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Manganese (Mn) toxicity and potassium (K) deficiency are the major factors that limit plant growth and development in acid soils. The objective of this study was to assess the role of high K on the alleviation of Mn toxicity in barley (Hordeum vulgare L. cv. `Minorimugi') grown in a phytotron for 14 d. Modified half-strength Hoagland- Anon solution (pH 5.5) was used as the medium. The treatments were (1) 0.25 μM Mn + 3 mM K (control); (2) 25 μM Mn + 3 mM K (Mn-toxic); and (3) 25 μM Mn + 30 mM K (K-alleviated). The Mn-toxic plants showed the symptoms of Mn toxicity and mild iron (Fe) deficiency, whereas in the K-alleviated plants such symptoms were absent. The K-alleviated plants had dry weight, chlorophyll content, and Fe concentration similar to that in the control plants, indicating that high K (30 mM) in the growth medium could alleviate Mn toxicity and Mn-induced Fe deficiency. Roots of plants fed separately with 54Mn and 59Fe in the presence of 3.0 and 30 mM K for 4 h were also studied. Results showed that high K could help in avoiding the accumulation of 54Mn, indicating that K plays an antagonistic role on Mn absorption by roots of barley and its subsequent translocation to the shoots. However, the absorption of 59Fe was not influenced by the high K concentration in a short-term experiment (4 h), indicating that high K does not affect short-term Fe absorption by the roots of barley plants. These results suggested that the alleviating effect of high K could be attributed to the antagonistic effect of K on Mn absorption by roots and translocation into shoots. [ABSTRACT FROM AUTHOR]

Purpose: We present a systematic literature review of dialogue agents for Artificial Intelligence (AI) and agent-based conversational systems dealing with cognitive disability of aged and impaired people including dementia and Parkinson's disease. We analyze current applications, gaps, and challenges in the existing research body, and provide guidelines and recommendations for their future development and use., Materials and Methods: We perform this study by applying Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. We performed a systematic search using relevant databases (ACM Digital Library, Google Scholar, IEEE Xplore, PubMed, and Scopus)., Results: This study identified 468 articles on the use of conversational agents in healthcare. We finally selected 124 articles based on their objectives and content as directly related to our main topic., Conclusion: We identified the main challenges in the field and analyzed the typical examples of the application of conversational agents in the healthcare domain, the desired characteristics of conversational agents, and chatbot support for aged people and people with cognitive disabilities. Our results contribute to a discussion on conversational health agents and emphasize current knowledge gaps and challenges for future research.IMPLICATIONS FOR REHABILITATIONA systematic literature review of dialogue agents for artificial intelligence and agent-based conversational systems dealing with cognitive disability of aged and impaired people.Main challenges and desired characteristics of the conversational agents, and chatbot support for aged people and people with cognitive disability.Current knowledge gaps and challenges for remote healthcare and rehabilitation.Guidelines and recommendations for future development and use of conversational systems.

Background: In Southeast Asia, tobacco use is a major public health threat. Tobacco users in this region may switch between or concurrently use smoked tobacco and smokeless tobacco (SLT), which makes effective tobacco control challenging. This study tracks transitions of use among different product users (cigarettes, bidis, and SLT) in Bangladesh, one of the largest consumers of tobacco in the region, and examines factors related to transitions and cessation., Methods: Four waves (2009-2015) of the International Tobacco Control (ITC) Bangladesh Survey with a cohort sample of 3245 tobacco users were analysed. Generalized Estimating Equations (GEE) models were used to explore the socioeconomic correlates of transitions from the exclusive use of cigarettes, bidis, or SLT to the use of other tobacco products or quitting over time., Findings: Among exclusive cigarette users, most remained as exclusive cigarette users (68.1%). However, rural smokers were more likely than urban smokers to transition to bidi use (odds ratio [OR] = 3.02, 95% confidence interval [CI] = 1.45-6.29); to SLT use (OR = 2.68, 95% CI = 1.79-4.02) and to quit tobacco (OR = 1.57, 95% CI = 1.06-2.33). Among exclusive bidi users, transitional patterns were more volatile. Fewer than half (43.3%) of the exclusive bidi users maintained their status throughout the waves. Those with higher socio-economic status (SES) were more likely to quit (OR = 4.16, 95% CI = 1.08-13.12) compared to low SES smokers. Exclusive SLT users either continued using SLT or quit with minimal transitions to other products (≤2%). Nevertheless, males were more likely to switch to other tobacco products; younger (OR = 2.94, 95% CI = 1.23-6.90 vs. older), more educated (OR = 1.55, 95% CI = 1.77-3.12 vs. less educated), and urban SLT users (OR = 0.52, 95% CI = 0.30-0.86 for rural vs. urban users) were more likely to quit., Interpretation: Complex transitional patterns were found among different types of tobacco product users over time in Bangladesh. These findings can inform more comprehensive and multi-faceted approaches to tackle diversified tobacco use in Bangladesh and neighbouring countries in the Southeast Asia region with similar tobacco user profiles of smoked tobacco and SLT products., Funding: This is an unfunded observational study with the use the ITC Bangladesh datasets. The ITC Bangladesh Surveys were supported by grants from the US National Cancer Institute (P01 CA138389), the International Development Research Centre (IDRC Grant 104831-003), and Canadian Institutes of Health Research (MOP-79551, MOP-115016)., Competing Interests: GTF has served as an expert witness or a consultant for governments defending their country's policies or regulations in litigation. All other authors have no conflicts of interest to declare. The authors alone are responsible for the views expressed in this article and they do not necessarily represent the views, decisions or policies of the institutions with which they are affiliated. No WHO fund is involved in developing this manuscript., (© 2023 The Author(s).)

Introduction: Transitions between different tobacco products are frequent among tobacco users in Bangladesh; however, the reasons leading to such transitions and why they quit are not well researched. The aim of the study is to examine perceptions and reasons reported by tobacco users in Bangladesh to transition to other products or quit., Methods: Data from four waves (2009-2015) of the International Tobacco Control (ITC) Bangladesh Survey were used. Repeated data on perceptions and reasons for exclusive cigarette (n=520), bidi (n=130), and SLT users (n=308) to either start using other products or quit were analyzed with sampling weights. The percentages of responses across waves were used to calculate the pooled proportion data using a meta-analysis approach., Results: Common reasonsig for respondents switching to other tobacco products were influence of friends/family (73.8-86.0%), and curiosity (44.4-71.3%). The perceived calming effect of smoking cigarettes and bidis (43.2-56.9%), and the impression that bidis were less harmful (52.3%) and taste better (71.2%) were major reasons for exclusive SLT users to switch products. Health concerns (16.5-62.7%) and disapproval from friends/family (29.8-56.4%) were generally the main reasons for quitting. For smoked tobacco users, doctor's advice (41.6%), package warning labels (32.3%), and price (32.4%) seemed to be the major driving factors to quit., Conclusions: Results highlight that the reasons for switching between tobacco products and quitting include social factors (e.g. friends/family) and (mis) perceptions regarding the products. Tobacco control policy could emphasize cessation support, increased price and education campaigns as key policies to reduce overall tobacco use in Bangladesh. Data from four waves (2009-2015) of the International Tobacco Control (ITC) Bangladesh Survey were used. Repeated data on perceptions and reasons for exclusive cigarette (n=520), bidi (n=130), and SLT users (n=308) to either start using other products or quit were analyzed with sampling weights. The percentages of responses across waves were used to calculate the pooled proportion data using a meta-analysis approach., Competing Interests: The authors have each completed and submitted an ICMJE form for disclosure of potential conflicts of interest. The authors declare that they have no competing interests, financial or otherwise, related to the current work. G.T. Fong and A.C.K. Quah report that since the initial planning of the work The ITC Bangladesh Surveys were supported by grants from the US National Cancer Institute (P01 CA138389), the International Development Research Centre (IDRC Grant 104831-003), and Canadian Institutes for Health Research (MOP-79551, MOP115016), and that they were supported by the Canadian Institutes for Health Research (FDN-148477). Furthermore, G.T. Fong reports that in the past 36 months he received a Senior Investigator Award from Ontario Institute for Cancer Research (IA-004)., (© 2023 Chen D.T.H. et al.)

Purpose: We propose a fuzzy analytic hierarchy process (AHP)-based risk priority number (RPN) method in failure modes and effects analysis (FMEA) to overcome the shortcomings of traditional RPN-based FMEA. Our research group has previously published the FMEA to mitigate the failure modes (FMs) for the commissioning process of a ring gantry LINAC. However, inter-relationships among FMs were observed in high ranked FMs due to a heavy reliance on imaging system., Methods: Fuzzy AHP was applied to determine relative weights of risk impacts based on inter-relationships among FMs. Since the time sequence dependency is a major factor for risk factors, a hierarchical structure of AHP was used to reflect the directional impacts such as causal influence and feedback loop. Two fuzzy weighted RPNs, called (RPN W and FRPN W , were calculated depending on the input values of severity (S), occurrence (O), and probability of not being detected (D) from the evaluators. The RPN W used numerical values, whereas the fuzzy values were used for FRPN W . Both RPNs were calculated by multiplying the weighted O, S, and D using the fuzzy AHP method., Results: The differences between the two fuzzy RPN rankings are due to inherent fuzzy uncertainty and deviations in O, S, and D values submitted by the evaluators. Considering all results of traditional and fuzzy-based FMEA, the two most highly ranked FMs were identified: errors in determining the non-isocentric SSD and SSD from MV images because of the unique features of the ring gantry LINAC., Conclusion: This study has demonstrated the feasibility of the use of a fuzzy AHP-based RPN to perform comprehensive analysis and prioritization of FMs. The risk analysis using fuzzy AHP can be improved and/or refined based on the department's specific workflow and clinical preferences taking various priority weighting approaches into account., (© 2022 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, LLC on behalf of The American Association of Physicists in Medicine.)

Introduction: Smokeless tobacco (ST) remains poorly regulated in Bangladesh. This study describes the prevalence and trends of ST use in Bangladesh, presents ST-related disease burden, identifies relevant policy gaps, and highlights key implications for future policy and practice for effective ST control in Bangladesh., Methods: We analyzed secondary data from the two rounds (2009 and 2017) of The Global Adult Tobacco Survey, estimated ST-related disease burden, and conducted a review to assess differences in combustible tobacco and ST policies. In addition, we gathered views in a workshop with key stakeholders in the country on gaps in existing tobacco control policies for ST control in Bangladesh and identified policy priorities using an online survey., Results: Smokeless tobacco use, constituting more than half of all tobacco use in Bangladesh, declined from 27.2% (25.9 million) in 2009 to 20.6% (22 million) in 2017. However, in 2017, at least 16947 lives and 403460 Disability-Adjusted Life Years (DALYs) were lost across Bangladesh due to ST use compared to 12511 deaths and 324020 DALYs lost in 2010. Policy priorities identified for ST control have included: introducing specific taxes and increasing the present ad valorem tax level, increasing the health development surcharge, designing and implementing a tax tracking and tracing system, standardizing ST packaging, integrating ST cessation within existing health systems, comprehensive media campaigns, and licensing of ST manufactures., Conclusions: Our analysis shows that compared to combustible tobacco, there remain gaps in implementing and compliance with ST control policies in Bangladesh. Thus, contrary to the decline in ST use and the usual time lag between tobacco exposure and the development of cancers, the ST-related disease burden is still on the rise in Bangladesh. Strengthening ST control at this stage can accelerate this decline and reduce ST related morbidity and mortality., Competing Interests: The authors have each completed and submitted an ICMJE form for disclosure of potential conflicts of interest. The authors declare that they have no competing interests, financial or otherwise, related to the current work. J.S. Ahluwalia reports that a payment was made to his institution from National Institute of Health (NIH) in the past 36 months. K. Siddiqi reports that a research grant was paid to his institution (University of York) since the initial planning of the work, from National Institute for Health Research, a public interest body., (© 2021 Huque R. et al.)

Objectives: This study aimed at examining health sufferings of readymade garments (RMG) workers, the factors that affect their health sufferings, their healthcare seeking pattern, knowledge about health insurance and health related rights in Bangladesh., Methods: A cross-sectional study was conducted among 486 RMG workers recruited randomly from eight garments factories located on the periphery of Dhaka, Bangladesh. The prevalence of musculoskeletal pain, headache, fever and abdominal pain was estimated and multivariable logistic regression analysis was performed to examine association between these illnesses of workers and their socio-demographic characteristics and other work related information. We also explored their healthcare seeking patterns, knowledge about health insurance and health related rights., Results: The prevalence of musculoskeletal pain, headache, fever and abdominal pain was found to be 78.1%, 57.9%, 52.2% and 24.6%, respectively, among the RMG workers. Factors that increased the odds of: musculoskeletal pain were working for more than 10 h per day (adjusted odds ratio [AOR]: 2.3, 95% confidence interval [CI]: 1.1-4.7) and being female [AOR: 4.6, 95% CI: 2.0-10.6]; fever was living in slums [AOR: 1.9, 95% CI: 1.1-3.5]; and abdominal pain was being female [AOR: 3.6, 95% CI: 1.4-9.3]. The workers commonly reported visiting drug sellers in local pharmacies for reported illnesses. They also had better knowledge of health related rights but poor knowledge of health insurance., Conclusion: In order to address the overall health and well-being of the RMG workers, it is imperative to lay out a blueprint for a safe and healthy workplace., (© 2021 The Authors. Journal of Occupational Health published by John Wiley & Sons Australia, Ltd on behalf of The Japan Society for Occupational Health.)

The extent of tobacco cultivation remains substantially high in Bangladesh, which is the 12th largest tobacco producer in the world. Using data from a household survey of current, former, and never tobacco farmers, based on a multi-stage stratified sampling design with a mix of purposive and random sampling of households, this study estimated the financial and economic profitability per acre of land used for tobacco cultivation. The environmental effects of tobacco cultivation on land and water resources were estimated using laboratory tests of sample water and soil collected from tobacco-cultivating and non-tobacco cultivating areas. The study finds that tobacco cultivation turns into a losing concern when the opportunity costs of unpaid family labour and other owned resources, and the health effects of tobacco cultivation are included. Tobacco cultivation poses a significantly high environmental cost that causes a net loss to society. Nevertheless, the availability of unpaid family labour and the options of advanced credit as well as a buy back guarantee from the tobacco companies attract farmers to engage in and continue tobacco cultivation. Therefore, supply side interventions to curb the tobacco epidemic in Bangladesh need to address major drivers of tobacco cultivation to correct the wrong incentives and motivate tobacco farmers to switch to alternative livelihood options.

This study aimed to assess the concentrations of heavy metal ('lead (Pb)''cadmium (Cd)', and 'chromium (Cr)') in various brands of four types of tobacco products (zarda, gul, cigarettes, and bidi) as well as calculate toxicological risk as a lifetime cancer risk for Pb, Cd, and Cr. In smokeless tobacco products, the metal concentration ranged from 0.99 to 10.02 μg/g for Pb, 1.05-3.53 μg/g for Cd, and 1.23-7.29 μg/g for Cr, respectively. Metal concentrations in the smoke-based tobacco products ranged from 0.98 to 3.07 μg/g for Pb, 0.91-3.46 μg/g for Cd, 1.08-6.75 μg/g for Cr, respectively. When assuming a 100% transfer of these metals, the calculated lifetime cancer risk was found 'unacceptable' in 33 out of 35 tobacco samples which exceeded the U.S. Environmental Protection Agency (USEPA) benchmark of an 'acceptable' cancer risk range of 10E-4 to 10E-6. Our study demonstrated higher levels of Pb, Cd, and Cr in various tobacco products of Bangladesh compared to GOTHIATEK standard. This study shows the need for the development of industry standards and regulation for tobacco products to reduce the levels of heavy metals.

Rice plants grown on soils with elevated arsenic have been shown to have increased arsenic content in their grains. To gain a better understanding of the likelihood of high grain arsenic in rice grown in different soils, it is important to understand the factors affecting the bioavailability and mobility of arsenic. Paddy soils from six different physiographic regions of Bangladesh were collected, and diffusive gradients in thin-films (DGT) were used to assess the porewater and solid phase arsenic. While significant differences were identified in total soil arsenic (1.4-9.8mg/kg), porewater arsenic ( As C soln ) (5.6-64.7μg/l), labile arsenic ( As C DGT ) (6.3-77.6μg/l), and solid phase pool of arsenic ( As K d ) (52-1057l/kg), importantly arsenic resupply capacity was not different between the physiographic regions. All soils had a high ratio of DGT to porewater arsenic (~1), this in conjunction with the porewater arsenic values and the high As K d values suggesting a large solid phase pool of arsenic capable of contributing towards the resupply/transport of the labile pool of arsenic in the soil porewater. This indicates that there is less difference in soil arsenic availability than might be predicted based solely on total soil arsenic content between the physiographic regions., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Despite the high prevalence of smokeless tobacco (SLT) use among adults in Bangladesh, SLT was not included in the Tobacco Control Law till 2013. Information on SLT use among Bangladeshi people is inadequate for policymaking and implementing effective control measures. With the aim to identify the prevalence and trends of different SLT products, health and economic impacts, manufacture, and sale of and policies related to SLT in Bangladesh, we carried out a literature review, which involved literature search, data extraction, and synthesis. Evidence suggests that in Bangladesh, SLTs range from unprocessed to processed or manufactured products including Sada Pata, Zarda, Gul, and Khoinee. Over 27% of Bangladeshi adults aged 15 years and older use SLT in one form or other. SLT use is associated with age, sex, education, and socioeconomic status. SLT consumption has reportedly been associated with increased prevalence of heart diseases, stroke, and oral cancer and led to around 320,000 disability adjusted life years lost in Bangladesh in 2010. No cessation service is available for SLT users in public facilities. Compared to cigarettes, taxation on SLT remains low in Bangladesh. The amendment made in Tobacco Control Law in 2013 requires graphic health warnings to cover 50% of SLT packaging, ban on advertisement of SLT products, and restriction to sale to minors. However, implementation of the law is weak. As the use of SLT is culturally accepted in Bangladesh, culturally appropriate public awareness program is required to curb SLT use along with increased tax and cessation services.

While the impact of arsenic in irrigated agriculture has become a major environmental concern in Bangladesh, to date there is still a limited understanding of arsenic in Bangladeshi paddy soils at a landscape level. A soil survey was conducted across ten different physiographic regions of Bangladesh, which encompassed six types of geomorphology (Bil, Brahmaputra floodplain, Ganges floodplain, Meghna floodplain, Karatoya-Bangali floodplain and Pleistocene terrace). A total of 1209 paddy soils and 235 matched non-paddy soils were collected. The source of irrigation water (groundwater and surface water) was also recorded. The concentrations of arsenic and sixteen other elements were determined in the soil samples. The concentration of arsenic was higher in paddy soils compared to non-paddy soils, with soils irrigated with groundwater being higher in arsenic than those irrigated with surface water. There was a clear difference between the Holocene floodplains and the Pleistocene terraces, with Holocene floodplain soils being higher in arsenic and other elements. The results suggest that arsenic is most likely associated with less well weathered/leached soils, suggesting it is either due to the geological newness of Holocene sediments or differences between the sources of sediments, which gives rise to the arsenic problems in Bangladeshi soils., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Besides dissolution, particle dispersion and mobilization can substantially contribute to element transfer from soils to waters. The dispersibility of the fine particulate and the associated potential losses of P and As from Bangladesh soils of the Ganges and Meghna floodplains have been evaluated with a simple dispersion test. The dispersible fraction was greater for the coarse-textured soils from the Meghna floodplain and increased with particle charge density. Particulate phosphorus (PP) and As (PAs) were the dominant forms in the dispersion, dissolved P and As being scarce to negligible. The PP and PAs were related to the amount of dispersed particulate, oxalate-extractable iron and, respectively, to the water-extractable P or phosphate-extractable As. Although reductive dissolution is reported as the main mechanism of As mobilization during prolonged monsoon flooding, the transfer in particulate form could potentially represent a major pathway for P and As transfer from soils to waters in oxic environments after sudden, extreme events. Since the frequency of extreme rainfall and floods is increasing because of the climate changes, and the intensified land cultivation is enhancing soil disturbance, larger contributions of particulate runoff to element migration from soils to waters could be expected in the future., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Intervertebral disc degeneration (IDD) is the leading cause of debilitating spinal disorders such as chronic lower back pain. Aging is the greatest risk factor for IDD. Previously, we demonstrated IDD in a murine model of a progeroid syndrome caused by reduced expression of a key DNA repair enzyme. This led us to hypothesize that DNA damage promotes IDD. To test our hypothesis, we chronically exposed adult wild-type (Wt) and DNA repair-deficient Ercc1(-/Δ) mice to the cancer therapeutic agent mechlorethamine (MEC) or ionization radiation (IR) to induce DNA damage and measured the impact on disc structure. Proteoglycan, a major structural matrix constituent of the disc, was reduced 3-5× in the discs of MEC- and IR-exposed animals compared to untreated controls. Expression of the protease ADAMTS4 and aggrecan proteolytic fragments was significantly increased. Additionally, new PG synthesis was reduced 2-3× in MEC- and IR-treated discs compared to untreated controls. Both cellular senescence and apoptosis were increased in discs of treated animals. The effects were more severe in the DNA repair-deficient Ercc1(-/Δ) mice than in Wt littermates. Local irradiation of the vertebra in Wt mice elicited a similar reduction in PG. These data demonstrate that genotoxic stress drives degenerative changes associated with IDD., (Published by Elsevier Ireland Ltd.)

A comparative study of arsenic enrichment in the Bengal Delta (BD) was carried out in three alluvial aquifers in south-central Bangladesh. Investigated sites included Sonargaon in Narayanganj, Chandina in Comilla and Sirajdikhan in Munshiganj districts. At all sites samples from different depths were collected, and water chemistry and redox status vs. depth trends were determined. The concentrations of DOC and HCO(3)(-) were highest at Sirajdikhan site, while at the Sonargaon and Chandina sites the concentrations were lower. On the contrary, the NH(4)(+) concentration was high at the Chandina site as compared to the other sites. There was a good match between dissolved As and Fe at the Sirajdikhan and Sonargaon sites, but not at the Chandina site. The dissolved aqueous concentration of Mn was low at the Chandina site, which suggested that the Mn(IV) redox buffering step was missing. Speciation modeling indicated a possibility of siderite precipitation at all sites, but precipitation of rhodochrosite only at the Sonargaon and Sirajdikhan sites. At the Sirajdikhan site, the log P(CO2) values were very high (-1.37), which revealed the production of CO(2) in redox processes. Principal component analysis (PCA) indicated an impact of sea water and redox status of different samples. These results suggest that the dissolved As is de-coupled from dissolved Mn because when released, As is re-adsorbed onto the Fe(III) minerals in solid phase, as well as from dissolved Fe when precipitation of Fe(II) minerals controls the aqueous concentrations of Fe. In addition, several other concurrent redox processes may exert kinetic constraints depending on refractory characteristics of Fe(III) minerals.

The bioavailability of arsenic (As) in the soil environment is largely governed by its adsorption-desorption reactions with soil constituents. We have investigated the sorption-desorption behaviour of As in four typical Bangladeshi soils subjected to irrigation with As-contaminated groundwater. The total As content of soils (160 samples) from the Laksham district ranged from <0.03 to approximately 43 mg kg(-1). Despite the low total soil As content, the concentration of As in the pore water of soils freshly irrigated with As-contaminated groundwater ranged from 0.01 to 0.1 mg l(-1). However, when these soils were allowed to dry, the concentration of As released in the pore water decreased to undetectable levels. Remoistening of soils to field moisture over a 10-day period resulted in a significant (up to 0.06 mg l(-1)) release of As in the pore water of soils containing >10 mg As kg(-1) soil, indicating the potential availability of As. In soils containing <5 mg As kg(-1), As was not detected in the pore water. A comparison of Bangladeshi soils with strongly weathered long-term As-contaminated soils from Queensland, Australia showed a much greater release of As in water extracts from the Australian soils. However, this was attributed to the much higher loading of As in these Australian soils. The correlation of pore water As with other inorganic ions (P, S) showed a strongly significant (P < 0.001) relationship with P, although there was no significant relationship between As and other inorganic cations, such as Fe and Mn. Batch sorption studies showed an appreciable capacity for both As(V) and As(III) sorption, with As(V) being retained in much greater concentrations than As(III).

The purpose of the study was to determine the concentration of trace elements present in scalp hair sample of schizophrenic patients and to find out the relationship between trace elements level and nutritional status or socioeconomic factors. The study was conducted among 30 schizophrenic male patients and 30 healthy male volunteers. Patients were recruited from Bangabandhu Sheikh Mujib Medical University by random sampling. Hair trace element concentrations were determined by flame atomic absorption spectroscopy and analyzed by independent t test, Pearson's correlation analysis, regression analysis, and analysis of variance (ANOVA). Mn, Zn, Ca, Cu, and Cd concentrations of schizophrenic patients were 3.8 +/- 2.31 microg/gm, 171.6 +/- 59.04 microg/gm, 396.23 +/- 157.83 microg/gm, 15.40 +/- 5.68 microg/gm, and 1.14 +/- 0.89 microg/gm of hair sample, while those of control subjects were 4.4 +/- 2.32 microg/gm, 199.16 +/- 27.85 microg/gm, 620.9 +/- 181.55 microg/gm, 12.23 +/- 4.56 microg/gm, and 0.47 +/- 0.32 microg/gm of hair sample, respectively. The hair concentration of Zn and Ca decreased significantly (p = 0.024; p = 0.000, respectively) and the concentration of Cu and Cd increased significantly (p = 0.021; p = 0.000, respectively) in schizophrenic patients while the concentration of Mn (p = 0.321) remain unchanged. Socioeconomic data reveals that most of the patients were poor, middle-aged and divorced. Mean body mass indices (BMIs) of the control group (22.26 +/- 1.91 kg/m(2)) and the patient group (20.42 +/- 3.16 kg/m(2)) were within the normal range (18.5-25.0 kg/m(2)). Pearson's correlation analysis suggested that only Ca concentration of patients had a significant positive correlation with the BMI (r = 0.597; p = 0.000) which was further justified from the regression analysis (R (2) = 44%; t = 3.59; p = 0.002) and one-way ANOVA test (F = 3.62; p = 0.015). A significant decrease in the hair concentration of Zn and Ca as well as a significant increase in the hair concentration of Cu and Cd in schizophrenic patients than that of its control group was observed which may provide prognostic tool for the diagnosis and treatment of this disease. However, further work with larger population is suggested to examine the exact correlation between trace element level and the degree of disorder.

Studies of organs in the thorax and abdomen have shown that these organs can move as much as 40 mm due to respiratory motion. Without compensation for this motion during the course of external beam radiation therapy, the dose coverage to target may be compromised. On the other hand, if compensation of this motion is by expansion of the margin around the target, a significant volume of normal tissue may be unnecessarily irradiated. In hypofractionated regimens, the issue of respiratory compensation becomes an important factor and is critical in single-fraction extracranial radiosurgery applications. CyberKnife is an image-guided radiosurgery system that consists of a 6-MV LINAC mounted to a robotic arm coupled through a control loop to a digital diagnostic x-ray imaging system. The robotic arm can point the beam anywhere in space with 6 degrees of freedom, without being constrained to a conventional isocenter. The CyberKnife has been recently upgraded with a real-time respiratory tracking and compensation system called Synchrony. Using external markers in conjunction with diagnostic x-ray images, Synchrony helps guide the robotic arm to move the radiation beam in real time such that the beam always remains aligned with the target. With the aid of Synchrony, the tumor motion can be tracked in three-dimensional space, and the motion-induced dosimetric change to target can be minimized with a limited margin. The working principles, advantages, limitations, and our clinical experience with this new technology will be discussed.

The purpose of this study was to evaluate the clinical implementation of tangential field IMRT using sliding window technique and to compare dosimetric parameters with 3-dimensional conformal radiation therapy (3DCRT). Twenty breast cancer patients were randomly selected for comparison of intensity modulated radiation therapy (IMRT)-based treatment plan with 3DCRT. Inverse treatment was performed using the sliding window technique, employing the Eclipse Planning System (version 7.1.59, Varian, Palo Alto, CA). The dosimetric parameters compared were V(95) (the percentage of target volume getting > or =95% of prescribed dose), V(105), V(110), and dose homogeneity index, DHI (percentage of target volume getting between 95% and 110% of prescribed dose). The mean V(95), DHI, V(105), and V(110) for target volume for IMRT vs. 3D were 90.6% (standard deviation [SD]: 3.2) vs. 91% (SD: 3.0), 87.7 (SD: 6.0) vs. 82.6 (SD: 7.8), 27.3% (SD: 20.3) vs. 49.4% (SD: 14.3), and 2.8 (SD: 5.6) vs. 8.4% (SD: 7.4), respectively. DHI was increased by 6.3% with IMRT compared to 3DCRT (p < 0.05). The reductions of V(105) and V(110) for the IMRT compared to 3DCRT were 44.7% and 66.3%, respectively (p < 0.01). The mean dose and V(30) for heart with IMRT were 2.3 (SD: 1.1) and 1.05 (SD: 1.5) respectively, which was a reduction by 6.8% and 7.9%, respectively, in comparison with 3D. Similarly, the mean dose and V(20) for the ipsilateral lung and the percentage of volume of contralateral volume lung receiving > 5% of prescribed dose with IMRT were reduced by 9.9%, 2.2%, and 35%, respectively. The mean of total monitor units used for IMRT and 3DCRT was about the same (397 vs. 387). The tangential field IMRT for intact breast using sliding window technique was successfully implemented in the clinic. We have now treated more than 1000 breast cancer patients with this technique. The dosimetric data suggest improved dose homogeneity in the breast and reduction in the dose to lung and heart for IMRT treatments, which may be of clinical value in potentially contributing to improved cosmetic results and reduced late treatment-related toxicity.

Arsenic contamination in groundwater in Bangladesh has become an additional concern vis-à-vis its use for irrigation purposes. Even if arsenic-safe drinking-water is assured, the question of irrigating soils with arsenic-laden groundwater will continue for years to come. Immediate attention should be given to assess the possibility of accumulating arsenic in soils through irrigation-water and its subsequent entry into the food-chain through various food crops and fodders. With this possibility in mind, arsenic content of 2,500 water, soil and vegetable samples from arsenic-affected and arsenic-unaffected areas were analyzed during 1999-2004. Other sources of foods and fodders were also analyzed. Irrigating a rice field with groundwater containing 0.55 mg/L of arsenic with a water requirement of 1,000 mm results in an estimated addition of 5.5 kg of arsenic per ha per annum. Concentration of arsenic as high as 80 mg per kg of soil was found in an area receiving arsenic-contaminated irrigation. A comparison of results from affected and unaffected areas revealed that some commonly-grown vegetables, which would usually be suitable as good sources of nourishment, accumulate substantially-elevated amounts of arsenic. For example, more than 150 mg/kg of arsenic has been found to be accumulated in arum (kochu) vegetable. Implications of arsenic ingested in vegetables and other food materials are discussed in the paper.

This paper depicts the spatial patterns of mortality of the administrative upazilas of Bangladesh. Due to the absence of adequate data on mortality rates from across the country, the mortality rates of the upazilas are calculated from the age sex structure of the population of the respective upazilas employing the standardized mortality rates of divisional headquarters. Crude death rates are used to determine spatial patterns of mortality in Bangladesh. The patterns portray strong regional differences. Such differentiation is accounted for by traditional differences in demographic and socio-economic factors. Also, regression analysis is used to assist in explaining spatial variations.