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Aim: Prostate biopsy can be prone to complications and thus should be avoided when unnecessary. Although the combination of magnetic resonance imaging (MRI), the prostate health index (PHI), and PHI density (PHID) has been shown to improve detection of clinically significant prostate cancer (csPCa), there is limited information available assessing its clinical utility. We sought to determine whether using PHID could enhance the detection of PCa on MRI ultrasound fusion-targeted biopsy (MRF-TB) compared to other biomarker cutoffs. Methods: Between June 2015 and December 2020, 302 men obtained PHI testing before MRF-TB at a single institution. We used descriptive statistics, multivariable logistic regression, and receiver operating characteristic curves to determine the predictive accuracy of PHID and PHI to detect ≥ Gleason grade group (GGG) 2 PCa and identify cutoff values. Results: Any cancer grade was identified in 75.5% of patients and ≥ GGG2 PCa was identified in 45% of patients. The median PHID was 1.05 [interquartile range (IQR) 0.59–1.64]. A PHID cutoff of 0.91 had a higher discriminatory ability to predict ≥ GGG2 PCa compared to PHI > 27, PHI > 36, and prostate specific-antigen (PSA) density > 0.15 (AUC: 0.707 vs. 0.549 vs. 0.620 vs. 0.601), particularly in men with Prostate Imaging Reporting and Data System (PI-RADS) 1–2 lesions on MRI (AUC: 0.817 vs. 0.563 vs. 0.621 vs. 0.678). At this cutoff, 35.0% of all the original biopsies could be safely avoided (PHID < 0.91 and no ≥ GGG2 PCa) and csPCa would be missed in 9.67% of patients who would have been biopsied. In patients with PI-RADS 1–2 lesions using a PHID cutoff of 0.91, 56.8% of biopsies could be safely avoided while missing 0 csPCa. Conclusions: These findings suggest that a PHID cutoff of 0.91 improves the selection of patients with elevated prostate-specific antigen who are referred for prostate biopsy, and potentially in patients with PI-RADS 1–2 lesions.

Globally, Vitamin D insufficiency is a problem that has a considerable impact on people’s health. According to recent studies, Vitamin D may potentially have positive impacts on serum lipid profiles, enhancing coronary condition. Therefore, the main aim of the present review is to examine Vitamin D supplement on hypercholesterolemia and coronary artery disease (CAD). We conducted a comprehensive literature search from 2012 to 2023, comprising Medline, Web of Science, PubMed, Cochrane Library, and additional sources such as Google Scholar and clinicaltrials.gov. We reviewed a wide range of study types, including studies, trials, commentaries, and editorials. To assess bias, we used a recommended methodology, utilizing a two-part tool to address five specific domains: Selection bias, performance bias, attrition bias, selective reporting, and other biases. We also employed a quality assessment tool for evaluating the quality of diagnostic accuracy studies. In this review, we incorporated 11 studies. The mean age of the cases was 60.11 years. The Vitamin D supplement mean dose was 8772.42 IU/day. The Vitamin D supplement group showed mean variations in high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglyceride (TAG) cholesterol, and total cholesterol levels of 3.3 mg/dl, 8.6 mg/dl, 10.625 mg/dl, and 9.45 mg/dl, correspondingly. Whereas, the mean variation in HDL-C, LDL-C, TAG as well as total cholesterol levels in the placebo group was 4.185714 mg/dl, 2.60825 mg/dl, 6.50625 mg/dl, and 6.2875 mg/dl, respectively. Vitamin D supplementation demonstrated enhancements in serum levels of total cholesterol, LDL-C, HDL-C, and TAGs. Clinical tests for hypercholesterolemia should be implemented on patients at risk for heart illness and CAD, and Vitamin D supplements are beneficial. For individuals who are Vitamin D deficient, doctors may think about supplementing their routine cholesterol therapies with Vitamin D.

Abstract Objective This study aims to evaluate the epidemiology of asthma among children and adolescents in the Eastern Mediterranean Region. Methods Exhaustive searches were conducted across databases, including PubMed, Scopus, Web of Knowledge Core Collection, Embase, and Google Scholar. The selection criteria included studies reporting asthma prevalence in individuals aged 0 to 19 years, using validated questionnaires. Data were extracted and synthesized using the DerSimonian and Laird random effects model. Results The overall prevalence of asthma in Eastern Mediterranean Regional Office (EMRO) countries, among the 514,468 children and adolescents included in this meta-analysis, was 10.61%, synthesized from 95 studies. Among the countries studied, Qatar exhibited the highest prevalence at 16.69%, followed by Saudi Arabia at 16.57%, Iraq at 16.22%, Oman at 15.20%, and Afghanistan at 14.90%. Adolescents showed a slightly higher prevalence of asthma at 10.10% compared to children at 9.70%. Boys exhibited a higher prevalence at 11.48% compared to girls at 9.75%. Urban areas demonstrated a higher prevalence at 11.27% than rural areas at 8.29%. Conclusion Efforts to reduce asthma prevalence in Arab countries and address underdiagnosis in African nations within the EMRO are crucial. Targeted interventions should focus on addressing environmental triggers and improving access to healthcare. Enhanced diagnostic capabilities and healthcare infrastructure are necessary in African countries. Collaborative action is essential to alleviate the asthma burden and promote respiratory health across the EMRO region.

Abstract Cardioprotective Unani drug, Saad Kufi (Cyperus scariosus R.Br.), mentioned by the intellectual colossus Ibn Sina (Avicenna) a thousand years back in his book, “Kitab al-Adviya al-Qalbia” and still widely used by Unani physicians, was selected for experimental study. The main objective of the study was to explore the trial drug ex vivo for validation, hemodynamic elucidation, and molecular mechanism identification for the improvement of Unani therapeutics and to identify a safe and effective novel cardiovascular drug for mainstream medicine. Five doses of 50% ethanolic extract of the physiochemically standardized root were studied in a normal rat heart, on a semi-automated Langendorff apparatus supported with an advanced data acquisition system, perfused with carbogenated non-recirculating Kreb’s-Hensleit solution, at constant flow mode, by continuous recording. The effect of 6 repetitions (n = 6) of each dose was studied with the following parameters on the Lab chart pro version: heart rate, left ventricular developed pressure, cardiac work, and coronary pressure. The significance of the difference was determined by the student’s “t” test. Results of all doses of Saad Kufi showed a significant increase in the above parameters. The maximum increase was observed by Dose III. It could be concluded that Unani’s clinical use of Saad Kufi (C. scariosus R.Br) as cardioprotective was validated and higher doses were indicated to be clinically optimal. Hemodynamically and molecular mechanism-wise, it is indicated to be a sympathomimetic or inotropic-like agent and possibly a direct vasodilator. Since existing long-term treatment of heart failure is not done by cardiac stimulants or positive inotropic and chronotropic agents, the possible future clinical demonstration of therapeutic improvement in heart failure will bring Saad Kufi as a novel drug in mainstream medicine.

Abstract A random initialization of the search particles is a strong argument in favor of the deployment of nature-inspired metaheuristic algorithms when the knowledge of a good initial guess is lacked. This article analyses the impact of the type of randomization on the working of algorithms and the acquired solutions. In this study, five different types of randomizations are applied to the Accelerated Particle Swarm Optimization (APSO) and Squirrel Search Algorithm (SSA) during the initializations and proceedings of the search particles for selective harmonics elimination (SHE). The types of randomizations include exponential, normal, Rayleigh, uniform, and Weibull characteristics. The statistical analysis shows that the type of randomization does impact the working of optimization algorithms and the fittest value of the objective function.

Abstract Background Little is known about the relationship of physical activity (PA) and fitness with cardiometabolic risk among rural adolescents in low- and middle-income countries. Thus, we examined the associations of PA and fitness with selected cardiometabolic indicators along with potential gender-based differences in a birth cohort of rural adolescents from southeast Bangladesh. Methods We utilized data from the 15-year follow-up of Maternal and Infant Nutrition Interventions in Matlab (MINIMat) cohort (n = 2253). Wrist-worn ActiGraph wGT3x-BT accelerometers were used to estimate sedentary time (ST) and PA. Fitness was assessed using: handgrip strength, standing long jump, and Chester Step Test. Anthropometric parameters, systolic blood pressure (SBP), and fasting lipid, insulin and glucose levels were measured. We calculated insulin resistance using the Homeostasis Model Assessment equation (HOMA-IR). Linear regression and isotemporal substitution models were fitted. Results The adolescents spent 64 min/day (inter-quartile range: 50–81) in moderate-to-vigorous physical activity (MVPA). A 10-minute-per-day higher vigorous PA (VPA) was associated with: 4.9% (95% confidence interval (CI): 2.9–6.8%) lower waist circumference (WC), 3.2 mmHg (95% CI: 1.5–4.8) lower SBP, 10.4% (95% CI: 2.9–17.3%) lower TG, and 24.4% (95% CI: 11.3–34.9%) lower HOMA-IR. MVPA showed similar associations of notably smaller magnitude. Except for WC, the associations were more pronounced among the boys. Substituting ST with VPA of equal duration was associated with lower WC, SBP, triglyceride and HOMA-IR. Grip strength was favorably associated with all indicators, displaying considerably large effect sizes. Conclusion Our findings indicated beneficial roles of PA– particularly VPA– and muscular fitness in shaping cardiometabolic profile in mid-adolescence. VPA and grip strength may represent potential targets for preventive strategies tailored to adolescents in resource-limited settings.

Climate change poses a significant threat to the security and sustainability of global food systems, particularly in vulnerable regions such as Bangladesh. This paper comprehensively reviews the impact of climate change on food system security and sustainability in Bangladesh. Specifically, it examines the country's food system and, the climatic conditions endangering food systems and associated vulnerabilities. A systematic review methodology was adopted to select the relevant literature, based on predefined inclusion criteria and research questions. To mitigate selection bias, the research team independently screened and evaluated the articles for inclusion in the review process. Our review reveals increasing trends in temperature fluctuations and irregular rainfall occurrences, posing significant challenges in terms of crop management and planning. The occurrence of floods due to extreme rainfall and sea-level rise exacerbates food insecurity in affected areas. Additionally, moderate to severe droughts have been identified in some regions. The paper also evaluates the effectiveness of current adaptation initiatives and the degree of integration among relevant stakeholders. Through this analysis, the paper emphasizes the importance of local climate-change adaptation strategies and stakeholder collaboration in mitigating the adverse impacts of climate-change on food system security. HIGHLIGHTS The study identifies the climate-change challenges to Bangladesh's fragile food system.; Economic losses and rice production decline are identified due to climate change.; Emphasis on local adaptation initiatives to build resilience among farmers.; Recognition of challenges in existing adaptation efforts.; Call for government-led scaling-up of adaptation programs to enhance food system security and sustainability.;

Abstract Basal cell carcinoma (BCC) is the most common skin cancer. Skin cancers may present either as a non-invasive tumor or an invasive malignancy. The terminology of carcinoma in situ is used when the tumor is either just limited to epidermis or not present as single cells or nests in the dermis. However, currently the terminology superficial BCC is inappropriately used instead of BCC in situ when the skin cancer is limited to epidermis. In this study we compare the pathologic changes of superficial, nodular, and infiltrative BCCs using electron microscopy to identify the ultrastructural characteristics and validate the previously proposed terminology. Three cases of BCC (superficial BCC, nodular BCC, and infiltrative BCC) diagnosed by dermatopathologists at our institute were selected for review. Paraffin block tissues from these cases were sent for electron microscopy studies which demonstrated disruption of basal lamina in both nodular and infiltrative type of BCC, while it remains intact in BCC superficial type after extensive examination. Therefore, similar to other in situ skin cancers, there is no invasion of the neoplasm in superficial BCC into the dermis. Hence, the older term superficial BCC should be appropriately replaced with the newer terminology BCC in situ.

Abstract Background Understanding the stressors and coping strategies of nursing students in their first clinical training is important for improving student performance, helping students develop a professional identity and problem-solving skills, and improving the clinical teaching aspects of the curriculum in nursing programmes. While previous research have examined nurses’ sources of stress and coping styles in the Arab region, there is limited understanding of these stressors and coping strategies of nursing students within the UAE context thereby, highlighting the novelty and significance of the study. Methods A qualitative study was conducted using semi-structured interviews. Overall 30 students who were undergoing their first clinical placement in Year 2 at the University of Sharjah between May and June 2022 were recruited. All interviews were recorded and transcribed verbatim and analyzed for themes. Results During their first clinical training, nursing students are exposed to stress from different sources, including the clinical environment, unfriendly clinical tutors, feelings of disconnection, multiple expectations of clinical staff and patients, and gaps between the curriculum of theory classes and labatories skills and students’ clinical experiences. We extracted three main themes that described students’ stress and use of coping strategies during clinical training: (1) managing expectations; (2) theory-practice gap; and (3) learning to cope. Learning to cope, included two subthemes: positive coping strategies and negative coping strategies. Conclusions This qualitative study sheds light from the students viewpoint about the intricate interplay between managing expectations, theory practice gap and learning to cope. Therefore, it is imperative for nursing faculty, clinical agencies and curriculum planners to ensure maximum learning in the clinical by recognizing the significance of the stressors encountered and help students develop positive coping strategies to manage the clinical stressors encountered. Further research is required look at the perspective of clinical stressors from clinical tutors who supervise students during their first clinical practicum.

BackgroundThe rapid advancement of digital technologies, particularly in big data analytics (BDA), artificial intelligence (AI), machine learning (ML), and deep learning (DL), is reshaping the global health care system, including in Bangladesh. The increased adoption of these technologies in health care delivery within Bangladesh has sparked their integration into health care and public health research, resulting in a noticeable surge in related studies. However, a critical gap exists, as there is a lack of comprehensive evidence regarding the research landscape; regulatory challenges; use cases; and the application and adoption of BDA, AI, ML, and DL in the health care system of Bangladesh. This gap impedes the attainment of optimal results. As Bangladesh is a leading implementer of digital technologies, bridging this gap is urgent for the effective use of these advancing technologies. ObjectiveThis scoping review aims to collate (1) the existing research in Bangladesh’s health care system, using the aforementioned technologies and synthesizing their findings, and (2) the limitations faced by researchers in integrating the aforementioned technologies into health care research. MethodsMEDLINE (via PubMed), IEEE Xplore, Scopus, and Embase databases were searched to identify published research articles between January 1, 2000, and September 10, 2023, meeting the following inclusion criteria: (1) any study using any of the BDA, AI, ML, and DL technologies and health care and public health datasets for predicting health issues and forecasting any kind of outbreak; (2) studies primarily focusing on health care and public health issues in Bangladesh; and (3) original research articles published in peer-reviewed journals and conference proceedings written in English. ResultsWith the initial search, we identified 1653 studies. Following the inclusion and exclusion criteria and full-text review, 4.66% (77/1653) of the articles were finally included in this review. There was a substantial increase in studies over the last 5 years (2017-2023). Among the 77 studies, the majority (n=65, 84%) used ML models. A smaller proportion of studies incorporated AI (4/77, 5%), DL (7/77, 9%), and BDA (1/77, 1%) technologies. Among the reviewed articles, 52% (40/77) relied on primary data, while the remaining 48% (37/77) used secondary data. The primary research areas of focus were infectious diseases (15/77, 19%), noncommunicable diseases (23/77, 30%), child health (11/77, 14%), and mental health (9/77, 12%). ConclusionsThis scoping review highlights remarkable progress in leveraging BDA, AI, ML, and DL within Bangladesh’s health care system. The observed surge in studies over the last 5 years underscores the increasing significance of AI and related technologies in health care research. Notably, most (65/77, 84%) studies focused on ML models, unveiling opportunities for advancements in predictive modeling. This review encapsulates the current state of technological integration and propels us into a promising era for the future of digital Bangladesh.

Abstract Background and Aim Premenstrual tension syndrome can vary in type and severity among females, potentially affecting their academic performance. This study aims to examine the prevalence and severity of premenstrual tension syndrome symptoms in female university students and their impact on academics. Methods A cross‐sectional descriptive study was conducted among female university students from Ras Al Khaimah, UAE over 6 months, from January 1, 2022 to June 30, 2022. The updated premenstrual tension syndrome self‐rating scale questionnaire was used to assess the prevalence and severity of symptoms. A total of 251 respondents were included in the study. The chi‐square test was used to determine the association between PMT and academic performance. Results The results showed that 78.9% of the participants experienced premenstrual tension syndrome, with 16.3% of them reporting premenstrual dysphoric disorder. The majority of participants reported mild to moderate symptoms, with anxiety and depressed mood being the most common psychological symptoms. In terms of behavioral symptoms, physical symptoms and feeling overwhelmed were the most prevalent. Furthermore, 90% of participants reported a negative impact on their academic performance, with paying attention in class being the most affected. The study also found that PMT disorder had a significant impact on physical activities and extracurricular activities. Conclusions Our study showed a high prevalence of premenstrual disorders among female students and their influence on physical activity and extracurricular participation. The study highlights the importance of implementing therapies for PMT syndrome and providing support to improve academic performance and overall quality of life.

Abstract Background and aims Hyperglycemia, also known as diabetes, is a metabolic disorder characterized by elevated levels of glucose in the bloodstream. It can lead to the prolonged dysfunction, injury, and deterioration of several organs. In addition, dengue is a viral illness transmitted by mosquitoes that has reached epidemic proportions worldwide. In this article, we focused on the severity of comorbidities, difficulties in managing them, and preventive measures meant to lessen the risks associated with comorbidities in diabetic patients with dengue infection. Methods We explored a number of databases, including PubMed, Scopus, Embase, Web of Science, Google Scholar, and the Cochrane Library, for this review article using various related keywords. Results The findings of this review article indicate that elderly dengue patients with diabetes should be admitted to the hospital for close observation and early management using fluid therapy. An observed association exists between dengue hemorrhagic fever (DHF) and diabetes, indicating a possible consequence in this specific group. Additionally, patients with diabetes who contract dengue show elevated levels of inflammatory markers. Diabetes mellitus deteriorates the immune system, which exacerbates the progression of dengue fever. Cutting‐edge technology and scientific research may assist in addressing the challenges that diabetes and dengue viruses pose in low‐ and middle‐income countries. Implementing innovative diabetic care management is essential to ensuring consistency of care, improving a healthy lifestyle, and lowering patient risk factors and comorbidities. Conclusion Dengue fever has spread to epidemic levels throughout the world. Inflammatory markers increase and the prevalence of DHF is greater in diabetes individuals with dengue infection. Given the continued growth of dengue in Asian nations, it is imperative that we concentrate our efforts and resources on providing more precise and effective treatment for this emerging issue.

Objectives: Pre-hepatic jaundice results from an imbalance between bilirubin production and clearance, often linked to hemoglobinopathies. Antioxidant vitamin C, malondialdehyde, and trace elements play roles in jaundice, yet their specific associations remain unclear. The objective is to assess and compare these biomarkers in pre-hepatic jaundice patients and healthy controls, aiming to identify potential diagnostic markers and understand distinctive characteristics related to the disease’s pathogenesis. Methods: This case–control study enrolled 50 pre-hepatic jaundice patients and 50 healthy controls, utilizing advanced techniques for biomarker quantification. We completed blood sample collection from study participants between 1 September 2023 and 31 December 2023. This study investigates the correlation between various biomarkers and pre-hepatic jaundice using serum samples with a focus on antioxidant vitamin C, malondialdehyde, and trace elements. Results: This study demonstrates elevated concentrations of malondialdehyde in patients with pre-hepatic jaundice, suggesting alterations in bilirubin metabolism and increased oxidative stress. We found that the serum levels of malondialdehyde were significantly higher in pre-hepatic jaundice patients compared to healthy controls. Our observations revealed a notable decrease in the average serum vitamin C levels in patients with pre-hepatic jaundice compared to healthy controls. The patients had lower serum Zn levels and higher serum Cu and Mn levels compared to the healthy controls. The correlation study demonstrates robust positive correlations among these biomarkers in pre-hepatic jaundice. As the levels of vitamin C rise, the levels of the other criteria often fall, and vice versa. There is an inverse relationship between higher levels of vitamin C and lower levels of malondialdehyde. The current investigation identifies possible changes in antioxidant vitamins, malondialdehyde levels, and trace elements, which provide significant insights for targeted interventions. Conclusions: The present research highlights the integrated significance of vitamin C, malondialdehyde, and trace elements in the progression of the disease.

Introduction: The growing problem of antimicrobial resistance on a global scale has highlighted the need to investigate alternative antimicrobial agents with reduced side effects. Plant-derived secondary metabolites have emerged as potential contenders in tackling this challenge. Jatropha curcas, a perennial plant, has traditionally been utilized for the treatment of gum boils, toothaches, and infections. This plant exhibits a wide range of pharmacological properties. However, its potential as an antimicrobial agent against oral microorganisms has yet to be investigated. Hence, the objective of this study was to investigate the antimicrobial properties of Jatropha curcas extracts against selected bacteria and fungi commonly present in the oral cavity. Methodology: Jatropha curcas samples were collected from Bagan Datuk, Perak, Malaysia, and subsequently identified at Universiti Malaya. The ethanolic extract of the leaves (ELJC) and the stem bark latex (LJC) of Jatropha curcas were tested against six species of oral microorganism: Streptococcus sanguinis, Streptococcus mutans, Streptococcus mitis, Lactobacillus helveticus, Candida albicans, Candida tropicalis, and a mixture of these microorganisms. The methods employed in this study were well diffusion assay, minimum inhibitory concentration, minimum bacterial concentration, live-dead assay, field emission scanning electron microscopy, and liquid chromatography with tandem mass spectrometry. Results: ELJC and LJC demonstrated significant antimicrobial effects (p

The heart shattering impact afflicted by the notorious cervical cancer is rising rapidly as it emerges as the second most prevalent cancer among women in the developing countries. There was an anticipated 604,127 observed reports and 341,831 fatalities reported worldwide in 2020. The mortality rate was 7.2 deaths per 100,000 women-years, while the age-standardized incidence rate was 13.3 cases per 100,000 women annually. In less developed countries, the accountability was around 87–90% of mortality and roughly 84% of newly diagnosed cases. Resource limitations, inadequate public awareness, and late-stage diagnosis aggravate the complications of cancer mitigation in these regions, compared to the higher income nations. While primary and secondary interventions come off as an enticing solution, international collaborations and the integration of technology also emerge as promising avenues for enhancing cancer care accessibility. This study aims to assess the progress of developing countries in meeting the World Health Organization’s mandate to eliminate cervical cancer by scrutinizing the prevalence of cervical cancer incidence and mortality rates, evaluating the impact and execution of HPV vaccination initiatives, and analyzing proposals for cervical cancer eradication within these nations, our objective is to accelerate advancements towards the ultimate goal of eradicating cervical cancer.

The study sought to explore the effect of Social Capital (SC) on banks’ financial performance and whether this effect is mediated by competitive advantage (CA) or not. Secondary data were collected from banks’ nine years’ annual reports (2014-2022). By stratified sampling method, 20 commercial banks in Bangladesh were selected. Findings revealed that the influence of SC on ROA and NIAT is significant and CA mediates between them. For one unit increase in SC, ROA and NIAT will increase by 0.274 and 0.508 units respectively. However, there is no significant effect of SC on ROI. SC has a significant impact on CA also. One unit increase in SC results in a 0.822 unit increase in CA and vice versa. The findings of the study will have implications for policymakers like Bangladesh Bank, government, bankers, depositors, borrowers, and other stakeholders as enrichment of social capital is likely to improve banks’ financial performance through the attainment of CA.

Identification of potential flood risk areas is crucial to reduce flood damage for the frequently flooded and low-lying South Asian developing countries. The present study has prepared district-level (District: second administrative unit of the country) flood risk map for the flood-prone Rangpur Division (Division: first administrative unit) of Bangladesh using the multi-criteria decision analysis along with the application of analytical hierarchy process (AHP) method. Eight physical factors such as elevation, slope, distance from river, drainage density, land cover, rainfall, height above nearest drainage (HAND), and topographic wetness index (TWI), and six social factors such as population density, dependent population, disabled population, female population, agriculture dependent population, and literacy have been assessed to create a final risk map. The flood risk map is divided into five risk zones: very low, low, moderate, high, and very high. Integration of the social factors along with the physical factors reflects the insight of the vulnerability and increases the authenticity of the generated risk map. This study found that 62.46% area of the Rangpur Division resides under the moderate to very high-risk zone of flooding. Using ROC (receiver operating characteristic)-AUC (area under the curve) curve, the risk map is validated with a score of 0.83 from the flood inventory map of 2020 generated from the Sentinel 1 image. This risk map will guide policymakers to easily identify the vulnerable area for flood hazards and suitable areas for development activities necessary to attain sustainable development.

Background Anaemia is commonly caused by iron deficiency and screened by haemoglobin (Hb) concentration in blood. There is a scarcity of longitudinal data on the relationship between maternal Hb levels during pregnancy and neurodevelopment in children. Objective To measure the relationship of maternal Hb concentrations during pregnancy on early child development. Methods This prospective cohort study included 1,720 mother-child dyads in rural Bangladesh. Maternal Hb concentrations were measured at 14 and 30 weeks of gestation. The child’s Mental Developmental Index (MDI) and Psychomotor Developmental Index (PDI) at 18 months of age were measured using Bayley Scales of Infant and Toddler Development (BSID-II). Data on socio-demographic characteristics, anthropometrics, mothers’ IQ and children’s home stimulation were also collected. Bivariate and multivariable-adjusted linear regression analyses were used to explore associations of maternal Hb with child development. Results Mean Hb concentrations at 14 and 30 weeks of gestation were 116.6 g/L (±12.7) and 114.7 g/L (±12.7), respectively. Mean MDI and PDI scores among 18-month-old children were 78.9 (±12.4) and 93.8 (±13.7), respectively. Maternal 14-week Hb concentration was correlated with PDI (r = 0.06; p

Background Chewing betel quid (BQ) – a preparation commonly containing areca nut and slaked lime wrapped in betel leaf – is entrenched in South Asia. Although BQ consumption during pregnancy has been linked to adverse birth outcomes, its effect on postnatal growth remains largely unexplored. Objective We examined the associations of BQ use during pregnancy with children’s height-for-age and body mass index-for-age z-scores (HAZ and BAZ, respectively) and fat and fat-free mass along with sex-based differences in association in rural Bangladesh. Methods With a prospective cohort design, we assessed BQ use among mothers enrolled in the Preterm and Stillbirth Study, Matlab (n = 3140) with a structured questionnaire around early third trimester. Children born to a subset of 614 women (including 134 daily users) were invited to follow-up between October 2021 and January 2022. HAZ and BAZ were calculated from anthropometric assessment, and fat and fat-free mass were estimated using bioelectric impedance. Overall and sex-specific multiple linear regression models were fitted. Results Growth data were available for 501 children (mean age 4.9 years): 43.3% of them were born to non-users, 35.3% to those using prior to or less-than-daily during the survey, and 21.3% to daily users. No statistically significant associations were observed after adjusting for sex, parity, maternal height and education, and household wealth. Conclusions There was no effect of BQ use during pregnancy on postnatal growth in this study. Longitudinal studies following up those born to heavy users beyond childhood are warranted for capturing long-term implications of prenatal BQ exposure.

This study investigates the ecological impacts of urban expansion in Savar Upazila, adjacent to Dhaka City, from 2011 to 2022. Utilizing Landsat (Level 2) imagery and the Time-weighted Dynamic Time Warping (TWDTW) classification method, the research assesses urban sprawl with high accuracy (98.87%, 96.01%, and 96.53% for 2011, 2015, and 2022, respectively). Urban expansion was predominantly through extension, with a 9.19% increase in urban areas. The study also calculates Urban Hotspot Zones (UHs) and the Urban Thermal Field Variance Index (UTFVI) from Land Surface Temperature (LST) data, highlighting the growth of urban hotspots. The Partial Least Squares Regression (PLSR) reveals that development type affects the Urban Heat Island effect and extension is the most determining factor for ecological change. A local level analysis reveals that nearly all unions, except Shimulia and Pathalia, experienced a rise in areas with adverse ecological conditions, with Tetulihora, Amin Bazar, Ashulia, and nearby areas facing the most significant ecological deterioration due to urbanization (∼50%). The findings underscore a considerable decline in the region's ecological health due to urban expansion, urging policymakers to integrate stable ecological zones into urban planning for sustainable development.

Abstract Background This article explored the possibility that the Mpox virus (MPXV) may initiate or stimulate the consequences of vascular inflammation. In 1970, it was discovered that Macaca cynomolgus primates infected with MPXV also infected humans in the Democratic Republic of the Congo. Discussion The study demonstrates that MPXV invades host cells via viral proteins and surface receptors, initiating the release of diverse inflammatory mediators such as IL‐1, IL‐6, TNF‐α, CCL2, CXCL2, CXCL8, CXCL10, and so forth probably through endothelial dysfunction by reactive oxygen species production. In general, these mediators have been found to contribute to vascular inflammation and the formation of atherosclerotic plaque at a later stage, which may contribute to the onset of vascular inflammation. Conclusion The discussed association between vascular inflammation and Mpox has the potential to be an important finding in the field of vascular biology research.

Background: In experimental studies, several polycyclic aromatic hydrocarbons (PAHs) have shown endocrine disrupting properties, but very few epidemiological studies have examined their impact on pubertal development and results have been heterogenous. Objective: To explore if maternal PAH exposure during pregnancy was associated with the offspring’s timing of pubertal onset. Methods: We studied 582 mother-daughter dyads originating from a population-based cohort in a rural setting in Bangladesh. Maternal urinary samples, collected in early pregnancy (on average, gestational week 8), were analyzed for monohydroxylated metabolites of phenanthrene (1-OH-Phe, Σ2-,3-OH-Phe, and 4-OH-Phe), fluorene (Σ2-,3-OH-Flu), and pyrene (1-OH-Pyr) using liquid chromatography with tandem mass spectrometry (LC-MS/MS). The girls were interviewed on two separate occasions concerning date of menarche, as well as breast and pubic hair development according to Tanner. Associations were assessed using Kaplan-Meier analysis and multivariable-adjusted Cox proportional hazards regression or ordered logistic regression. Results: In early pregnancy, the mothers’ median urinary concentrations of Σ1-,2-,3-,4-OH-Phe, Σ2-,3-OH-Flu, and 1-OH-Pyr were 3.25 ng/mL, 2.0 ng/mL, and 2.3 ng/mL respectively. At the second follow-up, 78 % of the girls had reached menarche, and the median age of menarche was 12.7 ± 0.81 years. Girls whose mothers belonged to the second and third quintiles of ΣOH-Phe metabolites had a higher rate of menarche, indicating a younger menarcheal age (HR 1.39; 95 % CI 1.04, 1.86, and HR 1.41; 95 % CI 1.05, 1.88, respectively), than girls of mothers in the lowest quintile. This trend was not observed in relation to either breast or pubic hair development. None of the other maternal urinary PAH metabolites or the sum of all thereof in early pregnancy were associated with age at menarche or pubertal stage. Conclusions: Indications of non-monotonic associations of prenatal phenanthrene exposure with the daughters’ age of menarche were found, warranting further investigation.

New sublineages of SARS-CoV-2 variants-of-concern (VOCs) continuously emerge with mutations in the spike glycoprotein. In most cases, the sublineage-defining mutations vary between the VOCs. It is unclear whether these differences reflect lineage-specific likelihoods for mutations at each spike position or the stochastic nature of their appearance. Here we show that SARS-CoV-2 lineages have distinct evolutionary spaces (a probabilistic definition of the sequence states that can be occupied by expanding virus subpopulations). This space can be accurately inferred from the patterns of amino acid variability at the whole-protein level. Robust networks of co-variable sites identify the highest-likelihood mutations in new VOC sublineages and predict remarkably well the emergence of subvariants with resistance mutations to COVID-19 therapeutics. Our studies reveal the contribution of low frequency variant patterns at heterologous sites across the protein to accurate prediction of the changes at each position of interest.

This research investigates the impact of sea level rise (SLR) on the Indus Delta, a vital ecosystem increasingly vulnerable to climate change repercussions. The objective of this study is to comprehensively assess the flooded areas under various shared socioeconomic pathway (SSP) scenarios based on the Intergovernmental Panel on Climate Change's (IPCC) 6th Assessment Report. The study employs a GIS-based bathtub model, utilizing historical (1995–2014) and IPCC-projected (2020–2150) tide gauge data from Karachi, Kandla, and Okha stations to identify potential inundated areas threatened by coastal flooding. Additionally, it analyzes LANDSAT-derived multispectral images to identify coastal erosion hotspots and changes in the landscape. A supervised random forest classifier is used to classify major landforms and understand alterations in land cover. Furthermore, neural network-based cellular automata simulations are applied to predict future land cover for 2050, 2100, and 2150 at risk of inundation. The results indicate that under different SSP scenarios, the estimated inundated land area varies from 307.36 km2 (5 % confidence on SSP1-1.9) to 7150.8 km2 (95 % confidence on SSP5-8.5). By 2150, the region will lose over 550 km2 of agricultural land and 535 km2 of mangroves (mean SLR projection). This work emphasizes identifying sensitive land cover for SLR-induced coastal flooding. It might fuel future policy and modeling endeavors to reduce SLR uncertainty and build effective coastal inundation mitigation methods.

Summary: Background: Although sustainable development goals mandate for quality early childhood development (ECD) interventions for children

Abstract Background and Aims Bangladesh has been going through outbreaks of dengue fever cases every year since 2000. Yet this year's (2023) episode of dengue fever has crossed every line concerning fatality. Symptoms of the fever range from high fever, headaches, and muscle aches to deadly dengue hemorrhagic fever (DHF). The present review aims to assess the current pathogenicity and associated risk factors of recent dengue outbreaks in Bangladesh. Methods To perform this review work, we extracted relevant information from published articles available in PubMed, Scopus, and Google Scholar. We used dengue virus, dengue fever, and dengue outbreaks as keywords while searching for information. Results This Aedes mosquito‐transmitted viral fever is more common in Bangladesh because of the tropical nature and immense burden of populations, resulting in convenient conditions for the reproduction of the vector. The rapid genetic transformation of this RNA virus and the resistance of its vector against insecticides have intensified the situation. The number of hospitalized patients has increased, and the case fatality rate has risen to 0.47%. Inadequate mosquito control measures, plenty of vector breeding sites, and a lack of public awareness have worsened the situation. Routine spraying of effective insecticides in high‐risk zones, regular inspection of potential mosquito breeding sites, and public awareness campaigns are the keys to limiting the spread of this virus. Also, the availability of detection kits, improved hospital settings, and trained health professionals are mandatory to keep disease fatalities under control. Conclusion Dengue fever is a preventable disease. The successful development of a competent vaccine is now a prime need for preventing any future upsurge of the disease. Also, we recommend public awareness, vector control activities, and global collaboration to prevent spread.

Phytoplankton are the world’s largest oxygen producers found in oceans, seas and large water bodies, which play crucial roles in the marine food chain. Unbalanced biogeochemical features like salinity, pH, minerals, etc., can retard their growth. With advancements in better hardware, the usage of Artificial Intelligence techniques is rapidly increasing for creating an intelligent decision-making system. Therefore, we attempt to overcome this gap by using supervised regressions on reanalysis data targeting global phytoplankton levels in global waters. The presented experiment proposes the applications of different supervised machine learning regression techniques such as random forest, extra trees, bagging and histogram-based gradient boosting regressor on reanalysis data obtained from the Copernicus Global Ocean Biogeochemistry Hindcast dataset. Results obtained from the experiment have predicted the phytoplankton levels with a coefficient of determination score (R2) of up to 0.96. After further validation with larger datasets, the model can be deployed in a production environment in an attempt to complement in-situ measurement efforts.

Background: Despite the crucial role of nursing students in managing public health crises, their understanding and attitudes towards monkeypox (mpox) remain underexplored. This study aims to assess nursing students' knowledge, attitudes, anxiety levels, and perceived need for mental healthcare support related to mpox across the UAE, Iraq, and Egypt. Methods: A cross-sectional survey was conducted with 1,386 nursing students from three universities using non-probability purposive sampling. Participants completed a structured questionnaire covering sociodemographic information, knowledge of mpox, attitudes towards the disease, levels of anxiety, and perceived mental healthcare needs. Knowledge was categorized into poor, fair, and good, attitudes into negative, neutral, and positive, and anxiety into low, moderate, and high levels. Data were analysed for correlations using Pearson's correlation coefficient and statistical tests. We performed multivariate regression analysis to find odd ratios of assessed parameters against several sociodemographic variables. Results: Among the participants, 21.8 % demonstrated good knowledge of mpox, while 53.4 % had moderate or fair knowledge and 24.8 % had poor knowledge. Attitudes were predominantly neutral (44.7 %) or negative (36 %), and 57.2 % reported moderate anxiety. Approximately 33 % of students felt a significant need for mental healthcare support. Knowledge correlated positively with attitudes and negatively with anxiety and perceived mental healthcare needs. Attitudes also negatively correlated with perceived mental healthcare needs. Conclusion: The neutral or negative attitudes towards mpox suggest a need for enhanced educational interventions. Addressing these gaps through targeted training programs could improve knowledge, foster positive attitudes, and mitigate anxiety, thereby better preparing future healthcare professionals for emerging health threats.