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Diabetes is one of the most serious chronic diseases that result in high blood sugar levels. Early prediction can significantly diminish the potential jeopardy and severity of diabetes. In this study, different machine learning (ML) algorithms were applied to predict whether an unknown sample had diabetes or not. However, the main significance of this research was to provide a clinical decision support system (CDSS) by predicting type 2 diabetes using different ML algorithms. For the research purpose, the publicly available Pima Indian Diabetes (PID) dataset was used. Data preprocessing, K-fold cross-validation, hyperparameter tuning, and various ML classifiers such as K-nearest neighbor (KNN), decision tree (DT), random forest (RF), Naïve Bayes (NB), support vector machine (SVM), and histogram-based gradient boosting (HBGB) were used. Several scaling methods were also used to improve the accuracy of the result. For further research, a rule-based approach was used to escalate the effectiveness of the system. After that, the accuracy of DT and HBGB was above 90%. Based on this result, the CDSS was implemented where users can give the required input parameters through a web-based user interface to get decision support with some analytical results for the individual patient. The CDSS, which was implemented, will be beneficial for physicians and patients to make decisions about diabetes diagnosis and offer real-time analysis-based suggestions to improve medical quality. For future work, if daily data of a diabetic patient can be put together, then a better clinical support system can be implemented for daily decision support for patients worldwide.

Background: Bangladesh's readymade garment (RMG) sector has developed as a major employer for individuals with disabilities. The number of workers with disabilities in Bangladesh's RMG industry has grown over the past few years. In Bangladesh, there has no statistics about the quality of life of workers with disabilities after their employment, especially after training-based employment support. Therefore, the researcher is interested to find out the quality of life of workers with disabilities in readymade garments factories in Bangladesh that will determine satisfaction over their life in different aspects. The objectives of this paper were to find out the health-related quality of life and overall satisfaction with life among workers with disabilities in the readymade garment sector in Bangladesh. Methods: This study used a cross-sectional design and recruited 102 participants with disabilities from various Bangladeshi garment factories who ranged up to 18 years by convenient sampling. The WHOQOL questionnaires were used for data collection through a combination of telephone and in-person interviews. Descriptive statistics were used for the data analysis. Results: Among the total participants 63% of them were women and 37% were men. The results revealed that education and job status significantly impacted on QOL. The majority of participants did not need any assistive devices; most of the participants resided in semi-urban areas, and physical disabilities predominated among them. On the other hand, most of the participants reported their quality of life as neither poor nor good but they were satisfied with health-related QOL. Conclusions: QOL is a vast aspect of every human being. This study finally concluded the overall QOL of maximum Workers with Disabilities in Readymade Garments Factories in Bangladesh was just average and most of them were satisfied with their health-related QOL.

Background: Proximal Femoral Nail (PFN) is a surgical technique used to treat unstable intertrochanteric fractures, which are fractures that occur in the upper portion of the thigh bone (femur). The procedure involves using a nail-like device that is inserted into the femur and secured in place with screws to stabilize the fracture and promote healing. It is a commonly used treatment option for this type of fracture and can lead to good outcomes in most cases. The aim of the study was to observe the outcome of Unstable Intertrochanteric fracture by Proximal Femoral Nail (PFN). Material Methods: This prospective observational study was conducted at the Department of Orthopedics, National Institute of Traumatology and Orthopedic Rehabilitation (NITOR), Dhaka, Bangladesh. The study duration was 2 years, from July 2017 to June 2019. A total of 34 cases were included in the study sing purposive sampling (non-randomized) according to availability of the patients and considering inclusion and exclusion criteria. Results: The participants’ age range was 16-90, with a mean of 56.91 ± 17.76. Most (35.29%) were 61-75 years old. 61.76% were female and 38.24% were male. 50% were housewives, 14.71% ex-service holders, 14.71% service holders, 11.76% businessmen, 5.88% students, and 2.94% farmers. The leading cause of injury was falls on slippery ground (55.88%), followed by motor vehicle injuries (44.12%). 70.59% of injuries occurred on the right side and 29.41% on the left. 76% had Kyle Type III fractures, 24% had type IV. 85.29% had open reduction, 14.71% had closed reduction. The mean duration of injury to operation was 15.59 days and the mean hospital stay was 19.15 days. 70.59% had no complications and 55.88% reported no pain at last follow-up. 58.82% had a good Harris hip score and 58.82% had excellent outcomes by final follow-up. Conclusion: The majority of patients in this study were in the 61-75 age range and female, with the most common cause of injury being falls on slippery ground. The most common fracture type was Kyle type IV, with a major portion of cases requiring open reduction. The rate of complications was relatively low, and the functional outcomes were acceptable and comparable to other studies. The duration of injury to operation and hospital stay were slightly longer than other studies, likely due to the busy nature of the study location. Overall, the Proximal Femoral Nail is a safe and effective treatment option for unstable proximal femoral fractures.

Purpose. This study aimed to provide the central bank of Bangladesh with some empirical data on the impact of bank agricultural credit on agricultural output as a priority sector lending. Methodology / approach. Econometric analysis is applied to discover the nature of the relationship between banks’ agricultural credit and agricultural gross domestic product (GDP) and to find the impact of bank agricultural credit on agricultural output in Bangladesh. Data are extracted from secondary sources, i.e., Bangladesh Bank, Bangladesh Bureau of Statistics, World Bank, and Ministry of Finance for 1991 to 2018. Time-series data are analyzed using the Augmented Dickey–Fuller (ADF) unit root test and the Johansen cointegration test and later examined with Vector Error Correction Model (VECM). Results. The Augmented Dickey–Fuller unit root test confirmed that the variables were non-stationary at their level data and became stationary after taking their first difference value. Since the variables are integrated at I(1), we performed the Johansen Co-integration test. Subsequently, one co-integration equation was found, and Vector Error Correction Model estimation was done afterwards. According to the results of VECM estimation, bank agricultural credit, pesticide consumption, and use of cropped areas have long-run relation with agricultural output. Originality / scientific novelty. This study reveals the nature of relationship and assessment of the impact of bank credit on agricultural GDP with empirically valid techniques and tools. In this context, the data from Bangladesh remains very rare. Moreover, for those works which have been done in the context of Bangladesh, appropriate methods and techniques are not always inherent. Hence, this significant research gap is addressed in our present study. Thus, we expect that the findings of this study from Bangladesh based on empirically valid standard techniques can incrementally contribute to the existing literature. Practical value / implications. Findings of this research, can be used as an information basis by the central bank of Bangladesh. Based on the findings of this research, Bangladesh Bank should initiate new policies and programs regarding agricultural credit for the projected increase in agricultural GDP in Bangladesh.

Entrepreneurs contribute to economic development regarding innovation, job creation and income generation. It is also effectively recognized as a fundamental part of economic development and vital in lifting countries from poverty. Women entrepreneurs organize and manage an organization, particularly a business. Women’s entrepreneurship has consistently expanded worldwide during the 20th and 21st centuries. Bangladesh will have a big number of young women and productive workers after the COVID-19 epidemic, allowing them to engage in the Small and Medium Enterprises (SME) sector. Women entrepreneurs can help in the elimination of hunger, the reduction of inequities, and the improvement of children’s nutrition, health, and school attendance. Also, it has been acknowledged as an important source of economic growth since it creates new jobs and provides society with various solutions to managerial, organizational, and business challenges. Therefore, the purpose of this research was to determine the impact of technological factors, parental support factors, municipal factors, knowledge and skills factors, psychological factors, and financial factors on women’s engagement in innovative business development in the context of Bangladesh’s SME sector in the post COVID-19 pandemic. This study included both statistical and discussion of the data. Data was collected from over 300 real Bangladeshi ladies using an online purposive sampling approach. To test hypotheses, the data were evaluated using descriptive statistics, collinearity statistics, and other regression analyses. As per study’s results, most variables, including administrative, scientific, and familial cooperation, knowledge and skills, psychological, and financial component, has both advantages statistically impressive relationship with women’s involvement in the context of the SME area in Bangladesh in the post COVID-19 pandemic. In the post COVID-19 pandemic, everyone from every sector will use the findings to encourage women’s participation in entrepreneurial activities in the context of the SME division in Bangladesh.

This present research aimed to investigate the effect of slice thickness and concentration of the osmotic solution on mass transfer kinetics, the color profile of osmotically dehydrated pineapple slices, and product quality characteristics of osmotically dehydrated microwave-dried (ODMWD) products. Three slice thicknesses (0.5, 1, and 1.5 cm) and three concentrations of osmotic solution (40, 50, and 60 °Brix) were used. The mass transfer kinetics (moisture reduction behaviour, weight loss, solid gain), physicochemical properties (color, TSS, pH, titratable acidity, vitamin C, and total sugar), and total phenolic content of pineapple slices were analyzed. During osmotic dehydration, the moisture reduction behaviour of 0.5 cm slices was faster in all osmotic solutions, whereas water loss and solid gain were higher for all slices treated with 60 °Brix. Both slice thickness and concentration of the solution significantly affected the color of OD pineapple slices. For ODMWD products, total soluble solids (TSS), pH, ascorbic acid content, total sugar, and total phenolic content increased for all slice thicknesses with an increase in osmotic solution concentration, whereas titratable acidity exhibited the opposite result. The rehydration ratio was higher in 0.5 cm slices for all solution concentrations. According to the finding, pineapple fruits can be dehydrated by using 60 °Brix solution concentration with 0.5 cm slices for making dehydrated pineapple fruit, and osmotic dehydration followed by microwave drying of pineapple fruit could be used for value-added processing products.

Background: Stricture urethra is a frequent urological problem and substitution urethroplasty is the standard treatment for longer (>2 cm) urerthral strictures, multiple urethral strictures and recurrent strictures. Currently, buccal mucosa graft (BMG) is the preferred donor site for substitution urethroplasty which is associated with donor site morbidities. The mucosa covering the lateral and undersurface of the tongue is identical to the rest of the lining of oral cavity and seems to be associated with less risk of donor site complications. The aim of the study was to compare the surgical outcome and donor site morbidity of buccal versus lingual mucosa graft in anterior urethroplasty. Methods: A prospective experimental study was done in the department of Urology Dhaka Medical College Hospital during the period of April 2017 to September 2018. Total 54 Patients were included by purposive sampling for the study as per inclusion and exclusion Criteria. Patients were than allocated into two groups. Group A consisted of 27 patients where Lingual mucosa graft (LMG) urethroplasty done and group B also consisted of 27 patients where Buccal mucosa graft (BMG) urethroplasty done. Results: In the present study, the baseline characteristics of the patients in group A and Group B were almost similar having no statistically significant difference. The overall surgical outcome between two groups was in group A 92% and in group B 88%. The inter-group difference was not statistically significant. Donor site complications more frequently occurred in Group B. Pain in oral cavity at 3rd week in Group A was in 1(4%) patient and in group B was in 9(36%) patients, at 6th month follow up, eating and drinking problem (Group A 4% versus group B 32%), peri-numbness (Group A 4% versus Group B 28%), oral tightness (Group A 0% versus Group B 32%), salivary disturbance (Group A 0% versus Group B 28%) were significant statistically (p

This work aims to investigate and assess the beneficial function and feasibility of nanofluids in minimum quantity lubrication (MQL) assisted machining. The goal is to develop newly generated CNT based nano hybrid cutting fluid and demonstrate its effect on surface roughness of Al alloy. Moreover, the fabricated nano hybrid cutting fluid will eventually reduce cutting fluid consumptions and maintain an eco-friendly environment. Three conditions were used to perform the machining process such as dry condition, conventional oil and Al_2O_3/CNT nanoparticle with EVO oil as base fluid. The lowest surface roughness achieved for nanofluid and the maximum surface roughness for the dry condition. In terms of looking for optimum parametric combination, Artificial Neural Network (ANN) and Response Surface Methodology (RSM) have been used. The ANN technique has proved its efficiency since its correlation coefficients, mean prediction errors (MPEs), and root mean square errors (RMSEs) are small compared to the RSM approach.

No one is calling the Russia-Ukraine conflict is considered the commencement of World War III right now. But all analyzes see it as Europe's biggest conflict since World War II as the war dragged on and it assumed a different character as well. The opening weeks of Russia's invasion of Ukraine were a war of military strategy. On the other hand, the Ukrainian troops-built resistance was necessary to stop the enemy's advance. In military strategy, a well-trained and efficient army is necessary to conduct war properly. Over the past six years, with the help of Western allies, Ukraine has been able to build a military capable of such a war. As part of such a war, where resistance is needed (such as in Kyiv), the Ukrainian military has done so. Again, the army has withdrawn from where it is necessary to retreat (Donetsk and Luhansk). The Russian - Ukraine war can be considered a multi-dimensional disaster, which is likely to get much worse in the foreseeable future because while a war is successful, little attention is paid to its causes, but when the outcome is disastrous, understanding how it happened becomes paramount. All in all, this study intends to provide an overview of the Russia-Ukraine war and its causes with Waltz's three Images as Individual, Domestic Politics, and international systems as well. In addition to this, it also has attempted to understand the long-term effect(s) on world politics as well.

A wildfire, an unplanned fire that is mainly uncontrolled and originates in combustible vegetation in rural or urban settings, is one of the most pervasive natural catastrophes in some areas, such as Siberia, California and Australia. Many studies, such as standard reviews, have been undertaken to look into the works of literature on wildfires or forest fires and their effects on aquatic and terrestrial ecosystems. Regrettably, conventional literature reviews failed to identify the important researchers, evolving complexities, emerging research hotspots, trends and opportunities for further research on the ground of wildfire study. The present study employs bibliometric analysis to investigate this study area qualitatively and quantitatively. The Scopus database systems and Web of Science Core Collection yielded 78 qualifying papers, which were then evaluated using Biblioshiny (A bibliometrix tool of R-studio). According to the statistics, the discipline is expanding at a pace that is 13.68% faster than average. So far, three key periods of transformation have been documented: preliminary evolution (8 articles; 1999–2005), gentle evolution (14 articles; 2006–2013) and quick evolution (56 articles; 2014 to 2021). Forest Ecology and Management and Science journals have the highest number of publications, accounting for 7.70% of total wildfire-related articles published from 1999 to 2021. However, recent data indicate that investigators are shifting their focus to wildfires, with the term ‘Australia’ having the highest frequency (91) and ‘wildfire’ having the second highest (58) as the most appeared keywords. The present study will provide a foundation for future research on wildfire incidence and management by receiving information by synthesising previously published literature in Australia and around the world.

PDF file, 293KB, Quantification of proliferating cells in 4T1 tumors.

The native sIGFIR decoy protein blocks IGF-I and IGF-II mediated functions in vitro

Kinetics and specificity of ligand binding to rhIGFBP-1

This documents contains the legends of Figures 1 to S6

This documents contains the materials and methods of experiments described in supplementary data

PDF file, 144KB.

Deregulation of TGF-β superfamily signaling is a causative factor in many diseases. Here we describe a protein engineering strategy for the generation of single-chain bivalent receptor traps for TGF-β superfamily ligands. Traps were assembled using the intrinsically disordered regions flanking the structured binding domain of each receptor as "native linkers" between two binding domains. This yields traps that are approximately threefold smaller than antibodies and consists entirely of native receptor sequences. Two TGF-β type II receptor-based, single-chain traps were designed, termed (TβRII)2 and (TβRIIb)2, that have native linker lengths of 35 and 60 amino acids, respectively. Both single-chain traps exhibit a 100 to 1,000 fold higher in vitro ligand binding and neutralization activity compared with the monovalent ectodomain (TβRII-ED), and a similar or slightly better potency than pan–TGF-β–neutralizing antibody 1D11 or an Fc-fused receptor trap (TβRII-Fc). Despite its short in vivo half-life (3) significantly inhibited further tumor growth, whereas the 1D11 antibody did not. Overall, our results indicate that our rationally designed bivalent, single-chain traps have promising therapeutic potential. Mol Cancer Ther; 11(7); 1477–87. ©2012 AACR.

PDF file, 832KB, Schematics and molecular models of single-chain activin and BMP traps.

The IGF-Trap blocks IGF-I and IGF-II mediated functions in vitro

Production and characterization of native, sIGFIR

PDF file, 243KB, Improved neutralization of BMP-2 using single-chain bivalent trap (BMPR1a)2 compared to monovalent receptor BMPR1a-ED.

PDF file, 2243KB, Molecular dynamics analysis of the (TBRII)2 trap in complex with TGF-B3.

This document contains Table S1 to S3

PDF file, 297KB, TGF-B1 neutralization using a (TBRII)2 trap having a natural or artificial linker sequence.

Plasma insulin levels are not markedly altered in IGF-Trap injected mice

Production and characterization of the IGF-Trap

Background: Hepatocellular Carcinoma (HCC) is the most common malignant neoplasm of the liver worldwide. Liver cancer ranks third among all cancer deaths in Bangladesh as the clinical presentation is non-specific, the modern imaging modalities can play an important role in the diagnosis of HCC and the radiologist is often the first to suggest the correct diagnosis. With the advent of multi-detector spiral CT, detection and characterization of HCC has markedly improved. Multi-detector spiral CT with its increased spatial and temporal resolution allows multiple perfusion phases of liver to be acquired.Multi-detector biphasic spiral CT techniques have been increasingly promising with respect to accurate preoperative diagnosis and assessment of the extent of HCC. This study was carried out to evaluate the role of biphasic contrast-enhanced spiral CT including Hepatic Arterial Phase (HAP) imaging with Portal Venous Phase (PVP) imaging, in the detection and characterization of HCC. Methods: The study included 35 patients (M=31, F=4) with histopathologically proven HCC. Age range was between 21-75 years (mean=51) by following consecutive patients in whom HCC was diagnosed or suspected either by raised serum a (alpha)-fetoprotein level or byultrasound imaging. Results: Biphasic contrast-enhanced examination in these 35 patients could reveal a total of 65 lesions, out of which 48% were unifocal and 46% were multifocal HCCs. On HAP imaging 92% lesions were detected. (hyper attenuating = 56, hypo attenuating = 4) while on PVP imaging delectability was only 51% (hyper attenuating=2, hypo attenuating=30). Hence delectability was significantly superior in HAP as compared to PVP imaging (p

Vegetables offer a low-cost source of nutrition relative to other food products. Vegetables are typically labor-intensive crops and thus deliver a large amount of food as well as a pledge to create expanded opportunities for rural jobs. Bangladesh's climate and soil is very suitable for growing vegetables all year round. Two upazila were picked from the Narsingdi district, namely Shibpur and Raypura. Data for the study were collected during the month of November 2019 to February in 2020. For sample collection, a random sampling technique was applied. 60 farmers were chosen for the analysis by random sampling. 21 were small, 26 were medium and 13 were large among the 60 farmers. The size of the farm was arbitrarily categorized on the basis of the land where vegetables and other crops are grown. Farmers with 0.01-0.33 acres were considered small, 0.34-1.00 acres were considered medium farmers, and those with over 1.00 acres were considered large farmers. For tabulation purposes, the collected data was scrutinized and summarized using the Statistical Package for Social Sciences (SPSS) and Microsoft Office Excel 2013. Socio-economic characteristics of vegetable farmers, description of the size of vegetable land, production methods, inputs used and returns of vegetable farmers were included in the tabular technique study. Statistical analysis has been used to demonstrate the influence of the inputs used and other associated vegetable cultivation factors. The variable cost per acre of production of Brinjal, Tomato and Country beans was calculated to be 74260, 61870 and 66680 respectively, and their corresponding fixed cost was Tk. 13713 and 13094, respectively, and 13334. The per acre gross cost of the production of Brinjal, Tomato and Country beans was Tk. Tk. 118000. 116977 as well as Tk. 120522, respectively, respectively. The gross margin per acre of vegetables picked was Tk. 179240, 155630 and 229420, respectively. The per acre net return of the production of Brinjal, Tomato and Country beans was Tk. 91267, 80666 and 149406, respectively, respectively. The undiscounted profit cost ratio per acre of production of Brinjal, Tomato and Country beans was 2.88, 2.90 and 3.70, respectively. The vegetable producers in the study areas were facing various problems which are broadly classified into production problems. Some of the production problems were inadequate capital, attack of pest and diseases, lack of quality seed, lack of availability of adequate inputs and higher cost of inputs.

Land cover change has posed significant concerns to biodiversity and climate change in Bangladesh and globally. Despite the country’s designation of forest regions as protected areas to conserve their valuable resources, deforestation and forest conversion remained unabated. Fashiakhali Wildlife Sanctuary (FKWS), a protected area in the Chittagong Hill Tracts, and its surrounding forested impact area have experienced considerable changes over the years, yet are deficient in extensive assessment. This study evaluated the land use land cover (LULC) changes in the FKWS impact area over almost 3 decades (1994–2021) using multispectral remotely sensed data. The Landsat images of 1994, 2001, 2010, and 2021 were classified using a maximum likelihood algorithm and analyzed for change detection. The comparative potential of vegetation indices, including Normalized Difference Vegetation Index (NDVI) and Soil Adjusted Vegetation Index (SAVI), in forest cover assessment, and the relationship between Land Surface Temperature (LST) and NDVI was also assessed. A significant forest cover loss of around 1117.17 ha (16%) was recorded in the FKWS impact area between 1994 and 2021, with the hugest proportion of 867.78 ha (12.24%) deforested in the first period (1994–2001). Agricultural land also declined by 593.73 ha (8.37%) within the entire period, despite its initial increase of 392.04 ha (5.53%) between 2001 and 2010, being the primary driver of earlier deforestation. However, in the recent decade (2010–2021), settlement expansion of 963.90 ha (13.59%) due to massive human migration in the area contributed to the most remarkable overall land cover change of 1731.51 ha (24.42%). Furthermore, NDVI provided a better and more accurate forest cover assessment than SAVI and was recommended to aid in the quick evaluation and monitoring of the future impacts of agriculture, settlement, and other sorts of land use on the forest cover. In tandem with the widely acknowledged issue of increased temperature due to climate change, an absolute negative correlation was found between the NDVI and LST, confirming the negative impact of climate change on forest loss in the FKWS impact area.

In this study, the authors tried to identify the relationship between bank credit and agricultural output in Bangladesh. Simultaneously impact assessment of bank credit on agricultural output is also investigated. Different econometric techniques are used to determine the nature of the relationship between bank credit and agricultural output and the impact of bank credit. A total of 40 years (1981-2020) of annual time series data were collected from the Annual Reports of the Bangladesh Bank and World Bank’s world development indicators. Stationarity and cointegration tests were performed initially and then analyzed with Vector Error Correction Model, confirming a long-run relationship between bank credit and agricultural output. Additionally, univariate and multivariate OLS models are performed to identify the magnitude of bank credit’s impact on agricultural output. Both models revealed that bank credit positively and significantly affects agricultural production in Bangladesh. Based on these findings, the authors recommend additional fund allocation to the agricultural production system by the banks in Bangladesh.

In this article, we execute the enhanced ( G ' / G )-expansion method to search for new and further general closed-form wave solutions to the nonlinear partial differential equation, namely the Benny Luke equation. This method is one of the powerful techniques that come into view in recent time for establishing more exact wave solutions to nonlinear partial differential equations. We have achieved some new exact solutions including soliton and periodic wave solutions with arbitrary parameters and the solutions are expressed in terms of hyperbolic and trigonometric functions. The efficiency of this method for finding exact solutions has been established. It is shown that the enhanced ( G ' / G )-expansion method is direct, effective and can be used for many other nonlinear partial differential equations in mathematical physics and engineering.

Preparation of biochar from kitchen waste could be a potential way of waste management. This research aimed to prepare biochar and compost from kitchen waste and test their effects on the yield and biomass production of maize. We separated kitchen waste from municipal waste to prepare biochar, compost and ComBio (co-composting with biochar). Four fertilizer combinations viz. T0 = Recommended doses of chemical fertilizer (RDF), T1= biochar (20 t ha-1) + RDF, T2= compost (15 t ha-1) + 75% RDF and T3= ComBio (15 t ha-1) + 50% RDF were used to grow maize. Maize biomass, and yield attributing characters and basic soil properties after harvesting maize were measured. Data explored that up to 50% reduction of chemical fertilizer has an insignificant effect on the growth and biomass accumulation of maize. Similarly, yield and yield contributing characteristics of maize such as cob length, cob diameter, the weight of 1000-grains and yield did not vary among the treatments. Further, soil pH, EC, TDS and SOM contents were higher in biochar treated soil compared to other treatments. The results indicate that the application of biochar has the potential to reduce the chemical fertilizer dose of maize by improving soil properties, a prerequisite issue of sustainable crop production.

A common problem in pixelwise classification or semantic segmentation is class imbalance, which tends to reduce the classification accuracy of minority-class regions. An effective way to address this is to tune the loss function, particularly when Cross Entropy (CE), is used for classification. Although several CE variants have been reported in previous studies to address this problem, for example, Weighted Cross Entropy (WCE), Dual Cross Entropy (DCE), and Focal Loss (FL), each has their own limitations, such as introducing a vanishing gradient, penalizing negative classes inversely, or a sub-optimal loss weighting between classes. This limits their ability to improve classification accuracy or reduces their ease of use. Focal Loss has proven to be effective at balancing loss by increasing the loss on hard-to-classify classes. However, it tends to produce a vanishing gradient during backpropagation. To address these limitations, a Dual Focal Loss (DFL) function is proposed to improve the classification accuracy of the unbalanced classes in a dataset. The proposed loss function modifies the loss scaling method of FL to be effective against a vanishing gradient. In addition, inspired by DCE, a regularization term has also been added to DFL to constrain the negative class labels to further reduce the vanishing gradient effect and increase the loss on hard-to-classify classes. Experimental results show that DFL has better training performance, and provides greater accuracy compared to CE, WCE, FL and DCE in every test run conducted over a variety of different network models and datasets.

Globally, healthcare systems are struggling to make a healthier citizen by dropping infectious and non-infectious diseases. South-east Asian countries have achieved several Millennium Development Goals (MDG) with the efforts of better health system management. For instance, in the year 2015, the healthcare system of Bangladesh has achieved the MDG-Four in reducing the infant mortality rate and growth rate. Even then, the life-threatening diseases still remain as a major challenge to the healthcare systems in Bangladesh. Among those, non-communicable diseases (NCDs) are the major cause of death, and stroke is the second leading NCD in accordance with causes of death and long-term disability in Bangladesh. The majority as 80% of stroke survivors are living with either minor or major physical, emotional, and cognitive disabilities. They could get back to their functional life through comprehensive rehabilitation services. Nevertheless, information on the availability of rehabilitation services is not visible to all citizens of Bangladesh. That’s why more than half of all stroke survivors are dying on their way to the hospital to seek health care facilities. Therefore, the aim of this literature review was to present a clear vision of the healthcare system and the path of care to all citizens of Bangladesh.

Species derived from N-Heterocycles with BF3 Lewis acids generate adducts that are redox active. Here we report the synthesis and characterization of 5 N-Heterocycle-BF3 adducts: Py-(BF3)2, Q-(BF3)2, Ph-(BF3)2, TMQ-(BF3), and Dipy-(BF3)2. The new adducts were structurally characterized by 1H, 11B, and 19F NMR. As an example, the Q-BF3 adduct is stable in an inert environment but in the presence of oxygen or water, its voltammetric profile decays, suggesting chemical decomposition of the adduct. Furthermore, this decomposition is accompanied by the generation of BF4-. The crystalline structure of the reaction product of TMQ-(BF3) with traces of water was obtained, showing that the BF3 generates BF4- counterion. Based on our observations, we proposed a plausible reaction mechanism for the generation of BF4-.

Background Healthcare workers (HCWs), such as doctors, nurses, and support staffs involved in direct or indirect patient care, are at increased risk of influenza virus infections due to occupational exposures. Vaccination is the most effective way to prevent influenza. Despite the World Health Organization (WHO) recommendations, Bangladesh lacks a seasonal influenza vaccination policy for HCWs, and thus vaccination rates remain low. The current project aims to investigate the effect of interventions on influenza vaccine awareness and availability of vaccine supply, explore HCWs’ knowledge and perceptions about influenza vaccination, understand the barriers and motivators for influenza vaccine uptake, and understand policymakers' views on the practicality of influenza vaccination among HCWs. Method We will conduct the study at four tertiary care teaching hospitals in Bangladesh, using a cluster randomized controlled trial approach, with the hospital as the unit of randomization and intervention. The study population will include all types of HCWs.The four different types of intervention will be randomly allocated and implemented in four study hospitals separately. The four interventions will be: i) ensuring the availability of influenza vaccine supply; ii) developing influenza vaccine awareness; iii) both ensuring influenza vaccine supply and developing influenza vaccine awareness and iv) control arm with no intervention. Both quantitative and qualitative approaches will be applied to assess the intervention effect. We will estimate the Difference in Differences (DID) with 95% CI of the proportion of vaccine uptake between each intervention and control (non-intervention) arm, adjusting for the clustering effect. The qualitative data will be summarised using a framework matrix method. Discussion The results of this study will inform the development and implementation of a context-specific strategy to enhance influenza vaccination rates among Bangladeshi HCWs. Trial registration Clinicaltrials.gov NCT05521763. Version 2.0 was registered in September 2022, and the first participant enrolled in March 2022. Retrospectively registered.

Acute pyelonephritis is a bacterial infection of the renal pelvis and parenchyma, most commonly seen in young women. Complicated and uncomplicated pyelonephritis, xanthogranulomatous pyelonephritis, and tuberculosis are all urinary tract infections for which imaging evaluation adds diagnostic information important for patient care. The incidence of focal acute pyelonephritis parallels that of lower urinary tract infection, approximately five times more common in female with a sharp increase following puberty. Diagnosis is typically based on characteristics clinical feature and abnormal laboratory values. Imaging aids further assessment. Here we present a case of young pregnant women who reported with severe right loin pain and burning micturition for an emergency ultrasound. Ultrasound showed features of acute pyelonephritis. Routine urine examination showed plenty of pus cells and absence of RBC. Considering risk: benefit ratio, the clinician performed CT scan which confirms the diagnosis. Sir Salimullah Med Coll J 2022; 30: 93-95