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Abstract Background Globally, non-communicable diseases (NCDs) are increasingly the primary cause of mortality and morbidity among women. Like many developing countries, Bangladesh also faces a growing burden of NCDs. The “Multisectoral Action Plan for Prevention and Control of Non-communicable Diseases, 2018–2025” signifies Bangladesh’s commitment to comprehensively combating the rising burden of NCDs. This study investigates the perceptions of those involved in developing the action plan and if/how a gender lens was incorporated into its implementation. Methods In-depth interviews were conducted with 25 key individuals involved in a high-level committee to develop and implement Bangladesh’s multisectoral action plan to address the burden of NCDs. Data were collected between July and November 2021, and thematic analysis was conducted. Results The findings revealed that interviewees believed the multisectoral action plan adopted a population-wide approach without considering gender-specific needs. This study presents the explanations for this inattention under five themes: (1) A population-level approach to NCD prevention; (2) Understanding women’s health beyond reproductive health; (3) Absence of gender-specific programs; (4) Lack of consideration of gender constraints on physical activity; and (5) Lack of collaborative efforts to address NCDs beyond the health ministry. Conclusion In conclusion, governments in countries like Bangladesh can develop more effective strategies to reduce the disease burden of NCDs among women by recognizing and addressing the gendered nature of preventive health. This can be achieved by promoting gender-responsive research, programs, and policy initiatives that consider women’s specific health concerns, ultimately leading to better health outcomes for all.

In the present work, several new glycoconjugates (8a–e) were generated from glycopyranosyl-α-trichloroacetimidates (sugar-OTCA) as glycosyl donors and dimethyl-l-tartrate as an aglycone acceptor in good to excellent yields. In the synthetic protocol, various monosaccharides were transformed into pentaacetylated derivatives and then into glycopyranosyl-α-trichloroacetimidates. Afterward, the sugar-OTCA was reacted with dimethyl-l-tartrate using Schmidt’s trichloroacetimidate protocol to give the desired products. The newly synthesized glycoconjugates were characterized by FT-IR, 1H, and 13C-NMR spectroscopic analytical methods. All the target compounds (8a–e) were tested in vitro against various strains of bacteria and fungi at different concentrations. The results revealed that the target compounds had encouraging antibacterial and antifungal potential. The antileishmanial activity of the target compounds against Leishmania tropica promastigotes was also investigated. The in vitro results were further supported by the in silico docking study that indicated minimum values of the docking scores and binding energies for the resulting complexes obtained by the favorable interactions between the target compounds (8a–e) and the selected strains of bacteria and fungi. The docking results proposed promising antibacterial and antifungal activities of the target compounds (8a–e) against the selected bacterial and fungal species.

Objectives: To explore the burden of coronavirus disease 2019 (COVID-19) in Somalia by measuring the seroprevalence of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the general population. Methods: We recruited a convenience sample of 2751 participants from among individuals attending outpatient and inpatient departments of public health facilities, or their accompanying family members. Participants were interviewed to collect sociodemographic data and provided a blood sample. We calculated seropositivity rates overall and by sex, age group, state, residence, education and marital status. We used logistic regression analysis – odds ratios and 95% confidence intervals (CI) – to investigate sociodemographic correlates of seropositivity. Results: The overall seropositivity rate was 56.4% (95% CI 54.5–58.3%), while 8.8% of participants reported being previously diagnosed with COVID-19 by July 2021. In the regression analysis, after controlling for covariates, urban residence was significantly asscoiated with seropositivity: OR = 1.74 (95% CI: 1.19–2.55). Conclusions: Our results show a high seroprevalence rate of SARS-CoV-2 in the Somali population (56.4%), and indicate that many infections have not been captured by the country’s surveillance system resulting in considerable under-reporting.

The purpose of this study is to find out and analyze about electronic signatures application in manufacture of authentic deeds reviewed from Indonesia legislation perspective and the validity of authentic deed that signed electronically. The legal issue that will be examined in this paper is existance of law conflict between Article 15 paragraph (3) Law Number 2 of 2014 concerning amendment to Law Number 30 of 2004 concerning Notary Position with Article 5 Juncto Article 6 Juncto Article 11 of Law Number 19 of 2016 concerning amendment to Law Number 11 of 2008 concerning electronic information and electronic regarding the use of electronic signatures in authentic deeds. The type of research in this research is normative juridical law research. The approach used in this research is the law approach, phylosophical law approach, and conceptual approach. The results of this research show if there is no explicit explanation about notary authority to make deeds electronically. That makes electronic deeds including electronic signatures on it based on the concept of cyber notary didn’t have perfect evidentiary power. The application of electronic signatures is very closely related to electronic deeds. However, the deeds manufacture must be conducted in front of authorized official. Thus, the deeds were manufacture and signed electronically are not considered authentic deeds but privately made deed. Abstrak Penelitian ini bertujuan untuk mengetahui dan menganalisis mengenai penerapan tanda tangan elektronik dalam pembuatan akta otentik dri perspektif peraturan perundang-undangan di Indonesia dan keabsahan akta otentik yang ditanda tangani secara elektronik. Isu hukum yang akan diteliti dalam penelitian ini adalah adanya konflik hukum antara Pasal 15 ayat (3) Undang-Undang Nomor 2 Tahun 2014 tentang perubahan Undang-Undang Nomor 30 Tahun 2004 tentang Jabatan Notaris dengan Pasal 5 Juncto Pasal 6 Juncto Pasal 11 Undang-Undang 19 Tahun 2016 tentang Perubahan atas Undang-Undang Nomor 11 Tahun 2008 tentang Informasi dan Transaksi Elektronik mengenai penggunaan tanda tangan elektronik dalam akta otentik. Tipe penelitian dalam penelitian ini adalah yuridis normatif. Pendekatan yang digunakan dalam penelitian ini adalah Pendekatan Undang-Undang (Statute Approach), Pendekatan Filosofis (philosophical approach), Pendekatan Konseptual (Conseptual Approach). Adapun hasil dari penelitian ini menunjukan bahwa tidak ada penjelasan secara tegas tentang kewenangan notaris membuat akta secara elektronik. Hal itu mengakibatkan akta elektronik termasuk tanda tangan elektronik didalamnya berdasarkan konsep cyber notary tidak memiliki kekuatan pembuktian yang sempurna. Penerapan tanda tangan elektronik sangat erat hubungannya dengan akta elektronik. Akan tetapi pembuatan akta harus dilakukan dihadapan pejabat yang berwenang. Sehingga, akta yang dibuat dan ditandatangani secara elektronik tidak dianggap sebagai akta otentik melainkan akta dibawah tangan.

Bacteria form an intense portion of reading and learning for students enrolled in microbiology education. As a part of the foundational course outline of bacteriology, bacterial classification is a significant topic of discussion. The purpose of our study was to analyze whether bacterial classification can be taught with a phylogenetic tree approach that might be more engaging and beneficial to student learners of microbiology. This methodology is unique compared to the conventional approach applied in introductory lectures of bacteriology that relies on morphology and Gram-staining to classify bacteria. The participants of this study were students enrolled in a two-semester medical school bridge program that offers a Master's degree in Pre-clinical Sciences. We presented bacterial origin and classification in the light of evolution and used a phylogenetic tree to signify clinically relevant groups of bacteria. Students were also taught the traditional bacterial classification using Gram stains and morphology. Both methods of classification were delivered in a didactic classroom session considering equal time spent and utilizing the same format. An online survey was distributed to the students after the session to collect their feedback. The results from the survey showed that 74% of participants would prefer learning bacterial classification using a combined approach that includes both Gram-staining and morphology as well as the phylogenetic tree. When asked if the study of bacterial classification through an evolutionary tree diagram is a clear and concise way of understanding bacteria, 79% of the students either agreed or strongly agreed with this statement. Interestingly, the alternative phylogenetic tree approach was considered more engaging and regarded as a means to expand the clinical knowledge of bacteria by 78% and 71% of the students, respectively. Overall, our study strongly supports the use of tree-based classification as an additional method to improve the learning of medically important groups of bacteria at varying levels of education.

This research study focuses on the growing concern of academic misconduct in distance education courses. A quasi-experimental study was conducted to measure the impact of introducing webcam recording software as an online supervision tool for high-stakes exams in two separate online courses (Management and Accounting). Results revealed that overall performance decreased following implementation of the software, and persisted after taking potential confounding factors into account. Additionally, the explanatory power of the regression analysis was higher for scores under supervision, which suggests that cheating was occurring before online supervision was introduced. It can be concluded from this study that online supervision is an effective tool to combat academic dishonesty in distance education courses.

This study was conducted to find the relationship of test-anxiety, emotional intelligence and academic performance of public private sector university students. A sample of 388 students, 194 male and 194 females was drawn through convenient sampling from the Public and Private universities of Karachi in Pakistan, using a cross sectional design. Test anxiety was assessed through Westside Test Anxiety Scale and emotional intelligence was assessed using The Schutte Emotional Intelligence Scale. Performance of the last two semesters attended by the students was used to assess academic performance and demographic information was gathered through the demographic form. The "Pearson Product Correlation" was calculated to find the relation between test anxiety and emotional intelligence and academic performance. t-test for independent sample was used to obtain the differences in test-anxiety and emotional intelligence and gender in Public and Private sector university students' academic performance on the respective variables. The results revealed an inverse relationship between test-anxiety and emotional intelligence, academic performance. However, the results showed a positive relation between emotional intelligence and academic performance. Gender differences were found in test anxiety but not in emotional intelligence. The students of both the sectors differed in test anxiety, whereas both the groups did not differ on the scores of emotional intelligence. It is incumbent on educational institutes to provide psychological services to students who find it hard to handle exam situations in the same way as financial assistance is provided to those who need it.

Abstract Background Adolescent mothers (Girls aged 15–19) constitute 8% of annual global births, but account for 10% of annual maternal deaths. WHO recommended 4–8 Antenatal Care (ANC) visits, in addition to quality care and facility-based deliveries, are well-documented interventions to reduce maternal and child morbidity and mortality. Determinants of maternal and child health care in Bangladesh have received considerable attention, but less attention has been focused on adolescent mothers. This study explores the factors associated with 4 or more (4 +) ANC visits and facility-based delivery among adolescent mothers in one rural area of Bangladesh. Methods This study uses Health and Demographic Surveillance System (HDSS) data. We conducted a comparative study on trends in 4 + ANC visits and facility-based deliveries among adolescent mothers (10–19 years) residing in an intervention area (icddr,b service area, ISA) against a comparison area (government service areas, GSA) of HDSS between 2007 and 2015. Totally, 4,996 adolescent mothers were included in the final analysis. Binary logistic regression was used to document the statistical difference on outcome indicators in the two study areas. Results Trends in 4 + ANC visits and facility-based deliveries were higher in the ISA relative to the GSA. The adjusted odds of an adolescent mother accessing 4 + ANC visits in the GSA, relative to ISA, were 0.57 (95% CI 0.49–0.66, p value

BackgroundMobile phone surveys provide a novel opportunity to collect population-based estimates of public health risk factors; however, nonresponse and low participation challenge the goal of collecting unbiased survey estimates. ObjectiveThis study compares the performance of computer-assisted telephone interview (CATI) and interactive voice response (IVR) survey modalities for noncommunicable disease risk factors in Bangladesh and Tanzania. MethodsThis study used secondary data from a randomized crossover trial. Between June 2017 and August 2017, study participants were identified using the random digit dialing method. Mobile phone numbers were randomly allocated to either a CATI or IVR survey. The analysis examined survey completion, contact, response, refusal, and cooperation rates of those who received the CATI and IVR surveys. Differences in survey outcomes between modes were assessed using multilevel, multivariable logistic regression models to adjust for confounding covariates. These analyses were adjusted for clustering effects by mobile network providers. ResultsFor the CATI surveys, 7044 and 4399 phone numbers were contacted in Bangladesh and Tanzania, respectively, and 60,863 and 51,685 phone numbers, respectively, were contacted for the IVR survey. The total numbers of completed interviews in Bangladesh were 949 for CATI and 1026 for IVR and in Tanzania were 447 for CATI and 801 for IVR. Response rates for CATI were 5.4% (377/7044) in Bangladesh and 8.6% (376/4391) in Tanzania; response rates for IVR were 0.8% (498/60,377) in Bangladesh and 1.1% (586/51,483) in Tanzania. The distribution of the survey population was significantly different from the census distribution. In both countries, IVR respondents were younger, were predominantly male, and had higher education levels than CATI respondents. IVR respondents had a lower response rate than CATI respondents in Bangladesh (adjusted odds ratio [AOR]=0.73, 95% CI 0.54-0.99) and Tanzania (AOR=0.32, 95% CI 0.16-0.60). The cooperation rate was also lower with IVR than with CATI in Bangladesh (AOR=0.12, 95% CI 0.07-0.20) and Tanzania (AOR=0.28, 95% CI 0.14-0.56). Both in Bangladesh (AOR=0.33, 95% CI 0.25-0.43) and Tanzania (AOR=0.09, 95% CI 0.06-0.14), there were fewer completed interviews with IVR than with CATI; however, there were more partial interviews with IVR than with CATI in both countries. ConclusionsThere were lower completion, response, and cooperation rates with IVR than with CATI in both countries. This finding suggests that, to increase representativeness in certain settings, a selective approach may be needed to design and deploy mobile phone surveys to increase population representativeness. Overall, CATI surveys may offer a promising approach for surveying potentially under-represented groups like women, rural residents, and participants with lower levels of education in some countries.

Abstract Introduction In Bangladesh, to address the challenges of ensuring adequate human resources for health (HRH), the government began implementing a digital tool for HRH management in 2017. However, evidence suggests institutionalizing such tools in low-and-middle-income countries is impeded by policy aspects like implementation strategy and poor regulatory framework. Therefore, we aimed to explore factors in the current policy landscape that might facilitate and challenge the implementation of the tool in Bangladesh. Methods We conducted a review of policies related to ICT implementation and human resources management in the health sector in Bangladesh using qualitative content analysis method. Ten policies have been identified, and extensive reading was done to ascertain common themes and patterns. A document analysis matrix was developed to synthesize and help interpret the findings. Results Regarding facilitators, strong upstream level commitments were reflected in the content of policies in terms of setting out specific objectives, targets, timelines, and budget allocation. However, the lack of explicit monitoring strategy and extent of stakeholders’ engagement was not well-defined, ultimately creating chances for impeding downstream implementation. In addition, effective coordination among stakeholders and different HRH and ICT policies could be strengthened. Discussion Findings support the current discourse that national commitment plays a vital role in the integration of ICTs in health services. However, well-defined monitoring strategy and inter-ministry and intra-ministry policy coordination are crucial.

Abstract Background The impact of the unpredictable COVID-19 pandemic had triggered new challenges for mental health. This quick survey aimed to identify the mental health status of physicians who served the people during COVID-19 in Bangladesh. Methodology The cross sectional survey was conducted adopting a quantitative approach and using an online questionnaire through Facebook Platform Group. Data was collected from August-October, 2020, on socio-demographic status, information on COVID-19 and questionnaires about Depression Anxiety Stress Scale (DASS-21). A total of 395 participants were enrolled from all eight administrative divisions of Bangladesh. Result Our study reported a higher prevalence of depression (55.3%), anxiety (35.2%), and stress (48.4%) among 347 participants. Female physicians were found to have more stress (OR = 2.16, 95% CI: 1.09 – 4.30) compared to the male. Physicians who were previously diagnosed as mentally ill were found to be significantly more depressed (OR = 3.45, 95% CI: 1.07 – 11.10) and stressed (OR = 4.22, 95% CI: 1.48 – 12.02) compared to them who did not. Along with that, having a chronic disease, working in non-government and COVID hospitals significantly contributed to poor mental health outcomes. Conclusion The study findings denoted that, the mental health of physicians was deeply affected by the pandemic situation. The availability of appropriate mental health support will help foster resilience by giving them the ability and confidence to manage crisis moments like the COVID-19 pandemic.

Abstract Avian influenza is endemic in Bangladesh, where greater than 90% of poultry are marketed through live poultry markets (LPMs). We conducted a population-based cross-sectional mobile telephone survey in urban Dhaka, Bangladesh to investigate the frequency and patterns of human exposure to live poultry in LPMs and at home. Among 1047 urban residents surveyed, 74.2% (95% CI 70.9–77.2) reported exposure to live poultry in the past year, with the majority of exposure occurring on a weekly basis. While visiting LPMs was less common amongst females (40.3%, 95% CI 35.0–45.8) than males (58.9%, 95% CI 54.0–63.5), females reported greater poultry exposure through food preparation, including defeathering (13.2%, 95% CI 9.5–17.9) and eviscerating (14.8%, 95% CI 11.2–19.4) (p

Abstract Background Access to and utilization of health services have remained major challenges for people living in low- and middle-income countries, especially for those living in impaired public health environment such as refugee camps and temporary settlements. This study presents health problems and utilization of health services among Forcibly Displaced Myanmar Nationals (FDMNs) living in the southern part of Bangladesh. Methods A mixed-method (quantitative and qualitative) approach was used. Altogether 999 household surveys were conducted among the FDMNs living in makeshift/temporary settlements and host communities. We used a grounded theory approach involving in-depth interviews (IDIs), focus group discussions (FGDs), and key informant interviews (KIIs) including 24 IDIs, 10 FGDs, and 9 KIIs. The quantitative data were analysed with STATA. Results The common health problems among the women were pregnancy and childbirth-related complications and violence against women. Among the children, fever, diarrhoea, common cold and malaria were frequently observed health problems. Poor general health, HIV/AIDS, insecurity, discrimination, and lack of employment opportunity were common problems for men. Further, 61.2% women received two or more antenatal care (ANC) visits during their last pregnancy, while 28.9% did not receive any ANC visit. The majority of the last births took place at home (85.2%) assisted by traditional birth attendants (78.9%), a third (29.3%) of whom suffered pregnancy- and childbirth-related complications. The clinics run by the non-governmental organizations (NGOs) (76.9%) and private health facilities (86.0%) were the most accessible places for seeking healthcare for the FDMNs living in the makeshift settlements. All participants heard about HIV/AIDS. 78.0% of them were unaware about the means of HIV transmission, and family planning methods were poorly used (45.2%). Conclusions Overall, the health of FDMNs living in the southern part of Bangladesh is poor and they have inadequate access to and utilization of health services to address the health problems and associated factors. Existing essential health and nutrition support programs need to be culturally appropriate and adopt an integrated approach to encourage men’s participation to improve utilization of health and family planning services, address issues of gender inequity, gender-based violence, and improve women empowerment and overall health outcomes.

This study aims to investigate the most prevalent and unacceptable classroom behavioral issues among public secondary school students in the Islamabad Capital Territory (ICT). Moreover, the study identified the reasons for these problem behaviors and ways to address these behaviors. The sample of the study was twenty-three (23) teachers (Female: 14 & Male: 09) having minimum sixteen years of education along with professional qualification. Teachers have wide experience of teaching ranging from 10-32 years and teach students aged between thirteen to fifteen years. In this qualitative research data was collected through semi-structured individualized interviews after getting consent from the Federal Directorate of Education and from study participants. Through thematic analysis, the main themes emerged were "lack of attention, creating a disturbance in the class, disobedience, and display of aggressive behaviors." The key causes of classroom problem behaviors were "parenting style, teachers' attitude/teaching strategies, society, home environment, and social media." Moreover, teachers also think that "lack of counseling" and "character building" along with "outdated teaching strategies and a boring classroom environment" were causes behavioral problems in the class. Teachers should incorporate student-centered teaching with engaging techniques, parents should pay attention in developing good relationship with children at home. Moreover, counseling facilities about psychological issues of teenage students' needs to be provided at school level. The limited yet empirical data can form a logical foundation for management to create a policy document addressing these issues in schools, offering guidance for parents and teachers to tackle student challenges effectively. [Note: The page range (107-128) shown on the PDF is incorrect. The correct page range is 107-129.]

Abstract Background This is the first study to examine the costs of conducting a mobile phone survey (MPS) through interactive voice response (IVR) to collect information on risk factors for noncommunicable diseases (NCD) in three low- and middle-income countries (LMIC); Bangladesh, Colombia, and Uganda. Methods This is a micro-costing study conducted from the perspective of the payer/funder with a 1-year horizon. The study evaluates the fixed costs and variable costs of implementing one nationally representative MPS for NCD risk factors of the adult population. In this costing study, we estimated the sample size of calls required to achieve a population-representative survey and associated incentives. Cost inputs were obtained from direct economic costs incurred by a central study team, from country-specific collaborators, and from platform developers who participated in the deployment of these MPS during 2017. Costs were reported in US dollars (USD). A sensitivity analysis was conducted assessing different scenarios of pricing and incentive strategies. Also, costs were calculated for a survey deployed targeting only adults younger than 45 years. Results We estimated the fixed costs ranging between $47,000 USD and $74,000 USD. Variable costs were found to be between $32,000 USD and $129,000 USD per nationally representative survey. The main cost driver was the number of calls required to meet the sample size, and its variability largely depends on the extent of mobile phone coverage and access in the country. Therefore, a larger number of calls were estimated to survey specific harder-to-reach sub-populations. Conclusion Mobile phone surveys have the potential to be a relatively less expensive and timely method of collecting survey information than face-to-face surveys, allowing decision-makers to deploy survey-based monitoring or evaluation programs more frequently than it would be possible having only face-to-face contact. The main driver of variable costs is survey time, and most of the variability across countries is attributable to the sampling differences associated to reaching out to population subgroups with low mobile phone ownership or access.

Abstract It is difficult to match the causes of exclusion among two independent review authors after screening the title and abstract or full texts in systematic reviews. We have proposed the prioritization and sequential exclusion approach to reduce the subjectivity in reporting reasons for exclusion. This approach might reduce the burden of mismatched numbers while describing the cause of exclusion.

BACKGROUND: Finerenone, a nonsteroidal mineralocorticoid receptor antagonist, has emerged as a novel therapeutic option for the management of patients with diabetes, chronic kidney disease, or heart failure. We seek to summarize the evidence on the drugs effectiveness regarding cardiovascular (CV) outcomes. METHODS: We conducted a literature search of Pubmed, Cochrane CENTRAL, Embase, and ClinicalTrials.gov from inception to September 2024. Trials exploring the effects of finerenone on CV outcomes were extracted and analyzed. The results of pooled analyses were presented as risk ratios (RRs) with 95% confidence intervals (CIs). RESULTS: A total of eight trials, incorporating 21 200 patients, were included. The pooled analysis demonstrated a significant reduction in all-cause death (RR 0.92, 95% CI: 0.85-0.99), major adverse CV events (RR 0.85, 95% CI: 0.81-0.90), heart failure-related hospitalizations or unplanned hospital visits (RR 0.82, 95% CI: 0.76-0.87) with finerenone administration compared to control. Finerenone use was associated with a trend of reduced risk of CV death without reaching statistical significance (RR 0.90, 95% CI: 0.81-1.00). The risk of myocardial infarction (RR 0.91, 95% CI: 0.74-1.12), adverse events (RR 0.96, 95% CI: 0.89-1.03), adverse events leading to discontinuation (RR 1.06, 95% CI: 0.96-1.17) remained comparable across both groups. However, an increased risk of hyperkalemia (RR 2.07, 95% CI: 1.88-2.27) was observed with finerenone therapy compared to the control group. CONCLUSION: Finerenone administration was associated with improved CV outcomes in the CV-renmetabolic conditions compared to the control group.

PURPOSE: The outcomes of anti-PD-1 agents plus fluoropyrimidine/platinum in frontline advanced gastroesophageal adenocarcinomas (aGEAs) remain poor. We investigated the safety, tolerability, and activity of fluoropyrimidine/oxaliplatin and tislelizumab with the DKK1-neutralizing antibody DKN-01 in aGEAs in a phase IIa open-label study. PATIENTS AND METHODS: Patients had untreated human epidermal growth factor receptor 2-negative aGEAs, RECIST v1.1 measurable disease, Eastern Cooperative Oncology Group (ECOG) performance status 0-1, and adequate organ function. Patients received intravenous DKN-01 300 mg once every 2 weeks, tislelizumab 200 mg once every 3 weeks, oxaliplatin 130 mg/m2 once every 3 weeks, and capecitabine 1,000 mg/m2 twice daily on days 1-15 of each 21-day cycle. The primary end point was safety and tolerability. Key secondary end points included objective response rate (ORR) by RECISTv1.1, progression-free survival (PFS), and overall survival (OS). RESULTS: Between September 18, 2020, and April 8, 2021, 25 patients were enrolled. All patients who received at least one dose of DKN-01 were included in the safety analysis. Most patients had gastroesophageal junction tumors, median age was 61 years, 76% were male, and 55% were ECOG of 0. All patients reported at least one treatment-emergent adverse event. The ORR was 73% (95% CI, 49.8 to 89.3), with a disease control rate of 95%. The ORR was 90% (95% CI, 55.5 to 99.7) in the DKK1-high tumor patients and 67% (95% CI, 29.9 to 92.5) in the DKK1-low tumor patients. The median PFS was 11.3 months (95% CI, 5.8 to 12.0) and the 12-month PFS rate was 33%. The median OS was 19.5 months (95% CI, 15.2 to 24.4) with a 12-month OS rate of 76% and an 18-month OS rate of 55%. CONCLUSION: DKN-01 can be safely combined with frontline fluoropyrimidine/oxaliplatin and tislelizumab and demonstrates encouraging activity independent of PD-L1 expression levels. A randomized phase II trial is ongoing (ClinicalTrials.gov identifier: NCT04363801).

The relative performance of rhizobial strains could depend on their resource allocation, environmental conditions, and host genotype. Here, we used a high-throughput shoot phenotyping to investigate the effects of Mesorhizobium strain on the growth dynamics, nodulation and bacteroid traits with four chickpea (Cicer arietinum) varieties grown under different water regimes in an experiment including four nitrogen sources (two Mesorhizobium strains, and two uninoculated controls: nitrogen fertilised and unfertilised) under well-watered and drought conditions. We asked three questions. Does the impact of rhizobial strains on chickpea growth change with well-watered versus drought conditions? Do Mesorhizobium strains differ in their ability to influence biomass and nodule traits of chickpea varieties under well-watered and drought conditions? Are bacteroid size and amount of polyhydroxybutyrate modified by Mesorhizobium strain, chickpea variety, water availability and their interactions? Under well-watered conditions, chickpea inoculated with CC1192 showed higher shoot growth rates than M075 and accumulated high plant biomass at harvest. Under drought conditions, however, the shoot growth rate was comparable between CC1192 and M075, with no significant difference in plant biomass and symbiotic effectiveness at harvest. Across sources of variation, plant biomass varied 3.0-fold, nodules per plant 3.9-fold, nodule dry weight 3.0-fold, symbiotic effectiveness 1.5-fold, bacteroid size 1.4-fold and bacteroid polyhydroxybutyrate 1.4-fold. Plant biomass was negatively correlated with both bacteroid size and allocation to polyhydroxybutyrate under well-watered conditions, suggesting a trade-off between plant and rhizobial fitness. This study demonstrates the need to reassess rhizobial strain effectiveness across diverse environments, recognising the dynamic nature of their interaction with host plants.

Purpose – Sixteen million adolescents give birth each year, constituting 11% of all births worldwide. Adverse adolescent pregnancy outcomes are well-documented. Available data on adolescent pregnancies have mainly relied on self-reported age and retrospective survey data, which might not capture adolescent births accurately. This paper reports on trends in adolescent pregnancy and associated adverse birth outcomes in Matlab, Bangladesh, using data from the Matlab Heath and Demographic System (HDSS) which precisely documents maternal age. Design/methodology/approach – The study was conducted in the rural subdistrict of Matlab in Bangladesh. HDSS data were used to examine trends in adolescent motherhood (10–19 years) in the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr, b) service areas (ISA) and government service areas (GSA) between 2007 and 2015. A total of 4,996 adolescent mothers were included in the analysis. Chi-square testing and binary logistic regression were used to document adolescent pregnancy trends and the differences in and causes of perinatal death. Findings – The fertility rate was 27 per 1000 adolescent mothers in ISA and 20 per 1000 adolescent mothers in GSA, during the 9 years of the study period. The adjusted odd of an adolescent mother having a perinatal death in ISA, relative to GSA was 0.69. Significant determinants of perinatal death among adolescent mothers included maternal education, paternal education, mother’s age at first birth, asset score and distance from the nearest health facility. Originality/value – This paper documents the real trend of adolescent pregnancy by capturing the accurate age at pregnancy for the first time in Bangladesh.