Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Characteristic analysis of Matuail landfill leachate

This research was undertaken to investigate the characteristic analysis of Matuail landfillleachate in order to intend an appropriate treatment option. Samples were collected twicefrom two different pits of Matuail landfill site for both dry and wet weather conditions.Characteristics of the landfill leachate samples were determined through extensive laboratoryanalysis. The leachate samples were in intermediate semi-aerobic phase and characterized asmedium aged. Low bio-degradability of Matuail leachate indicates that these samples may beefficiently treated with physico/chemical process or reverse osmosis rather than biologicaltreatment. The concentrations of various contaminants reveal that the quality of leachatevaried considerably with location and time but all the samples had the potential tocontaminate soil, surface water and groundwater of the site

Prevention of Alzheimer's disease through diet: An exploratory review

Introduction: This exploratory review article describes about the genetic factors behind Alzheimer's disease (AD), their association with foods, and their relationships with cognitive impairment. It explores the dietary patterns and economic challenges in AD prevention. Methods: Scopus, PubMed and Google Scholar were searched for articles that examined the relationships between Diets, Alzheimer's Disease (AD), and Socioeconomic conditions in preventative Alzheimer's disease studies. Graphs and Network analysis data were taken from Scopus under the MeSH search method, including words, Alzheimer's, APoE4, Tau protein, APP, Amyloid precursor protein, Beta-Amyloid, Aβ, Mediterranean Diet, MD, DASH diet, MIND diet, SES, Socioeconomic, Developed country, Underdeveloped country, Preventions. The network analysis was done through VOS viewer. Results: Mediterranean diet (MD) accurately lowers AD (Alzheimer's Disease) risk to 53% and 35% for people who follow it moderately. MIND scores had a statistically significant reduction in AD rate compared to those in the lowest tertial (53% and 35% reduction, respectively). Subjects with the highest adherence to the MD and DASH had a 54% and 39% lower risk of developing AD, respectively, compared to those in the lowest tertial. Omega-6, PUFA, found in nuts and fish, can play most roles in the clearance of Aβ. Vitamin D inhibits induced fibrillar Aβ apoptosis. However, the high cost of these diet components rise doubt about the effectiveness of AD prevention through healthy diets. Conclusion: The finding of this study revealed an association between diet and the effects of the chemical components of foods on AD biomarkers. More research is required to see if nutrition is a risk or a protective factor for Alzheimer's disease to encourage research to be translated into therapeutic practice and to clarify nutritional advice

Introduction of rhombus frame to improve building performance in earthquake

The primary focus of this study is to present a frame shape which will improve building performance in earthquake excitations. The investigation started with 3-story frame. The proposed Rhombus Shape is introduced to compare with the Rectangular Shape frame, keeping the height-to-width ratio and the loading same. The performance of the proposed Rhombus Shape Frame is compared with the popular Rectangular Moment Resisting Frame for different earthquake records. The seismic performance of the frame is evaluated based on the inter-story drift. This study report, that even with significant amount of member reduction, the proposed frame shape exhibits higher lateral stiffness than the equivalent rectangular moment resisting frame

E-Service Quality and Trust on Customer\u27s Patronage Intention: Moderation Effect of Adoption of Advanced Technologies

The extensive development of electronic gadgets along with technology-oriented communication tools has created a significant impact on the realm of online retail banking transactions. In Bangladesh, online retail banking can strengthen the financial frameworks by establishing associations between both financial institutions and customers. The evaluation of e-service quality, trust, and customer\u27s adoption of advanced technology are still unexplored within the retail banking context. Thus, this research paper fills a specific research gap via empirically testing the role of trust in between the relationship of e-service quality and customers\u27 patronage intentions in the context of online retail banking. Moreover, the research also examines the moderation role of adoption of advanced technology in between the relationship among trust and customers\u27 patronage intentions. Structural equation modelling (SEM) was applied to analyze the proposed hypotheses. The results confirmed that customer\u27s trust plays a significant role in mediating the relationship between e-service quality and customers\u27 patronage intentions. Adoption of advanced technology has also proved as significant moderator in explaining trust and customer\u27s patronage intention in online retail banking setting

Tacit knowledge-sharing behavior among the academic staff

Purpose – The purpose of this paper is to examine the critical success factor of tacit knowledge-sharing behavior among the academic staff of higher learning institutions. Design/methodology/approach – A total of 200 questionnaires were distributed among the academic staff of higher learning institutions in Bangladesh. Collectively, 150 usable responses were returned. Apart from descriptive statistics, this research applied confirmatory factor analysis (CFA) and structural equation modeling (SEM) to assess the measurement model and test the research hypotheses. Findings – The findings from this empirical examination show that all the Big Five personality traits affect tacit knowledge-sharing behavior among the academic staff of higher learning institutions, except conscientiousness personality trait. However, the role of motivation, self-efficacy and mutual trust are also playing a significant role in tacit knowledge-sharing behavior. The CFA, SEM analysis confirmed the proposed conceptual model with a good model fit. Research limitations/implications – The findings of this research contribute to the understanding of the role of personality traits and other antecedents which play a significant role for the academic staff tacit knowledge-sharing behavior which are interesting for policymakers and authorities of higher learning institutions. As there was no sampling frame, the researchers applied convenient sampling technique in choosing the respondents. Originality/value – This research plays a pioneering role where it contributes to the growing literature on the relationships between personality traits and other factors to construct a model for the tacit knowledge behavior by considering academic staff of higher learning institutions from a developing country’s perspectiv

Mediating effect of employee’s commitment on workplace spirituality and executive’s sales performance An empirical investigation

Purpose This study aims to develop a comprehensive framework that conceptualizes and measures the antecedents of the sales executive’s performance with regard to workplace spirituality and employee’s commitment. Design/methodology/approach This research applied a cross-sectional survey design to test the proposed hypotheses. Data were collected from 160 sales executives who are studying MBA and EMBA respectively and are working in various services and manufacturing organizations from Dhaka, Bangladesh. Findings The results suggest, when sales executives experience workplace spirituality; they feel more committed to their respective organizations and influences activities relating to sales performance. Research limitations/implications The study collected data for the constructs from the same source, simultaneously. This can produce the risk of common method variance, leading to an inflation of statistical relationships. A longitudinal research design may also be suitable. Practical implications By improving spirituality climates in the workplace, managers can enhance employee’s commitment, and thus, individual sales officers may boost up their sales performance. It is likely that occurs because sales executives react reciprocally toward their respective company that satisfies their spiritual needs. Originality/value The paper contributes by filling the gaps in literature related to sales management, where empirical studies on workplace spirituality have been scarce till date. This study is the first of a kind to include workplace spirituality, commitment and executive’s sales performance simultaneously in the context of Bangladesh

Classifying Bengali Newspaper Headlines with Advanced Deep Learning Models: LSTM, Bi-LSTM, and Bi-GRU Approaches

Reading newspapers is beneficial for people of all ages and the global community. The enjoyment of gathering diverse data from various sources adds to the overall experience. To enhance specificity in Bengali news headlines, recognizing the news genre becomes crucial. Recognizing the genre of the news, it is a very challenging task in Bengali Text Classification with the help of AI. A very few research works is done on Bengali News headline classification and we have done a model to provide a solution to the addressed issue. Due to the continuous change of the structure of the news headlines, we have employed a neural network adoption connection to our methodology experiment on a mixture of primary and secondary dataset. Achieving significant results, we implemented a Bengali dataset in Multi Classification using Long-Short Term Memory (LSTM), Bi- Long-Short Term Memory (Bi-LSTM), and Bi-Gated Recurrent Unit (Bi-GRU). The dataset is established by aggregating news headlines from various Bengali news portals and websites, showcasing robust categorization performance in the end product. Six categories were employed for the classification of Bengali newspaper headlines. The Bi-LSTM Model emerged with the highest training accuracy at 97.96% and the lowest validation accuracy at 77.91%. Furthermore, it demonstrated enhanced sensitivity and specificity

Temperature induced changes in physiological traits and expression of selected candidate genes in black tiger shrimp (Penaeus monodon) larvae

Temperature is an important abiotic factor influencing growth, development, metabolic performance and sex determination of aquatic organisms. The present study was conducted to test the effect of six different temperature levels (24℃, 26℃, 28℃ as control, 30℃, 32℃ and 34℃) on the physiological (growth, developmental durations, survivability, sex ratios and O2 consumption) and genetic (changes in expression pattern of seven candidate genes: three male sex determining genes, three female sex determining genes and a single thermal stress response gene) aspects of black tiger shrimp (Penaeus monodon) larvae. Temperature treatments significantly altered the growth performance of shrimp individuals (P P. monodon individuals; significantly higher (P P. monodon that in turn can help to improve aquaculture production