Carcinogenic and non-carcinogenic health hazards of potentially toxic elements in commonly consumed rice cultivars in Dhaka city, Bangladesh.

The study aimed to assess the level of potentially toxic elements (As, Cd, Pb, Zn, Cu, Cr, Mn, and Ni) and associated health implications through commonly consumed rice cultivars of Bangladesh available in Capital city, Dhaka. The range of As, Cd, Pb, Zn, Cu, Cr, Mn, and Ni in rice grains were 0.04-0.35, 0.01-0.15, 0.01-1.18, 10.74-34.35, 1.98-13.42, 0.18-1.43, 2.51-22.08, and 0.21-5.96 mg/kg fresh weight (FW), respectively. The principal component analysis (PCA) identified substantial anthropogenic activities to be responsible for these elements in rice grains. The estimated daily intake (EDI) of the elements was below the maximum tolerable daily intake (MTDI) level. The hazard index (HI) was above the threshold level, stating non-carcinogenic health hazards from consuming these rice cultivars. The mean target cancer risk (TCR) of As and Pb exceeded the USEPA acceptable level (10-6), revealing carcinogenic health risks from the rice grains.

Bangla_MER: A unique dataset for Bangla mathematical entity recognition.

Mathematical entity recognition is essential for machines to define and illustrate mathematical substance faultlessly and to facilitate sufficient mathematical operations and reasoning. As mathematical entity recognition in the Bangla language is novel, to our best knowledge, there is no available dataset exists in any repository. In this paper, we present state of the art Bangla mathematical entity dataset containing 13,717 observations. Each record has a mathematical statement, mathematical type and mathematical entity. This dataset can be utilized to conduct research involving the recognition of mathematical operators, renowned mathematical terms (such as complex numbers, real numbers, prime numbers, etc.), and operands as numbers. The findings mentioned above, and their combination are also feasible with a modest tweak to the dataset. Furthermore, we have structured this dataset in raw format and made a CSV file, incorporating three columns: text, math entity, and label. As an outcome, researchers may easily handle the data, facilitating a variety of deep learning and machine learning explorations.

Burn injuries and acute burn management in the rural areas in northern Bangladesh - A household survey.

INTRODUCTION: Burn injuries pose a significant public health challenge, especially in low- and middle-income countries (LMICs). In Bangladesh, burn injuries are prevalent and often result in severe disability or death. However, knowledge regarding the causes of burn injuries, acute burn management, and barriers to seeking burn care in the riverine areas of northern Bangladesh is limited. METHODS: We conducted a questionnaire-based study in eight subunits and five selected districts in northern Bangladesh to determine the prevalence, causes, and management of burn injuries in these areas. A total of 210 individuals from different households were interviewed, which represented a population of 1020 persons. RESULTS: Among the respondents, 55% reported that at least one member of their household suffered from a burn injury in the past. The most common causes of burn injuries were open fire (41%) and hot fluids (30%). More than 40% of burns were not rinsed with water directly after sustaining the injury. Additionally, almost 30% of respondents did not seek medical care immediately after the injury, with financial constraints being the most commonly cited reason. DISCUSSION: We found a low rate of adequate cooling and seeking medical care. The need for basic knowledge on prevention and treatment of burn injuries and improved access to affordable health care services in the region is high.

In Vivo Antioxidant and Nephroprotective Effects of Ethanolic Extract of Carica papaya Seeds and Its Isolated Flavonoid on Gentamicin-Induced Nephrotoxicity in Wistar Albino Rats.

Background The nephrotoxic side effects of gentamicin, a potent aminoglycoside antibiotic, significantly restrict its clinical use. Identifying compounds that can mitigate this nephrotoxicity is of paramount importance. The research examines how the ethanolic extract of Carica papaya seeds (EECPS) and isoliquiritigenin (ISL), a flavonoid separated from them, protect the kidneys and fight free radicals in gentamicin-treated Wistar albino rats. Methodology A total of 48 mature Wistar albino rats were divided into eight groups, with each group consisting of six rats. The experimental setup included a normal control group receiving oral saline as a negative control, and a standard control group administered gentamicin intraperitoneally (IP) at 100 mg/kg body weight for 13 days to induce nephrotoxicity, followed by oral silymarin at 100 mg/kg body weight as a positive control from days 14 to 21. A toxicant control group was exposed to gentamicin IP without subsequent treatment. Two test groups were given 400 mg/kg and 800 mg/kg of EECPS orally after being given gentamicin. Three other test groups were given 20 mg/kg, 40 mg/kg, and 80 mg/kg of ISL orally after being given gentamicin. Serum levels of creatinine, urea, and blood urea nitrogen (BUN) were used to test renal function. Malondialdehyde (MDA), nitric oxide (NO), and reduced glutathione (GSH), which are signs of oxidative stress, were also measured in renal tissues. Results Gentamicin administration markedly increased serum creatinine, urea, and BUN levels, confirming its nephrotoxic effect. Nephroprotection depended on the dose of EECPS and ISL used. It was found that 80 mg/kg of ISL had the most powerful effect, which was not what was thought at first. These treatments effectively reduced MDA and NO levels while enhancing GSH levels, exhibiting their strong antioxidant properties. Notably, the nephroprotective efficacy of these treatments exceeded that of silymarin, a known nephroprotective agent. Histopathological analysis confirmed reduced renal damage and enhanced tissue repair in the treated groups. Conclusions These findings demonstrate how effective EECPS and ISL are at shielding the kidneys from gentamicin-caused damage. They do this by acting as antioxidants and nephroprotectants. Their ability to protect kidney function and fight oxidative stress makes them interesting as possible treatments for gentamicin-related kidney damage. These results advocate for further investigation into the utility of these natural compounds in the management of nephrotoxicity.

Risk Assessment and Sources Apportionment of Toxic Metals in Two Commonly Consumed Fishes from a Subtropical Estuarine Wetland System.

The widespread occurrence of heavy metals in aquatic environments, resulting in their bioaccumulation within aquatic organisms like fish, presents potential hazards to human health. This study investigates the concentrations of five toxic heavy metals (Pb, Hg, Zn, Cu, and Cr) and their potential health implications in two economically important fish species (Otolithoides pama and Labeo bata) from a subtropical estuarine wetland system (Feni estuary, Bangladesh). Muscle and gill samples from 36 individual fish were analyzed using energy dispersive X-ray fluorescence (EDXRF). The results revealed that the average quantities of heavy metals in both fishes' muscle followed the declining order of Zn (109.41-119.93 mg/kg) > Cu (45.52-65.43 mg/kg) > Hg (1.25-1.39 mg/kg) > Pb (0.68-1.12 mg/kg) > Cr (0.31-5.82 mg/kg). Furthermore, Zn was found to be present in the highest concentration within the gills of both species. While the levels of Cu, Zn, and Cr in the fish muscle were deemed acceptable for human consumption, the concentrations of Pb and Hg exceeded the permissible limits (>0.5 mg/kg) for human consumption. Different risk indices, including estimated daily intake (EDI), target hazard quotient (THQ), hazard index (HI), and carcinogenic or target risk (TR), revealed mixed and varying degrees of potential threat to human health. According to the EDI values, individuals consuming these fish may face health risks as the levels of Zn, Cu, and Cr in the muscle are either very close to or exceed the maximum tolerable daily intake (MTDI) threshold. Nevertheless, the THQ and HI values suggested that both species remained suitable for human consumption, as indicated by THQ (<1) and HI (<1) values. Carcinogenic risk values for Pb, Cr, and Zn all remained within permissible limits, with TR values falling below the range of (10-6 to 10-4), except for Zn, which exceeded it (>10-4). The correlation matrix and multivariate principal component analysis (PCA) findings revealed that Pb and Cr primarily stemmed from natural geological backgrounds, whereas Zn, Cu, and Hg were attributed to human-induced sources such as agricultural chemicals, silver nanoparticles, antimicrobial substances, and metallic plating. Given the significance of fish as a crucial and nutritious element of a balanced diet, it is essential to maintain consistent monitoring and regulation of the levels and origins of heavy metals found within it.

SalmonScan: A novel image dataset for machine learning and deep learning analysis in fish disease detection in aquaculture.

Fish diseases pose a significant threat to food security in aquaculture, as they can lead to considerable reductions in fish production, quality, and profitability. Globally, salmon aquaculture is the quickest-expanding food production system. Detecting and diagnosing fish diseases in their early stages is essential to prevent the spread of diseases and reduce the negative impact on aquaculture's economy and environment. To serve this purpose, we introduce the SalmonScan dataset, a novel and comprehensive collection of images of healthy and infected salmon fish, which can be used for various applications in computer science and aquaculture. Images from online sources and aquaculture salmon firms were gathered to create the dataset. The dataset was then labeled based on the health status of the fish, fresh or infected. Data augmentation methods like rotation, cropping, flipping, and scaling were used to guarantee the dataset's strength and size. The dataset includes 456 images of fresh fish and 752 images of infected fish, both varied and inclusive while maintaining excellent quality. Other researchers and practitioners can use the dataset we have collected for various purposes. They can use it to create and test new or existing machine learning (ML) and deep learning (DL) based computer vision models for identifying, categorizing, counting, and analyzing the behavior and biomass of salmon fish. They can also use it to study how different environmental factors affect the health and growth of salmon fish. Furthermore, they can evaluate the accuracy and performance of different image acquisition and processing methods. Additionally, they can explore the feasibility of using generative adversarial networks (GANs) and transfer learning to improve the training speed and stability of DL models designed for fish detection. This SalmonScan dataset paper describes and documents the dataset in detail, making it publicly available and reusable for the research community.

Recent Progress and Challenges of Implantable Biodegradable Biosensors.

Implantable biosensors have evolved to the cutting-edge technology of personalized health care and provide promise for future directions in precision medicine. This is the reason why these devices stand to revolutionize our approach to health and disease management and offer insights into our bodily functions in ways that have never been possible before. This review article tries to delve into the important developments, new materials, and multifarious applications of these biosensors, along with a frank discussion on the challenges that the devices will face in their clinical deployment. In addition, techniques that have been employed for the improvement of the sensitivity and specificity of the biosensors alike are focused on in this article, like new biomarkers and advanced computational and data communicational models. A significant challenge of miniaturized in situ implants is that they need to be removed after serving their purpose. Surgical expulsion provokes discomfort to patients, potentially leading to post-operative complications. Therefore, the biodegradability of implants is an alternative method for removal through natural biological processes. This includes biocompatible materials to develop sensors that remain in the body over longer periods with a much-reduced immune response and better device longevity. However, the biodegradability of implantable sensors is still in its infancy compared to conventional non-biodegradable ones. Sensor design, morphology, fabrication, power, electronics, and data transmission all play a pivotal role in developing medically approved implantable biodegradable biosensors. Advanced material science and nanotechnology extended the capacity of different research groups to implement novel courses of action to design implantable and biodegradable sensor components. But the actualization of such potential for the transformative nature of the health sector, in the first place, will have to surmount the challenges related to biofouling, managing power, guaranteeing data security, and meeting today's rules and regulations. Solving these problems will, therefore, not only enhance the performance and reliability of implantable biodegradable biosensors but also facilitate the translation of laboratory development into clinics, serving patients worldwide in their better disease management and personalized therapeutic interventions.

Investigating Rhythmicity in App Usage to Predict Depressive Symptoms: Protocol for Personalized Framework Development and Validation Through a Countrywide Study.

BACKGROUND: Understanding a student's depressive symptoms could facilitate significantly more precise diagnosis and treatment. However, few studies have focused on depressive symptom prediction through unobtrusive systems, and these studies are limited by small sample sizes, low performance, and the requirement for higher resources. In addition, research has not explored whether statistically significant rhythms based on different app usage behavioral markers (eg, app usage sessions) exist that could be useful in finding subtle differences to predict with higher accuracy like the models based on rhythms of physiological data. OBJECTIVE: The main objective of this study is to explore whether there exist statistically significant rhythms in resource-insensitive app usage behavioral markers and predict depressive symptoms through these marker-based rhythmic features. Another objective of this study is to understand whether there is a potential link between rhythmic features and depressive symptoms. METHODS: Through a countrywide study, we collected 2952 students' raw app usage behavioral data and responses to the 9 depressive symptoms in the 9-item Patient Health Questionnaire (PHQ-9). The behavioral data were retrieved through our developed app, which was previously used in our pilot studies in Bangladesh on different research problems. To explore whether there is a rhythm based on app usage data, we will conduct a zero-amplitude test. In addition, we will develop a cosinor model for each participant to extract rhythmic parameters (eg, acrophase). In addition, to obtain a comprehensive picture of the rhythms, we will explore nonparametric rhythmic features (eg, interdaily stability). Furthermore, we will conduct regression analysis to understand the association of rhythmic features with depressive symptoms. Finally, we will develop a personalized multitask learning (MTL) framework to predict symptoms through rhythmic features. RESULTS: After applying inclusion criteria (eg, having app usage data of at least 2 days to explore rhythmicity), we kept the data of 2902 (98.31%) students for analysis, with 24.48 million app usage events, and 7 days' app usage of 2849 (98.17%) students. The students are from all 8 divisions of Bangladesh, both public and private universities (19 different universities and 52 different departments). We are analyzing the data and will publish the findings in a peer-reviewed publication. CONCLUSIONS: Having an in-depth understanding of app usage rhythms and their connection with depressive symptoms through a countrywide study can significantly help health care professionals and researchers better understand depressed students and may create possibilities for using app usage-based rhythms for intervention. In addition, the MTL framework based on app usage rhythmic features may more accurately predict depressive symptoms due to the rhythms' capability to find subtle differences. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/51540.

Role of internet use, mobile phone, media exposure and domestic migration on reproductive health service use in Bangladeshi married adolescents and young women.

Numerous studies have identified factors that are associated with increased access to reproductive health services in lower-middle-income countries (LMICs). However, limited studies examined the influence of access to internet or a mobile phone, media exposure and domestic migration on reproductive health services use in LMICs like Bangladesh. This study investigated the role of such factors on the use of contraceptives, antenatal care (ANC) and postnatal care (PNC) by married adolescents and young women in Bangladesh and whether it was varied by area. Secondary data for 1665 married women aged 15-24 years, sourced from the 2019 Multiple Indicator Cluster Surveys, were included in both bivariate analyses and logistic regression modelling to examine the role of access to internet and/or mobile phone, media exposure and domestic migration on the outcome variables (contraceptive, ANC and PNC). All regression models were controlled for age, wealth, education and number of existing children. Among all participants, 69.8% were aged 20-24 years and 85.6% lived in rural areas. Of the total sample, 67.5% used contraceptives, 75.7% utilised ANC and 48.7% accessed PNC. Domestic migration significantly increased contraceptive use, with women who had moved locally within the last five years 1.84 times more likely to use contraception than those who had never moved (95% CI: 1.41-2.41, p<0.001). Women with internet or mobile phone access were more likely to receive ANC (aOR: 1.57, 95% CI: 1.22-2.00, p<0.001) compared to those without internet/mobile phone access. Media exposure was found to increase the likelihood of receiving ANC in urban areas. No significant influence was found on the use of PNC. Internet/mobile-based platforms are promising avenues for public health messaging regarding ANC in Bangladeshi married adolescents and young women. Further research is required into determinants of PNC service use in low-resource settings.

Posterior reversible encephalopathy syndrome associated with dengue fever induced intrauterine death: A case report.

In recent years dengue fever has become a major health concern specifically due to its diverse presentation and adverse outcome. Progression from mild febrile illness to a severe systemic illness may occur in dengue fever including neurological disorder. Here, we report an unusual and rare case of a 20-year-old mother who developed posterior reversible encephalopathy syndrome (PRES) following dengue fever induced intrauterine death and septic shock.

Heavy Metals in Common Fishes Consumed in Dhaka, a Megacity of Asia: A Probabilistic Carcinogenic and Non-Carcinogenic Health Hazard.

Heavy metal contamination of fish is a serious public health concern worldwide, including in Bangladesh. In this study, six commonly consumed fish species namely Hilsha (Tenualosa ilisha), Kachki (Corica soborna), Punti (Puntitus ticto), Taki (Channa punctatus), Meni (Nandus nandus), and Tengra (Mystus tengara) were analyzed for arsenic (As), cadmium (Cd), lead (Pb), zinc (Zn), copper (Cu), chromium (Cr), manganese (Mn), and nickel (Ni), by inductively coupled plasma mass spectrometry. The fish samples were collected from wholesale markets in Dhaka city, the main business hub of Bangladesh where the fishes converged from countrywide and are redistributed to the whole city. The metal concentration varied among the studied fish species. Hilsha, the national fish of Bangladesh, contained the highest As among the other fishes of this study, whereas Zn, Cd, Cu, Mn, and Ni were the highest in Kachki, and Pb and Cr were the highest in Tengra. The probable source of metal accumulation in the fish species may be the river or marine water that can be contaminated by industrial waste, pesticide, and/or fertilizer use in agriculture and/or commercial fish feeds. All analyzed fish species showed serious heavy metal pollution, having high average pollution load index (APLI) values (> 1). The estimated daily intake (EDI) values for the metals were lower than the maximum tolerable daily intake (MTDI). The hazard index (HI) for all the fish species was above 1 for adults, showing non-carcinogenic health risks. The target carcinogenic risk (TCR) values were below the acceptable limit (10-4) for most of the metals, indicating safe for consumption with respect to the risk of cancer.

Provision of Quality Physical Education to enhance the motive of Physical Activity and its underlying Behavior among university students.

Background: Physical activity (PA) plays a crucial role in promoting good health and an active lifestyle among university students. Quality Physical Education (QPE) program is instrumental in achieving sustainability in PA. Motivation is a key factor in encouraging PA in students. However, motivation alone may not lead to inclusivity unless quality components are thoughtfully integrated into physical education (PE) programs. Aims: This study aimed to address three research questions: i) Can the motivation for PA participation be enhanced through the provision of high-quality PE programs in university settings? ii) Does the quality provision of PE contribute to promoting sustainable PA among adolescents? and iii) Is this carry-over process influenced by gender? Methods: This cross-sectional study enrolled N = 610 university students, comprising 467 males and 143 females. Only students who had PE as a part of their coursework were included. These students participated in more than 27 different sports and had an average age of 20.76 years (SD = 3.47) and an average of 4.70 years (SD = 4.93) of athletic experience. To achieve the study's objectives, descriptive statistics (mean, SD), Pearson's correlation, and regression analysis were employed. Additionally, a 2 (Gender) by 2 (Type of Sport: Individual vs. Team) MANCOVA, with age as a covariate, was used to assess gender-based differences in the variables. Results: The study found that the factors demonstrated strong reliability and positive correlations between QPE and exercise needs satisfaction. However, these factors did not establish significant correlations with PA. Perceived competence for exercise needs satisfaction showed gender differences, with males scoring higher. Additionally, QPE did not exhibit significant gender-based differences. In terms of PA, males had higher mean scores compared to females. Conclusion: The provision of QPE was identified as a crucial determinant of exercise satisfaction competence among students. While QPE provision was adequate at the university level, it did not promote PA among females as anticipated.

Hydrothermal synthesis of NiO nanoparticles decorated hierarchical MnO2 nanowire for supercapacitor electrode with improved electrochemical performance.

In this work, MnO2/NiO nanocomposite electrode materials have been synthesized by a cost-effective hydrothermal method. The effect of the concentrations (0, 1, 3, 5, and 7 wt%) of NiO nanoparticles on the surface morphology, structural properties, and electrochemical performance of the nanocomposites was characterized by different characterization techniques. The scanning electron micrographs (SEM) reveal that the as-prepared NiO nanoparticles are well connected and stuck with the MnO2 nanowires. The transmission electron microscopy (TEM) analysis showed an increase in the interplanar spacing due to the incorporation of NiO nanoparticles. The different structural parameters of MnO2/NiO nanocomposites were also found to vary with the concentration of NiO. The MnO2/NiO nanocomposites provide an improved electrochemical performance together with a specific capacitance as high as 343 F/g at 1.25 A/g current density. The electrochemical spectroscopic analysis revealed a reduction in charge transfer resistance due to the introduction of NiO, indicating a rapid carrier transportation between the materials interface. The improved electrochemical performance of MnO2/NiO can be attributed to good interfacial interaction, a large interlayer distance, and low charge transfer resistance. The unique features of MnO2/NiO and the cost-effective hydrothermal method will open up a new route for the fabrication of a promising supercapacitor electrode.

An ensemble novel architecture for Bangla Mathematical Entity Recognition (MER) using transformer based learning.

Mathematical entity recognition is indispensable for machines to accurately explain and depict mathematical content and to enable adequate mathematical operations and reasoning. It expedites automated theorem proving, speeds up the analysis and retrieval of mathematical knowledge from documents, and improves e-learning and educational platforms. It also simplifies translation, scientific research, data analysis, interpretation, and the practical application of mathematical information. Mathematical entity recognition in the Bangla language is novel; to our best knowledge, no other similar works have been done. Here, we identify the mathematical operator, operands as numbers, and popular mathematical terms (complex numbers, real numbers, prime numbers, etc.). In this work, we recognize Bangla Mathematical Entity Recognition (MER) utilizing the ensemble architecture of deep neural networks known as Bidirectional Encoder Representations from Transformers (BERT). We prepare a novel dataset comprising 13,717 observations, each containing a mathematical statement, mathematical entity, and mathematical type. In our recognition process, we consider our proposed architectures using accuracy, precision, recall and f1-score as the performance metrics. The results have shown a satisfactory accuracy percentage of 97.98 with BERT and 99.76% with ensemble BERT.

Climate shocks' impact on agricultural income and household food security in Bangladesh: An implication of the food insecurity experience scale.

Floods and extreme rainfall are common climatic phenomena in Bangladesh, and farm households are more susceptible to such shocks. This paper assesses the impact of climate shocks on agricultural income and food security of farm households in Bangladesh using an extensive nationally representative dataset from the Bangladesh Integrated Household Survey 2018-19, including 5604 sample rural households in 64 districts. However, this research considered 24 districts, representing 2131 sample farm households, by developing an exogenous climate shock indicator based on data from the Yearbook of Agricultural Statistics of Bangladesh 2018. Empirical findings on the grounds of simultaneous quantile regression reveal that climate shocks substantially lower agricultural income in the study regions. However, the presence of prime-age women (15-49) in the home, the male-headed family, farmland, and livestock ownership of the household are the decisive factors that safeguard agricultural income. Applying the Food Insecurity Experience Scale (FIES), descriptive statistics disclose that most farm households suffer at various food insecurity levels (considerably moderate, noticeably mild, and tiny severe), while the rest are at the food security level. The key finding regarding ordered probit regression uncovers that climate shocks significantly increase household food insecurity (at different levels of FIES). In other words, cropland damage due to floods and extreme rainfall reduces the food security of farm households in the study districts. On the other hand, increased farm size and educated households are profoundly protected against food insecurity. This study, therefore, recommends that raising livestock can complement agricultural income, and enhancing education would ensure households' food security in the climate-exposed areas of Bangladesh.

Enhancing malaria detection in resource-limited areas: A high-performance colorimetric LAMP assay for Plasmodium falciparum screening.

Malaria eradication efforts in resource-limited areas require a rapid, economical, and accurate tool for detecting of the low parasitemia. The malaria rapid diagnostic test (mRDT) is the most suitable for on-site detection of the deadliest form of malaria, Plasmodium falciparum. However, the deletions of histidine rich protein 2 and 3 genes are known to compromise the effectiveness of mRDT. One of the approaches that have been explored intensively for on-site diagnostics is the loop-mediated isothermal amplification (LAMP). LAMP is a one-step amplification that allows the detection of Plasmodium species in less than an hour. Thus, this study aims to present a new primer set to enhance the performance of a colorimetric LAMP (cLAMP) for field application. The primer binding regions were selected within the A-type of P. falciparum 18S rRNA genes, which presents a dual gene locus in the genome. The test result of the newly designed primer indicates that the optimal reaction condition for cLAMP was 30 minutes incubation at 65°C, a shorter incubation time compared to previous LAMP detection methods that typically takes 45 to 60 minutes. The limit of detection (LoD) for the cLAMP using our designed primers and laboratory-grown P. falciparum (3D7) was estimated to be 0.21 parasites/µL which was 1,000-fold higher than referencing primers. Under optimal reaction condition, the new primer sets showed the sensitivity (100%, 95% CI: 80.49-100%) and specificity (100%, 95% CI: 94.64-100%) with 100% (95% CI: 95.70-100%) accuracy on the detection of dried blood spots from Malawi (n = 84). Briefly, the newly designed primer set for P. falciparum detection exhibited high sensitivity and specificity compared to referenced primers. One great advantage of this tool is its ability to be detected by the naked eye, enhancing field approaches. Thus, this tool has the potential to be effective for accurate early parasite detection in resource-limited endemic areas.

Prevalence, inequality and associated factors of overweight/obesity among Bangladeshi adolescents aged 15-19 years.

BACKGROUND: The objective of the current study was to estimate the prevalence and associated factors of overweight/obesity among Bangladeshi adolescents aged 15-19 y and to identify whether wealth-related inequality exists for overweight/obesity among Bangladeshi older adolescents. METHODS: We analyzed publicly available national representative secondary data from the 2019-2020 Bangladesh Adolescent Health and Wellbeing Survey. This cross-sectional survey was carried out among 18 249 adolescents aged 15-19 y regardless of their marital status using a two-stage stratified sampling technique (the data of 9128 eligible adolescents were included in this analysis). The WHO reference population for body mass index-for-age (1+Z score) was considered as overweight/obesity. RESULTS: We found that girls had significantly (p<0.05) higher prevalence of overweight/obesity (11.63%) than boys (8.25%); however, their biological sex as well their age were not significantly associated with higher odds of overweight/obesity. Those who were in their higher grade (grade 11 and higher) in the school and had been exposed to media were more likely (1.67 and 1.39 times, respectively) to be overweight/obesity compared with primary grade (0-5) and those who experienced no media exposure, respectively. Inequality analysis revealed that adolescents belonging to wealthy households had significantly higher rates of overweight/obesity than those in poorer households (concentration index=0.093). CONCLUSIONS: The study exhibited the multifaceted nature of overweight/obesity among Bangladeshi older teenagers, revealing that their school grade, exposure to media content and wealth-related inequality emerged as significant contributing factors. The findings underscore the urgent need for targeted interventions and public health strategies to address the escalating burden of overweight and obesity in this age group.

Gender Differences in Hospital Outcomes among COVID-19 Hospitalizations.

OBJECTIVES: Many epidemiological studies have shown that coronavirus disease 2019 (COVID-19) disproportionately affects males, compared with females, although other studies show that there were no such differences. The aim of the present study was to assess differences in the prevalence of hospitalizations and in-hospital outcomes between the sexes, using a larger administrative database. METHODS: We used the 2020 California State Inpatient Database for this retrospective analysis. International Classification of Diseases, Tenth Revision, Clinical Modification diagnosis code U07.1 was used to identify COVID-19 hospitalizations. These hospitalizations were subsequently stratified by male and female sex. Diagnosis and procedures were identified using the International Classification of Diseases, Tenth Revision, Clinical Modification codes. The primary outcome of the study was hospitalization rate, and secondary outcomes were in-hospital mortality, prolonged length of stay, vasopressor use, mechanical ventilation, and intensive care unit (ICU) admission. RESULTS: There were 95,180 COVID-19 hospitalizations among patients 18 years and older, 52,465 (55.1%) of which were among men and 42,715 (44.9%) were among women. In-hospital mortality (12.4% vs 10.1%), prolonged length of hospital stays (30.6% vs 25.8%), vasopressor use (2.6% vs 1.6%), mechanical ventilation (11.8% vs 8.0%), and ICU admission rates (11.4% versus 7.8%) were significantly higher among male compared with female hospitalizations. Conditional logistic regression analysis showed that the odds of mortality (odds ratio [OR] 1.38, 95% confidence interval [CI] 1.38-1.44), hospital lengths of stay (OR 1.35, 95% CI 1.31-1.39), vasopressor use (OR 1.59, 95% CI 1.51-1.66), mechanical ventilation (OR 1.62, 95% CI 1.47-1.78), and ICU admission rates (OR 1.58, 95% CI 1.51-1.66) were significantly higher among male hospitalizations. CONCLUSION: Our findings show that male sex is an independent and strong risk factor associated with COVID-19 severity.

Initial experience with an electron FLASH research extension (FLEX) for the Clinac system.

PURPOSE: Radiotherapy delivered at ultra-high-dose-rates (≥40 Gy/s), that is, FLASH, has the potential to effectively widen the therapeutic window and considerably improve the care of cancer patients. The underlying mechanism of the FLASH effect is not well understood, and commercial systems capable of delivering such dose rates are scarce. The purpose of this study was to perform the initial acceptance and commissioning tests of an electron FLASH research product for preclinical studies. METHODS: A linear accelerator (Clinac 23EX) was modified to include a non-clinical FLASH research extension (the Clinac-FLEX system) by Varian, a Siemens Healthineers company (Palo Alto, CA) capable of delivering a 16 MeV electron beam with FLASH and conventional dose rates. The acceptance, commissioning, and dosimetric characterization of the FLEX system was performed using radiochromic film, optically stimulated luminescent dosimeters, and a plane-parallel ionization chamber. A radiation survey was conducted for which the shielding of the pre-existing vault was deemed sufficient. RESULTS: The Clinac-FLEX system is capable of delivering a 16 MeV electron FLASH beam of approximately 1 Gy/pulse at isocenter and reached a maximum dose rate >3.8 Gy/pulse near the upper accessory mount on the linac gantry. The percent depth dose curves of the 16 MeV FLASH and conventional modes for the 10 × 10 cm2 applicator agreed within 0.5 mm at a range of 50% of the maximum dose. Their respective profiles agreed well in terms of flatness but deviated for field sizes >10 × 10 cm2 . The output stability of the FLASH system exhibited a dose deviation of <1%. Preliminary cell studies showed that the FLASH dose rate (180 Gy/s) had much less impact on the cell morphology of 76N breast normal cells compared to the non-FLASH dose rate (18 Gy/s), which induced large-size cells. CONCLUSION: Our studies characterized the non-clinical Clinac-FLEX system as a viable solution to conduct FLASH research that could substantially increase access to ultra-high-dose-rate capabilities for scientists.