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Typhoid vaccination is a public health priority in developing countries where young children are greatly affected by typhoid fever. Because present vaccines are not recommended for children younger than 2 years, the Novartis Vaccines Institute for Global Health developed a conjugate vaccine (Vi-CRM197) for infant immunisation. We aimed to assess the immunogenicity and safety of Vi-CRM197 in participants of various ages in endemic countries in south and southeast Asia. We did two randomised, observer-blind, age de-escalation, phase 2 trials at two sites in Pakistan and India (study A), and at one site in the Philippines (study B), between March 2, 2011, and Aug 9, 2012. Adults aged 18–45 years, children aged 24–59 months, older infants aged 9–12 months, and infants aged 6–8 weeks were randomly assigned (1:1) with a computer-generated randomisation list (block size of four) to receive either 5 μg Vi-CRM197 or 25 μg Vi-polysaccharide vaccine (or 13-valent pneumococcal conjugate vaccine in children younger than 2 years). Both infant populations received Vi-CRM197 concomitantly with vaccines of the Expanded Programme on Immunization (EPI), according to WHO schedule. With the exception of designated study site personnel responsible for vaccine preparation, study investigators, those assessing outcomes, and data analysts were masked to treatment allocation. We specified no a-priori null hypothesis for the immunogenicity or safety objectives and all analyses were descriptive. Analyses were by modified intention-to-treat. These studies are registered with ClinicalTrials.gov, numbers NCT01229176 and NCT01437267. 320 participants were enrolled and vaccinated in the two trials: 200 in study A (all age groups) and 120 in study B (children and infants only), of whom 317 (99%) were included in the modified intention-to-treat analysis. One dose of Vi-CRM197 significantly increased concentrations of anti-Vi antibody in adults (from 113 U/mL [95% CI 67–190] to 208 U/mL [117–369]), children (201 U/mL [138–294] to 368 U/mL [234–580]), and older infants (179 U/mL [129–250] to 249 U/mL [130–477]). However, in children and older infants, a second dose of conjugate vaccine had no incremental effect on antibody titres and, at all ages, concentrations of antibodies increased substantially 6 months after vaccination (from 55 U/mL [33–94] to 63 U/mL [35–114] in adults, from 23 U/mL [15–34] to 51 U/mL [34–76] in children, and from 21 U/mL [14–31] to 22 U/mL [14–33] in older infants). Immune response in infants aged 6–8 weeks was lower than that in older participants and, 6 months after third vaccination, antibody concentrations were significantly higher than pre-vaccination concentrations in Filipino (21 U/mL [16–28] vs 2·88 U/mL [1·95–4·25]), but not Pakistani (3·76 U/mL [2·77–5·08] vs 2·77 U/mL [2·1–3·66]), infants. Vi-CRM197 was safe and well tolerated and did not induce any significant interference with EPI vaccines. No deaths or vaccine-related serious adverse events were reported throughout the studies. Vi-CRM197 is safe and immunogenic in endemic populations of all ages. Given at 9 months of age, concomitantly with measles vaccine, Vi-CRM197 shows a promise for potential inclusion in EPI schedules of countries endemic for typhoid. An apparent absence of booster response and a reduction in antibody titres 6 months after immunisation should be further investigated, but data show that an immunogenic typhoid vaccine can be safely delivered to infants during EPI visits recommended by WHO. Sclavo Vaccines Association and Regione Toscana.

Low birthweight (LBW) remains a significant public health problem in Pakistan and further understanding of factors associated with LBW is required. We conducted a hospital-based matched case control study to identify risk factors associated with LBW in a rural district of Pakistan. We found that illiteracy (AOR: 2.68; 95% CI: 1.59 - 4.38), nulliparity (AOR: 1.82; 95% CI: 1.26-2.44), having a previous miscarriage/abortion (AOR: 1.22; 95% CI: 1.06-2.35), having < 2 antenatal care (ANC) visits during last pregnancy (AOR: 2.43; 95% CI: 1.34-2.88), seeking ANC in third trimester (AOR: 3.62; 95% CI : 2.14-5.03), non-use of iron folic acid during last pregnancy (AOR: 2.72; 95% CI: 1.75-3.17), having hypertension during last pregnancy (AOR: 1.42; 95% CI: 1.13-2.20), being anemic (AOR: 2.67; 95% CI: 1.65-5.24) and having postpartum weight of <45 kg (AOR: 3.30; 95% CI : 1.97-4.52) were significantly associated with an increased odds of having a LBW baby. Our study identifies modifiable risk factors requiring immediate commitment from the health authorities.

Background Every year an estimated three million neonates die globally and two hundred thousand of these deaths occur in Pakistan. Majority of these neonates die in rural areas of underdeveloped countries from preventable causes (infections, complications related to low birth weight and prematurity). Similarly about three hundred thousand mother died in 2010 and Pakistan is among ten countries where sixty percent burden of these deaths is concentrated. Maternal and neonatal mortality remain to be unacceptably high in Pakistan especially in rural areas where more than half of births occur. Method/Design This community based cluster randomized controlled trial will evaluate the impact of an Emergency Obstetric and Newborn Care (EmONC) package in the intervention arm compared to standard of care in control arm. Perinatal and neonatal mortality are primary outcome measure for this trial. The trial will be implemented in 20 clusters (Union councils) of District Rahimyar Khan, Pakistan. The EmONC package consists of provision of maternal and neonatal health pack (clean delivery kit, emollient, chlorhexidine) for safe motherhood and newborn wellbeing and training of community level and facility based health care providers with emphasis on referral of complicated cases to nearest public health facilities and community mobilization. Discussion Even though there is substantial evidence in support of effectiveness of various health interventions for improving maternal, neonatal and child health. Reduction in perinatal and neonatal mortality remains a big challenge in resource constrained and diverse countries like Pakistan and achieving MDG 4 and 5 appears to be a distant reality. A comprehensive package of community based low cost interventions along the continuum of care tailored according to the socio cultural environment coupled with existing health force capacity building may result in improving the maternal and neonatal outcomes. The findings of this proposed community based trial will provide sufficient evidence on feasibility, acceptability and effectiveness to the policy makers for replicating and scaling up the interventions within the health system Trial registration ClinicalTrial.gov NCT01751945

Low birthweight (LBW) remains a significant public health problem in Pakistan and further understanding of factors associated with LBW is required. We conducted a hospital-based matched case control study to identify risk factors associated with LBW in a rural district of Pakistan. We found that illiteracy (AöR: 2.68; 95% CI: 1.59 - 4.38), nulliparity (AöR: 1.82; 95% CI: 1.26-2.44), having a previous miscarriage/abortion (AöR: 1.22; 95% CI: 1.06-2.35), having < 2 antenatal care (ANC) visits during last pregnancy (AöR: 2.43; 95% CI: 1.34-2.88), seeking ANC in third trimester (AöR: 3.62; 95% CI : 2.14-5.03), non-use of iron folic acid during last pregnancy (AöR: 2.72; 95% CI: 1.75-3.17), having hypertension during last pregnancy (AöR: 1.42; 95% CI: 1.13-2.20), being anemic (AöR: 2.67; 95% CI: 1.65-5.24) and having postpartum weight of <45 kg (AöR: 3.30; 95% CI : 1.97-4.52) were significantly associated with an increased odds of having a LBW baby. Our study identifies modifiable risk factors requiring immediate commitment from the health authorities.

Silicon nanoparticles (Si-NPs) have shown their potential for use in farming under water-deficient conditions. Thus, the experiment was accomplished to explore the impacts of seed priming of Si-NPs on wheat ( Triticum aestivum L.) growth and yield under different drought levels. The plants were grown in pots under natural ecological environmental conditions and were harvested on 25th of April, 2020. The results revealed that seed priming of Si-NPs (0, 300, 600, and 900 mg/L) suggestively improved, the spike length, grains per spike, 1000 grains weight, plant height, grain yield, and biological yield by 12–42%, 14–54%, 5–49%, 5–41%, 17–62%, and 21–64%, respectively, relative to the control. The Si-NPs improved the leaf gas trade ascribes and chlorophyll a and b concentrations, though decreased the oxidative pressure in leaves which was demonstrated by the diminished electrolyte leakage and upgrade in superoxide dismutase and peroxidase activities in leaf under Si-NPs remedies over the control. The outcomes proposed that Si-NPs could improve the yield of wheat under a dry spell. In this manner, the utilization of Si-NPs by seed priming technique is a practical methodology for controlling the drought stress in wheat. These findings will provide the basis for future research and helpful to improve the food security under drought and heat related challenges.

Advanced Driver Assistance Systems (ADAS) and Collision Avoidance Systems (CAS) are the primary modules of modern human-centric and autonomous driving applications, such as forward and rear-end collision warnings. To enhance the performance of ADAS and CAS systems in foggy weather, an Efficient and Cost-Effective Vehicle Detection and Tracking with Driver Assistance (ECE-VDTDA) system is proposed. The proposed ECE-VDTDA system comprises vehicle detection, tracking, and driver assistance modules. An optimized SimYOLO-V5s_WIOU vehicle detection algorithm is proposed, based on the SimSPPF module, the baseline You Only Look Once (YOLO) algorithm (YOLO-V5s), and the Wise Intersection Over Union (WIOU) localization loss function. State-of-the-art Deep-SORT, Strong-SORT, and optimized Deep-SORT algorithms are utilized for vehicle tracking. The vehicle detection and tracking performance of the ECE-VDTDA system is rigorously evaluated on DAWN, foggy driving, foggy cityscapes, BDD100K, web-collected, and self-collected foggy weather datasets. Optimized SimYOLO-V5s_WIOU algorithm outperformed on the foggy driving dataset with a 17.45% increase in mAP50, and foggy cityscapes dataset with a 0.32%, 1.05%, 1.58%, 2%, 0.54% increase in the multiclass mAP50, mAP50-95, F1 score, precision, and recall scores, respectively, compared to the baseline YOLO-V5s. Furthermore, the SimYOLO-V5s_WIOU algorithm also outperformed the state-of-the-art methods and enables Deep-SORT, Strong-SORT, and optimized Deep-SORT vehicle tracking algorithms to track vehicles with high confidence. The driver assistance module of the ECE-VDTDA system helps prevent imminent road collisions in foggy weather by estimating distance, speed, and time-to-collision and by issuing timely collision warnings. The experimental results demonstrate the robustness and computational efficiency of the proposed ECE-VDTDA system.

The worldwide resurgence of natural dyes in all fields is due to the carcinogenic effects of effluent loads shed by synthetic industries. Coconut coir ( Cocos nucifera ) containing tannin as a source of natural colorants has been selected for coloration of bio-mordanted silk under the influence of ultrasonic radiations at various dyeing conditions. For extraction of tannin dye from cocos powder, different media were employed, and dyeing variables such as dyeing time, dye bath pH, dyeing bath temperature, and the effect of salts on dyeing were optimized. For achieving new shades with excellent color characteristics, bio-mordants in comparison with chemical mordants were employed. It has been found that acid-solubilized extract after ultrasonic treatment for 45 min has yielded high color strength, when coconut coir extract of 4 pH from 6g of cocos powder, containing 5g/100mL salt solution as exhaust agent, was used to dye silk at 75°C for 65 min. Among bio-mordants turmeric ( K / S =13.828) and among chemical mordants iron has shown excellent results ( K / S =2.0856). Physiochemical analysis of fabric before and after US treatment shows that there is no change in the chemical structure of the fabric. It is found that ultrasonic waves have excellent potential to isolate the colorant followed by dyeing and environmental friendly mordanting at optimal conditions, but also the usage of herbal-based plant anchors, i.e., bio-mordants, has made the natural dyeing process more sustainable and clean.

Climatic variability has been acquiring an extensive consideration due to its widespread ability to impact food production and livelihoods. Climate change has the potential to intersperse global approaches in alleviating hunger and undernutrition. It is hypothesized that climate shifts bring substantial negative impacts on food production systems, thereby intimidating food security. Vast developments have been made addressing the global climate change, undernourishment, and hunger for the last few decades, partly due to the increase in food productivity through augmented agricultural managements. However, the growing population has increased the demand for food, putting pressure on food systems. Moreover, the potential climate change impacts are still unclear more obviously at the regional scales. Climate change is expected to boost food insecurity challenges in areas already vulnerable to climate change. Human-induced climate change is expected to impact food quality, quantity, and potentiality to dispense it equitably. Global capabilities to ascertain the food security and nutritional reasonableness facing expeditious shifts in biophysical conditions are likely to be the main factors determining the level of global disease incidence. It can be apprehended that all food security components (mainly food access and utilization) likely be under indirect effect via pledged impacts on ménage, incomes, and damages to health. The corroboration supports the dire need for huge focused investments in mitigation and adaptation measures to have sustainable, climate-smart, eco-friendly, and climate stress resilient food production systems. In this paper, we discussed the foremost pathways of how climate change impacts our food production systems as well as the social, and economic factors that in the mastery of unbiased food distribution. Likewise, we analyze the research gaps and biases about climate change and food security. Climate change is often responsible for food insecurity issues, not focusing on the fact that food production systems have magnified the climate change process. Provided the critical threats to food security, the focus needs to be shifted to an implementation oriented-agenda to potentially cope with current challenges. Therefore, this review seeks to have a more unprejudiced view and thus interpret the fusion association between climate change and food security by imperatively scrutinizing all factors.

A pandemic of coronavirus disease 2019 (COVID-19) emerged and affected most of the world in early 2020. To inform effective public health measures we conducted a knowledge, attitude and practice (KAP) survey among a Hausa Muslim society in Nigeria in March 2020. The study is an analytic cross-sectional survey with questionnaires administered to the general population including Health Care Workers (HCW) in Kano, Nigeria. Participants were recruited by convenience sampling following informed consent. The percentage of KAP scores were categorized as good and poor. Independent predictors of good knowledge of COVID 19 were ascertained using a binary logistic regression model. The questionnaire was administered among urban 32.8%, peri-urban dwellers 32.4%, and to online participants 34.8%. The peri-urban and urban participants were given paper questionnaires. There were 886 study participants with mean age 28.58yrs [SD:10.25] (Interquartile range [IQR]:22yrs-32yrs), males 55.4% with 57.3% having had or were in tertiary education. Most participants were students 40% and civil servants 20%. The overall mean [standard deviation (SD)] for knowledge, attitude and practice scores expressed in percentage was 65.38%[SD15.90], 71.45% [SD14.10], and 65.04% [SD17.02] respectively. Out of the respondents, 270(30.47%) had good knowledge (GK), 158(17.8%) had good attitude (GA), and 230(25.96%) had good practice (GP) using cut-off scores of 75%, 86.5%, and 75% respectively. Over 48% did not agree COVID-19 originated from animals while 60% perceived the pandemic to be due to God's punishment. Also, 36% thought it was a man-made virus. When rating fear, most respondents [63.5%] had marked fear i.e. ≥ 7 out of 10 and 56% admitted to modifying their habits recently in fear of contracting the virus. As regards attitude to religious norms, 77.77% agreed on cancellation of the lesser pilgrimage as a measure to curb the spread of the disease while 23.64% admitted that greater pilgrimage (Hajj) should proceed despite the persistence of the ongoing pandemic. About 50% of the respondents insisted on attending Friday congregational prayers despite social distancing. One in four people still harbored stigma towards a person who has recovered from the virus. 28% felt some races are more at risk of the disease though 66% mentioned always practicing social distancing from persons coughing or sneezing. Almost 70% of respondents said they were willing to accept a vaccine with 39% saying they would be willing to pay for it if not publicly funded. In univariate analysis increasing age and having been ever married were associated with GK while tertiary education was associated with GA [Odds Ratio; 95% Confidence Interval] 2.66(1.79-3.95). Independent positive predictors of GK were those who were or had ever been married, those who had marked fear of COVID-19, and had modified their habits in the last three months. Those who had non-tertiary education and had the questionnaire administered as paper rather than online version had GK but age was not a predictor. Knowledge of transmission and preventive measures should be improved in the general population cognizant of cultural norms and Islamic practices. The study highlights the importance of considering belief systems and perception in developing control measures against COVID-19.

Energy efficiency and balanced load distribution remain persistent challenges in the Routing Protocol for Low-Power and Lossy Networks (RPL), significantly affecting the lifetime and reliability of Internet of Things (IoT) deployments. This study introduces EDCC-RPL, a novel multi-metric objective function that integrates Expected Transmission Count (ETX), end-to-end delay, and child count through an adaptive additive model. Unlike conventional single or dual metric schemes such as OF0, MRHOF, and EA-EPL, EDCC-RPL simultaneously enhances energy efficiency, network stability, and scalability. Extensive simulations in Contiki Cooja with 20–50 nodes demonstrate up to 32% lower energy consumption, 18% higher Packet Delivery Ratio (PDR), and 50–60% reduction in parent switching (churn) in dense topologies. These improvements validate EDCC-RPL’s novelty in achieving joint optimization of reliability, delay, and load balancing. The proposed approach provides a practical and scalable solution for sustainable IoT networks in smart cities, industrial monitoring, and environmental sensing applications. The implementation code of the proposed EDCC-RPL algorithm is publicly available at https://github.com/drmasifhabib/edcc-rpl-github for reproducibility and reuse.