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Abstract Background The origin of the spatial variability of dissolved As concentrations in shallow aquifers of the Bengal Basin remains poorly understood. To address this, we compare here transects of simultaneously-collected groundwater and aquifer solids perpendicular to the banks of the Hooghly River in Chakdaha, India, and the Old Brahmaputra River in Araihazar, Bangladesh. Results Variations in surface geomorphology mapped by electromagnetic conductivity indicate that permeable sandy soils are associated with underlying aquifers that are moderately reducing to a depth of 10–30 m, as indicated by acid-leachable Fe(II)/Fe ratios 5 mg L-1. More reducing aquifers are typically capped with finer-grained soils. The patterns suggest that vertical recharge through permeable soils is associated with a flux of oxidants on the banks of the Hooghly River and, further inland, in both Chakdaha and Araihazar. Moderately reducing conditions maintained by local recharge are generally associated with low As concentrations in Araihazar, but not systematically so in Chakdaha. Unlike Araihazar, there is also little correspondence in Chakdaha between dissolved As concentrations in groundwater and the P-extractable As content of aquifer particles, averaging 191 ± 122 ug As/L, 1.1 ± 1.5 mg As kg-1 (n = 43) and 108 ± 31 ug As/L, 3.1 ± 6.5 mg As kg-1 (n = 60), respectively. We tentatively attribute these differences to a combination of younger floodplain sediments, and therefore possibly more than one mechanism of As release, as well as less reducing conditions in Chakdaha compared to Araihazar. Conclusion Systematic dating of groundwater and sediment, combined with detailed mapping of the composition of aquifer solids and groundwater, will be needed to identify the various mechanisms underlying the complex distribution of As in aquifers of the Bengal Basin.

Coronary artery disease (CAD) is considered as a major cause of morbidity and mortality worldwide. Inflammatory cytokines play an important role in the pathogenesis and progression of atherosclerosis. The aim of the study was to find out the association of C-reactive protein (CRP) and triglyceride (TG) level on the severity of CAD in patients with ischemic heart disease (IHD). This cross-sectional study was performed in the Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh during the period of March 2018 to February 2021. Total 431 patients with ischemic heart disease were enrolled after taking informed written consent. CRP values were categorized into normal (<6 mg/L), borderline (6-10 mg/L) and high (>10mg/L) and TG level were categorized into normal (<150 mg/dl), borderline (150-199mg/dl) and high (≥200 mg/dl). Patients with ischemic heart disease (IHD) were stratified according to CRP value and TG level. Severity of CAD was assessed by the Gensini score. Most of the patients (33.4%) belonged to age 51-60 years. The mean age was 51.31±10.30 years. The majority (74.5%) of patients were male. Among risk factors, the highest 205(47.6%) patients were smokers followed by hypertension 190(44.1%) and diabetes mellitus 175(40.5%). The association of TG and CRP with the whole spectrum of IHD was found statistically significant (p<0.05). Severe CAD was found higher in high TG and high CRP level group compared with the other groups and was statistically significant. Inflammation assessed by high CRP and hypertriglyceridemia associated with the risk and severity of CAD.

Women's empowerment is an important policy agenda that is critical for developing countries like Bangladesh to achieve sustainable development goals (SDGs). The prime objective of this paper was to examine whether community savings groups can truly improve the economic conditions of women which turns into women's empowerment in fishing communities or not. The propensity score matching (PSM) and logistic regression technique were incorporated, and required data were collected from Community Savings Groups (CSG) interventions and non-CSG villages of coastal Bangladesh. Quantitative data were collected from 615 women comprising 306 CSG participants (treatment group) and 309 non-participants (control group). The results affirm CSG group members were economically more solvent and less dependent on borrowed money than non-CSG group members. Improved economic indicators (savings, income and expenditure) of CSG households make the foundation of attaining women's empowerment for the intervened group. The findings revealed that CSG women performed better in various dimensions of leadership capacity than non-CSG women. Econometric analysis confirmed positive impacts of CSG interventions on savings, gross household income, earning from catching fish, alternative income-generating activities (AIGAs), expenditure, and women's empowerment. The initiatives of CSG not only generate economic well-being but also contribute to women's empowerment. Financial access, improved literacy and an enabling environment for the productive engagement of women reduce gender inequality in fishing communities. To sustain the benefits of CSG, establishing institutional linkages (advisory and financial), legality/registration of CSGs from the government authority, and facilitation of alternative IGAs are crucial., Competing Interests: 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., (© 2024 The Authors. Published by Elsevier Ltd.)

The current study shows that using a batch approach to remove crystal violet dye from synthetic wastewater is feasible when using royal palm leaf sheath powder as an adsorbent. In order to investigate the effects of many parameters, including starting concentration, pH effect, dye concentration, adsorbent dose, contact time, and temperature, experiments were carried out under various operating conditions. Maximum removal was obtained at pH 6 and at a concentration of 100 ppm, which are considered as ideal values. The influence of pH and dye concentration was shown to be substantial. Langmuir, Freundlich, and Temkin isotherm models were fitted to equilibrium data. The Langmuir isotherm model, which showed a maximum monolayer adsorption capacity of 454.5455 mg/g, best described the equilibrium data. The Pseudo-second-order kinetic model was found to closely resemble rather than the first-order and intra-particle diffusion models. Standard enthalpy (∆H◦), entropy (∆S◦), and free energy (∆G◦) were evaluated as thermodynamic parameters. It was discovered that the adsorption contact was endothermic in nature. The outcomes highlight the applicability of the inexpensive, locally accessible adsorbent in the specialty area of wastewater treatment and can be used in commercial dye-enriched effluent., (© 2024. The Author(s).)

Background: In low- and middle-income countries like Bangladesh, where medical education faces a range of challenges-such as lack of infrastructure, well-trained educators, and advanced technologies, abrupt changes in methodologies without adequate preparation are more challenging than in higher-income countries. This was worsened during the COVID-19 pandemic and these challenges have resulted in a change in medical education methodology. This study assesses the medical education procedure, impacts and adaptation strategies and challenges of the COVID-19 pandemic in the medical education system of Bangladesh from learners' as well as educators' perspectives., Methods: The study collected data from 22 Medical Colleges/Universities across 18 districts of eight divisions using quantitative and qualitative methods. A total of 408 samples were collected consisting of 316 from students and 92 from medical teachers. Descriptive analysis and probit model were performed for obtaining results., Results: The efficacy of online learning was questionable, but results showed that it was more effective for theory classes (92.4%) followed by clinical classes (75.63%) and the efficacy rate was low for practical classes (54.11%). All types of classes (theory, practical and clinical) are currently using mixed methods to some extent in medical education in Bangladesh. Regarding impacts and adaptation strategy, approximately 75.3% of the students surveyed expressed their acceptance of online education. Over 80% of the participants acknowledged the advantages of online learning, highlighting the freedom to learn from home, cost and time savings, and avoiding physical closeness with other students as major benefits., Conclusions: To address future challenges like the COVID-19 pandemic in medical education in Bangladesh, a comprehensive policy approach such as strengthening technological infrastructure, promoting blended learning approaches, enhancing faculty training and support, integrating telemedicine into the curriculum, and continuously evaluating and improving policies and interventions can enhance the resilience of its medical education system, and prepare for future challenges., Competing Interests: No competing interests were disclosed., (Copyright: © 2024 Rahman MW et al.)

The availability of wild chickpea ( Cicer reticulatum L.) accessions has the potential to be used for the improvement of important traits in cultivated chickpeas. The main objectives of this study were to evaluate the phenotypic and genetic variations of chickpea progeny derived from interspecific crosses between C. arietinum and C. reticulatum, and to establish the association between single nucleotide polymorphism (SNP) markers and a series of important agronomic traits in chickpea. A total of 486 lines derived from interspecific crosses between C. arietinum (CDC Leader) and 20 accessions of C. reticulatum were evaluated at different locations in Saskatchewan, Canada in 2017 and 2018. Significant variations were observed for seed weight per plant, number of seeds per plant, thousand seed weight, and plant biomass. Path coefficient analysis showed significant positive direct effects of the number of seeds per plant, thousand seed weight, and biomass on the total seed weight. Cluster analysis based on the agronomic traits generated six groups that allowed the identification of potential heterotic groups within the interspecific lines for yield improvement and resistance to ascochyta blight disease. Genotyping of the 381 interspecific lines using a modified genotyping by sequencing (tGBS) generated a total of 14,591 SNPs. Neighbour-joining cluster analysis using the SNP data grouped the lines into 20 clusters. The genome wide association analysis identified 51 SNPs that had significant associations with different traits. Several candidate genes associated with early flowering and yield components were identified. The candidate genes and the significant SNP markers associated with different traits have a potential to aid the trait introgression in the breeding program.

This study presents a recently compiled dataset called "BDHusk," which encompasses a wide range of husk images representing eight different husk species as a component of cattle feed sourced from different locales in Sirajganj, Bangladesh. The following are eight husk species: Oryza sativa, Zea mays, Triticum aestivum, Cicer arietinum, Lens culinaris, Glycine max, Lathyrus sativus, and Pisum sativum var. arvense L. Poiret. This dataset consists of a total of 2,400 original images and an additional 9,280 augmented images, all showcasing various husk species. Every single one of the original images was taken with the right backdrop and in enough amount of natural light. Every image was appropriately positioned into its respective subfolder, enabling a wide variety of machine learning and deep learning models to make the most effective use of the images. By utilizing this extensive dataset and employing various machine learning and deep learning techniques, researchers have the potential to achieve significant advancements in the fields of agriculture, food and nutrition science, environmental monitoring, and computer sciences. This dataset allows researchers to improve cattle feeding using data-driven methods. Researchers can improve cattle health and production by improving feed compositions. Furthermore, it not only presents potential for substantial advancements in these fields but also serves as a crucial resource for future research endeavors., Competing Interests: The authors hereby confirm that they currently possess no existing financial or interpersonal conflicts that could have potentially influenced the outcomes of this study., (© 2023 The Author(s).)

The "WaterHyacinth" dataset, a recently gathered collection of images featuring four distinct species of Water hyacinth from different regions of Bangladesh, is presented in this article. There are four different classifications: Lemna minor, Eichhornia crassipes, Monochoria korsakowii , and Pistia stratiotes . The collection consists of 1790 original images and in addition 4050 augmented photos of Water hyacinth species. Every original picture was captured with the appropriate background and in sufficient natural light. Every image was correctly placed in its corresponding subfolder, providing optimal use of the pictures by various machine learning and deep learning models. Researchers could make major progress in agriculture, environmental monitoring, aquatic science, and remote sensing domains by utilizing this enormous dataset and various machine learning and deep learning approaches. In addition to opening opportunities for significant developments in these domains, it offers an essential asset for further study., (© 2023 The Author(s).)

Electro-physiological diagnosis of mild Carpal Tunnel Syndrome (CTS) based on traditional median motor and sensory studies are often inconclusive. Therefore, we wanted to investigate the utility of Median-to-Ulnar Sensory Conduction studies in diagnosis of mild CTS. Data from Nerve conduction study (NCS) of 82 cases with symptoms suggestive of CTS from September 2017 to October 2020 attending electrophysiology department of Mount Adora Hospital, Sylhet, Bangladesh was selected for study. About 54(66.0%) out of 82 symptomatic patients were diagnosed as CTS by the conventional method, and 28(34.0%) patients required further investigation as their test report were found to be inconclusive. combining methods showed 70(85.37%) were found to be positive and 12(14.63%) were negative in comparison study. Thus, it can be concluded that those patients found to be negative in conventional methods; comparison method is an option for diagnostic confirmation.

Background Compared with a conventional wrist puncture for radial artery catheterization, a distal radial artery puncture has the advantage of reducing the incidence of radial artery occlusion (RAO). Aim The present study was designed to evaluate the feasibility of distal trans-radial access compared with conventional trans-radial access for coronary angiography. Methods A prospective, randomized, single-blinded, comparative study was conducted at a tertiary care center in India between December 2018 and November 2020. A total of 420 patients (aged >18 years) with signs and symptoms suggestive of coronary artery disease (CAD) and with a palpable radial artery in anatomical snuffbox were randomized into two groups. Group A comprised patients accessed at the distal trans-radial site, and Group B consisted of patients accessed at the conventional trans-radial site for coronary angiography. Baseline demographics, clinical history, and risk factors for CAD were documented. Procedural-related parameters and complications were compared between the two groups. Results The procedural success rate was non-significant between Group A and Group B (96% vs. 98%; p=0.38). Puncture in a single attempt was higher in Group B compared to Group A (92% vs. 78%; p<0.001). There was no significant difference between Group A and Group B for operation time (p=0.207), fluoroscopy time (p=0.183), and contrast volume (p=0.345). The rate of RAO was higher in Group B compared to Group A (13% vs. 2%; p<0.001). Radial artery hematoma/swelling at the puncture site between Group A (10%) and Group B (8%) was not significant (p=0.61). Post-procedural hemostasis time in Group A was 28 ± 7.86 minutes, and in Group B was 24 ± 6.23 minutes. Both post-procedural persistence of pain (p<0.001) and hand clumsiness (p<0.001) were significantly higher in Group B compared to Group A. Conclusion For coronary angiography, the distal trans-radial access site is a reliable and secure alternate access site., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Gupta et al.)

This study aimed to identify the optimum level of supplementary feeds on the carcass traits and meat quality of Jamuna basin lambs. Forty selected lambs were divided into four treatments such as T 0 (no concentrate supplementation), T 1 (1% concentrate feed), T 2 (1.5% concentrate feed) and T 3 (2% concentrate feed) having ten lambs per treatment. The data were analyzed through Completely Randomized Design (CRD) with SAS software. Hot carcass, dressing percentage, head, leg, neck, loin, heart, and spleen weight were showed significantly ( p < 0.05) higher values with increasing concentrate feed. The crude protein (CP), ether extract (EE) and ash values were significantly increased ( p < 0.001) except T 2 treatment. The ultimate pH was significantly increased except T 2 and cooked pH was significantly decreased ( p < 0.001) except T 3 treatment. Drip loss and cooking loss (CL) % had significantly reduced ( p < 0.001) except T 3 treatment. The water holding capacity (WHC) % was significantly increased ( p < 0.001) except T 3 treatment. The score of color, juiciness and tenderness were significantly different ( p < 0.001). Flavor and overall acceptability score were significantly increased ( p < 0.05) in different treatments. The color values L* and b* had significantly changed ( p < 0.001) and a* value was found significantly higher ( p < 0.05) in all treatments. Hence, 12 months of aged lambs with 1.5% concentrate feed showed better performances on carcass, nutritional, physicochemical, sensory and instrumental color values to increase the carcass and the meat quality of lambs., Competing Interests: No potential conflict of interest relevant to this article was reported., (© Copyright 2023 Korean Society of Animal Science and Technology.)

Considering that it has been more than 24 months since SARS-CoV-2 emerged, it is crucial to identify measures that prevent and control pathogen transmission in workplace settings. Our aim was to report results of a hospital-based program that delivered hydroxychloroquine (HCQ) tablets as COVID-19 prophylaxis to the frontline healthcare workers (HCW)s who cared for COVID-19 patients and to evaluate the efficacy of HCQ. Setting and participants: Quasi-experimental, controlled, single-center study. The included participants were doctors, nurses, health workers, cleaning staff, and non-healthcare supportive staff. The main outcome was contracting COVID-19 anytime during the period of taking the prophylaxis, confirmed by RT-PCR. A total of 336 participants, without any clinical evidence of COVID-19 and without any known contact with family members, were included in the trial; 230 were assigned to HCQ and 106 declined to take any drug. Results: Among the participants, 43 (18.7%) in the HCQ group and 11 (10.4%) participants in the control group developed COVID-19. For the evaluation of side effects, we evaluated 12-lead ECGs of both groups at the baseline and after 4 weeks to monitor QTc interval. A total of 91% (198 of 217) participants in the prophylaxis group and 92% (11 of 12) in the control group had a QTc < 45o msec, which is within normal limits. Conclusions: Although the number of symptomatic infections in health personnel was lower in the control group, the difference was not statistically significant. However, in the absence of any effective pre-exposure prophylaxis medicine for COVID-19, practicing proper infection prevention and control (IPC) and vaccination is the only way forward.

Current-perpendicular-to-plane magnetoresistance (CPP MR) in layered heterojunctions is at the heart of modern magnetic field sensing and data storage technologies. van der waals heterostructures and two-dimensional (2D) magnets opened a new playground for exploring this effect, although most 2D magnets exhibit large CPP MR only at very low temperatures due to their very low Curie temperatures. vanadium diselenide (VSe 2 ) is a promising material since its monolayers can potentially act as room temperature ferromagnets. VSe 2 multilayers have been predicted to exhibit CPP MR effects, although experimental work in this area remains scarce. In this work we investigate CPP MR in 1T-VSe 2 ultrathin flakes, revealing a large (∼60%-70%), positive, linear, and non saturating CPP MR, which persists close to room temperature (∼250 K), in a relatively small magnetic field range of ±12 kG . The CPP MR has been found to increase with decreasing flake thickness. The CPP MR originates due to the intrinsic inhomogeneity in the CPP transport path, and exhibits unprecedented immunity against thermal fluctuations, leading to increasingly enhanced MR as temperature is increased, even significantly beyond the charge density wave transition temperature . The observed 'thermally-driven' MR features are remarkably robust and reproducible, and can offer a viable route for developing practical room temperature 2D based magnetic sensor technologies. Our results also suggest that harnessing similar effects in other 2D systems could result in large MR as well, thereby motivating further research on CPP transport in these systems, which has been relatively unexplored so far., (Creative Commons Attribution license.)

Supramolecular short-peptide assemblies have been widely used for the development of biomaterials with potential biomedical applications. These peptides can self-assemble in a multitude of chiral hierarchical structures triggered by the application of different stimuli, such as changes in temperature, pH, solvent, etc. The self-assembly process is sensitive to the chemical composition of the peptides, being affected by specific amino acid sequence, type, and chirality. The resulting supramolecular chirality of these materials has been explored to modulate protein and cell interactions. Recently, significant attention has been focused on the development of chiral materials with potential spintronic applications, as it has been shown that transport of charge carriers through a chiral environment polarizes the carrier spins. This effect, named chirality-induced spin selectivity or CISS, has been studied in different chiral organic molecules and materials, as well as carbon nanotubes functionalized with chiral molecules. Nevertheless, this effect has been primarily explored in homochiral systems in which the chirality of the medium, and hence the resulting spin polarization, is defined by the chirality of the molecule, with limited options for tunability. Herein, we have developed heterochiral carbon-nanotube-short-peptide materials made by the combination of two different chiral sources : that is, homochiral peptides (l/d) + glucono-δ-lactone. We show that the presence of a small amount of glucono-δ-lactone with fixed chirality can alter the supramolecular chirality of the medium, thereby modulating the sign of the spin signal from "up" to "down" and vice versa. In addition, small amounts of glucono-δ-lactone can even induce nonzero spin polarization in an otherwise achiral and spin-inactive peptide-nanotube composite. Such "chiral doping" strategies could allow the development of complementary CISS-based spintronic devices and circuits on a single material platform.

Background: Acute coronary syndrome (ACS) remains a cause of high morbidity and mortality among adults, despite advances in treatment. Treatment modality and outcomes of ACS mainly depend on the time yielded since the onset of symptoms. Prehospital delay is the time between the onset of myocardial ischemia/infarction symptoms and arrival at the hospital, where either pharmacological or interventional revascularization is available. This delay remains unacceptably long in many countries worldwide, including Bangladesh. The current study investigates several sociodemographic characteristics as well as clinical, social, and treatment-seeking behaviors, with an aim to uncover the factors responsible for the decision time to get medical help and home-to-hospital delay. Materials and Methods: A prospective cross-sectional study was conducted between July 2019 and June 2020 in 21 district hospitals and 6 medical college hospitals where cardiac care facilities were available. The population selected for this study was patients with ACS who visited the studied hospitals during the study period. Following confirmation of ACS, a semi-structured data sheet was used to collect the patient data and was subsequently analyzed. Results: This study evaluated 678 ACS patients from 30 districts. The majority of the patients were male (81.9%), married (98.2%), rural residents (79.2), middle-aged (40-60 years of age) (55.8%), low-income holders (89.4%), and overweight (56.9%). It was found that 37.5% of the patients received their first medical care after 12 h of first symptom presentation. The study found that the patients' age, residence, education, and employment status were significant factors associated with prehospital delay. The patients with previous myocardial infarction (MI) and chest pain arrived significantly earlier at the hospital following ACS onset. Location of symptom onset, first medical contact with a private physician, distance from symptom onset location to location of first medical contact, the decision about hospitalization, ignorance of symptoms, and mode of transportation were significantly associated with prehospital delay. Conclusions : Several factors of prehospital delay of the ACS patients in Bangladesh have been described in this study. The findings of this study may help the national health management system identify the factors related to treatment delay in ACS and thus reduce ACS-related morbidity and mortality.

The use of organic fertilisers and soil amendments are almost universally recommended for improving the organic matter levels and maintaining soil health, but few studies documenting the actual availability and quality of such materials on smallholder farms are available. We selected a case study of 300 households from northern and southern Bangladesh to assess the types of waste materials available for recycling and their usage patterns at household level and we applied a novel approach to empirically identify household waste as input inefficiency in a production context. Northern districts have highly intensive farming systems whereas southern districts have low intensity farming. The total amount of agricultural waste produced at household level was estimated at 822 kg per month. Cow dung contributed about 65% of the total waste followed by animal feed refusal waste (11%), garbage (7%) and kitchen waste (6%). Most of the farmers utilised cow dung and wastes as organic fertiliser and lesser amounts as cooking fuel. Econometric analysis shows that the number of cattle and small ruminant per holding, total area of cultivated land and family size were significant factors that influence the amount of waste production at household level. Each household can reduce the chemical fertiliser cost by Tk. 1463 (US$ 17.84) per month by using compost prepared from household waste. There were ample opportunities for compost/vermicomposting and potential markets. The Department of Agricultural Extension from the public sector and private sector agents might motivate farmers to harvest the potential benefits of agricultural waste through effective management and utilisation.

Introduction: Septic shock can often lead to death, even in resourceful settings, if not handled carefully. Therefore, we sought to evaluate the factors associated with deaths in the context of severe malnutrition and also the effects of early, i.e., within 3 hours of diagnosing septic shock vs. late blood transfusion., Methodology: Here, all under-five severely malnourished septic shock children were admitted to ICU during 2013-2017. Children who died constituted cases (n = 54), and the survived (n = 39) represented controls. We excluded children who received the blood transfusion for other causes and who left against medical advice., Results: In both descriptive and multivariate analysis, we found that death was significantly associated with the use of fourth-line antibiotics, corticosteroids, and the addition of vasopressors on top of dopamine (all p < 0.05). However, the decrease of serum calcium level was found significantly associated with death only after adjusting (p < 0.05). Even though the cases more often received early blood transfusion than the controls, the difference was insignificant (p = 0.134)., Conclusions: When a severely malnourished under-five child develops septic shock, requiring vasopressors, fourth-line antibiotic, and corticosteroid, with reduced serum calcium, the probability of death increases significantly. Our findings underscore the gravity of close monitoring at these points and the niches for early interventions., Competing Interests: No Conflict of Interest is declared, (Copyright (c) 2022 Visnu Pritom Chowdhury, Monira Sarmin, Mehnaz Kamal, Shafiul Islam, Mohammad Abubakar Siddik, Farzana Afroze, Muhammad Waliur Rahman, Tahmeed Ahmed, Mohammod Jobayer Chisti.)

The advent of improved lentil varieties (ILVs) in the mid-1990s solved the disease problem which almost halted lentil production in Bangladesh. Levels of adoption of ILVs have been documented in the literature, but little is known about their impacts. Applying an instrumental variables regression to data collected from a sample of 1,694 lentil plots and DNA fingerprinting for varietal identification, this study provides estimates of the plot-level impacts of adoption of ILVs in Bangladesh. Model results show that adoption of ILVs is associated with 14.3% (181.14 kg/ha) higher yields and 17.23% (US$169.44/ha) higher gross margins. Since 45% of lentil area is under ILVs, they generated over 8.77 tones (6%) more supply of lentils from domestic sources, saving the country US$8.22 million in imports in 2015 alone. By investing in the generation and scaling of ILVs, Bangladesh and other South Asian countries with similar agro-ecologies can increase production and decrease dependency on lentil imports., Competing Interests: The authors have declared that no competing interests exist.

Background: Personal payments from the pharmaceutical industry to US physicians are common and are associated with changes in physicians' clinical practice and interpretation of clinical trial results. We assessed temporal trends in industry payments to oncologists, with particular emphasis on payments to authors of oncology clinical practice guideline and on payments related to immunotherapy drugs., Methods: We included US physicians with active National Plan and Provider Enumeration System records and demographic data available in the Centers for Medicare & Medicaid Services Physician Compare system who had a specialty type of medical oncology or general internal medicine. Medical oncologists serving on NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) Panels were identified manually. Industry payments, and the subset associated with PD-1/PD-L1 drugs, were identified in Open Payments, the federal repository of all transactions of financial value from industry to physicians and teaching hospitals, from 2014 to 2017., Results: There were 13,087 medical oncologists and 85,640 internists who received payments. The mean, annual, per-physician value of payments to oncologists increased from $3,811 in 2014 to $5,854 in 2017, and from $444 to $450 for internists; the median payment increased from $152 to $199 for oncologists and remained at $0 for internists. Oncologists who served on NCCN Guidelines Panels received a greater value in payments and experienced a greater relative increase: mean payments increased from $10,820 in 2014 to $18,977 in 2017, and median payments increased from $500 to $1,366. Among companies marketing PD-1/PD-L1 drugs, mean annual per-oncologist payments associated with PD-1/PD-L1 drugs increased from $28 to $773. Total per-oncologist payments from companies marketing PD-1/PD-L1 drugs experienced a 165% increase from 2014 to 2017, compared with a 31% increase among similar companies not marketing PD-1/PD-L1 drugs., Conclusions: Pharmaceutical industry payments increased for US oncologists from 2014 to 2017 more than for general internists. The increase was greater among oncologists contributing to clinical practice guidelines and among pharmaceutical companies marketing PD-1/PD-L1 drugs. The increasing flow of money from industry to US oncologists supports ongoing concern regarding commercial interests in guideline development and clinical decision-making.

Molecular functionalization of CNTs is a routine procedure in the field of nanotechnology. However, whether and how these molecules affect the spin polarization of the charge carriers in CNTs are largely unknown. In this work we demonstrate that spin polarization can indeed be induced in two-dimensional (2D) CNT networks by "certain" molecules and the spin signal routinely survives length scales significantly exceeding 1 μm. This result effectively connects the area of molecular spintronics with that of carbon-based 2D nanoelectronics. By using the versatility of peptide chemistry, we further demonstrate how spin polarization depends on molecular structural features such as chirality as well as molecule-nanotube interactions. A chirality-independent effect was detected in addition to the more common chirality-dependent effect, and the overall spin signal was found to be a combination of both. Finally, the magnetic field dependence of the spin signals has been explored, and the "chirality-dependent" signal has been found to exist only in certain field angles.

Importance: World Health Organization (WHO) guidelines do not recommend routine antibiotic use for children with acute watery diarrhea. However, recent studies suggest that a significant proportion of such episodes have a bacterial cause and are associated with mortality and growth impairment, especially among children at high risk of diarrhea-associated mortality. Expanding antibiotic use among dehydrated or undernourished children may reduce diarrhea-associated mortality and improve growth., Objective: To determine whether the addition of azithromycin to standard case management of acute nonbloody watery diarrhea for children aged 2 to 23 months who are dehydrated or undernourished could reduce mortality and improve linear growth., Design, Setting, and Participants: The Antibiotics for Children with Diarrhea (ABCD) trial was a multicountry, randomized, double-blind, clinical trial among 8266 high-risk children aged 2 to 23 months presenting with acute nonbloody diarrhea. Participants were recruited between July 1, 2017, and July 10, 2019, from 36 outpatient hospital departments or community health centers in a mixture of urban and rural settings in Bangladesh, India, Kenya, Malawi, Mali, Pakistan, and Tanzania. Each participant was followed up for 180 days. Primary analysis included all randomized participants by intention to treat., Interventions: Enrolled children were randomly assigned to receive either oral azithromycin, 10 mg/kg, or placebo once daily for 3 days in addition to standard WHO case management protocols for the management of acute watery diarrhea., Main Outcomes and Measures: Primary outcomes included all-cause mortality up to 180 days after enrollment and linear growth faltering 90 days after enrollment., Results: A total of 8266 children (4463 boys [54.0%]; mean [SD] age, 11.6 [5.3] months) were randomized. A total of 20 of 4133 children in the azithromycin group (0.5%) and 28 of 4135 children in the placebo group (0.7%) died (relative risk, 0.72; 95% CI, 0.40-1.27). The mean (SD) change in length-for-age z scores 90 days after enrollment was -0.16 (0.59) in the azithromycin group and -0.19 (0.60) in the placebo group (risk difference, 0.03; 95% CI, 0.01-0.06). Overall mortality was much lower than anticipated, and the trial was stopped for futility at the prespecified interim analysis., Conclusions and Relevance: The study did not detect a survival benefit for children from the addition of azithromycin to standard WHO case management of acute watery diarrhea in low-resource settings. There was a small reduction in linear growth faltering in the azithromycin group, although the magnitude of this effect was not likely to be clinically significant. In low-resource settings, expansion of antibiotic use is not warranted. Adherence to current WHO case management protocols for watery diarrhea remains appropriate and should be encouraged., Trial Registration: ClinicalTrials.gov Identifier: NCT03130114.

The present work is an effort to produce liquid fuel oil from plastic based medical wastes through thermal cracking process under oxidizing conditions. The mixed plastics from medical wastes were considered as a feedstock, shredded into small pieces and heated at 773 ± 10 K for 40 min with a heating rate of 20 K/min in a batch reactor for thermal cracking process. The feedstock was characterized by proximate and ultimate analysis along with thermogravimetric investigation. Moreover, chemical compositions of the liquid fuel oil were examined by FTIR and GC-MS spectroscopy. The properties of liquid product were also examined and compared to the commercial fuel oil. The average yield of brownish and sticky liquid fuel was obtained to be 52 wt% and the gross calorific value of the liquid was found 41.32 MJ/kg which is comparable to that of commercial diesel. FTIR spectrum showed characteristic absorption bands of C-H and =CH 2 groups indicating presence of alkane and alkene compounds. GC-MS study demonstrated the chemical constituents of the liquid product that is mostly aliphatic compounds of mainly alkanes (16.28%), alkenes (10.67%), alcohols (14.65%) and ester groups (10.38%) including iso-phthalate (40.02%) as a predominant product. This experiment concludes that the liquid oil derived from thermal cracking of mixed plastics comprised of a composite mixture of organic components. A significant amount of non-degraded constituents like plasticizers, precursors, etc. remained in the product having some economic values with human health and environmental impacts during burning has been addressed in the current issue., (© 2021. The Author(s).)

Helical functionalization of carbon nanotubes using DNA strands can polarize carrier spins through chirality induced spin selectivity (or CISS) effect. Detection of this effect using transport experiments unravels an underlying magnetoresistance effect, origin of which is not well understood. In the present study, we investigate this effect, a fundamental understanding of which is crucial for the potential use of this system in spintronic devices. The conduction mechanism has been found to be in the strongly localized regime due to DNA functionalization, with the observed magnetoresistance originating from the interference effects between the forward and backward hopping paths. CISS-induced spin polarization has been estimated to increase the carrier localization length by an order of magnitude in the low temperature range and it affects the magnetoresistance effect in a non-trivial way that is not observed in conventional systems., (© 2021 IOP Publishing Ltd.)

Magnesium based niobium oxides (Mg-Nb-O) were prepared by solid-state reactions owing to understand the function of transition metal oxides as promoters/catalysts for practical application. Magnesium niobate (Mg 3 Nb 6 O 11 ) was synthesized for the first time in nearly pure form reported in this context. MgNb 2 O 6 and Mg 4 Nb 2 O 9 were prepared in oxidizing conditions; on the contrary, Mg 3 Nb 6 O 11 preferred reducing environment. Stoichiometric mixtures of the precursor materials MgO, Nb 2 O 5 and/or metallic Nb were annealed for the syntheses which revealed the effect of temperature on phase formation, reaction kinetics and heat of reaction. The products were examined by ex-situ, in-situ X-ray diffraction (XRD) and differential scanning calorimetry (DSC). Crystallographic parameters of various binary and ternary compounds (Mg/Nb/O) formed in different calcination conditions, were extracted by Rietveld method. In-situ experiment results in single step reaction for the MgNb 2 O 6 synthesis and the heat of formation of the solid-state reaction obtained to be minimum (93 kJ/mol). In contrast, the formation of Mg 4 Nb 2 O 9 and Mg 3 Nb 6 O 11 compounds towards pure phases rather complicated due to multistep reactions and corresponding heat of formation were estimated to be 140 and 190 kJ/mol. Experimental results have been discussed based on kinetic and thermodynamic constrains., (© 2021. The Author(s).)

Background: Dengue, a febrile illness, is caused by a Flavivirus transmitted by Aedes aegypti and Aedes albopictus mosquitoes. Climate influences the ecology of the vectors. We aimed to identify the influence of climatic variability on the occurrence of clinical dengue requiring hospitalization in Zone-5, a high incidence area of Dhaka City Corporation (DCC), Bangladesh., Methods and Findings: We retrospectively identified clinical dengue cases hospitalized from Zone-5 of DCC between 2005 and 2009. We extracted records of the four major catchment hospitals of the study area. The Bangladesh Meteorological Department (BMD) provided data on temperature, rainfall, and humidity of DCC for the study period. We used autoregressive integrated moving average (ARIMA) models for the number of monthly dengue hospitalizations. We also modeled all the climatic variables using Poisson regression. During our study period, dengue occurred throughout the year in Zone-5 of DCC. The median number of hospitalized dengue cases was 9 per month. Dengue incidence increased sharply from June, and reached its peak in August. One additional rainy day per month increased dengue cases in the succeeding month by 6% (RR = 1.06, 95% CI: 1.04-1.09)., Conclusions: Dengue is transmitted throughout the year in Zone-5 of DCC, with seasonal variation in incidence. The number of rainy days per month is significantly associated with dengue incidence in the subsequent month. Our study suggests the initiation of campaigns in DCC for controlling dengue and other Aedes mosquito borne diseases, including Chikunguniya from the month of May each year. BMD rainfall data may be used to determine campaign timing.

The efficacy of commonly used antibiotics for treating severe cholera has been compromised over time because of the reduced antibiotic susceptibility. This study aimed to describe the rate of detection of Vibrio cholerae O1 from fecal samples and antimicrobial susceptibility profiles of V. cholerae O1 serotypes to commonly used antibiotics. During January 2000-December 2018, V. cholerae O1 was detected in fecal samples of 7,472 patients. Vibrio cholerae O1 Inaba serotype was predominant, ranging from 60% to 86% during the period 2000-2006 except for 2003 and 2005 when the Ogawa serotype was predominant. Later on, the Ogawa serotype became predominant from 2007 to 2015, fluctuating between 52% and 100%. However, in 2016 and 2017, isolation rates declined to 2% and 1%, respectively, but surged again to 75% in 2018. Nearly 100% of V. cholerae O1 strains were sensitive to tetracycline during 2000-2004. Thereafter, a declining trend of sensitivity was observed to be continued and dropped down to < 6% during 2012-2017 and again increased to 76% in 2018. Susceptibility to azithromycin and ciprofloxacin was nearly 100%, and susceptibility to cotrimoxazole and furazolidone was 01% throughout the study period. We also found the emergence of resistance to erythromycin in 2005 and sensitivity to cotrimoxazole in 2018. Thus, the rapid decline of the sensitivity of V . cholerae O1 to tetracycline and a reversed peak after 6 years need continued monitoring and reporting.

Background: Outbreak investigations typically focus their efforts on identifying cases that present at healthcare facilities. However, these cases rarely represent all cases in the wider community. In this context, community-based investigations may provide additional insight into key risk factors for infection, however, the benefits of these more laborious data collection strategies remains unclear., Methods: We used different subsets of the data from a comprehensive outbreak investigation to compare the inferences we make in alternative investigation strategies., Results: The outbreak investigation team interviewed 1,933 individuals from 460 homes. 364 (18%) of individuals had symptoms consistent with chikungunya. A theoretical clinic-based study would have identified 26% of the cases. Adding in community-based cases provided an overall estimate of the attack rate in the community. Comparison with controls from the same household revealed that those with at least secondary education had a reduced risk. Finally, enrolling residents from households across the community allowed us to characterize spatial heterogeneity of risk and identify the type of clothing usually worn and travel history as risk factors. This also revealed that household-level use of mosquito control was not associated with infection., Conclusions: These findings highlight that while clinic-based studies may be easier to conduct, they only provide limited insight into the burden and risk factors for disease. Enrolling people who escaped from infection, both in the household and in the community allows a step change in our understanding of the spread of a pathogen and maximizes opportunities for control., (Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: Zinc is an essential trace element that has an enormous role in regulation of physiological processes whose deviant value leads to malfunction in the body. So, establishing a country specific reference value is needed to serve as a standard for the interpretation of laboratory results during clinical decision making., Objective: The objective of this study was to determine the reference value of serum zinc level of adult population in Bangladesh., Materials and Methods: The overnight fasting blood was collected from 154 apparently healthy individuals aged 18 to 65 years, from a rural community after considering several criteria. Graphite furnace atomic absorption spectrophotometry (GF-AAS) method was used for serum zinc analysis. The 2.5 th and 97.5 th percentiles of zinc level were calculated for the reference value according to the recommendations of the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC)., Results: The estimated reference range of serum zinc level in sample population was 60-120 μg/dL, where the range was 59-125 μg/dL for male and 50-103 μg/dL for female. Significant differences of serum zinc level between male and female (p<0.001) was observed. However, there was no significant correlation between age of the respondents and serum zinc level (r=0.110, p>0.05)., Conclusion: The estimated reference range for serum zinc level in adult population of Bangladesh can serve as a useful indicator for clinical decision making., (Copyright © 2020 International Federation of Clinical Chemistry and Laboratory Medicine (IFCC). All rights reserved.)

Carbon nanotubes (CNTs), helically wrapped with single-stranded DNA, have recently emerged as a spin-filtering material. The inversion asymmetric helical potential of DNA creates a spin-filtering effect (commonly known as "chirality-induced spin selectivity" or CISS), which polarizes carrier spins in the nanotube. Thus, tuning of the DNA-CNT interaction is expected to affect carrier spins in nanotubes. The CISS effect induces spin polarization, which is coupled with the carrier's momentum direction, and therefore, in one-dimensional systems, such as nanotubes, momentum flip must be accompanied by a simultaneous spin flip. This spin momentum locking can have a profound impact on charge transport in nanotubes as backscattering due to phonons and disorder will be suppressed as these mechanisms are spin-independent. Here, we report DNA-CNT spin filters in which CNTs have been functionalized with two different classes of sequences, exhibiting different degrees of interaction with the CNT. They induce different degrees of spin polarization in the channel, with significant impact on temperature-dependent charge transport and interference phenomena arising from carrier backscattering. This work raises the intriguing possibility of engineering charge transport in nanotubes via CISS-induced spin polarization by tailor-made DNA sequences.

Acute post-streptococcal glomerulonephritis (APSGN) is the commonest cause of acute glomerulonephritis (AGN), which usually present with gross hematuria, mild edema, oliguria, hypertension and varying degree of renal insufficiency. It is more common among the population of school going age where poverty, overcrowding and poor hygienic conditions are prevailing. This cross sectional observational study was aimed to know the socio-demographic variables, clinical profile and immediate outcome of AGN in hospitalized children and was conducted in the Pediatric department of Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh from November 2014 to April 2015. A detailed history was taken from the parents in each case with a written questionnaire. A written consent was also taken from the guardian of the including patients and also permission was taken from the ethical committee of MMCH. Thorough clinical examination and available relevant investigations were done in all patients. Progresses of the patient were monitored by daily clinical examinations and also by investigations. Data were analyzed by statistical package for social science (SPSS) windows version 18. Results were verified by doing standard test for significance. Among total 60 cases male was 58.3% & female was 41.7%. The common age group of presentation was between 7-12 years (73%), peak age of incidence was 7-9 years. Most of them came from low socioeconomic status (83.3%), 63.3% from rural area with average 5-6 member's family size. Most of the parents were illiterate. History of (H/O) skin infection was present in 35(58.3%) patients, 15(25%) had H/O sore throat, 15% did not give any H/O infection before presentation. Average duration of gap between infection and appearance of clinical feature was 7-14 days in 73.40%and 15-21 days was in 45.7% in case of sore throat & skin infection respectively. Almost all (95%) patients presented with puffiness of face, others presented with scanty micturition, gross hematuria, respiratory distress, fever, convulsion and altered sensorium. Edema (75%), hypertension (88.3%), pallor (38%), tachypnea (25%), tachycardia (26.7%) were the important clinical findings. Microscopic hematuria was present among 96.66% patients; low complement level was found in 85% cases. There is significant association between low socioeconomic statuses with more hospital stay. Only one patient died due to heart failure and 98.3% patient had complete recovery. Results of this study conclude that most of the patients came from rural illiterate family with low socioeconomic background. Skin infection is the commonest cause of acute glomerulonephritis. Edema, scanty micturation, hematuria and hypertension are the common mode of presentation. Heart failure and hypertensive encephalopathy are the common complication of AGN. Immediate prognosis of AGN was excellent.

Background: The diagnosis of childhood tuberculosis (TB) can be difficult in severely malnourished children. This is mainly due to the fact of our perceived notion that clinical signs of TB are often subtle in severely malnourished children and we may rely on laboratory investigation for the diagnosis. However, comparative data on the performance of clinical and laboratory diagnostics of TB in such population are also very limited. Objectives: To compare the performance of composite clinical criteria and a technique that measures antibodies in lymphocyte supernatant (ALS) for the diagnosis of TB in severely malnourished children with pneumonia. Methods: Severely malnourished children under five with radiological pneumonia admitted to the Dhaka Hospital of International Centre for Diarrhoeal Disease Research, Bangladesh were enrolled consecutively following informed consent. We collected venous blood for ALS, gastric lavage fluid and induced sputum for microscopy, mycobacterial culture, and real-time PCR by Xpert MTB/RIF. We compared the sensitivity, specificity, positive, and negative predictive values, and accuracy of modified Kenneth Jones criteria (MKJC) score, World Health Organization (WHO) criteria, and ALS in diagnosing TB in severely malnourished children with pneumonia for "Confirmed TB" and "All TB" ("Confirmed TB" plus "Probable TB") vs. "Not TB." Results: Compared to culture confirmed TB, the sensitivity, and specificity (95% CI) for MKJC were 60 (27-86) and 84 (79-87)% and for WHO criteria were 40 (14-73) and 84 (80-87)%, respectively. Compared to culture and/or Xpert MTB/RIF positive TB, the sensitivity and specificity (95% CI) for the criteria were 37 (20-58) and 84 (79-87)%; and 22 (9-43) and 83 (79-87)%, respectively. For both these comparisons, the sensitivity and specificity of ALS were 50 (14-86) and 60 (53-67)%, respectively. Conclusion: Our data suggest that WHO criteria and MKJC scoring mainly based on clinical criteria are more useful than ALS in diagnosing TB in young severely malnourished children with pneumonia. The results underscore the importance of using clinical criteria for the diagnosis of TB in severely malnourished children that may help to minimize the chance of over treatment with anti-TB in such population, especially in resource limited TB endemic settings., (Copyright © 2019 Chisti, Shahid, Shahunja, Banu, Raqib, Shahrin, Islam, Sharifuzzaman, Saha, Alam, Rahman, Nuzhat, Afroze, Sarmin and Ahmed.)

The aim of this prospective experimental study was to analyze the radiological and clinical results of the supra condylar fracture of Humerus in children and conducted the functional outcome of closed reduction and internal fixation by percutaneous Kirschner-wire from lateral side and crossed technique in the National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR), Sher-E-Bangla Nagor, Dhaka, Bangladesh from July 2011 to June 2013. Patients diagnosed as closed Supracondylar fracture of Humerus in children due to trauma were the study population. Total 30 patients aged 2 to 12 years irrespective of sex were included in the study and were divided in 2 groups. Information obtained included age, sex, type of fracture, management, outcomes and complications. The mean age was 7.80±2.08 and 5.93±2.31 years for Group I and Group II patients. Age range was 2-12 years. Males were predominant 11(73.3%) Group I and Group II. Fractures were primarily caused by fall from tree and left side predominant. In Group I the time elapsed between injury and surgery was minimum 2 hours and maximum 24 hours with mean±SD was 9.20±7.20, while in Group II minimum and maximum of 3 and 48 hours respectively with mean±SD was 9.60±11.01. Minimum and maximum post operative hospital stays were 1 and 2 days in Group I and Group II. Follow-up were carried out after 1, 3, 6 and 12 weeks of operation. Loss of post operative range of motion of elbow and loss of carrying angle was not significant (p>0.05). Functional outcome was analyzed by Flynn's grading. In this study there were 3(20%) cases with excellent, 10(66.67%) were good and 2(13.33%) were fair functional outcomes in Group I. In Group II excellent, good and fair functional outcome were 3(20%), 9(60%) and 3(20%) respectively. After chi-square test there was no significant difference between two groups.

Treatment of extra-articular distal humeral shaft fractures with plating techniques is often difficult. The recent development of LCP has improved the surgical treatment of fractures by overcoming the few drawbacks of older fixators. The aim of this prospective observational study was to assess the effectiveness of osteosynthesis of extra-articular diaphyseal fractures of the distal third of the humerus using a single locking compression plate (LCP) and was conducted from July 2016 to June 2018 at the National Institute of Traumatology and Orthopedic Rehabilitation (NITOR), Dhaka, Bangladesh. Thirty (30) patients with closed fracture distal 3rd extra-articular humeral shaft fractures were treated by open reduction and internal fixation by locking compression plate. Two cases were excluded from the evaluation of final outcome due to their discontinued follow up. Detailed clinical conditions of all patients, technical difficulty with the implant, postoperative hospital stay period were recorded. Patients were followed up at 2nd week, 4th week, then 4 weekly upto 6 months. The patients were evaluated clinically and radiologically for outcomes. The progresses of healing as well as occurrence of complications were recorded. The range of motion of the shoulder and elbow were evaluated according to the criteria by Rommens grading. Functional evaluation was made according to the criteria by Modified Constant and Murley Scoring System. Union was achieved in all the patients after a mean of 15 weeks (range 12-20 weeks). There were no complications like deep infection, nonunion, malunion, implant failure, or nerve injury occurs in any of the patients. Two patients had transient radial nerve palsy. Two patients developed superficial infection. All patients were relieved pain postoperatively. Functional outcome were excellent in 10 patients, good in 15 patients which constituted 89% satisfactory results. The study has shown that the LCP is an effective, dependable solution for the management of distal third diaphyseal fractures of the humerus.

Helical molecules such as DNA have recently been found to behave as an efficient source and detector of spin-polarized charge carriers. This phenomenon, often dubbed as chirality-induced spin selectivity or CISS, could be used to significantly improve the performance of spintronic devices, which utilize carrier spins (rather than charge) to realize electronic and sensing functions. Recently, it has been reported that carbon nanotubes, helically wrapped with DNA, can also act as an efficient source and detector of spin-polarized carriers, by virtue of spin-orbit coupling originating from the helical potential. It has been postulated that spin polarization should increase with the length of the wrapped tubes. However, in literature, most fabrication processes yield tubes with submicron lengths, which can produce ∼70% spin polarization. In an effort to enhance this effect further, here, we report a fabrication process that can yield DNA-wrapped nanotubes of length ∼1-4 microns. Detailed characterization of these devices, using atomic force microscopy, Raman, UV-vis, and temperature-dependent transport, has been presented. Initial transport measurements indicate the presence of strong magnetoresistance in these tubes, which could be attributed to spin-dependent effects. Systematic fabrication of long DNA-wrapped nanotubes, which has hitherto not been reported, is expected to enable further investigation into the spin-dependent properties of these ultimate one-dimensional nanoscale hybrids and may have a significant impact on nanoscale spintronics., Competing Interests: The authors declare no competing financial interest.