' Health and the Every Newborn Action Plan aim to prevent stillbirths. The first step toward this end is to gather standardized stillbirth rates across countries, although the rates of stillbirth are not often recorded in lower-and middle-income countries. This article gathers data from across countries to estimate stillbirth rates and their trends for 195 countries from the years 2000 to 2019 based on data from the UN Inter-agency Group for Child Mortality Estimation.To develop a systematic assessment, the researchers created a data set of 2833 country-year data points of their stillbirth rates from 171 countries. They then incorporated data on registration and health information systems, household-based surveys, and population-based studies. Stillbirth rates were extracted from nationwide administrative registration systems. Following this, the researchers used a Bayesian hierarchical temporal sparse regression model using 1531 data points to estimate country-specific stillbirth rates. Stillbirth rates were measured by at least 28 weeks' gestation. Estimated stillbirth rates were compared with previously reported mortality estimates in children younger than 5 years old.Through this research, the authors found that, in 2019, an estimated 2 million babies (90% uncertainty interval [UI], 1.9-2.2) were stillborn at 28 weeks or more of gestation, with a global stillbirth rate of 13.9 stillbirths (90% UI, 13.5-15.4) per 1000 total births. The greatest decrease in stillbirth rate was estimated in east Asia and the Pacific, with a 50.8% (45.1-55.9) decrease in rate, followed by Eastern ) and South ). In 2019, stillbirth rates differed among various regions, from 22.8 stillbirths (19.8-27.7) per 1000 total births in West and Central Africa to 2.9

A catalyst free visible light assisted synthesis of thiazoles and imidazo[2,1-b]thiazoles in EtOH : H2O green medium.

Visible light mediated, an eco-friendlier synthetic protocol for dihydropyrano[2,3-c]pyrazoles via catalyst-free and solvent-free conditions at room temperature.

One of the common agenda of underdeveloped economies is to achieve a high and sustainable level of economic growth in the long run. Domestic and external borrowings are playing a crucial role in fulfilling the resource gap in the context of Nepal for a long period. A growing number of recent studies support the idea of a debt threshold level (turning point) above which debt starts reducing economic growth. This paper empirically investigates the relationship between economic growth and several other factors (investment, trade openness, population growth, domestic savings, and government debt) in the context of Nepal. The debt-growth relationship has been estimated by regression analysis and further explored the non-linear relationship between public debt and economic growth using time series annual data for the period of 1976-2019. The ARDL bound technique has been applied to estimate the short-run and the long run impact of debt on economic growth. Moreover, a quadratic bivariate model based on ARDL coefficients has been estimated to identify the growth maximizing level of debt. The estimated parameters confirm the optimum public debt to GDP ratio in the context of Nepal is 33 per cent. The policy implication of this finding for the Government of Nepal (GoN) is to ensure public debt management in line with the growth maximizing debt threshold. Further, a high level of trade deficits and government effectiveness in public sector management squeezes the fiscal space in utilizing adequate public debt in Nepal.

Introduction In many African settings, women concurrently face substantial risk of human immunodeficiency virus type 1 ( HIV ‐1) infection, sexually transmitted infections ( STI s) and unintended pregnancies. Few studies have evaluated STI risk among users of hormonal implants and copper intrauterine devices ( IUD s) although these long‐acting reversible contraceptive methods are being promoted widely because of their benefits. Within a prospective study of women at risk for HIV ‐1, we compared the risk of acquisition of Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis among women using different contraceptive methods. Methods MTN ‐020/ ASPIRE was a randomized trial of the dapivirine vaginal ring for HIV ‐1 prevention among 2629 women aged 18 to 45 years from Malawi, South Africa, Uganda and Zimbabwe, of whom 2264 used copper IUD s or progestin‐based injectables or implants during follow‐up. Screening for the above STI s occurred semi‐annually. Results Over 3440 person‐years of follow‐up, 408 cases of C. trachomatis (incidence 11.86/100 person‐years), 196 of N. gonorrhoeae (5.70/100 person‐years) and 213 cases of T. vaginalis (6.19/100 person‐years) were detected. C. trachomatis and N. gonorrhoeae incidence were not significantly different across contraceptive methods. T. vaginalis incidence was significantly higher for copper IUD users compared to depot medroxyprogesterone acetate ( DMPA ), implant and norethisterone enanthate users. Conclusion Among African women at high HIV ‐1 risk, STI s were common. Risk of cervical infections did not differ across contraceptive methods. Significantly higher rates of T. vaginalis were observed among progestin‐based methods compared to copper IUD users. Overall, these findings call for more intensive routine screening for STI s, and they support current World Health Organization guidance that women should have a wide range of contraceptive options.