Level of depression and its associated factors among the frontline physicians of Bangladesh during the COVID-19 outbreak

The COVID-19 pandemic has exposed the frontline physicians to a greater risk of getting infected, tremendous workload, and drastic changes in their work environment, leading to an increased prevalence of depression among doctors from many countries, including Bangladesh. The aim of this study was to examine the association of various personal, professional and psychosocial factors with different degrees of depressive symptoms among the frontline doctors of Bangladesh working during the COVID-19 pandemic. An online, cross-sectional survey was conducted for that purpose and data were collected from 312 doctors working in Bangladeshi hospitals using a self-administered survey questionnaire inclusive of a validated tool (Patient Health Questionnaire-9). Among the participants, around half were of age 30-34 years (51.3%), 81.8% worked in public hospitals and 70.5% did not have any comorbidity. Regarding workplace conditions, 77% of the doctors reported a perceived shortage of healthcare providers at their workplace, while 95% reported a perceived shortage of equipment, most commonly N95 masks (49%), gowns (35%), eye-protective shields (35%). A total of 199 (63.8%) participants received formal training since the beginning of the pandemic. According to the response from PHQ-9 questionnaire, 17 (5%) participants reported having no depression, while 18 (6%), 18 (6%), 25 (8%), and 234 (75%) reported having mild, moderate, moderately severe, and severe depression. Findings from multiple logistic regression showed the odds of moderate-to-severe depression to be higher among physicians with comorbidities (OR:7.47, CI: 1.27-43.89, P: 0.026) and those who felt extremely worried from looking at negative news on social/mass media (aOR: 15.180, CI:1.98-116.683, P: 0.009). To preserve and promote the psychological well-being of Bangladeshi doctors, it is, therefore, crucial to take these identified sources and risk factors of depression under sincere consideration by the responsible authorities and appropriate measures should be designed to remove these sources of depression to better support the physicians of the country

Navigating Copper-Atom-Pair Structural Effect inside a Porous Organic Polymer Cavity for Selective Hydrogenation of Biomass-Derived 5-Hydroxymethylfurfural

In recent times, selective hydrogenation of biomass-derived 5-hydroxymethylfurfural (5-HMF) to produce the novel difuranic polyol scaffold 2,5-dihydroxymethylfuran (DHMF) has attracted the interest of the many researchers due to its peculiar symmetrical structure and its widespread application as a monomer for the preparation of cross-linked polyesters and polyurethane. Copper-based catalysts have been explored for selective catalytic hydrogenation; however, hurdles are still associated with the strongly reducing H2 atmosphere and oxidizing C–O bond that make the Cu0 and Cux+ surface active species unstable, limiting the rational design of highly efficient integrated catalyst systems. To address this, herein, we built catalytic systems for 5-HMF hydrogenation with stable and balanced Cu0 and Cux+ active surface species inside the nanocage of a catechol-based porous organic polymer (POP) endowed with large surface areas, impressive stabilities, and spatial restriction inhibiting nanoparticle aggregation. Batch reactor screening identified that a superior catalytic performance (DHMF selectivity of 98%) has been achieved with our newly designed Cu@C-POP at 150 °C temperature and 20 bar H2 pressure, which was also higher than that of other reported copper catalysts. Comprehensive characterization understanding with H2-TPR and X-ray photoelectron spectroscopy (XPS) study revealed that substantially boosted activity is induced by the presence of the bulk CuOx phase and atomically dispersed Cu species incorporating isolated Cu ions, which are further confirmed through the positive binding energy shift of Cu 2p3/2 XPS spectra (∼0.4 eV). The Cu environment in our catalytic systems comprises a predominantly square planar geometry (probably Jahn–Teller distorted OH), which we gleaned from the extended X-ray absorption for fine structure (EXAFS) analysis featuring two adjacent copper atoms with the valence state in between of 0 and +2, as validated by XANES absorption edge positions. EXAFS studies further revealed a lowering of the Cu coordination number for the most active Cu@C-POP-B catalyst, suggesting the presence of metal vacancies. Density functional theory calculations showed that the presence of Cu metal vacancies stabilized the reaction intermediates formed during 5-HMF hydrogenation and decreased the hydrogenation barriers, resulting in an enhanced catalytic activity of the Cu@C-POP-B catalyst

Single and two-particle energy gaps across the disorder-driven superconductor-insulator transition

The competition between superconductivity and localization raises profound questions in condensed matter physics. In spite of decades of research, the mechanism of the superconductor-insulator transition (SIT) and the nature of the insulator are not understood. We use quantum Monte Carlo simulations that treat, on an equal footing, inhomogeneous amplitude variations and phase fluctuations, a major advance over previous theories. We gain new microscopic insights and make testable predictions for local spectroscopic probes. The energy gap in the density of states survives across the transition, but coherence peaks exist only in the superconductor. A characteristic pseudogap persists above the critical disorder and critical temperature, in contrast to conventional theories. Surprisingly, the insulator has a two-particle gap scale that vanishes at the SIT, despite a robust single-particle gap.Comment: 7 pages, 5 figures (plus supplement with 4 pages, 5 figures

Post-Kala-azar Dermal Leishmaniasis in Nepal: A Retrospective Cohort Study (2000–2010)

Post-kala-azar dermal leishmaniasis (PKDL) is a skin disorder seen in patients treated for Leishmania donovani visceral leishmaniasis (VL), a neglected tropical disease that is fatal if left untreated. In the Indian subcontinent, PKDL is seen in 5–10% of all past VL cases and is also reported in some without history of VL. As persons with PKDL do not feel sick, the disease has only cosmetic significance for the individual and treatment is rarely sought. However, PKDL lesions harbour parasites and therefore could represent a source of transmission, through the bite of female sand flies. Our study shows that the occurrence of PKDL in patients with past treated VL is low in Nepal compared to neighboring countries. Treatment of the original VL episode with SSG (sodium stibogluconate), inadequate treatment and treatment on ambulatory basis were significantly associated with PKDL. Though SSG has since been replaced by other drugs, counseling and supervision of adherence to the prescribed VL treatment is of vital importance to reduce risk of treatment failure and relapse as well as later development of PKDL. Policy makers should include surveillance and case management of PKDL in the VL elimination program

Interplay between NS3 protease and human La protein regulates translation-replication switch of Hepatitis C virus

HCV NS3 protein plays a central role in viral polyprotein processing and RNA replication. We demonstrate that the NS3 protease (NS3pro) domain alone can specifically bind to HCV-IRES RNA, predominantly in the SLIV region. The cleavage activity of the NS3 protease domain is reduced upon HCV-RNA binding. More importantly, NS3pro binding to the SLIV hinders the interaction of La protein, a cellular IRES-trans acting factor required for HCV IRES-mediated translation, resulting in inhibition of HCV-IRES activity. Although overexpression of both NS3pro as well as the full length NS3 protein decreased the level of HCV IRES mediated translation, replication of HCV replicon RNA was enhanced significantly. These observations suggest that the NS3pro binding to HCV IRES reduces translation in favor of RNA replication. The competition between the host factor (La) and the viral protein (NS3) for binding to HCV IRES might regulate the molecular switch from translation to replication of HCV

Enhancing lepton flavour violation in the supersymmetric inverse seesaw beyond the dipole contribution

In minimal supersymmetric models the $Z$-penguin usually provides sub-dominant contributions to charged lepton flavour violating observables. In this study, we consider the supersymmetric inverse seesaw in which the non-minimal particle content allows for dominant contributions of the $Z$-penguin to several lepton flavour violating observables. In particular, and due to the low-scale (TeV) seesaw, the penguin contribution to, for instance, \Br(\mu \to 3e) and $\mu-e$ conversion in nuclei, allows to render some of these observables within future sensitivity reach. Moreover, we show that in this framework, the $Z$-penguin exhibits the same non-decoupling behaviour which had previously been identified in flavour violating Higgs decays in the Minimal Supersymmetric Standard Model.Comment: 29 pages, 9 figures, 4 tables; v2: minor corrections, version to appear in JHE

Malaria Prevalence in Endemic Districts of Bangladesh

BACKGROUND: Following the 1971 ban of DDT in Bangladesh, malaria cases have increased steadily. Malaria persists as a major health problem in the thirteen south-eastern and north-eastern districts of Bangladesh. At present the national malaria control program, largely supported by the Global Fund for AIDS, Tuberculosis and Malaria (GFATM), provides interventions including advocacy at community level, Insecticide Treated Net (ITN) distribution, introduction of Rapid Diagnostic Tests (RDT) and combination therapy with Coartem. It is imperative, therefore, that baseline data on malaria prevalence and other malaria indicators are collected to assess the effectiveness of the interventions and rationalize the prevention and control efforts. The objective of this study was to obtain this baseline on the prevalence of malaria and bed net use in the thirteen malaria endemic districts of Bangladesh. METHODS AND PRINCIPAL FINDINGS: In 2007, BRAC and ICDDR,B carried out a malaria prevalence survey in thirteen malaria endemic districts of Bangladesh. A multi-stage cluster sampling technique was used and 9750 blood samples were collected. Rapid Diagnostic Tests (RDT) were used for the diagnosis of malaria. The weighted average malaria prevalence in the thirteen endemic districts was 3.97%. In five south-eastern districts weighted average malaria prevalence rate was 6.00% and in the eight north-eastern districts weighted average malaria prevalence rate was (0.40%). The highest malaria prevalence was observed in Khagrachari district. The majority of the cases (90.18%) were P. falciparum infections. Malaria morbidity rates in five south-eastern districts was 2.94%. In eight north-eastern districts, morbidity was 0.07%. CONCLUSION AND SIGNIFICANCE: Bangladesh has hypoendemic malaria with P. falciparum the dominant parasite species. The malaria situation in the five north-eastern districts of Bangladesh in particular warrants urgent attention. Detailed maps of the baseline malaria prevalence and summaries of the data collected are provided along with the survey results in full, in a supplemental information

Cryptosporidium Priming Is More Effective than Vaccine for Protection against Cryptosporidiosis in a Murine Protein Malnutrition Model

Cryptosporidium is a major cause of severe diarrhea, especially in malnourished children. Using a murine model of C. parvum oocyst challenge that recapitulates clinical features of severe cryptosporidiosis during malnutrition, we interrogated the effect of protein malnutrition (PM) on primary and secondary responses to C. parvum challenge, and tested the differential ability of mucosal priming strategies to overcome the PM-induced susceptibility. We determined that while PM fundamentally alters systemic and mucosal primary immune responses to Cryptosporidium, priming with C. parvum (106 oocysts) provides robust protective immunity against re-challenge despite ongoing PM. C. parvum priming restores mucosal Th1-type effectors (CD3+CD8+CD103+ T-cells) and cytokines (IFNγ, and IL12p40) that otherwise decrease with ongoing PM. Vaccination strategies with Cryptosporidium antigens expressed in the S. Typhi vector 908htr, however, do not enhance Th1-type responses to C. parvum challenge during PM, even though vaccination strongly boosts immunity in challenged fully nourished hosts. Remote non-specific exposures to the attenuated S. Typhi vector alone or the TLR9 agonist CpG ODN-1668 can partially attenuate C. parvum severity during PM, but neither as effectively as viable C. parvum priming. We conclude that although PM interferes with basal and vaccine-boosted immune responses to C. parvum, sustained reductions in disease severity are possible through mucosal activators of host defenses, and specifically C. parvum priming can elicit impressively robust Th1-type protective immunity despite ongoing protein malnutrition. These findings add insight into potential correlates of Cryptosporidium immunity and future vaccine strategies in malnourished children

Interaction of Chandipura Virus N and P Proteins: Identification of Two Mutually Exclusive Domains of N Involved in Interaction with P

The nucleocapsid protein (N) and the phosphoprotein (P) of nonsegmented negative-strand (NNS) RNA viruses interact with each other to accomplish two crucial events necessary for the viral replication cycle. First, the P protein binds to the aggregation prone nascent N molecules maintaining them in a soluble monomeric (N0) form (N0-P complex). It is this form that is competent for specific encapsidation of the viral genome. Second, the P protein binds to oligomeric N in the nucleoprotein complex (N-RNA-P complex), and thereby facilitates the recruitment of the viral polymerase (L) onto its template. All previous attempts to study these complexes relied on co-expression of the two proteins in diverse systems. In this study, we have characterised these different modes of N-P interaction in detail and for the first time have been able to reconstitute these complexes individually in vitro in the chandipura virus (CHPV), a human pathogenic NNS RNA virus. Using a battery of truncated mutants of the N protein, we have been able to identify two mutually exclusive domains of N involved in differential interaction with the P protein. An unique N-terminal binding site, comprising of amino acids (aa) 1–180 form the N0-P interacting region, whereas, C-terminal residues spanning aa 320–390 is instrumental in N-RNA-P interactions. Significantly, the ex-vivo data also supports these observations. Based on these results, we suggest that the P protein acts as N-specific chaperone and thereby partially masking the N-N self-association region, which leads to the specific recognition of viral genome RNA by N0

Impact of Rapid Urbanization on the Rates of Infection by Vibrio cholerae O1 and Enterotoxigenic Escherichia coli in Dhaka, Bangladesh

Bangladesh is a country where acute dehydrating diarrhea or cholera is common and is seen at least two times every year and additionally in natural disasters. In addition cholera cases have increased in the country, especially in urban settings such as in the capital city, Dhaka, where the number of hospitalized patients with more severe disease has tremendously increased. In the present observation, we have concentrated on determining the occurrence of diarrhoea caused by the two most common bacterial agents V. cholerae O1 and enterotoxigenic Escherichia coli (ETEC) in a densely populated, disease prone area Mirpur in Dhaka for two years from March 2008 to February 2010. Stool or rectal specimens from diarrheal patients coming to the ICDDR,B hospital from Mirpur were tested for the two bacterial pathogens. We found that V. cholerae O1 was the major bacterial pathogen and a cause of severe cholera disease in 23% of patients (2,647 of a total of 11,395 patients) from Mirpur. We surmise that cholera vaccines, as well as other public health tools that can target such high risk groups in the country, will be able to reduce the disease morbidity and the transmission of pathogens to improve the quality of life in urban settings