Phage predation, disease severity, and pathogen genetic diversity in cholera patients.

Despite an increasingly detailed picture of the molecular mechanisms of bacteriophage (phage)-bacterial interactions, we lack an understanding of how these interactions evolve and impact disease within patients. In this work, we report a year-long, nationwide study of diarrheal disease patients in Bangladesh. Among cholera patients, we quantified Vibrio cholerae (prey) and its virulent phages (predators) using metagenomics and quantitative polymerase chain reaction while accounting for antibiotic exposure using quantitative mass spectrometry. Virulent phage (ICP1) and antibiotics suppressed V. cholerae to varying degrees and were inversely associated with severe dehydration depending on resistance mechanisms. In the absence of antiphage defenses, predation was "effective," with a high predator:prey ratio that correlated with increased genetic diversity among the prey. In the presence of antiphage defenses, predation was "ineffective," with a lower predator:prey ratio that correlated with increased genetic diversity among the predators. Phage-bacteria coevolution within patients should therefore be considered in the deployment of phage-based therapies and diagnostics.

Population-Based Serologic Survey of Vibrio cholerae Antibody Titers before Cholera Outbreak, Haiti, 2022.

A Vibrio cholerae O1 outbreak emerged in Haiti in October 2022 after years of cholera absence. In samples from a 2021 serosurvey, we found lower circulating antibodies against V. cholerae lipopolysaccharide in children <5 years of age and no vibriocidal antibodies, suggesting high susceptibility to cholera, especially among young children.

Evaluation of Inbred Maize (Zea mays L.) for Tolerance to Low Phosphorus at the Seedling Stage.

In underdeveloped nations where low-input agriculture is practiced, low phosphorus (LP) in the soil reduces the production of maize. In the present study, a total of 550 inbred maize lines were assessed for seedling traits under LP (2.5 × 10-6 mol L-1 of KH2PO4) and NP (2.5 × 10-4 mol L-1 of KH2PO4) hydroponic conditions. The purpose of this study was to quantify the amount of variation present in the measured traits, estimate the genetic involvement of these characteristics, examine the phenotypic correlation coefficients between traits, and to integrate this information to prepare a multi-trait selection index for LP tolerance in maize. A great deal of variability in the maize genotype panel was confirmed by descriptive statistics and analysis of variance (ANOVA). Estimated broad-sense heritability (h2) ranged from 0.7 to 0.91, indicating intermediate to high heritability values for the measured traits. A substantial connection between MSL and other root traits suggested that the direct selection of MSL (maximum shoot length) could be beneficial for the enhancement of other traits. The principal component analysis (PCA) of the first two main component axes explained approximately 81.27% of the variation between lines for the eight maize seedling variables. TDM (total dry matter), SDW (shoot dry weight), RDW (root dry weight), SFW (shoot fresh weight), RFW (root fresh weight), MRL (maximum root length), and MSL measurements accounted for the majority of the first principal component (59.35%). The multi-trait indices were calculated based on PCA using all the measured traits, and 30 genotypes were selected. These selected lines might be considered as the potential source for the improvement of LP tolerance in maize.

Appraisal and validation of a method used for detecting heavy metals in poultry feed in Bangladesh.

Background and Aim: Low concentrations of heavy metals are toxic and pose a serious threat to human health and the environment. Therefore, regular assessments of the toxic metal content in poultry feed are crucial for evaluating feed quality and customer safety. It is difficult to determine the heavy metals in the poultry feed at the trace amount. Therefore, this study aimed to validate this method through the detection of three heavy metals, chromium (Cr), cadmium (Cd), and lead (Pb), in poultry feed samples. Materials and Methods: Graphite furnace atomic absorption spectrometry (GF-AAS) method was used to analyze the heavy metals in poultry feed according to the guidelines given by the Council Directive 333/2007/EC, Commission Decision 657/2002/EC. In this study, various parameters such as linearity check, limit of detection (LOD), limit of quantification (LOQ), recovery percentage, precision checks, repeatability, reproducibility, and uncertainty measurement were considered to validate and assess the method following international guidelines. Heavy metals, such as Pb, Cr, and Cd, were analyzed from the feed samples in the laboratory using the GF-AAS method (Model: AA-7000 Shimadzu, Japan) with high purity argon as the inert gas, and the absorbance was read at wavelengths of 283.0, 357.9, and 228.8 nm, respectively. Results: The coefficient of variation (CV%) for system suitability and precision data was <10% for all the metals (Pb, Cr, and Cd) detected in this study. The overall CV% of repeatability and reproducibility ranged from 8.70% to 8.76% and 8.65% to 9.96%, respectively. The linearity of the calibration curves was excellent (r2 > 0.999) at various concentration levels for the three different metals. The recovery (%) was found to be 94.53, 93.97, and 101.63% for Pb, Cr, and Cd, respectively. The LOD values in feed were 0.065, 0.01, and 0.11 mg/kg, and the LOQ values were 0.22, 0.03, and 0.38 mg/kg for Cr, Cd, and Pb, respectively. The values recorded for the measurement uncertainty (%) were 11.48, 4.43, and 12.42% for Cr, Cd, and Pb, respectively. Conclusion: The results show that these study criteria or parameters have met the validated or acceptable range. Therefore, it is a reliable technique that can be used undoubtedly for the routine analysis of heavy metals in poultry feed samples across the globe.

Statistical Bioinformatics to Uncover the Underlying Biological Mechanisms That Linked Smoking with Type 2 Diabetes Patients Using Transcritpomic and GWAS Analysis.

Type 2 diabetes (T2D) is a chronic metabolic disease defined by insulin insensitivity corresponding to impaired insulin sensitivity, decreased insulin production, and eventually failure of beta cells in the pancreas. There is a 30-40 percent higher risk of developing T2D in active smokers. Moreover, T2D patients with active smoking may gradually develop many complications. However, there is still no significant research conducted to solve the issue. Hence, we have proposed a highthroughput network-based quantitative pipeline employing statistical methods. Transcriptomic and GWAS data were analysed and obtained from type 2 diabetes patients and active smokers. Differentially Expressed Genes (DEGs) resulted by comparing T2D patients' and smokers' tissue samples to those of healthy controls of gene expression transcriptomic datasets. We have found 55 dysregulated genes shared in people with type 2 diabetes and those who smoked, 27 of which were upregulated and 28 of which were downregulated. These identified DEGs were functionally annotated to reveal the involvement of cell-associated molecular pathways and GO terms. Moreover, protein-protein interaction analysis was conducted to discover hub proteins in the pathways. We have also identified transcriptional and post-transcriptional regulators associated with T2D and smoking. Moreover, we have analysed GWAS data and found 57 common biomarker genes between T2D and smokers. Then, Transcriptomic and GWAS analyses are compared for more robust outcomes and identified 1 significant common gene, 19 shared significant pathways and 12 shared significant GOs. Finally, we have discovered protein-drug interactions for our identified biomarkers.

Perceptions and practices on newborn care and managing complications at rural communities in Bangladesh: a qualitative study.

BACKGROUND: Community misperception on newborn care and poor treatment of sick newborn attributes to neonatal death and illness severity. Misperceptions and malpractices regarding neonatal care and neonatal complications are the leading causes of neonatal deaths in Bangladesh. The study was conducted to explore neonatal care's perceptions and practices and manage complications among Bangladesh's rural communities. METHODS: A qualitative study was conducted in Netrakona district of Bangladesh from April to June 2015. Three sub-districts (Upazilas) including Purbadhala, Durgapur and Atpara of Netrakona district were selected purposively. Five focus group discussions (FGDs) and twenty in-depth interviews (IDIs) were conducted in the rural community. Themes were identified through reading and re-reading the qualitative data and thematic analysis was performed. RESULTS: Community people were far behind, regarding the knowledge of neonatal complications. Most of them felt that the complications occurred due to lack of care by the parents. Some believed that mothers did not follow the religious customs after delivery, which affected the newborns. Many of them followed the practice of bathing the newborns and cutting their hair immediately after birth. The community still preferred to receive traditional treatment from their community, usually from Kabiraj (traditional healer), village doctor, or traditional birth attendant. Families also refrained from seeking treatment from the health facilities during neonatal complications. Instead, they preferred to wait until the traditional healers or village doctors recommended transferring the newborn. CONCLUSIONS: Poor knowledge, beliefs and practices are the key barriers to ensure the quality of care for the newborns during complications. The communities still depend on traditional practices and the level of demand for facility care is low. Appropriate interventions focusing on these issues might improve the overall neonatal mortality in Bangladesh.

The role of turbulent fluctuations in aerosol activation and cloud formation.

Aerosol indirect effects are one of the leading contributors to cloud radiative properties relevant to climate. Aerosol particles become cloud droplets when the ambient relative humidity (saturation ratio) exceeds a critical value, which depends on the particle size and chemical composition. In the traditional formulation of this problem, only average, uniform saturation ratios are considered. Using experiments and theory, we examine the effects of fluctuations, produced by turbulence. Our measurements, from a multiphase, turbulent cloud chamber, show a clear transition from a regime in which the mean saturation ratio dominates to one in which the fluctuations determine cloud properties. The laboratory measurements demonstrate cloud formation in mean-subsaturated conditions (i.e., relative humidity <100%) in the fluctuation-dominant activation regime. The theoretical framework developed to interpret these measurements predicts a transition from a mean- to a fluctuation-dominated regime, based on the relative values of the mean and standard deviation of the environmental saturation ratio and the critical saturation ratio at which aerosol particles activate or become droplets. The theory is similar to the concept of stochastic condensation and can be used in the context of the atmosphere to explore the conditions under which droplet activation is driven by fluctuations as opposed to mean supersaturation. It provides a basis for future development of cloud droplet activation parameterizations that go beyond the internally homogeneous parcel calculations that have been used in the past.

Exploring the perceptions, practices and challenges to maternal and newborn health care among the underprivileged teagarden community in Bangladesh: a qualitative study.

Poor health care-seeking behaviour, access to services and availability of service delivery have implications for the health of the community. This study explored the perceptions, practices and challenges related to maternal and neonatal care in the teagarden community in Bangladesh. The study also identified service gaps and problems prevalent in teagarden health facilities. A qualitative study was conducted in five teagardens in the Moulvibazar district of Bangladesh. Six focus group discussions (FGDs) were completed with individuals from the teagarden community, and twelve in-depth interviews (IDIs) were performed with health facility staff working in those teagarden facilities. Misconceptions and harmful traditional practices were found to exist among the families in the teagardens, restricting them from accessing quality health care. Pregnant women are not aware of antenatal care, and deliveries are being conducted at home by untrained birth attendants. Unhygienic and harmful postnatal practices are used. Teagarden health facilities are not well equipped or prepared to provide good care. Inequities exist within the teagarden communities, with unregistered workers having even poorer access to care. Improvement of the quality of maternal health care for this marginalised community is needed to progress maternal health.

Gestational Diabetes: Exploring the Perceptions, Practices and Barriers of the Community and Healthcare Providers in Rural Bangladesh: A Qualitative Study.

BACKGROUND AND OBJECTIVE: Gestational Diabetes Mellitus (GDM) is a prevalent and important disease during pregnancy and has detrimental effects on both the mother and the baby. The current study explored the perception and attitude of the community people about GDM and describes the challenges and gaps in knowledge, availability and accessibility of services for GDM screening and management at a rural community in Bangladesh. METHODS: We performed a qualitative study including seven Focus Group Discussions (FGDs) and eight Key Informant Interviews (KIIs) from November 2017 to January 2018 at randomly selected areas of Tangail district. A highly trained team including two anthropologists conducted the qualitative studies (FGDs and KIIs) under the guidance of experienced researchers. Thematic analysis was performed. RESULTS: GDM is not a known term for pregnant women, their husbands, mothers, and mothers-in-law. Most of the participants (78.7%) did not even hear the term. Some of them (25.5%) perceived that GDM will persist for whole life and transmit from husband to wife and mother to baby. Some people (21.3%) thought that GDM entirely depends on the wish of the God. Most of the participants (68.1%) perceived that symptoms of other types of diabetes and GDM are almost the same. Some participants (19.1%) thought that GDM patients need to intake some medicines that might affect the fetus. The majority of the respondents (83%) had no idea when a pregnant woman should test her diabetes during pregnancy. If GDM diagnosed, pregnant women decided to follow the advice of the doctors. The results from KII with health managers found that they lack in-depth knowledge of GDM. There is no structured guideline or protocol at their facilities for GDM management. CONCLUSION: The existing barriers at the communities for adequate detection and management of GDM are identified properly. The findings of this study will be helpful for the decision-makers in taking necessary actions to control the GDM.

Monitoring compositional changes in Ni(OH)2 electrocatalysts employed in the oxygen evolution reaction.

Electrochemical water splitting to generate hydrogen has been identified as a possible solution to the storage of intermittent renewable energy. However there are still challenges remaining in the development of stable electrocatalysts for the oxygen evolution half-reaction. Here we investigate the effects that the oxygen evolution reaction (OER) has on an electrodeposited Ni(OH)2 catalyst operated under alkaline conditions. The electrocatalyst was characterised by established methods including cyclic voltammetry, electrochemical impedance spectroscopy, scanning electron microscopy, atomic force microscopy, X-ray photoelectron spectroscopy both before and after the OER to identify changes that may have occurred in the structure and/or composition of the catalyst. In addition, synchrotron X-ray absorption near edge structure mapping was used to generate spatially resolved maps of the species present within the Ni(OH)2 catalyst and how they change in a heterogeneous manner into a NiO species after the OER. When compared to the morphological data it suggests that changes in the morphology after the OER can be correlated to the formation of NiO within the newly formed clusters that were generated across the electrocatalyst.

Effects of Climate Change and Maternal Morality: Perspective from Case Studies in the Rural Area of Bangladesh.

This study explored the community perception of maternal deaths influenced by natural disaster (flood), and the practice of maternal complications during natural disaster among the rural population in Bangladesh. It also explored the challenges faced by the community for providing healthcare and referring the pregnant women experiencing complications during flood disaster. Three focus group discussions (FGDs) and eight in-depth interviews (IDIs) were conducted in the marginalized rural communities in the flood-prone Khaliajhuri sub-district, Netrakona district, Bangladesh. Flood is one of the major risk factors for influencing maternal death. Pregnant women seriously suffer from maternal complications, lack of antenatal checkup, and lack of doctors during flooding. During the time of delivery, it is difficult to find a skilled attendant, and referring the patient with delivery complications to the healthcare facility. Boats are the only mode of transport. The majority of maternal deaths occur on the boats during transfer from the community to the hospital. Rural people feel that the maternal deaths influenced by natural disaster are natural phenomena. Pre-preparation is needed to support pregnant women during disasters. There is unawareness of maternal health, related care, and complications during disasters among local health service providers and volunteers.

Social autopsy for maternal and perinatal deaths in Bangladesh: a tool for community dialog and decision making.

Bangladesh has an established comprehensive death review system for tracking and reviewing maternal and perinatal deaths. This death review system, established in 2010, was initially known as the "Maternal and Perinatal Death Review (MPDR) System." One of the key interventions of the MPDR system, social autopsy (SA), is generally undertaken following a maternal or perinatal death notification. Social autopsy is managed at the community level by government field health workers. The main purpose of SA is to enable community discussion and create awareness of the preventable causes of maternal or neonatal deaths. Through these conversations, it is hoped to reduce future maternal and neonatal deaths. During the scaling up of the system in Bangladesh in 2016, the Ministry of Health and Family Welfare (MoH&FW) included social autopsy as a useful intervention in reviewing death at the community level and named it "Maternal and Perinatal Death Surveillance and Response" (MPDSR). The new MPDSR tool is currently being administered for the the 2017 to 2021 period under the National Health and Nutrition Population Sector Program (HPNSP). This paper seeks to review the experiences of the social autopsy tool, from the initial MPDR system to the current MPDSR system and its role in reducing maternal and neonatal deaths in Bangladesh.

Exploring perceptions of common practices immediately following burn injuries in rural communities of Bangladesh.

BACKGROUND: Burns can be the most devastating injuries in the world, they constitute a global public health problem and cause widespread public health concern. Every year in Bangladesh more than 365,000 people are injured by electrical, thermal and other causes of burn injuries. Among them 27,000 need hospital admission and over 5600 people die. Immediate treatment and medication has been found to be significant in the success of recovering from a burn. However, common practices used in the treatment of burn injuries in the community is not well documented in Bangladesh. This study was designed to explore the perception of local communities in Bangladesh the common practices used and health-seeking behaviors sought immediately after a burn injury has occurred. METHODS: A qualitative study was conducted using Focus Group Discussions (FGD) as the data collection method. Six unions of three districts in rural Bangladesh were randomly selected and FGDs were conducted in these districts with six burn survivors and their relatives and neighbours. Data were analyzed manually, codes were identified and the grouped into themes. RESULTS: The participants stated that burn injuries are common during the winter in Bangladesh. Inhabitants in the rural areas said that it was common practice, and correct, to apply the following to the injured area immediately after a burn: egg albumin, salty water, toothpaste, kerosene, coconut oil, cow dung or soil. Some also believed that applying water is harmful to a burn injury. Most participants did not know about any referral system for burn patients. They expressed their dissatisfaction about the lack of available health service facilities at the recommended health care centers at both the district level and above. CONCLUSIONS: In rural Bangladesh, the current first-aid practices for burn injuries are incorrect; there is a widely held belief that using water on burns is harmful.

Timely referral saves the lives of mothers and newborns: Midwifery led continuum of care in marginalized teagarden communities - A qualitative case study in Bangladesh.

Background: Prompt and efficient identification, referral of pregnancy related complications and emergencies are key factors to the reduction of maternal and newborn morbidity and mortality. As a response to this critical need, a midwifery led continuum of reproductive health care was introduced in five teagardens in the Sylhet division, Bangladesh during 2016. Within this intervention, professional midwives provided reproductive healthcare to pregnant teagarden women in the community.  This study evaluates the effect of the referral of pregnancy related complications. Methods: A qualitative case study design by reviewing records retrospectively was used to explore the effect of deploying midwives on referrals of pregnancy related complications from the selected teagardens to the referral health facilities in Moulvibazar district of the Sylhet division during 2016.  In depth analyses was also performed on 15 randomly selected cases to understand the facts behind the referral. Results: Out of a total population of 450 pregnant women identified by the midwives, 72 complicated mothers were referred from the five teagardens to the facilities. 76.4% of mothers were referred to conduct delivery at facilities, and 31.1% of them were referred with the complication of prolonged labour. Other major complications were pre-eclampsia (17.8%), retention of the placenta with post-partum hemorrhage (11.1%) and premature rupture of the membrane (8.9%). About 60% of complicated mothers were referred to the primary health care centre, and among them 14% of mothers were delivered by caesarean section. 94% deliveries resulted in livebirths and only 6% were stillbirths. Conclusions: This study reveals that early detection of pregnancy complications by skilled professionals and timely referral to a facility is beneficial in saving the majority of baby's as well as mother's lives in resource-poor teagardens with a considerable access barrier to health facilities.

Maternal complications in a geographically challenging and hard to reach district of Bangladesh: a qualitative study.

Background: Maternal complications contribute to maternal deaths in developing countries. Bangladesh still has a high prevalence of maternal mortality, which is often preventable. There are some geographically challenging and hard to reach rural districts in Bangladesh and it is difficult to get information about maternal complications in these areas. In this study, we examined the community lay knowledge of possible pregnancy complications. We also examined the common practices associated with complications and we discuss the challenges for the community. Methods: The study was conducted in Moulvibazar of north east Bangladesh, a geographically challenged, difficult to reach district. Qualitative methods were used to collect the information. Pregnant women, mothers who had recently delivered, their guardians and traditional birth attendants participated in focus group discussions. Additionally, in-depth interviews were conducted with the family members. Thematic analyses were performed. Results: The study revealed that there is a lack of knowledge of maternal complications. In the majority of cases, the mothers did not receive proper treatment for maternal complications.   There are significant challenges that these rural societies need to address: problems of ignorance, traditional myths and family restrictions on seeking better treatment. Moreover, traditional birth attendants and village doctors also have an important role in assuring appropriate, effective and timely treatment. Conclusions:  The rural community lacks adequate knowledge on maternal complications.  Reduction of the societal barriers including barriers within the family can improve overall practices. Moreover, dissemination of adequate information to the traditional birth attendant and village doctors may improve the overall situation, which would eventually help to reduce maternal deaths.