Whole Genome Interpretation for a Family of Five.

Although best practices have emerged on how to analyse and interpret personal genomes, the utility of whole genome screening remains underdeveloped. A large amount of information can be gathered from various types of analyses via whole genome sequencing including pathogenicity screening, genetic risk scoring, fitness, nutrition, and pharmacogenomic analysis. We recognize different levels of confidence when assessing the validity of genetic markers and apply rigorous standards for evaluation of phenotype associations. We illustrate the application of this approach on a family of five. By applying analyses of whole genomes from different methodological perspectives, we are able to build a more comprehensive picture to assist decision making in preventative healthcare and well-being management. Our interpretation and reporting outputs provide input for a clinician to develop a healthcare plan for the individual, based on genetic and other healthcare data

Asphericity Can Cause Nonuniform Lithium Intercalation in Battery Active Particles

Uniform intercalation is desired to enable next-generation Li-ion batteries. While we expect nonuniformity in materials undergoing a phase change, single-phase intercalation materials such as nickel manganese cobalt oxide are believed to lithiate uniformly at the particle/electrolyte interface. However, recent imaging reveals nonuniform lithiation. Motivated by this discrepancy, we examine if aspherical particle shape can cause such nonuniformity since the conventional belief is based on spherical particle theory. We obtain real particle geometries using rapid lab-based X-ray computed tomography and subsequently perform physics-based calculations accounting for electrochemical reactions at the particle/electrolyte interface and lithium transport inside the particle bulk. The aspherical geometry breaks the symmetry and causes nonuniform reaction distribution. Such nonuniformity is exacerbated as the particle becomes more aspherical. The proposed mechanism represents a fundamental limit on achievable lithiation uniformity in aspherical particles in the absence of other mechanisms causing inhomogeneity, such as grain structure, nonuniform carbon-binder coating, etc

Placental expression of eNOS, iNOS and the major protein components of caveolae in women with pre-eclampsia

Caveolae regulate many cardiovascular functions and thus could be of interest in relation to pre-eclampsia, a pregnancy specific disorder characterised by hypertension and proteinuria. We examined placental mRNA and protein expression/localisation of the caveolae components Caveolin 1-3, Cavin 1-4 as well as eNOS/ iNOS in normotensive control (n=24) and pre-eclamptic pregnancies (n=19). Placental mRNA expression of caveolin-1, cavin 1-3, was lower and eNOS expression was increased in pre-eclampsia (P<0.05 for all). Additionally Caveolin-1 protein expression was also reduced in pre-eclampsia (P=0.007); this could be an adaptive response in pre-eclampsia, possibly to attenuate the oxidative stress/inflammation

Drug utilization pattern of antiseizure drugs and their adverse effects in the pediatric population, in a tertiary care hospital attached to a medical college

Background: Epilepsy is “a condition characterized by recurrent (two or more) seizure, unprovoked by any immediate identified cause.” The desired outcome of antiseizure drug (ASD) therapy is to be seizure-free throughout the rest of life. The objective was to study the utilization pattern and adverse drug reactions (ADRs) associated with the use of ASDs in pediatric outpatients in epilepsy clinic.Methods: This cross-sectional, observational and single center study was carried out over a period of 1 year in 430 pediatric patients. Analyzed data included demographic details and drugs prescribed in respective seizure types along with ADRs due to ASDs. Results: In a total 430 patients analyzed, seizure were most commonly observed in boys (69.8%) in 6-10 year of age (45.3%), with a positive family history in (16%), with no specific cause of seizure in (71.6%), with most common type was focal seizure in (62.3%), which was mainly treated with carbamazepine (73.8%). Most common ADR was irritability (32.2%) with Valproate being main drug. 87.3% ADRs were in “ possible” as per World Health Organization causality assessment scale, 94.9% ADRs were “mild” as per Hartwig and Siegel severity assessment scale and 98.3% ADRs were “preventable” as per Schumock and Thornton preventability scale.Conclusion: Focal seizure was most common type of seizure observed mainly in boys of 6-10 year with carbamazepine as mainly prescribed drug. Use of appropriate ASDs in the majority of patients as per guidelines, has decreased number of ADRs in our study. Prescribing drugs were mainly from essential drug list and by generic names

Changes in loneliness prevalence and its associated factors among Bangladeshi older adults during the COVID-19 pandemic

Aims Worldwide, loneliness is one of the most common psychological phenomena among older adults, adversely affecting their physical and mental health conditions during the COVID-19 pandemic. This study aims to assess changes in the prevalence of loneliness in the two timeframes (first and second waves of COVID-19 in Bangladesh) and identify its correlates in pooled data. Methods This repeated cross-sectional study was conducted on two successive occasions (October 2020 and September 2021), overlapping with the first and second waves of the COVID-19 pandemic in Bangladesh. The survey was conducted remotely through telephone interviews among 2077 (1032 in the 2020-survey and 1045 in the 2021-survey) older Bangladeshi adults aged 60 years and above. Loneliness was measured using the 3-item UCLA Loneliness scale. The binary logistic regression model was used to identify the factors associated with loneliness in pooled data. Results We found a decline in the loneliness prevalence among the participants in two survey rounds (51.5% in 2021 versus 45.7% in 2020; P = 0.008), corresponding to 33% lower odds in the 2021-survey (AOR 0.67, 95% CI 0.54-0.84). Still, nearly half of the participants were found to be lonely in the latest survey. We also found that, compared to their respective counterparts, the odds of loneliness were significantly higher among the participants without a partner (AOR 1.58, 95% CI 1.20-2.08), with a monthly family income less than 5000 BDT (AOR 2.34, 95% CI 1.58-3.47), who lived alone (AOR 2.17, 95% CI 1.34-3.51), with poor memory or concentration (AOR 1.58, 95% CI 1.23-2.03), and suffering from non-communicable chronic conditions (AOR 1.55, 95% CI 1.23-1.95). Various COVID-19-related characteristics, such as concern about COVID-19 (AOR 1.28, 95% CI 0.94-1.73), overwhelm by COVID-19 (AOR 1.53, 95% CI 1.14-2.06), difficulty earning (AOR 2.00, 95% CI 1.54-2.59), and receiving routine medical care during COVID-19 (AOR 2.08, 95% CI 1.61-2.68), and perception that the participants required additional care during the pandemic (AOR 2.93, 95% CI 2.27-3.79) were also associated with significantly higher odds of loneliness. However, the odds of loneliness were significantly lower among the participants with formal schooling (AOR 0.71, 95% CI 0.57-0.89) and with a family of more than four members (AOR 0.76, 95% CI 0.60-0.96). Conclusions The current study found a decreased prevalence of loneliness among Bangladeshi older adults during the ongoing pandemic. However, the prevalence is still very high. The findings suggest the need for mental health interventions that may include improving social interactions increasing opportunities for meaningful social connections with family and community members and providing psychosocial support to the vulnerable population including older adults during the pandemic. It also suggests that policymakers and public health practitioners should emphasise providing mental health services at the peripheral level where the majority of older adults reside

Prognosis of operable squamous cell carcinoma of the esophagus. Relationship with clinicopathologic features and DNA ploidy

Background: Reports on the influence of various prognostic factors in carcinoma of the esophagus are conflicting. The prognostic value of a set of clinicopathologic factors and DNA ploidy were examined in 74 patients with surgically resected squamous cell carcinoma of the lower and middle third of the esophagus. Methods: All patients had surgery performed in a single thoracic surgical unit at the Tata Memorial Hospital between January, 1984 and December, 1987. The clinicopathologic factors studied were (1) gross residual disease at operation; (2) morphology of the tumor; (3) depth of microscopic invasion; (4) lymph node involvement; (5) histologic grade; (6) vascular and lymphatic embolism; and (7) sex. DNA ploidy and S-phase fraction (SpF) were determined by flow cytometry on archival tissues extracted from paraffin blocks. Ploidy status could be determined successfully in all 74 tumors, whereas SpF could be assessed only in 25. Results: Of the various prognostic factors examined with the Cox stepwise regression model, residual disease (P = 0.000), depth of invasion (P = 0.047), and lymph node status (P = 0.077) were found to be correlated with overall survival. Conclusions: DNA ploidy was not related to prognosis. The overall survival of this group of patients at 36 months was 28%, and median survival was 18 months

Global COVID-19 vaccine equity and the booster dose in low-resource countries : a decolonizing global health perspective

On July 30, 2021, the administration of a third (booster) dose of the COVID-19 vaccine was introduced to enhance immunity among vaccinated people. Many developed countries have introduced vaccine booster doses as additional protection for their population to mitigate the severity of the ongoing COVID-19 pandemic. However, this idea is currently being replicated by low- and lower-middle-income countries (LMICs), where full vaccination coverage is, as of now, still below 45%, which is considerably lower than that of high-income countries (73%). This commentary focuses on the critiques of introducing booster dose strategy in low-income countries. We highlight different decolonizing global health perspectives, including vaccine equity, effective resource utilization, and priority setup, in this commentary

COVID-19 vaccination coverage is extremely low among older population in Bangladesh : findings from a cross-sectional study

This cross-sectional study was conducted in September 2021 among 1,045 Bangladeshi older adults aged 60 years or above to explore the COVID-19 vaccination coverage and its associated factors. We used a semi-structured questionnaire to collect data on participants’ sociodemographic and lifestyle characteristics, and COVID-19 related information (selected based on an extensive literature review). A multinomial logistic regression model was used to identify the factors independently associated with vaccine receipt. Nearly, two-thirds of the participants (64.5%) were unvaccinated and 12.5% received a single dose. Among the unvaccinated, approximately 94% reported that there was a problem in accessing the vaccine. We found that participants with formal schooling had 42% lower risk of being unvaccinated (RRR (Relative Risk Ratio) = 0.58, 95% CI 0.42–0.80) or 39% lower risk of receiving a single dose (RRR = 0.61, 95% CI 0.39–0.96) than the participants having no formal schooling. The middle family monthly income groups had 65% higher risk (RRR = 1.65, 95% CI 1.17–2.32) and rural participants had 84% higher risk (RRR = 1.84, 95% CI 1.26–2.70) of not receiving vaccines compared to their counterparts. Also, the participants with non-communicable chronic conditions had a significantly lower risk of being unvaccinated (RRR = 0.49, 95% CI 0.35–0.68) or receiving a single dose (RRR = 0.49, 95% CI 0.31–0.77) compared to their counterparts. This finding may help strengthen the existing efforts to maximize vaccine coverage among older populations in Bangladesh and reach herd immunity to break the transmission chain and gain greater overall population protection more rapidly