Specialized nutritious foods and behavior change communication interventions during the first 1,000 days of life to prevent stunting: A quasi-experimental study in Afghanistan.

BACKGROUND: Considerable evidence supports the effectiveness of nutritional supplementation with or without nutrition education in preventing stunting in developing countries, but evidence from Afghanistan is scarce. OBJECTIVE: This project aimed to assess the effectiveness of specialized nutritious food (SNF), social and behavior change communication (SBCC) intervention to prevent stunting among children under 2 years during the first 1,000 days of life in Badakhshan, Afghanistan. METHODS: We used a community-based quasi-experimental pre-post study design with a control group. Pregnant and lactating women received a monthly ration of 7.5 kg of Super Cereal (250g/day) during pregnancy and the first 6 months of breastfeeding. Children aged 6-23 months received 30 sachets of medium-quantity lipid-based nutrient supplement (50g/sachet/day) monthly. We compared pre- and post-intervention assessments of the intervention and control groups to isolate the effect of the intervention on key study outcomes at the endline by difference-in-differences (DID) estimates. RESULTS: A total of 2,928 and 3,205 households were surveyed at baseline and endline. DID estimates adjusted for child, maternal, and household characteristics indicated a significant reduction in stunting (DID: -5% (95% CI: -9.9, -0.2) and underweight (DID: -4.6% (95% CI: -8.6, -0.5) among children <2 years of age. However, DID estimates for wasting among children in the intervention and control groups were not significantly different (DID: -1.7 (95% CI: -5.1,1.6). Furthermore, exposure to the SBCC messages was associated with improvements in the early initiation of breastfeeding (DID: 19.6% (95% CI: 15.6,23.6), exclusive breastfeeding under 6-months (DID: 11.0% (95% CI: 2.3,19.7), minimum meal frequency (MMF) (DID: 23% (95% CI: 17.7,28.2), minimum acceptable diet (MAD) (DID: 13% (95% CI: 9.8,16.3). CONCLUSIONS: The provision of SNF in combination with SBCC during the first 1,000 days of life was associated with reduction in stunting and underweight and improvements in IYCF practices among children under 2 years of age. CLINICAL TRIAL REGISTRY NUMBER: Clinicaltrials.gov, NCT04581993.

Impact of resistant starch: Absorption of dietary minerals, glycemic index and oxidative stress in healthy rats.

BACKGROUND & AIMS: Resistant starch (RS) is a prebiotic fiber that has been scientifically shown to control the development of obesity. Prebiotic role of RS has also seen to be very important as it helps gut bacteria to regulate fermentation and fatty acid production. This study aimed to check the different levels of RS on glycemic index, oxidative stress and mineral absorption rate in healthy rat models. To evaluate these objectives, the trial was conducted for 40 days of follow up; 10 days were the adjustment period and the collection period over 30 days. METHODS: Thirty-six healthy female Wistar rats were divided into 4 groups of (9 animals each) NC (Normal Control: without resistant starch), RS0.20 (resistant starch: 0.20 g/kg body weight), RS0.30 (resistant starch: 0.30 g/kg body weight), RS0.40 (resistant starch: 0.40 g/kg body weight). All the diets were isocaloric and isonitroginous. RESULTS: The impact of different levels of RS on the dry-matter intake (DMI) presented statistically significant results (p ≤ 0.05): DMI was reduced in RS (0.02) fed rats as compared to NC rats in first 3 weeks; and after 4th and 5th weeks, there was a DMI reduction of 28% in RS (0.04) fed rats. Moreover, there was no significant increase in the nutrient intake in all RS diets. The dry-matter (DM) digestibility was statistically significantly (P ≤ 0·05), which increased in all rats fed with different level of RS. The weight loss showed statistically significant results: RS (0.04) exhibited 19 g reduction in weight as compared with NC rats. Significant increase was observed in total oxidant status (TOS), in all the RS fed rats when compared with NC rats. The levels of Mg, Ca, Fe and Zn were shown to be decrease in feces analysis, which proves their better absorbance in gut. Statistically significant increase was observed in antioxidant capacity, whereas significant decrease was observed in the total weight of the animals, showing the role of RS in controlling obesity. CONCLUSIONS: Overall, significant results were found in all dosage level of RS but long term administration of the higher dosage level (RS0.40) may need to be studied for enhanced results. RS can help improve insulin sensitivity in overweight adults.

Optimized spray-dried conditions' impact on fatty acid profiles and estimation of in vitro digestion of spray-dried chia/fish oil microcapsules.

Long-chain polyunsaturated fatty acids (LCPUFA) are of interest due to their potential health properties and have a significant role in reducing the risk of various chronic diseases in humans. It is commonly used as a supplement. However, lipid oxidation is an important negative factor caused by environmental, processing, and limited water solubility of LCPUFA, making them difficult to incorporate into food products. The objective of this research work was to prevent oxidation, extend shelf life, enhance the stability of fatty acids, and to achieve controlled release by preparing spray-dried powder (SDM). For spray-drying, aqueous emulsion blends were formulated using a 1:1 ratio of chia seed oil (CSO) and fish oil (FO) and using a laboratory-scale spray-dryer with varying conditions: inlet air temperature (IAT, 125-185 °C), wall material (WM, 5-25%), pump speed (PS, 3-7 mL/min), and needle speed (NS, 3-11 s). The maximum alpha-linolenic acid (ALA) content was 33 ± 1%. The highest values of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in the microcapsules were 8.4 ± 0.4 and 13 ± 1%, respectively. Fourier transform infrared and X-Ray diffraction analysis results indicated that SDM was successfully formulated with Gum Arabic and maltodextrin (MD). The blending without encapsulation of CSO and FO was digested more efficiently and resulted in more oil being released with simulated gastric fluid (SGF), simulated intestinal fluid (SIF), and SGF + SIF conditions without heating. No significant changes were observed for saturated, monounsaturated, and LCPUFA, whether exposed or not to gastrointestinal conditions. However, compared to the release of SDM, it can be useful for designing delivery systems for the controlled release of essential fatty acids.

Validation of Bos taurus SNPs for Milk Productivity of Sahiwal Breed (Bos indicus), Pakistan.

The aim of the present study was the validation of the already reported Bos taurus SNPs in the Sahiwal breed. A total of nine SNPs of the casein gene were studied. Out of nine, seven Bos taurus SNPs of casein protein genes were found to be significantly associated with milk productivity traits. The genomic DNA was extracted from the mammary alveolar endothelial cells of a flock of 80 purebred Sahiwal lactating dams available at Khizrabad Farm near Sargodha. New allele-specific primers were designed from the NCBI annotated sequence database of Bos taurus to obtain 100 nt-long PCR products. Each dam was tested separately for all the SNPs investigated. Animals with genotype GG for the SNPs rs43703010, rs10500451, and 110323127, respectively, exhibited high milk yield. Similarly, animals with genotype AA for the SNPs rs11079521, rs43703016, and rs43703017 showed high milk yield consistently. For the SNP rs43703015, animals with genotype CC showed high milk productivity. These above-mentioned SNPs have previously been reported to significantly up-regulate casein protein contents in Bos taurus. Our results indicated SNPs that significantly affect the milk protein contents may also significantly increase per capita milk yield. These finding suggest that the above-mentioned reported SNPs can also be used as genetic markers of milk productivity in Sahiwal cattle.

Exploring the path to polio eradication: insights from consecutive seroprevalence surveys among Pakistani children.

Introduction: After trivalent oral poliovirus vaccine (tOPV) cessation, Pakistan has maintained immunity to type 2 poliovirus by administering inactivated polio vaccine (IPV) in routine immunization, alongside monovalent OPV type 2 (mOPV2) and IPV in supplementary immunization activities (SIAs). This study assesses the change in poliovirus type 2 immunity after tOPV withdrawal and due to SIAs with mOPV2 and IPV among children aged 6-11 months. Methods: Three cross-sectional sequential serological surveys were conducted in 12 polio high-risk areas of Pakistan. 25 clusters from each geographical stratum were selected utilizing probability proportional to size. Results: Seroprevalence of type 2 poliovirus was 49%, with significant variation observed among surveyed areas; <30% in Pishin, >80% in Killa Abdullah, Mardan & Swabi, and Rawalpindi. SIAs with IPV improved immunity from 38 to 57% in Karachi and 60 to 88% in Khyber. SIAs with IPV following mOPV2 improved immunity from 62 to 65% in Killa Abdullah, and combined mOPV2 and IPV SIAs in Pishin improved immunity from 28 to 89%. Results also reflected that immunity rates for serotypes 1 and 3 were consistently above 90% during all three phases and across all geographical areas. Conclusion: The study findings highlight the importance of implementing effective vaccination strategies to prevent the re-emergence of poliovirus. Moreover, the results provide crucial information for policymakers working toward achieving global polio eradication.

Fatty Acid Composition, Phenolic Compounds, Phytosterols, and Lipid Oxidation of Single- and Double-Fractionated Olein of Safflower Oil Produced by Low-Temperature Crystallization.

By dry crystallization, concentrations of unsaturated fatty acids and bioactive compounds can be increased in olein and super-olein fractions in vegetable oils. Among all sources of vegetable oils, safflower oil (SO) possesses the maximum linoleic acid content. To boost the industrial applications of SO, two variants were produced by single- and two-stage crystallization. This study aimed to determine the fatty acid compositions, phenolic compounds, phytosterols, and oxidative stability of fractionated olein (OF) and double-fractionated olein (DFO) produced by dry crystallization. For this, SO was cooled to -45 °C and filtered, the filtrate was denoted as single-fractionated olein (OF), and 40% of this section was taken for analytical purposes, while the remaining 60% was again cooled to -70 °C and filtered, and the filtrate was denoted as double-fractionated olein (DFO). Unfractionated safflower (SO) was used as a control, filled in amber glass bottles, and stored at 20-25 °C for 90 days. Fatty acid compositions and phytosterols were determined by gas chromatography-mass spectrometry (GC-MS). Phenolic compounds and induction periods were determined by high-performance liquid chromatography (HPLC) and Rancimat. GC-MS analysis revealed that the C18:2 contents of SO, OF, and DFO were 77.63 ± 0.82, 81.57 ± 0.44, and 89.26 ± 0.48 mg/100 g (p < 0.05), respectively. The C18:1 contents of SO, OF, and DFO were 6.38 ± 0.19, 7.36 ± 0.24, and 9.74 ± 0.32 mg/100 g (p < 0.05), respectively. HPLC analysis showed that phenolic compounds were concentrated in the low-melting-point fractions. In DFO, concentrations of tyrosol, rutin, vanillin, ferulic acid, and sinapic acid were 57.36 ± 0.12, 129.45 ± 0.38, 165.11 ± 0.55, 183.61 ± 0.15, 65.94 ± 0.11, and 221.75 ± 0.29 mg/100 g, respectively. In SO, concentrations of tyrosol, rutin, vanillin, ferulic acid, and sinapic acid were 24.79 ± 0.08, 78.93 ± 0.25, 115.67 ± 0.41, 34.89 ± 0.51, and 137.26 ± 0.08 mg/100 g, respectively. In OF, concentrations of tyrosol, rutin, vanillin, ferulic acid, and sinapic acid were 35.96 ± 0.20, 98.69 ± 0.64, 149.14 ± 0.13, 57.53 ± 0.74, and 188.28 ± 0.82 mg/100 g, respectively. The highest concentrations of brassicasterol, campesterol, stigmasterol, ß-sitosterol, avenasterol, stigmastenol, and avenasterol were noted in DFO followed by OF and SO. The total antioxidant capacities of SO, OF, and DFO were 54.78 ± 0.12, 71.36 ± 0.58, and 86.44 ± 0.28%, respectively. After the end of the storage time, the peroxide values (POVs) of SO, OF, and DFO stored for 3 months were 0.68, 0.85, and 1.16 mequiv O2/kg, respectively, with no difference in the free fatty acid content.

Rational synthesis of two isostructural thiophene-containing metal-organic frameworks toward photocatalytic degradation of organic pollutants.

In this work, thiophene moieties (as the crucial functional groups) have been successfully incorporated into the skeleton of metal-organic frameworks (MOFs) by using thienyl-substituted triazole ligands. Reaction of AgCF3SO3 with 3-phenyl-5-(2-thienyl)-1,2,4-triazole (PTTzH) or 3,5-bis(2-thienyl)-1,2,4-triazole (BTTzH) afforded two isostructural MOFs (AgTz-3 and AgTz-4) in gram-scale. AgTz-4 with higher thiophene content showed significantly stronger photocatalytic activity than AgTz-3 with lower thiophene content. Noteworthy, the photodegradation rate constants of AgTz-4 were 0.055 mg·L-1·min-1 for rhodamine B and 0.24 min-1 for salazosulfapyridine, which is comparable or even higher than some MOF-based materials reported in the literature. More importantly, AgTz-4 demonstrated good reusability and stability after four cycles of photodegradation. Our experimental results revealed that the enhanced photodegradation efficiency can be attributed to the increased light absorption capacity and optimized band structure of Ag-MOFs resulting from the introduction of thiophene groups into MOF structures.

Determinants of immunization in polio super high-risk union councils of Pakistan.

BACKGROUND: The current polio epidemiology in Pakistan poses a unique challenge for global eradication as the country is affected by ongoing endemic poliovirus transmission. Across the country, 40 union councils (UCs) which serve as core reservoirs for poliovirus with continuous incidences of polio cases are categorized as super-high-risk union councils (SHRUCs). METHODOLOGY: A cross-sectional survey was conducted in 39 SHRUCs using a two-stage stratified cluster sampling technique. 6,976 children aged 12-23 months were covered. A structured questionnaire was used for data collection. Data were analyzed using STATA version 17. RESULTS: Based on both vaccination records and recall, 48.3% of children were fully-, 35.4 % were partially-, and 16.3% were non-vaccinated in the SHRUC districts. A child is considered fully vaccinated when h/she completed vaccination for BCG, OPV0, OPV 1-3, Penta 1-3, PCV 1-3, IPV, and MCV1. Vaccination cards were seen for over half of the children in the SHRUC districts of Khyber Pakhtunkhwa (KP) and the majority of the SHRUC districts in Sindh, except for the SHRUC district of Malir the districts of Balochistan. Results for polio vacancies show that 60.9% of children from the SHRUC districts were vaccinated with at least three doses of OPV and one dose of IPV, while 20.4% were vaccinated with any OPV doses or IPV and 18.7% of children did not receive any polio vaccines. The dropout rate between vaccine visits was higher than the WHO-recommended cutoff point of 10% for all vaccine doses in the SHRUC districts. The likelihood of being fully vaccinated was higher among the children of educated parents. Full vaccination was found significant among the children of any SHRUC districts compared to district Killa Abdullah. CONCLUSION: Context-specific strategies with more focus on community engagement and targeted mobilization, along with robust monitoring mechanisms, would help address the underlying challenges of under-immunization in the SHRUCs.

Stabilization of the Antioxidant Properties in Spray-Dried Microcapsules of Fish and Chia Oil Blends.

Even with healthy foods, there is still a need to protect the functionality during processing. The stabilization and enrichment of fish oil (FO) extracted from fish fillets using solvent extraction might make this healthy oil more available. FO was stabilized by mixing it with chia seed oil (CSO) at 50:50 at room temperature. The antioxidant properties of the blends were evaluated using the total phenolic content (TPC), free radical scavenging activity (DPPH), ferric reducing antioxidant potential (FRAP), and 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) activities with FO and CSO as controls. The blends of FO and CSO increased the oxidative stability, while FO was the most susceptible to degradation. The stability and bioactivity of antioxidants against environmental factors were improved by using encapsulation. Response surface methodology (RSM) was used to optimize spray-drying operating conditions for spray-dried microcapsules (SDMs). The independent variables were the inlet air temperature (IAT), which varied from 125 to 185 °C; wall material (WM) concentration, which varied from 5 to 25%; pump speed (PS), which varied from 3 to 7 mL/min; and needle speed (NS), which varied from 3 to 11 s. The results indicated that the maximum antioxidant activity of SDM was obtained at 140 °C IAT, 10% WM, 4 mL/min PS, and 5 s NS, while the minimum value was obtained at 170 °C IAT, 20% WM, 6 mL/min PS, and 9 s NS. The IAT had a significant effect on the antioxidant activities, and the stability of SDMs was increased. These SDMs can be used in the formulation of food matrices due to their therapeutic and nutritional properties.

Does IPV Boost Intestinal Immunity among Children under Five Years of Age? An Experience from Pakistan.

The oral poliovirus vaccine (OPV) has been the mainstay of polio eradication, especially in low-income countries, and its use has eliminated wild poliovirus type 2. However, the inactivated poliovirus vaccine (IPV) is safer than OPV, as IPV protects against paralytic poliomyelitis without producing adverse reactions. The present study compared mucosal and humoral responses to poliovirus vaccines administered to previously OPV-immunized children to assess the immunity gap in children in areas of high poliovirus transmission. A cluster-randomized trial was implemented in three high-risk districts of Pakistan-Karachi, Kashmore, and Bajaur-from June 2013 to May 2014. This trial was community-oriented and included three arms, focusing on healthy children below five years of age. The study involved the randomization of 387 clusters, of which 360 were included in the final analysis. The control arm (A) received the routine polio program bivalent poliovirus vaccine (bOPV). The second arm (B) received additional interventions, including health camps providing routine vaccinations and preventive maternal and child health services. In addition to the interventions in arm B, the third arm (C) was also provided with IPV. Blood and stool samples were gathered from children to evaluate humoral and intestinal immunity. The highest levels of poliovirus type 1 serum antibodies were observed in Group C (IPV + OPV). The titers for poliovirus type 2 (P2) and poliovirus type 3 (P3) were noticeably higher in those who had received a routine OPV dose than in those who had not across all study groups and visits. Providing an IPV booster after at least two OPV doses could potentially fill immunity gaps in regions where OPV does not show high efficacy. However, IPV only marginally enhances humoral immunity and fails to offer intestinal immunity, which is critical to stop the infection and spread of live poliovirus in populations that have not been exposed before.

Prevalence and Risk Factors for Iron Deficiency Anemia among Children under Five and Women of Reproductive Age in Pakistan: Findings from the National Nutrition Survey 2018.

INTRODUCTION: Anemia remains a global public health problem, especially in developing countries. It affects primarily children under five (CU5), women of reproductive age (WRA), and pregnant women due to their higher need for iron. The most common form of anemia is iron-deficiency anemia (IDA). IDA is estimated to cause half of all anemia cases and one million deaths per year worldwide. However, there remains a lack of well-documented and biochemically assessed prevalence of IDA based on the representative population-based samples globally and regionally. In this study, we aimed to assess the National Nutrition Survey (NNS) 2018 to identify the prevalence and risk factors of IDA in Pakistani CU5 and WRA. METHODS: Secondary analysis was conducted on the NNS 2018, a cross-sectional survey, which collected data on dietary practices, malnutrition, and food insecurity. Anemia was defined as hemoglobin levels < 11.0 g/dL in children and 12.0 g/dL in women. IDA was defined as low hemoglobin and low ferritin (<12 ng/mL) levels, adjusted for inflammation using AGP and CRP biomarkers in CU5 and WRA. Univariate and multivariable logistic regressions were conducted using Stata statistical software (version 16). We also compared the IDA rates of NNS 2018 and 2011. RESULTS: A total of 17,814 CU5 and 22,114 WRA were included in the analysis. Of the CU5, 28.9% had IDA, while 18.4% of WRA reported to experience IDA. Among the CU5, IDA was most prevalent among male children aged 6-23 months living in rural areas and with the presence of diarrhea and fevers in the last 2 weeks. Children whose mothers had no education, were aged 20-34 years, and employed, had a higher prevalence of IDA. Married WRA, who are employed, living in rural areas, and with no education, had a higher prevalence of IDA. In the multivariable logistic regression, children aged 6-23 months (AOR = 1.19, 95% CI [1.08-1.33], p < 0.001) and with the presence of diarrhea in the last 2 weeks (AOR = 1.32, 95% CI [1.13-1.54], p < 0.001) or fever (AOR = 1.16, 95% CI [1.02-1.32], p = 0.02) had higher odds of IDA. At the household level, the odds of IDA among CU5 were higher in the poorest households (AOR = 1.27, 95% CI [1.08-1.50], p = 0.005), with ≥5 CU5 (AOR = 1.99, 95% CI [1.28-3.11], p = 0.002), and with no access to improved sanitation facilities (AOR = 1.17, 95% CI [1.02-1.34], p = 0.026). For WRA, the multivariable logistic regression found that the odds of IDA were higher among women with vitamin A deficiency (Severe: AOR = 1.26, 95% CI [1.05-1.52], p = 0.013; Mild: AOR = 1.36, 95% CI [1.23-1.51], p < 0.001), zinc deficiency (AOR = 1.42, 95% CI [1.28-1.57], p < 0.001), no education (AOR = 1.53, 95% CI [1.30-1.81], p < 0.001), and from severely food insecure households (AOR = 1.20, 95% CI [1.07-1.34], p = 0.001). The odds of IDA were lower among women whose body mass index was overweight (AOR = 0.77, 95% CI [0.69-0.86], p < 0.001) or obese (AOR = 0.71, 95% CI [0.62-0.81], p < 0.001). CONCLUSIONS: The child's age, presence of diarrhea or fever, place of residence, household size, wealth status, and access to sanitation facilities were significantly associated with IDA among CU5 in Pakistan. For WRA, education, body mass index, vitamin A and zinc status, household food security status, wealth status, and access to sanitation facilities were significantly associated with IDA. Large, well-established, government-funded programmes focused on micronutrient supplementation, food fortification, the diversification of food supplies, and the treatment and prevention of infectious and parasitic diseases are needed to prevent IDA and all forms of anemia among children and women in Pakistan.

Determinants of Stunting among Children under Five in Pakistan.

INTRODUCTION: Child stunting remains a public health concern. It is characterized as poor cognitive and physical development in children due to inadequate nutrition during the first 1000 days of life. Across south Asia, Pakistan has the second-highest prevalence of stunting. This study assessed the most recent nationally representative data, the National Nutrition Survey (NNS) 2018, to identify the stunting prevalence and determinants among Pakistani children under five. METHODS: The NNS 2018, a cross-sectional household-level survey, was used to conduct a secondary analysis. Data on malnutrition, dietary practices, and food insecurity were used to identify the prevalence of stunting among children under five years in terms of demographic, socioeconomic, and geographic characteristics. The prevalence of stunting was calculated using the World Health Organization (WHO) height for age z-score references. Univariate and multivariable logistic regressions were conducted to identify the factors associated with child stunting. RESULTS: The analysis showed that out of 52,602 children under five, 40.0% were found to be stunted. Male children living in rural areas were more susceptible to stunting. Furthermore, stunting was more prevalent among children whose mothers had no education, were between 20 and 34, and were employed. In the multivariable logistic regression, male children (AOR = 1.08, 95% CI [1.04-1.14], p < 0.001) from rural areas (AOR = 1.07, 95% CI [1.01-1.14], p = 0.014), with the presence of diarrhea in the last two weeks (AOR = 1.15, 95% CI [1.06-1.25], p < 0.001) and mothers who had no education (AOR = 1.57, 95% CI [1.42-1.73], p < 0.001) or lower levels of education (primary: AOR = 1.35, 95% CI [1.21-1.51], p < 0.001; middle: AOR = 1.29, 95% CI [1.15-1.45], p < 0.001), had higher odds of stunting. Younger children aged < 6 months (AOR = 0.53, 95% CI [0.48-0.58], p < 0.001) and 6-23 months (AOR = 0.89, 95% CI [0.84-0.94], p < 0.001), with mothers aged 35-49 years (AOR = 0.78, 95% CI [0.66-0.92], p = 0.003), had lower odds of stunting. At the household level, the odds of child stunting were higher in lower-income households (AOR = 1.64, 95% CI [1.46-1.83], p < 0.001) with ≥ 7 members (AOR = 1.09, 95% CI [1.04-1.15], p < 0.001), with no access to improved sanitation facilities (AOR = 1.14, 95% CI [1.06-1.22], p < 0.001) and experiencing severe food insecurity (AOR = 1.07, 95% CI [1.01-1.14], p = 0.02). CONCLUSION: Child stunting in Pakistan is strongly associated with various factors, including gender, age, diarrhea, residence, maternal age and education, household size, food and wealth status, and access to sanitation. To address this, interventions must be introduced to make locally available food and nutritious supplements more affordable, improve access to safe water and sanitation, and promote female education for long-term reductions in stunting rates.

Application of Methyl Jasmonate to Papaya Fruit Stored at Lower Temperature Attenuates Chilling Injury and Enhances the Antioxidant System to Maintain Quality.

Papaya fruit has a limited shelf life due to its sensitivity to decay and chilling damage during cold storage. The application of methyl jasmonate (MeJA) is known to reduce the incidence of disease and chilling injury, and to maintain the overall quality of the papaya fruit when stored at low temperature. Consequently, the effects of postharvest MeJA (1 mM) immersion on papaya fruits during low-temperature storage (10 °C ± 2 °C) for 28 days were studied. The experiment revealed that MeJA treatment significantly decreased the papaya fruit's weight loss, disease incidence, and chilling injury index. Furthermore, the accumulation of malondialdehyde and hydrogen peroxide was markedly lower after the application of MeJA. In addition, MeJA treatment exhibited significantly higher total phenols, ascorbic acid, antioxidant activity, and titratable acidity in contrast to the control. Similarly, MeJA-treated papaya fruits showed higher antioxidant enzymatic activity (superoxide dismutase, catalase, and peroxidase enzymes) with respect to the control fruits. In addition, MeJA reduced the soluble solids content, ripening index, pH, and sugar contents compared to the control fruits. Furthermore, MeJA-treated papaya fruit exhibited higher sensory and organoleptic quality attributes with respect to untreated papaya fruits. These findings suggested that postharvest MeJA application might be a useful approach for attenuating disease incidence and preventing chilling injury by enhancing antioxidant activities along with enhanced overall quality of papaya fruits during low-temperature storage.

Wheel Defect Detection Using a Hybrid Deep Learning Approach.

Defective wheels pose a significant challenge in railway transportation, impacting operational performance and safety. Excessive traction and braking forces give rise to deviations from the intended conical tread shape, resulting in amplified vibrations and noise. Moreover, these deviations contribute to the accelerated damage of track components. Detecting wheel defects at an early stage is crucial to ensure safe and comfortable operation, as well as to minimize maintenance costs. However, the presence of various vibrations, such as those induced by the track, traction motors, and other rolling stock subsystems, poses a significant challenge for onboard detection techniques. These vibrations create difficulties in accurately identifying wheel defects in real-time during operational activities, often resulting in false alarms. This research paper aims to address this issue by using a hybrid deep learning-based approach for the accurate detection of various types of wheel defects using accelerometer data. The proposed approach aims to enhance wheel defect detection accuracy while considering onboard techniques' cost-effectiveness and efficiency. A realistic simulation model of the railway wheelset is developed to generate a comprehensive dataset. To generate vibration data in various scenarios, the model is simulated for 20 s under different conditions, including one non-faulty scenario and six faulty scenarios. The simulations are conducted at different speeds and track conditions to capture a wide range of operating conditions. Within each simulation iteration, a total of 200,000 data points are generated, providing a comprehensive dataset for analysis and evaluation. The generated data are then utilized to train and evaluate a hybrid deep learning model, employing a multi-layer perceptron (MLP) as a feature extractor and multiple machine learning models (support vector machine, random forest, decision tree, and k-nearest neighbors) for performance comparison. The results demonstrate that the MLP-RF (multi-layer perceptron with random forest) model achieved an accuracy of 99%, while the MLP-DT (multi-layer perceptron with decision tree) model achieved an accuracy of 98%. These high accuracy values indicate the effectiveness of the models in accurately classifying and predicting the outcomes. The contributions of this research work include the development of a realistic simulation model, the evaluation of sensor layout effectiveness, and the application of deep learning techniques for improved wheel flat detections.

Exploring Knowledge and Perceptions of Polio Disease and Its Immunization in Polio High-Risk Areas of Pakistan.

Pakistan is one of the few countries where poliovirus transmission still persists, despite intensive efforts to eradicate the disease. Adequate vaccination coverage is essential to achieve polio eradication, but misconceptions about polio vaccines have hindered vaccination efforts. To address this issue, we conducted a mixed-methods study to explore knowledge and perceptions regarding polio disease and immunization in high-risk areas of Pakistan. We collected quantitative data from 3780, 1258, and 2100 households in Karachi, Bajaur, and Pishin, respectively, and supplemented this with qualitative data from focus group discussions and in-depth interviews. Our findings reveal a high level of awareness about polio and its immunization; however, misperceptions about the polio vaccine persist, leading to refusal for both polio vaccines and routine immunizations. Our study provides up-to-date data on knowledge and perceptions of polio and its immunization and identifies critical gaps. These findings can inform the development of future strategies and innovative approaches to improve the success of the polio program in Pakistan.

Hot Water Treatment Improves Date Drying and Maintains Phytochemicals and Fruit Quality Characteristics of Date Palm (Phoenix dactylifera).

Fresh date fruits (cvs. Hillawi and Khadrawi) were harvested at the khalal stage and treated with hot water treatment (HWT) for different time durations (control, HWT-1 min, HWT-3 min, HWT-5 min, and HWT-7 min) to investigate the physicochemical characteristics, phytochemical properties, and sensory attributes. The results revealed that both date cultivars took less time to reach the tamar stage in response to HWT-7 min compared to control. However, Hillawi date fruit showed a higher fruit ripening index (75%) at HWT-3 min, while Khadrawi fruit had a higher ripening index (80%) at HWT-5 min than untreated fruit (10%). Higher weight loss and lower moisture contents were observed in Hillawi (25%) and Khadrawi (20%) date fruit as the immersion period increased in both cultivars. Moreover, soluble solid content was higher in Hillawi (11.77° Brix) in response to HWT-3 min and Khadrawi (10.02° Brix) date fruit immersed in HWT-5 min in contrast with the control group, whereas significantly lower levels of titratable acidity and ascorbic acid content were observed in Hillawi (0.162%, 0.67 mg/100 g) and Khadrawi (0.206%, 0.73 mg/100 g) date fruit in response to HWT (HWT-1 min, HWT-3 min, HWT-5 min, and HWT-7 min) than untreated fruit. Furthermore, noticeably higher levels of reducing sugar (69.83%, 57.01%), total sugar (34.47%, 31.14%), glucose (36.84%, 29.42%), fructose (33.99%, 27.61%), and sucrose (3.16%, 1.33%) were found in hot water-treated Hillawi (immersed for 3-min) and Khadrawi (immersed for 5-min) date fruit, respectively. In addition, total phenolic content, total flavonoids, total antioxidants, and total tannins were substantially superior in date fruits subjected to HWT-3 min (in Hillawi, 128 mg GAE/100 g, 61.78%, 20.18 mg CEQ/100 g) and HWT-5 min (in Khadrawi, 139.43 mg GAE/100 g, 72.84%, and 18.48 mg CEQ/100 g) compared to control. Overall, sensory attributes were recorded to be higher in Hillawi and Khadrawi date fruit after treatment for 3 min and 5 min, respectively. Our findings suggest that HWT is a promising technique that can be adopted commercially to improve fruit ripening and preserved nutritional quality of dates after harvest.

Factors Associated with Vaccine Refusal (Polio and Routine Immunization) in High-Risk Areas of Pakistan: A Matched Case-Control Study.

BACKGROUND: Pakistan has subpar childhood immunization rates and immunization activities have faced several challenges over the past years. We evaluated the social-behavioral and cultural barriers and risk factors for refusal of polio, Routine Immunization (RI), or both in high-risk areas of poliovirus circulation. METHODS: A matched case-control study was conducted from April to July 2017 in eight super high-risk Union Councils of five towns in Karachi, Pakistan. A total of 3 groups, each with 250 cases, including refusals for the Oral Polio Vaccine (OPV) in campaigns (national immunization days and supplementary immunization activities), RI, and both, were matched with 500 controls and identified using surveillance records. Sociodemographic characteristics, household information, and immunization history were assessed. Study outcomes included social-behavioral and cultural barriers and reasons for vaccine refusal. Data were analyzed in STATA using conditional logistic regression. RESULTS: RI refusal was associated with illiteracy and fear of the vaccine's adverse effects, while OPV refusals were linked to the mother's decision authority and the assumption that the OPV caused infertility. Conversely, higher socioeconomic status (SES) and knowledge of and willingness to vaccinate with Inactivated Polio Vaccine (IPV) were inversely associated with RI; and lower SES, walking to the vaccination point, knowledge of IPV, and an understanding of contracting polio were inversely associated with OPV refusals, with the latter two also inversely associated with complete vaccine refusal. CONCLUSION: Education, knowledge and understanding of vaccines, and socioeconomic determinants influenced OPV and RI refusals among children. Effective interventions are needed to address knowledge gaps and misconceptions among parents.

Routine Immunization Coverage and Immunization Card Retention in Pakistan: Results From a Cross-sectional National Survey.

BACKGROUND: Immunization is one of the most successful public health interventions available, saving millions of lives from death and disability each year. Therefore, improving immunization coverage is a high priority for the Government of Pakistan and essential to progress toward universal health coverage. This survey reports the national and provincial/regional coverage and determinants of fully, partially, and not-vaccinated children 12-23 months of age, antigen-wise coverage, percentage of home-based vaccination records (HBR) retention, and reasons for nonretention; dropout, timeliness, and prevalence of missed opportunities for simultaneous vaccination (MOSV). METHODS: The survey was a descriptive cross-sectional national household survey carried out across Pakistan. The survey included 110,790 children 12-23 months old and their caregivers. A World Health Organization (WHO)-Expanded Program on Immunization (EPI) Survey questionnaire was adapted to collect information. Data were analyzed using the WHO Vaccination Coverage Quality Indicators (VCQI) software and Stata version 17. RESULTS: Nationally excluding Azad Jammu and Kashmir (AJK) and Gilgit Baltistan (GB), the coverage of fully vaccinated children was 76.5%. The likelihood of being fully vaccinated was higher among children of educated parents who belonged to higher wealth quintiles and resided in any province/region other than Balochistan. The main reasons for unimmunization were no faith in immunization, rumors about vaccines, and distance to the facility. About two-thirds (66.2%) of the children had their HBR available, and the main reasons for not having a card were never visiting a health facility and having no awareness about the importance of a card. Dropout was discernible for later doses of vaccines compared with earlier ones. Higher proportions of children received the last doses late by more than two months. Of the 218,002 vaccination visits documented on HBR in the provinces, MOSVs occurred in 17.6% of the visits. CONCLUSION: The immunization coverage rates provide a direction to strategize the progress to improve the vaccination rates in Pakistan. The country needs to outline the immediate and long-term actions to combat vaccine-preventable diseases, such as escalating integrated immunization campaigns and outreach activities, provision of mobility support, and deploying behavioral interventions as a cross-cutting strategy to improve awareness and reduce misconceptions.

Distance-quality trade-off and choice of family planning provider in urban Pakistan.

BACKGROUND: There is limited evidence between contraceptive use, availability of commodities and distance to the facility in developing countries. Distance to the facility is an essential determinant of contraceptive use. Still, women may not seek family planning services from the nearest facility and may be prepared to travel the farthest distance to receive quality family planning services. METHODS: We analyzed women's survey data linked to health facility data and applied an alternate specific conditional logit model to examine the distance a woman is prepared to travel and the quality of services offered by facilities in urban areas in Karachi, Pakistan. RESULTS: This study analyzed data from 336 women and 28 facilities and identified that the mean distance to the nearest facility was 0.44 km; the chosen facility was, on average, 5 km away. Women preferred facilities that offered a range of contraceptive methods and additional services provided by female healthcare providers only. Furthermore, on average, women are willing to travel a further 1.7 km for a facility that offers more family planning methods, 1.4 km for a facility that offers additional health services and 11 km for a facility that offers services delivered by female healthcare providers. CONCLUSIONS: The findings highlight the quality measures women prioritize over distance and consider essential when choosing a family planning facility.

Ramadan-specific nutrition education improves cardio-metabolic health and inflammation-a prospective nutrition intervention study from Pakistan.

There are recent reports that Ramadan fasting (RF) results in weight gain instead of weight loss. In addition, the data on the efficacy of brief nutrition education on healthy eating practices in Ramadan for better health are scarce. Therefore, a study was conducted to investigate the effects of brief nutrition education before the start of RF on healthy eating practices during RF. For this purpose, a prospective observational study focused on "Dietary Education and Awareness for Ramadan (DEAR)" as an intervention was carried out. The participants (n = 74) were recruited and divided into two groups, i.e., intervention and control groups (n = 37 each). As an intervention, nutrition education lessons were given before and during RF month. The control group did not attend these nutrition education lessons. Data on anthropometrics, dietary intake, and other parameters were collected at three time points: before, in the end, and 4 weeks after RF. Weight was measured in kg; height, waist circumference (WC), and hip circumference (HC) were measured in cm; and body mass index (BMI) was calculated. Waist-to-hip ratio (WHR) was calculated by dividing the waist value by the hip value. Body composition analysis was performed by the body composition analyzer (BF-907). Blood pressure (BP) was measured using a validated automated blood pressure. A 3-5 ml of venous blood was collected, and plasma and serum were separated. Serum and plasma samples were processed for general blood chemistry (blood lipid profile, glucose, and CRP) within 2 h. CRP was determined by the immunoturbidimetry method using an auto-analyzer. An enzyme-linked immunosorbent assay (ELISA) was used to determine cytokine/chemokines. Adherence to nutrition education (intervention) was assessed. The results show that nutrition education has positive effects on overall nutrition. Significant improvement in dietary adherence to dietary advice in the intervention group was noted. Significant BW loss (mean loss: 1.21 kg) in the intervention group was observed. The majority (63.3%) had lost BW ≥ 1.0 kg. Other changes observed as a result of the intervention included improvements in blood glucose, cholesterol, CRP levels, and systolic and diastolic BP. There was a notable shift in pro- and anti-inflammatory cytokine concentrations: IL-7, IL-4, and TGF-α decreased, while IL-2, TNF-α and resistin, IL-1 RA, IL-17 A, and sCD40 increased. In conclusion, RF resulted in a loss in mean BW and an improvement in related blood chemistry and cytokine profiles. Furthermore, nutrition education before RF resulted in better nutrition practices during RF and a desirable healthy BW, blood lipid, and cytokine profiles.