Bacterial and viral etiology of acute respiratory infection among the Forcibly Displaced Myanmar Nationals (FDMNs) in fragile settings in Cox's Bazar- a prospective case-control study.

The leading infectious cause of death in children worldwide is lower acute respiratory infection (LARI), particularly pneumonia. We enrolled a total of 538 acute respiratory infection (ARI) cases according to WHO criteria and age-sex matched 514 controls in the Forcibly Displaced Myanmar National (FDMN) refugee camps in Cox's Bazar, Bangladesh, between June 2018 and March 2020 to investigate the role of bacteria, viruses, and their co-infection patterns and observe Streptococcus pneumoniae (S. pneumoniae) serotype distribution. According to the etiological findings, children ≤5 years of age have a higher bacterial positivity (90%) and viral positivity (34%) in nasopharyngeal samples (NPS) compared to those >5 years of age, in both ARI cases as well as for the control group. Among the bacteria, S. pneumoniae was predominant in both cases and controls (85% and 88%). Adenovirus (ADV)(34), influenza virus A and B (IFV-A, B)(32,23), and respiratory syncytial virus (RSV)(26) were detected as the highest number among the viruses tested for the ARI cases. The total number of viruses was also found higher in ≤5 years of age group. Within this group, positive correlation was observed between bacteria and viruses but negative correlation was observed between bacteria. Both single and co-infection for viruses were found higher in the case group than the control group. However, co-infection was significantly high for Streptococcus aureus (S. aureus) and Haemophilus influenzae b (H. influenza b) (p<0.05). Additionally, semi-quantitative bacterial and viral load was found higher for the ARI cases over control considering Cycle threshold (Ct)≤30. Pathogen identification from blood specimens was higher by qRT-PCR than blood culture (16% vs 5%, p<0.05). In the S. pneumoniae serotype distribution, the predominant serotypes in ARI cases were 23F, 19A, 16F, 35B, 15A, 20 and 10F, while 11A, 10A, 34, 35A and 13 serotypes were predominant in the control group. Pathogen correlation analysis showed RSV positively correlated with human metapneumovirus (HMPV), S. aureus and H. influenza b while S. pneumoniae was negatively correlated with other pathogens in ≤5 years age group of ARI cases. However, in >5 years age group, S. aureus and H. influenza b were positively correlated with IFVs, and S. pneumoniae was positively correlated with HMPV and ADV. Logistic regression data for viruses suggested among the respondents in cases were about 4 times more likely to be RSV positive than the control. Serotype distribution showed 30% for PCV10 serotypes, 41% for PCV13 and 59% for other serotypes. Also, among the 40 serotypes of S. pneumoniae tested, the serotypes 22F, Sg24, 9V, 38, 8, and 1 showed strong positive correlation with viruses in the case group whereas in the control group, it was predominant for serotypes 14, 38, 17F and 39 ARI cases were prevalent mostly in monsoon, post-monsoon, and winter periods, and peaked in September and October. Overall these region-specific etiological data and findings, particularly for crisis settings representing the FDMNs in Cox's Bazar, Bangladesh, is crucial for disease management and disease prevention control as well as immunization strategies more generally in humanitarian crisis settings.

Seroprevalence of SARS-CoV-2 infection and associated factors among Bangladeshi slum and non-slum dwellers in pre-COVID-19 vaccination era: October 2020 to February 2021.

BACKGROUND: Seroprevalence studies have been carried out in many developed and developing countries to evaluate ongoing and past infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Data on this infection in marginalized populations in urban slums are limited, which may offer crucial information to update prevention and mitigation policies and strategies. We aimed to determine the seroprevalence of SARS-CoV-2 infection and factors associated with seropositivity in slum and non-slum communities in two large cities in Bangladesh. METHODS: A cross-sectional study was carried out among the target population in Dhaka and Chattogram cities between October 2020 and February 2021. Questionnaire-based data, anthropometric and blood pressure measurements and blood were obtained. SARS-CoV-2 serology was assessed by Roche Elecsys® Anti-SARS-CoV-2 immunoassay. RESULTS: Among the 3220 participants (2444 adults, ≥18 years; 776 children, 10-17 years), the overall weighted seroprevalence was 67.3% (95% confidence intervals (CI) = 65.2, 69.3) with 71.0% in slum (95% CI = 68.7, 72.2) and 62.2% in non-slum (95% CI = 58.5, 65.8). The weighted seroprevalence was 72.9% in Dhaka and 54.2% in Chattogram. Seroprevalence was positively associated with limited years of formal education (adjusted odds ratio [aOR] = 1.61; 95% CI = 1.43, 1.82), lower income (aOR = 1.23; 95% CI = 1.03, 1.46), overweight (aOR = 1.2835; 95% CI = 1.26, 1.97), diabetes (aOR = 1.67; 95% CI = 1.21, 2.32) and heart disease (aOR = 1.38; 95% CI = 1.03, 1.86). Contrarily, negative associations were found between seropositivity and regular wearing of masks and washing hands, and prior BCG vaccination. About 63% of the population had asymptomatic infection; only 33% slum and 49% non-slum population showed symptomatic infection. CONCLUSION: The estimated seroprevalence of SARS-CoV-2 was more prominent in impoverished informal settlements than in the adjacent middle-income non-slum areas. Additional factors associated with seropositivity included limited education, low income, overweight and pre-existing chronic conditions. Behavioral factors such as regular wearing of masks and washing hands were associated with lower probability of seropositivity.

Hepatitis E Virus Capsid Antigen (HEV-Ag) - A practical diagnostic biomarker in the HEV outbreak scenario.

BACKGROUND: The increased global incidence of hepatitis E virus (HEV) infections, warrants accurate and affordable diagnostics across different geographical regions. The soluble and highly conserved HEV open reading frame 2 (ORF2) capsid antigen (HEV-Ag) is detectable in self-limited acute enteric hepatitis by HEV-Ag ELISA which is a promising serological assay in settings where HEV-RNA testing is not feasible. Our aim was to assess the HEV-Ag biomarker in an HEV outbreak in a low income country. METHODS: A prospective single center longitudinal study during HEV outbreaks in the Chittagong, Bangladesh region between October 2018 and October 2019 was conducted based on recruitment of acute jaundice cases with clinical signs and symptoms of suspect HEV infections. Acute HEV infection was defined as a positive test result for anti-HEV IgM antibodies. RESULTS: Forty four of the 51 enrolled enteric hepatitis cases (86 %) were confirmed HEV by anti-HEV IgM ELISA at day 0 hospital entry. The anti-HEV-IgM and IgG were positive in all patients and did not reveal significant differences; neither between the time points day 0 and follow-up hospitalization on day 2-6 or day 7-10 nor between RNA-positive (n = 36) versus RNAnegative (n = 8) HEV groups. The HEV-Ag positivity was higher in viral RNA-positive (29/36, 81 %) than the viral RNA-negative (1/8, 12 %) group, p < 0.001 and the HEV-Ag levels positively correlated with viremia, r = 0.77, p < 0.0001. All non-HEV cases; n = 7 tested negative anti-HEV IgM and HEV-Ag and 5 of 7 (71 %) tested anti-HAV IgM positive. CONCLUSIONS: The HEV-Ag ELISA is a reliable and practical diagnostic tool in this acute HEV outbreak.

Overdamped Antiferromagnetic Strange Metal State in Sr_{3}IrRuO_{7}.

The unconventional electronic ground state of Sr_{3}IrRuO_{7} is explored via resonant x-ray scattering techniques and angle-resolved photoemission measurements. As the Ru content approaches x=0.5 in Sr_{3}(Ir_{1-x}Ru_{x})_{2}O_{7}, intermediate to the J_{eff}=1/2 Mott state in Sr_{3}Ir_{2}O_{7} and the quantum critical metal in Sr_{3}Ru_{2}O_{7}, a thermodynamically distinct metallic state emerges. The electronic structure of this intermediate phase lacks coherent quasiparticles, and charge transport exhibits a linear temperature dependence over a wide range of temperatures. Spin dynamics associated with the long-range antiferromagnetism of this phase show nearly local, overdamped magnetic excitations and an anomalously large energy scale of 200 meV-an energy far in excess of exchange energies present within either the Sr_{3}Ir_{2}O_{7} or Sr_{3}Ru_{2}O_{7} solid-solution end points. Overdamped quasiparticle dynamics driven by strong spin-charge coupling are proposed to explain the incoherent spectral features of the strange metal state in Sr_{3}IrRuO_{7}.

Disorder raises the critical temperature of a cuprate superconductor.

With the discovery of charge-density waves (CDWs) in most members of the cuprate high-temperature superconductors, the interplay between superconductivity and CDWs has become a key point in the debate on the origin of high-temperature superconductivity. Some experiments in cuprates point toward a CDW state competing with superconductivity, but others raise the possibility of a CDW-superconductivity intertwined order or more elusive pair-density waves (PDWs). Here, we have used proton irradiation to induce disorder in crystals of [Formula: see text] and observed a striking 50% increase of [Formula: see text], accompanied by a suppression of the CDWs. This is in sharp contrast with the behavior expected of a d-wave superconductor, for which both magnetic and nonmagnetic defects should suppress [Formula: see text] Our results thus make an unambiguous case for the strong detrimental effect of the CDW on bulk superconductivity in [Formula: see text] Using tunnel diode oscillator (TDO) measurements, we find indications for potential dynamic layer decoupling in a PDW phase. Our results establish irradiation-induced disorder as a particularly relevant tuning parameter for the many families of superconductors with coexisting density waves, which we demonstrate on superconductors such as the dichalcogenides and [Formula: see text].

Preferential quenching of 5d antiferromagnetic order in Sr3(Ir1-x Mn x )2O7.

The breakdown of [Formula: see text] antiferromagnetism in the limit of strong disorder is studied in Sr3(Ir1-x Mn x )2O7. Upon Mn-substitution, antiferromagnetic ordering of the Ir cations becomes increasingly two-dimensional, resulting in the complete suppression of long-range Ir magnetic order above [Formula: see text]. Long-range antiferromagnetism however persists on the Mn sites to higher Mn concentrations (x > 0.25) and is necessarily mediated via a random network of majority Ir sites. Our data suggest a shift in the Mn valence from Mn4+ to Mn3+ at intermediate doping levels, which in turn generates nonmagnetic Ir5+ sites and suppresses long-range order within the Ir network. The collapse of long-range [Formula: see text] antiferromagnetism and the survival of percolating antiferromagnetic order on Mn-sites demonstrates a complex 3d-5d exchange process that surprisingly enables minority Mn spins to order far below the conventional percolation threshold for a bilayer square lattice.

Unidirectional spin density wave state in metallic (Sr1-xLa x )2IrO4.

Materials that exhibit both strong spin-orbit coupling and electron correlation effects are predicted to host numerous new electronic states. One prominent example is the Jeff = 1/2 Mott state in Sr2IrO4, where introducing carriers is predicted to manifest high temperature superconductivity analogous to the S = 1/2 Mott state of La2CuO4. While bulk superconductivity currently remains elusive, anomalous quasiparticle behaviors paralleling those in the cuprates such as pseudogap formation and the formation of a d-wave gap are observed upon electron-doping Sr2IrO4. Here we establish a magnetic parallel between electron-doped Sr2IrO4 and hole-doped La2CuO4 by unveiling a spin density wave state in electron-doped Sr2IrO4. Our magnetic resonant X-ray scattering data reveal the presence of an incommensurate magnetic state reminiscent of the diagonal spin density wave state observed in the monolayer cuprate (La1-xSr x )2CuO4. This link supports the conjecture that the quenched Mott phases in electron-doped Sr2IrO4 and hole-doped La2CuO4 support common competing electronic phases.

Correlated states in ß-Li2IrO3 driven by applied magnetic fields.

Magnetic honeycomb iridates are thought to show strongly spin-anisotropic exchange interactions which, when highly frustrated, lead to an exotic state of matter known as the Kitaev quantum spin liquid. However, in all known examples these materials magnetically order at finite temperatures, the scale of which may imply weak frustration. Here we show that the application of a relatively small magnetic field drives the three-dimensional magnet ß-Li2IrO3 from its incommensurate ground state into a quantum correlated paramagnet. Interestingly, this paramagnetic state admixes a zig-zag spin mode analogous to the zig-zag order seen in other Mott-Kitaev compounds. The rapid onset of the field-induced correlated state implies the exchange interactions are delicately balanced, leading to strong frustration and a near degeneracy of different ground states.Materials with a Kitaev spin liquid ground state are sought after as models of quantum phases but candidates so far form either zig-zag or incommensurate magnetic order. Ruiz et al. find a crossover between these states in ß-Li2IrO3 under weak magnetic fields, indicating strongly frustrated spin interactions.

Prognostic Value of Ocular Trauma Score in Evaluating Visual Outcome of Pediatric (4-16 Years) Open Globe Injuries.

PURPOSE: This study aimed to assess the prognostic value of ocular trauma score (OTS) in pediatric open globe injury. DESIGN: A prospective observational study was conducted. METHODS: A total of 210 patients aged 4 to 16 years (mean ± SD age, 9.30 ± 3.29 years) with open globe injury were recruited by nonrandomized purposive sampling based on the inclusion and exclusion criteria. Ocular trauma score variables, including visual acuity (VA), rupture, endophthalmitis, perforating injury, retinal detachment, and afferent pupillary defect, were determined and converted into OTS categories. The final VA in each category was compared with the prognostic outcome. RESULTS: Patients were categorized into 5 groups according to the OTS model, with 30 (14.28%) patients in category 1, 52 (24.77%) patients in category 2, 40 (19.05%) patients in category 3, 40 (19.05%) patients in category 4, and 48 (22.86%) patients in category 5.Forty-three (20.48%) patients had a final VA of 20/40 or greater, all of whom were in category 5. No patients in category 1 could achieve a VA of 20/40 or greater. Of the 35 (16.67%) patients who had no perception of light in follow-up visits, 28 were from category 1 and 7 were from category 2. CONCLUSIONS: Ocular trauma score has good prognostic significance if other interventions such as proper evaluation, early surgery, and proper follow-up can be ensured.

A single-solenoid pulsed-magnet system for single-crystal scattering studies.

We present a pulsed-magnet system that enables x-ray single-crystal diffraction in addition to powder and spectroscopic studies with the magnetic field applied on or close to the scattering plane. The apparatus consists of a single large-bore solenoid, cooled by liquid nitrogen. A second independent closed-cycle cryostat is used for cooling samples near liquid helium temperatures. Pulsed magnetic fields close to ~30 T with a zero-to-peak-field rise time of ~2.9 ms are generated by discharging a 40 kJ capacitor bank into the magnet coil. The unique characteristic of this instrument is the preservation of maximum scattering angle (~23.6°) on the entrance and exit sides of the magnet bore by virtue of a novel double-funnel insert. This instrument will facilitate x-ray diffraction and spectroscopic studies that are impractical, if not impossible, to perform using split-pair and narrow-opening solenoid magnets. Furthermore, it offers a practical solution for preserving optical access in future higher-field pulsed magnets.

Time-resolved one-dimensional detection of x-ray scattering in pulsed magnetic fields.

We have developed an application of a one-dimensional micro-strip detector for capturing x-ray diffraction data in pulsed magnetic fields. This detector consists of a large array of 50 µm-wide Si strips with a full-frame read out at 20 kHz. Its use substantially improves data-collection efficiency and quality as compared to point detectors, because diffraction signals are recorded along an arc in reciprocal space in a time-resolved manner. By synchronizing with pulsed fields, the entire field dependence of a two-dimensional swath of reciprocal space may be determined using a small number of field pulses.

High prevalence of antibiotic resistance in pathogenic Escherichia coli from large- and small-scale poultry farms in Bangladesh.

Antibiotic resistance in avian bacterial pathogens is a common problem in the Bangladesh poultry industry. The aim of the present study was to provide information on the present status of antibiotic resistance patterns in avian pathogenic Escherichia coli in Bangladesh. Of 279 dead or sick poultry of different ages, 101 pathogenic E coli strains isolated from broilers and layer hens with colibacillosis infections were screened to determine phenotypic expression of antimicrobial resistance against 13 antibiotics used in both veterinary and human medicine in Bangladesh. Of 101 pathogenic E. coli isolates, more than 55% were resistant to at least one or more of the tested compounds, and 36.6% of the isolates showed multiple-drug-resistant phenotypes. The most common resistances observed were against tetracycline (45.5%), trimethoprim-sulphamethoxazole (26.7%), nalidixic acid (25.7%), ampicillin (25.7%), and streptomycin (20.8%). Resistance to ciprofloxacin (12.9%), chlormaphenicol (8.9%), nitrofurantoin (2%), and gentamicin (2%) was also observed, and none of the isolates were resistant to tigecycline as well as extended spectrum beta-lactamase (ESBL) producers. One isolate was resistant to cefuroxime (1%), cefadroxil (1%), and mecillinam (1%) but was not an ESBL producer. Resistance rates, although significant in Bangladeshi isolates, were found to be lower than those reported for avian isolates from the Republic of Korea and clinical, avian, and environmental isolates from Bangladesh. The high level of antibiotic resistance in avian pathogens from Bangladesh is worrisome and indicates that widespread use of antibiotics as feed additives for growth promotion and disease prevention could have negative implications for human and animal health and the environment.

In-plane resistivity anisotropy in an underdoped iron arsenide superconductor.

High-temperature superconductivity often emerges in the proximity of a symmetry-breaking ground state. For superconducting iron arsenides, in addition to the antiferromagnetic ground state, a small structural distortion breaks the crystal's C(4 )rotational symmetry in the underdoped part of the phase diagram. We reveal that the representative iron arsenide Ba(Fe(1)(-x)Co(x))(2)As(2) develops a large electronic anisotropy at this transition via measurements of the in-plane resistivity of detwinned single crystals, with the resistivity along the shorter b axis rho(b) being greater than rho(a). The anisotropy reaches a maximum value of ~2 for compositions in the neighborhood of the beginning of the superconducting dome. For temperatures well above the structural transition, uniaxial stress induces a resistivity anisotropy, indicating a substantial nematic susceptibility.

A portable high-field pulsed-magnet system for single-crystal x-ray scattering studies.

We present a portable pulsed-magnet system for x-ray studies of materials in high magnetic fields (up to 30 T). The apparatus consists of a split-pair of minicoils cooled on a closed-cycle cryostat, which is used for x-ray diffraction studies with applied field normal to the scattering plane. A second independent closed-cycle cryostat is used for cooling the sample to near liquid helium temperatures. Pulsed magnetic fields (approximately 1 ms in total duration) are generated by discharging a configurable capacitor bank into the magnet coils. Time-resolved scattering data are collected using a combination of a fast single-photon counting detector, a multichannel scaler, and a high-resolution digital storage oscilloscope. The capabilities of this instrument are used to study a geometrically frustrated system revealing strong magnetostrictive effects in the spin-liquid state.

Four-unit-cell superstructure in the optimally doped YBa2Cu3O6.92 superconductor.

Diffuse x-ray scattering measurements reveal that the optimally doped YBa2Cu3O6.92 superconductor is intrinsically modulated due to the formation of a kinetically limited 4-unit-cell superlattice, q(0)=(1/4, 0, 0), along the shorter Cu-Cu bonds. The superlattice consists of large anisotropic displacements of Cu, Ba, and O atoms, respectively, which are correlated over approximately 3-6 unit cells in the ab plane, and appears to be consistent with the presence of an O-ordered "ortho-IV" phase. Long-range strains emanating from these modulated regions generate an inhomogeneous lattice which may play a fundamentally important role in the electronic properties of yttrium-barium-copper-oxides.