Prevalence and risk factors of post-acute sequelae of SARS-CoV-2 (PASC) among veterans in the airborne hazards and open burn pit registry: a prospective, observational, nested study.

BACKGROUND: Veterans have unique military risk factors and exposures during deployment that may augment their risk of post-acute sequelae of SARS-CoV-2 (PASC). The purpose of this study is to identify potential risk factors for PASC among Veterans in the national Airborne Hazards and Open Burn Pit Registry (AHOBPR). METHODS: This prospective observational study consisted of a semi-structured interview conducted via phone or videoconference from November 2021 to December 2022 among a stratified random sample of deployed Veterans nested within the national AHOBPR with laboratory-confirmed SARS-CoV-2 infection. PASC was defined as persistent new-onset symptoms lasting more than 2 months after initial SARS-CoV-2 infection. Deployment history, airborne hazards exposure and symptoms were obtained from the AHOBPR self-assessment questionnaire completed prior to SARS-CoV-2 infection (past). Post-infection symptoms and health behaviors obtained at study interview (present) were used to test the hypothesis that deployment experience and exposure increases the risk for PASC. RESULTS: From a sample of 212 Veterans, 149 (70%) met criteria for PASC with a mean age of 47 ± 8.7 years; 73 (49%) were women and 76 (51%) were men, and 129 (82.6%) continued to experience persistent symptoms of SARS-CoV-2 (596.8 ± 160.4 days since initial infection). Neither exposure to airborne hazards (OR 0.97, CI 0.92-1.03) or to burn pits (OR 1.00, CI 0.99-1.00) augmented risk for PASC. CONCLUSIONS: PASC is highly common among Veterans enrolled in the AHOBPR, but we did not observe any unique military risk factors (e.g., airborne hazards exposure) that augmented the risk of PASC. Our findings may provide guidance to clinicians in the VHA network to administer appropriate care for Veterans experiencing PASC.

Data-driven modelling for assessing trophic status in marine ecosystems using machine learning approaches.

Assessing eutrophication in coastal and transitional waters is of utmost importance, yet existing Trophic Status Index (TSI) models face challenges like multicollinearity, data redundancy, inappropriate aggregation methods, and complex classification schemes. To tackle these issues, we developed a novel tool that harnesses machine learning (ML) and artificial intelligence (AI), enhancing the reliability and accuracy of trophic status assessments. Our research introduces an improved data-driven methodology specifically tailored for transitional and coastal (TrC) waters, with a focus on Cork Harbour, Ireland, as a case study. Our innovative approach, named the Assessment Trophic Status Index (ATSI) model, comprises three main components: the selection of pertinent water quality indicators, the computation of ATSI scores, and the implementation of a new classification scheme. To optimize input data and minimize redundancy, we employed ML techniques, including advanced deep learning methods. Specifically, we developed a CHL prediction model utilizing ten algorithms, among which XGBoost demonstrated exceptional performance, showcasing minimal errors during both training (RMSE = 0.0, MSE = 0.0, MAE = 0.01) and testing (RMSE = 0.0, MSE = 0.0, MAE = 0.01) phases. Utilizing a novel linear rescaling interpolation function, we calculated ATSI scores and evaluated the model's sensitivity and efficiency across diverse application domains, employing metrics such as R2, the Nash-Sutcliffe efficiency (NSE), and the model efficiency factor (MEF). The results consistently revealed heightened sensitivity and efficiency across all application domains. Additionally, we introduced a brand new classification scheme for ranking the trophic status of transitional and coastal waters. To assess spatial sensitivity, we applied the ATSI model to four distinct waterbodies in Ireland, comparing trophic assessment outcomes with the Assessment of Trophic Status of Estuaries and Bays in Ireland (ATSEBI) System. Remarkably, significant disparities between the ATSI and ATSEBI System were evident in all domains, except for Mulroy Bay. Overall, our research significantly enhances the accuracy of trophic status assessments in marine ecosystems. The ATSI model, combined with cutting-edge ML techniques and our new classification scheme, represents a promising avenue for evaluating and monitoring trophic conditions in TrC waters. The study also demonstrated the effectiveness of ATSI in assessing trophic status across various waterbodies, including lakes, rivers, and more. These findings make substantial contributions to the field of marine ecosystem management and conservation.

Unlocking the Therapeutic Potential of Marine Collagen: A Scientific Exploration for Delaying Skin Aging.

Aging is closely associated with collagen degradation, impacting the structure and strength of the muscles, joints, bones, and skin. The continuous aging of the skin is a natural process that is influenced by extrinsic factors such as UV exposure, dietary patterns, smoking habits, and cosmetic supplements. Supplements that contain collagen can act as remedies that help restore vitality and youth to the skin, helping combat aging. Notably, collagen supplements enriched with essential amino acids such as proline and glycine, along with marine fish collagen, have become popular for their safety and effectiveness in mitigating the aging process. To compile the relevant literature on the anti-aging applications of marine collagen, a search and analysis of peer-reviewed papers was conducted using PubMed, Cochrane Library, Web of Science, and Embase, covering publications from 1991 to 2024. From in vitro to in vivo experiments, the reviewed studies elucidate the anti-aging benefits of marine collagen, emphasizing its role in combating skin aging by minimizing oxidative stress, photodamage, and the appearance of wrinkles. Various bioactive marine peptides exhibit diverse anti-aging properties, including free radical scavenging, apoptosis inhibition, lifespan extension in various organisms, and protective effects in aging humans. Furthermore, the topical application of hyaluronic acid is discussed as a mechanism to increase collagen production and skin moisture, contributing to the anti-aging effects of collagen supplementation. The integration of bio-tissue engineering in marine collagen applications is also explored, highlighting its proven utility in skin healing and bone regeneration applications. However, limitations to the scope of its application exist. Thus, by delving into these nuanced considerations, this review contributes to a comprehensive understanding of the potential and challenges associated with marine collagen in the realm of anti-aging applications.

A Wearable Personalised Sonification and Biofeedback Device to Enhance Movement Awareness.

Movement sonification has emerged as a promising approach for rehabilitation and motion control. Despite significant advancements in sensor technologies, challenges remain in developing cost-effective, user-friendly, and reliable systems for gait detection and sonification. This study introduces a novel wearable personalised sonification and biofeedback device to enhance movement awareness for individuals with irregular gait and posture. Through the integration of inertial measurement units (IMUs), MATLAB, and sophisticated audio feedback mechanisms, the device offers real-time, intuitive cues to facilitate gait correction and improve functional mobility. Utilising a single wearable sensor attached to the L4 vertebrae, the system captures kinematic parameters to generate auditory feedback through discrete and continuous tones corresponding to heel strike events and sagittal plane rotations. A preliminary test that involved 20 participants under various audio feedback conditions was conducted to assess the system's accuracy, reliability, and user synchronisation. The results indicate a promising improvement in movement awareness facilitated by auditory cues. This suggests a potential for enhancing gait and balance, particularly beneficial for individuals with compromised gait or those undergoing a rehabilitation process. This paper details the development process, experimental setup, and initial findings, discussing the integration challenges and future research directions. It also presents a novel approach to providing real-time feedback to participants about their balance, potentially enabling them to make immediate adjustments to their posture and movement. Future research should evaluate this method in varied real-world settings and populations, including the elderly and individuals with Parkinson's disease.

Trends and long-term variation explaining nutritional determinants of child linear growth: analysis of Bangladesh Demographic and Health Surveys 1996-2018.

OBJECTIVE: To examine the height-for-age z-score (HAZ) of 0-35 months' children along with stunting prevalence to identify trends, changes and available nutrition-sensitive and specific determinants that could help explain the long-term variation in child linear growth using successive Bangladesh Demographic and Health Surveys (BDHS) data from 1996 to 2018. DESIGN: The BDHS pooled data are used for determining the key outcome variables HAZ, stunting and severe stunting. Trends, kernel-weighted local polynomial smoothing illustrations, pooled multivariable linear probability model (LPM), ordinary least squares method (OLS) and regression decomposition were used. PARTICIPANTS: Mothers having 0-35 months' children, the most critical age range for growth faltering. RESULTS: The mean HAZ increased by 0·91(±1·53) with 0·041 annual average change, while the percentages of stunting (-26·63 ± 0·54) and severe stunting (-21·12 ± 0·48) showed a reduction with 1·21 and 0·96 average annual changes, respectively. The average HAZ improvement (0·42 ± 1·56) in urban areas was less than the rural areas (1·16 ± 1·44). Similar patterns followed for stunting and severe stunting. The prenatal doctor visits (3064·65 %), birth in a medical facility (1054·32 %), breastfeeding initiation (153·18 %) and asset index (144·73 %) demonstrated a huge change. The findings of OLS, LPM and regression decomposition identified asset index, birth order, paternal and maternal education, bottle-fed, prenatal doctor visit, birth in a medical facility, vaccination, maternal BMI and ever-breastfed as influencing factors to predict the long-term changes of stunting and severe stunting. CONCLUSION: The nutrition-sensitive and specific factors identified through regression decomposition describing long-term variation in child linear growth should be focused further to attain the sustainable development goals.

Marine waters assessment using improved water quality model incorporating machine learning approaches.

In marine ecosystems, both living and non-living organisms depend on "good" water quality. It depends on a number of factors, and one of the most important is the quality of the water. The water quality index (WQI) model is widely used to assess water quality, but existing models have uncertainty issues. To address this, the authors introduced two new WQI models: the weight based weighted quadratic mean (WQM) and unweighted based root mean squared (RMS) models. These models were used to assess water quality in the Bay of Bengal, using seven water quality indicators including salinity (SAL), temperature (TEMP), pH, transparency (TRAN), dissolved oxygen (DOX), total oxidized nitrogen (TON), and molybdate reactive phosphorus (MRP). Both models ranked water quality between "good" and "fair" categories, with no significant difference between the weighted and unweighted models' results. The models showed considerable variation in the computed WQI scores, ranging from 68 to 88 with an average of 75 for WQM and 70 to 76 with an average of 72 for RMS. The models did not have any issues with sub-index or aggregation functions, and both had a high level of sensitivity (R2 = 1) in terms of the spatio-temporal resolution of waterbodies. The study demonstrated that both WQI approaches effectively assessed marine waters, reducing uncertainty and improving the accuracy of the WQI score.

Identification of Catalytic Active Sites for Durable Proton Exchange Membrane Fuel Cell: Catalytic Degradation and Poisoning Perspectives.

Recent progress in synthetic strategies, analysis techniques, and computational modeling assist researchers to develop more active catalysts including metallic clusters to single-atom active sites (SACs). Metal coordinated N-doped carbons (M-N-C) are the most auspicious, with a large number of atomic sites, markedly performing for a series of electrochemical reactions. This perspective sums up the latest innovative and computational comprehension, while giving credit to earlier/pioneering work in carbonaceous assembly materials towards robust electrocatalytic activity for proton exchange membrane fuel cells via inclusive performance assessment of the oxygen reduction reaction (ORR). M-Nx -Cy are exclusively defined active sites for ORR, so there is a unique possibility to intellectually design the relatively new catalysts with much improved activity, selectivity, and durability. Moreover, some SACs structures provide better performance in fuel cells testing with long-term durability. The efforts to understand the connection in SACs based M-Nx -Cy moieties and how these relate to catalytic ORR performance are also conveyed. Owing to comprehensive practical application in the field, this study has covered very encouraging aspects to the current durability status of M-N-C based catalysts for fuel cells followed by degradation mechanisms such as macro-, microdegradation, catalytic poisoning, and future challenges.

Inference of a "Hot Ice" Layer in Nitrogen-Rich Planets: Demixing the Phase Diagram and Phase Composition for Variable Concentration Helium-Nitrogen Mixtures Based on Isothermal Compression.

Van der Waals (vdW) chemistry in simple molecular systems may be important for understanding the structure and properties of the interiors of the outer planets and their satellites, where pressures are high and such components may be abundant. In the current study, Raman spectra and visual observation are employed to investigate the phase separation and composition determination for helium-nitrogen mixtures with helium concentrations from 20 to 95% along the 295 K isothermal compression. Fluid-fluid-solid triple-phase equilibrium and several equilibria of two phases including fluid-fluid and fluid-solid have been observed in different helium-nitrogen mixtures upon loading or unloading pressure. The homogeneous fluid in helium-nitrogen mixtures separates into a helium-rich fluid (F1) and a nitrogen-rich fluid (F2) with increasing pressure. The triple-phase point occurs at 295 K and 8.8 GPa for a solid-phase (N2)11He vdW compound, fluid F1 with around 50% helium, and fluid F2 with 95% helium. Helium concentrations of F1 coexisted with the (N2)11He vdW compound or δ-N2 in helium-nitrogen mixtures with different helium concentrations between 40 and 50% and between 20 and 40%, respectively. In addition, the helium concentration of F2 is the same in helium-nitrogen mixtures with different helium concentrations and decreases upon loading pressure. Pressure-induced nitrogen molecule ordering at 32.6 GPa and a structural phase transition at 110 GPa are observed in (N2)11He. In addition, at 187 GPa, a pressure-induced transition to an amorphous state is identified.

Prevalence and determinants of wife-beating in Bangladesh: evidence from a nationwide survey.

BACKGROUND: Intimate partner violence (IPV) is a global public health concern, with women in low- and middle-income countries (LMICs) bearing a disproportionately high burden. This study investigates the prevalence and factors correlated with attitudes regarding wife-beating among Bangladeshi women in urban-rural contexts. METHODS: A sample of 13,033 urban women and 51,344 rural women data from the Bangladesh Multiple Indicator Cluster Survey (MICS) 2019 were analyzed using the Chi-square test and ordinal logistic regression model. RESULTS: The findings reveal that arguing with her husband is the widespread reason for wife-beating in Bangladesh (urban: 17.3%, rural: 21.9%), followed by neglecting the children (urban: 12.7%, rural: 15.8%). About 8% of urban women and 10% of rural women favoured the opinion that refusing to involve sexual intercourse is a legitimate justification for wife-beating. In comparison, around 5% feel that a husband has a right to beat his wife due to burning food. The respondents' age, education, marital status, number of children, socioeconomic level, any health or physical difficulty, having problems becoming pregnant, and the husband's age are all significant factors in justifying wife-beating. CONCLUSIONS: Bangladesh has a massive challenge in eliminating IPV. Women from lower socioeconomic classes, low levels of education, other challenges, and residents of rural areas are particularly more vulnerable than their urban counterparts. Therefore, it is vital to develop a proper action plan that considers women's education and occupation to raise awareness of the various implications of wife-beating in women, particularly in Bangladesh's rural areas.

A comparison of rural Australian First Nations and Non-First Nations survey responses to COVID-19 risks and impacts: implications for health communications.

INTRODUCTION: This study investigated differences between rural Australian First Nations and non-First Nations survey respondents' perceptions of COVID-19-related risks and analysed other variables that could predict an exacerbation of anxiety related to COVID-19 harms. METHODS: A cross-sectional online and paper survey of rural residents from the western regions of NSW, Australia, was conducted. Descriptive and multivariate statistical analyses were used to assess links between First Nations status and demographic measures including postcode, age, gender, education, rural or town/village location, proximity to medical services and living situation. The analysis included five items related to perceptions about COVID-19: perceived likelihood of contracting COVID-19 in the next 12 months, perceived harmfulness of the virus, how often people felt afraid, perception about respondents' ability to do something about the virus and perceived economic impacts of the pandemic. RESULTS: There were significant differences between First Nations (n=60) and non-First Nations (n= 639) respondents across all sociodemographic categories. The results reflect a significantly higher level of anxiety among the First Nations Australians in the sample: they felt afraid more often, felt it was highly likely they would catch the virus and if they did catch the virus perceived that it would be very harmful. Living with children under eighteen years of age and in small rural towns were key factors linked to feeling afraid of COVID-19 and First Nations status. CONCLUSION: Health risk communication in pandemic response should include an equitable focus on rural areas, recognising that First Nations Australians are a significant proportion of the rural population with different risk factors and concerns than those of non-First Nations Australians. This principle of First Nations-led design is critical to all health policy and planning. The Australian Government should include rural areas in planning pandemic responses, recognising that First Nations populations are a significant proportion of the rural population creating syndemic conditions.

Prevalence and determinants of fever, ARI and diarrhea among children aged 6-59 months in Bangladesh.

BACKGROUND: Although efforts have been made by the international community to improve childhood health, risk factors linked with the healthiness of preschool-age children in low and middle-income countries (LMICs) are very diverse. Therefore, this paper examines the prevalence and determinants of fever, acute respiratory infection and diarrhea of preschool children in Bangladesh. METHODS: A sample of 8,421 children from the latest country representative BDHS-2017-18 survey was analyzed by utilizing both the bivariate and multivariate techniques. RESULTS: The results revealed that about 4.7, 33.1, and 35.8% of the children aged under 5 years had suffered from diarrhea, fever and ARI respectively during the 2 weeks preceding the date of the survey. Demographic, socio-economic, and community and health characteristics likely to play an important role in suffering under-five children from diarrhea, fever, and ARI in Bangladesh. The child's age of 13-24 months, delivery by cesarean section, unsafe drinking water, unhygienic toilet facility, low level of family wealth index and parental education, a higher number of living children in the household, rural residency and regional difference were all found to be most crucial determinants of the occurrences of fever, ARI and diarrhea. CONCLUSION: Interventions should focus on improving these significant demographic, socioeconomic, and community and health risk factors. A special attention is necessary to the people who live in rural areas and geospatially disadvantaged regions.

Chitin and Chitosan: Prospective Biomedical Applications in Drug Delivery, Cancer Treatment, and Wound Healing.

Chitin and its derivative chitosan are highly abundant polymers in nature, appearing in both the shells and exoskeletons of various marine and non-marine species. Since they possess favorable properties, such as biocompatibility, biodegradability, non-toxicity, and non-immunogenicity, they have gained recent attention due to their enormous potential biomedical applications. The polycationic surface of chitosan enables it to form hydrogenic and ionic bonds with drug molecules, which is one of its most useful properties. Because chitosan is biocompatible, it can therefore be used in drug delivery systems. The development of chitosan-based nanoparticles has also contributed to the significance of chitin as a drug delivery system that can deliver drugs topically. Furthermore, chitin can be used in cancer treatment as a vehicle for delivering cancer drugs to a specific site and has an antiproliferative effect by reducing the viability of cells. Finally, chitosan can be used as a wound dressing in order to promote the faster regeneration of skin epithelial cells and collagen production by fibroblasts. As discussed in this review, chitin and chitosan have diverse applications in the medical field. Recognizing the biomedical applications of these two polymers is essential for future research in tissue engineering and nanobiotechnology.

Collagens from Marine Organisms towards Biomedical Applications.

Collagen is the main fibrous structural protein in the extracellular matrix and connective tissue of animals [...].

Marine Collagen: A Promising Biomaterial for Wound Healing, Skin Anti-Aging, and Bone Regeneration.

Marine organisms harbor numerous bioactive substances that can be utilized in the pharmaceutical and cosmetic industries. Scientific research on various applications of collagen extracted from these organisms has become increasingly prevalent. Marine collagen can be used as a biomaterial because it is water soluble, metabolically compatible, and highly accessible. Upon review of the literature, it is evident that marine collagen is a versatile compound capable of healing skin injuries of varying severity, as well as delaying the natural human aging process. From in vitro to in vivo experiments, collagen has demonstrated its ability to invoke keratinocyte and fibroblast migration as well as vascularization of the skin. Additionally, marine collagen and derivatives have proven beneficial and useful for both osteoporosis and osteoarthritis prevention and treatment. Other bone-related diseases may also be targeted by collagen, as it is capable of increasing bone mineral density, mineral deposition, and importantly, osteoblast maturation and proliferation. In this review, we demonstrate the advantages of marine collagen over land animal sources and the biomedical applications of marine collagen related to bone and skin damage. Finally, some limitations of marine collagen are briefly discussed.

Robust machine learning algorithms for predicting coastal water quality index.

Coastal water quality assessment is an essential task to keep "good water quality" status for living organisms in coastal ecosystems. The Water quality index (WQI) is a widely used tool to assess water quality but this technique has received much criticism due to the model's reliability and inconsistence. The present study used a recently developed improved WQI model for calculating coastal WQIs in Cork Harbour. The aim of the research is to determine the most reliable and robust machine learning (ML) algorithm(s) to anticipate WQIs at each monitoring point instead of repeatedly employing SI and weight values in order to reduce model uncertainty. In this study, we compared eight commonly used algorithms, including Random Forest (RF), Decision Tree (DT), K-Nearest Neighbors (KNN), Extreme Gradient Boosting (XGB), Extra Tree (ExT), Support Vector Machine (SVM), Linear Regression (LR), and Gaussian Naïve Bayes (GNB). For the purposes of developing the prediction models, the dataset was divided into two groups: training (70%) and testing (30%), whereas the models were validated using the 10-fold cross-validation method. In order to evaluate the models' performance, the RMSE, MSE, MAE, R2, and PREI metrics were used in this study. The tree-based DT (RMSE = 0.0, MSE = 0.0, MAE = 0.0, R2 = 1.0 and PERI = 0.0) and the ExT (RMSE = 0.0, MSE = 0.0, MAE = 0.0, R2 = 1.0 and PERI = 0.0) and ensemble tree-based XGB (RMSE = 0.0, MSE = 0.0, MAE = 0.0, R2 = 1.0 and PERI = +0.16 to -0.17) and RF (RMSE = 2.0, MSE = 3.80, MAE = 1.10, R2 = 0.98, PERI = +3.52 to -25.38) models outperformed other models. The results of model performance and PREI indicate that the DT, ExT, and GXB models could be effective, robust and significantly reduce model uncertainty in predicting WQIs. The findings of this study are also useful for reducing model uncertainty and optimizing the WQM-WQI model architecture for predicting WQI values.

Genesis and Mechanism of Some Cancer Types and an Overview on the Role of Diet and Nutrition in Cancer Prevention.

Cancer is a major disease with a high mortality rate worldwide. In many countries, cancer is considered to be the second most common cause of death after cardiovascular disease. The clinical management of cancer continues to be a challenge as conventional treatments, such as chemotherapy and radiation therapy, have limitations due to their toxicity profiles. Unhealthy lifestyle and poor dietary habits are the key risk factors for cancer; having a healthy diet and lifestyle may minimize the risk. Epidemiological studies have shown that a high fruit and vegetable intake in our regular diet can effectively reduce the risk of developing certain types of cancers due to the high contents of antioxidants and phytochemicals. In vitro and in vivo studies have shown that phytochemicals exert significant anticancer effects due to their free radical scavenging capacity potential. There has been extensive research on the protective effects of phytochemicals in different types of cancers. This review attempts to give an overview of the etiology of different types of cancers and assesses the role of phytonutrients in the prevention of cancers, which makes the present review distinct from the others available.

Two-dimensional magnetic interplay in the tensile-strained LaCoO3 thin films.

High-quality epitaxial LaCoO3 (LCO) thin films have been deposited on SrTiO3 (STO) substrates with pulsed laser deposition (PLD). We find that the LCO films undergo a typical ferromagnetic-paramagnetic (FM-PM) phase transition at ∼80 K. To understand the nature of magnetic phase transition, various methods, including the modified Arrott plot and critical isotherm analysis, were used to determine the critical exponents, which are ß = 0.754(1) with a Curie temperature TC = 79.8(8) K and γ = 1.52(2) with TC = 79.9(2) K. The reliability of these critical exponents was confirmed using the Widom scaling relation and the scaling hypothesis. Further analysis revealed that the spin coupling within the LCO films exhibits two-dimensional (2D) long-range magnetic interaction and the magnetic exchange distance decays as J(r) ∼r-(3.46). Our critical behavior analysis may shed new light on the further understanding of the origin of FM and the relatively fixed TC in LCO thin films.

Evaluating Nicotine Abstinence, Smoking Cessation, Reduction and its Relapsed Among Electronic Cigarettes Single and Dual Malaysian Users: A One Year Observational Study.

PURPOSE: Evidence for the complete nicotine cessation is inadequate among electronic cigarettes (ECs) single users (SUs, use only ECs), and dual users (DUs, use both ECs and conventional cigarettes (CCs). The primary aim of this study was to evaluate the nicotine cessation among SUs and DUs who used ECs over one year. METHODS: We observed 70 SUs and 148 DUs for 52 weeks and tested their exhaled carbon monoxide and saliva cotinine to confirm their complete nicotine cessation status through cotinine in saliva. Safety issues were to be identified through self-report. Smoking cessation, CCs reduction of ≥ 50%, and relapsed to CCs smoking and safety issues were also documented. RESULTS: The nicotine cessation rate was higher in SUs then DUs (15.9% vs. 6.8%; P = 0.048; 95% CI (2.328-0.902). A similar result for smoking cessation (34.8% SUs vs. 17.1% DUs; P = 0.005; 95% CI: 2.031-0.787), whereas CCs ≥ 50% reduction was 23.3% DUs vs 21.7% SUs (P = 0.863; 95% CI :1.020-0.964). Relapse to CC smoking was 47.3% in DUs versus 30.4% in SUs (P = 0.026; 95% CI: 1.555-0.757). The adverse effects reported were coughing and breathing problems, whereas craving smoking was documented as a major withdrawal symptom. Smoking-related diseases were also identified, five in DUs and two in SUs, during the one-year study period. CONCLUSIONS: Study showed SUs achieved higher complete nicotine and smoking cessation rates as compared to DUs. However, the rates of reduced CC use were not different between both the groups. No serious adverse effects related to the sole use of ECs were detected. However, the safety of the sole use of ECs in absolute terms needs to be further validated in different populations.

Factors associated with coverage of vitamin a supplementation among Bangladeshi children: mixed modelling approach.

BACKGROUND: Vitamin A deficiency (VAD) is a prominent and widespread public health problem in developing countries, including Bangladesh. About 2% of all deaths among under-five children are attributable to VAD. Evidence-based information is required to understand the influential factors to increase vitamin A supplementation (VAS) coverage and reduce VAD. We investigated the potential factors affecting VAS coverage and its significant predictors among Bangladeshi children aged 6 to 59 months using the VAS clustered data extracted from the latest Bangladesh Demographic and Health Survey 2014. METHODS: Data were analysed using mixed logistic regression (MLR) modelling approach in the generalised linear mixed model framework. The MLR model performs better than logistic regression for analysing the clustered data because of its minimum Akaike information criterion value. The likelihood ratio test showed that the variance component was significant. Therefore, the clustering effect among children was inevitable to use. RESULTS: VAS coverage among under-five children was 63.6%, which is not optimal and below the WHO's recommendation and the country's target of 90%. Children aged 25 to 36 months (AOR = 2.07, 95% CI: 1.711 to 2.513), who had higher educated mothers (AOR = 1.37, p = 0.033, 95% CI: 1.026-1.820) and fathers (AOR = 1.32, p = 0.027, 95% CI: 1.032-1.683), whose mothers had media exposure (AOR = 1.22, p = 0.006, 95% CI: 1.059-1.408) and NGO membership (AOR = 1.24, p = 0.002, 95% CI: 1.089-1.422) were more likely to consume VAS. CONCLUSION: The relevant authorities should create proactive awareness programs for highly vulnerable local communities, specifically targeted to educate the children's mothers about the necessity and benefits of childhood nutrition.

Rural-urban determinants of vitamin a deficiency among under 5 children in Bangladesh: Evidence from National Survey 2017-18.

BACKGROUND: Vitamin A supplementation reduces child morbidity, mortality, and blindness of people, especially in developing countries like Bangladesh. This study explores significant determinants of vitamin A deficiency among preschool children in rural and urban areas of Bangladesh. METHODS: The data set was extracted from a nationally representative survey based on a cross-sectional study, the BDHS-2017-18. The base survey was conducted using a two-stage stratified sample of households. A sample of 8364 (urban 2911, rural 5453) children under-5 years old was analyzed using bivariate and multivariate statistical techniques. RESULTS: Results have demonstrated that 73.9 and 73.2% of children have had a vitamin A supplementation from urban and rural areas, respectively. Logistic regression analysis showed that parents' education plays a vital role in consuming vitamin A supplements in urban and rural areas. Children whose mothers have secondary (OR: 1.17, CI: 0.76-1.81) and higher (OR: 1.21, CI: 0.72-2.04) education were more likely to consume vitamin A supplementation than children whose mothers were illiterate in urban areas. However, in rural areas, children whose mothers have secondary education were about 24% and higher education with 60% more likely to consume vitamin A supplementation than children whose mothers were illiterate. Child's age, regional variation and wealth index also contributing factors for vitamin A deficiency in Bangladesh. CONCLUSIONS: These findings indicated that the consumption of vitamin A does not cover the target of sustainable development goals. Thus special national and community level efforts are required to ensure the coverage of the national vitamin A program is increased adequately to the most vulnerable groups of children in Bangladesh.