Exploring the decision-making power of Bangladeshi women of reproductive age: Results from a national survey

Empowerment is personal, multi-dimensional and latent phenomenon that is difficult to measure directly. Bangladesh is a developing country in South Asia and women population  of the country is almost equal to the male with the male dominant norms. It was aimed to look into the decision making authority and gender role of Bangladeshi women of reproductive age group. Bangladesh Demographic and Health Survey (BDHS) 2014 data was used for the study. A total of 17,863 women of reproductive age were included in this study. The mean age of the respondents was 31 years. About 23.5% respondents had no education and only 11.6% completed primary education. It was found that 68.5% respondents were working and about 73.6% respondents had no NGO (non-governmental organization) membership. Respondents from richest background were more likely to take their own decisions. Urban residence and with higher educational attainment were more likely to take their own decisions. Working status and membership to NGO are significantly associated with decision making power of women. The study revealed that women from urban area, with NGO membership and employed were more empowered. Poor attainment of primary education, low employment, and few NGO memberships are seemed to be the hindrance in women empowerment in Bangladesh. Keywords: Women empowerment, Decision-making, Health seeking behavior, BDHS, Bangladesh

Radon in the DRIFT-II directional dark matter TPC: emanation, detection and mitigation

Radon gas emanating from materials is of interest in environmental science and also a major concern in rare event non-accelerator particle physics experiments such as dark matter and double beta decay searches, where it is a major source of background. Notable for dark matter experiments is the production of radon progeny recoils (RPRs), the low energy (~ 100 keV) recoils of radon daughter isotopes, which can mimic the signal expected from WIMP interactions. Presented here are results of measurements of radon emanation from detector materials in the 1 m3 DRIFT-II directional dark matter gas time projection chamber experiment. Construction and operation of a radon emanation facility for this work is described, along with an analysis to continuously monitor DRIFT data for the presence of internal 222Rn and 218Po. Applying this analysis to historical DRIFT data, we show how systematic substitution of detector materials for alternatives, selected by this device for low radon emanation, has resulted in a factor of ~ 10 reduction in internal radon rates. Levels are found to be consistent with the sum from separate radon emanation measurements of the internal materials and also with direct measurement using an attached alpha spectrometer. The current DRIFT detector, DRIFT-IId, is found to have sensitivity to 222Rn of 2.5 μBql−1 with current analysis efficiency, potentially opening up DRIFT technology as a new tool for sensitive radon assay of materials

Independent susceptibility markers for atrial fibrillation on chromosome 4q25

Background-: Genetic variants on chromosome 4q25 are associated with atrial fibrillation (AF). We sought to determine whether there is more than 1 susceptibility signal at this locus. Methods and results-: Thirty-four haplotype-tagging single-nucleotide polymorphisms (SNPs) at the 4q25 locus were genotyped in 790 case and 1177 control subjects from Massachusetts General Hospital and tested for association with AF. We replicated SNPs associated with AF after adjustment for the most significantly associated SNP in 5066 case and 30 661 referent subjects from the German Competence Network for Atrial Fibrillation, Atherosclerosis Risk In Communities Study, Cleveland Clinic Lone AF Study, Cardiovascular Health Study, and Rotterdam Study. All subjects were of European ancestry. A multimarker risk score composed of SNPs that tagged distinct AF susceptibility signals was constructed and tested for association with AF, and all results were subjected to meta-analysis. The previously reported SNP, rs2200733, was most significantly associated with AF (minor allele odds ratio 1.80, 95% confidence interval 1.50 to 2.15, P=1.2×10) in the discovery sample. Adjustment for rs2200733 genotype revealed 2 additional susceptibility signals marked by rs17570669 and rs3853445. A graded risk of AF was observed with an increasing number of AF risk alleles at SNPs that tagged these 3 susceptibility signals. Conclusions-: We identified 2 novel AF susceptibility signals on chromosome 4q25. Consideration of multiple susceptibility signals at chromosome 4q25 identifies individuals with an increased risk of AF and may localize regulatory elements at the locus with biological relevance in the pathogenesis of AF

Assessment of a Genomic Assay in Patients with ERBB2 -Positive Breast Cancer Following Neoadjuvant Trastuzumab-Based Chemotherapy with or Without Pertuzumab

Importance: Biomarkers to guide the use of pertuzumab in the treatment of early-stage ERBB2 (formerly HER2)-positive breast cancer beyond simple ERBB2 status are needed. Objective: To determine if use of the HER2DX genomic assay (Reveal Genomics) in pretreatment baseline tissue samples of patients with ERBB2-positive breast cancer is associated with response to neoadjuvant trastuzumab-based chemotherapy with or without pertuzumab. Design, Setting, and Participants: This is a retrospective diagnostic/prognostic analysis of a multicenter academic observational study in Spain performed during 2018 to 2022 (GOM-HGUGM-2018-05). In addition, a combined analysis with 2 previously reported trials of neoadjuvant cohorts with results from the assay (DAPHNe and I-SPY2) was performed. All patients had stage I to III ERBB2-positive breast cancer, signed informed consent, and had available formalin-fixed paraffin-embedded tumor specimens obtained prior to starting therapy. Exposures: Patients received intravenous trastuzumab, 8 mg/kg, loading dose, followed by 6 mg/kg every 3 weeks in combination with intravenous docetaxel, 75 mg/m2, every 3 weeks and intravenous carboplatin area under the curve of 6 every 3 weeks for 6 cycles, or this regimen plus intravenous pertuzumab, 840 mg, loading dose, followed by an intravenous 420-mg dose every 3 weeks for 6 cycles. Main Outcome and Measures: Association of baseline assay-reported pathologic complete response (pCR) score with pCR in the breast and axilla, as well as association of baseline assay-reported pCR score with response to pertuzumab. Results: The assay was evaluated in 155 patients with ERBB2-positive breast cancer (mean [range] age, 50.3 [26-78] years). Clinical T1 to T2 and node-positive disease was present in 113 (72.9%) and 99 (63.9%) patients, respectively, and 105 (67.7%) tumors were hormone receptor positive. The overall pCR rate was 57.4% (95% CI, 49.2%-65.2%). The proportion of patients in the assay-reported pCR-low, pCR-medium, and pCR-high groups was 53 (34.2%), 54 (34.8%), and 48 (31.0%), respectively. In the multivariable analysis, the assay-reported pCR score (as a continuous variable from 0-100) showed a statistically significant association with pCR (odds ratio [OR] per 10-unit increase, 1.43; 95% CI, 1.22-1.70; P <.001). The pCR rates in the assay-reported pCR-high and pCR-low groups were 75.0% and 28.3%, respectively (OR, 7.85; 95% CI, 2.67-24.91; P <.001). In the combined analysis (n = 282), an increase in pCR rate due to pertuzumab was found in the assay-reported pCR-high tumors (OR, 5.36; 95% CI, 1.89-15.20; P <.001) but not in the assay-reported pCR-low tumors (OR, 0.86; 95% CI, 0.30-2.46; P =.77). A statistically significant interaction between the assay-reported pCR score and the effect of pertuzumab in pCR was observed. Conclusions and Relevance: This diagnostic/prognostic study demonstrated that the genomic assay predicted pCR following neoadjuvant trastuzumab-based chemotherapy with or without pertuzumab. This assay could guide therapeutic decisions regarding the use of neoadjuvant pertuzumab

Pain distress : the negative emotion associated with procedures in ICU patients

The intensity of procedural pain in intensive care unit (ICU) patients is well documented. However, little is known about procedural pain distress, the psychological response to pain. Post hoc analysis of a multicenter, multinational study of procedural pain. Pain distress was measured before and during procedures (0-10 numeric rating scale). Factors that influenced procedural pain distress were identified by multivariable analyses using a hierarchical model with ICU and country as random effects. A total of 4812 procedures were recorded (3851 patients, 192 ICUs, 28 countries). Pain distress scores were highest for endotracheal suctioning (ETS) and tracheal suctioning, chest tube removal (CTR), and wound drain removal (median [IQRs] = 4 [1.6, 1.7]). Significant relative risks (RR) for a higher degree of pain distress included certain procedures: turning (RR = 1.18), ETS (RR = 1.45), tracheal suctioning (RR = 1.38), CTR (RR = 1.39), wound drain removal (RR = 1.56), and arterial line insertion (RR = 1.41); certain pain behaviors (RR = 1.19-1.28); pre-procedural pain intensity (RR = 1.15); and use of opioids (RR = 1.15-1.22). Patient-related variables that significantly increased the odds of patients having higher procedural pain distress than pain intensity were pre-procedural pain intensity (odds ratio [OR] = 1.05); pre-hospital anxiety (OR = 1.76); receiving pethidine/meperidine (OR = 4.11); or receiving haloperidol (OR = 1.77) prior to the procedure. Procedural pain has both sensory and emotional dimensions. We found that, although procedural pain intensity (the sensory dimension) and distress (the emotional dimension) may closely covary, there are certain factors than can preferentially influence each of the dimensions. Clinicians are encouraged to appreciate the multidimensionality of pain when they perform procedures and use this knowledge to minimize the patient's pain experience.Peer reviewe

Low Threshold Results and Limits from the DRIFT Directional Dark Matter Detector

We present results from a 54.7 live-day shielded run of the DRIFT-IId detector, the world's most sensitive, directional, dark matter detector. Several improvements were made relative to our previous work including a lower threshold for detection, a more robust analysis and a tenfold improvement in our gamma rejection factor. After analysis, no events remain in our fiducial region leading to an exclusion curve for spin-dependent WIMP-proton interactions which reaches 0.28 pb at 100 GeV/c^2 a fourfold improvement on our previous work. We also present results from a 45.4 live-day unshielded run of the DRIFT-IId detector during which 14 nuclear recoil-like events were observed. We demonstrate that the observed nuclear recoil rate of 0.31+/-0.08 events per day is consistent with detection of ambient, fast neutrons emanating from the walls of the Boulby Underground Science Facility