Implementing radical cure diagnostics for malaria: user perspectives on G6PD testing in Bangladesh.

BACKGROUND: The radical cure of Plasmodium vivax requires treatment with an 8-aminoquinoline drug, such as primaquine and tafenoquine, to eradicate liver hypnozoite stages, which can reactivate to cause relapsing infections. Safe treatment regimens require prior screening of patients for glucose-6-phosphate dehydrogenase (G6PD) deficiency to avoid potential life-threatening drug induced haemolysis. Testing is rarely available in malaria endemic countries, but will be needed to support routine use of radical cure. This study investigates end-user perspectives in Bangladesh on the introduction of a quantitative G6PD test (SD Biosensor STANDARD™ G6PD analyser) to support malaria elimination. METHODS: The perspectives of users on the SD Biosensor test were analysed using semi-structured interviews and focus group discussions with health care providers and malaria programme officers in Bangladesh. Key emerging themes regarding the feasibility of introducing this test into routine practice, including perceived barriers, were analysed. RESULTS: In total 63 participants were interviewed. Participants emphasized the life-saving potential of the biosensor, but raised concerns including the impact of limited staff time, high workload and some technical aspects of the device. Participants highlighted that there are both too few and too many P. vivax patients to implement G6PD testing owing to challenges of funding, workload and complex testing infrastructure. Implementing the biosensor would require flexibility and improvisation to deal with remote sites, overcoming a low index of suspicion and mutual interplay of declining patient numbers and reluctance to test. This approach would generate new forms of evidence to justify introduction in policy and carefully consider questions of deployment given declining patient numbers. CONCLUSIONS: The results of the study show that, in an elimination context, the importance of malaria needs to be maintained for both policy makers and the affected communities, in this case by ensuring P. vivax, PQ treatment, and G6PD deficiency remain visible. Availability of new technologies, such as the biosensor, will fuel ongoing debates about priorities for allocating resources that must be adapted to a constantly evolving target. Technical and logistical concerns regarding the biosensor should be addressed by future product designs, adequate training, strengthened supply chains, and careful planning of communication, advocacy and staff interactions at all health system levels.

Marine Debris and Trace Metal (Cu, Cd, Pb, and Zn) Pollution in the Stranded Green Sea Turtles (Chelonia mydas).

Marine debris and trace metals are among the common environmental contaminants known to affect marine organisms. In this study, the quantitative and qualitative aspects of marine debris levels and bioaccumulation of trace metals (Cadmium: Cd; Copper: Cu; Lead: Pb; and Zinc: Zn) were investigated in 42 green sea turtles (Chelonia mydas) stranded on the northern coast of the Sea of Oman. The greatest quantity of debris was found in the intestine, stomach, and esophagus of the animals, respectively. Results of a Marine Strategy Framework Directive (MSFD) subcategory analysis of the ingested debris showed that sheet and thread-like plastics were the most frequently detected debris followed by various rubbish. The results revealed that white-colored debris were the most common debris, followed by black > green > blue > transparent > and brown ones. The results suggested that the rope monofilament was the main source of the ingested debris by the green sea turtles. Concentrations of the trace metals in the liver, kidney, and muscle ranged between 0.66-33.43, 0.36-15.12, and 0.33-7.47 µg/g (ww), respectively. The results of this study suggest that ingested marine debris and tissue concentrations of trace metals are present at levels that may cause sublethal effects on green sea turtles (C. mydas) through potentially affecting the physiological processes and making the turtles susceptible to other natural or human threats. Results indicated that the green sea turtles from the northern coast of the Sea of Oman have high interaction with the marine debris. These factors are considered as a serious threat to the existence and survival of the green sea turtles (C. mydas) living on the northern coast of the Sea of Oman.

Biochemical and histological alterations induced by the smoke of allethrin based mosquito coil on mice model.

BACKGROUND: Mosquito coil (MC) emits insecticide upon burning which provides limited protection against lethal mosquito borne diseases. However, apart from killing the insect, toxicities associated with the inhalation of these insecticides poses severe health hazards. However, the use of MC is increasing day by day in third world countries in particular but, yet to receive enough attention of both policy maker and general public. The current study was aimed to assess the MC smoke induced damage of pulmonary and hepatic tissues along with observing the alterations of several blood biochemical parameters in mice model. METHODS: A total of twenty four Swiss albino mice were allowed to inhale the smoke of allethrin based MC at different duration per day for 120 days. By the end of treatment period, blood sample was drawn from each mouse and blood biochemical parameters including alanine transaminase (ALT), aspartate transaminase (AST), blood urea nitrogen(BUN), serum total protein, cholesterol, low density lipoprotein (LDL) and triglyceride (TG) were analyzed. Intact lung and liver were collected for histological analysis using standard protocol. RESULTS: Biochemical study indicates elevated activity of two hepatic enzymes: ALT (89%), AST (85%), in comparison with the respective control. Increased level of some parameters of lipid profile including cholesterol (36%), LDL (48%) and triglyceride (30%) in smoke inhaled mice is the new finding of this study. On the contrary, the activity of serum total protein and BUN was decreased by 20% and 24%, respectively in inhaled mice. Pulmonary tissue of treated mice shows severe forms of emphysema and hyperplasia, especially in the peripheral region of lung, which is the hallmark of chronic obstructive pulmonary disease (COPD). Histological study of hepatic tissue shows apoptosis mediated damage of hepatocytes along with severe form of necrosis. Infiltration of Inflammatory cells was also observed in both of the organs. CONCLUSION: Results from the present studies suggest that chronic exposure of allethrin based MC is responsible factor for severe health complications such as COPD due to the alterations of the key biochemical parameters of blood and histo-organization of lung and liver.

Molecular Dynamics Study of the Hydrophilic-to-Hydrophobic Switching in the Wettability of a Gold Surface Corrugated with Spherical Cavities.

This paper reports a large scale molecular dynamics (MD) simulation study of the wettability of a gold surface engraved with (hemi)spherical cavities. By increasing the depth of cavities, the contact angle (CA) of a water droplet on the surface was varied from a hydrophilic (69°) to a hydrophobic value (>109°). The nonmonotonic behavior of the CA vs the depth of the cavities was consistent with the Cassie-Baxter theory, as found in the experiment by Abdelsalam et al. (Abdelsalam, M. E.; Bartlett, P. N.; Kelf, T.; Baumberg, J. Wetting of Regularly Structured Gold Surfaces. Langmuir 2005, 21, 1753-1757). Depending on the depth of cavities, however, the droplet existed not only in the Cassie-Baxter state, but also in the Wenzel or an intermediate state, where the cavities were penetrated partially by the droplet.

Genetic characterization and linkage analysis of spotted leaf 6,liguleless and lax panicle traits in mutant rice.

Phenotypic mutants are valuable resources for elucidating the function of genes responsible for their expression. This study examined mutant rice strains expressing three traits: spotted leaf 6 (spl6), lax panicle (lax), and liguleless (lg). In the mutant, the spl6 phenotype was a genetically programmed lesion-mimicking mutation (LMM) that displayed spontaneously scattered spots across the leaf surface. In the lg trait, the plant lacked a collar region, and there were no auricles and ligules at the junction of the leaf blade and leaf sheath. The lax panicle trait manifested as sparely arranged spikelets resulting from the terminal spikelet with no lateral spikelets, which caused a drastic reduction of the total seed number in the mutant. All three mutant genes were genetically recessive and had nuclear gene regulation. The dihybrid segregation of the lg gene was classified independently according to the Mendelian 9:3:3:1 dihybrid segregation ratio in the F2 generation, suggesting that the lg gene is not linked to the same chromosome as the lax and spl6 genes. On the other hand, spl6 and lax were not assorted independently, indicating that they are closely linked on chromosome 1 in rice. Additional linkage analysis from the recombination of spl6 and lax genes reconfirmed that the two genes were ~9.4 cM away from each other. The individual single-gene mutant plant from one plant with a three-gene mutation (spl6, lax, and lg) was isolated and characterized, which will be a crucial resource for the gene cloning and molecular characterization of these genes.

Assessment of the salt tolerance of diverse bread wheat (Triticum aestivum L.) genotypes during the early growth stage under hydroponic culture conditions.

Objectives: Soil salinity affects the growth of crop plants, leading to reduced productivity, and is a major challenge for wheat production worldwide. Various adaptations and mitigation approaches in combination with tolerant wheat genotypes can be useful for the sustainability of crop production in saline environments. However, the development of salt-tolerant wheat genotypes is one of the best and most efficient solutions for obtaining desirable yields. Considering these issues, an investigation was carried out under hydroponic nutrient culture conditions to assess the genetic variability and selection of salt-tolerant wheat genotypes by categorizing inequitable morphophysiological and genetic variability as well as multivariate analysis. Methods: To meet the objectives of this study, 100 wheat genotypes were tested hydroponically in 0 (control) and 15 dS m-1 salt solutions. Conclusion: For all the wheat genotypes grown under saline conditions, the shoot length (SL), root length (RL), shoot fresh weight (SFW), root fresh weight (RFW), total fresh weight (TFW), shoot dry weight (SDW), root dry weight (RDW), and total dry weight (TDW) decreased significantly. Furthermore, significant variation was observed among the genotypes in terms of their characteristics only under saline conditions. In the case of genetic diversity analysis, a high genotypic coefficient of variation (GCV), phenotypic coefficient of variation (PCV), genetic advance in the percentage of the mean (GAM) and high heritability (h2b) were recorded for all tested wheat genotypes based on the SDW, RDW and TDW. Correlation analysis for both genotypic and phenotypic relationships revealed strong positive correlations for TDW, SDW, TFW and SFW. Principal component analysis (PCA) revealed that TDW, TFW, SDW, and SFW were the most discriminative variables for the wheat genotypes, which was confirmed by discriminant function analysis (DFA). PCA-biplot analysis also revealed significant positive correlations between SDW and SFW and between TDW and TFW. Hierarchical cluster analysis was performed for ten clusters based on the relative performance of the genotypes, where the genotypes were characterized into salt-tolerant, medium-salt-tolerant, medium-salt-susceptible and salt-susceptible groups. Among the genotypes, G11, G25 and G29 under cluster VII were categorized as salt tolerant based on their outstanding performance in terms of characteristics only under saline conditions. D2 analysis proved that the wheat genotypes of this cluster were highly divergent from the other cluster genotypes; as a result, these genotypes might be utilized as parents in the development of salt-tolerant wheat genotypes. The current study concluded that SDW and TDW could be employed as criteria for selecting and defining salt-tolerant genotypes during the early growth stage of wheat.

Characterization of Plant-Derived Natural Inhibitors of Dipeptidyl Peptidase-4 as Potential Antidiabetic Agents: A Computational Study.

Diabetes, characterized by elevated blood sugar levels, poses significant health and economic risks, correlating with complications like cardiovascular disease, kidney failure, and blindness. Dipeptidyl peptidase-4 (DPP-4), also referred to as T-cell activation antigen CD26 (EC 3.4.14.5.), plays a crucial role in glucose metabolism and immune function. Inhibiting DPP-4 was anticipated as a potential new therapy for diabetes. Therefore, identification of plant-based natural inhibitors of DPP-4 would help in eradicating diabetes worldwide. Here, for the identification of the potential natural inhibitors of DPP-4, we developed a phytochemicals library consisting of over 6000 phytochemicals detected in 81 medicinal plants that exhibited anti-diabetic potency. The library has been docked against the target proteins, where isorhamnetin, Benzyl 5-Amino-5-deoxy-2,3-O-isopropyl-alpha-D-mannofuranoside (DTXSID90724586), and 5-Oxo-7-[4-(trifluoromethyl) phenyl]-4H,6H,7H-[1,2]thiazolo[4,5-b]pyridine 3-carboxylic acid (CHEMBL3446108) showed binding affinities of -8.5, -8.3, and -8.3 kcal/mol, respectively. These compounds exhibiting strong interactions with DPP-4 active sites (Glu205, Glu206, Tyr547, Trp629, Ser630, Tyr662, His740) were identified. ADME/T and bioactivity predictions affirmed their pharmacological safety. Density functional theory calculations assessed stability and reactivity, while molecular dynamics simulations demonstrated persistent stability. Analyzing parameters like RMSD, RG, RMSF, SASA, H-bonds, MM-PBSA, and FEL confirmed stable protein-ligand compound formation. Principal component analysis provided structural variation insights. Our findings suggest that those compounds might be possible candidates for developing novel inhibitors targeting DPP-4 for treating diabetes.

Stability and performance analysis of storage root yield in a dataset of sweet potato varieties (Ipomoea batatas L.).

The dataset focuses on evaluating the performance of 17 sweet potato varieties (G) released by the Bangladesh Agricultural Research Institute (BARI) in terms of storage root yield and stability across five locations (E) in Bangladesh-Gazipur, Bogura, Jamalpur, Jashore, and Chattogram. The result revealed that BARI Mistialu-12 exhibited the highest average storage root yield at 45.35 t/ha, closely followed by BARI Mistialu-16 at 44.64 t/ha. Conversely, BARI Mistialu-1 had the lowest mean yield of 25.99 t/ha. Among the locations, Bogura recorded the highest mean root yield at 37.05 t/ha, while Chattogram exhibited the lowest at 31.27 t/ha. A combined analysis of variance revealed the presence of variability in storage root yield attributed to the genotype-location (environment) interaction (GEI). To delve deeper into this interaction, additive and multiplicative interaction effect models (AMMI) along with a linear mixed model (LMM) were employed for further investigations to confirm the significant contribution of GEI variance to root yield. The LMM results showed genetic variance (%), heritability (%), selection accuracy (%), and GEI correlation coefficients of 52.27, 54, 94, and 30, respectively. The AMMI analysis indicated that the first two principal components accounted for 74.60 % of GEI, with 20.16 % attributed to it. Assessing significant Interaction Principal Component Analyses (IPCAs) through the Weighted Average of Absolute Scores (WAAS) indicated that BARI Mistialu-12 is the most stable genotype, followed by BARI Mistialu-16 and BARI Mistialu-8, all displaying above-average root yield. The mega-environment analysis associated the highest root production of BARI Mistialu-11 and BARI Mistialu-2 with the Jamalpur location, while Gazipur, Bogura, and Jashore were linked with the superior performance of BARI Mistialu-12 and BARI Mistialu-16 genotypes. These findings are crucial for future breeding programs and the rapidly growing sweet potato industry, given the stable high-yield potential across diverse agro-ecological conditions. However, it is imperative to repeat the study to ensure reliable outcomes.

Monte Carlo study on the self-assembly of nanoparticles into a nanorod structure.

It is well known that semiconductor nanoparticles (NPs) can assemble into a range of low dimensional structures, such as nanowires, nanorods and nanosheets. In this study, we investigate the self-assembly of CdTe NPs by using Monte Carlo simulation. Using a simple model for the anisotropic interaction of NPs, the present Monte Carlo simulation demonstrated that NPs with large dipole moments assemble spontaneously into a nanorod even if the short range interactions among NPs is isotropic. Interestingly, we found that the present nanorod grew by forming a transient structure which looks similar to a double ring. For NPs similar to CdTe, the dipole-dipole interaction had a dominant effect over van der Waals attractions and steric repulsion on the final structure of the NP aggregates. The simulated rods are similar to those observed in the experimental self-assembly of CdTe NPs. The NPs with relatively small electric dipole moments aggregated into more or less isotropic structures.

Identification of medicinal plant-based phytochemicals as a potential inhibitor for SARS-CoV-2 main protease (Mpro) using molecular docking and deep learning methods.

Highly transmissive and rapidly evolving Coronavirus disease-2019 (COVID-19), a viral disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), triggered a global pandemic, which is one of the most researched viruses in the academia. Effective drugs to treat people with COVID-19 have yet to be developed to reduce mortality and transmission. Studies on the SARS-CoV-2 virus identified that its main protease (Mpro) might be a potential therapeutic target for drug development, as this enzyme plays a key role in viral replication. In search of potential inhibitors of Mpro, we developed a phytochemical library consisting of 2431 phytochemicals from 104 Korean medicinal plants that exhibited medicinal and antioxidant properties. The library was screened by molecular docking, followed by revalidation by re-screening with a deep learning method. Recurrent Neural Networks (RNN) computing system was used to develop an inhibitory predictive model using SARS coronavirus Mpro dataset. It was deployed to screen the top 12 compounds based on their docked binding affinity that ranged from -8.0 to -8.9 kcal/mol. The top two lead compounds, Catechin gallate and Quercetin 3-O-malonylglucoside, were selected depending on inhibitory potency against Mpro. Interactions with the target protein active sites, including His41, Met49, Cys145, Met165, and Thr190 were also examined. Molecular dynamics simulation was performed to analyze root mean square deviation (RMSD), root mean square fluctuation (RMSF), radius of gyration (RG), solvent accessible surface area (SASA), and number of hydrogen bonds. Results confirmed the inflexible nature of the docked complexes. Absorption, distribution, metabolism, excretion, and toxicity (ADMET), as well as bioactivity prediction confirmed the pharmaceutical activities of the lead compound. Findings of this research might help scientists to optimize compatible drugs for the treatment of COVID-19 patients.

Adherence to Anti-Malarial Treatment in Malaria Endemic Areas of Bangladesh.

Ensuring adherence to antimalarial treatment is crucial for achieving a radical cure and elimination of malaria, especially in hard-to-reach areas. We conducted this study to assess the current scenario of drug adherence in four endemic sub-districts of Bangladesh. Among 110 enrolled participants, 70% were mono-infected with Plasmodium falciparum and the remaining 30% with P. vivax. The overall treatment adherence frequency was 92.7% (95% CI: 83.0-96.3%). A total of eight participants were found to be nonadherent to treatment and all of them were from Bandarban. Level of nonadherence was equally observed in two age groups: 11-17 and 18+ years. However, male participants (n = 6) were found to be more nonadherent than females (n = 2). Among 7.3% with nonadherence to treatment, a single participant with P. falciparum mono-infection refused to take medication and became nonadherent. Remaining participants stated that they were feeling well and going to work, thus leaving treatment course uncompleted. Although overall compliance with malaria medication seems good, a gradual increase in noncompliance to P. vivax malaria treatment suggests that the National Malaria Elimination Program must be enhanced and monitored to fulfil the projected malaria elimination goal before 2030 from Bangladesh.

Genetic analysis of a DROOPING LEAF mutant allele dl-6 associated with a twisted and folded leaf base caused by a deficiency in midrib development in rice.

The failure of midrib formation in rice leaf blades results in the drooping leaf (dl) phenotype. A normal DROOPING LEAF (DL) gene is necessary for leaf homeotic transformation, which affects midrib and pistil development. Genetic analysis was performed on a new drooping leaf (dl) mutant named dl-6 in rice. The dl-6 allelic mutant exhibited drooping leaves that were severely folded and twisted at the base but had normal flower structure. The dl-6 allele is a nuclear recessive trait that fits a 3:1 Mendelian segregation ratio. The dl-6 mutant leaves displayed an abnormal main vein (midrib-less) with undeveloped aerenchyma and vascular bundles, resulting in severe leaf drooping. The lack of a midrib in dl-6 caused weak mechanical support, which resulted in folding at the collar junction of the leaf base and downward bending. Through genetic mapping, the dl-6 allele was identified at approximately 28.2 cM on rice chromosome 3. The allele was caused by mutations within the DL (LOC_Os03g11600.1) gene, with specific amino acid substitutions and additions in the encoded protein of the YABBY transcription factor. The dl-6 mutant is a recessive allele encoding a dysfunctional YABBY transcription factor that regulates leaf midrib development and aerenchymatous clear cell structures, leading to a drooping leaf phenotype in rice.

Analysis of gyrobianisotropic media effect on the input impedance, field distribution and mutual coupling of a printed dipole antenna.

In this paper, we present an analytical study for the investigation of the effects of the magnetoelectric elements of a reciprocal and nonreciprocal bianisotropic grounded substrate on the input impedance, resonant length of a dipole antenna as well as on the mutual coupling between two element printed dipole array in three configuration geometries: broadside, collinear and echelon printed on the same material. This study examines also the effect of the considered bianisotropic medium on the electric and magnetic field distributions that has been less addressed in the literature for antenna structures. Computations are based on the numerical resolution, using the spectral method of moments, of the integral equation developed through the mathematical derivation of the appropriate spectral Green's functions of the studied dipole configuration. Original results, for chiral, achiral, Tellegen and general bi-anisotropic media cases, are obtained and discussed with the electric and magnetic field distributions for a better understanding and interpretation. These interesting results can serve as a stepping stone for further works to attract more attention to the reciprocal and non-reciprocal Tellgen media in-depth studies.

Rice Lesion Mimic Mutants (LMM): The Current Understanding of Genetic Mutations in the Failure of ROS Scavenging during Lesion Formation.

Rice lesion mimic mutants (LMMs) form spontaneous lesions on the leaves during vegetative growth without pathogenic infections. The rice LMM group includes various mutants, including spotted leaf mutants, brown leaf mutants, white-stripe leaf mutants, and other lesion-phenotypic mutants. These LMM mutants exhibit a common phenotype of lesions on the leaves linked to chloroplast destruction caused by the eruption of reactive oxygen species (ROS) in the photosynthesis process. This process instigates the hypersensitive response (HR) and programmed cell death (PCD), resulting in lesion formation. The reasons for lesion formation have been studied extensively in terms of genetics and molecular biology to understand the pathogen and stress responses. In rice, the lesion phenotypes of most rice LMMs are inherited according to the Mendelian principles of inheritance, which remain in the subsequent generations. These rice LMM genetic traits have highly developed innate self-defense mechanisms. Thus, although rice LMM plants have undesirable agronomic traits, the genetic principles of LMM phenotypes can be used to obtain high grain yields by deciphering the efficiency of photosynthesis, disease resistance, and environmental stress responses. From these ailing rice LMM plants, rice geneticists have discovered novel proteins and physiological causes of ROS in photosynthesis and defense mechanisms. This review discusses recent studies on rice LMMs for the Mendelian inheritances, molecular genetic mapping, and the genetic definition of each mutant gene.

Stomatal development and genetic expression in Arabidopsis thaliana L.

Stomata are turgor-driven microscopic epidermal valves of land plants. The controlled opening and closing of the valves are essential for regulating the gas exchange and minimizing the water loss and eventually regulating the internal temperatures. Stomata are also a major site of pathogen/microbe entry and plant defense system. Maintaining proper stomatal density, distribution, and development are pivotal for plant survival. Arabidopsis is a model plant to study molecular basis including signaling pathways, transcription factors, and key components for the growth and development of specific organs as well as the whole plant. It has intensively been studied and found out the driver for the development and patterning of stomata. In this review, we have explained how the MAPK signaling cascade is controlled by TOO MANY MOUTHS (TMM) receptor-like protein and the Erecta (ER) receptor-like kinase family. We have also summarized how this MAPK cascade affects primary transcriptional regulators to finally activate the main three basic Helix-Loop-Helix (bHLH) principal transcription factors, which are required for the development and patterning of stomata. Moreover, regulatory activity and cellular connections of polar proteins and environmentally mediated ligand-receptor interactions in the stomatal developmental pathways have extensively been discussed in this review.

Community-based antibiotic access and use in six low-income and middle-income countries: a mixed-method approach.

BACKGROUND: Antimicrobial misuse is common in low-income and middle-income countries (LMICs), and this practice is a driver of antibiotic resistance. We compared community-based antibiotic access and use practices across communities in LMICs to identify contextually specific targets for interventions to improve antibiotic use practices. METHODS: We did quantitative and qualitative assessments of antibiotic access and use in six LMICs across Africa (Mozambique, Ghana, and South Africa) and Asia (Bangladesh, Vietnam, and Thailand) over a 2·5-year study period (July 1, 2016-Dec 31, 2018). We did quantitative assessments of community antibiotic access and use through supplier mapping, customer exit interviews, and household surveys. These quantitative assessments were triangulated with qualitative drug supplier and consumer interviews and discussions. FINDINGS: Vietnam and Bangladesh had the largest proportions of non-licensed antibiotic dispensing points. For mild illness, drug stores were the most common point of contact when seeking antibiotics in most countries, except South Africa and Mozambique, where public facilities were most common. Self-medication with antibiotics was found to be widespread in Vietnam (55·2% of antibiotics dispensed without prescription), Bangladesh (45·7%), and Ghana (36·1%), but less so in Mozambique (8·0%), South Africa (1·2%), and Thailand (3·9%). Self-medication was considered to be less time consuming, cheaper, and overall, more convenient than accessing them through health-care facilities. Factors determining where treatment was sought often involved relevant policies, trust in the supplier and the drug, disease severity, and whether the antibiotic was intended for a child. Confusion regarding how to identify oral antibiotics was revealed in both Africa and Asia. INTERPRETATION: Contextual complexities and differences between countries with different incomes, policy frameworks, and cultural norms were revealed. These contextual differences render a single strategy inadequate and instead necessitate context-tailored, integrated intervention packages to improve antibiotic use in LMICs as part of global efforts to combat antibiotic resistance. FUNDING: Wellcome Trust and Volkswagen Foundation.

Precarity at the Margins of Malaria Control in the Chittagong Hill Tracts in Bangladesh: A Mixed-Methods Study.

Bangladesh has achieved significant progress towards malaria elimination, although health service delivery for malaria remains challenging in remote forested areas such as the Chittagong Hill Tracts (CHT). The aim of this study was to investigate perceptions of malaria and its treatment among the local population to inform contextualized strategies for rolling out radical cure for P. vivax in Bangladesh. The study comprised two sequential strands whereby the preliminary results of a qualitative strand informed the development of a structured survey questionnaire used in the quantitative strand. Results show that ethnic minority populations in the CHT live in precarious socio-economic conditions which increase their exposure to infectious diseases, and that febrile patients often self-treat, including home remedies and pharmaceuticals, before attending a healthcare facility. Perceived low quality of care and lack of communication between Bengali health providers and ethnic minority patients also affects access to public healthcare. Malaria is viewed as a condition that affects vulnerable people weakened by agricultural work and taking away blood is perceived to increase such vulnerability. Healthcare providers that initiate and sustain a dialogue about these issues with ethnic minority patients may foster the trust that is needed for local malaria elimination efforts.

What influences antibiotic sales in rural Bangladesh? A drug dispensers' perspective.

BACKGROUND: Antibiotic resistance poses a great threat to global health, especially in low- and middle-income countries with a high infectious disease burden and limited resources. In spite of regulations, antibiotics are sold in many settings as non-prescription medicines, resulting in inappropriate use and resistance. OBJECTIVE: This study aimed to investigate the current status of access and use of antibiotics in rural Bangladesh, by exploring the perspectives and sales practices of antibiotic drug dispensers. METHODS: We used a mixed methods approach (qualitative and quantitative). We mapped and characterized antibiotic purchasing and dispensing sites in the Matlab Health and Demographic Surveillance System catchment area. Furthermore, we investigated the volume of provision of systemic antibiotics in 10 drug outlets. We held 16 in-depth interviews with randomly selected antibiotics dispensers. Interviews explored factors associated with antibiotic selling. Responses were transcribed, coded for themes, and summarized. We used ATLAS.ti 5.2 for conducting a thematic analysis. RESULTS: A total of 301 antibiotic dispensers were identified, of whom 92% (n = 278) were private and 8% (n = 23) public. 52% (n = 155) operated informally (i.e. without legal authorization). In order to promote and survive in their business, dispensers sell antibiotics for a range of conditions without a qualified physician's prescription. Factors that facilitate these inappropriate sales include lack of access to healthcare in the rural community, inadequate doctor: population ratio, limited dispenser knowledge, poor pharmacovigilance concerning safety of self medication, lack of enforcement of policies, financial benefits for both customers and dispensers, and high dependency on pharmaceutical companies' information. CONCLUSION: Dispensers in rural Bangladesh sell antibiotics inappropriately by ignoring existing national regulations. They operate the antibiotic sales without facing any legal barriers and primarily with a view to sustain their business, resulting in inappropriate sales of antibiotics to the rural community. The influence of the drug industry needs to be replaced with evidence-based, not commercially driven information. Awareness programs for antibiotic providers that promote understanding of antibiotics and antibiotic resistance through tailored interventions may be helpful in changing current antibiotic sales practices.

Feasibility Study on Discrimination of Neo-plastic and Non-Neoplastic Gastric Tissues Using Spark Discharge Assisted Laser Induced Breakdown Spectroscopy.

Introduction: The present work is a novel in vitro study that evaluated the possibility of diagnosing neoplastic from nonneoplastic gastric tissues using spark discharge assisted laser induced breakdown spectroscopy (SD-LIBS) method. Methods: In these experiments, the low energy laser pulses ablated a tiny amount of tissue surface leading to plasma formation. Then, a spark discharge was applied to plasma in order to intensify the plasma radiation. Light emission from plasma was recorded as spectra which were analyzed. Gastric tissues of 5 people were studied through this method. Results: The SD-LIBS technique had the potential to discriminate normal and cancerous tissues based on the significant differences in the intensities of some particular elements. The comparison of normalized calcium (Ca) and magnesium (Mg) peaks of neoplastic and nonneoplastic gastric tissues could be viewed as a practical measure for tissue discrimination since Ca and Mg peaks in spectra of neoplastic were noticeably higher than nonneoplastic. Conclusion: Considering the identification of gastric cancer, the applied method in these experiments seems quite fast, noninvasive and cost-effective with respect to other conventional methods. The significant increment of specific Ca and Mg lines of neoplastic gastric tissues in comparison to the nonneoplastic ones can be considered as valuable information that might bring about tissue classification. The number of samples in this work, however, was not sufficient for a decisive conclusion and further researches is needed to generalize this idea.

Association between intimate partner violence and child morbidity in South Asia.

BACKGROUND: This study investigates the association between intimate partner violence (IPV) against women and its impact on child morbidity in the south Asian region. METHODS: The analysis uses logistic regression models with cross sectional nationally representative data from three countries - Bangladesh, India and Nepal. The data have been pooled from 'Demographic and Health Surveys' (DHS) of Bangladesh, Nepal and 'National Family and Health Survey' (NFHS) of India. RESULTS: The study revealed that after controlling for potential confounders, children of mothers experiencing physical violence, sexual violence or both were more likely to have Acute Respiratory Infection (ARI) (OR(adj) 1.57; 95% CI 1.48-1.67), fever (OR(adj) 1.44; 95% CI 1.35-1.54) and diarrhea (OR(adj )1.56; 95% CI 1.44-1.69). CONCLUSIONS: The results highlight that IPV can influence childhood morbidity and support the need to address IPV with a greater focus within current child nutrition and health programs and policies.