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Hasan MZ, Rabbani MG, Akter O, Mehdi GG, Ahmed MW, Ahmed S, Chowdhury ME. Patient Satisfaction With the Health Care Services of a Government-Financed Health Protection Scheme in Bangladesh: Cross-Sectional Study. JMIR Form Res 2024; 8:e49815. [PMID: 38656783 DOI: 10.2196/49815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 10/07/2023] [Accepted: 11/22/2023] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Since 2016, the government of Bangladesh has been piloting a health protection scheme known as Shasthyo Surokhsha Karmasuchi (SSK), which specifically targets households living below the poverty line. This noncontributory scheme provides enrolled households access to inpatient health care services for 78 disease groups. Understanding patients' experiences with health care utilization from the pilot SSK scheme is important for enhancing the quality of health care service delivery during the national-level scale-up of the scheme. OBJECTIVE We aimed to evaluate patient satisfaction with the health care services provided under the pilot health protection scheme in Bangladesh. METHODS A cross-sectional survey was conducted with the users of the SSK scheme from August to November 2019. Patients who had spent a minimum of 2 nights at health care facilities were selected for face-to-face exit interviews. During these interviews, we collected information on patients' socioeconomic characteristics, care-seeking experiences, and level of satisfaction with various aspects of health care service delivery. To measure satisfaction, we employed a 5-point Likert scale (very satisfied, 5; satisfied, 4; neither satisfied nor dissatisfied, 3; dissatisfied, 2; very dissatisfied, 1). Descriptive statistics, statistical inferential tests (t-test and 1-way ANOVA), and linear regression analyses were performed. RESULTS We found that 55.1% (241/438) of users were either very satisfied or satisfied with the health care services of the SSK scheme. The most satisfactory indicators were related to privacy maintained during diagnostic tests (mean 3.91, SD 0.64), physicians' behaviors (mean 3.86, SD 0.77), services provided at the registration booth (mean 3.86, SD 0.62), confidentiality maintained regarding diseases (mean 3.78, SD 0.72), and nurses' behaviors (mean 3.60, SD 0.83). Poor satisfaction was identified in the interaction of patients with providers about illness-related information (mean 2.14, SD 1.40), availability of drinking water (mean 1.46, SD 0.76), cleanliness of toilets (mean 2.85, SD 1.04), and cleanliness of the waiting room (mean 2.92, SD 1.09). Patient satisfaction significantly decreased by 0.20 points for registration times of 16-30 minutes and by 0.32 points for registration times of >30 minutes compared with registration times of ≤15 minutes. Similarly, patient satisfaction significantly decreased with an increase in the waiting time to obtain services. However, the satisfaction of users significantly increased if they received a complete course of medicines and all prescribed diagnostic services. CONCLUSIONS More than half of the users were satisfied with the services provided under the SSK scheme. However, there is scope for improving user satisfaction. To improve the satisfaction level, the SSK scheme implementation authorities should pay attention to reducing the registration time and waiting time to obtain services and improving the availability of drugs and prescribed diagnostic services. The authorities should also ensure the supply of drinking water and enhance the cleanliness of the facility.
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Affiliation(s)
- Md Zahid Hasan
- Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh
- Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom
| | - Md Golam Rabbani
- Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh
| | - Orin Akter
- Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh
| | - Gazi Golam Mehdi
- Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh
| | | | - Sayem Ahmed
- Health Economics and Health Technology Assessment, School of Health & Wellbeing, University of Glasgow, Glasgow, United Kingdom
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Rahman MF, Hasan Toki MN, Irfan A, Chaudhry AR, Rahaman R, Rasheduzzaman M, Hasan MZ. A novel investigation of pressure-induced semiconducting to metallic transition of lead free novel Ba 3SbI 3 perovskite with exceptional optoelectronic properties. RSC Adv 2024; 14:11169-11184. [PMID: 38590348 PMCID: PMC10999911 DOI: 10.1039/d4ra00395k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 03/27/2024] [Indexed: 04/10/2024] Open
Abstract
The structural, electronic, mechanical, and optical characteristics of barium-based halide perovskite Ba3SbI3 under the influence of pressures ranging from 0 to 10 GPa have been analyzed using first-principles calculations for the first time. The new perovskite Ba3SbI3 material was shown to be a direct band gap semiconductor at 0 GPa, but the band gap diminished when the applied pressure increased from 0 to 10 GPa. So the Ba3SbI3 material undergoes a transition from semiconductor to metallic due to high pressure at 10 GPa. The Ba3SbI3 material also exhibits an increase in optical absorption and conductivity with applied pressure due to the change in band gap, which is more suitable for solar absorbers, surgical instruments, and optoelectronic devices. The charge density maps confirm the presence of both ionic and covalent bonding characteristics. Exploration into the mechanical characteristics indicates that the Ba3SbI3 perovskite is mechanically stable. Additionally, the Ba3SbI3 compound becomes strongly anisotropic at high pressure. The insightful results of our simulations will all be helpful for the experimental structure of a new effective Ba3SbI3-based inorganic perovskite solar cell in the near future.
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Affiliation(s)
- Md Ferdous Rahman
- Advanced Energy Materials and Solar Cell Research Laboratory, Department of Electrical and Electronic Engineering, Begum Rokeya University Rangpur 5400 Bangladesh
| | - Md Naim Hasan Toki
- Advanced Energy Materials and Solar Cell Research Laboratory, Department of Electrical and Electronic Engineering, Begum Rokeya University Rangpur 5400 Bangladesh
| | - Ahmad Irfan
- Department of Chemistry, College of Science, King Khalid University P. O. Box 9004 Abha 61413 Saudi Arabia
| | - Aijaz Rasool Chaudhry
- Department of Physics, College of Science, University of Bisha P. O. Box 551 Bisha 61922 Saudi Arabia
| | - Rajabur Rahaman
- Department of Electrical and Electronic Engineering, International Islamic University Chittagong Kumira Chittagong 4318 Bangladesh
| | - Md Rasheduzzaman
- Department of Electrical and Electronic Engineering, International Islamic University Chittagong Kumira Chittagong 4318 Bangladesh
| | - Md Zahid Hasan
- Department of Electrical and Electronic Engineering, International Islamic University Chittagong Kumira Chittagong 4318 Bangladesh
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Biswas S, Kuwata T, Yamauchi S, Okazaki K, Kaku Y, Hasan MZ, Morioka H, Matsushita S. Idiotopes of antibodies against HIV-1 CD4-induced epitope shared with those against microorganisms. Immunology 2024; 171:534-548. [PMID: 38102962 DOI: 10.1111/imm.13742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 12/04/2023] [Indexed: 12/17/2023] Open
Abstract
Induction of antibodies (Abs) against the conformational CD4-induced (CD4i) epitope is frequent in HIV-1 infection. However, the mechanism of development of anti-CD4i Abs is unclear. We used anti-idiotypic (aID) monoclonal Abs (mAbs) of anti-CD4i mAbs to isolate anti-CD4i mAbs from infected subjects and track the causative antigens. One anti-aID mAb sorted from infected subjects by aID mAbs had the characteristics of anti-CD4i Abs, including IGHV1-69 usage and ability to bind to HIV-1 Env enhanced by sCD4. Critical amino acid sequences for the binding of six anti-aID mAbs, with shared idiotope to anti-CD4i mAbs, were analysed by phage display. The identified amino acid sequences showed similarity to proteins from human microbiota and infectious agents. Peptides synthesized from Caudoviricetes sp and Vibrio vulnificus based on the identified sequences were reactive to most anti-aID and some anti-CD4i mAbs. These results suggest that anti-CD4i Abs may evolve from B cells primed by microorganisms.
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Affiliation(s)
- Shashwata Biswas
- Division of Clinical Retrovirology, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan
| | - Takeo Kuwata
- Division of Clinical Retrovirology, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan
| | - Soichiro Yamauchi
- Department of Analytical and Biophysical Chemistry, Faculty of Medical and Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan
| | - Kyo Okazaki
- Department of Analytical and Biophysical Chemistry, Faculty of Medical and Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan
| | - Yu Kaku
- Division of Clinical Retrovirology, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan
| | - Md Zahid Hasan
- Division of Clinical Retrovirology, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan
| | - Hiroshi Morioka
- Department of Analytical and Biophysical Chemistry, Faculty of Medical and Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan
| | - Shuzo Matsushita
- Division of Clinical Retrovirology, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan
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Hasan MZ, Ahmed S, Mehdi GG, Ahmed MW, Arifeen SE, Chowdhury ME. The effectiveness of a government-sponsored health protection scheme in reducing financial risks for the below-poverty-line population in Bangladesh. Health Policy Plan 2024; 39:281-298. [PMID: 38164712 DOI: 10.1093/heapol/czad115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 11/09/2023] [Indexed: 01/03/2024] Open
Abstract
The Government of Bangladesh is piloting a non-contributory health protection scheme called Shasthyo Surokhsha Karmasuchi (SSK) to increase access to quality essential healthcare services for the below-poverty-line (BPL) population. This paper assesses the effect of the SSK scheme on out-of-pocket expenditure (OOPE) for healthcare, catastrophic health expenditure (CHE) and economic impoverishment of the enrolled population. A comparative cross-sectional study was conducted in Tangail District, where the SSK was implemented. From August 2019 to March 2020, a total of 2315 BPL households (HHs) (1170 intervention and 1145 comparison) that had at least one individual with inpatient care experience in the last 12 months were surveyed. A household is said to have incurred CHE if their OOPE for healthcare exceeds the total (or non-food) HH's expenditure threshold. Multiple regression analysis was performed using OOPE, incidence of CHE and impoverishment as dependent variables and SSK membership status, actual BPL status and benefits use status as the main explanatory variables. Overall, the OOPE was significantly lower (P < 0.01) in the intervention areas (Bangladeshi Taka (BDT) 23 366) compared with the comparison areas (BDT 24 757). Regression analysis revealed that the OOPE, CHE incidence at threshold of 10% of total expenditure and 40% of non-food expenditure and impoverishment were 33% (P < 0.01), 46% (P < 0.01), 42% (P < 0.01) and 30% (P < 0.01) lower, respectively, in the intervention areas than in the comparison areas. Additionally, HHs that utilized SSK benefits experienced even lower OOPE by 92% (P < 0.01), CHE incidence at 10% and 40% threshold levels by 72% (P < 0.01) and 59% (P < 0.01), respectively, and impoverishment by 27% at 10% level of significance. These findings demonstrated the significant positive effect of the SSK in reducing financial burdens associated with healthcare utilization among the enrolled HHs. This illustrates the importance of the nationwide scaling up of the scheme in Bangladesh to reduce the undue financial risk of healthcare utilization for those in poverty.
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Affiliation(s)
- Md Zahid Hasan
- Health Systems and Population Studies Division, icddr,b, Dhaka 1212, Bangladesh
- Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Worsley Building, Clarendon Way, Leeds LS2 9NL, UK
- Nuffield Centre for International Health and Development, Leeds Institute of Health Sciences, University of Leeds, Worsley Building, Clarendon Way, Leeds LS2 9NL, UK
| | - Sayem Ahmed
- Health Economics and Health Technology Assessment, School of Health and Wellbeing, University of Glasgow, 90 Byres Road, Glasgow G12 8TB, UK
- Centre for Health Economics and Medicines Evaluation, Bangor University, Ardudwy, Normal Site, Holyhead Road, Gwynedd, Wales LL57 2PZ, UK
| | - Gazi Golam Mehdi
- Health Systems and Population Studies Division, icddr,b, Dhaka 1212, Bangladesh
| | | | - Shams El Arifeen
- Maternal and Child Health Division, icddr,b, Dhaka 1212, Bangladesh
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Hasan MZ, Semmens EO, Navarro DuBose K, McCray LK, Noonan CW. Subclinical Measures of Cardiovascular Health Among Wildland Firefighters. J Occup Environ Med 2024; 66:e116-e121. [PMID: 38234129 DOI: 10.1097/jom.0000000000003041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
OBJECTIVE The aim of the study is to compare subclinical measures of cardiovascular health among wildland firefighters (WFFs) to the US general population. METHODS Our cross-sectional study compared body mass index, total cholesterol, and blood pressure in 11,051 WFFs aged 17 to 64 years using Department of the Interior Medical Screening Program clinical screening examinations between 2014-2018 to National Health and Nutrition Examination Survey of 2015-2016 cycle using adjusted logistic regression analyses. RESULTS The logistic regression model shows significantly higher odds of hypertension and prehypertension in WFFs (2.84 times more with 95% CI: 2.28-3.53) than US general population. There were no consistent differences in body mass index or total cholesterol between the two population. CONCLUSIONS Hypertension and prehypertension were more prevalent in WFFs compared with the US general population, which suggests the need for actions for protecting against cardiovascular disease among WFFs.
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Affiliation(s)
- Md Zahid Hasan
- From the Center for Population Health Research, School of Public and Community Health Sciences University of Montana, Missoula, MT (M.Z.H., E.O.S., C.W.N.); Department of the Interior, Office of Wildland Fire, Boise, ID (K.N.D., L.K.M.)
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Karim T, Shaon MSH, Sultan MF, Hasan MZ, Kafy AA. ANNprob-ACPs: A novel anticancer peptide identifier based on probabilistic feature fusion approach. Comput Biol Med 2024; 169:107915. [PMID: 38171261 DOI: 10.1016/j.compbiomed.2023.107915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 12/28/2023] [Accepted: 12/29/2023] [Indexed: 01/05/2024]
Abstract
Anticancer Peptides (ACPs) offer significant potential as cancer treatment drugs in this modern era. Quickly identifying active compounds from protein sequences is crucial for healthcare and cancer treatment. In this paper ANNprob-ACPs, a novel and effective model for detecting ACPs has been implemented based on nine feature encoding techniques, including AAC, CC, W2V, DPC, PAAC, QSO, CTDC, CTDT, and CKSAAGP. After analyzing the performance of several machine learning models, the six best models were selected based on their overall performances in every evaluation metric. The probability scores of each model were subsequently aggregated and used as input of our meta- model, called ANNprob-ACPs. Our model outperformed all others and its potential to lead to phenomenal identification of ACPs. The results of this study showed notable improvement in 10-fold cross-validation and independent test, with accuracy of 93.72% and 90.62%, respectively. Our proposed model, ANNprob-ACPs outperformed existing approaches in terms of accuracy and effectiveness in discovering ACPs. By using SHAP, this study obtained the physicochemical properties of QSO, and compositional properties of DPC, AAC, and PAAC are more impactful for our model's performances, which have a major impact on a drug's interactions and future discoveries. Consequently, this model is crucial for the future and has a high probability of detecting ACPs more frequently. We developed a web server of ANNprob-ACPs, which is accessible at ANNprob-ACPs webserver.
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Affiliation(s)
- Tasmin Karim
- Department of Computer Science & Engineering, Daffodil International University, Daffodil Smart City, Birulia, Dhaka, 1216, Bangladesh; Health Informatics Research Lab, Department of Computer Science and Engineering, Daffodil International University, Daffodil Smart City, Birulia, Dhaka, 1216, Bangladesh.
| | - Md Shazzad Hossain Shaon
- Department of Computer Science & Engineering, Daffodil International University, Daffodil Smart City, Birulia, Dhaka, 1216, Bangladesh; Health Informatics Research Lab, Department of Computer Science and Engineering, Daffodil International University, Daffodil Smart City, Birulia, Dhaka, 1216, Bangladesh.
| | - Md Fahim Sultan
- Department of Computer Science & Engineering, Daffodil International University, Daffodil Smart City, Birulia, Dhaka, 1216, Bangladesh; Health Informatics Research Lab, Department of Computer Science and Engineering, Daffodil International University, Daffodil Smart City, Birulia, Dhaka, 1216, Bangladesh.
| | - Md Zahid Hasan
- Department of Computer Science & Engineering, Daffodil International University, Daffodil Smart City, Birulia, Dhaka, 1216, Bangladesh; Health Informatics Research Lab, Department of Computer Science and Engineering, Daffodil International University, Daffodil Smart City, Birulia, Dhaka, 1216, Bangladesh.
| | - Abdulla-Al Kafy
- Department of Urban & Regional Planning, Rajshahi University of Engineering & Technology (RUET), Rajshahi, 6204, Bangladesh.
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Chowa SS, Azam S, Montaha S, Payel IJ, Bhuiyan MRI, Hasan MZ, Jonkman M. Graph neural network-based breast cancer diagnosis using ultrasound images with optimized graph construction integrating the medically significant features. J Cancer Res Clin Oncol 2023; 149:18039-18064. [PMID: 37982829 PMCID: PMC10725367 DOI: 10.1007/s00432-023-05464-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 10/06/2023] [Indexed: 11/21/2023]
Abstract
PURPOSE An automated computerized approach can aid radiologists in the early diagnosis of breast cancer. In this study, a novel method is proposed for classifying breast tumors into benign and malignant, based on the ultrasound images through a Graph Neural Network (GNN) model utilizing clinically significant features. METHOD Ten informative features are extracted from the region of interest (ROI), based on the radiologists' diagnosis markers. The significance of the features is evaluated using density plot and T test statistical analysis method. A feature table is generated where each row represents individual image, considered as node, and the edges between the nodes are denoted by calculating the Spearman correlation coefficient. A graph dataset is generated and fed into the GNN model. The model is configured through ablation study and Bayesian optimization. The optimized model is then evaluated with different correlation thresholds for getting the highest performance with a shallow graph. The performance consistency is validated with k-fold cross validation. The impact of utilizing ROIs and handcrafted features for breast tumor classification is evaluated by comparing the model's performance with Histogram of Oriented Gradients (HOG) descriptor features from the entire ultrasound image. Lastly, a clustering-based analysis is performed to generate a new filtered graph, considering weak and strong relationships of the nodes, based on the similarities. RESULTS The results indicate that with a threshold value of 0.95, the GNN model achieves the highest test accuracy of 99.48%, precision and recall of 100%, and F1 score of 99.28%, reducing the number of edges by 85.5%. The GNN model's performance is 86.91%, considering no threshold value for the graph generated from HOG descriptor features. Different threshold values for the Spearman's correlation score are experimented with and the performance is compared. No significant differences are observed between the previous graph and the filtered graph. CONCLUSION The proposed approach might aid the radiologists in effective diagnosing and learning tumor pattern of breast cancer.
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Affiliation(s)
- Sadia Sultana Chowa
- Faculty of Science and Technology, Charles Darwin University, Casuarina, NT, 0909, Australia
| | - Sami Azam
- Faculty of Science and Technology, Charles Darwin University, Casuarina, NT, 0909, Australia.
| | - Sidratul Montaha
- Faculty of Science and Technology, Charles Darwin University, Casuarina, NT, 0909, Australia
| | - Israt Jahan Payel
- Health Informatics Research Laboratory (HIRL), Department of Computer Science and Engineering, Daffodil International University, Dhaka, 1216, Bangladesh
| | - Md Rahad Islam Bhuiyan
- Faculty of Science and Technology, Charles Darwin University, Casuarina, NT, 0909, Australia
| | - Md Zahid Hasan
- Health Informatics Research Laboratory (HIRL), Department of Computer Science and Engineering, Daffodil International University, Dhaka, 1216, Bangladesh
| | - Mirjam Jonkman
- Faculty of Science and Technology, Charles Darwin University, Casuarina, NT, 0909, Australia
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Guguchia Z, Gawryluk DJ, Shin S, Hao Z, Mielke Iii C, Das D, Plokhikh I, Liborio L, Shenton JK, Hu Y, Sazgari V, Medarde M, Deng H, Cai Y, Chen C, Jiang Y, Amato A, Shi M, Hasan MZ, Yin JX, Khasanov R, Pomjakushina E, Luetkens H. Hidden magnetism uncovered in a charge ordered bilayer kagome material ScV 6Sn 6. Nat Commun 2023; 14:7796. [PMID: 38016982 PMCID: PMC10684576 DOI: 10.1038/s41467-023-43503-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 11/10/2023] [Indexed: 11/30/2023] Open
Abstract
Charge ordered kagome lattices have been demonstrated to be intriguing platforms for studying the intertwining of topology, correlation, and magnetism. The recently discovered charge ordered kagome material ScV6Sn6 does not feature a magnetic groundstate or excitations, thus it is often regarded as a conventional paramagnet. Here, using advanced muon-spin rotation spectroscopy, we uncover an unexpected hidden magnetism of the charge order. We observe an enhancement of the internal field width sensed by the muon ensemble, which takes place within the charge ordered state. More importantly, the muon spin relaxation rate below the charge ordering temperature is substantially enhanced by applying an external magnetic field. Taken together with the hidden magnetism found in AV3Sb5 (A = K, Rb, Cs) and FeGe kagome systems, our results suggest ubiqitous time-reversal symmetry-breaking in charge ordered kagome lattices.
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Affiliation(s)
- Z Guguchia
- Laboratory for Muon Spin Spectroscopy, Paul Scherrer Institute, CH-5232, Villigen PSI, Switzerland.
| | - D J Gawryluk
- Laboratory for Multiscale Materials Experiments, Paul Scherrer Institut, 5232, Villigen PSI, Switzerland.
| | - S Shin
- Laboratory for Multiscale Materials Experiments, Paul Scherrer Institut, 5232, Villigen PSI, Switzerland
| | - Z Hao
- Department of Physics, Southern University of Science and Technology, Shenzhen, Guangdong, 518055, China
| | - C Mielke Iii
- Laboratory for Muon Spin Spectroscopy, Paul Scherrer Institute, CH-5232, Villigen PSI, Switzerland
- Physik-Institut, Universität Zürich, Winterthurerstrasse 190, CH-8057, Zürich, Switzerland
| | - D Das
- Laboratory for Muon Spin Spectroscopy, Paul Scherrer Institute, CH-5232, Villigen PSI, Switzerland
| | - I Plokhikh
- Laboratory for Multiscale Materials Experiments, Paul Scherrer Institut, 5232, Villigen PSI, Switzerland
| | - L Liborio
- Scientific Computing Department, Science & Technology Facilities Council, Rutherford Appleton Laboratory, Didcot, OX11 0QX, UK
| | - J Kane Shenton
- Scientific Computing Department, Science & Technology Facilities Council, Rutherford Appleton Laboratory, Didcot, OX11 0QX, UK
| | - Y Hu
- Photon Science Division, Paul Scherrer Institut, CH-5232, Villigen PSI, Switzerland
| | - V Sazgari
- Laboratory for Muon Spin Spectroscopy, Paul Scherrer Institute, CH-5232, Villigen PSI, Switzerland
| | - M Medarde
- Laboratory for Multiscale Materials Experiments, Paul Scherrer Institut, CH-5232, Villigen PSI, Switzerland
| | - H Deng
- Department of Physics, Southern University of Science and Technology, Shenzhen, Guangdong, 518055, China
| | - Y Cai
- Shenzhen Institute for Quantum Science and Engineering, Southern University of Science and Technology, Shenzhen, 518055, China
| | - C Chen
- Shenzhen Institute for Quantum Science and Engineering, Southern University of Science and Technology, Shenzhen, 518055, China
| | - Y Jiang
- Laboratory for Topological Quantum Matter and Advanced Spectroscopy (B7), Department of Physics, Princeton University, Princeton, NJ, 08544, USA
| | - A Amato
- Laboratory for Muon Spin Spectroscopy, Paul Scherrer Institute, CH-5232, Villigen PSI, Switzerland
| | - M Shi
- Photon Science Division, Paul Scherrer Institut, CH-5232, Villigen PSI, Switzerland
| | - M Z Hasan
- Laboratory for Topological Quantum Matter and Advanced Spectroscopy (B7), Department of Physics, Princeton University, Princeton, NJ, 08544, USA
- Princeton Institute for the Science and Technology of Materials, Princeton University, Princeton, NJ, 08540, USA
- Quantum Science Center, Oak Ridge, TN, 37831, USA
| | - J-X Yin
- Department of Physics, Southern University of Science and Technology, Shenzhen, Guangdong, 518055, China
| | - R Khasanov
- Laboratory for Muon Spin Spectroscopy, Paul Scherrer Institute, CH-5232, Villigen PSI, Switzerland
| | - E Pomjakushina
- Laboratory for Multiscale Materials Experiments, Paul Scherrer Institut, 5232, Villigen PSI, Switzerland
| | - H Luetkens
- Laboratory for Muon Spin Spectroscopy, Paul Scherrer Institute, CH-5232, Villigen PSI, Switzerland
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Fatema K, Rony MAH, Azam S, Mukta MSH, Karim A, Hasan MZ, Jonkman M. Development of an automated optimal distance feature-based decision system for diagnosing knee osteoarthritis using segmented X-ray images. Heliyon 2023; 9:e21703. [PMID: 38027947 PMCID: PMC10665756 DOI: 10.1016/j.heliyon.2023.e21703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 10/25/2023] [Accepted: 10/26/2023] [Indexed: 12/01/2023] Open
Abstract
Knee Osteoarthritis (KOA) is a leading cause of disability and physical inactivity. It is a degenerative joint disease that affects the cartilage, cushions the bones, and protects them from rubbing against each other during motion. If not treated early, it may lead to knee replacement. In this regard, early diagnosis of KOA is necessary for better treatment. Nevertheless, manual KOA detection is time-consuming and error-prone for large data hubs. In contrast, an automated detection system aids the specialist in diagnosing KOA grades accurately and quickly. So, the main objective of this study is to create an automated decision system that can analyze KOA and classify the severity grades, utilizing the extracted features from segmented X-ray images. In this study, two different datasets were collected from the Mendeley and Kaggle database and combined to generate a large data hub containing five classes: Grade 0 (Healthy), Grade 1 (Doubtful), Grade 2 (Minimal), Grade 3 (Moderate), and Grade 4 (Severe). Several image processing techniques were employed to segment the region of interest (ROI). These included Gradient-weighted Class Activation Mapping (Grad-Cam) to detect the ROI, cropping the ROI portion, applying histogram equalization (HE) to improve contrast, brightness, and image quality, and noise reduction (using Otsu thresholding, inverting the image, and morphological closing). Besides, the focus filtering method was utilized to eliminate unwanted images. Then, six feature sets (morphological, GLCM, statistical, texture, LBP, and proposed features) were generated from segmented ROIs. After evaluating the statistical significance of the features and selection methods, the optimal feature set (prominent six distance features) was selected, and five machine learning (ML) models were employed. Additionally, a decision-making strategy based on the six optimal features is proposed. The XGB model outperformed other models with a 99.46 % accuracy, using six distance features, and the proposed decision-making strategy was validated by testing 30 images.
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Affiliation(s)
- Kaniz Fatema
- Health Informatics Research Lab, Department of Computer Science and Engineering, Daffodil International University, Dhaka, 1341, Bangladesh
| | - Md Awlad Hossen Rony
- Health Informatics Research Lab, Department of Computer Science and Engineering, Daffodil International University, Dhaka, 1341, Bangladesh
| | - Sami Azam
- Faculty of Science and Technology, Charles Darwin University, Darwin, NT, 0909, Australia
| | - Md Saddam Hossain Mukta
- Department of Computer Science and Engineering, United International University, Dhaka, 1212, Bangladesh
| | - Asif Karim
- Faculty of Science and Technology, Charles Darwin University, Darwin, NT, 0909, Australia
| | - Md Zahid Hasan
- Health Informatics Research Lab, Department of Computer Science and Engineering, Daffodil International University, Dhaka, 1341, Bangladesh
| | - Mirjam Jonkman
- Faculty of Science and Technology, Charles Darwin University, Darwin, NT, 0909, Australia
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Hossain S, Azam S, Montaha S, Karim A, Chowa SS, Mondol C, Zahid Hasan M, Jonkman M. Automated breast tumor ultrasound image segmentation with hybrid UNet and classification using fine-tuned CNN model. Heliyon 2023; 9:e21369. [PMID: 37885728 PMCID: PMC10598544 DOI: 10.1016/j.heliyon.2023.e21369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 10/11/2023] [Accepted: 10/20/2023] [Indexed: 10/28/2023] Open
Abstract
Introduction Breast cancer stands as the second most deadly form of cancer among women worldwide. Early diagnosis and treatment can significantly mitigate mortality rates. Purpose The study aims to classify breast ultrasound images into benign and malignant tumors. This approach involves segmenting the breast's region of interest (ROI) employing an optimized UNet architecture and classifying the ROIs through an optimized shallow CNN model utilizing an ablation study. Method Several image processing techniques are utilized to improve image quality by removing text, artifacts, and speckle noise, and statistical analysis is done to check the enhanced image quality is satisfactory. With the processed dataset, the segmentation of breast tumor ROI is carried out, optimizing the UNet model through an ablation study where the architectural configuration and hyperparameters are altered. After obtaining the tumor ROIs from the fine-tuned UNet model (RKO-UNet), an optimized CNN model is employed to classify the tumor into benign and malignant classes. To enhance the CNN model's performance, an ablation study is conducted, coupled with the integration of an attention unit. The model's performance is further assessed by classifying breast cancer with mammogram images. Result The proposed classification model (RKONet-13) results in an accuracy of 98.41 %. The performance of the proposed model is further compared with five transfer learning models for both pre-segmented and post-segmented datasets. K-fold cross-validation is done to assess the proposed RKONet-13 model's performance stability. Furthermore, the performance of the proposed model is compared with previous literature, where the proposed model outperforms existing methods, demonstrating its effectiveness in breast cancer diagnosis. Lastly, the model demonstrates its robustness for breast cancer classification, delivering an exceptional performance of 96.21 % on a mammogram dataset. Conclusion The efficacy of this study relies on image pre-processing, segmentation with hybrid attention UNet, and classification with fine-tuned robust CNN model. This comprehensive approach aims to determine an effective technique for detecting breast cancer within ultrasound images.
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Affiliation(s)
- Shahed Hossain
- Health Informatics Research Laboratory (HIRL), Department of Computer Science and Engineering, Daffodil International University, Dhaka, 1341, Bangladesh
| | - Sami Azam
- Faculty of Science and Technology, Charles Darwin University, Casuarina, 0909, NT, Australia
| | - Sidratul Montaha
- Department of Computer Science, University of Calgary, Calgary, AB, T2N 1N4, Canada
| | - Asif Karim
- Faculty of Science and Technology, Charles Darwin University, Casuarina, 0909, NT, Australia
| | - Sadia Sultana Chowa
- Health Informatics Research Laboratory (HIRL), Department of Computer Science and Engineering, Daffodil International University, Dhaka, 1341, Bangladesh
| | - Chaity Mondol
- Health Informatics Research Laboratory (HIRL), Department of Computer Science and Engineering, Daffodil International University, Dhaka, 1341, Bangladesh
| | - Md Zahid Hasan
- Health Informatics Research Laboratory (HIRL), Department of Computer Science and Engineering, Daffodil International University, Dhaka, 1341, Bangladesh
| | - Mirjam Jonkman
- Faculty of Science and Technology, Charles Darwin University, Casuarina, 0909, NT, Australia
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11
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Hasan MZ, Saha PS, Korfhage MO, Zhu C. Non-contact optical spectroscopy for tumor-sensitive diffuse reflectance and fluorescence measurements on murine subcutaneous tissue models: Monte Carlo modeling and experimental validations. Biomed Opt Express 2023; 14:5418-5439. [PMID: 37854556 PMCID: PMC10581788 DOI: 10.1364/boe.502778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/12/2023] [Accepted: 09/16/2023] [Indexed: 10/20/2023]
Abstract
Fiber-optic probes are commonly used in biomedical optical spectroscopy platforms for light delivery and collection. At the same time, it was reported that the inconsistent probe-sample contact could induce significant distortions in measured optical signals, which consequently cause large analysis errors. To address this challenge, non-contact optical spectroscopy has been explored for tissue characterizations. However, existing non-contact optical spectroscopy platforms primarily focused on diffuse reflectance measurements and may still use a fiber probe in which the probe was imaged onto the tissue surface using a lens, which serves as a non-contact probe for the measurements. Here, we report a fiber-probe-free, dark-field-based, non-contact optical spectroscopy for both diffuse reflectance and fluorescence measurements on turbid medium and tissues. To optimize the system design, we developed a novel Monte Carlo method to simulate such a non-contact setup for both diffuse reflectance and fluorescence measurements on murine subcutaneous tissue models with a spherical tumor-like target. We performed Monte Carlo simulations to identify the most tumor-sensitive configurations, from which we found that both the depth of the light focal point in tissue and the lens numerical aperture would dramatically affect the system's tumor detection sensitivity. We then conducted tissue-mimicking phantom studies to solidify these findings. Our reported Monte Carlo technique can be a useful computational tool for designing non-contact optical spectroscopy systems. Our non-contact optical setup and experimental findings will potentially offer a new approach for sensitive optical monitoring of tumor physiology in biological models using a non-contact optical spectroscopy platform to advance cancer research.
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Affiliation(s)
- Md Zahid Hasan
- Department of Biomedical Engineering, University of Kentucky, Lexington, KY 40506, USA
| | - Pranto Soumik Saha
- Department of Biomedical Engineering, University of Kentucky, Lexington, KY 40506, USA
| | - Madison O. Korfhage
- Department of Biomedical Engineering, University of Kentucky, Lexington, KY 40506, USA
| | - Caigang Zhu
- Department of Biomedical Engineering, University of Kentucky, Lexington, KY 40506, USA
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12
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Sin MP, Hasan MZ, Forsberg BC. Change in economic burden of diarrhoea in children under-five in Bangladesh: 2007 vs. 2018. J Glob Health 2023; 13:04089. [PMID: 37622687 PMCID: PMC10451101 DOI: 10.7189/jogh.13.04089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2023] Open
Abstract
Background In Bangladesh, diarrhoea in children under-five is a major public health problem with cost implications. Although under-five diarrhoea mortality and morbidity have declined from 2007 to 2018, change in the economic burden is unknown. This study determined the change in the societal economic burden of under-five diarrhoea in Bangladesh comparing 2007 to 2018. Methods A prevalence-based, retrospective cost analysis was conducted from a societal perspective, including costs to households, providers, and economic loss from premature deaths. Data were obtained from the previous cost of illness studies, government reports, and international databases. Direct costs for treatment were estimated by the bottom-up costing approach. Indirect costs on the loss of productivity of caretakers and loss from premature deaths were calculated by the human capital method. Total costs were presented in both local currency (Bangladeshi Taka (BDT)) and US dollars (US$)) in 2018 price. Sensitivity analyses were conducted to assess the robustness of the input parameters. Results A 36.4% reduction was found on the economic burden of under-five diarrhoea when comparing 2007 and 2018; US$1 209 million (95% CI = 1066 million-1299 million) for 2007 and US$769 million (95% CI = 484 million-873 million) for 2018. Economic loss from premature deaths imposed the highest costs (2007 = 66%, 2018 = 66% of all) followed by indirect costs on the loss of productivity of caretakers (2007 = 21%, 2018 = 26%) and direct medical costs (2007 = 13%, 2018 = 8%). Conclusions Societal costs from diarrhoeal diseases were reduced from 2007 to 2018 in Bangladesh. However, the economic burden was equivalent to 0.29% of country's gross domestic product in 2018 and remains a challenge. The major contributor to the costs was premature mortality from diarrhoeal diseases. Premature deaths are still prevalent though they to a large extent are avoidable. To further limit the economic burden, under-five diarrhoea mortality and morbidity reduction should be accelerated.
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Affiliation(s)
- May Phyu Sin
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Md Zahid Hasan
- Health Systems and Population Studies Division, ICDDR,B, Mohakhali, Dhaka, Bangladesh
- Nuffield Centre for International Health and Development, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Birger C Forsberg
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
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13
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Yan J, Lima Goncalves CF, Korfhage MO, Hasan MZ, Fan TWM, Wang X, Zhu C. Portable optical spectroscopic assay for non-destructive measurement of key metabolic parameters on in vitro cancer cells and organotypic fresh tumor slices. Biomed Opt Express 2023; 14:4065-4079. [PMID: 37799678 PMCID: PMC10549737 DOI: 10.1364/boe.497127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 10/07/2023]
Abstract
To enable non-destructive metabolic characterizations on in vitro cancer cells and organotypic tumor models for therapeutic studies in an easy-to-access way, we report a highly portable optical spectroscopic assay for simultaneous measurement of glucose uptake and mitochondrial function on various cancer models with high sensitivity. Well-established breast cancer cell lines (MCF-7 and MDA-MB-231) were used to validate the optical spectroscopic assay for metabolic characterizations, while fresh tumor samples harvested from both animals and human cancer patients were used to test the feasibility of our optical metabolic assay for non-destructive measurement of key metabolic parameters on organotypic tumor slices. Our optical metabolic assay captured that MCF-7 cells had higher mitochondrial metabolism, but lower glucose uptake compared to the MDA-MB-231 cells, which is consistent with our microscopy imaging and flow cytometry data, as well as the published Seahorse Assay data. Moreover, we demonstrated that our optical assay could non-destructively measure both glucose uptake and mitochondrial metabolism on the same cancer cell samples at one time, which remains challenging by existing metabolic tools. Our pilot tests on thin fresh tumor slices showed that our optical assay captured increased metabolic activities in tumors compared to normal tissues. Our non-destructive optical metabolic assay provides a cost-effective way for future longitudinal therapeutic studies using patient-derived organotypic fresh tumor slices through the lens of tumor energetics, which will significantly advance translational cancer research.
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Affiliation(s)
- Jing Yan
- Department of Biomedical Engineering,
University of Kentucky, Lexington, KY 40506, USA
| | | | - Madison O. Korfhage
- Department of Biomedical Engineering,
University of Kentucky, Lexington, KY 40506, USA
| | - Md Zahid Hasan
- Department of Biomedical Engineering,
University of Kentucky, Lexington, KY 40506, USA
| | - Teresa W.-M. Fan
- Center for Environmental and Systems Biochemistry, University of Kentucky, Lexington, KY 40536, USA
- Markey Cancer Center, University of Kentucky, Lexington, KY 40536, USA
- Department of Toxicology and Cancer Biology, University of Kentucky, Lexington, KY 40536, USA
| | - Xiaoqin Wang
- Department of Radiology, University of Kentucky, Lexington, KY 40536, USA
| | - Caigang Zhu
- Department of Biomedical Engineering,
University of Kentucky, Lexington, KY 40506, USA
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14
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Hasan MZ, Yan J, Yi Z, Korfhage MO, Tong S, Zhu C. Low-cost compact optical spectroscopy and novel spectroscopic algorithm for point-of-care real-time monitoring of nanoparticle delivery in biological tissue models. IEEE J Sel Top Quantum Electron 2023; 29:7100208. [PMID: 36341280 PMCID: PMC9635618 DOI: 10.1109/jstqe.2022.3205862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Real-time monitoring of nanoparticle delivery in biological models is essential to optimize nanoparticle-mediated therapies. However, few techniques are available for convenient real-time monitoring of nanoparticle concentrations in tissue samples. This work reported novel optical spectroscopic approaches for low-cost point-of-care real-time quantification of nanoparticle concentrations in biological tissue samples. METHODS Fiber probe measured diffuse reflectance can be described with a simple analytical model by introducing an explicit dependence on the reduced scattering coefficient. Relying on this, the changes on the inverse of diffuse reflectance are proportional to absorption change when the scattering perturbation is negligible. We developed this model with proper wavelength pairs and implemented it with both a standard optical spectroscopy platform and a low-cost compact spectroscopy device for near real-time quantification of nanoparticle concentrations in biological tissue models. RESULTS Both tissue-mimicking phantom and ex vivo tissue sample studies showed that our optical spectroscopic techniques could quantify nanoparticle concentrations in near real-time with high accuracies (less than 5% error) using only a pair of narrow wavelengths (530 nm and 630 nm). CONCLUSION Novel low-cost point-of-care optical spectroscopic techniques were demonstrated for rapid accurate quantification of nanoparticle concentrations in tissue-mimicking medium and ex vivo tissue samples using optical signals measured at a pair of narrow wavelengths. SIGNIFICANCE Our methods will potentially facilitate real-time monitoring of nanoparticle delivery in biological models using low-cost point-of-care optical spectroscopy platforms, which will significantly advance nanomedicine in cancer research.
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Affiliation(s)
- Md Zahid Hasan
- Department of Biomedical Engineering, University of Kentucky, Lexington, KY 40506, USA
| | - Jing Yan
- Department of Biomedical Engineering, University of Kentucky, Lexington, KY 40506, USA
| | - Zhongchao Yi
- Department of Biomedical Engineering, University of Kentucky, Lexington, KY 40506, USA
| | - Madison O Korfhage
- Department of Biomedical Engineering, University of Kentucky, Lexington, KY 40506, USA
| | - Sheng Tong
- Department of Biomedical Engineering, University of Kentucky, Lexington, KY 40506, USA
| | - Caigang Zhu
- Department of Biomedical Engineering, University of Kentucky, Lexington, KY 40506, USA
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15
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Hasan MZ, Ahmed S, Islam Z, Dorin F, Rabbani MG, Mehdi GG, Ahmed MW, Tahsina T, Mahmood SS, Islam Z. Costs of services and funding gap of the Bangladesh National Tuberculosis Control Programme 2016-2022: An ingredient based approach. PLoS One 2023; 18:e0286560. [PMID: 37267308 DOI: 10.1371/journal.pone.0286560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 05/18/2023] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND Bangladesh National Tuberculosis (TB) Control Programme (NTP) has deployed improved diagnostic technologies which may drive up the programme costs. We aimed to estimate the supply-side costs associated with the delivery of the NTP and the funding gap between the cost of implementation and available funding for the Bangladesh NTP. METHODS An ingredient-based costing approach was applied using WHO's OneHealth Tool software. We considered 2016, as the base year and projected cost estimates up to 2022 using information on NTP planned activities. Data were collected through consultative meetings with experts and officials/managers, review of documents and databases, and visits to five purposively selected TB healthcare facilities. The estimated costs were compared with the funds allocated to the NTP between 2018 and 2022 to estimate the funding gap. FINDINGS The estimated total cost of NTP was US$ 49.22 million in 2016, which would increase to US$ 146.93 million in 2022. Human resources (41.1%) and medicines and investigations/ supplies (38.0%) were the major two cost components. Unit costs were highest for treating extensively drug-resistant TB at US$ 7,422.4 in 2016. Between 2018-2022, NTP would incur US$ 536.8 million, which is US$ 235.18 million higher than the current allocation for NTP. CONCLUSION Our results indicated a funding gap associated with the NTP in each of the years between 2018-2022. Policy planners should advocate for additional funding to ensure smooth delivery of TB services in the upcoming years. The cost estimates of TB services can also be used for planning and budgeting for delivering TB services in similar country contexts.
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Affiliation(s)
- Md Zahid Hasan
- Health Economics and Financing, Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
- Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom
| | - Sayem Ahmed
- Health Economics and Health Technology Assessment (HEHTA), Institute of Health & Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Zeenat Islam
- Health Economics and Financing, Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Farzana Dorin
- Health Economics and Financing, Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Md Golam Rabbani
- Health Economics and Financing, Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Gazi Golam Mehdi
- Health Economics and Financing, Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mohammad Wahid Ahmed
- Health Economics and Financing, Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Tazeen Tahsina
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Shehrin Shaila Mahmood
- Health Economics and Financing, Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Ziaul Islam
- Health Economics and Financing, Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
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16
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Mina SA, Hasan MZ, Hossain AKMZ, Barua A, Mirjada MR, Chowdhury AMMA. The Prevalence of Multi-Drug Resistant Salmonella typhi Isolated From Blood Sample. Microbiol Insights 2023; 16:11786361221150760. [PMID: 36726577 PMCID: PMC9885025 DOI: 10.1177/11786361221150760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 12/26/2022] [Indexed: 01/29/2023] Open
Abstract
Typhoid is a major public health concern. Even though antibiotics are usually used to treat typhoid fever, the spread of multi drug resistant Salmonella typhi is making antibiotics much less effective. This study was conducted to assess the prevalence of multidrug-resistant Salmonella typhi from the clinical samples. During this study, 154 blood samples of suspected typhoid patients were collected from the hospital and diagnostic center located in Chattogram City, Bangladesh. Isolation and identification of Salmonella typhi was done by both biochemical tests. PCR analysis was also done for the confirmation of biochemical result. Antimicrobial susceptibility test was performed according to the Kirby-Bauer disk diffusion method against ampicillin, chloramphenicol, cefepime, cotrimoxazole, ceptriaxone, ciprofloxacin, nalidixic acid, and azithtomycin. Out of 154, 21 (13.64%) isolates were identified as Salmonella typhi and the prevalence of typhoid in Chattogram, Bangladesh was 13.64% (n = 21). It was also found that children under the age of 5 are the more vulnerable target of Salmonella typhi infection. Antibiotic resistance profiling revealed 85% isolates were Multi-Drug Resistant (MDR) and highest resistance was found in case of Nalidixic acid. Although, most of the isolated Salmonella typhi were MDR, first generation antibiotics Co-trimoxazile, Chloramphenicol, and Ampicillin were found effective against Salmonella typhi.
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Affiliation(s)
- Sohana Akter Mina
- Department of Genetic Engineering and
Biotechnology, Faculty of Biological Sciences, University of Chittagong, Chittagong,
Bangladesh
| | - Md Zahid Hasan
- Department of Genetic Engineering and
Biotechnology, Faculty of Biological Sciences, University of Chittagong, Chittagong,
Bangladesh
| | - A. K. M. Zakir Hossain
- Department of Genetic Engineering and
Biotechnology, Faculty of Biological Sciences, University of Chittagong, Chittagong,
Bangladesh
| | - Anupam Barua
- Department of Medicine, Chittagong
Medical College, Chittagong, Bangladesh
| | - Md Rashed Mirjada
- Department of Medicine, Chittagong
Medical College, Chittagong, Bangladesh
| | - A. M. Masudul Azad Chowdhury
- Department of Genetic Engineering and
Biotechnology, Faculty of Biological Sciences, University of Chittagong, Chittagong,
Bangladesh,A. M. Masudul Azad Chowdhury, Laboratory of
Microbial and Cancer Genomics, Department of Genetic Engineering and
Biotechnology, University of Chittagong, Chittagong 4331, Bangladesh.
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17
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Hasan MZ, Nahar K, Sharif JU, Paul SC, Thakur AK, Mahmud A, Siddique NA, Islam MR, Paul GK. Serum Magnesium Level and It's Relation in Predicting Adverse In-Hospital Outcome in Patients with First Attack of Myocardial Infarction. Mymensingh Med J 2023; 32:65-72. [PMID: 36594303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Acute myocardial infarction (AMI) patients characterize a large proportion of admissions in coronary care unit and their management and risk stratification is of immense importance. Hypomagnesemia is a long-term risk factor for incident of both myocardial infarction and arrhythmia. We assessed whether serum magnesium levels at admission is associated with arrhythmias and in-hospital mortality in patients with acute myocardial infarction (AMI). The aim of the study was to evaluate the prognostic implications of serum magnesium level in patients with acute myocardial infarction. This cross-sectional observational study was conducted in the department of cardiology in Mymensingh Medical College Hospital from October 2017 to March 2019. Total 259 acute myocardial infarction patients were included considering inclusion and exclusion criteria. The sample population was divided into two groups: Group-I: Patients with acute myocardial infarction with serum magnesium ≥1.82mg/dl. Group-II: Patients with acute myocardial infarction with serum magnesium <1.82mg/dl. Serum magnesium level was measured on admission, and the incidence of in-hospital major cardiac events was assessed. In this study mean serum magnesium level of Group-I, Group-II were 2.21±0.14mg/dl, 1.60±0.15mg/dl respectively. It was statistically significant (p<0.05). In-hospital outcomes of the study group revealed that low risk group patients were uneventful outcome during hospitalization period, they had no any complication. In Group-I patient, 9(4.8%) were developed arrhythmias, 26(13.9%) were developed heart failure, 9(4.8%) were developed cardiogenic shock and 3(1.6%) were died and in Group-II patient, 44(61.10%) developed arrhythmias, 9(12.50%) were developed heart failure, 7(9.7%) were developed cardiogenic shock and 12(16.7%) were died out of them which was statistically significant (p<0.05). Mean duration of hospital stay of the study population according serum magnesium level was in Group-I, 4.27±0.68 days, in Group-II, 5.84±1.05 days which was statistically significant (p<0.05). In conclusion patient with serum magnesium level less than 1.82mg/dl increased the risk of in-hospital arrhythmia and death.
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Affiliation(s)
- M Z Hasan
- Dr Md Zunaid Hasan, Assistant Registrar, Department of Cardiology, Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh; E-mail:
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18
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Nahar K, Hasan MZ, Tuli JZ, Hoque MR, Akhter S, Runa US. Changes in Serum Uric Acid Level in Acute Myocardial Infarction Patients. Mymensingh Med J 2023; 32:35-38. [PMID: 36594297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Myocardial infarction (MI) is one of the dangerous manifestations of coronary artery disease and one of the commonest causes of mortality. This cross-sectional study was carried out in the department of Biochemistry, Mymensingh Medical College in collaboration with the department of Cardiology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh during the period of January 2018 to December 2018. A total of 120 subjects were included in this study. Among them 60 were diagnosed AMI patients denoted as case group and 60 were apparently normal healthy individuals denoted as control group. Biochemical values were expressed as Mean±SD (Standard deviation). Statistical analysis was done by using SPSS (Statistical package for social science) version 21.0 windows package. Serum uric acid determined by enzymatic colorimetric method using the test kit. Among the study groups the mean±SD values of uric acid were 6.61±2.62 and 5.38±1.16mg/dl in case and control group respectively. The analysis showed that, serum uric acid was statistically increased in case group compared with control group. The level of significance was 0.001. Statistical significance of difference between two groups were evaluated by using Student's unpaired 't' test.
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Affiliation(s)
- K Nahar
- Dr Kamrun Nahar, Clinical Pathologist, Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh; E-mail:
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19
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Hasan MZ, Ahmed MW, Mehdi GG, Khan JAM, Islam Z, Chowdhury ME, Ahmed S. Factors affecting the healthcare utilization from Shasthyo Suroksha Karmasuchi scheme among the below-poverty-line population in one subdistrict in Bangladesh: a cross sectional study. BMC Health Serv Res 2022; 22:885. [PMID: 35804366 PMCID: PMC9270808 DOI: 10.1186/s12913-022-08254-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 06/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Financing healthcare through out-of-pocket (OOP) payment is a major barrier in accessing healthcare for the poor people. The Health Economics Unit (HEU) of the Ministry of Health and Family Welfare of the government of Bangladesh has developed Shasthyo Suroksha Karmasuchi (SSK), a health protection scheme, with the aim of reducing OOP expenditure and improving access of the below-poverty-line (BPL) population to healthcare. The scheme started piloting in 2016 at Kalihati sub-district of Tangail District. Our objective was to assess healthcare utilization by the enrolled BPL population and to identify the factors those influencing their utilization of the scheme. METHOD A cross-sectional household survey was conducted from July to September 2018 in the piloting sub-district. A total of 806 households were surveyed using a semi-structured questionnaire. Information on illness and sources of healthcare service were captured for the last 90 days before the survey. Multiple logistic regression models were applied to determine the factors related to utilization of healthcare from the SSK scheme and other medically trained providers (MTPs) by the SSK members for both inpatient and outpatient care. RESULT A total of 781 (24.6%) people reported of suffering from illness of which 639 (81.8%) sought healthcare from any sources. About 8.0% (51 out of 639) of them sought healthcare from SSK scheme and 28.2% from other MTPs within 90 days preceding the survey. Households with knowledge about SSK scheme were more likely to utilize healthcare from the scheme and less likely to utilize healthcare from other MTPs. Non-BPL status and suffering from an accident/injury were significantly positively associated with utilization of healthcare from SSK scheme. CONCLUSION Among the BPL population, healthcare utilization from the SSK scheme was very low compared to that of other MTPs. Effective strategies should be in place for improving knowledge of BPL population on SSK scheme and the benefits package of the scheme should be updated as per the need of the target population. Such initiative can be instrumental in increasing utilization of the scheme and ultimately will reduce the barriers of OOP payment among BPL population for accessing healthcare.
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Affiliation(s)
- Md Zahid Hasan
- Health Systems and Population Studies Division, Health Economics and Financing, icddr,b, 68 Shahid Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212, Bangladesh. .,Leeds Institute of Health Sciences, University of Leeds, 6 Clarendon Way, Woodhouse, LS2 9NL, Leeds, UK.
| | - Mohammad Wahid Ahmed
- Health Systems and Population Studies Division, Health Economics and Financing, icddr,b, 68 Shahid Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Gazi Golam Mehdi
- Health Systems and Population Studies Division, Health Economics and Financing, icddr,b, 68 Shahid Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Jahangir A M Khan
- Health Economics and Policy Unit, School of Public Health and Community Medicine, University of Gothenburg, Medicinaregatan 18A, 405 30, Gothenburg, Sweden
| | - Ziaul Islam
- Health Systems and Population Studies Division, Health Economics and Financing, icddr,b, 68 Shahid Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Mahbub Elahi Chowdhury
- Health Systems and Population Studies Division, Health Economics and Financing, icddr,b, 68 Shahid Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Sayem Ahmed
- Health Economics and Health Technology Assessment (HEHTA), Institute of Health & Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow, G12 8RZ, UK
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Mahmood SS, Hasan MZ, Hasan AMR, Rabbani MG, Begum F, Yousuf TB, Hanifi SMA, Reidpath DD, Rasheed S. Health system impact of COVID-19 on urban slum population of Bangladesh: a mixed-method rapid assessment study. BMJ Open 2022; 12:e057402. [PMID: 35197355 PMCID: PMC8882639 DOI: 10.1136/bmjopen-2021-057402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE We aimed to rapidly assess the health system impact of COVID-19 in the urban slums of Bangladesh. DESIGN Setting and participantsA cross-sectional survey among 476 households was conducted during October-December 2020 in five selected urban slums of Dhaka North, Dhaka South and Gazipur City Corporation. In-depth interviews with purposively selected 22 slum dwellers and key informant interviews with 16 local healthcare providers and four policymakers and technical experts were also conducted. OUTCOME MEASURES Percentage of people suffering from general illness, percentage of people suffering from chronic illness, percentage of people seeking healthcare, percentage of people seeking maternal care, health system challenges resulting from COVID-19. RESULTS About 12% of members suffered from general illness and 25% reported chronic illness. Over 80% sought healthcare and the majority sought care from informal healthcare providers. 39% of the recently delivered women sought healthcare in 3 months preceding the survey. An overall reduction in healthcare use was reported during the lockdown period compared with prepandemic time. Mismanagement and inefficient use of resources were reported as challenges of health financing during the pandemic. Health information sharing was inadequate at the urban slums, resulting from the lack of community and stakeholder engagement (51% received COVID-19-related information, 49% of respondents knew about the national hotline number for COVID-19 treatment). Shortage of human resources for health was reported to be acute during the pandemic, resulting from the shortage of specialist doctors and uneven distribution of health workforce. COVID-19 test was inadequate due to the lack of adequate test facilities and stigma associated with COVID-19. Lack of strong leadership and stakeholder engagement was seen as the barriers to effective pandemic management. CONCLUSION The findings of the current study are expected to support the government in tailoring interventions and allocating resources more efficiently and timely during a pandemic.
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Affiliation(s)
| | - Md Zahid Hasan
- Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh
| | - A M Rumayan Hasan
- Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh
| | - Md Golam Rabbani
- Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh
| | - Farzana Begum
- Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh
| | - Tariq Bin Yousuf
- Urban Resilience Project, Dhaka North City Corporation, Dhaka, Bangladesh
| | | | - Daniel D Reidpath
- Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh
| | - Sabrina Rasheed
- Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh
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21
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Sirica N, Orth PP, Scheurer MS, Dai YM, Lee MC, Padmanabhan P, Mix LT, Teitelbaum SW, Trigo M, Zhao LX, Chen GF, Xu B, Yang R, Shen B, Hu C, Lee CC, Lin H, Cochran TA, Trugman SA, Zhu JX, Hasan MZ, Ni N, Qiu XG, Taylor AJ, Yarotski DA, Prasankumar RP. Photocurrent-driven transient symmetry breaking in the Weyl semimetal TaAs. Nat Mater 2022; 21:62-66. [PMID: 34750539 DOI: 10.1038/s41563-021-01126-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 09/08/2021] [Indexed: 06/13/2023]
Abstract
Symmetry plays a central role in conventional and topological phases of matter, making the ability to optically drive symmetry changes a critical step in developing future technologies that rely on such control. Topological materials, like topological semimetals, are particularly sensitive to a breaking or restoring of time-reversal and crystalline symmetries, which affect both bulk and surface electronic states. While previous studies have focused on controlling symmetry via coupling to the crystal lattice, we demonstrate here an all-electronic mechanism based on photocurrent generation. Using second harmonic generation spectroscopy as a sensitive probe of symmetry changes, we observe an ultrafast breaking of time-reversal and spatial symmetries following femtosecond optical excitation in the prototypical type-I Weyl semimetal TaAs. Our results show that optically driven photocurrents can be tailored to explicitly break electronic symmetry in a generic fashion, opening up the possibility of driving phase transitions between symmetry-protected states on ultrafast timescales.
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Affiliation(s)
- N Sirica
- Center for Integrated Nanotechnologies, Los Alamos National Laboratory, Los Alamos, NM, USA.
| | - P P Orth
- Ames Laboratory, Ames, IA, USA
- Department of Physics and Astronomy, Iowa State University, Ames, IA, USA
| | - M S Scheurer
- Institute for Theoretical Physics, University of Innsbruck, Innsbruck, Austria
| | - Y M Dai
- Center for Integrated Nanotechnologies, Los Alamos National Laboratory, Los Alamos, NM, USA
- Center for Superconducting Physics and Materials, National Laboratory of Solid State Microstructures and Department of Physics, Nanjing University, Nanjing, China
| | - M-C Lee
- Center for Integrated Nanotechnologies, Los Alamos National Laboratory, Los Alamos, NM, USA
| | - P Padmanabhan
- Center for Integrated Nanotechnologies, Los Alamos National Laboratory, Los Alamos, NM, USA
| | - L T Mix
- Center for Integrated Nanotechnologies, Los Alamos National Laboratory, Los Alamos, NM, USA
| | - S W Teitelbaum
- Department of Physics, Arizona State Univeristy, Tempe, AZ, USA
- Beus CXFEL Labs, Biodesign Institute, Arizona State Univeristy, Tempe, AZ, USA
| | - M Trigo
- Stanford PULSE Institute, SLAC National Accelerator Laboratory, Menlo Park, CA, USA
- Stanford Institute for Materials and Energy Sciences, SLAC National Accelerator Laboratory, Menlo Park, CA, USA
| | - L X Zhao
- Institute of Physics, Chinese Academy of Sciences, Beijing, China
| | - G F Chen
- Institute of Physics, Chinese Academy of Sciences, Beijing, China
| | - B Xu
- Institute of Physics, Chinese Academy of Sciences, Beijing, China
| | - R Yang
- Institute of Physics, Chinese Academy of Sciences, Beijing, China
| | - B Shen
- Department of Physics and Astronomy, University of California, Los Angeles, CA, USA
- State Key Laboratory of Optoelectronic Materials and Technologies, School of Physics, Guangzhou, China
| | - C Hu
- Department of Physics and Astronomy, University of California, Los Angeles, CA, USA
| | - C-C Lee
- Department of Physics, Tamkang University, New Taipei, Taiwan
| | - H Lin
- Institute of Physics, Academia Sinica, Taipei, Taiwan
| | - T A Cochran
- Laboratory for Topological Quantum Matter and Advanced Spectroscopy (B7), Department of Physics, Princeton University, Princeton, NJ, USA
| | - S A Trugman
- Center for Integrated Nanotechnologies, Los Alamos National Laboratory, Los Alamos, NM, USA
| | - J-X Zhu
- Center for Integrated Nanotechnologies, Los Alamos National Laboratory, Los Alamos, NM, USA
| | - M Z Hasan
- Laboratory for Topological Quantum Matter and Advanced Spectroscopy (B7), Department of Physics, Princeton University, Princeton, NJ, USA
- Materials Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - N Ni
- Department of Physics and Astronomy, University of California, Los Angeles, CA, USA
| | - X G Qiu
- Institute of Physics, Chinese Academy of Sciences, Beijing, China
| | - A J Taylor
- Center for Integrated Nanotechnologies, Los Alamos National Laboratory, Los Alamos, NM, USA
| | - D A Yarotski
- Center for Integrated Nanotechnologies, Los Alamos National Laboratory, Los Alamos, NM, USA
| | - R P Prasankumar
- Center for Integrated Nanotechnologies, Los Alamos National Laboratory, Los Alamos, NM, USA.
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22
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Rabbani MG, Akter O, Hasan MZ, Samad N, Mahmood SS, Joarder T. COVID-19 Knowledge, Attitudes, and Practices Among People in Bangladesh: Telephone-Based Cross-sectional Survey. JMIR Form Res 2021; 5:e28344. [PMID: 34519660 PMCID: PMC8575001 DOI: 10.2196/28344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/04/2021] [Accepted: 04/22/2021] [Indexed: 11/16/2022] Open
Abstract
Background The world has been grappling with the COVID-19 pandemic, a dire public health crisis, since December 2019. Preventive and control measures have been adopted to reduce the spread of COVID-19. To date, the public’s knowledge, attitudes, and practices regarding COVID-19 across Bangladesh have been poorly understood. Therefore, it is important to assess people’s knowledge, attitudes, and practices (KAP) toward the disease and suggest appropriate strategies to combat COVID-19 effectively. Objective This study aimed to assess the KAP of Bangladeshi people toward COVID-19 and to identify their determinants. Methods We conducted a country-wide cross-sectional telephonic survey from May 7 to 29, 2020. A purposive sampling method was applied, and adult Bangladeshi citizens who have mobile phones were approached to participate in the survey. Interviews were conducted based on verbal consent. Multiple logistic regression analyses and several tests were performed to identify the factors associated with KAP related to COVID-19. Results A total of 492 of 576 Bangladeshi adults aged 18 years and above completed the interview, with a response rate of 85.4% (492/576). Of the 492 participants, 321 (65.2%) were male, and 304 (61.8%) lived in a rural area. Mean scores for knowledge, attitudes, and practices were 10.56 (SD 2.86), 1.24 (SD 0.83), and 3.17 (SD 1.5), respectively. Among the 492 respondents, 273 (55.5%) had poor knowledge, and 251 (49%) expressed a negative attitude; 192 out of 359 respondents (53.5%) had poor practices toward COVID-19. Mean scores of knowledge, attitudes, and practices differed significantly across various demographic and socioeconomic groups. Rural residents had lower mean scores of knowledge (mean 9.8, SD 3.1, P<.001) and adherence to appropriate practice measures (mean 4, SD 1.4, P<.001) compared to their urban counterparts. Positive and statistically strong correlations between knowledge and attitudes (r=0.21, P<.001), knowledge and practices (r=0.45, P<.001), and attitudes and practices (r=0.27, P<.001) were observed. Television (53.7%) was identified as the major source of knowledge regarding COVID-19. Almost three-quarters of the respondents (359/492, 73%) went outside the home during the lockdown period. Furthermore, the study found that good knowledge (odds ratio [OR] 3.13, 95% CI 2.03-4.83, and adjusted OR 2.33, 95% CI 1.16-4.68) and a positive attitude (OR 2.43, 95% CI 1.59-3.72, and adjusted OR 3.87, 95% CI 1.95-7.68) are significantly associated with better practice of COVID-19 health measures. Conclusions Evidence-informed and context-specific risk communication and community engagement, and a social and behavior change communication strategy against COVID-19 should be developed in Bangladesh based on the findings of this study, targeting different socioeconomic groups.
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Affiliation(s)
| | - Orin Akter
- Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Md Zahid Hasan
- Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Nandeeta Samad
- Department of Public Health, North South University, Dhaka, Bangladesh
| | - Shehrin Shaila Mahmood
- Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
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23
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Hasan MZ, Mehdi GG, De Broucker G, Ahmed S, Ali MW, Martin Del Campo J, Constenla D, Patenaude B, Uddin MJ. The economic burden of diarrhea in children under 5 years in Bangladesh. Int J Infect Dis 2021; 107:37-46. [PMID: 33864914 PMCID: PMC8208894 DOI: 10.1016/j.ijid.2021.04.038] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 04/09/2021] [Accepted: 04/12/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Diarrhea is a leading cause of morbidity and mortality among under-five children in Bangladesh. Hospitalization for diarrhea can pose a significant burden on households and health systems. The aim of this study was to estimate the cost of illness due to diarrhea from the healthcare facility, caregiver, and societal perspectives in Bangladesh. METHOD A cross-sectional study with an ingredient-based costing approach was conducted in 48 healthcare facilities in Bangladesh. In total, 899 caregivers of under-five children with diarrhea were interviewed face-to-face between August 2017 and May 2018, followed up over phone after 7-14 days of discharge, to capture all expenses and time costs related to the entire episode of diarrhea. RESULTS The average cost per episode for caregivers was US$62, with $29 direct and $34 indirect costs. From the societal perspective, average cost per episode of diarrhea was $71. In 2018, an estimated $79 million of economic costs were incurred for treating diarrhea in Bangladesh. Using 10% of income as threshold, over 46% of interviewed households faced catastrophic expenditure from diarrheal disease. CONCLUSION The economic costs incurred by caregivers for treating per-episode of diarrhea was around 4% of the annual national gross domestic product per-capita. Investment in vaccination can help to reduce the prevalence of diarrheal diseases and avert this public health burden.
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Affiliation(s)
- Md Zahid Hasan
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b).
| | - Gazi Golam Mehdi
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
| | - Gatien De Broucker
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Sayem Ahmed
- Mathematical Modelling Group, Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, United Kingdom; Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Md Wazed Ali
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
| | - Jorge Martin Del Campo
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Dagna Constenla
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; GlaxoSmithKline Plc., Panama City, Panama
| | - Bryan Patenaude
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Md Jasim Uddin
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
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24
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Ahmed S, Ahmed MW, Hasan MZ, Mehdi GG, Islam Z, Rehnberg C, Niessen LW, Khan JAM. Assessing the incidence of catastrophic health expenditure and impoverishment from out-of-pocket payments and their determinants in Bangladesh: evidence from the nationwide Household Income and Expenditure Survey 2016. Int Health 2021; 14:84-96. [PMID: 33823538 PMCID: PMC8769950 DOI: 10.1093/inthealth/ihab015] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 02/01/2021] [Accepted: 03/08/2021] [Indexed: 12/04/2022] Open
Abstract
Background Out-of-pocket (OOP) payments for healthcare have been increasing steadily in Bangladesh, which deteriorates the financial risk protection of many households. Methods We aimed to investigate the incidence of catastrophic health expenditure (CHE) and impoverishment from OOP payments and their determinants. We employed nationally representative Household Income and Expenditure Survey 2016 data with a sample of 46 076 households. A household that made OOP payments of >10% of its total or 40% of its non-food expenditure was considered to be facing CHE. We estimated the impoverishment using both national and international poverty lines. Multiple logistic models were employed to identify the determinants of CHE and impoverishment. Results The incidence of CHE was estimated as 24.6% and 10.9% using 10% of the total and 40% of non-food expenditure as thresholds, respectively, and these were concentrated among the poor. About 4.5% of the population (8.61 million) fell into poverty during 2016. Utilization of private facilities, the presence of older people, chronic illness and geographical location were the main determinants of both CHE and impoverishment. Conclusion The financial hardship due to OOP payments was high and it should be reduced by regulating the private health sector and covering the care of older people and chronic illness by prepayment-financing mechanisms.
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Affiliation(s)
- Sayem Ahmed
- Liverpool School of Tropical Medicine, Liverpool, UK.,Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden.,Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City 700000, Vietnam.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7BN, UK
| | - Mohammad Wahid Ahmed
- Health Economics and Financing Research, Health Systems and Population Studies Division, icddr, b, Dhaka, Bangladesh
| | - Md Zahid Hasan
- Health Economics and Financing Research, Health Systems and Population Studies Division, icddr, b, Dhaka, Bangladesh
| | - Gazi Golam Mehdi
- Health Economics and Financing Research, Health Systems and Population Studies Division, icddr, b, Dhaka, Bangladesh
| | - Ziaul Islam
- Health Economics and Financing Research, Health Systems and Population Studies Division, icddr, b, Dhaka, Bangladesh
| | - Clas Rehnberg
- Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
| | - Louis W Niessen
- Liverpool School of Tropical Medicine, Liverpool, UK.,Department of International Health, Johns Hopkins School of Public Health, USA
| | - Jahangir A M Khan
- Liverpool School of Tropical Medicine, Liverpool, UK.,Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden.,School of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
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25
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Goni O, Khan MF, Rahman MM, Hasan MZ, Kader FB, Sazzad N, Sakib MA, Romano B, Haque MA, Capasso R. Pharmacological insights on the antidepressant, anxiolytic and aphrodisiac potentials of Aglaonema hookerianum Schott. J Ethnopharmacol 2021; 268:113664. [PMID: 33278545 DOI: 10.1016/j.jep.2020.113664] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 10/11/2020] [Accepted: 11/30/2020] [Indexed: 05/03/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Aglaonema hookerianum Schott is an ethnomedicinally important plant used to treat a variety of diseases, including sexual and depression-like disorders. However, the scientific basis underlying the aforesaid properties have not been well justified. AIM OF THE STUDY The present investigation aimed to investigate the anxiolytic, antidepressant and aphrodisiac potentials of methanol leaves extract of A. hookerianum (MEAH) in Swiss albino mice. MATERIALS & METHODS Swiss albino mice (20-30 g) were orally administrated with MEAH at the doses ranging from 100 to 400 mg/kg, b.w. The elevated plus maze (EPM) and hole board test (HBT) were performed to determine the anxiolytic activity and the forced swimming test (FST) and tail suspension test (TST) were performed to determine the antidepressant activity of MEAH. Besides, the aphrodisiac activity of MEAH was conducted through the mounting behaviour and orientation behaviour analysis. Diazepam (1 mg/kg, b.w., i.p.) for EPM and HBT; fluoxetine HCl (20 mg/kg, b.w., p.o.) for FST and TST, and sildenafil (5 mg/kg, b.w., p.o.) for the mounting behaviour analysis and orientation behaviour analysis were used as reference drugs. RESULTS The administration of the MEAH produced a strong (p < 0.001) dose-dependent anxiolytic effects in both HBT and EPM tests. Likewise, the extract revealed a significant (p < 0.001) reduction in the immobility time in both FST and TST as compared to the control group. Besides, the MEAH also found to possess marked aphrodisiac activity complying several facets such as an increase in the sexual performance at the highest dose (400 mg/kg, p.o.) as well as the orientation toward female mice (p < 0.001) at all tested doses. CONCLUSION Taken together, MEAH can be recommended as a potent source of neuroprotective and a libido-boosting drug candidate for the management of neurological and sexual disorders.
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Affiliation(s)
- Osman Goni
- Department of Natural Sciences, Hochschule Bonn-Rhein-Sieg, 53359 Rheinbach, Germany; Department of Pharmacy, International Islamic University Chittagong, 4318 Chittagong, Bangladesh
| | - Mohammad Forhad Khan
- Department of Pharmacy, International Islamic University Chittagong, 4318 Chittagong, Bangladesh
| | - Md Masudur Rahman
- Department of Pharmacy, International Islamic University Chittagong, 4318 Chittagong, Bangladesh
| | - Md Zahid Hasan
- Department of Pharmacy, International Islamic University Chittagong, 4318 Chittagong, Bangladesh
| | - Faisal Bin Kader
- Department of Pharmacy, International Islamic University Chittagong, 4318 Chittagong, Bangladesh
| | - Nasim Sazzad
- Department of Pharmacy, International Islamic University Chittagong, 4318 Chittagong, Bangladesh
| | - Mahfuz Ahmed Sakib
- Department of Pharmacy, International Islamic University Chittagong, 4318 Chittagong, Bangladesh
| | - Barbara Romano
- Department of Pharmacy, University of Naples Federico II, Naples, Italy
| | - Md Areeful Haque
- Department of Pharmacy, International Islamic University Chittagong, 4318 Chittagong, Bangladesh; Drug & Herbal Research Centre, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, 50300 Kuala Lumpur, Malaysia.
| | - Raffaele Capasso
- Department of Agricultural Sciences, University of Naples Federico II, 80055 Portici, Italy.
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26
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Rana MM, Rahman MS, Ullah MA, Siddika A, Hossain ML, Akhter MS, Hasan MZ, Asaduzzaman SM. Amnion and collagen-based blended hydrogel improves burn healing efficacy on a rat skin wound model in the presence of wound dressing biomembrane. Biomed Mater Eng 2021; 31:1-17. [PMID: 32144968 DOI: 10.3233/bme-201076] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND A burn wound is one of the most frequent and devastating injuries for patients which requires extensive care. Early treatment of burn wounds improves healing significantly. OBJECTIVE This study was designed to investigate the efficacy of amnion and collagen-based hydrogels on cutaneous burn wound healing in rats with covering membrane. METHODS We prepared a novel cell free hydrogel comprising human amnion, rabbit collagen, carboxymethyl cellulose sodium salt, citric acid, methyl paraben, propyl paraben, glycerin and triethanol amine. The wound covering membrane was developed from rabbit collagen and prawn shell chitosan. Beside swelling ratio, water absorption, equilibrium water content, gel fraction and spreadability analysis, in vitro cytotoxicity and biocompatibility tests were performed for the formulated hydrogels. Following the skin irritation study, second-degree burns were created on the dorsal region of the rats and the gels were applied with/without covering membrane to study the wound contraction and re-epithelialization period. RESULTS The formulated hydrogels were observed non-cytotoxic and compatible with human blood cells. No erythema and edema were found in skin irritation assay confirming the safety and applicability. Hydrogel consisting in a combination of amnion and collagen demonstrated significantly rapid wound healing, driven by complete re-epithelialization (16.75 ± 0.96 days) and closure by wound contraction (72 ± 3.27%, P < 0.0000009) when wound dressing membrane was used, whereas this gel alone healed about 62.5 ± 4.43% (P < 0.00001) and required 18.75 ± 0.50 days to complete re-epithelialization. Additionally, the gel with covering membrane treated group had maximum average body weight, food and water intake. CONCLUSION The amnion and collagen-based blended gel offers alternative possibilities to treat skin wounds when covered with film, which could overcome the limitations associated with modern therapeutic products such as high costs, long manufacturing times, complexities, storing, and presence of living biomaterials.
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Affiliation(s)
- Md Masud Rana
- Institute of Tissue Banking and Biomaterial Research, Atomic Energy Research Establishment, Dhaka, Bangladesh
| | - Md Shaifur Rahman
- Institute of Tissue Banking and Biomaterial Research, Atomic Energy Research Establishment, Dhaka, Bangladesh.,Institute for Stem Cell Research and Regenerative Medicine, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Md Akib Ullah
- Biotechnology and Genetic Engineering Discipline, Khulna University, Khulna, Bangladesh
| | - Ayesha Siddika
- Institute of Tissue Banking and Biomaterial Research, Atomic Energy Research Establishment, Dhaka, Bangladesh
| | - Md Liakat Hossain
- Institute of Tissue Banking and Biomaterial Research, Atomic Energy Research Establishment, Dhaka, Bangladesh
| | - Md Shamim Akhter
- Biotechnology and Genetic Engineering Discipline, Khulna University, Khulna, Bangladesh
| | - Md Zahid Hasan
- Institute of Tissue Banking and Biomaterial Research, Atomic Energy Research Establishment, Dhaka, Bangladesh
| | - Sikder M Asaduzzaman
- Institute of Tissue Banking and Biomaterial Research, Atomic Energy Research Establishment, Dhaka, Bangladesh
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Mitro SK, Majumder R, Hossain KM, Hasan MZ, Hossain ME, Hadi MA. Insights into the physical properties and anisotropic nature of ErPdBi with an appearance of low minimum thermal conductivity. Chinese Phys B 2021; 30:016203. [DOI: 10.1088/1674-1056/abaf9d] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
We theoretically study the structural, elastic and optical properties of ErPdBi together with its anisotropic behaviors using density functional theory. It is observed that ErPdBi satisfies the Born stability criteria nicely and possesses high quality of machinability. The anisotropic behavior of ErPdBi is reported with the help of theoretical anisotropy indices incorporating 3D graphical presentation, which suggests that ErPdBi is highly anisotropic in nature. It is noticed that the minimum thermal conductivity is very low for ErPdBi compared to the several species. This low value of minimum thermal conductivity introduces the potentiality of ErPdBi in high-temperature applications such as thermal barrier coatings. In addition, deep optical insights of ErPdBi reveal that our material can be used in different optoelectronic and electronic device applications ranging from organic light-emitting diodes, solar panel efficiency, waveguides etc. to integration of integrated circuits. Therefore, we believe that our results will provide a new insight into high-temperature applications and will benefit for the development of promising optoelectric devices as well.
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28
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de Broucker G, Ahmed S, Hasan MZ, Mehdi GG, Martin Del Campo J, Ali MW, Uddin MJ, Constenla D, Patenaude B. The economic burden of measles in children under five in Bangladesh. BMC Health Serv Res 2020; 20:1026. [PMID: 33172442 PMCID: PMC7653835 DOI: 10.1186/s12913-020-05880-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 10/30/2020] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND This study estimated the economic cost of treating measles in children under-5 in Bangladesh from the caregiver, government, and societal perspectives. METHOD We conducted an incidence-based study using an ingredient-based approach. We surveyed the administrative staff and the healthcare professionals at the facilities, recording their estimates supported by administrative data from the healthcare perspective. We conducted 100 face-to-face caregiver interviews at discharge and phone interviews 7 to 14 days post-discharge to capture all expenses, including time costs related to measles. All costs are in 2018 USD ($). RESULTS From a societal perspective, a hospitalized and ambulatory case of measles cost $159 and $18, respectively. On average, the government spent $22 per hospitalized case of measles. At the same time, caregivers incurred $131 and $182 in economic costs, including $48 and $83 in out-of-pocket expenses in public and private not-for-profit facilities, respectively. Seventy-eight percent of the poorest caregivers faced catastrophic health expenditures compared to 21% of the richest. In 2018, 2263 cases of measles were confirmed, totaling $348,073 in economic costs to Bangladeshi society, with $121,842 in out-of-pocket payments for households. CONCLUSION The resurgence of measles outbreaks is a substantial cost for society, requiring significant short-term public expenditures, putting households into a precarious financial situation. Improving vaccination coverage in areas where it is deficient (Sylhet division in our study) would likely alleviate most of this burden.
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Affiliation(s)
- Gatien de Broucker
- International Vaccine Access Center, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 415 North Washington Street, #530, Baltimore, MD, 21231, USA.
| | - Sayem Ahmed
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
- Liverpool School of Tropical Disease (LSTM), Liverpool, UK
| | - Md Zahid Hasan
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Gazi Golam Mehdi
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Jorge Martin Del Campo
- International Vaccine Access Center, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 415 North Washington Street, #530, Baltimore, MD, 21231, USA
| | - Md Wazed Ali
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Md Jasim Uddin
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Dagna Constenla
- International Vaccine Access Center, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 415 North Washington Street, #530, Baltimore, MD, 21231, USA
- GlaxoSmithKline Plc, Panama City, Panama
| | - Bryan Patenaude
- International Vaccine Access Center, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 415 North Washington Street, #530, Baltimore, MD, 21231, USA
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Islam MM, Sharif JU, Khan S, Hossain MS, Rahman MS, Hasan MZ, Kamal AM, Thakur AK, Shakil SS. Relationship of Plasma Vitamin-D Level with Left Ventricular Ejection Fraction in Patients with First Attack of Acute Myocardial Infarction. Mymensingh Med J 2020; 29:852-858. [PMID: 33116087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
It has been widely reported that vitamin D deficiency is associated with Coronary heart disease (CHD), especially acute Myocardial infarction (MI). Many factors are responsible for reduced Left ventricular ejection fraction (LVEF) and acute Left ventricular fraction (LVF) after acute MI. This cross sectional descriptive type of study was conducted in the Cardiology department of Mymensingh Medical College Hospital from October 2017 to March 2019 to investigate the relationship of plasma vitamin D with LVEF in patients with first attack of acute MI. Total 185 patients of first attack of acute MI were included considering inclusion and exclusion criteria. Fasting blood samples were analyzed for plasma vitamin D level. Sample population were grouped at first into two, normal and low vitamin D level, taking 30ng/ml as cut-off value, low vitamin D level is further subdivided into insufficiency (21-29ng/ml), deficiency (10-20ng/ml) and severe deficiency (<10ng/ml). LVEF among the patients was observed. LVEF was found 49.88±8.58% patients having normal vitamin D level (>30ng/ml), 47.60±8.24% of patients having vitamin D insufficiency (21-29ng/ml), 44.38±8.12% of patients having vitamin D deficiency (10-20ng/ml) and 40.61±8.64% patients having severe vitamin D deficiency (<10ng/ml), which was statistically significant (p<0.05). So, low plasma vitamin D level is associated with reduced LVEF in patients hospitalized with first attack of acute MI.
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Affiliation(s)
- M M Islam
- Professor Dr Mirza Md Nazrul Islam, Professor, Department of Cardiology, Mymensingh Medical College (MMC), Mymensingh, Bangladesh
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Ahmed S, Sarker AR, Sultana M, Roth F, Mahumud RA, Kamruzzaman M, Hasan MZ, Mirelman AJ, Islam Z, Niessen LW, Rehnberg C, Khan AA, Gyr N, Khan JAM. Do employer-sponsored health insurance schemes affect the utilisation of medically trained providers and out-of-pocket payments among ready-made garment workers? A case-control study in Bangladesh. BMJ Open 2020; 10:e030298. [PMID: 32132134 PMCID: PMC7059493 DOI: 10.1136/bmjopen-2019-030298] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 12/02/2019] [Accepted: 12/17/2019] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE We estimated the effect of an employer-sponsored health insurance (ESHI) scheme on healthcare utilisation of medically trained providers and reduction of out-of-pocket (OOP) expenditure among ready-made garment (RMG) workers. DESIGN We used a case-control study design with cross-sectional preintervention and postintervention surveys. SETTINGS The study was conducted among workers of seven purposively selected RMG factories in Shafipur, Gazipur in Bangladesh. PARTICIPANTS In total, 1924 RMG workers (480 from the insured and 482 from the uninsured, in each period) were surveyed from insured and uninsured RMG factories, respectively, in the preintervention (October 2013) and postintervention (April 2015) period. INTERVENTIONS We tested the effect of a pilot ESHI scheme which was implemented for 1 year. OUTCOME MEASURES The outcome measures were utilisation of medically trained providers and reduction of OOP expenditure among RMG workers. We estimated difference-in-difference (DiD) and applied two-part regression model to measure the association between healthcare utilisation, OOP payments and ESHI scheme membership while controlling for the socioeconomic characteristics of workers. RESULTS The ESHI scheme increased healthcare utilisation of medically trained providers by 26.1% (DiD=26.1; p<0.01) among insured workers compared with uninsured workers. While accounting for covariates, the effect on utilisation significantly reduced to 18.4% (p<0.05). The DiD estimate showed that OOP expenditure among insured workers decreased by -3700 Bangladeshi taka and -1100 Bangladeshi taka compared with uninsured workers when using healthcare services from medically trained providers or all provider respectively, although not significant. The multiple two-part models also reported similar results. CONCLUSION The ESHI scheme significantly increased utilisation of medically trained providers among RMG workers. However, it has no significant effect on OOP expenditure. It can be recommended that an educational intervention be provided to RMG workers to improve their healthcare-seeking behaviours and increase their utilisation of ESHI-designated healthcare providers while keeping OOP payments low.
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Affiliation(s)
- Sayem Ahmed
- Health Economics and Financing Research, Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
- Health Economics and Policy, Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
- Liverpool School of Tropical Medicine, Liverpool, UK
| | - Abdur Razzaque Sarker
- Health Economics and Financing Research, Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
- Department of Management Science, University of Strathclyde, Glasgow, UK
- Health Economics and Financing Research, Bangladesh Institute of Development Studies (BIDS), Dhaka, Bangladesh
| | - Marufa Sultana
- Deakin Health Economics, School of Health and Social Development, Deakin University, Melbourne, Victoria, Australia
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Felix Roth
- Swiss Micro Insurance Consultancy Group (SMCG), Basel, Switzerland
| | - Rashidul Alam Mahumud
- Health Economics and Financing Research, Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
- Health Economics and Policy Research, Centre for Health, Informatics and Economic Research, University of Southern Queensland, Toowoomba, Queensland, Australia
| | | | - Md Zahid Hasan
- Health Economics and Financing Research, Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | | | - Ziaul Islam
- Health Economics and Financing Research, Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Louis W Niessen
- Liverpool School of Tropical Medicine, Liverpool, UK
- Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
| | - Clas Rehnberg
- Health Economics and Policy, Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
| | - Ak Azad Khan
- Diabetic Association of Bangladesh, Dhaka, Bangladesh
| | - Niklaus Gyr
- Department of Internal Medicine, University of Basel, Basel, Switzerland
| | - Jahangir A M Khan
- Health Economics and Policy, Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
- Liverpool School of Tropical Medicine, Liverpool, UK
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Guguchia Z, Verezhak JAT, Gawryluk DJ, Tsirkin SS, Yin JX, Belopolski I, Zhou H, Simutis G, Zhang SS, Cochran TA, Chang G, Pomjakushina E, Keller L, Skrzeczkowska Z, Wang Q, Lei HC, Khasanov R, Amato A, Jia S, Neupert T, Luetkens H, Hasan MZ. Tunable anomalous Hall conductivity through volume-wise magnetic competition in a topological kagome magnet. Nat Commun 2020; 11:559. [PMID: 31992705 PMCID: PMC6987130 DOI: 10.1038/s41467-020-14325-w] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 12/17/2019] [Indexed: 11/23/2022] Open
Abstract
Magnetic topological phases of quantum matter are an emerging frontier in physics and material science. Along these lines, several kagome magnets have appeared as the most promising platforms. Here, we explore magnetic correlations in the kagome magnet Co3Sn2S2. Using muon spin-rotation, we present evidence for competing magnetic orders in the kagome lattice of this compound. Our results show that while the sample exhibits an out-of-plane ferromagnetic ground state, an in-plane antiferromagnetic state appears at temperatures above 90 K, eventually attaining a volume fraction of 80% around 170 K, before reaching a non-magnetic state. Strikingly, the reduction of the anomalous Hall conductivity (AHC) above 90 K linearly follows the disappearance of the volume fraction of the ferromagnetic state. We further show that the competition of these magnetic phases is tunable through applying either an external magnetic field or hydrostatic pressure. Our results taken together suggest the thermal and quantum tuning of Berry curvature induced AHC via external tuning of magnetic order.
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Affiliation(s)
- Z Guguchia
- Laboratory for Muon Spin Spectroscopy, Paul Scherrer Institute, CH-5232, Villigen PSI, Switzerland.
- Laboratory for Topological Quantum Matter and Spectroscopy, Department of Physics, Princeton University, Princeton, NJ, 08544, USA.
| | - J A T Verezhak
- Laboratory for Muon Spin Spectroscopy, Paul Scherrer Institute, CH-5232, Villigen PSI, Switzerland
| | - D J Gawryluk
- Laboratory for Multiscale Materials Experiments, Paul Scherrer Institut, 5232, Villigen PSI, Switzerland
| | - S S Tsirkin
- Department of Physics, University of Zürich, Winterthurerstrasse 190, Zurich, Switzerland
| | - J-X Yin
- Laboratory for Topological Quantum Matter and Spectroscopy, Department of Physics, Princeton University, Princeton, NJ, 08544, USA
| | - I Belopolski
- Laboratory for Topological Quantum Matter and Spectroscopy, Department of Physics, Princeton University, Princeton, NJ, 08544, USA
| | - H Zhou
- International Center for Quantum Materials and School of Physics, Peking University, Beijing, China
- CAS Center for Excellence in Topological Quantum Computation, University of Chinese Academy of Science, Beijing, China
| | - G Simutis
- Laboratory for Muon Spin Spectroscopy, Paul Scherrer Institute, CH-5232, Villigen PSI, Switzerland
| | - S-S Zhang
- Laboratory for Topological Quantum Matter and Spectroscopy, Department of Physics, Princeton University, Princeton, NJ, 08544, USA
| | - T A Cochran
- Laboratory for Topological Quantum Matter and Spectroscopy, Department of Physics, Princeton University, Princeton, NJ, 08544, USA
| | - G Chang
- Laboratory for Topological Quantum Matter and Spectroscopy, Department of Physics, Princeton University, Princeton, NJ, 08544, USA
| | - E Pomjakushina
- Laboratory for Multiscale Materials Experiments, Paul Scherrer Institut, 5232, Villigen PSI, Switzerland
| | - L Keller
- Laboratory for Neutron Scattering, Paul Scherrer Institut, CH-5232, Villigen PSI, Switzerland
| | - Z Skrzeczkowska
- Laboratory for Multiscale Materials Experiments, Paul Scherrer Institut, 5232, Villigen PSI, Switzerland
| | - Q Wang
- Department of Physics and Beijing Key Laboratory of Opto-electronic Functional Materials and Micro-nano Devices, Renmin University of China, Beijing, China
| | - H C Lei
- Department of Physics and Beijing Key Laboratory of Opto-electronic Functional Materials and Micro-nano Devices, Renmin University of China, Beijing, China
| | - R Khasanov
- Laboratory for Muon Spin Spectroscopy, Paul Scherrer Institute, CH-5232, Villigen PSI, Switzerland
| | - A Amato
- Laboratory for Muon Spin Spectroscopy, Paul Scherrer Institute, CH-5232, Villigen PSI, Switzerland
| | - S Jia
- International Center for Quantum Materials and School of Physics, Peking University, Beijing, China
- CAS Center for Excellence in Topological Quantum Computation, University of Chinese Academy of Science, Beijing, China
| | - T Neupert
- Department of Physics, University of Zürich, Winterthurerstrasse 190, Zurich, Switzerland
| | - H Luetkens
- Laboratory for Muon Spin Spectroscopy, Paul Scherrer Institute, CH-5232, Villigen PSI, Switzerland.
| | - M Z Hasan
- Laboratory for Topological Quantum Matter and Spectroscopy, Department of Physics, Princeton University, Princeton, NJ, 08544, USA.
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Rahman MS, Rana MM, Spitzhorn LS, Akhtar N, Hasan MZ, Choudhury N, Fehm T, Czernuszka JT, Adjaye J, Asaduzzaman SM. Fabrication of biocompatible porous scaffolds based on hydroxyapatite/collagen/chitosan composite for restoration of defected maxillofacial mandible bone. Prog Biomater 2019; 8:137-154. [PMID: 31144260 PMCID: PMC6825626 DOI: 10.1007/s40204-019-0113-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 04/29/2019] [Indexed: 12/20/2022] Open
Abstract
Fabrication of scaffolds from biomaterials for restoration of defected mandible bone has attained increased attention due to limited accessibility of natural bone for grafting. Hydroxyapatite (Ha), collagen type 1 (Col1) and chitosan (Cs) are widely used biomaterials which could be fabricated as a scaffold to overcome the paucity of bone substitutes. Here, rabbit Col1, shrimp Cs and bovine Ha were extracted and characterized with respect to physicochemical properties. Following the biocompatibility, degradability and cytotoxicity tests for Ha, Col1 and Cs a hydroxyapatite/collagen/chitosan (Ha·Col1·Cs) scaffold was fabricated using thermally induced phase separation technique. This scaffold was cross-linked with (1) either glutaraldehyde (GTA), (2) de-hydrothermal treatment (DTH), (3) irradiation (IR) and (4) 2-hydroxyethyl methacrylate (HEMA), resulting in four independent types (Ha·Col1·Cs-GTA, Ha·Col1·Cs-IR, Ha·Col1·Cs-DTH and Ha·Col1·Cs-HEMA). The developed composite scaffolds were porous with 3D interconnected fiber microstructure. However, Ha·Col1·Cs-IR and Ha·Col1·Cs-GTA showed better hydrophilicity and biodegradability. All four scaffolds showed desirable blood biocompatibility without cytotoxicity for brine shrimp. In vitro studies in the presence of human amniotic fluid-derived mesenchymal stem cells revealed that Ha·Col1·Cs-IR and Ha·Col1·Cs-DHT scaffolds were non-cytotoxic and compatible for cell attachment, growth and mineralization. Further, grafting of Ha·Col1·Cs-IR and Ha·Col1·Cs-DHT was performed in a surgically created non-load-bearing rabbit maxillofacial mandible defect model. Histological and radiological observations indicated the restoration of defected bone. Ha·Col1·Cs-IR and Ha·Col1·Cs-DHT could be used as an alternative treatment in bone defects and may contribute to further development of scaffolds for bone tissue engineering.
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Affiliation(s)
- Md Shaifur Rahman
- Institute for Stem Cell Research and Regenerative Medicine, Medical Faculty, Heinrich-Heine-Universität Düsseldorf, 40225, Düsseldorf, Germany
| | - Md Masud Rana
- Institute of Tissue Banking and Biomaterial Research, Atomic Energy Research Establishment, 1349, Dhaka, Bangladesh
| | - Lucas-Sebastian Spitzhorn
- Institute for Stem Cell Research and Regenerative Medicine, Medical Faculty, Heinrich-Heine-Universität Düsseldorf, 40225, Düsseldorf, Germany
| | - Naznin Akhtar
- School of Medicine, Geelong Waurn Ponds Campus, Deakin University, Waurn Ponds, Victoria, 3217, Australia
| | - Md Zahid Hasan
- Institute of Tissue Banking and Biomaterial Research, Atomic Energy Research Establishment, 1349, Dhaka, Bangladesh
| | | | - Tanja Fehm
- Department of Obstetrics and Gynaecology, Medical Faculty, Heinrich-Heine-Universität Düsseldorf, 40225, Düsseldorf, Germany
| | - Jan T Czernuszka
- Department of Materials, University of Oxford, Oxford, OX1 3PH, UK
| | - James Adjaye
- Institute for Stem Cell Research and Regenerative Medicine, Medical Faculty, Heinrich-Heine-Universität Düsseldorf, 40225, Düsseldorf, Germany
| | - Sikder M Asaduzzaman
- Institute of Tissue Banking and Biomaterial Research, Atomic Energy Research Establishment, 1349, Dhaka, Bangladesh.
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Rahman MS, Akhtar N, Hasan MZ, Asaduzzaman SM. Human tissue banking in Bangladesh: hope for the patients of massive burns, surgical wound and bone associated complications. Int J Burns Trauma 2019; 9:23-27. [PMID: 31149389 PMCID: PMC6526381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Accepted: 01/25/2018] [Indexed: 06/09/2023]
Abstract
Each year throughout Bangladesh, thousands of people suffering from massive burns and surgical wounds require amniotic grafts for transplantation. Additionally, the stricken persons of the country have to embrace bone associated disability for the whole life due to traumatic complications need bone graft to treat. As a result, these two problems are the largest financial burden as this situation not only affect the family of patients but also cripple down national economy. However, institute of tissue banking in Bangladesh has undertaken the service program on the processing, preservation and clinical applications of amnion membrane and bone graft for rehabilitative surgery. Importantly, in recent years, this institute has started cranial bone autograft processing and transplantation. In accidental cases such as head injury, it is difficult to provide suitable cranial bone allograft according to demand. In this situation, injured cranial bone of the patient is being transported to the lab of the institute, where the scientist, tissue banker and medic work together immediately to process the cranial bone and sterilize by gamma radiation; and after quality assurance, the processed cranial bone autograft is being supplied for replacement surgery. The use of irradiated amnion and bone allografts and cranial bone autograft in reconstructive surgery restore normalcy to lives of many patients from disabilities. This tissue bank is based on finding and obtaining qualified donors from the community and a demand for tissue grafts from the hospitals. Although growing needs for tissue transplantation but raw and processed tissue grafts preservation and banking braces enormous logistical limitations. The only human tissue bank in Bangladesh, however, ensures the availability of tissue allografts of high quality and acceptability to the recipients for rehabilitative surgery for a decade, regardless patients' socio-economic status.
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Affiliation(s)
- Md Shaifur Rahman
- Institute of Tissue Banking and Biomaterial Research, Atomic Energy Research EstablishmentDhaka 1349, Bangladesh
- Institute for Stem Cell Research and Regenerative Medicine, University Hospital, Heinrich Heine UniversityDüsseldorf 40225, Germany
| | - Naznin Akhtar
- Institute of Tissue Banking and Biomaterial Research, Atomic Energy Research EstablishmentDhaka 1349, Bangladesh
| | - Md Zahid Hasan
- Institute of Tissue Banking and Biomaterial Research, Atomic Energy Research EstablishmentDhaka 1349, Bangladesh
| | - Sikder M Asaduzzaman
- Institute of Tissue Banking and Biomaterial Research, Atomic Energy Research EstablishmentDhaka 1349, Bangladesh
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Ahmed S, Hasan MZ, MacLennan M, Dorin F, Ahmed MW, Hasan MM, Hasan SM, Islam MT, Khan JAM. Measuring the efficiency of health systems in Asia: a data envelopment analysis. BMJ Open 2019; 9:e022155. [PMID: 30918028 PMCID: PMC6475137 DOI: 10.1136/bmjopen-2018-022155] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 12/01/2018] [Accepted: 01/08/2019] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE This study aims to estimate the technical efficiency of health systems in Asia. SETTINGS The study was conducted in Asian countries. METHODS We applied an output-oriented data envelopment analysis (DEA) approach to estimate the technical efficiency of the health systems in Asian countries. The DEA model used per-capita health expenditure (all healthcare resources as a proxy) as input variable and cross-country comparable health outcome indicators (eg, healthy life expectancy at birth and infant mortality per 1000 live births) as output variables. Censored Tobit regression and smoothed bootstrap models were used to observe the associated factors with the efficiency scores. A sensitivity analysis was performed to assess the consistency of these efficiency scores. RESULTS The main findings of this paper demonstrate that about 91.3% (42 of 46 countries) of the studied Asian countries were inefficient with respect to using healthcare system resources. Most of the efficient countries belonged to the high-income group (Cyprus, Japan, and Singapore) and only one country belonged to the lower middle-income group (Bangladesh). Through improving health system efficiency, the studied high-income, upper middle-income, low-income and lower middle-income countries can improve health system outcomes by 6.6%, 8.6% and 8.7%, respectively, using the existing level of resources. Population density, bed density, and primary education completion rate significantly influenced the efficiency score. CONCLUSION The results of this analysis showed inefficiency of the health systems in most of the Asian countries and imply that many countries may improve their health system efficiency using the current level of resources. The identified inefficient countries could pay attention to benchmarking their health systems within their income group or other within similar types of health systems.
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Affiliation(s)
- Sayem Ahmed
- Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
- Health Economics and Policy Research Group, Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
| | - Md Zahid Hasan
- Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mary MacLennan
- Department of Social Policy, London School of Economics and Political Science, London, United Kingdom
| | - Farzana Dorin
- Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mohammad Wahid Ahmed
- Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Md Mehedi Hasan
- Institute for Social Science Research, The University of Queensland, Indooroopilly, Queensland, Australia
| | - Shaikh Mehdi Hasan
- Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | | | - Jahangir A M Khan
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
- Health Economics and Policy Research Group, Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
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Ahmed S, Tariqujjaman M, Rahman MA, Hasan MZ, Hasan MM. Inequalities in the prevalence of undiagnosed hypertension among Bangladeshi adults: evidence from a nationwide survey. Int J Equity Health 2019; 18:33. [PMID: 30770739 PMCID: PMC6377713 DOI: 10.1186/s12939-019-0930-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Accepted: 01/28/2019] [Indexed: 11/28/2022] Open
Abstract
Background In recent years, developing countries like Bangladesh are facing a higher burden of non-communicable diseases such as hypertension as a result of demographic transition. Prevalence of hypertension is often studied in this setting. However, evidence on undiagnosed hypertension is not widely available in the existing literature. Therefore, the current study focuses on inequalities in the prevalence of undiagnosed hypertension in Bangladesh. Methods A total of 8835 participants aged 35+ years were included in this study using nationally representative Bangladesh Demographic and Health Survey 2011 (BDHS). In the survey, systolic blood pressure (SBP) and diastolic blood pressure (DBP) of these participants were measured three times with approximately 10 minutes of an interval between each measurement. Any respondent with either SBP ≥ 140 mmHg or DBP ≥ 90 mmHg was considered as patient with hypertension as per the guidelines from American Heart Association. Among the participants, undiagnosed hypertension was defined as having SBP > =140 mmHg or DBP > =90 mmHg and never taking prescribed medicine or being told by health professionals to lower/control blood pressure. Multiple logistic regression analysis was applied for identifying factors associated with undiagnosed hypertension. Further, socioeconomic inequalities in the prevalence of undiagnosed hypertension were estimated using Concentration Index (C). Results We found 978 (59.9% of the total) were undiagnosed among 1685 hypertensive patients studied. Regression analysis showed individuals with being underweight, having poor socioeconomic conditions, and lower educational qualifications were more likely to have undiagnosed hypertension. A similar association between undiagnosed hypertension and socioeconomic quintiles was observed using concentration index (C = − 0.07). On the other hand, individuals from higher age group (50–64 or above), female sex, and Sylhet region were at lower risk of undiagnosed hypertension. Conclusions This study showed that a large proportion of the cases with hypertension are remained undiagnosed in Bangladesh, especially among the poor and low educated population. Screening and awareness building initiatives on hypertension should be taken for this group of population to reduce the burden of undiagnosed hypertension.
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Affiliation(s)
- Sayem Ahmed
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, 1212, Bangladesh. .,Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, 171 77, Sweden. .,Department of Tropical Disease Biology, Liverpool School of Tropical Medicine (LSTM), Liverpool, L3 5QA, UK.
| | - Md Tariqujjaman
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, 1212, Bangladesh
| | - Md Arafat Rahman
- Department of Economics, Faculty of Business and Economics, Macquarie University, Sydney, NSW, 2109, Australia
| | - Md Zahid Hasan
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, 1212, Bangladesh
| | - Md Mehedi Hasan
- Institute for Social Science Research, The University of Queensland, Indooroopilly, 4068, Queensland, Australia
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Ahmed S, Hasan MZ, Ahmed MW, Dorin F, Sultana M, Islam Z, Mirelman AJ, Rehnberg C, Khan JAM, Chowdhury ME. Evaluating the implementation related challenges of Shasthyo Suroksha Karmasuchi (health protection scheme) of the government of Bangladesh: a study protocol. BMC Health Serv Res 2018; 18:552. [PMID: 30012139 PMCID: PMC6048757 DOI: 10.1186/s12913-018-3337-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 06/27/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Rapidly increasing healthcare costs and the growing burden of non-communicable diseases have increased the out-of-pocket (OOP) spending (63.3% of total health expenditure) in Bangladesh. This increasing OOP spending for healthcare has catastrophic economic impact on households. To reduce this burden, the Health Economics Unit (HEU) of the Ministry of Health and Family Welfare has developed the Shasthyo Surokhsha Karmasuchi (SSK) health protection scheme for the below-poverty line (BPL) population. The key actors in the scheme are HEU, contracted scheme operator and hospital. Under this scheme, each enrolled household is provided 50,000 BDT (620 USD) coverage per year for healthcare services against a government financed premium of 1000 BDT (12 USD). This initiative faces some challenges e.g., delays in scheme activities, registering the targeted population, low utilization of services, lack of motivation of the providers, and management related difficulties. It is also important to estimate the financial requirement for nationwide scale-up of this project. We aim to identify these implementation-related challenges and provide feedback to the project personnel. METHODS This is a concurrent process documentation using mixed-method approaches. It will be conducted in the rural Kalihati Upazila where the SSK is being implemented. To validate the BPL population selection process, we will estimate the positive predictive value. A community survey will be conducted to assess the knowledge of the card holders about SSK services. From the SSK information management system, numbers of different services utilized by the card holders will be retrieved. Key-informant interviews with personnel from three key actors will be conducted to understand the barriers in the implementation of the project as per plan and gather their suggestions. To estimate the project costs, all inputs to be used will be identified, quantified and valued. The nationwide scale-up cost of the project will be estimated by applying economic modeling. DISCUSSION SSK is the first ever government initiated health protection scheme in Bangladesh. The study findings will enable decision makers to gain a better understanding of the key challenges in implementation of such scheme and provide feedback towards the successful implementation of the program.
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Affiliation(s)
- Sayem Ahmed
- Universal Health Coverage Programme, Health Systems and Population Studies Division, icddr,b, 68 Shahid Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212, Bangladesh. .,Health Economics and Policy Research Group, Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden.
| | - Md Zahid Hasan
- Universal Health Coverage Programme, Health Systems and Population Studies Division, icddr,b, 68 Shahid Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Mohammad Wahid Ahmed
- Universal Health Coverage Programme, Health Systems and Population Studies Division, icddr,b, 68 Shahid Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Farzana Dorin
- Universal Health Coverage Programme, Health Systems and Population Studies Division, icddr,b, 68 Shahid Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Marufa Sultana
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.,School of Health and Social Development, Deakin University, Melbourne, Australia
| | - Ziaul Islam
- Universal Health Coverage Programme, Health Systems and Population Studies Division, icddr,b, 68 Shahid Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212, Bangladesh
| | | | - Clas Rehnberg
- Health Economics and Policy Research Group, Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
| | - Jahangir A M Khan
- Health Economics and Policy Research Group, Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Mahbub Elahi Chowdhury
- Universal Health Coverage Programme, Health Systems and Population Studies Division, icddr,b, 68 Shahid Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212, Bangladesh
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Ahmed S, Sarker AR, Sultana M, Chakrovorty S, Hasan MZ, Mirelman AJ, Khan JAM. Adverse Selection in Community Based Health Insurance among Informal Workers in Bangladesh: An EQ-5D Assessment. Int J Environ Res Public Health 2018; 15:E242. [PMID: 29385072 PMCID: PMC5858311 DOI: 10.3390/ijerph15020242] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 01/04/2018] [Accepted: 01/29/2018] [Indexed: 11/29/2022]
Abstract
Community-based Health Insurance (CBHI) schemes are recommended for providing financial risk protection to low-income informal workers in Bangladesh. We assessed the problem of adverse selection in a pilot CBHI scheme in this context. In total, 1292 (646 insured and 646 uninsured) respondents were surveyed using the Bengali version of the EuroQuol-5 dimensions (EQ-5D) questionnaire for assessing their health status. The EQ-5D scores were estimated using available regional tariffs. Multiple logistic regression was applied for predicting the association between health status and CBHI scheme enrolment. A higher number of insured reported problems in mobility (7.3%; p = 0.002); self-care (7.1%; p = 0.000) and pain and discomfort (7.7%; p = 0.005) than uninsured. The average EQ-5D score was significantly lower among the insured (0.704) compared to the uninsured (0.749). The regression analysis showed that those who had a problem in mobility (m 1.25-2.17); self-care (OR = 2.29; 95% CI: 1.62-3.25) and pain and discomfort (OR = 1.43; 95% CI: 1.13-1.81) were more likely to join the scheme. Individuals with higher EQ-5D scores (OR = 0.46; 95% CI: 0.31-0.69) were less likely to enroll in the scheme. Given that adverse selection was evident in the pilot CBHI scheme, there should be consideration of this problem when planning scale-up of these kind of schemes.
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Affiliation(s)
- Sayem Ahmed
- Health Economics and Financing Research Group, Health Systems and Population Studies Division, Bangladesh (icddr,b), Dhaka 1212, Bangladesh.
- Health Economics and Policy Research Group, Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, SE-171 77 Stockholm, Sweden.
| | - Abdur Razzaque Sarker
- Health Economics and Financing Research Group, Health Systems and Population Studies Division, Bangladesh (icddr,b), Dhaka 1212, Bangladesh.
- Department of Management Science, University of Strathclyde, Glasgow G1 1XQ, UK.
| | - Marufa Sultana
- Health Economics and Financing Research Group, Health Systems and Population Studies Division, Bangladesh (icddr,b), Dhaka 1212, Bangladesh.
- Faculty of Health, Deakin University, Melbourne, VIC 3125, Australia.
| | - Sanchita Chakrovorty
- Health Economics and Financing Research Group, Health Systems and Population Studies Division, Bangladesh (icddr,b), Dhaka 1212, Bangladesh.
- Department of Agriculture Economics, Purdue University, IN 47907, USA.
| | - Md Zahid Hasan
- Health Economics and Financing Research Group, Health Systems and Population Studies Division, Bangladesh (icddr,b), Dhaka 1212, Bangladesh.
| | | | - Jahangir A M Khan
- Health Economics and Financing Research Group, Health Systems and Population Studies Division, Bangladesh (icddr,b), Dhaka 1212, Bangladesh.
- Health Economics and Policy Research Group, Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, SE-171 77 Stockholm, Sweden.
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK.
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Hasan MZ, Ishika A, Ullah TR, Rabbi MF, Jesmin. P-84 Association between HIF1A rs11549465 C/T polymorphism and elite athlete. Br J Sports Med 2016. [DOI: 10.1136/bjsports-2016-097120.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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39
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Xu SY, Liu C, Alidoust N, Neupane M, Qian D, Belopolski I, Denlinger JD, Wang YJ, Lin H, Wray LA, Landolt G, Slomski B, Dil JH, Marcinkova A, Morosan E, Gibson Q, Sankar R, Chou FC, Cava RJ, Bansil A, Hasan MZ. Corrigendum: Observation of a topological crystalline insulator phase and topological phase transition in Pb1-xSnxTe. Nat Commun 2016; 7:12505. [PMID: 27489130 PMCID: PMC5155670 DOI: 10.1038/ncomms12505] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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40
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Neupane M, Xu SY, Alidoust N, Bian G, Kim DJ, Liu C, Belopolski I, Chang TR, Jeng HT, Durakiewicz T, Lin H, Bansil A, Fisk Z, Hasan MZ. Non-Kondo-like electronic structure in the correlated rare-earth hexaboride YbB(6). Phys Rev Lett 2015; 114:016403. [PMID: 25615485 DOI: 10.1103/physrevlett.114.016403] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Indexed: 06/04/2023]
Abstract
We present angle-resolved photoemission studies on the rare-earth-hexaboride YbB(6), which has recently been predicted to be a topological Kondo insulator. Our data do not agree with the prediction and instead show that YbB(6) exhibits a novel topological insulator state in the absence of a Kondo mechanism. We find that the Fermi level electronic structure of YbB(6) has three 2D Dirac cone like surface states enclosing the Kramers's points, while the f orbital that would be relevant for the Kondo mechanism is ∼1 eV below the Fermi level. Our first-principles calculation shows that the topological state that we observe in YbB(6) is due to an inversion between Yb d and B p bands. These experimental and theoretical results provide a new approach for realizing novel correlated topological insulator states in rare-earth materials.
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Affiliation(s)
- Madhab Neupane
- Joseph Henry Laboratory and Department of Physics, Princeton University, Princeton, New Jersey 08544, USA
| | - Su-Yang Xu
- Joseph Henry Laboratory and Department of Physics, Princeton University, Princeton, New Jersey 08544, USA
| | - Nasser Alidoust
- Joseph Henry Laboratory and Department of Physics, Princeton University, Princeton, New Jersey 08544, USA
| | - Guang Bian
- Joseph Henry Laboratory and Department of Physics, Princeton University, Princeton, New Jersey 08544, USA
| | - D J Kim
- Department of Physics and Astronomy, University of California at Irvine, Irvine, California 92697, USA
| | - Chang Liu
- Joseph Henry Laboratory and Department of Physics, Princeton University, Princeton, New Jersey 08544, USA
| | - I Belopolski
- Joseph Henry Laboratory and Department of Physics, Princeton University, Princeton, New Jersey 08544, USA
| | - T-R Chang
- Department of Physics, National Tsing Hua University, Hsinchu 30013, Taiwan
| | - H-T Jeng
- Department of Physics, National Tsing Hua University, Hsinchu 30013, Taiwan and Institute of Physics, Academia Sinica, Taipei 11529, Taiwan
| | - T Durakiewicz
- Condensed Matter and Magnet Science Group, Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - H Lin
- Graphene Research Centre, Department of Physics, National University of Singapore, Singapore 117542, Singapore
| | - A Bansil
- Department of Physics, Northeastern University, Boston, Massachusetts 02115, USA
| | - Z Fisk
- Department of Physics and Astronomy, University of California at Irvine, Irvine, California 92697, USA
| | - M Z Hasan
- Joseph Henry Laboratory and Department of Physics, Princeton University, Princeton, New Jersey 08544, USA and Princeton Center for Complex Materials, Princeton University, Princeton, New Jersey 08544, USA
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Wray LA, Xu S, Neupane M, Fedorov AV, Hor YS, Cava RJ, Hasan MZ. Chemically gated electronic structure of a superconducting doped topological insulator system. ACTA ACUST UNITED AC 2013. [DOI: 10.1088/1742-6596/449/1/012037] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Lin H, Markiewicz RS, Wray LA, Fu L, Hasan MZ, Bansil A. Single-Dirac-cone topological surface states in the TlBiSe(2) class of topological semiconductors. Phys Rev Lett 2010; 105:036404. [PMID: 20867784 DOI: 10.1103/physrevlett.105.036404] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2010] [Indexed: 05/29/2023]
Abstract
We investigate several strong spin-orbit coupling ternary chalcogenides related to the (Pb,Sn)Te series of compounds. Our first-principles calculations predict the low-temperature rhombohedral ordered phase in TlBiTe₂, TlBiSe₂, and TlSbX₂ (X=Te, Se, S) to be topologically nontrivial. We identify the specific surface termination that realizes the single Dirac cone through first-principles surface state computations. This termination minimizes effects of dangling bonds, making it favorable for photoemission experiments. In addition, our analysis predicts that thin films of these materials could harbor novel 2D quantum spin Hall states, and support odd-parity topological superconductivity.
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Affiliation(s)
- Hsin Lin
- Department of Physics, Northeastern University, Boston, Massachusetts 02115, USA
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43
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Hsieh D, Xia Y, Qian D, Wray L, Meier F, Dil JH, Osterwalder J, Patthey L, Fedorov AV, Lin H, Bansil A, Grauer D, Hor YS, Cava RJ, Hasan MZ. Observation of time-reversal-protected single-dirac-cone topological-insulator states in Bi2Te3 and Sb2Te3. Phys Rev Lett 2009; 103:146401. [PMID: 19905585 DOI: 10.1103/physrevlett.103.146401] [Citation(s) in RCA: 255] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2009] [Indexed: 05/28/2023]
Abstract
We show that the strongly spin-orbit coupled materials Bi2Te3 and Sb2Te3 and their derivatives belong to the Z2 topological-insulator class. Using a combination of first-principles theoretical calculations and photoemission spectroscopy, we directly show that Bi2Te3 is a large spin-orbit-induced indirect bulk band gap (delta approximately 150 meV) semiconductor whose surface is characterized by a single topological spin-Dirac cone. The electronic structure of self-doped Sb2Te3 exhibits similar Z2 topological properties. We demonstrate that the dynamics of spin-Dirac fermions can be controlled through systematic Mn doping, making these materials classes potentially suitable for topological device applications.
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Affiliation(s)
- D Hsieh
- Joseph Henry Laboratories of Physics, Princeton University, Princeton, New Jersey 08544, USA
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44
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Hsieh D, Xia Y, Qian D, Wray L, Dil JH, Meier F, Osterwalder J, Patthey L, Checkelsky JG, Ong NP, Fedorov AV, Lin H, Bansil A, Grauer D, Hor YS, Cava RJ, Hasan MZ. A tunable topological insulator in the spin helical Dirac transport regime. Nature 2009; 460:1101-5. [PMID: 19620959 DOI: 10.1038/nature08234] [Citation(s) in RCA: 539] [Impact Index Per Article: 35.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2009] [Accepted: 06/29/2009] [Indexed: 11/09/2022]
Abstract
Helical Dirac fermions-charge carriers that behave as massless relativistic particles with an intrinsic angular momentum (spin) locked to its translational momentum-are proposed to be the key to realizing fundamentally new phenomena in condensed matter physics. Prominent examples include the anomalous quantization of magneto-electric coupling, half-fermion states that are their own antiparticle, and charge fractionalization in a Bose-Einstein condensate, all of which are not possible with conventional Dirac fermions of the graphene variety. Helical Dirac fermions have so far remained elusive owing to the lack of necessary spin-sensitive measurements and because such fermions are forbidden to exist in conventional materials harbouring relativistic electrons, such as graphene or bismuth. It has recently been proposed that helical Dirac fermions may exist at the edges of certain types of topologically ordered insulators-materials with a bulk insulating gap of spin-orbit origin and surface states protected against scattering by time-reversal symmetry-and that their peculiar properties may be accessed provided the insulator is tuned into the so-called topological transport regime. However, helical Dirac fermions have not been observed in existing topological insulators. Here we report the realization and characterization of a tunable topological insulator in a bismuth-based class of material by combining spin-imaging and momentum-resolved spectroscopies, bulk charge compensation, Hall transport measurements and surface quantum control. Our results reveal a spin-momentum locked Dirac cone carrying a non-trivial Berry's phase that is nearly 100 per cent spin-polarized, which exhibits a tunable topological fermion density in the vicinity of the Kramers point and can be driven to the long-sought topological spin transport regime. The observed topological nodal state is shown to be protected even up to 300 K. Our demonstration of room-temperature topological order and non-trivial spin-texture in stoichiometric Bi(2)Se(3).M(x) (M(x) indicates surface doping or gating control) paves the way for future graphene-like studies of topological insulators, and applications of the observed spin-polarized edge channels in spintronic and computing technologies possibly at room temperature.
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Affiliation(s)
- D Hsieh
- Joseph Henry Laboratories of Physics, Department of Physics, Princeton University, Princeton, New Jersey 08544, USA
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45
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Xia Y, Qian D, Wray L, Hsieh D, Chen GF, Luo JL, Wang NL, Hasan MZ. Fermi surface topology and low-lying quasiparticle dynamics of parent Fe1+xTe/Se superconductor. Phys Rev Lett 2009; 103:037002. [PMID: 19659308 DOI: 10.1103/physrevlett.103.037002] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2009] [Indexed: 05/28/2023]
Abstract
We report the first photoemission study of Fe1+xTe-the host compound of the newly discovered iron-chalcogenide superconductors (maximum Tc approximately 27 K). Our results reveal a pair of nearly electron-hole compensated Fermi pockets, strong Fermi velocity renormalization, and an absence of a spin-density-wave gap. A shadow hole pocket is observed at the "X" point of the Brillouin zone which is consistent with a long-range ordered magnetostructural ground state. No signature of Fermi surface nesting instability associated with Q=(pi/2,pi/2) is observed. Our results collectively reveal that the Fe1+xTe series is different from the undoped phases of the high Tc pnictides and likely harbor an unusual mechanism for superconductivity and magnetic order.
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Affiliation(s)
- Y Xia
- Joseph Henry Laboratories of Physics, Department of Physics, Princeton Center for Complex Materials, Princeton University, Princeton, New Jersey 08544, USA
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46
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Li G, Hu WZ, Dong J, Qian D, Hsieh D, Hasan MZ, Morosan E, Cava RJ, Wang NL. Anomalous Metallic State of Cu0.07TiSe2: an optical spectroscopy study. Phys Rev Lett 2007; 99:167002. [PMID: 17995282 DOI: 10.1103/physrevlett.99.167002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2007] [Revised: 06/30/2007] [Indexed: 05/25/2023]
Abstract
We report an optical spectroscopy study on the newly discovered superconductor Cu0.07TiSe2. Consistent with the development from a semimetal or semiconductor with a very small indirect energy gap upon doping TiSe2, it is found that the compound has a low carrier density. Most remarkably, the study reveals a substantial shift of the screened plasma edge in reflectance towards high energy with decreasing temperature. This phenomenon, rarely seen in metals, indicates either a sizable increase of the conducting carrier concentration or/and a decrease of the effective mass of carriers with reducing temperature. We attribute the shift primarily to the latter effect.
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Affiliation(s)
- G Li
- Beijing National Laboratory for Condensed Matter Physics, Institute of Physics, Chinese Academy of Sciences, Beijing 100080, People's Republic of China
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47
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Li G, Hu WZ, Qian D, Hsieh D, Hasan MZ, Morosan E, Cava RJ, Wang NL. Semimetal-to-semimetal charge density wave transition in 1T-TiSe(2). Phys Rev Lett 2007; 99:027404. [PMID: 17678260 DOI: 10.1103/physrevlett.99.027404] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2007] [Indexed: 05/16/2023]
Abstract
We report an infrared study on 1T-TiSe(2), the parent compound of the newly discovered superconductor Cu(x)TiSe(2). Previous studies of this compound have not conclusively resolved whether it is a semimetal or a semiconductor-information that is important in determining the origin of its unconventional charge density wave (CDW) transition. Here we present optical spectroscopy results that clearly reveal that the compound is metallic in both the high-temperature normal phase and the low-temperature CDW phase. The carrier scattering rate is dramatically different in the normal and CDW phases and the carrier density is found to change with temperature. We conclude that the observed properties can be explained within the scenario of an Overhauser-type CDW mechanism.
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Affiliation(s)
- G Li
- Beijing National Laboratory for Condensed Matter Physics, Institute of Physics, Chinese Academy of Sciences, Beijing 100080, People's Republic of China
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Qian D, Hsieh D, Wray L, Morosan E, Wang NL, Xia Y, Cava RJ, Hasan MZ. Emergence of Fermi pockets in a new excitonic charge-density-wave melted superconductor. Phys Rev Lett 2007; 98:117007. [PMID: 17501082 DOI: 10.1103/physrevlett.98.117007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2006] [Indexed: 05/15/2023]
Abstract
A superconducting state (T(c) approximately 4.2 K) has very recently been observed upon successful doping of the charge-density-wave (CDW) ordered triangular lattice TiSe(2), with copper. Using state-of-the-art photoemission spectroscopy we identify, for the first time, momentum-space locations of doped electrons that form the Fermi sea of the superconductor. With doping, we find that kinematic nesting volume increases, whereas coherence of the CDW collective order sharply drops. In superconducting doping, as chemical potential rises, we observe the emergence of a large density of states in the form of a narrow electron pocket near the L point of the Brillouin zone with d-like character. The k-space spectral evolution directly demonstrates, for the first time, that the CDW order parameter microscopically competes with superconductivity in the same band.
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Affiliation(s)
- D Qian
- Department of Physics, Joseph Henry Laboratories of Physics, Princeton University, Princeton, New Jersey 08544, USA
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49
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Qian D, Wray L, Hsieh D, Viciu L, Cava RJ, Luo JL, Wu D, Wang NL, Hasan MZ. Complete d-band dispersion relation in sodium cobaltates. Phys Rev Lett 2006; 97:186405. [PMID: 17155565 DOI: 10.1103/physrevlett.97.186405] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2006] [Indexed: 05/12/2023]
Abstract
We utilize fine-tuned polarization selection coupled with excitation-energy variation of photoelectron signal to image the complete d-band dispersion relation in sodium cobaltates. A hybridization gap anticrossing is observed along the Brillouin zone corner and the full quasiparticle band is found to emerge as a many-body entity lacking a pure orbital polarization. At low dopings, the quasiparticle bandwidth (Fermion scale, many-body E(F) approximately 0.25 eV) is found to be smaller than most known oxide metals. The low-lying density of states is found to be in agreement with bulk-sensitive thermodynamic measurements for nonmagnetic dopings where the 2D Luttinger theorem is also observed to be satisfied.
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Affiliation(s)
- D Qian
- Department of Physics, Joseph Henry Laboratories, Princeton University, Princeton, New Jersey 08544, USA
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50
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Qian D, Hsieh D, Wray L, Chuang YD, Fedorov A, Wu D, Luo JL, Wang NL, Viciu L, Cava RJ, Hasan MZ. Low-lying quasiparticle states and hidden collective charge instabilities in parent cobaltate superconductors. Phys Rev Lett 2006; 96:216405. [PMID: 16803261 DOI: 10.1103/physrevlett.96.216405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2005] [Indexed: 05/10/2023]
Abstract
We report a state-of-the-art photoemission (angle-resolved photoemission spectroscopy) study of high quality single crystals of NaxCoO2 the series focusing on the fine details of the low-energy states. The Fermi velocity is found to be small (<0.5 eV A) and only weakly anisotropic over the Fermi surface at all dopings, setting the size of the pair wave function to be on the order of 10-20 nm. In the low-doping regime, the exchange interlayer splitting vanishes and two-dimensional collective instabilities such as 120 degrees -type fluctuations become kinematically allowed. Our results suggest that the unusually small Fermi velocity and the unique symmetry of kinematic instabilities distinguish cobaltates from most other oxide superconductors.
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Affiliation(s)
- D Qian
- Department of Physics, Joseph Henry Laboratories, Princeton University, Princeton, New Jersey 08544, USA
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