Pivotal relationship between heavy metal, PM2.5 exposures and tuberculosis in Bangladeshi children: protocol paper of a case-control study.

INTRODUCTION: Air pollution is a global issue that poses a significant threat to public health. Children, due to their developing physiology, are particularly susceptible to the inhalation of environmental pollutants. Exposure can trigger immune modulation and organ damage, increasing susceptibility to respiratory diseases. Therefore, we aim to examine the association between heavy metal and particulate matter exposure with tuberculosis in children. METHODS AND ANALYSIS: As a case-control study, we will include children diagnosed with pulmonary tuberculosis (n=60) and matched healthy controls (n=80) recruited from the same communities in Dhaka, Bangladesh. Exposure data for both cases and controls will be collected by a trained field team conducting home visits. They will administer an exposure questionnaire, measure child anthropometry, collect blood and household dust samples and instal 48-hour air quality monitors. The blood samples will be analysed by inductively coupled plasma mass spectrometry for serum heavy metal concentrations (lead, cadmium, arsenic, mercury and chromium), as a representative marker of exposure, and the presence of inflammatory biomarkers. Descriptive and inferential statistics, including independent samples t-tests, analysis of variance and conditional regression analysis, will be used to quantify heavy metal and particulate matter exposure status in tuberculosis cases compared with healthy controls, while accounting for potential confounders. Dust samples and air quality results will be analysed to understand household sources of heavy metal and particulate matter exposure. To test the study hypothesis, there is a positive association between exposure and tuberculosis diseases, we will also measure the accumulated effect of simultaneous exposures using Bayesian statistical modelling. ETHICS AND DISSEMINATION: This study has been approved by International Centre for Diarrhoeal Disease Research, Bangladesh's Institutional Review Board (PR-22030). The study findings will be disseminated at conferences and published in peer-reviewed journals.

Effect of leisure-time physical activity on blood pressure in people with hypertension: a systematic review and meta-analysis.

High blood pressure is a major risk factor for premature death. Leisure-time physical activities have been recommended to control hypertension. Studies examining how leisure-time physical activity affects blood pressure have found mixed results. We aimed to conduct a systematic review examining the effect of leisure-time physical activity (LTPA) on lowering blood pressure among adults living with hypertension. We searched studies in Embase, Medline/PubMed, Web of Science, Physical Education Index, Scopus and CENTRAL (the Cochrane Library). The primary outcome variables were systolic blood pressure (SBP) and diastolic blood pressure (DBP). This systematic review is registered on PROSPERO (CRD42021260751). We included 17 studies out of 12,046 screened articles in this review. Moderate-intensity LTPA (all types) reduced SBP compared to the non-intervention control group (MD -5.35 mm Hg, 95% CI -8.06 to -2.65, nine trials, n = 531, low certainty of the evidence). Mean DBP was reduced by -4.76 mm Hg (95% CI -8.35 to -1.17, nine trials, n = 531, low certainty of the evidence) in all types of LTPA (moderate intensity) group compared to the non-intervention control group. Leisure-time walking reduced mean SBP by -8.36 mmHg, 95% CI -13.39 to -3.32, three trials, n = 128, low certainty of the evidence). Walking during leisure time reduced -5.03 mmHg mean DBP, 95% CI -8.23 to -1.84, three trials, n = 128, low certainty of the evidence). Performing physical activity during free time probably reduces SBP and DBP (low certainty of the evidence) among adults with hypertension.

Generating binomial coefficients in a row of Pascal's triangle from extensions of powers of eleven.

Sir Isaac Newton noticed that the values of the first five rows of Pascal's triangle are each formed by a power of 11, and claimed that subsequent rows can also be generated by a power of 11. Literally, the claim is not true for the 5 t h row and onward. His genius mind might have suggested a deep relation between binomial coefficients and a power of some integer that resembles the number 11 in some form. In this study, we propose and prove a general formula to generate the values in any row of Pascal's triangle from the digits of ( 1 0 ⋯ 0 ︸ Θ zeros 1 ) n . It can be shown that the numbers in the cells in n t h row of Pascal's triangle may be achieved from Θ + 1 partitions of the digits of the number ( 1 0 ⋯ 0 ︸ Θ zeros 1 ) n , where Θ is a non-negative integer. That is, we may generate the number in the cells in a row of Pascal's triangle from a power of 11, 101, 1001, or 10001 and so on. We briefly discuss how to determine the number of zeros Θ in relation to n, and then empirically show that the partition really gives us binomial coefficients for several values of n. We provide a formula for Θ and prove that the ( n + 1 ) t h row of Pascal's triangle is simply Θ + 1 partitions of the digits of ( 1 0 ⋯ 0 ︸ Θ zeros 1 ) n from the right.

Cigarette smoking and associated factors among men in five South Asian countries: A pooled analysis of nationally representative surveys.

Smoking is one of the leading causes of premature deaths worldwide. The cigarette is the commonest form of tobacco smoking. This study investigated the factors associated with cigarette smoking among men in five South Asian countries. We analyzed nationally representative cross-sectional study (Demographic and Health Survey) data conducted in Afghanistan, India, Maldives, Nepal, and Pakistan from 2015-2018. Our study population was men aged between 15 and 49 years. The outcome variable was the prevalence of cigarette smoking. We performed both pooled and country-specific analyses using multivariable logistic regression. The prevalence of cigarette smoking among men is the highest (41.2%) in the Maldives and the lowest (20.1%) in Pakistan. Our pooled analysis found that higher age, lower education, lower wealth status, and involvement in any occupations were strongly associated with cigarette smoking (p-value <0.001). However, we did not find a significant association between age and wealth status in Afghanistan, occupations in Nepal and Pakistan, and education in Pakistan with cigarette smoking when country-specific analyses were performed. In this study, socioeconomic position, age, and urban area are strongly associated with cigarette smoking in South Asian countries. The country-specific circumstances should be considered in planning and designing national smoking control strategies and interventions. However, improving access to smoking cessation services could be an effective intervention for all studied countries, Afghanistan, India, Maldives, Nepal, and Pakistan.

Pivotal role of environmental toxicants on developing infectious diseases in LMICs: a protocol for a systematic review and meta-analysis.

INTRODUCTION: Environmental toxicants such as chemical pollution have an enormous impact on the health of people and the planet. Emerging findings suggest that non-communicable diseases are linked to early and chronic environmental exposures. However, the rapid globalisation in developing countries, environmental change and the emergence, spread, persistence and severity of infectious diseases are not yet well understood. The aim of this study is to understand which environmental toxicants are commonly associated with infectious diseases in low-income and middle-income countries (LMICs). METHODS AND ANALYSIS: A total of four electronic databases, MEDLINE through PubMed, Scopus, Web of Science and CENTRAL (the Cochrane Library) be searched to identify relevant studies and will be screened by two independent reviewers. The Cochrane risk of bias (ROB) tool for randomised control trials (RCTs) and ROB assessment tool for non-randomised studies for non-RCTs will be used to assess the ROB. A meta-analysis will be used to determine the pooled effect if we find out the included articles have similar environmental exposure, participant groups, study design and outcome measures. A narrative synthesis of the findings will be provided, along with summaries of the intervention effect. Heterogeneity between the studies will be assessed, and sensitivity analysis will be conducted based on study quality. ETHICS AND DISSEMINATION: Findings will be summarised in a single manuscript. This review attempts to explore the pivotal role of environmental toxicants in predisposing, developing, persistent and severity of infectious diseases in LMICs. Findings from this study will highlight the effects of individual environmental toxicants' role on infectious disease outcomes for the early prevention and limit toxic exposure to guide individual, community, and occupational health policy for future strategies. PROSPERO REGISTRATION NUMBER: CRD42021274359.

Prevalence of and factors associated with tobacco smoking in the Gambia: a national cross-sectional study.

OBJECTIVES: To examine the prevalence of and risk factors associated with tobacco smoking in the Gambia. DESIGN: A nationwide cross-sectional study. SETTING: The Gambia. PARTICIPANTS: The study participants were both women and men aged between 15 and 49 years old. We included 16,066 men and women in our final analysis. DATA ANALYSIS: We analysed data from the Gambia Demographic and Health Survey (DHS), 2019-2020. DHS collected nationally stratified data from local government areas and rural-urban areas. The outcome variable was the prevalence of tobacco smoking. Descriptive analysis, prevalence and logistic regression methods were used to analyse data to identify the potential determinants of tobacco smoking. RESULTS: The response rate was 93%. The prevalence of current tobacco smoking was 9.92% in the Gambia in 2019-2020, of which, 81% of the consumers smoked tobacco daily. Men (19.3%) smoked tobacco much higher than women (0.65%) (p<0.001). People aged 40-49 years, with lower education, and manual workers were the most prevalent group of smoking in the Gambia (p<0.001).Men were 33 times more likely to smoke tobacco than women. The chance of consuming smoked tobacco increased with the increase of age (adjusted OR (AOR) 9.08, 95% CI 5.08 to 16.22 among adults aged 40-49 years, p<0.001). The strength of association was the highest among primary educated individuals (AOR 5.35, 95% CI 3.35 to 8.54).Manual workers (AOR 2.73) and people from the poorest households (AOR 1.86) were the risk groups for smoking. However, place of residency and region were insignificantly associated with smoking in the Gambia. CONCLUSIONS: Men, older people, manual workers, individuals with lower education and lower wealth status were the vulnerable groups to tobacco smoking in the Gambia. Government should intensify awareness programmes on the harmful effects of smoking, and introduce proper cessation support services among tobacco smoking users prioritising these risk groups.

Non-pharmacological interventions for the prevention of type 2 diabetes in low-income and middle-income countries: a systematic review of randomised controlled trials.

OBJECTIVE: Diabetes poses serious health threats and economic burdens to patients, especially in low-income and middle-income countries (LMICs). This systematic review searches for non-pharmacological interventions for the prevention of type-2 diabetes mellitus (T2DM) among patients who are non-diabetic and pre-diabetic from LMICs. SETTINGS: LMICs. PARTICIPANTS: Adult population aged over 18 years without having diabetes. PRIMARY AND SECONDARY OUTCOMES: Primary outcome is to measure the change in the incidence of T2DM. The secondary outcome is to measure changes in glycated haemoglobin (HbA1c) level, weight/body mass index (BMI), fasting glucose level and 2-hour glucose from baseline of the included randomised controlled trials. METHODS: This review has been conducted following the standard systematic review guidelines. A total of six electronic databases including MEDLINE, Embase, the Cochrane Library, Web of Science, ClinicalTrials.gov and International Clinical Trials Registry Platform were searched in February 2021 using a comprehensive search strategy.Two sets of independent reviewers performed screening, risk of bias (ROB) assessment using the Cochrane ROB tool and data extraction. Narrative coalescence of selected articles was demonstrated using tables. No meta-analysis was performed due to the lack of homogenous intervention strategies and study settings. RESULT: A total of five studies were included for the review with a combined population of 1734 from three countries. Three of the studies showed a significant reduction in T2DM incidence after the intervention of physical training and dietary modifications. Four of the studies also demonstrated a significant reduction of different secondary outcomes like weight, BMI, fasting and 2-hour plasma glucose and HbA1c. All the studies demonstrated a low ROB in most of the bias assessment domains with some unclear results in allocation concealments. CONCLUSIONS: Emphasising non-pharmacological interventions for T2DM prevention can improve health outcomes and lessen the economic burdens, which will be of paramount importance in LMICs. SYSTEMATIC REVIEW REGISTRATION NUMBER: CRD42020191507.

Effect of leisure-time physical activity in controlling hypertension: a systematic review and meta-analysis protocol.

INTRODUCTION: Hypertension is a major risk factor for cardiovascular diseases. In 2015, over 1.13 billion individuals worldwide had hypertension. Globally, it results in 10.8 million deaths every year. Around half of the individuals do not continue treatment with medicine to control blood pressure. Physical activity, a non-pharmacological option of treatment, reduces blood pressure. We aim in this research to examine the effect of leisure-time physical activity in controlling blood pressure. METHODS AND ANALYSIS: We will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses to conduct this study. We will perform a systematic search in Medline/PubMed, Embase, Scopus, Web of Science, Physical Education Index (ProQuest) and CENTRAL (the Cochrane Library). Both experimental and observational studies will be included. The study population would be people with hypertension. Two reviewers will perform screening of the articles, bias assessment and data extraction independently. We will use the Joanna Briggs Institute Critical Appraisal Tools to assess the risk of bias. We will conduct a meta-analysis if it is applicable. ETHICS AND DISSEMINATION: The results will be published in peer-reviewed journals and presented at relevant scientific seminars and conferences. Ethical approval is not applicable. PROSPERO REGISTRATION NUMBER: CRD42021260751.

Differences in risk factors associated with single and multiple concurrent forms of undernutrition (stunting, wasting or underweight) among children under 5 in Bangladesh: a nationally representative cross-sectional study.

OBJECTIVES: The study aims to differentiate the risk factors of single and multiple concurrent forms of undernutrition among children under 5 in Bangladesh. DESIGN: A nationally representative cross-sectional study. SETTING: Bangladesh. RESPONDENTS: Children age under 5 years of age. OUTCOME MEASURE: This study considered two dichotomous outcomes: single form (children without single form and with single form) and multiple concurrent forms (children without multiple forms and with multiple forms) of undernutrition. STATISTICAL ANALYSIS: Adjusted OR (AOR) and CI of potential risk factors were calculated using logistic regression analysis. RESULTS: Around 38.2% of children under 5 in Bangladesh are suffering from undernutrition. The prevalence of multiple concurrent forms and single form of child undernutrition was 19.3% and 18.9%, respectively. The key risk factors of multiple concurrent forms of undernutrition were children born with low birth weight (AOR 3.76, 95% CI 2.78 to 5.10); children in the age group 24-35 months (AOR 2.70, 95% CI 2.20 to 3.30) and in the lowest socioeconomic quintile (AOR 2.57, 95% CI 2.05 to 3.23). In contrast, those children in the age group 24-35 months (AOR 1.94, 95% CI 1.61 to 2.34), in the lowest socioeconomic quintile (AOR 1.79, 95% CI 1.45 to 2.21) and born with low birth weight (AOR 1.52, 95% CI 1.11 to 2.08) were significantly associated with a single form of undernutrition. Parental education, father's occupation, children's age and birth order were the differentiating risk factors for multiple concurrent forms and single form of undernutrition. CONCLUSION: One-fifth of children under 5 years of age are suffering multiple concurrent forms of undernutrition, which is similar to the numbers suffering the single form. Parental education, father's occupation, children's age and birth order disproportionately affect the multiple concurrent forms and single form of undernutrition, which should be considered to formulate an evidence-based strategy for reducing undernutrition among these children.

Improvement of Physicomechanical Properties of Pineapple Leaf Fiber Reinforced Composite.

Pineapple leaf fiber (PALF) reinforced polypropylene (PP) composites were prepared by compression molding. The fiber content varied from 25% to 45% by weight. Water uptake percentages of the composites containing various wt% of fiber were measured. All the composites demonstrated lower water uptake percentages and maximum of 1.93% for 45 wt% PALF/PP composite treated with 7(w/v)% NaOH. Tensile Strength (TS), Tensile Modulus (TM), Elongation at Break (Eb %), Bending Strength (BS), Bending Modulus (BM), and Impact Strength (IS) were evaluated for various fiber content. The 45 wt% PALF/PP composite exhibited an increase of 210% TS, 412% TM, 155% BS, 265% BM, and 140% IS compared to PP matrix. Moreover, with the increasing of fiber content, all the mechanical properties increase significantly; for example, 45 wt% fiber loading exhibited the best mechanical property. Fibers were also treated with different concentration of NaOH and the effects of alkali concentrations were observed. The composite treated with 7 (w/v)% NaOH exhibited an increase of 25.35% TS, 43.45% TM, 15.78% BS, and 52% BM but 23.11% decrease of IS compared to untreated composite. Alkali treatment improved the adhesive characteristics of fiber surface by removing natural impurities, hence improving the mechanical properties. However, over 7% NaOH concentration of the tensile strength of the composite reduced slightly due to overexposure of fibers to NaOH.

Extremely high birefringent terahertz fiber using a suspended elliptic core with slotted airholes.

A suspended core microstructured fiber with extremely high birefringence has been proposed for terahertz (THz) wave propagation. An elliptical-shaped core has been formed with slotted rectangular airholes to disrupt the vertical symmetry of the refractive index of the designed fiber. Different design parameters such as the core diameter, ellipticity, porosity, and suspended strut width have been checked to achieve optimum performance from the fiber. The resultant birefringence of the proposed fiber is unprecedented, of the order of 10-1 (1.057×10-1 to be precise) with a low effective material loss of 0.047 cm-1 and confinement loss of 9.4×10-3 cm-1 at 1 THz. The dispersion of the designed fiber is below 1 ps/THz/cm extended over a band of 500 GHz (1-1.5 THz) with almost flat profile. It is expected that this fiber could be useful in interferometry, filtering, and sensing applications in the THz range where polarized lights are favorably essential.

In vivo sedative and hypnotic activities of methanol extract from the leaves of Jacquemontia paniculata (Burm.f.) Hallier f. in Swiss Albino mice.

BACKGROUND: The superior genus Jacquemontia belongs to Convolvulaceae, with around 120 species, and is also considered taxonomically difficult. The aim of this experiment was to assess the sedative and hypnotic activities of methanol extract from the leaves of Jacquemontia paniculata (Burm.f.) Hallier f. METHODS: The sedative and hypnotic activities were evaluated by hole-cross, open field, hole-board, elevated plus maze (EPM), and thiopental sodium-induced sleeping time determination tests in mice at doses of 200 and 400 mg/kg. RESULTS: In this investigation, we found that methanol extract of Jacquemontia paniculata (MEJP) produced a significant dose-dependent inhibition of spontaneous activity of mice both in hole-cross and open field tests. In addition, it also decreased the number of head dips in hole-board test. In the case of EPM test, this crude extract induced an anxiogenic-like effect rather than anxiolytic effect in mice. Moreover, MEJP significantly decreased the induction time to sleep and prolonged the duration of sleeping, induced by thiopental sodium. CONCLUSIONS: To conclude, these results suggest that the MEJP leaves possess potent sedative and hypnotic activities, which supported its therapeutic use for sleep disorders like insomnia.