The creation of smart healthcare systems is a viable strategy to improve the quality and availability of healthcare services. Identity theft, data breaches, and denial-of-service attacks are just ...some of the security concerns that have arisen as a result of connecting wireless networks and smart medical equipment. A secure and trustworthy smart healthcare system that can protect patient data and preserve the confidentiality of private medical information is especially important in light of these vulnerabilities. Medical diagnosis assumes increasing importance as the amount of data created daily in the 6G-enabled Internet-of-Medical Things (IoMT) grows exponentially. To enhance the anticipation accuracy and supply a real-time medicinal diagnosis, this research presents an approach integrated into the 6G-enabled IoMT that requires less human intervention for healthcare applications. To do this, the proposed system combines deep learning with optimization methods. MobileNetV3 architecture is then used to learn the features taken from each image. In addition, we improved the performance of the HGS-based arithmetic optimization algorithm (AOA). The operators of the HGS are used in the new approach, dubbed AOAHG, to improve the AOA operation capacity as the viable province is divided up. We design a 6G-enabled IoMT approach that requires fewer humans in healthcare settings but yields faster diagnostic results. The new approach was developed to be used in systems with limited means. The created AOAHG prioritizes the most important features and guarantees an overall upgrade in model categorization. When compared to other methodologies in the literature, the framework’s results were impressive. The created AOAHG also outperformed alternative FS methods in terms of the achieved accuracy, precision, recall, and F1-score. For instance, AOAHG had 92.12% accuracy with the ISIC dataset, 98.27% with the PH2 dataset, 95.24% with the WBC dataset, and 99.84% with the OCT dataset.
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FIS, FZAB, GEOZS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Lipid-based formulations improve the absorption capacity of poorly-water-soluble drugs and digestion of the formulation is a critical step in that absorption process. A recent approach to ...understanding the propensity for drug to dissolve in digesting lipid-based formulations couples an in vitro pH-stat lipolysis model to small-angle X-ray scattering (SAXS) by means of a flow-through capillary. However, the conventional pH-stat apparatus used to measure the extent of lipid digestion during such experiments requires digest volumes of 15–30 mL and drug doses of 50–200 mg, which is problematic for scarce compounds and can require excessive amounts of formulation reagents. This manuscript describes an approach to reduce the amount of material required for in vitro lipolysis experiments coupled to SAXS, for use in instances where the amount of drug or formulation medium is limited. Importantly, this was achieved while maintaining the pH stat conditions, which is critical for maintaining biorelevance and driving digestion to completion. The digestibility of infant formula with the poorly-water-soluble drugs halofantrine and clofazimine dispersed into it was measured as an exemplar paediatric-friendly lipid formulation. Halofantrine was incorporated in its powdered free base form and clofazimine was incorporated both as unformulated drug powder and as drug in nanoparticulate form prepared using Flash NanoPrecipitation. The fraction of triglyceride digested was found to be independent of vessel size and the incorporation of drug. The dissolution of the two forms of clofazimine during the digestion of infant formula were then measured using synchrotron SAXS, which revealed complete and partial solubilisation over 30 min of digestion for the powdered drug and nanoparticle formulations, respectively. The main challenge in reducing the volume of the measurements was in ensuring that thorough mixing was occurring in the smaller digestion vessel to provide uniform sampling of the dispersion medium.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Human cytomegalovirus (HCMV) is a widespread virus that can cause serious and irreversible neurological damage in newborns and even death in children who do not have the access to much-needed ...medications. While some vaccines and drugs are found to be effective against HCMV, their extended use has given rise to dose-limiting toxicities and the development of drug-resistant mutants among patients. Despite half a century's worth of research, the lack of a licensed HCMV vaccine heightens the need to develop newer antiviral therapies and vaccine candidates with improved effectiveness and reduced side effects. In this study, the immunoinformatics approach was utilized to design a potential polyvalent epitope-based vaccine effective against the four virulent strains of HCMV. The vaccine was constructed using seven CD8+ cytotoxic T lymphocytes epitopes, nine CD4+ helper T lymphocyte epitopes, and twelve linear B-cell lymphocyte epitopes that were predicted to be antigenic, non-allergenic, non-toxic, fully conserved, and non-human homologous. Subsequently, molecular docking study, protein-protein interaction analysis, molecular dynamics simulation (including the root mean square fluctuation (RMSF) and root mean square deviation (RMSD)), and immune simulation study rendered promising results assuring the vaccine to be stable, safe, and effective. Finally, in silico cloning was conducted to develop an efficient mass production strategy of the vaccine. However, further in vitro and in vivo research studies on the proposed vaccine are required to confirm its safety and efficacy.
Communicated by Ramaswamy H. Sarma
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BFBNIB, GIS, IJS, KISLJ, NUK, PNG, UL, UM, UPUK
Umbilical cord hygiene prevents sepsis, a leading cause of neonatal mortality. The World Health Organization recommends 7.1% chlorhexidine digluconate (CHX) application to the umbilicus after home ...birth in high mortality contexts. In Bangladesh and Nepal, national policies recommend CHX use for all facility births. Population-based household surveys include optional questions on CHX use, but indicator validation studies are lacking. The Every Newborn Birth Indicators Research Tracking in Hospitals (EN-BIRTH) was an observational study assessing measurement validity for maternal and newborn indicators. This paper reports results regarding CHX.
The EN-BIRTH study (July 2017-July 2018) included three public hospitals in Bangladesh and Nepal where CHX cord application is routine. Clinical-observers collected tablet-based, time-stamped data regarding cord care during admission to labour and delivery wards as the gold standard to assess accuracy of women's report at exit survey, and of routine-register data. We calculated validity ratios and individual-level validation metrics; analysed coverage, quality and measurement gaps. We conducted qualitative interviews to assess barriers and enablers to routine register-recording.
Umbilical cord care was observed for 12,379 live births. Observer-assessed CHX coverage was very high at 89.3-99.4% in all 3 hospitals, although slightly lower after caesarean births in Azimpur (86.8%), Bangladesh. Exit survey-reported coverage (0.4-45.9%) underestimated the observed coverage with substantial "don't know" responses (55.5-79.4%). Survey-reported validity ratios were all poor (0.01 to 0.38). Register-recorded coverage in the specific column in Bangladesh was underestimated by 0.2% in Kushtia but overestimated by 9.0% in Azimpur. Register-recorded validity ratios were good (0.9 to 1.1) in Bangladesh, and poor (0.8) in Nepal. The non-specific register column in Pokhara, Nepal substantially underestimated coverage (20.7%).
Exit survey-report highly underestimated observed CHX coverage in all three hospitals. Routine register-recorded coverage was closer to observer-assessed coverage than survey reports in all hospitals, including for caesarean births, and was more accurately captured in hospitals with a specific register column. Inclusion of CHX cord care into registers, and tallied into health management information system platforms, is justified in countries with national policies for facility-based use, but requires implementation research to assess register design and data flow within health information systems.
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Progress in reducing maternal and neonatal deaths and stillbirths is impeded by data gaps, especially regarding coverage and quality of care in hospitals. We aimed to assess the validity of ...indicators of maternal and newborn health-care coverage around the time of birth in survey data and routine facility register data.
Every Newborn-BIRTH Indicators Research Tracking in Hospitals was an observational study in five hospitals in Bangladesh, Nepal, and Tanzania. We included women and their newborn babies who consented on admission to hospital. Exclusion critiera at admission were no fetal heartbeat heard or imminent birth. For coverage of uterotonics to prevent post-partum haemorrhage, early initiation of breastfeeding (within 1 h), neonatal bag-mask ventilation, kangaroo mother care (KMC), and antibiotics for clinically defined neonatal infection (sepsis, pneumonia, or meningitis), we collected time-stamped, direct observation or case note verification data as gold standard. We compared data reported via hospital exit surveys and via hospital registers to the gold standard, pooled using random effects meta-analysis. We calculated population-level validity ratios (measured coverage to observed coverage) plus individual-level validity metrics.
We observed 23 471 births and 840 mother–baby KMC pairs, and verified the case notes of 1015 admitted newborn babies regarding antibiotic treatment. Exit-survey-reported coverage for KMC was 99·9% (95% CI 98·3–100) compared with observed coverage of 100% (99·9–100), but exit surveys underestimated coverage for uterotonics (84·7% 79·1–89·5) vs 99·4% 98·7–99·8 observed), bag-mask ventilation (0·8% 0·4–1·4) vs 4·4% 1·9–8·1), and antibiotics for neonatal infection (74·7% 55·3–90·1 vs 96·4% 94·0–98·6 observed). Early breastfeeding coverage was overestimated in exit surveys (53·2% 39·4–66·8) vs 10·9% 3·8–21·0 observed). “Don’t know” responses concerning clinical interventions were more common in the exit survey after caesarean birth. Register data underestimated coverage of uterotonics (77·9% 37·8–99·5 vs 99·2% 98·6–99·7 observed), bag-mask ventilation (4·3% 2·1–7·3 vs 5·1% 2·0–9·6 observed), KMC (92·9% 84·2–98·5 vs 100% 99·9–100 observed), and overestimated early breastfeeding (85·9% (58·1–99·6) vs 12·5% 4·6–23·6 observed). Inter-hospital heterogeneity was higher for register-recorded coverage than for exit survey report. Even with the same register design, accuracy varied between hospitals.
Coverage indicators for newborn and maternal health care in exit surveys had low accuracy for specific clinical interventions, except for self-report of KMC, which had high sensitivity after admission to a KMC ward or corner and could be considered for further assessment. Hospital register design and completion are less standardised than surveys, resulting in variable data quality, with good validity for the best performing sites. Because approximately 80% of births worldwide take place in facilities, standardising register design and information systems has the potential to sustainably improve the quality of data on care at birth.
Children's Investment Fund Foundation and Swedish Research Council.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Poly(hydroxybutyrate‐co‐hydroxyhexanoate) (PHBHH)/poly(butylene succinate) (PBS) blends were prepared using a melt blending technique. A compatibilizer of maleated PBS (PBSgMA) was produced using ...reactive melt grafting by varying the maleic anhydride (MA) monomer concentration ranging from 3 to 10 parts per hundred resin (phr). Fourier‐transform infrared (FTIR) spectroscopy and nuclear magnetic resonance (NMR) spectroscopy analyses confirmed the grafting reaction of the PBSgMA. The PBSgMA was incorporated in the 80PHBHH/20PBS and 50PHBHH/50PBS blends to investigate the effect of maleated compatibilizer on the tensile, flexural, drop weight impact, and water absorption properties of the blends with droplets dispersed and co‐continuous morphology. The incorporation of PBSgMA increased the tensile and flexural strength of both the 80PHBHH/20PBS and 50PHBHH/50PBS blends, where the optimum properties achieved at 5 phr concentration of MA. The drop weight impact test results showed that uncompatibilized and compatibilized 50PHBHH/50PBS blends had higher critical strain energy release rate (Gc) than the neat PHBHH. However, blending and compatibilizing did not have a positive effect on the critical stress intensity factor (Kc) of the neat PHBHH. Scanning electron microscopy (SEM) confirmed the improvement of interfacial adhesion and PBS polymer dispersion in PHBHH/PBS blends when incorporated with 5PBSgMA. The water absorption test results demonstrated that compatibilized blends absorbed slightly more water than uncompatibilized blends due to the presence of hygroscopic carboxyl groups of the PBSgMA. However, water absorption effects were reversible and did not result in severe permanent damage to the blends.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
We report the sequencing of three severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) genomes from Bangladesh. We have identified a unique mutation (NSP2_V480I) in one of the sequenced ...genomes (isolate hCoV-19/Bangladesh/BCSIR-NILMRC-006/2020) compared to the sequences available in the Global Initiative on Sharing All Influenza Data (GISAID) database. The data from this analysis will contribute to advancing our understanding of the epidemiology of SARS-CoV-2 in Bangladesh as well as worldwide at the molecular level and will identify potential new targets for interventions.
Abstract
The coagulation-flocculation process frequently employs chemical-based coagulants and flocculants. The disadvantages of utilizing these chemical substances have triggered researchers to ...investigate natural substances to replace or reduce the number of chemical-based coagulants and flocculants. Thus, this study investigates the potential use of tannin as a natural coagulant for slaughterhouse wastewater treatment. Results indicated that a pH of 6.9 and a dosage of 2mL of tannin resulted in the higher removal of different pollutants from slaughterhouse wastewater. Tannin was able to perform excellent elimination efficiency for all parameters under these ideal conditions. Turbidity, COD, colour, and TSS all had removal efficiencies of 93.7%, 76.2%, 95.7%, and 88.9%, respectively. Results were compared to alum, which was used as a coagulant, and it was found that pH 6.9 and dosage of 5mL were the optimum conditions for alum in slaughterhouse wastewater treatment. Alum achieved 92.8% for turbidity, 75.4% for COD, 93.1% for colour, and 91.7% for TSS, respectively. In contrast to alum, tannin is a natural substance that produces a small quantity of sludge while being safe for the environment and non-toxic. The tannin coagulant has the potential to be an efficient and productive coagulant agent for wastewater treatment from slaughterhouses.
This study investigated the contribution of termites to mass loss of dead wood (Macaranga bancana, Elateriospermum tapos, and Dillenia beccariana) in a lowland tropical rainforest, Brunei Darussalam. ...Mesh bag method was used to exclude termites, and the mass remaining was monitored after 3, 7, 13, and 23 months. C/N ratio of the samples was analyzed after 13 and 23 months. Initial wood density was 0.63, 0.92, and 1.02 g/cm3 for M. bancana, E. tapos, and D. beccariana, respectively, and the termite contribution to mass loss was an average (range) of 13.05±5.68 (4.17-29.59%), 3.48±1.13 (2.20-6.49), and 3.40±1.92% (0.74-10.78), respectively. Until 7 months, termites contributed highly to mass loss, given the low initial wood density, and interaction effect of species and treatment was significant. After 7 months, the contribution decreased in M. bancana and E. tapos, whereas it increased consistently in D. beccariana. The interaction effect was not significant, whereas differences in C/N ratio among the species were significant, with a lower C/N ratio in M. bancana and E. tapos than in D. beccariana. After 23 months, the differences in C/N ratio were not significant, and ants were present at 40% of control samples in M. bancana and E. tapos. Our results suggest that the contribution of termites to mass loss varies by dead wood species and is temporally variable. Initial wood traits could affect the termite feeding in the beginning, however, termites thereafter could forage in response to the varying C/N ratio among species and predators.
Birth registration marks a child's right to identity and is the first step to establishing citizenship and access to services. At the population level, birth registration data can inform effective ...programming and planning. In Tanzania, almost two-thirds of births are in health facilities, yet only 26% of children under 5 years have their births registered. Our mixed-methods research explores the gap between hospital birth and birth registration in Dar es Salaam, Tanzania.
The study was conducted in the two Tanzanian hospital sites of the Every Newborn-Birth Indicators Research Tracking in Hospitals (EN-BIRTH) multi-country study (July 2017-2018). We described the business processes for birth notification and registration and collected quantitative data from women's exit surveys after giving birth (n = 8038). We conducted in-depth interviews (n = 21) to identify barriers and enablers to birth registration among four groups of participants: women who recently gave birth, women waiting for a birth certificate at Temeke Hospital, hospital employees, and stakeholders involved in the national birth registration process. We synthesized findings to identify opportunities to improve birth registration.
Standard national birth registration procedures were followed at Muhimbili Hospital; families received birth notification and were advised to obtain a birth certificate from the Registration, Insolvency, and Trusteeship Agency (RITA) after 2 months, for a fee. A pilot programme to improve birth registration coverage included Temeke Hospital; hand-written birth certificates were issued free of charge on a return hospital visit after 42 days. Among 2500 women exit-surveyed at Muhimbili Hospital, 96.3% reported receiving a birth notification form and nearly half misunderstood this to be a birth certificate. Of the 5538 women interviewed at Temeke Hospital, 33.0% reported receiving any documentation confirming the birth of their child. In-depth interview respondents perceived birth registration to be important but considered both the standard and pilot processes in Tanzania complex, burdensome and costly to both families and health workers.
Birth registration coverage in Tanzania could be improved by further streamlining between health facilities, where most babies are born, and the civil registry. Families and health workers need support to navigate processes to register every child.
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