Preterm birth and neonatal mortality in selected slums in and around Dhaka City of Bangladesh: A cohort study.

BACKGROUND: Although under-five mortality has declined appreciably in Bangladesh over the last few decades, neonatal mortality still remains high. The objective of the study is to assess the level and determinants of preterm birth and the contribution of preterm birth to neonatal mortality. METHODS: Data for this study came from selected slums in and around Dhaka city, where; since 2015, icddr,b has been maintaining the Health and Demographic Surveillance System (HDSS). The HDSS data were collected by female Field Workers by visiting each household every three months; however, during the visit, data on the Last Menstrual Period (LMP) were also collected by asking each eligible woman to ascertain the date of conception. Gestational age was estimated in complete weeks by subtracting LMP from the date of the pregnancy outcome. In this study, 6,989 livebirths were recorded by HDSS during 2016-2018, and these births were followed for neonatal survival; both bivariate and multivariate analyses were performed. RESULTS: Out of total births, 21.7% were born preterm (before 37 weeks of gestation), and sub-categories were: 2.19% for very preterm (28 to 31 weeks), 3.81% for moderate preterm (32 to 33 weeks), and 15.71% for late preterm (34 to 36 weeks). The study revealed that preterm babies contributed to 39.6% of neonatal deaths; however, the probability of death was very high on the 1st day of birth (0.124 for very preterm, 0.048 for moderate preterm, 0.024 for late preterm, and 0.013 for term birth), and continued until the 3rd day. In the regression analysis, compared to the term neonates, the odds of neonatal mortality were 8.66 (CI: 5.63, 13.32, p<0.01), 4.13 (CI: 2.69, 6.34, p<0.01) and 1.48 (CI: 1.05, 2.08, p<0.05) respectively for very, moderate, and late preterm birth categories. The population attributable fraction for neonatal mortality was 23%, and sub-categories were 14% for very preterm, 10% for moderate preterm, and 6% for late preterm. CONCLUSIONS: Although urban slums are in proximity to many health facilities, a substantial proportion of preterm births contribute to neonatal deaths. So, pregnant women should be targeted, to ensure timely care during pregnancy, delivery, and post-partum periods to improve the survival of new-borns in general and preterm birth in particular.

COVID-19 Vaccine Hesitancy among Temporary Foreign Workers from Bangladesh.

The COVID-19 pandemic poses an extraordinary threat to the health, safety, and freedom of temporary foreign workers (TFWs). Highly effective vaccines against COVID-19 may hold an outsized benefit for TFWs, particularly those living in congregate settings where protective measures such as social distancing are not possible. While some studies of migrant destination countries have included migrants, no study to date has sought to understand variations in vaccine hesitancy among individuals in a single migrant source population across different destinations. Such a design is critical for understanding how the context of immigration affects levels of hesitancy among migrants from similar conditions of origin. This observational study leverages longitudinal data from an ongoing monthly rapid-response survey of TFWs from Bangladesh (n = 360). Overall vaccine hesitancy was 25%, with significant variation by host country. Multivariate analyses confirmed that immigration system factors and threat perception are the strongest predictors of COVID-19 vaccine hesitancy for TFWs. The predicted probability of hesitancy for an undocumented TFW was 0.405, while the predicted probability for those with valid visas was 0.207 (p < .01). The probability of being hesitant for TFWs who were worried about getting COVID-19 was 0.129 compared to 0.305 (p < .01) for those who were not worried. Results reveal low vaccine hesitancy among TFWs from Bangladesh with differences in location, undocumented status, COVID-19 threat perception, and level of worry about side effects. There could be relatively high returns for targeting vaccine access and distribution to TFWs because of their high levels of vaccine acceptance.

Hybrid EEG-fNIRS BCI Fusion Using Multi-Resolution Singular Value Decomposition (MSVD).

Brain-computer interface (BCI) multi-modal fusion has the potential to generate multiple commands in a highly reliable manner by alleviating the drawbacks associated with single modality. In the present work, a hybrid EEG-fNIRS BCI system-achieved through a fusion of concurrently recorded electroencephalography (EEG) and functional near-infrared spectroscopy (fNIRS) signals-is used to overcome the limitations of uni-modality and to achieve higher tasks classification. Although the hybrid approach enhances the performance of the system, the improvements are still modest due to the lack of availability of computational approaches to fuse the two modalities. To overcome this, a novel approach is proposed using Multi-resolution singular value decomposition (MSVD) to achieve system- and feature-based fusion. The two approaches based up different features set are compared using the KNN and Tree classifiers. The results obtained through multiple datasets show that the proposed approach can effectively fuse both modalities with improvement in the classification accuracy.

A Computationally Efficient Method for Hybrid EEG-fNIRS BCI Based on the Pearson Correlation.

A hybrid brain computer interface (BCI) system considered here is a combination of electroencephalography (EEG) and functional near-infrared spectroscopy (fNIRS). EEG-fNIRS signals are simultaneously recorded to achieve high motor imagery task classification. This integration helps to achieve better system performance, but at the cost of an increase in system complexity and computational time. In hybrid BCI studies, channel selection is recognized as the key element that directly affects the system's performance. In this paper, we propose a novel channel selection approach using the Pearson product-moment correlation coefficient, where only highly correlated channels are selected from each hemisphere. Then, four different statistical features are extracted, and their different combinations are used for the classification through KNN and Tree classifiers. As far as we know, there is no report available that explored the Pearson product-moment correlation coefficient for hybrid EEG-fNIRS BCI channel selection. The results demonstrate that our hybrid system significantly reduces computational burden while achieving a classification accuracy with high reliability comparable to the existing literature.

Selection bias in the link between child wantedness and child survival: theory and data from Matlab, Bangladesh.

We examine the potential effects of selection bias on the association between unwanted births and child mortality from 7,942 women from Matlab, Bangladesh who declared birth intentions in 1990 prior to conceiving pregnancies. We explore and test two opposing reasons for bias in the distribution of observed births. First, some women who report not wanting more children could face starvation or frailty; and if these women are infecund, the remaining unwanted births would appear more healthy. Second, some women who report not wanting more children could have social privileges in acquiring medical services, abortion, and contraceptives; and if these women avoid births, the remaining unwanted births would appear less healthy. We find (1) no overall effect of unwantedness on child survival in rural Bangladesh in the 1990s, (2) no evidence that biological processes are spuriously making the birth cohort look more healthy, and (3) some evidence that higher schooling for women who avoid unwanted births is biasing the observed sample to make unwanted births look less healthy. Efforts to understand the effect of unwantedness in data sets that do not control for complex patterns of selective birth may be misleading and require more cautious interpretation.

Do self-reported health indicators predict mortality? Evidence from Matlab, Bangladesh.

In order to understand current and changing patterns of population health, there is a clear need for high-quality health indicators. The World Health Organization Study on Global AGEing and Adult Health (SAGE) survey platform and the International Network for the Demographic Evaluation of Populations and Their Health in developing countries (INDEPTH) generated data for this study. A total of 4300 people aged 50 years or older were selected randomly from the Matlab Health and Demographic Surveillance System of the International Centre for Diarrhoeal Disease Research, Bangladesh. The health indicators derived from these survey data are self-rated general health, overall health state, quality of life and disability levels. The outcome of the study is mortality over a 2-year follow-up since the survey. Among the four health indicators, only self-rated health was significantly associated with subsequent mortality irrespective of sex: those who reported bad health had higher mortality than those who reported good health, even after controlling for socio-demographic factors. For all other three health indicators, such associations exist but are significant only for males, while for females it is significant only for 'quality of life'.

Dynein-dynactin complex subunits are differentially localized in brain and spinal cord, with selective involvement in pathological features of neurodegenerative disease.

AIMS: The dynein-dynactin complex, mostly recognized for axonal retrograde transport in neurones, has an ever growing list of essential subcellular functions. Here, the distribution of complex subunits in human central nervous system (CNS) has been assessed using immunohistochemistry in order to test the hypothesis that this may be altered in neurodegenerative disease. METHODS: Three dynactin and two dynein subunits were immunolocalized in the CNS of human post mortem sections from motor neurone disease, Alzheimer's disease and patients with no neurological disease. RESULTS: Unexpectedly, coordinated distribution of complex subunits was not evident, even in normal tissues. Complex subunits were differentially localized in brain and spinal cord, and localization of certain subunits, but not others, occurred in pathological structures of motor neurone and Alzheimer's diseases. CONCLUSIONS: These results suggest that dynein-dynactin complex subunits may have specific subcellular roles, and primary events that disturb the function of individual components may result in disequilibrium of subunit pools, with the possibility that availability for normal cytoplasmic functions becomes impaired, with consequent organelle and axonal transport misfunction.

Pregnancy spacing and maternal morbidity in Matlab, Bangladesh.

OBJECTIVE: The study examines the relationship between pregnancy spacing and seven measures of maternal morbidity in Matlab, Bangladesh. METHOD: The study analyzes maternal morbidity data on 11,122 women who visited a health center during their third trimester of pregnancy between 1996 and 2002. Adjusted odds ratios were obtained through logistic regression analysis to assess the effects of pregnancy intervals of differing lengths while holding constant other influences (six variables) on maternal morbidity. RESULTS: After controlling these variables, pre-eclampsia and high blood pressure are significantly more likely for women with preceding inter-pregnancy intervals of less than 6 months or 75 months or more compared to those with intervals of 27-50 months. Premature rupture of membranes is significantly more likely following inter-pregnancy intervals of 6-14 months, and edema is significantly more likely following inter-pregnancy intervals over 50 months. CONCLUSION: Short and long inter-pregnancy intervals are associated with increased incidence of some maternal morbidities.

Pregnancy spacing and maternal morbidity in Matlab, Bangladesh.

OBJECTIVE: The study examines the relationship between pregnancy spacing and seven measures of maternal morbidity in Matlab, Bangladesh. METHOD: The study analyzes maternal morbidity data on 11,122 women who visited a health center during their third trimester of pregnancy between 1996 and 2002. Adjusted odds ratios were obtained through logistic regression analysis to assess the effects of pregnancy intervals of differing lengths while holding constant other influences (six variables) on maternal morbidity. RESULTS: After controlling these variables, pre-eclampsia and high blood pressure are significantly more likely for women with preceding inter-pregnancy intervals of less than 6 months or 75 months or more compared to those with intervals of 27-50 months. Premature rupture of membranes is significantly more likely following inter-pregnancy intervals of 6-14 months, and edema is significantly more likely following inter-pregnancy intervals over 50 months. CONCLUSION: Short and long inter-pregnancy intervals are associated with increased incidence of some maternal morbidities.

Sulfur-to-nitrogen transnitrosation: transfer of nitric oxide from S-nitroso compounds to diethanolamine and the role of intermediate sulfur-to-sulfur transnitrosation.

S-Nitrosothiols are formed in vivo and are involved in NO signaling. We investigated the sulfur-to-nitrogen transnitrosation activity of S-nitrosocysteine, S-nitrosoglutathione, S-nitrosohomocysteine, S-nitrosocysteinylglycine and S-nitroso-N-acetylcysteine in their reaction with the secondary amine diethanolamine in vitro. The resulting N-nitrosodiethanolamine, a strong carcinogen, was formed in yields of up to 11% from S-nitrosocysteine and S-nitrosocysteinylglycine, whereas the transnitrosation activity of the other S-nitroso compounds was weak. However, the addition of L-cysteine to a solution of S-nitrosohomocysteine and diethanolamine accelerated the decomposition of S-nitrosohomocysteine and resulted in a significant formation of N-nitrosodiethanolamine accompanied by the intermediate generation of S-nitrosocysteine. Thus, reactive nitrosothiols can be formed from less reactive analogs via sulfur-to-sulfur transnitrosation. We suggest that this affects regulation of NO trafficking in vivo. The reaction provides an alternative mechanism for the generation of carcinogenic N-nitroso derivatives.

Capripox in Bangladesh.

In 1984 capripox entered Bangladesh developing into a severe epidemic causing high mortality in the indigenous goat population. Although at present mainly confined to the western districts the disease has spread to some central and northern districts and unless controlled could spread further. Clinically and biochemically the strain is closely related to a strain previously isolated in central India. It has been shown that restriction endonuclease analysis of the genome of field isolates of capripoxvirus can provide a useful epidemiological technique in investigating outbreaks of capripox.