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Cohort profile: A prospective cohort study on newlywed couples in rural and poor urban Bangladesh

Sexual and Reproductive Health and Rights (SRHR) aim to enhance quality of life through safe sexual experiences, reproductive autonomy, and protection against gender-based violence. However, existing SRHR research and interventions in low- and middle-income countries like Bangladesh predominantly focus on women, often understating men and neglecting the nuanced contextual issues faced by married couples. This study contributes to filling this gap by examining SRHR dynamics among newlyweds in rural and poor urban areas of Bangladesh, especially focusing on marital satisfaction, fertility preferences, and post-marriage adaptation mechanisms. Employing a prospective cohort design across four Health and Demographic Surveillance Systems (HDSS) managed by icddr,b, the study spans from November 2021 to March 2025, with data collection starting in December 2022. Of the 2011 newlywed couples identified, 666 who met eligibility criteria (married for ≤6 months, first marriage, and no pregnancy history) were enrolled. Participants will undergo six quantitative interview sessions over a two-year period. Additionally, 44 in-depth qualitative interviews were conducted with 22 purposefully selected couples. Demographic data reveal that a significant proportion of husbands (67.3% in rural areas, 71.8% in poor urban areas) are aged 20–29 years, while a majority of wives (67.9% in rural areas, 84.8% in poor urban areas) are adolescents. Education levels varied, with a higher proportion of poor urban husbands lack formal education compared to their rural counterparts (7.2% vs. 3.0%), while no significant variation was observed among wives (0.6% vs 1.0%). Arranged marriages are more common among rural couples (80%) compared to those in poor urban areas (50%). Moreover, poor urban participants tend to marry at a younger age than the rural participants, with poor urban wives marrying earlier than rural wives (60.4% vs 39.7%). This pioneering study provides valuable insights into the SRHR needs of newlywed couples in Bangladesh. The findings will be instrumental for designing targeted interventions aimed at improving SRHR service utilization and enhancing overall well-being, particularly in rural and poor urban areas of the country.

E-cigarettes are not associated with post-acute COVID-19 syndrome among US adults

Densely populated macrocyclic dicobalt sites in ladder polymers for low-overpotential oxygen reduction catalysis

Long-term dynamics of density dependence reveals a more stable effect of the neighborhood on tree growth than tree survival

Density dependence is a vital mechanism for explaining tree species diversity. Empirical studies worldwide have demonstrated that neighbor density influences plant survival and growth in various communities. However, it remains unclear how neighbor density affects plant survival and growth over extended periods. We used data from tree censuses collected every five years from 1981 to 2015 (seven intervals) to assess how density dependence affects adult tree survival and growth by using generalized linear mixed models and the coefficients of variation in Barro Colorado Island plot. Linear regression models were used to assess whether the effects of density dependence on tree survival and growth correlated with species abundance. The results indicated that the effects of tree size (DBH) on tree survival and growth differed across all intervals. We found that the effects of heterospecific neighbor density on tree survival varied over time and consistently had significant negative impacts on tree growth. Conspecific neighbor densities had significant negative effects on tree survival and growth across all intervals. The effect of density dependence on tree growth was more stable than its impact on tree survival. Additionally, the relationship of species abundance and the effect of negative conspecific and heterospecific neighbor densities significantly affected tree growth but not survival, with negative and positive correlations to tree abundance over time, respectively. Our results revealed that neighboring density dependence can predict more accurately of tree growth than survival.

Evaluating survival outcomes and treatment recommendations in resectable gastric cancer

Abstract No consensus exists on the optimal therapy for resectable gastric cancer (GC) and gastroesophageal junction (GEJ) tumors, including the effectiveness of chemoradiotherapy versus perioperative chemotherapy (PC). Our study aimed to compare overall survival (OS) outcomes associated with the recommended treatment modalities for GC and GEJ tumors and evaluate treatment trends from 2010 to 2020. A national registry cohort identified patients with ≥ cT2 nonmetastatic GC and GEJ cancer. Treatment modalities were classified as neoadjuvant chemotherapy (NC), neoadjuvant chemoradiotherapy (NCR), PC, adjuvant chemotherapy (AC), and adjuvant chemoradiation (ACR). Kaplan-Meier curve and multivariable Cox regression models evaluated factors associated with OS. A cohort of 7665 patients were included. Patients who received PC had the highest OS (median 86.80 months, 95% CI 73.40-NE), while chemoradiotherapy in the neoadjuvant and adjuvant settings had worse OS than PC and NC (NCR median 47.15 months, 95% CI 44.58–52.27, and ACR median 52.67 months, 95%CI 42.78–63.93). The Cox proportional hazards model showed that NCR and NC had worse survival than PC (HR 1.74, 95% CI 1.50–2.02, p < 0.001 and HR 1.26, 95% CI 1.10–1.44, p = 0.0008, respectively). Additionally, the most utilized modality during 2020 was NC (35.8%), followed by PC (28.0%) and NCR (24.9%). The utilization of PC and NC had the most substantial rise between 2010 and 2020, increasing by 11.0%. The study demonstrates the association of PC with improved OS outcomes for nonmetastatic GC and GEJ tumors. Therapies combining radiation with chemotherapy and extended lymph node dissection correlated with a worse prognosis compared to PC and NC. Despite the association with improved outcomes, national data reveals low utilization rates for PC.

RNA folding kinetics control riboswitch sensitivity in vivo

Transfer accuracy of partially enclosed single hard vacuum-formed trays with 3D-printed models for lingual bracket indirect bonding: A prospective in-vivo study

Objective This study aims to evaluate the clinical transfer accuracy of partially enclosed single hard vacuum-formed trays based on three-dimensional (3D) printed models for lingual bracket indirect bonding. Materials and methods Thirty-two consecutive patients receiving lingual orthodontic treatment were enrolled. Digital models with ideal bracket positions were 3D-printed, followed by fabrication of partially enclosed single hard vacuum-formed trays. Digital impressions captured actual bracket positions and were compared to the ideal positions. One-tailed t-tests assessed if errors were within clinically acceptable thresholds of 0.5 mm for linear measurements and 2° for angular measurements. Results Mean bracket transfer errors were 0.052 mm, 0.076 mm, 0.106 mm, 0.795°, 1.344°, and 2.485° for mesiodistal, buccolingual, occlusogingival, rotation, tip, and torque, respectively. Transfer errors were statistically below the clinically acceptable thresholds for all dimensions except torque. Frequencies of acceptable transfer errors were 100%, 100%, 99.3%, 93.1%, 78.3%, and 54.0%, respectively. Conclusion Partially enclosed single hard vacuum-formed trays with 3D-printed models transfer lingual brackets with high accuracy in the mesiodistal, buccolingual, and occlusogingival dimensions, rotation, and tip. However, the transfer of torque remains questionable.

Disrupted microsaccade responses in late-life depression

Fine-tuning d-p hybridization in Ni-Bx cocatalyst for enhanced photocatalytic H2 production

A scoping review to examine health care professionals’ experiences as family caregivers

Background Health and social care systems must confront the challenge of supporting a growing elderly population and their caregivers. Family caregivers who are healthcare professionals are part of this context, but their caregiving experiences remain unclear. Objective This scoping review explored the experiences of healthcare professionals who are also family caregivers for older adults. Methodology A scoping review methodology identified and summarized pertinent studies. Searches were conducted in Medline, Embase, PsycINFO, CINAHL, and AgeLine. We sought articles published from each journals’ inception to October 19, 2023. Inclusion criteria were English-language studies about healthcare professionals caring for older adult family members. Diverse research designs were included. Data were extracted and synthesized according to key themes. Results The review included 19 studies, highlighting four themes. Studies were published between 1994 and 2019, with most studies published before 2017. The overarching theme was "Expectations," where healthcare professional family caregivers faced multifaceted expectations from themselves, their families, and the healthcare system. Expectations also highlights the dual role of participants as both caregivers and healthcare professionals This complex interplay led to a theme related to personal consequences, including stress, guilt, and potential burnout, but also positive aspects of the dual roles. Studies described how dual roles could enhance the quality-of-care healthcare professional caregivers provided to their family members. Finally, support needs were identified, emphasizing the importance of workplace accommodations and support from the healthcare system and peers. Conclusions The experiences of healthcare professional family caregivers are shaped by unique expectations, resulting in both positive and negative consequences. The support needs of this group are multifaceted, requiring workplace accommodations and tailored support within the healthcare system. Further research is needed to delve deeper into the nuances of their experiences and develop targeted interventions to alleviate the stress and challenges they face in their dual roles. Understanding the evolving needs of healthcare professional family caregivers over time can inform support strategies along the caregiving trajectory.

Real-world clinical multi-omics analyses reveal bifurcation of ER-independent and ER-dependent drug resistance to CDK4/6 inhibitors

Prevalence of mortality caused by injuries at Livingstone University Hospital, Zambia. A retrospective cross-sectional study

Background Trauma is a major global public health issue, with an annual death toll of approximately 5 million, disproportionately affecting low- and middle-income countries. Zambia bears a significant burden of trauma-related mortalities, contributing to 7% of all annual deaths and 1 in 5 premature deaths in the country. Despite the significant burden of trauma in our country, few studies have been conducted, with most focusing on high-population centers, and there is a lack of epidemiological data on trauma-related deaths in our region. Therefore, our aim was to estimate the proportion of deaths caused by injuries at Livingstone University Teaching Hospital, a tertiary hospital located in Zambia’s southern province. Methods We conducted a retrospective cross-sectional study from June 22, 2020, to June 22, 2021, among 956 individuals from 1 month old (29 days of age) to 100 years. Demographic and clinical data were collected from patient’s records from Accident and Emergency department. Data analysis included descriptive statistics, chi square, mann-whitney test and multivariable logistic using forward stepwise generalized linear model equations (GLM) to identified factors associated with mortality, with a significance level set at p < 0.05. Data were analyzed using STATA version 15. Results Among the study participants, the median age was 26 years (interquartile range (IQR) 15, 37) and the majority were males (74.2%, n = 709). Prevalence of mortality was 1.0% (n = 10). The deaths were caused by burns (60%, n = 6), violence (30%, n = 3), and traffic accidents (10%, n = 1). Among those who died, the majority of the trauma occurred at home (90%, n = 9), followed by road (10%, n = 1) and were as a result of burns (60%, n = 6) and community violence (30%, n = 3). Survivors had significantly higher treatment costs (ZMK 9,837 vs. ZMK 6,037, p<0.005). Having burns (AOR: 1.06, 95% CI: 1.05, 1.09, p< 0.001) and hospital stay of one day (AOR: 1.04, 95% CI: 1.02, 1.05, p< 0.001) was positively associated with mortality, while hospital stay of more than five days (AOR: 0.98, 95% CI: 0.96, 0.99, p = 0.002) was negatively associated with mortality. Conclusion The prevalence of death due to trauma was relatively low, with the majority experiencing multiple traumas. Burns were the most common cause and were associated with death, occurring within a day of hospitalization. The findings underscore the need for targeted preventive measures, improved access to quality emergency trauma care, and rehabilitation services, especially among patients with burns.

Telomerase RNA structural heterogeneity in living human cells detected by DMS-MaPseq

Abstract Biogenesis of human telomerase requires its RNA subunit (hTR) to fold into a multi-domain architecture that includes the template-pseudoknot (t/PK) and the three-way junction (CR4/5). These hTR domains bind the telomerase reverse transcriptase (hTERT) protein and are essential for telomerase activity. Here, we probe hTR structure in living cells using dimethyl sulfate mutational profiling with sequencing (DMS-MaPseq) and ensemble deconvolution analysis. Approximately 15% of the steady state population of hTR has a CR4/5 conformation lacking features required for hTERT binding. The proportion of hTR CR4/5 folded into the primary functional conformation is independent of hTERT expression levels. Mutations that stabilize the alternative CR4/5 conformation are detrimental to telomerase assembly and activity. Moreover, the alternative CR4/5 conformation is not found in purified telomerase RNP complexes, supporting the hypothesis that only the primary CR4/5 conformer is active. We propose that this misfolded portion of the cellular hTR pool is either slowly refolded or degraded, suggesting that kinetic RNA folding traps studied in vitro may also hinder ribonucleoprotein assembly in vivo.

Protect or prevent? A practicable framework for the dilemmas of COVID-19 vaccine prioritization

Determining COVID-19 vaccination strategies presents many challenges in light of limited vaccination capacity and the heterogeneity of affected communities. Who should be prioritized for early vaccination when different groups manifest different levels of risks and contact rates? Answering such questions often becomes computationally intractable given that network size can exceed millions. We obtain a framework to compute the optimal vaccination strategy within seconds to minutes from among all strategies, including highly dynamic ones that adjust vaccine allocation as often as required, and even with modest computation resources. We then determine the optimal strategy for a large range of parameter values representative of various US states, countries, and case studies including retirement homes and prisons. The optimal is almost always one of a few candidate strategies, and, even when not, the suboptimality of the best among these candidates is minimal. Further, we find that many commonly deployed vaccination strategies, such as vaccinating the high risk group first, or administering second doses without delay, can often incur higher death rates, hospitalizations, and symptomatic infection counts. Our framework can be easily adapted to future variants or pandemics through appropriate choice of the compartments of the disease and parameters.

Coordinated conformational changes in P450 decarboxylases enable hydrocarbons production from renewable feedstocks

A linear tessellation model for the identification of “food desert”: A case study of Shanghai, China

The "food desert" problem has been treated under a national strategy in the United States and other countries. At present, there is little research on the phenomenon of "food desert" in China. This study takes Shanghai as the research area and proposes a multiscale analysis method using a linear tessellation model that splits the street network into homogeneous linear units. Firstly, the network kernel density estimation using a linear tessellation model is used to measure the travel-mode-based food accessibility. Considering the actual travel constraints, the GPS trajectory data of four travel modes (walking, bicycle, metro and taxi) are applied to calculate the speed of each linear unit. Secondly, the “food desert” phenomenon in Shanghai are identified combing with the results of the network K-function. Finally, the resident income conditions in different modes are fitted based on the housing price data and the spatial distribution of four "food desert" patterns are detected by the overlay analysis of food accessibility and resident income conditions. The experimental results show that fifty percent of Shanghai is characterized by low food accessibility, and half of these areas are disadvantaged and low-income areas in suburbs, which are the locations experiencing the “food desert” phenomenon. Comparing the results of the proposed method and that of the traditional planar method, the identification results for all modes based on the traditional planar method underestimate the severity of the “food desert”, especially for the bicycle and taxi modes. This study also provides corresponding decision-making reference for the alleviation and resolution of “food desert” issues. Moreover, the proposed method provides a new research perspective for urban research under the street network space.

PRMT1-methylated MSX1 phase separates to control palate development

Impact of high body mass index on hepatocellular carcinoma risk in chronic liver disease: A population-based prospective cohort study

Background and aims We investigated associations between body mass index (BMI) and hepatocellular carcinoma (HCC) in patients with hepatitis B (HBV) C (HCV) virus infection, alcoholic liver disease (ALD), non-alcoholic fatty liver disease (NAFLD), and liver cirrhosis (LC). Methods We followed 350,608 Korean patients with liver disease who underwent routine health examinations from 2003–2006 until December 2018 via national hospital discharge records. Multivariable adjusted hazard ratios (HRs) per 5-kg/m2 BMI increase (BMI ≥25 kg/m2) for HCC risk were calculated using Cox models. HCC developed in 17,752 patients. Results The HRs (95% CI) were 1.17 (1.06–1.28), 1.08 (0.87–1.34), 1.34 (1.14–1.58), 1.51 (1.17–1.94), and 1.11 (1.00–1.23) for HBV, HCV, ALD, NAFLD, and LC, respectively. The HRs for HBV were 1.45 (1.23–1.70) and 1.06 (0.95–1.19) in women and men, respectively; the corresponding HRs for LC were 1.27 (1.07–1.50) and 1.02 (0.90–1.16), respectively. In patients <65 years old with HBV, HCV, and NAFLD, the HRs were 1.17 (1.07–1.29), 1.33 (1.03–1.73), and 1.20 (0.87–1.64), respectively; the corresponding HRs were 1.05 (0.70–1.59), 0.74 (0.50–1.10), and 2.40 (1.62–3.54), respectively, in patients ≥65 years old. A BMI of 27.5–29.9 kg/m2 showed significantly higher HCC risks in patients with HBV, ALD, NAFLD, and LC. Conclusions Higher BMIs were associated with increased HCC risks in patients with HBV, ALD, NAFLD, and LC. Overweight status increased HCC risk. Women with HBV and LC had stronger BMI-HCC associations than men. The effect of high BMI was stronger in older patients with NAFLD and younger patients with viral hepatitis.

Metal-oxide phase transition of platinum nanocatalyst below fuel cell open-circuit voltage

Abstract The long-term stability of Pt-based catalysts is critical to the reliability of proton exchange membrane fuel cells (PEMFCs), and receives constant attention. However, the current knowledge of Pt oxidation is restricted to unrealistic PEMFC cathode environment or operation, which questions its practical relevance. Herein, Pt oxidation is investigated directly in a PEMFC with stroboscopic operando high energy X-ray scattering. The onset potential for phase transition of the nanoparticles surface from metallic to amorphous electrochemical oxide is observed far below previously reported values, and most importantly, below the open-circuit potential of PEMFC cathode. Such phase transition is shown to impact PEMFC performance and its role on Pt transient dissolution is verified by electrochemical on-line inductively coupled plasma mass spectrometry. By further demonstrating and resolving the limitations of currently employed accelerated stress test protocols in the light of metal-oxide phase transitions kinetics, this picture of Pt oxidation enables new mitigation strategies against PEMFC degradation.

Effects of clinical stage, behavioral and psychological symptoms of dementia, and living arrangement on social distance towards people with dementia

Background Dementia presents significant challenges, including social exclusion, which can be exacerbated by public stigma. This study aimed to clarify how social distances, a common measure of public stigma, towards people living with dementia and its associated factors vary with clinical stage, presence of behavioral and psychological symptoms of dementia (BPSD), and living arrangements. Methods The study involved 2,589 Japanese participants aged 40 to 90 years. They were exposed to one of four vignettes depicting an 80-year-old woman progressing from normal ageing to mild, moderate, and severe dementia: Vignette A (living with husband, without BPSD); Vignette B (living with husband, with BPSD); Vignette C (living alone, without BPSD); and Vignette D (living alone, with BPSD). Results Social distance showed no significant differences in the normal aging and mild stage of dementia across all vignettes. At the moderate stage, social distance was higher for individuals exhibiting BPSD, regardless of living arrangement. At the severe stage, the lowest social distance was observed towards individuals living with their family without BPSD, whereas the highest was towards those living alone, exhibiting BPSD. For Vignette A, possession of social capital (p<0.001) and having experience of social contact with people living with dementia (PLWD) (p = 0.001–0.007) were independently associated with lower social distance across all dementia stages. In addition, in the mild stage of dementia, high perceived social support (p = 0.005) and having knowledge about dementia (p = 0.036) were associated with lower social distance, but not in the moderate or severe stage of dementia. For Vignette D, possession of social capital (p≤0.001) and having experience of social contact with PLWD (p<0.001 to p = 0.006) were independently associated with lower social distance across all dementia stages. In mild dementia, female sex (p = 0.004) and knowledge about dementia (p = 0.026) were associated with lower social distance. Furthermore, in mild and moderate dementia, living in rural area (p = 0.003–0.048) was associated with lower social distance. Conclusions Social distance is higher toward PLWD who live alone and exhibit BPSD than toward those who live with family and/or do not show BPSD, indicating a higher risk of exclusion for the former. Moreover, factors affecting social distance towards PLWD vary across different clinical stages of dementia. While greater knowledge about dementia is associated with lower social distance toward PLWD, this effect appears to be most pronounced in the mild stage. In contrast, opportunities for social contact with PLWD are crucial for achieving lower social distance across all stages of dementia. The findings underscore the need for stage-specific interventions to address stigma, with a focus on education and opportunities for social contact. Targeted efforts are especially important for promoting the inclusion of PLWD who live alone and exhibit BPSD.