Rotavirus trends and distribution of genotypes before and during COVID-19 pandemic era: Bangladesh, 2017-2021.

Rotavirus gastroenteritis is accountable for an estimated 128 500 deaths among children younger than 5 years worldwide, and the majority occur in low-income countries. Although the clinical trials of rotavirus vaccines in Bangladesh revealed a significant reduction of severe rotavirus disease by around 50%, the vaccines are not yet included in the routine immunization program. The present study was designed to provide data on rotavirus diarrhea with clinical profiles and genotypes before (2017-2019) and during the COVID-19 pandemic period (2020-2021). Fecal samples were collected from 2% of the diarrheal patients at icddr,b Dhaka hospital of all ages between January 2017 and December 2021 and were tested for VP6 rotavirus antigen using ELISA. The clinical manifestations such as fever, duration of diarrhea and hospitalization, number of stools, and dehydration and so on were collected from the surveillance database (n = 3127). Of the positive samples, 10% were randomly selected for genotyping using Sanger sequencing method. A total of 12 705 fecal samples were screened for rotavirus A antigen by enzyme immunoassay. Overall, 3369 (27%) were rotavirus antigen-positive, of whom children <2 years had the highest prevalence (88.6%). The risk of rotavirus A infection was 4.2 times higher in winter than in summer. Overall, G3P[8] was the most prominent genotype (45.3%), followed by G1P[8] (32.1%), G9P[8] (6.8%), and G2P[4] (6.1%). The other unusual combinations, such as G1P[4], G1P[6], G2P[6], G3P[4], G3P[6], and G9P[6], were also present. Genetic analysis on Bangladeshi strains revealed that the selection pressure (dN/dS) was estimated as <1. The number of hospital visits showed a 37% drop during the COVID-19 pandemic relative to the years before the pandemic. Conversely, there was a notable increase in the rate of rotavirus positivity during the pandemic (34%, p < 0.00) compared to the period before COVID-19 (23%). Among the various clinical symptoms, only the occurrence of watery stool significantly increased during the pandemic. The G2P[4] strain showed a sudden rise (19%) in 2020, which then declined in 2021. In the same year, G1P[8] was more prevalent than G3P[8] (40% vs. 38%, respectively). The remaining genotypes were negligible and did not exhibit much fluctuation. This study reveals that the rotavirus burden remained high during the COVID-19 prepandemic and pandemic in Bangladesh. Considering the lack of antigenic variations between the circulating and vaccine-targeted strains, integrating the vaccine into the national immunization program could reduce the prevalence of the disease, the number of hospitalizations, and the severity of cases.

Integrated polarization-free Bragg filters with subwavelength gratings for photonic sensing.

We present polarization-free Bragg filters having subwavelength gratings (SWGs) in the lateral cladding region. This Bragg design expands modal fields toward upper cladding, resulting in enhanced light interaction with sensing analytes. Two device configurations are proposed and examined, one with index-matched coupling between transverse electric (TE) and transverse magnetic (TM) modes and the other one with hybrid-mode (HM) coupling. Both configurations introduce a strong coupling between two orthogonal modes (either TE-TM or HM1-HM2) and rotate the polarization of the input wave through Bragg reflection. The arrangements of SWGs help to achieve two configurations with different orthogonal modes, while expanding modal profiles toward the upper cladding region. Our proposed SWG-assisted Bragg gratings with polarization independency eliminate the need for a polarization controller and effectively tailor the modal properties, enhancing the potential of integrated photonic sensing applications.

High-resolution Si3N4 spectrometer: architecture & virtual channel synthesis and experimental demonstration.

Up-to-date network telemetry is the key enabler for resource optimization by capacity scaling, fault recovery, and network reconfiguration among other means. Reliable optical performance monitoring in general and, specifically, the monitoring of the spectral profile of WDM signals in fixed- and flex- grid architectures across the entire C-band, remains challenging. This article describes a two-stage spectrometer architecture amenable to integration on a single chip that can measure quantitatively the spectrum across the entire C-band with a resolution of ∼ 1.4 GHz. The first stage consists of a ring resonator with intra-ring phase shifter to provide a tuneable fine filter. The second stage makes use of an AWG subsystem and a novel processing algorithm to synthesize a tuneable coarse filter with a flat passband which isolates individual resonances of a multiplicity of ring resonances. The spectrometer is capable of scanning the entire C-band with high resolution using only one dynamic control. Due to its maturity and low loss, CMOS compatible Si3N4 is chosen for fabrication of the ring resonator and two cyclic AWGs. Complete spectrometer operation is demonstrated experimentally over a selected portion of the C-band. A novel virtual channel synthesis algorithm based on the weighted summation of the AWG output port powers relaxes the conventional AWG design requirement of a flat passband and sharp transition to stopband. The operation of the circuit is invariant to the optical path length between individual components and the algorithm corrects to some extent fabrication process variation impairments of the AWG channel spectra substantially improving robustness.

Average collision velocity of single yeast cells during electrochemically induced impacts.

We recorded current-time (i-t) profiles for oxidizing ferrocyanide (FCN) while spherical yeast cells of radius (rc ≈ 2 µm) collided with disk ultramicroelectrodes (UMEs) of increasing radius (re ≈ 12-45 µm). Collision signals appear as minority steps and majority blips of decreased current overlayed on the i-t baseline when cells block ferrocyanide flux (JFCN). We assigned steps to adsorption events and blips to bouncing collisions or contactless passages. Yeast cells exhibit impact signals of long duration (Δt ≈ 15-40 s) likely due to sedimentation. We assume cells travel a threshold distance (T) to generate collision signals of duration Δt. Thus, T represents a distance from the UME surface, at which cell perturbations on JFCN blend in with the UME noise level. To determine T, we simulated the UME current, while placing the cell at increasing distal points from the UME surface until matching the bare UME current. T-Values at 90°, 45°, and 0° from the UME edge and normal to the center were determined to map out T-regions in different experimental conditions. We estimated average collision velocities using the formula T/Δt, and mimicked cells entering and leaving T-regions at the same angle. Despite such oversimplification, our analysis yields average velocities compatible with rigorous transport models and matches experimental current steps and blips. We propose that single-cells encode collision dynamics into i-t signals only when cells move inside the sensitive T-region, because outside, perturbations of JFCN fall within the noise level set by JFCN and rc/re (experimentally established). If true, this notion will enable selecting conditions to maximize sensitivity in stochastic blocking electrochemistry. We also exploited the long Δt recorded here for yeast cells, which was undetectable for the fast microbeads used in early pioneering work. Because Δt depends on transport, it provides another analytical parameter besides current for characterizing slow-moving cells like yeast.

Age and sex-specific disability-free life expectancy in urban and rural settings of Bangladesh.

BACKGROUND: Disability-free life expectancy (DFLE) has been used to gain a better understanding of the population's quality of life. OBJECTIVES: The authors aimed to estimate age and sex-specific disability-free life expectancy (DFLE) for urban and rural areas of Bangladesh, as well as to investigate the differences in DFLE between males and females of urban and rural areas. METHODS: Data from the Bangladesh Sample Vital Statistics-2016 and the Bangladesh Household Income and Expenditure Survey (HIES)-2016 were used to calculate the disability-free life expectancy (DFLE) of urban and rural males and females in Bangladesh in 2016. The DFLE was calculated using the Sullivan method. RESULTS: With only a few exceptions, rural areas have higher mortality and disability rates than urban areas. For both males and females, statistically significant differences in DFLE were reported between urban and rural areas between the ages of birth and 39 years. In comparison to rural males and females, urban males and females had a longer life expectancy (LE), a longer disability-free life expectancy, and a higher share of life without disability. CONCLUSION: This study illuminates stark urban-rural disparities in LE and DFLE, especially among individuals aged < 1-39 years. Gender dynamics reveal longer life expectancy but shorter disability-free life expectancy for Bangladeshi women compared to men, emphasizing the need for targeted interventions to address these pronounced health inequalities.

Unveiling microplastics pollution in a subtropical rural recreational lake: A novel insight.

While global attention has been primarily focused on the occurrence and persistence of microplastics (MP) in urban lakes, relatively little attention has been paid to the problem of MP pollution in rural recreational lakes. This pioneering study aims to shed light on MP size, composition, abundance, spatial distribution, and contributing factors in a rural recreational lake, 'Nikli Lake' in Kishoreganj, Bangladesh. Using density separation, MPs were extracted from 30 water and 30 sediment samples taken from ten different locations in the lake. Subsequent characterization was carried out using a combination of techniques, including a stereomicroscope, Fourier transform infrared spectroscopy (FTIR) and field emission scanning electron microscopy (FE-SEM). The results showed a significant prevalence of MPs in all samples, with an average amount of 109.667 ± 10.892 pieces/kg3 (dw) in the sediment and 98.167 ± 12.849 pieces/m3 in the water. Small MPs (<0.5 mm), fragments and transparent colored particles formed the majority, accounting for 80.2%, 64.5% and 55.3% in water and 78.9%, 66.4% and 64.3% in sediment, respectively. In line with global trends, polypropylene (PP) (53%) and polyethylene (PE) (43%) emerged as the predominant polymers within the MPs. MP contents in water and sediment showed positive correlations with outflow, while they correlated negatively with inflow and lake depth (p > 0.05). Local activities such as the discharge of domestic sewage, fishing waste and agricultural runoff significantly influence the distribution of polypropylene. Assessment of pollution factor, pollution risk index and pollution load index values at the sampling sites confirmed the presence of MPs, with values above 1. This study is a baseline database that provides a comprehensive understanding of MP pollution in the freshwater ecosystem of Bangladesh, particularly in a rural recreational lake. A crucial next step is to explore ecotoxicological mechanisms, legislative measures and future research challenges triggered by MP pollution.

Antimicrobial Resistance Profiles of Campylobacter spp. Recovered from Chicken Farms in Two Districts of Bangladesh.

The rapid emergence of antimicrobial resistance (AMR) in Campylobacter has reinforced its status as a foodborne pathogen of significant public health concern. Resistant Campylobacter is typically transferred to humans via the consumption of contaminated animal products, particularly poultry. The genes associated with antimicrobial resistance in Campylobacter spp. are poorly understood. To address this knowledge gap, we conducted a prevalence survey of AMR Campylobacter across 84 chicken farms in two districts of Bangladesh. Pooled cloacal swabs were collected from chickens and underwent bacteriological testing for Campylobacter spp. with PCR confirmation. Antimicrobial susceptibility was tested against 14 antibiotics by disk diffusion method, and 12 resistance genes were screened in Campylobacter-positive isolates using multiplex PCR. A total of 34 (40.5%) farms were Campylobacter-positive of which 73.5% of isolates were resistant to at least 10 antibiotics. The antimicrobial susceptibility results indicate a high level of resistance against streptomycin (97.1%), clindamycin (97.1%), ampicillin (94.1%), tetracycline (94.1%), erythromycin (91.2%), ciprofloxacin (88.2%), nalidixic acid (85.3%), and imipenem (82.4%), and comparatively a low frequency of resistance to chloramphenicol (47.1%), ceftazidime (44.1%), and colistin (35.3%). Multidrug-resistant (MDR) and extensively drug-resistant Campylobacter were identified in 97.1%, and 50% of isolates, respectively. Ten resistance genes were identified including blaTEM (in 97.1% of isolates), strA-strB (85.9%), tetA (70.6%), tetB (32.4%), qnrS (23.5%), blaCTX-M-1 (20.6%), qnrB (20.6%), blaSHV (8.8%), aadB (5.9%), and qnrA (2.9%). Our findings demonstrate that resistance to ampicillin, tetracycline, and ceftazidime in Campylobacter isolates was significantly (p ≤ 0.05) associated with the presence of blaTEM, tetA, and blaSHV genes, respectively. The high rates of AMR in Campylobacter isolates from our study are not surprising given the liberal use of antimicrobials and incomplete biosecurity provisions on farms. Of particular concern are resistance rates to those classes of antibiotics that should be reserved for human use (azithromycin, ciprofloxacin, and colistin). AMR was more prevalent in chicken farms that used multiple antibiotics, engaged in prophylactic treatment of the birds, and improperly disposed of antibiotic packages. The high prevalence of MDR in chicken-derived Campylobacter isolates from the different regions of our study reinforces the need for more prudent use of antimicrobial compounds in Bangladeshi chicken farms.

Bioenergy-producing two-stage septic tank and floating wetland for onsite wastewater treatment: Circuit connection and external aeration.

This study designed a two-stage, electrode-integrated septic tank-floating wetland system and assessed their pollutant removal performances under variable operational conditions. The two-stage system achieved mean organic, nitrogen, phosphorus, and coliform removal percentages of 99, 78, 99, and 97%, respectively, throughout the experimental run. The mean metals (chromium, cadmium, nickel, copper, zinc, lead, iron, and manganese) removal percentages ranged between 81 and 98%. Accumulated sludge, filler media, and the hanging root mass contributed to pollutant removals by supporting physicochemical and biological pathways. The mean effluent organic concentration and coliform number across the two-stage system were 20 mg/L and 1682 CFU/100 mL, respectively, during the closed-circuit protocol, which was beneath the open-circuit-based performance profiles, i.e., 32 mg/L and 2860 CFU/100 mL, respectively. Effluent organic, nitrogen, phosphorus, metals, and coliform number ranges across the two-stage system were 9-17 mg/L, 13-24 mg/L, 1-1.5 mg/L, 0.001-0.2 mg/L, and 1410-2270 CFU/100 mL, respectively during intermittent and continuous aeration periods. The air supply rate differences influenced pollutant removal depending on the associated removal mechanisms. The non-aeration phase produced higher effluent pollutant concentrations than the aeration periods-based profiles. The overall mean power density production of the septic tank ranged between 107 and 596 mW/m3; 110 and 355 mW/m3 with the floating wetland. The bioenergy production capacity of the septic tank was positively correlated to external air supply rates. This study demonstrates the potential application of the novel bioenergy-producing septic tank-floating wetland system for wastewater treatment in decentralized areas.

Rapidly Rising Diabetes and Increasing Body Weight: A Counterfactual Analysis in Repeated Cross-sectional Nationally Representative Data from Bangladesh.

BACKGROUND: Diabetes is a growing concern in South Asia but few nationally representative studies identify factors behind this rising disease burden. We studied the nationwide change in diabetes prevalence in Bangladesh, subpopulations disproportionately affected, and the contribution of rising unhealthy weight to the change in diabetes prevalence. METHODS: Based on a sample of 13,959 adults aged 35 years and older with biomarker measurements from the 2011 and 2017/2018 Bangladesh Demographic and Health Surveys, we estimated how the prevalence of diabetes changed nationally and across socioeconomic/geographic groups. Using counterfactual decomposition, we assessed how much the prevalence of diabetes would have grown if body mass index (BMI) had not changed between 2011 and 2017. RESULTS: Diabetes prevalence increased from 12.1% (11.1, 13.1) to 14.4% (13.3, 15.5) between 2011 and 2017/2018. Diabetes grew disproportionately quickly among population groups with higher household wealth, and more education, and in three regions. Over this same period, mean BMI increased from 20.9 (20.8, 21.1) to 22.5 kg/m 2 (22.4, 22.7) and overweight from 25.8 (24.4, 27.3) to 42.1% (40.4, 43.7). Under the counterfactual scenario of constant BMI, diabetes would have risen by only 1.0 (-0.4, 2.4) instead of 2.3 percentage points (0.8, 3.7) nationally, corresponding to a contribution of 58% (-106.3, 221.7). Similarly, group-specific trends were largely attributable to increasing BMI. CONCLUSIONS: Diabetes prevalence in Bangladesh has increased rapidly between 2011 and 2017/2018. Decomposition analysis estimates have wide confidence intervals but are consistent with the hypothesis that this change was driven by the dramatic rise in body weights.

Polarization-independent photonic Bragg grating filter with cladding asymmetry.

A photonic Bragg grating is a fundamental building block that reflects the direction of wave propagation through spatial phase modulation and can be implemented using sidewall corrugation. However, due to the asymmetric aspect ratio of a waveguide cross section, typical Bragg gratings exhibit a strong polarization sensitivity. Here, we show that photonic Bragg gratings with cladding asymmetry can enable polarization-independent notch filters by rotating input polarizations. Such Bragg gratings strongly couple transverse electric (TE) and transverse magnetic (TM) modes propagating in opposite directions, filtering the input signal and reflecting the rotated mode. We analyzed this polarization-rotating Bragg grating using the coupled-mode theory and experimentally demonstrated it on a silicon-on-insulator platform. Our device concept is simple to implement and compatible with other platforms, readily available as polarization transparent Bragg components.

The impact of climate change on the lives and livelihoods of readymade garment (RMG) workers: an exploratory study in selected readymade garment factories in Bangladesh.

BACKGROUND: There is a paucity of resources focusing on the climate change experience of readymade garment (RMG) workers in developing countries such as Bangladesh. Therefore, this mixed method approach aims to understand the distinctive types of climate change experiences from a health and occupational perspective, along with the consequences of these changes among RMG workers in Bangladesh. METHODS: The study was conducted from January 2022 and February 2022 where the quantitative data were collected from 200 RMG workers in 10 randomly selected garments and two focus group discussions took place with 20 conveniently selected RMG workers. The key informants were relevant stakeholders in the industry. Quantitative findings were reported using descriptive methods and qualitative findings were analysed using a content analysis approach. RESULT: A total of 200 RMG workers were included in the study of which the majority belonged to the age group of 26-30 years (44%), were male (55%), worked in a compliant factory (70%), and were machine operators (79%). Half of the respondents experienced damage from natural disasters (51%), but only approximately 37% received humanitarian help. Migration and urbanisation were among the aftermath of the damage caused by e natural disasters, and 42% were forced to shift their homes due to natural disasters. Competition in the job market increased, and the owners had the opportunity to take on employees at a reduced salary. The respondents flagged climate change as a major contributor to their disease patterns. More than three-quarters of the respondents became sick because of increased heat while working; however, only half received any treatment. CONCLUSION: Employee participation in hazard recognition, employer preparedness, prevention through design, research, surveillance, and upholding workplace ethics and standards can be the answers to climate change problems for readymade garment workers.

Low back pain among professional bus drivers: a cross-sectional study from Bangladesh.

BACKGROUND: Low back pain (LBP) is a common condition contributing to impaired quality of life among professional vehicle drivers. Our study aimed to assess LBP prevalence and associated factors among professional bus drivers in Bangladesh. METHODS: A cross-sectional study was conducted among 368 professional bus drivers using a semi-structured questionnaire. A Nordic Musculoskeletal Questionnaire (NMQ) subscale was used to measure LBP. Multivariable logistic regression analysis was used to identify the factors associated with LBP. RESULTS: In the last month, 127 (34.51%) participants reported experiencing pain or discomfort in the lower backside. Multivariable logistic regression analysis showed that age of more than 40 years (adjusted odds ratio (aOR): 2.07, 95% confidence interval (CI): 1.14 to 3.75), the income of more than 15,000 BDT per month (aOR: 1.91, 95% CI: 1.11 to 3.26), work duration more than ten years (aOR: 2.53, 95% CI: 1.12 to 5.70), working more than 15 days per month (aOR: 1.93, 95% CI: 1.02 to 3.65), working more than 10 h per day (aOR: 2.46, 95% CI: 1.05 to 5.75), poor condition of the driving seat (aOR: 1.80, 95% CI: 1.08 to 3.02), current smoking habit (aOR: 9.71, 95% CI: 1.25 to 75.15), illicit substances use (aOR: 1.97, 95% CI: 1.11 to 3.48), and four hours or less sleeping time per day (aOR: 1.83, 95% CI: 1.09 to 3.06) were positively associated with LBP. CONCLUSION: The high burden of LBP among the participants calls for a focus on this vulnerable group's occupational health and safety, with particular emphasis on implementing standard measures.

Smokeless and combustible tobacco use among 148,944 South Asian adults: a cross-sectional study of South Asia Biobank.

INTRODUCTION: Tobacco use, in both smoking and smokeless forms, is highly prevalent among South Asian adults. The aims of the study were twofold: (1) describe patterns of SLT and combustible tobacco product use in four South Asian countries stratified by country and sex, and (2) assess the relationships between SLT and smoking intensity, smoking quit attempts, and smoking cessation among South Asian men. METHODS: Data were obtained from South Asia Biobank Study, collected between 2018 and 2022 from 148,944 men and women aged 18 years and above, living in Bangladesh, India, Pakistan, or Sri Lanka. Mixed effects multivariable logistic and linear regression were used to quantify the associations of SLT use with quit attempt, cessation, and intensity. RESULTS: Among the four South Asian countries, Bangladesh has the highest rates of current smoking (39.9% for male, 0.4% for female) and current SLT use (24.7% for male and 23.4% for female). Among male adults, ever SLT use was associated with a higher odds of smoking cessation in Bangladesh (OR, 2.88; 95% CI, 2.65, 3.13), India (OR, 2.02; 95% CI, 1.63, 2.50), and Sri Lanka (OR, 1.36; 95% CI, 1.14, 1.62). Ever SLT use and current SLT use was associated with lower smoking intensity in all countries. CONCLUSIONS: In this large population-based study of South Asian adults, rates of smoking and SLT use vary widely by country and gender. Men who use SLT products are more likely to abstain from smoking compared with those who do not.

Insomnia and job stressors among healthcare workers who served COVID-19 patients in Bangladesh.

BACKGROUND: The global outbreak of COVID-19 has created unprecedented havoc among health care workers, resulting in significant psychological strains like insomnia. This study aimed to analyze insomnia prevalence and job stressors among Bangladeshi health care workers in COVID-19 units. METHODOLOGY: We conducted this cross-sectional study to assess insomnia severity from January to March 2021 among 454 health care workers working in multiple hospitals in Dhaka city with active COVID-dedicated units. We selected 25 hospitals conveniently. We used a structured questionnaire for face-to-face interviews containing sociodemographic variables and job stressors. The severity of insomnia was measured by the Insomnia Severity Scale (ISS). The scale has seven items to evaluate the rate of insomnia, which was categorized as the absence of Insomnia (0-7); sub-threshold Insomnia (8-14); moderate clinical Insomnia (15-21); and severe clinical Insomnia (22-28). To identify clinical insomnia, a cut-off value of 15 was decided primarily. A cut-off score of 15 was initially proposed for identifying clinical insomnia. We performed a chi-square test and adjusted logistic regression to explore the association of different independent variables with clinically significant insomnia using the software SPSS version 25.0. RESULTS: 61.5% of our study participants were females. 44.9% were doctors, 33.9% were nurses, and 21.1% were other health care workers. Insomnia was more dominant among doctors and nurses (16.2% and 13.6%, respectively) than others (4.2%). We found clinically significant insomnia was associated with several job stressors (p < 0.05). In binary logistic regression, having sick leave (OR = 0.248, 95% CI = 0.116, 0.532) and being entitled to risk allowance (OR = 0.367, 95% CI = 0.124.1.081) showed lower odds of developing Insomnia. Previously diagnosed with COVID-19-positive health care workers had an OR of 2.596 (95% CI = 1.248, 5.399), pointing at negative experiences influencing insomnia. In addition, we observed that any training on risk and hazard increased the chances of suffering from Insomnia (OR = 1.923, 95% CI = 0.934, 3.958). CONCLUSION: It is evident from the findings that the volatile existence and ambiguity of COVID-19 have induced significant adverse psychological effects and subsequently directed our HCWs toward disturbed sleep and insomnia. The study recommends the imperativeness to formulate and implement collaborative interventions to help HCWs cope with this crisis and mitigate the mental stresses they experience during the pandemic.

Food environment and diabetes mellitus in South Asia: A geospatial analysis of health outcome data.

BACKGROUND: The global epidemic of type 2 diabetes mellitus (T2DM) renders its prevention a major public health priority. A key risk factor of diabetes is obesity and poor diets. Food environments have been found to influence people's diets and obesity, positing they may play a role in the prevalence of diabetes. Yet, there is scant evidence on the role they may play in the context of low- and middle-income countries (LMICs). We examined the associations of food environments on T2DM among adults and its heterogeneity by income and sex. METHODS AND FINDINGS: We linked individual health outcome data of 12,167 individuals from a network of health surveillance sites (the South Asia Biobank) to the density and proximity of food outlets geolocated around their homes from environment mapping survey data collected between 2018 and 2020 in Bangladesh and Sri Lanka. Density was defined as share of food outlets within 300 m from study participant's home, and proximity was defined as having at least 1 outlet within 100 m from home. The outcome variables include fasting blood glucose level, high blood glucose, and self-reported diagnosed diabetes. Control variables included demographics, socioeconomic status (SES), health status, healthcare utilization, and physical activities. Data were analyzed in ArcMap 10.3 and STATA 15.1. A higher share of fast-food restaurants (FFR) was associated with a 9.21 mg/dl blood glucose increase (95% CI: 0.17, 18.24; p < 0.05). Having at least 1 FFR in the proximity was associated with 2.14 mg/dl blood glucose increase (CI: 0.55, 3.72; p < 0.01). A 1% increase in the share of FFR near an individual's home was associated with 8% increase in the probability of being clinically diagnosed as a diabetic (average marginal effects (AMEs): 0.08; CI: 0.02, 0.14; p < 0.05). Having at least 1 FFR near home was associated with 16% (odds ratio [OR]: 1.16; CI: 1.01, 1.33; p < 0.05) and 19% (OR: 1.19; CI: 1.03, 1.38; p < 0.05) increases in the odds of higher blood glucose levels and diagnosed diabetes, respectively. The positive association between FFR density and blood glucose level was stronger among women than men, but the association between FFR proximity and blood glucose level was stronger among men as well as among those with higher incomes. One of the study's key limitations is that we measured exposure to food environments around residency geolocation; however, participants may source their meals elsewhere. CONCLUSIONS: Our results suggest that the exposure to fast-food outlets may have a detrimental impact on the risk of T2DM, especially among females and higher-income earners. Policies should target changes in the food environments to promote better diets and prevent T2DM.

Reference equations for evaluation of spirometry function tests in South Asia, and among South Asians living in other countries.

BACKGROUND: There are few data to support accurate interpretation of spirometry data in South Asia, a major global region with a high reported burden of chronic respiratory disease. METHOD: We measured lung function in 7453 healthy men and women aged ≥18 years, from Bangladesh, North India, South India, Pakistan and Sri Lanka, as part of the South Asia Biobank study. First, we assessed the accuracy of existing equations for predicting normal forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1) and FEV1/FVC ratio. Then, we used our data to derive (n=5589) and internally validate (n=1864) new prediction equations among South Asians, with further external validation among 339 healthy South Asians living in Singapore. RESULTS: The Global Lung Initiative (GLI) and National Health and Nutrition Examination Survey consistently overestimated expiratory volumes (best fit GLI-African American, mean±sd z-score: FEV1 -0.94±1.05, FVC -0.91±1.10; n=7453). Age, height and weight were strong predictors of lung function in our participants (p<0.001), and sex-specific reference equations using these three variables were highly accurate in both internal validation (z-scores: FEV1 0.03±0.99, FVC 0.04±0.97, FEV1/FVC -0.03±0.99) and external validation (z-scores: FEV1 0.31±0.99, FVC 0.24±0.97, FEV1/FVC 0.16±0.91). Further adjustment for study regions improves the model fit, with highest accuracy for estimation of region-specific lung function in South Asia. CONCLUSION: We present improved equations for predicting lung function in South Asians. These offer the opportunity to enhance diagnosis and management of acute and chronic lung diseases in this major global population.

Wave Packet Dynamics in Synthetic Non-Abelian Gauge Fields.

It is generally admitted that in quantum mechanics, the electromagnetic potentials have physical interpretations otherwise absent in classical physics as illustrated by the Aharonov-Bohm effect. In 1984, Berry interpreted this effect as a geometrical phase factor. The same year, Wilczek and Zee generalized the concept of Berry phases to degenerate levels and showed that a non-Abelian gauge field arises in these systems. In sharp contrast with the Abelian case, spatially uniform non-Abelian gauge fields can induce particle noninertial motion. We explore this intriguing phenomenon with a degenerated Fermionic atomic gas subject to a two-dimensional synthetic SU(2) non-Abelian gauge field. We reveal the spin Hall nature of the noninertial dynamic as well as its anisotropy in amplitude and frequency due to the spin texture of the system. We finally draw the similarities and differences of the observed wave packet dynamic and the celebrated Zitterbewegung effect of the relativistic Dirac equation.

Different Doses, Forms, and Frequencies of Zinc Supplementation for the Prevention of Diarrhea and Promotion of Linear Growth among Young Bangladeshi Children: A Six-Arm, Randomized, Community-Based Efficacy Trial.

BACKGROUND: Children in resource-limited settings remain vulnerable to zinc deficiency and its consequences. OBJECTIVES: To evaluate the effects of different doses, durations, and frequencies of zinc supplementation on the incidence of diarrhea and change in linear growth among young children. METHODS: We conducted a randomized, partially double-blind, controlled, 6-arm, community-based efficacy trial in Dhaka, Bangladesh. Children aged 9-11 mo were randomly assigned to receive 1 of the following interventions for 24 wk: 1) standard micronutrient powder (MNP) containing 4.1 mg zinc and 10 mg iron, daily; 2) high-zinc (10 mg), low-iron (6 mg) (HiZn LoFe) MNP, daily; 3) HiZn (10 mg) LoFe (6 mg)/HiZn (10 mg), no-iron MNPs on alternating days; 4) dispersible zinc tablet (10 mg), daily; 5) dispersible zinc tablet (10 mg), daily for 2 wk at enrollment and 12 wk; 6) placebo powder, daily. Primary outcomes were incidence of diarrhea and change in length-for-age z-score (LAZ) over the 24-wk intervention period. Home visits were conducted twice weekly to assess diarrhea and other morbidity. Incidence and prevalence outcomes were compared among groups with Poisson regression; continuous outcomes were compared using ANCOVA. RESULTS: A total of 2886 children were enrolled between February 2018 and July 2019. The mean incidence and prevalence of diarrhea among all participants was 1.21 episodes per 100 d and 3.76 d per 100 d, respectively. There were no differences in the incidence or prevalence of diarrhea across intervention groups. The decline in LAZ was slightly smaller among children in the daily HiZn LoFe MNP group compared with the placebo powder group (P < 0.05). CONCLUSIONS: The dose of zinc in MNPs as well as the duration and frequency of supplementation evaluated in this trial were not effective in reducing diarrhea; however, the daily HiZn LoFe MNP formulation offered modest improvements in linear growth among young children. This trial was registered at clinicaltrials.gov as NCT03406793.

Prevalence of and factors associated with insufficient physical activity among adolescents: evidence from a nationwide survey in Bangladesh.

The World Health Organization set a target of a 15% relative reduction in the prevalence of insufficient physical activity (IPA) by 2025 among adolescents and adults globally. In Bangladesh, there are no national estimates of the prevalence of IPA among adolescents. The aim of this study was to estimate the prevalence of and risk factors associated with IPA among adolescent girls and boys. Data for 4865 adolescent girls and 4907 adolescent boys, collected as a part of a National Nutrition Surveillance in 2018-19, were analysed for this study. A modified version of the Global Physical Activity Questionnaire (GPAQ) was used to collect physical activity data. The World Health Organization recommended cut-off points were used to estimate the prevalence of IPA. Bivariate and multivariable logistic regression was performed to identify factors associated with IPA. Prevalences of IPA among adolescent girls and boys were 50.3% and 29.0%, respectively, and the prevalence was significantly higher among early adolescents (10-14 years) than late adolescents (15-19 years) among both boys and girls. The IPA prevalence was highest among adolescents living in non-slum urban areas (girls: 77.7%; boys: 64.1%). For both boys and girls, younger age, non-slum urban residence, higher paternal education and increased television viewing time were significantly associated with IPA. Additionally, residing in slums was significantly associated with IPA only among the boys. Higher maternal education was associated with IPA only among the girls. This study identified several modifiable risk factors associated with IPA among adolescent boys and girls in Bangladesh. These factors should be addressed through comprehensive public health interventions to promote physical activity among adolescent girls and boys.

TEM study of chronic alcoholism effects on early carcinogenesis by probing the nanoscale structural alterations of cell nuclei.

Nanoscale structural alteration in the nuclei of cells with the progression of carcinogenesis is due to the rearrangements of the basic building blocks in the cell such as DNA, RNA, lipids, etc. Although epigenetic modifications underlie the development of cancer, exposure to carcinogenic chemicals such as alcohol also enhances the development of cancer. We report the effects of chronic alcoholism on early-carcinogenesis based on changes in the degree of nanoscale structural alterations (L d) in nuclei. For this, transmission electron microscopy (TEM) imaging of the nuclei of colonic cells is performed for the following four mouse models: control mice; chronic alcoholic mice treated with ethanol (i.e., EtOH mice); mice treated with colonic carcinogen azoxymethane (AOM) and dextran sulfate sodium (DSS) that induced colitis (i.e., AOM + DSS mice); and chronic alcoholic or EtOH treated mice, together with AOM and DSS treatment (i.e., AOM + DSS + EtOH mice). The disordered optical lattices are constructed from their respective TEM images of thin colonic cell nuclei and the L d values are calculated using the inverse participation ratio (IPR) technique from the spatially localized eigenfunctions of these lattices. Results show no significant difference in the average L d value of the colon cell nuclei of alcohol treated mice relative to its control [i.e., L d(C) ∼ L d(EtOH)]; however, an increase in the L d value of alcohol treated precancerous cells [i.e., L d(AOM + DSS + EtOH) > L d(AOM + DSS)], indicating that alcohol accelerates the early carcinogenic process.