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Introduction: Dengue is a major public health concern in our country. The alarming thing is that the seasonal trend of dengue infection is changing with time in Bangladesh due to climate change and unplanned urbanization. Our study was conducted to determine the frequency of dengue virus infection among the febrile patients in 2018 at Dhaka Medical College Hospital (DMCH) and to observe the seasonal trend. Materials and Methods: The study was carried out on 899 febrile patients attended in DMCH from January to December, 2018. Whole blood samples were collected and sera were tested for dengue NS1 antigen and anti-dengue IgM antibodies using commercial test kits (NS1 by OMC Healthcare (Pvt.) Ltd & IgM antibody by Omega Diagnostics Ltd.), respectively. All negative dengue cases were tested for anti Chikungunya antibody to exclude chikungunya. Results: Of the total 899 febrile patients, 350(38.93%) were positive for Dengue infection. Out of them 264(75.43%) were positive for NS1, 82 (23.43%) were positive for IgM and 4 (1.14%) were positive for dengue NS1antigen + anti dengue IgM antibody. More than 50% patients belonged to age group 15-29 years. Males were predominant. More than 60% cases were detected in the post monsoon season. Conclusion: Highest dengue cases were detected in this year in comparison to the previous years probably due to re-emergence of DEN-3 serotype. Due to pattern of climate change, seasonal trend of dengue infection was not maintained. Moreover, unplanned urbanization and poor solid waste management have worsened the situation more. [ABSTRACT FROM AUTHOR]

Introduction: Dengue is now established as one of the most important Arboviral infection in tropical countries. As the epidemic continues worldwide, this Aedes mosquito-transmitted pathogen is considered a major re-emerging tropical disease and significant public health concern. The study was conducted to determine the sero-epidemiology and clinical picture of dengue virus infection among the clinically suspected patients attended in Dhaka Medical College Hospital during January to December 2016. Materials and Methods: The study was carried out on 145 clinically suspected Dengue patients attended in Dhaka Medical College Hospital from January to December 2016 who had fever with temperature >39°C. Blood sample was collected during acute febrile phase of patients and separated sera were tested for NS1 dengue antigen and IgM antibodies using commercial test kits (NS1 by OMC Healthcare (Pvt.) Ltd & IgM antibody by Omega Diagnostics Ltd.). Results: Of the total 145 patients 40 (27.6%) were positive for Dengue NS1 antigen and or IgM antibody test. Of the positive 40 patients, 18 (45%) were positive for NS1, 19 (47.5%) were positive for IgM and 3 (7.5%) were positive for both NS1 and IgM antibody. Major clinical manifestations were fever with arthralgia (79.5%) and retro-orbital pain (50%). Conclusion: Outbreak of Dengue fever is continuing every year and typical presentation of Dengue fever has changed. Arthralgia and retro orbital pain was the most common clinical feature in the present study instead of headache and rash with fever. A large number of suspected dengue cases were negative by Dengue tests for antigen NS1 and IgM antibody which suggests other organisms of similar clinical manifestations are becoming prevalent in Dhaka city. [ABSTRACT FROM AUTHOR]

Six marketed oral antidiabetic metformin tablets in Bangladesh have been studied for their drug content, release profile and glucose lowering capacities. This sort of study is a good indicator for in vivo evaluation of the quality of an oral antidiabetic preparation. Marketed preparations of metformin-HCl from different manufacturers were randomly chosen for this study. The drug content was within the United State Pharmacopoeia (USP) specified limit (95-105%) in all cases. The blood glucose levels were investigated in streptozotocin-induced diabetic rats (SIDRs) after 5 hours of single dose (110 mg/kg body weight) treatment of the products; significantly (p<0.05) reduced blood glucose level by 58.1, 53.2, 50.8, 77.0, 72.9 and 49.1%, respectively; which were consistent with antihyperglycemic effects of standard metformin-HCl (71.3%). All the products were found to be qualified in lowering blood glucose level. It may be inferred that the metformin-HCl tablets of Bangladeshi manufacturers complies with the standard specifications for drug contents, dissolution and antihyperglycemic properties. [ABSTRACT FROM AUTHOR]

Ethanolic extracts of some fruits of Cucurbitaceae family such as Cucumis sativus (cucumber), Lagenaria siceraria (white pumpkin), Luffa acutangula (ridge gourd), Benincasa hispida (ash gourd), Citrullus lanatus (sweet melon) and Cucarbita maxima (pumpkin) have been studied for their hypoglycemic effects on alloxan induced diabetic rats (AIDRs). Screening results suggested that among the tested fruits the hypoglycemic potency follows: cucumber > white pumpkin > ridge gourd. These three fruit-extracts were further investigated for their hypoglycemic, hypolipidemic and glycogenesis effects. Cucumber, white pumpkin and ridge gourd extracts reduced blood glucose level by 67, 65 and 51%, respectively at 12 hours after single intraperitoneal injection; while reduced the low density lipoprotein (LDL) level to 13, 28 and 86%, respectively in AIDRs. The maximum reduction 87% was observed by cucumber extract. Cucumber, white pumpkin and ridge gourd extracts reduced total cholesterol level to 29, 15 and 38%, respectively comparing with the diabetic control group. Here the maximum reduction of 85% was observed by white pumpkin extract. Cucumber, white pumpkin and ridge gourd also reduced triglyceride levels to 72, 68 and 80%, respectively. Maximum reduction of 32% was observed by white pumpkin. Significant improvement of glycogenesis was also observed by ridge gourd extracts in AIDRs. [ABSTRACT FROM AUTHOR]

The article presents a study on quantum monitoring of cellular metabolic activities in single mitochondria. It performs measurements on single isolated mitochondria. We were able to detect free radicals generated by individual mitochondria in either living cells or isolated mitochondria after stimulation or inhibition. It reports that , free radicals have short lifetimes and are highly reactive, making them difficult to measure using current methods.

Dengue virus (DENV) that caused an outbreak in Dhaka, Bangladesh during 2018 was analysed phylogenetically. DENV samples were classified into type 2-Cosmopolitan genotype (54%) and type 3-genotype I (46%), indicating co-circulation of two DENV types and resurgence of type 3 associated with genotype replacement. [ABSTRACT FROM AUTHOR]

Objective: We present a novel method for detecting atrial fibrillation (AFib) by analyzing Lead II electrocardiograms (ECGs) using a unique set of features., Methods: For this purpose, we used specific signal processing techniques, such as proper orthogonal decomposition, continuous wavelet transforms, discrete cosine transform, and standard cross-correlation, to extract 48 features from the ECGs. Thus, our approach aims to more effectively capture AFib signatures, such as beat-to-beat variability and fibrillatory waves, than traditional metrics. Moreover, our features were designed to be physiologically interpretable. Subsequently, we incorporated an XGBoost-based ECG classifier to train and evaluate it using the publicly available 'Training' dataset of the 2017 PhysioNet Challenge, which includes 'Normal,' 'AFib,' 'Other,' and 'Noisy' ECG categories., Results: Our method achieved an accuracy of 96 % and an F1-score of 0.83 for 'AFib' detection and 80 % accuracy and 0.85 F1-score for 'Normal' ECGs. Finally, we compared our method's performance with the top-classifiers from the 2017 PhysioNet Challenge, namely ENCASE, Random Forest, and Cascaded Binary. As reported by Clifford et al., 2017, these three best performing models scored 0.80, 0.83, 0.82, in terms of F1-score for 'AFib' detection, respectively., Conclusion: Despite using significantly fewer features than the competition's state-of-the-art ECG detection algorithms (48 vs. 150-622), our model achieved a comparable F1-score of 0.83 for successful 'AFib' detection., Significance: The interpretable features specifically designed for 'AFib' detection results in our method's adaptability in clinical settings for real-time arrhythmia detection and is even effective with short ECGs (<10 heartbeats)., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Cardiovascular diseases are currently the most common cause of death in developed countries. Due to lifestyle and environmental factors, this problem is only expected to increase in the future. Reactive oxygen species (ROS) are a key player in the onset of cardiovascular diseases but also have important functions in healthy cardiac tissue. Here, the interplay between ROS generation and cardiac mechanical forces is shown, and the state of the art and a perspective on future directions are discussed. To this end, an overview of what is currently known regarding ROS and mechanosignaling at a subcellular level is first given. There the role of ROS in mechanosignaling as well as the interplay between both factors in specific organelles is emphasized. The consequences at a larger scale across the population of heart cells are then discussed. Subsequently, the roles of ROS in embryogenesis, pathogenesis, and aging are further discussed, exemplifying some aspects of mechanoregulation. Finally, different models that are currently in use are discussed to study the topics above., (© 2024 The Author(s). Advanced Healthcare Materials published by Wiley‐VCH GmbH.)

Programmed cell death (PCD) is crucial for normal development and homeostasis. Our first insights into the genetic regulation of apoptotic cell death came from in vivo studies in the powerful genetic model system of C. elegans. More recently, novel developmental cell death programs occurring both embryonically and post-embryonically, and sex-specifically, have been elucidated. Recent studies in the apoptotic setting have also shed new light on the intricacies of phagocytosis in particular. This review provides a brief historical perspective of the origins of PCD studies in C. elegans, followed by a more detailed description of non-canonical apoptotic and non-apoptotic death programs. We conclude by posing open questions and commenting on our outlook on the future of PCD studies in C. elegans, highlighting the importance of advanced imaging tools and the continued leveraging of C. elegans genetics both with classical and modern cutting-edge approaches., Competing Interests: Declaration of Competing Interest The authors declare no competing interests., (Copyright © 2023. Published by Elsevier Ltd.)

There is increasing evidence of the post-COVID-19 suffering and decreased quality of life in the COVID-19 patients. This study aimed to assess the quality of life and associated factors of COVID-19 patients at one month after discharge from the hospital. This was a cross-sectional study that was conducted at the post-covid clinic of Dhaka Medical College Hospital (DMCH) where RT-PCR-confirmed adult COVID-19 recovered patients were enrolled one month after discharge from the same hospital. They were consecutively selected from January 01 to May 30. A pretested semi-structured questionnaire was used for the data collection for clinical variables. The generic multi-attributable utility instrument EQ-5D-5L was used for assessing health-related quality of life (HRQoL). A total of 563 patients were enrolled in the study. The patients had a mean age with standard deviation (±SD) of 51.18 (±13.49) years and 55.95% were male. The mean (SD) EQ-5D-5L index score and EQ-VAS scores were 0.78 (±0.19) and 70.26 (±11.13), respectively. Overall, 45.77%, 50.99%, 52.79%, 55.14% and 62.16% had problems (slight to extreme) in the mobility, self-care, usual activities, pain/discomfort and anxiety/depression dimensions, respectively. Patients aged ≥60 years had significant problem in mobility (odds ratio [OR] 3.24, 95% confidence interval [CI]: 1.07-9.77). Female participants were 5.50 times (95% CI: 2.22-13.62) more likely to have problems in their usual activities. In comparison to urban area, living in a peri-urban setting was significantly associated with problems in mobility (OR 1.89, 95% CI: 1.13-3.20), pain/discomfort (OR 1.82, 95% CI: 1.04-3.12) and anxiety/depression (OR 2.16, 95% CI: 1.22-3.84). Comorbid patients were 1.75 times (95% CI: 1.07-2.85) more likely to report problems in the pain/discomfort dimension. Presence of symptom(s) was associated with problems in self-care (OR 3.27, 95%CI: 1.31-8.18), usual-activity (OR 3.08, 95%CI: 1.21-7.87), pain/discomfort dimensions (OR 2.75, 95%CI: 1.09-6.96) and anxiety/depression (OR 3.35, 95%CI: 1.35-8.30). Specific management strategies should be planned to address the factors associated with low health-related quality of life in post-acute care of COVID-19 patients., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Hoque et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background The weight-for-height z-score (WHZ) is considered the gold standard for detecting acute malnutrition in children. However, an accurate assessment of WHZ can often be challenging, especially in community settings. Mid-upper arm circumference (MUAC) is a simple and easy-to-perform method to identify children with acute malnutrition. The objective of the study was to evaluate the accuracy of MUAC in detecting acute malnutrition compared to WHZ among children aged 6-59 months in Bangladesh. Methods We used anthropometric data for 239 children aged 6-59 months from a cross-sectional study conducted in 2013 in an urban slum in Dhaka, Bangladesh. The sensitivity and specificity of MUAC to detect acute malnutrition were calculated, considering WHZ as the gold standard. Results The mean age of the children was 29.4 ± 12.7 months, with a male-to-female ratio of 1:1.2. The prevalence of acute malnutrition was 17.1% and 22.5% based on WHZ and MUAC, respectively. The total area under the receiver operating characteristic curve was 0.816. For detecting acute malnutrition, the sensitivity of MUAC was 61.0% and the specificity was 85.4% for the World Health Organization (WHO) recommended cutoff of <125 mm. Using the Youden index, the best MUAC cutoff point to detect acute malnutrition was <128 mm with a sensitivity of 75.6% and a specificity of 74.7%. Conclusions Our study demonstrated a low sensitivity of MUAC to identify acute malnutrition at the WHO cutoff of <125 mm. The cutoff could be increased to <128 mm to capture more children with acute malnutrition., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Khan et al.)

Acetaminophen overdoses cause cell injury in the liver. It is widely accepted that liver toxicity is initiated by the reactive N -acetyl- para -aminophenol (APAP) metabolite N -acetyl- p -benzoquinone imine (NAPQI), which first depletes glutathione and then irreversibly binds to mitochondrial proteins and nuclear DNA. As a consequence, mitochondrial respiration is inhibited, and DNA strands break. NAPQI also promotes the oxidative stress since glutathione is one of the main free-radical scavengers in the cell. However, so far it is unknown where exactly free radicals are generated. In this study, we used relaxometry, a novel technique that allows nanoscale magnetic resonance imaging detection of free radicals. The method is based on fluorescent nanodiamonds, which change their optical properties based on their magnetic surrounding. To achieve subcellular resolution, these nanodiamonds were targeted to cellular locations, that is, the cytoplasm, mitochondria, and the nucleus. Since relaxometry is sensitive to spin noise from radicals, we were able to measure the radical load in these different organelles. For the first time, we measured APAP-induced free-radical production in an organelle-specific manner, which helps predict and better understand cellular toxicity.

Background: Diabetes mellitus (DM) is rising at a rapid rate worldwide. As a chronic, incurable metabolic disease, diabetes affects a person's life in all ways. Studies thus far have focused on the impact of diabetes on the physical and mental health of persons affected by the quality of life (QoL). This study aimed to explore the whole range of QoL deficits using the World Health Organization Quality of Life brief version (WHOQOL-BREF) in type-2 diabetic patients., Methods: This cross-sectional study was carried out among individuals aged at or above 15 years with type 2 diabetes (T2DM). Patients with prior mental health illness and unwillingness to give consent were excluded. A pretested structured questionnaire including the 26-item WHOQOL-BREF questionnaire was used for face-to-face interviews. Appropriate ethical measures were ensured. All statistical analyses were carried out using the statistical software STATA (Version 16.1). Graphs were created using R (Version 4.0.0)., Results: A total of 500 T2 DM patients with a mean age of 55.8 ± 13.2 years (± SD) and a female proportion of 50.8% were included. Overall, 22.2% of participants rated their QoL as poor, and 25% were dissatisfied with their health (as assessed by questions 1 and 2 of the WHOQOL-BREF questionnaire). More than half (54% and 51.2%, respectively) had an average evaluation of their QoL and health. The QoL scores were below average, with mean scores (± SD) for the physical health, psychological, social relationship, and environmental domains of 37.2 ± 20.5, 44.2 ± 21.0, 39.6 ± 23.2, and 41.6 ± 19.5, respectively. Multiple regression analysis revealed that the patient's level of education and monthly family income were significant positive modifiers and that complications (nephropathy, retinopathy, and peripheral artery disease) were significant negative determinants of the QoL score in different domains., Conclusion: This study found the overall quality of life among T2DM patients below average. Health authorities and clinicians should take these findings into account and incorporate necessary measures to ameliorate negative modifiers of the quality of life of sufferers., (© 2022. The Author(s).)

Free-radical generation is suspected to play a key role in cardiovascular diseases. Another crucial factor is shear stress. Human umbilical vein endothelial cells (HUVECS), which form the lining of blood vessels, require a physiological shear stress to activate many vasoactive factors. These are needed for maintaining vascular cell functions such as nonthrombogenicity, regulation of blood flow, and vascular tone. Additionally, blood clots form at regions of high shear stress within a blood vessel. Here, we use a new method called diamond magnetometry which allows us to measure the dynamics of free-radical generation in real time under shear stress. This quantum sensing technique allows free-radical detection with nanoscale resolution at the single-cell level. We investigate radical formation in HUVECs in a microfluidic environment under different flow conditions typically found in veins and arteries. Here, we looked into free-radical formation before, during, and after flow. We found that the free-radical production varied depending on the flow conditions. To confirm the magnetometry results and to differentiate between radicals, we performed conventional fluorescent reactive oxygen species (ROS) assays specific for superoxide, nitric oxide, and overall ROS.

Ethnopharmacological Relevance: Tabebuia pallida (Lindl.) Miers (T. pallida) is a well-known native Caribbean medicinal plant. The leaves and barks of T. pallida are used as traditional medicine in the form of herbal or medicinal tea to manage cancer, fever, and pain. Moreover, extracts from the leaves of T. pallida showed anticancer activity. However, the chemical profile and mechanism of anticancer activity of T. pallida leaves (TPL), stem bark (TPSB), root bark (TPRB) and flowers (TPF) remain unexplored., Aim of the Study: The present study was designed to explore the regulation of apoptosis by T. pallida using Ehrlich Ascites Carcinoma (EAC) cultured cells and an EAC mouse model. LC-ESI-MS/MS was used for compositional analysis of T. pallida extracts., Materials and Methods: Dried and powdered TPL, TPSB, TPRB and TPF were extracted with 80% methanol. Using cultured EAC cells and EAC-bearing mice with and without these extracts, anticancer activities were studied by assessing cytotoxicity and tumor cell growth inhibition, changes in life span of mice, and hematological and biochemical parameters. Apoptosis was analyzed by microscopy and expression of selected apoptosis-related genes (Bcl-2, Bcl-xL, NFκ-B, PARP-1, p53, Bax, caspase-3 and -8) using RT-PCR. LC-ESI-MS analysis was performed to identify the major compounds from active extracts. Computer aided analyses was undertaken to sort out the best-fit phytoconstituent of total ten isolated compounds of this plant for antioxidant and anticancer activity., Results: In EAC mice compared with untreated controls, the TPL extract exhibited the highest cancer cell toxicity with significant tumor cell growth inhibition (p < 0.001), reduced ascites by body weight (p < 0.01), increased the life span (p < 0.001), normalized blood parameters (RBC/WBC counts), and increased the levels of superoxide dismutase and catalase. TPL-treated EAC cells showed increased apoptotic characteristics of membrane blebbing, chromatin condensation and nuclear fragmentation, and caspase-3 activation, compared with untreated EAC cells. Moreover, annexin V-FITC and propidium iodide signals were greatly enhanced in response to TPL treatment, indicating apoptosis induction. Pro- and anti-apoptotic signaling after TPL treatment demonstrated up-regulated p53, Bax and PARP-1, and down-regulated NFκ-B, Bcl-2 and Bcl-xL expression, suggesting that TPL shifts the balance of pro- and anti-apoptotic genes towards cell death. LC-ESI-MS data of TPL showed a mixture of glycosides, lapachol, and quercetin antioxidant and its derivatives that were significantly linked to cancer cell targets. The compound, pelargonidin-3-O-glucoside was found to be most effective in computer aided models., Conclusions: In conclusion, the TPL extract of T. pallida possesses significant anticancer activity. The tumor suppressive mechanism is due to apoptosis induced by activation of antioxidant enzymes and caspases and mediated by a change in the balance of pro- and anti-apoptotic genes that promotes cell death., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background: The Royal College of Physicians recently introduced the 4AT (Alertness, Abbreviated Mental Test-4, Attention, and Acute change or fluctuating course) for screening cognitive impairment and delirium. Here, we examined the association of the 4AT with nutrition status in patients admitted to a hospital with hip fractures between January 1, 2016, and June 6, 2019., Methods: Nutrition status was assessed using the Malnutrition Universal Screening Tool, and the 4AT was assessed within 1 day after hip surgery. χ 2 Tests and logistic regression were conducted to assess the association of nutrition status with 4AT scores, adjusted for age and sex., Results: From 1082 patients aged 60-103 years, categorized into 4AT scores of 0, 1-3, or ≥4, the prevalence of malnutrition risk was 15.5%, 27.3%, and 39.6% and malnourishment was 4.1%, 13.2%, and 11.3%, respectively. Compared with the 4AT = 0 cohort, a 4AT score = 1-3 was associated with an increased malnutrition risk (odds ratio [OR], 2.3; 95% CI, 1.6-3.1) or malnourishment (OR, 3.6; 95% CI, 2.1-6.3). For a 4AT score ≥4, corresponding ORs were 4.0 (95% CI, 2.8-5.9) and 3.6 (95% CI, 1.9-6.8). Overall, there was a significant positive association: as 4AT scores increased, so did malnutrition risk., Conclusions: Among older adults admitted with hip fractures, high 4AT scores, which are suggestive of cognitive impairment and delirium, identified patients at increased malnutrition risk. These findings lend further support for the use of 4AT to identify patients who are at increased health risk., (© 2020 American Society for Parenteral and Enteral Nutrition.)

Successful delivery of fluorescent nanodiamonds (FNDs) into the cytoplasm is essential to many biological applications. Other applications require FNDs to stay within the endosomes. The diversity of cellular uptake of FNDs and following endosomal escape are less explored. In this article, we quantify particle uptake at a single cell level. We report that FNDs enter into the cells gradually. The number of internalized FNDs per cell differs significantly for the cell lines we investigated at the same incubation time. In HeLa cells we do not see any significant endosomal escape. We also found a wide distribution of FND endosomal escape efficiency within the same cell type. However, compared with HeLa cells, FNDs in HUVECs can easily escape from the endosomes and less than 25% FNDs remained in the vesicles after 4 h incubation time. We believe this work can bring more attention to the diversity of the cells and provide potential guidelines for future studies.

While the microenvironment is known to alter the cellular behavior in terms of metabolism, growth and the degree of endoplasmic reticulum stress, its influence on the nanoparticle uptake is not yet investigated. Specifically, it is not clear if the cells cultured in a microenvironment ingest different amounts of nanoparticles than cells cultured in a macroenvironment (for example a petri dish). To answer this question, here we used J774 murine macrophages and fluorescent nanodiamonds (FND) as a model system to systematically compare the uptake efficiency of cells cultured in a petri dish and in a microfluidic channel. Specifically, equal numbers of cells were cultured in two devices followed by the FND incubation. Then cells were fixed, stained and imaged to quantify the FND uptake. We show that the FND uptake in the cells cultured in petri dishes is significantly higher than the uptake in a microfluidic chip where the alteration in CO 2 environment, the cell culture medium pH and the surface area to volume ratio seem to be the underlying causes leading to this observed difference., (Copyright © 2020 Damle, Sharmin, Morita, Nie and Schirhagl.)

Background: the 4AT (Alertness, Abbreviated Mental Test-4, Attention and Acute change or fluctuating course), a tool to screen cognitive impairment and delirium, has recently been recommended by the Scottish Intercollegiate Guidelines Network. We examined its ability to predict health outcomes among patients admitted with hip fractures to a single hospital between January 2018 and June 2019., Methods: the 4AT was performed within 1 day after hip surgery. A 4AT score of 0 means unlikely delirium or severe cognitive impairment (reference group); a score of 1-3 suggests possible chronic cognitive impairment, without excluding possibility of delirium; a score ≥ 4 suggests delirium with or without chronic cognitive impairment. Logistic regression, adjusted for: age; sex; nutritional status; co-morbidities; polypharmacy; and anticholinergic burden, used the 4AT to predict mobility, length of stay (LOS), mortality and discharge destination, compared with the reference group., Results: from 537 (392 women, 145 men: mean = 83.7 ± standard deviation [SD] = 8.8 years) consecutive patients, 522 completed the 4AT; 132 (25%) had prolonged LOS (>2 weeks) and 36 (6.8%) died in hospital. Risk of failure to mobilise within 1 day of surgery was increased with a 4AT score ≥ 4 (OR = 2.4, 95% confidence interval [CI] = 1.3-4.3). Prolonged LOS was increased with 4AT scores of 1-3 (OR = 2.4, 95%CI = 1.4-4.1) or ≥4 (OR = 3.1, 95%CI = 1.9-6.7). In-patient mortality was increased with a 4AT score ≥ 4 (OR = 3.1, 95%CI = 1.2-8.2) but not with a 4AT score of 1-3. Change of residence on discharge was increased with a 4AT score ≥ 4 (OR = 3.1, 95%CI = 1.4-6.8). These associations persisted after excluding patients with dementia. 4AT score = 1-3 and ≥ 4 associated with increased LOS by 3 and 6 days, respectively., Conclusions: for older adults with hip fracture, the 4AT independently predicts immobility, prolonged LOS, death in hospital and change in residence on discharge., (© The Author(s) 2019. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Background: Host vulnerabilities associated with acute malnutrition could facilitate the ability of specific enteric pathogens to cause diarrhoea and associated mortality. Using data from the Global Enteric Multicenter Study, we assessed whether acute malnutrition modifies the association between common enteric pathogens and moderate-to-severe diarrhoea, and whether associations between enteric pathogens and death were modified by acute malnutrition., Methods: Children with moderate-to-severe diarrhoea and age-matched and community-matched controls were included in this post-hoc analysis if their mid-upper arm circumference had been measured and if they were older than 6 months of age. Acute malnutrition was defined as mid-upper arm circumference below 12·5 cm, capturing both severe acute malnutrition (<11·5 cm) and moderate acute malnutrition (≥11·5 cm and <12·5 cm). We tested whether acute malnutrition modified associations between enteric pathogens and moderate-to-severe diarrhoea in conditional logistic regression models. Among children with moderate-to-severe diarrhoea, Cox proportional hazards regression evaluated the modifying effect of acute malnutrition on the relationship between pathogens and 60-day fatality rate., Findings: The age, site, and co-infection adjusted odds ratios (aORs) for moderate-to-severe diarrhoea associated with typical enteropathogenic Escherichia coli among children aged 6-11 months was 2·08 (95% CI 1·14-3·79) in children with acute malnutrition, and 0·97 (0·77-1·23) in children with better nutritional status, compared with healthy controls. Enterotoxigenic E coli producing heat-stable toxin among children aged 12-23 months also had a stronger association with moderate-to-severe diarrhoea in children with acute malnutrition (aOR 7·60 [2·63-21·95]) than among similarly aged children with better nutritional status (aOR 2·39 [1·76-3·25]). Results for Shigella spp, norovirus, and sapovirus suggested they had a stronger association with moderate-to-severe diarrhoea than other pathogens among children with better nutritional status, although Shigella spp remained associated with moderate-to-severe diarrhoea in both nutritional groups. 92 (64%) of 144 children with moderate-to-severe diarrhoea who died had acute malnutrition. Pathogen-specific 60-day fatality rates for all pathogens were higher among children with acute malnutrition, but no individual pathogen had a significantly larger increase in its relative association with mortality., Interpretation: Acute malnutrition might strengthen associations between specific pathogens and moderate-to-severe diarrhoea. However, the strong link between acute malnutrition and mortality during moderate-to-severe diarrhoea in children is not limited to specific infections, and affects a broad spectrum of enteric pathogens. Interventions addressing acute malnutrition could be an effective way to lower the mortality of both childhood malnutrition and diarrhoea., Funding: The Bill & Melinda Gates Foundation., (Copyright © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)

Dengue virus (DENV) that caused an outbreak in Dhaka, Bangladesh during 2018 was analysed phylogenetically. DENV samples were classified into type 2-Cosmopolitan genotype (54%) and type 3-genotype I (46%), indicating co-circulation of two DENV types and resurgence of type 3 associated with genotype replacement., (© 2019 The Author(s).)

Household members of cholera patients are at a 100 times higher risk of cholera than the general population. Despite this risk, there are only a handful of studies that have investigated the handwashing practices among hospitalized diarrhea patients and their accompanying household members. To investigate handwashing practices in a hospital setting among this high-risk population, 444 hours of structured observation was conducted in a hospital in Dhaka, Bangladesh, among 148 cholera patients and their household members. Handwashing with soap practices were observed at the following key events: after toileting, after cleaning the anus of a child, after removing child feces, during food preparation, before eating, and before feeding. Spot-checks were also conducted to observe the presence of soap at bathroom areas. Overall, 4% (4/103) of key events involved handwashing with soap among cholera patients and household members during the structured observation period. This was 3% (1/37) among cholera patients and 5% (3/66) for household members. For toileting events, observed handwashing with soap was 7% (3/46) overall, 7% (1/14) for cholera patients, and 6% (2/32) for household members. For food-related events, overall observed handwashing with soap was 2% (2/93 overall), and 0% (0/34) and 3% (2/59) for cholera patients and household members, respectively. Soap was observed at only 7% (4/55) of handwashing stations used by patients and household members during spot-checks. Observed handwashing with soap at key times among patients and accompanying household members was very low. These findings highlight the urgent need for interventions to target this high-risk population., (© The American Society of Tropical Medicine and Hygiene.)

Background: MERS-CoV is a newly emerged human coronavirus reported closely related with HKU4 and HKU5 Bat coronaviruses. Bat and MERS corona-viruses are structurally related. Therefore, it is of interest to estimate the degree of conserved antigenic sites among them. It is of importance to elucidate the shared antigenic-sites and extent of conservation between them to understand the evolutionary dynamics of MERS-CoV., Results: Multiple sequence alignment of the spike (S), membrane (M), enveloped (E) and nucleocapsid (N) proteins was employed to identify the sequence conservation among MERS and Bat (HKU4, HKU5) coronaviruses. We used various in silico tools to predict the conserved antigenic sites. We found that MERS-CoV shared 30 % of its S protein antigenic sites with HKU4 and 70 % with HKU5 bat-CoV. Whereas 100 % of its E, M and N protein's antigenic sites are found to be conserved with those in HKU4 and HKU5., Conclusion: This sharing suggests that in case of pathogenicity MERS-CoV is more closely related to HKU5 bat-CoV than HKU4 bat-CoV. The conserved epitopes indicates their evolutionary relationship and ancestry of pathogenicity.

Background: Thousands of groundwater tube wells serving millions of Bangladeshis are arsenic contaminated. This study investigates the effect of these wells on the education attainment and school attendance of youths who rely on those wells for drinking water., Methods: The analysis combines data from the 2006 Bangladesh Multiple Indicator Cluster Survey (2006 MICS) and the National Hydrochemical Survey (NHS) of Bangladeshi tube wells' contamination conducted between 1998 and 2000. The study uses multiple regression analysis to estimate the differences in education attainment and school attendance among the following: (i) youths who live where tube wells are safe, (ii) youths who live where tube wells are unsafe but who report drinking from an arsenic-free source, and (iii) youths who live where tube wells are unsafe but who do not report drinking from an arsenic-free source., Results: Controlling for other determinants of education attainment and school attendance, young Bangladeshi males who live where tube wells are unsafe (by Bangladeshis standards) but who report drinking from arsenic-free sources are found to have the same education attainment (among 19- to 21-year-olds) and school attendance (among 6- to 10-year-olds), on average, as corresponding young Bangladeshi males who live where wells are safe. But young Bangladeshi males who live where tube wells are unsafe and who do not report drinking from an arsenic-free source attain, on average, a half-year less education (among 19- to 21-year-olds) and attend school, on average, five to seven fewer days a year (among 6- to 10-year-olds) than do other Bagladeshi males of those ages. The estimated effects for females are of the same sign but much smaller in magnitude., Conclusion: Bangladeshi public health measures to shift drinking from unsafe to safe wells not only advance good health but also increase males' education attainment.

Background: Coronaviruses are the diverse group of RNA virus. From 1960, six strains of human coronaviruses have emerged that includes SARS-CoV and the recent infection by deadly MERS-CoV which is now going to cause another outbreak. Prevention of these viruses is urgent and a universal vaccine for all strain could be a promising solution in this circumstance. In this study we aimed to design an epitope based vaccine against all strain of human coronavirus., Results: Multiple sequence alignment (MSA) approach was employed among spike (S), membrane (M), enveloped (E) and nucleocapsid (N) protein and replicase polyprotein 1ab to identify which one is highly conserve in all coronaviruses strains. Next, we use various in silico tools to predict consensus immunogenic and conserved peptide. We found that conserved region is present only in the RNA directed RNA polymerase protein. In this protein we identified one epitope WDYPKCDRA is highly immunogenic and 100% conserved among all available human coronavirus strains., Conclusions: Here we suggest in vivo study of our identified novel peptide antigen in RNA directed RNA polymerase protein for universal vaccine--which may be the way to prevent all human coronavirus disease.

In this paper, a phase-based direct average strain estimation method is developed. A mathematical model is presented to calculate axial strain directly from the phase of the zero-lag cross-correlation function between the windowed precompression and stretched post-compression analytic signals. Unlike phase-based conventional strain estimators, for which strain is computed from the displacement field, strain in this paper is computed in one step using the secant algorithm by exploiting the direct phase-strain relationship. To maintain strain continuity, instead of using the instantaneous phase of the interrogative window alone, an average phase function is defined using the phases of the neighboring windows with the assumption that the strain is essentially similar in a close physical proximity to the interrogative window. This method accounts for the effect of lateral shift but without requiring a prior estimate of the applied strain. Moreover, the strain can be computed both in the compression and relaxation phases of the applied pressure. The performance of the proposed strain estimator is analyzed in terms of the quality metrics elastographic signal-to-noise ratio (SNRe), elastographic contrast-to-noise ratio (CNRe), and mean structural similarity (MSSIM), using a finite element modeling simulation phantom. The results reveal that the proposed method performs satisfactorily in terms of all the three indices for up to 2.5% applied strain. Comparative results using simulation and experimental phantom data, and in vivo breast data of benign and malignant masses also demonstrate that the strain image quality of our method is better than the other reported techniques.

Dengue fever (DF) and dengue haemorrhagic fever (DHF) are now endemic in Bangladesh with outbreaks being reported quite frequently. This cross sectional study was done clinically suspected dengue patients were selected from different hospitals of Dhaka city, Bangladesh, from January 2008 to December 2008. The clinical features, risk factors and laboratory findings associated with dengue infection were investigated among 201 clinically suspected patients. Antibodies were detected in 137(68.2%) cases. Of these, 80(58.4%) were primary and 57(41.6%) as secondary dengue cases according to presence of dengue-specific IgM and/or IgG antibodies. Among primary cases, 70(87.5%) were DF and 10(12.5%) were DHF cases, in contrast to secondary cases, where 10(18.1%) were DF and 47(81.9%) were DHF cases. Majority (57.9%) of patients presented with Grade I and 42.1% had Grade II disease. Patients between 16-30 years were the most vulnerable age group (81.3% DF and 71.9% DHF patients). Males out-numbered females with 72.5% male vs. 27.5% female patients having DF and 68.4% male vs. 31.6% female patients having DHF. The monsoon period was the peak season for dengue infection. Headache and arthralgia were the most frequent symptoms in both DF and DHF, but vomiting was more common in DHF. The Tourniquet test was significantly positive among DHF than DF cases (p = 0.001). Platelet count was the only laboratory parameter that showed significantly higher values among DHF than DF cases (p = 0.001).

Attenuation is a key diagnostic parameter of tissue pathology change and thus may play a vital role in the quantitative discrimination of malignant and benign tumors in soft tissue. In this paper, two novel techniques are proposed for estimating the average ultrasonic attenuation in soft tissue using the spectral domain weighted nearest neighbor method. Because the attenuation coefficient of soft tissues can be considered to be a continuous function in a small neighborhood, we directly estimate an average value of it from the slope of the regression line fitted to the 1) modified average midband fit value and 2) the average center frequency shift along the depth. To calculate the average midband fit value, an average regression line computed from the exponentially weighted short-time Fourier transform (STFT) of the neighboring 1-D signal blocks, in the axial and lateral directions, is fitted over the usable bandwidth of the normalized power spectrum. The average center frequency downshift is computed from the maximization of a cost function defined from the normalized spectral cross-correlation (NSCC) of exponentially weighted nearest neighbors in both directions. Different from the large spatial signal-block-based spectral stability approach, a costfunction- based approach incorporating NSCC functions of neighboring 1-D signal blocks is introduced. This paves the way for using comparatively smaller spatial area along the lateral direction, a necessity for producing more realistic attenuation estimates for heterogeneous tissue. For accurate estimation of the attenuation coefficient, we also adopt a reference-phantombased diffraction-correction technique for both methods. The proposed attenuation estimation algorithm demonstrates better performance than other reported techniques in the tissue-mimicking phantom and the in vivo breast data analysis.

Unlabelled: Photocatalytic oxidation (PCO) is a promising technology for indoor air purification due to low operating cost, potentially long service life, and low maintenance. Ultraviolet light-emitting diode (UVLED) is a new concept in the field of PCO, which has several advantages over conventional UV light sources. Limited research has been conducted using UVLED PCO for air treatment. This study demonstrated the potential application of UVLED for the removal of volatile organic compounds (VOCs; toluene and xylene) from indoor air under different operating conditions including flow rate (25-117 cubic feet per minute [cfm]), types of catalysts (Degussa P25, sol-gel TiO2, nitrogen-doped TiO2, clay TiO2, and Bi2O3), LED intensity, and humidity in a continuous reactor. About 7-32% VOC removal occurred depending on the experimental conditions. The results show that UVLED can activate different types of photocatalysts effectively., Implications: This study demonstrates the effectiveness of UVLED in photocatalytic oxidation applied for indoor air cleaning. Several TiO2 catalysts (Degussa P25, sol-gel TiO2, nitrogen-doped TiO2, clay TiO2, and Bi2O3) were used in the reactor to characterize the removal performance of indoor air pollutants, for example, VOCs. This is one of the very few studies that have, to date, examined toluene and xylene removal from indoor air using these catalysts with UVLED in a continuous reactor. The intent is to develop an energy-efficient continuous reaction system to remove VOCs from indoor air. The performance of the system was characterized with respect to air flow rate, humidity, types of catalysts, and light intensity.

At concentrations above the critical micelle concentration, surfactants can significantly enhance the solubilization of residual nonaqueous phase liquids (NAPL) and, for this reason, are the focus of research on surfactant-enhanced aquifer remediation (SEAR). As a consequence of their amphiphilic nature, surfactants may also partition to various extents between the organic and aqueous phases, thereby affecting SEAR performance. We report here on the observation and analysis of the effect of surfactant partitioning on the dissolution kinetics of residual perchloroethylene (PCE) by aqueous solutions (1000 mg/L) of the non-ionic surfactant Triton X-100 in a model porous medium. For this fluid system, batch equilibration experiments showed that the surfactant partitions strongly into the NAPL (NAPL-water partition coefficient equal to 12.5). Dynamic interfacial tension (IFT) measurements were employed to study surfactant diffusion and interfacial adsorption. The dynamic IFT measurements were consistent with partitioning of the surfactant between the two liquid phases. PCE dissolution experiments, conducted in a transparent glass micromodel using an aqueous surfactant solution, were contrasted to experiments using clean water. Surfactant partitioning was observed to delay significantly the onset of micellar solubilization of PCE, an observation reproduced by a numerical model. This effect is attributed to the reduction of surfactant concentration in the immediate vicinity of the NAPL-water interface, which accompanies transport of the surfactant into the NAPL. Accordingly, it is suggested that both the rate and the extent of diffusion of the surfactant into the NAPL affect the onset of and the driving force for micellar solubilization. While many surfactants do not readily partition in NAPL, this possibility must be considered when selecting non-ionic surfactants for the enhanced solubilization of residual chlorinated solvents in porous media.