Cardiac Outcomes in Adults With Mitochondrial Diseases Savvatis, Konstantinos; Vissing, Christoffer Rasmus; Klouvi, Lori ...
Journal of the American College of Cardiology,
10/2022, Letnik:
80, Številka:
15
Journal Article
Recenzirano
Odprti dostop
Patients with mitochondrial diseases are at risk of heart failure (HF) and arrhythmic major adverse cardiac events (MACE).
We developed prediction models to estimate the risk of HF and arrhythmic ...MACE in this population.
We determined the incidence and searched for predictors of HF and arrhythmic MACE using Cox regression in 600 adult patients from a multicenter registry with genetically confirmed mitochondrial diseases.
Over a median follow-up time of 6.67 years, 29 patients (4.9%) reached the HF endpoint, including 19 hospitalizations for nonterminal HF, 2 cardiac transplantations, and 8 deaths from HF. Thirty others (5.1%) reached the arrhythmic MACE, including 21 with third-degree or type II second-degree atrioventricular blocks, 4 with sinus node dysfunction, and 5 sudden cardiac deaths. Predictors of HF were the m.3243A>G variant (HR: 4.3; 95% CI: 1.8-10.1), conduction defects (HR: 3.0; 95% CI: 1.3-6.9), left ventricular (LV) hypertrophy (HR: 2.6; 95% CI: 1.1-5.8), LV ejection fraction <50% (HR: 10.2; 95% CI: 4.6-22.3), and premature ventricular beats (HR: 4.1; 95% CI: 1.7-9.9). Independent predictors for arrhythmia were single, large-scale mtDNA deletions (HR: 4.3; 95% CI: 1.7-10.4), conduction defects (HR: 6.8; 95% CI: 3.0-15.4), and LV ejection fraction <50% (HR: 2.7; 95% CI: 1.1-7.1). C-indexes of the Cox regression models were 0.91 (95% CI: 0.88-0.95) and 0.80 (95% CI: 0.70-0.90) for the HF and arrhythmic MACE, respectively.
We developed the first prediction models for HF and arrhythmic MACE in patients with mitochondrial diseases using genetic variant type and simple cardiac assessments.
According to the A10 Networks survey, in 2017 the DDoS of Things (DoT) has reached critical mass in each attack. And the rise of DDoS attacks on cloud computing is commonplace. In this paper, we ...review and analyze different existing DDoS detecting techniques against different parameters, and propose a new composite architecture to protect AWS infrastructure. The proposed work provides prevention against the DDoS attack on SOAP (Simple Object Access Protocol) based web services. Our proposed framework check the authenticity of the user, who want to access the data, which is available on the cloud server. And one more thing we reveal in this research that what are the problems facing by the developer and AWS user by the questions they asked recently in Stackoverflow site.
The Question and Answer (Q&A) sites are very popular nowadays for discussion on technological issues. Among the most prominent topics of these sites, posts related to security are widely visited. ...Security discussions may be classified broadly into two categories: application and infrastructure security. In this research, we studied several community Q&A sites to analyze the characteristics of requirements and difficulties to implement security in data transmission, one of the most dominant topics of infrastructure security. To the best of our knowledge, this is the first study of this kind. Our findings are expected to make it easier for the interested people to acquire knowledge about recent threats and security issues of data transmission in a methodical way and also to understand the trends of relevant technologies. We found that Transport Layer Security (TLS) is the most discussed technique over the years and Cross-Site Scripting (XSS) attack is the primary concern for the developers.
This cross-sectional study has evaluated the level of the COVID-19 response among the general people of Bangladesh through their COVID-19 basic knowledge, attitude and practice level to reduce the ...outbreak. A rapid self-administered online survey was conducted during the COVID-19 lockdown period in Bangladesh. Convenience and snowball sampling technique were followed in this study. The online survey was open for all Bangladeshi general people whether they were infected or not. For this study, total 616 Bangladeshi respondents participated where majority of them were from Dhaka city, one of the worst COVID-19 affected cities in the world. Normality of data was checked before statistical analysis. Majority of the respondents reported moderate safety of their current place from COVID-19 with high concern of their mental health during COVID-19 lockdown period. The total COVID-19 responses among these people were moderate along with the alarming high percentages of low COVID-19 responses. The respondents reported moderate COVID-19 knowledge level and moderate attitude level toward the COVID-19 control. They demonstrated that they followed practices to prevent the COVID-19 infection. Female respondents were identified with better COVID-19 responses compared to their male counterpart. Dhaka city residents had less confidence on their current place being safe from COVID-19. They also had low COVID-19 responses during the lockdown period compared to the residents living outside Dhaka city.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Girls' menstrual experiences impact their social and educational participation, physical and psychological health. We conducted a pilot study to assess the acceptability and feasibility of a ...multi-component intervention intended to support menstruating girls; improve menstrual care knowledge, practices, and comfort; and increase school attendance.We conducted a pre/post evaluation of a 6-month pilot intervention in four schools (2 urban, 2 rural) in Dhaka, Bangladesh. We selected 527 schoolgirls (grades 5 to 10; aged 10 to 17 years) for a baseline survey and 528 girls at endline. The intervention included: 1) Menstrual Hygiene Management (MHM) packs- reusable cloth pads, underwear, carry bags and menstrual cycle tracking calendars, 2) education curriculum- pictorial flipcharts, puberty related-booklets, and teachers' training to deliver puberty and MHM sessions, 3) maintenance- improvements to school sanitation, provision of disposable pads in the school office, provision of chute disposal systems for disposable pads, and gender committees to promote a gender-friendly school environment and maintenance of intervention facilities. We estimated intervention uptake and intervention effect by calculating prevalence differences and 95% confidence intervals using fixed-effects logistic regression.The intervention uptake was more than 85% for most indicators; 100% reported receiving puberty education, 85% received MHM packs, and 92% received booklets. Reusable cloth pads uptake was 34% by endline compared with 0% at baseline. Knowledge about menstrual physiology and knowledge of recommended menstrual management practices significantly improved from baseline to endline. Reported improvements included more frequent changing of menstrual materials (4.2 times/day at endline vs. 3.4 times/day at baseline), increased use of recommended disposal methods (prevalence difference (PD): 8%; 95% Confidence Interval: 1, 14), and fewer staining incidents (PD: - 12%; 95% CI: - 22, - 1). More girls reported being satisfied with their menstrual materials (59% at endline vs. 46% at baseline, p < 0.005) and thought school facilities were adequate for menstrual management at endline compared to baseline (54% vs. 8%, p < 0.001). At endline, 64% girls disagreed/strongly disagreed that they felt anxious at school due to menstruation, compared to 33% at baseline (p < 0.001). Sixty-five percent girls disagreed/strongly disagreed about feeling distracted or trouble concentrating in class at endline, compared to 41% at baseline (p < 0.001). Self-reported absences decreased slightly (PD: - 8%; 95% CI: - 14, - 2).Uptake of cloth pads, improved maintenance and disposal of menstrual materials, and reduced anxiety at school suggest acceptability and feasibility of the intervention aiming to create a supportive school environment.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Agriculture is one of the few remaining sectors that is yet to receive proper attention from the machine learning community. The importance of datasets in the machine learning discipline cannot be ...overemphasized. The lack of standard and publicly available datasets related to agriculture impedes practitioners of this discipline to harness the full benefit of these powerful computational predictive tools and techniques. To improve this scenario, we develop, to the best of our knowledge, the first-ever standard, ready-to-use, and publicly available dataset of mango leaves. The images are collected from four mango orchards of Bangladesh, one of the top mango-growing countries of the world. The dataset contains 4000 images of about 1800 distinct leaves covering seven diseases. Although the dataset is developed using mango leaves of Bangladesh only, since we deal with diseases that are common across many countries, this dataset is likely to be applicable to identify mango diseases in other countries as well, thereby boosting mango yield. This dataset is expected to draw wide attention from machine learning researchers and practitioners in the field of automated agriculture.
Access to washroom facilities and a place to dispose of menstrual waste are prerequisites for optimal menstrual hygiene management in schools. Like other low- and middle-income countries, Bangladeshi ...schools lack facilities for girls to change and dispose of their menstrual absorbents. We explored existing systems for disposing of menstrual absorbent wastes in urban and rural schools of Bangladesh and assessed the feasibility and acceptability of alternative disposal options.
We explored how girls dispose of their menstrual products, identified girls' preferences and choices for a disposal system and piloted four disposal options in four different schools. We then implemented one preferred option in four additional schools. We explored girls', teachers', and janitors' perspectives and evaluated the acceptability, feasibility, and potential for sustainability of the piloted disposal system.
Barriers to optimal menstrual hygiene management included lack of functional toilets and private locations for changing menstrual products, and limited options for disposal. Girls, teachers, and janitors preferred and ranked the chute disposal system as their first choice, because it has large capacity (765 L), is relatively durable, requires less maintenance, and will take longer time to fill. During implementation of the chute disposal system in four schools, girls, teachers, and janitors reported positive changes in toilet cleanliness and menstrual products disposal resulting from the intervention.
The chute disposal system for menstrual products is a durable option that does not require frequent emptying or regular maintenance, and is accepted by schoolgirls and janitors alike, and can improve conditions for menstrual hygiene management in schools. However, regular supervision, motivation of girls to correctly dispose of their products, and a long-term maintenance and management plan for the system are necessary.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Background: Antimicrobial resistance is a serious concern and life threat in public health globally. Gram-positive clinical isolates are one of the leading etiological agents showing drug resistance ...traits. This study aimed to detect the antimicrobial resistance pattern of clinically isolated Gram-positive bacterial isolates collected from various renowned diagnostic centers of Dhaka city, Bangladesh. Methods: A laboratory-based cross-sectional study was conducted at the Microbiological Laboratory of the Department of Microbiology, Stamford University Bangladesh. A total of 104 clinical specimens (wound swab, pus, blood, urine, ear discharge, nasal swab, sputum, nipple discharge, breast milk, catheter tip, umbilical swab, and throat swab) from different age groups were collected from some renowned diagnostic centers of Dhaka city for analyzing the cultural and drug sensitivity patterns from January 2023 to April 2023. According to the study plan, only the Gram-positive bacteria were collected and transported to the laboratory of the Department of Microbiology, Stamford University Bangladesh following WHO guidelines, and the antimicrobial susceptibility tests were carried out by Kirby–Bauer disk diffusion method and the results were interpreted as per CLSI guidelines, 2022. Results: This study highlights the presence of Staphylococcus aureus (65.4%), Streptococcus spp. (23.1%), and Enterococcus spp . (11.5%) as causative agents of Gram-positive bacterial infections from overall 104 clinical specimens. Most of our isolates were found multidrug-resistant. For S. aureus isolates, cefixime (100%); for Streptococcus spp., doxycycline (95.83%); and for Enterococcus spp., amoxicillin (100%), cefixime (100%), colistin (100%), and cotrimoxazole (100%) were found to be the most ineffective drug when compared to other antibiotics. Conclusion: Our study portrayed the remarkable antibiotic resistance feature of Gram-positive bacterial isolates which is a matter of public health concern. It is necessary to carry out a continuous assessment of antibiotic sensitivity patterns of resistant Gram-positive bacteria; otherwise, it will become an uncontrollable problem not only in Bangladesh but also worldwide in the near future.
Nearly half of Bangladeshi girls reach menarche without knowledge of menstruation and many fear seeking support due to pervasive menstrual stigma. We aimed to explore the types of ...menstruation-related information and support adolescent female and male students want but may be uncomfortable verbalising. We installed a locked box in four school classrooms in rural and urban Bangladesh as part of a menstrual hygiene management pilot intervention between August 2017 and April 2018. Trained teachers provided puberty education to female and male students in classes 5–10 (ages 10–17 years) and encouraged students to submit questions anonymously to the boxes if they did not want to ask aloud. We conducted a content analysis of the 374 menstruation-related questions from a total of 834 submissions. Questions regarded experiences of menstrual bleeding (35%); menstrual symptoms and management (32%); menstrual physiology (19%); behavioural prescriptions and proscriptions (6%); concerns over vaginal discharge (4%); and menstrual stigma, fear, and social support (4%). Students wanted to understand the underlying causes of various menstrual experiences, and concern over whether particular experiences are indicative of health problems was pervasive. Ensuring comprehensive school-based menstruation education and strengthening engagement among schools, parents, and healthcare providers is important for improving access to reliable menstrual health information and may relieve adolescents’ concerns over whether their menstrual experiences are ’normal’.
COVID-19 has become one of the poignant infectious diseases in human history. This cross-sectional study intended to evaluate the adverse impact of COVID-19 among university students of Bangladesh. ...It also disclosed the COVID-19 responses through knowledge, attitude, and practice level across these university students. A rapid online survey was conducted to administer a self-reported questionnaire among these university students during the country's COVID-19 induced lockdown period. Convenience and snowball sampling technique was employed for this study. Total of 418 university students participated. Statistical analyses were conducted based on type and normality distribution of data. Majority of the participated students experienced high impact (61.48%) on their study. They were also exceedingly concerned with their mental health (47.84%) due to this pandemic. Large number of students attended online classes (69.62%). Students living in the capital city Dhaka, reported more unsafe current places than the students living outside Dhaka. Furthermore, universities supported their students through multiple financial and mental assistance initiatives. Participated students reported moderate knowledge, attitude, and high practice scores. They were also observed moderate total KAP score in this study. Female students demonstrated good knowledge and practice scores than the male students.
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