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• Average monthly EPI attendance reduced by 13.4% during the COVID interrupted period. • Average monthly immunizations were reduced by 38.3% during the interruption period. • Highest decline was observed in vaccines given early in infancy. • Reduced EPI attendance during the pandemic interruption period lasted only 3 months. • Mothers were comfortable to re-start EPI attendance with older than younger infants. The COVID-19 pandemic has affected the delivery of essential health services, such as routine immunization. We assessed the impact of the pandemic on the uptake of routine immunization in rural Gambia. We collected real-time vaccine administration data in the Basse and Fuladu West Health & Demographic Surveillance Systems from September 01, 2019, to December 31, 2020. We assessed the monthly number of Expanded Program on Immunization (EPI) clinic attendances and vaccines administered, comparing data during the baseline period (September 01, 2019–March 31, 2020), COVID-19 interruption period (April 01–June 30, 2020), initial recovery period (Jul 01–September 30, 2020) and the late recovery period (October 01–December 31, 2020). Compared to the baseline period, there was an overall average monthly decline of 13.4% in EPI attendance and 38.3% reduction in average monthly immunizations during the interruption period. This decrease was particularly noticeable for Bacille Calmette-Guérin (BCG) (47.2%), birth dose hepatitis B (Hep B) (46.9%), 1st dose pentavalent (Penta1) (43.1%), 1st dose pneumococcal conjugate vaccine (PCV1) (42.4%), and measles vaccines (15.5%). Comparing the late recovery to baseline period, average monthly EPI attendance was 5.3% higher, with 1.9% increase in average monthly immunizations. Monthly immunizations for BCG were 3.0% greater, 2.5% greater for Hep B, 22.7% greater for oral polio vaccine (OPV1), 2.0% less for Penta1, 19.2% less for Penta2, and 2.6% less for PCV1. The reduced EPI attendance during the pandemic interruption period lasted only 3 months. Significant recovery in EPI attendance occurred during the late recovery period, while rates of monthly immunization returned to pre-pandemic levels for most antigens. EPI programmes should implement strategies to deliver missed antigens when infants do present to EPI clinics, aware that missed doses may be age dependent. [ABSTRACT FROM AUTHOR]

We analyze hourly PM 2.5 (particles with an aerodynamic diameter of ≤2.5 μm) concentrations measured at the U.S. Embassy in Dhaka over the 2016–2021 time period and find that concentrations are seasonally dependent with the highest occurring in winter and the lowest in monsoon seasons. Mean winter PM 2.5 concentrations reached ∼165–175 μg/m3 while monsoon concentrations remained ∼30–35 μg/m3. Annual mean PM 2.5 concentration reached ∼5–6 times greater than the Bangladesh annual PM 2.5 standard of 15 μg/m3. The number of days exceeding the daily PM 2.5 standard of 65 μg/m3 in a year approached nearly 50%. Daily-mean PM 2.5 concentrations remained elevated (>65 μg/m3) for more than 80 consecutive days. Night-time concentrations were greater than daytime concentrations. The comparison of results obtained from the Community Multiscale Air Quality (CMAQ) model simulations over the Northern Hemisphere using 108-km horizontal grids with observed data suggests that the model can reproduce the seasonal variation of observed data but underpredicts observed PM 2.5 in winter months with a normalized mean bias of -13 to –32%. In the model, organic aerosol is the largest component of PM 2.5 , of which secondary organic aerosol plays a dominant role. Transboundary pollution has a large impact on the modeled PM 2.5 concentration in Dhaka, with an annual mean contribution of ∼40 μg/m3. • Daily mean PM 2.5 level in Dhaka exceeds 65 μg/m3 on 144 or more days per year. • A pollution episode in Dhaka can persist for more than 80 consecutive days. • Annual mean PM 2.5 concentration in Dhaka can reach nearly 100 μg/m3. • Organic aerosol is the largest component of PM 2.5 in Dhaka. • Annual mean contribution of transboundary pollution in Dhaka is ∼40 μg/m3. [ABSTRACT FROM AUTHOR]

The impact of the QCD critical point on the propagation of nonlinear waves has been studied. The effects have been investigated within the scope of second-order causal dissipative hydrodynamics by incorporating the critical point into the equation of state, and the scaling behavior of transport coefficients and of thermodynamic response functions. Near the critical point, the nonlinear waves are found to be significantly damped which may result in the disappearance of the Mach cone effects of the away side jet. Such damping may lead to enhancement in the fluctuations of elliptic and higher flow coefficients. Therefore, the disappearance of Mach cone effects and the enhancement of fluctuations in flow harmonics in the event-by-event analysis may be considered as signals of the critical endpoint. [ABSTRACT FROM AUTHOR]

• Estimating pandemic-related excess mortality in Sub-Saharan Africa entails additional challenges. • These include a lack of reliable death registration systems and limited testing capacity in most of Sub-Saharan Africa. • Time-series analysis of local health and demographic surveillance systems data may provide an opportunity to address the gap in information during pandemics. • Using The Gambia health and demographic surveillance systems, we show that there was little evidence of overall excess mortality in 2020. • However, excess mortality may have occurred among vulnerable age groups. Estimates for COVID-19-related excess mortality for African populations using local data are needed to design and implement effective control policies. We applied time-series analysis using data from three health and demographic surveillance systems in The Gambia (Basse, Farafenni, and Keneba) to examine pandemic-related excess mortality during 2020, when the first SARS-CoV-2 wave was observed, compared to the pre-pandemic period (2016-2019). Across the three sites, average mortality during the pre-pandemic period and the total deaths during 2020 were 1512 and 1634, respectively (Basse: 1099 vs 1179, Farafenni: 316 vs 351, Keneba: 98 vs 104). The overall annual crude mortality rates per 100,000 (95% CI) were 589 (559, 619) and 599 (571, 629) for the pre-pandemic and 2020 periods, respectively. The adjusted excess mortality rate was 8.8 (-34.3, 67.6) per 100,000 person-month with the adjusted rate ratio (aRR) = 1.01 (0.94,1.11). The age-stratified analysis showed excess mortality in Basse for infants (aRR = 1.22 [1.04, 1.46]) and in Farafenni for the 65+ years age group (aRR = 1.19 [1, 1.44]). We did not find significant excess overall mortality in 2020 in The Gambia. However, some age groups may have been at risk of excess death. Public health response in countries with weak health systems needs to consider vulnerable age groups and the potential for collateral damage. [Display omitted] [ABSTRACT FROM AUTHOR]

• Sustained use of clean fuel for cooking reduced household air pollution (HAP). • Exclusive LPG use for 26 months reduced personal PM 2.5 and CO exposure. • Sustained reductions in HAP decreased CD8+T, T regulatory and CD19+B cells. • Reduced HAP exposure increased CD4+T cells, plasmablasts, early & memory B cells. We conducted a clean fuel intervention trial (Bangladesh Global Environmental and Occupational Health (GEOHealth) (NCT02824237) with liquefied petroleum gas (LPG) for 26 months among rural Bangladeshi women chronically exposed to household air pollution (HAP) from biomass fuel (BMF) use. We aimed to evaluate the effect of HAP reduction following LPG intervention on immune response outcome. We supplied LPG cook stove and refills in cylinder in 200 households for 26 months. We measured personal exposure to HAP [particulate matter 2.5 (PM 2·5), black carbon (BC) and carbon monoxide (CO)] in 200 women (main cook) by personal monitors at pre- and post-intervention. Immune function was assessed before and after intervention, in blood collected within 2 weeks of HAP measurements. Primary endpoints included reduction in HAP, lymphocyte proliferation and oxidative stress response, and alterations in T and B cell proportions. Exclusive LPG use for 26 months resulted in significant reduction in PM 2·5 (43.5%), BC (13%) and CO (48%) exposure in the women. For one unit decrease in BC, Treg cells and memory B cells increased by 7% and 34% respectively, in the peripheral circulation. One unit decrease in CO was significantly associated with increase in early B cells and plasmablasts by 66% and 5% respectively. For one unit decrease in BC, percent-dividing cells, proliferation and expansion indices increased by 2%, 0.4%, and 1%, respectively. Reduced personal exposure to HAP through clean fuel intervention was related to a return towards cellular immune balance. [ABSTRACT FROM AUTHOR]

• Early childhood is a critical period for telomere biology. • Prior studies of urinary As and telomere length in children have had mixed findings. • We examined urinary As and telomere length in 5–7 year old Bangladeshi children. • Urinary As was associated with significant decreases in relative telomere length. • Arsenic exposure may be related to telomere shortening in early to mid-childhood. Telomere length has been associated with the occurrence and progression of common chronic and age-related diseases, and in younger populations, may represent a biomarker of disease susceptibility. Early childhood is a critical period for telomere biology as this period is characterized by a rapid decline in telomere length due to a large turnover of highly proliferative cells and may represent a period of unique sensitivity to environmental insults. Arsenic (As) exposure has been associated with both telomere lengthening and shortening in adults and children and some evidence suggests the effects may differ by level and timing of exposure. Given the lack of clarity across studies, we investigated the association between urinary As and leukocyte telomere length among 476 five- to seven-year-old children enrolled in the Bangladesh Environmental Research in Children's Health (BiRCH) cohort. In a series of multivariable models, adjusted for key covariates, we examined associations between urinary As and relative telomere length (RTL) of whole blood DNA. We observed small but consistent, negative associations between urinary As and RTL, such that a doubling of urinary As was associated with a −0.017 (95% CI: −0.030, −0.005; p = 0.0056) decrease in RTL, in fully adjusted models. We also observed a somewhat stronger inverse relationship between urinary As concentration and RTL among children born to fathers ≥ 30 years of age at the time of birth, than those < 30 years; however, we did not observe a statistically significant interaction. Our study suggests that As influences RTL, with detectable associations in early to mid-childhood. Further studies are needed to confirm our findings and investigate the potential long-term impacts of telomere shortening in childhood on later life health outcomes. Additional studies exploring how dose and timing of exposure may relate to RTL are critical to understanding As's relationship to telomere length. [ABSTRACT FROM AUTHOR]