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Background Currently, no validated instruments are available to measure the health status of Bangladeshi patients with fibromyalgia (FM). The aims of this study were to cross-culturally adapt the modified Fibromyalgia Impact Questionnaire (FIQ) into Bengali (B-FIQ) and to test its validity and reliability in Bangladeshi patients with FM. Methods The FIQ was translated following cross-cultural adaptation guidelines and pretested in 30 female patients with FM. Next, the adapted B-FIQ was physician-administered to 102 consecutive female FM patients together with the Health Assessment Questionnaire (HAQ), selected subscales of the SF-36, and visual analog scales for current clinical symptoms. A tender point count (TPC) was performed by an experienced rheumatologist. Forty randomly selected patients completed the B-FIQ again after 7 days. Two control groups of 50 healthy people and 50 rheumatoid arthritis (RA) patients also completed the B-FIQ. Results For the final B-FIQ, five physical function sub-items were replaced with culturally appropriate equivalents. Internal consistency was adequate for both the 11-item physical function subscale (α = 0.73) and the total scale (α = 0.83). With exception of the physical function subscale, expected correlations were generally observed between the B-FIQ items and selected subscales of the SF-36, HAQ, clinical symptoms, and TPC. The B-FIQ was able to discriminate between FM patients and healthy controls and between FM patients and RA patients. Test-retest reliability was adequate for the physical function subscale (r = 0.86) and individual items (r = 0.73-0.86), except anxiety (r = 0.27) and morning tiredness (r = 0.64). Conclusion This study supports the reliability and validity of the B-FIQ as a measure of functional disability and health status in Bangladeshi women with FM.

IntroductionDespite the profound burden of disease, a strategic global response to optimise musculoskeletal (MSK) health and guide national-level health systems strengthening priorities remains absent. Auspiced by the Global Alliance for Musculoskeletal Health (G-MUSC), we aimed to empirically derive requisite priorities and components of a strategic response to guide global and national-level action on MSK health.MethodsDesign: mixed-methods, three-phase design.Phase 1: qualitative study with international key informants (KIs), including patient representatives and people with lived experience. KIs characterised the contemporary landscape for MSK health and priorities for a global strategic response.Phase 2: scoping review of national health policies to identify contemporary MSK policy trends and foci.Phase 3: informed by phases 1–2, was a global eDelphi where multisectoral panellists rated and iterated a framework of priorities and detailed components/actions.ResultsPhase 1: 31 KIs representing 25 organisations were sampled from 20 countries (40% low and middle income (LMIC)). Inductively derived themes were used to construct a logic model to underpin latter phases, consisting of five guiding principles, eight strategic priority areas and seven accelerators for action.Phase 2: of the 165 documents identified, 41 (24.8%) from 22 countries (88% high-income countries) and 2 regions met the inclusion criteria. Eight overarching policy themes, supported by 47 subthemes, were derived, aligning closely with the logic model.Phase 3: 674 panellists from 72 countries (46% LMICs) participated in round 1 and 439 (65%) in round 2 of the eDelphi. Fifty-nine components were retained with 10 (17%) identified as essential for health systems. 97.6% and 94.8% agreed or strongly agreed the framework was valuable and credible, respectively, for health systems strengthening.ConclusionAn empirically derived framework, co-designed and strongly supported by multisectoral stakeholders, can now be used as a blueprint for global and country-level responses to improve MSK health and prioritise system strengthening initiatives.

Rheumatoid arthritis (RA) is the most common inflammatory polyarthritis in Bangladesh. Bangladesh Rheumatology Society (BRS) proposes these management recommendations to treat the considerable burden of RA in the resource-constrained situation based on the best current evidence combined with societal challenges and opportunities. BRS formed a task force (TF) comprising four rheumatologists. The TF searched for all available literature, including updated American College of Rheumatology (ACR), European Alliance of Associations for Rheumatology (EULAR), and Asia-Pacific League of Associations for Rheumatology (APLAR) and several other guidelines, and systematic literature reviews until October 2023, and then a steering committee was formed, which included rheumatologists and internists. We followed the EULAR standard operating procedures to categorize levels of evidence and grading of recommendations. This recommendation has two parts -- general (diagnosis of RA, nomenclature of disease-modifying anti-rheumatic drugs [DMARDs], disease activity indices) and management portion. The TF agreed on four overarching principles and 12 recommendations. Overarching principles deal with early diagnosis and disease activity monitoring. Recommendations 1-5 discuss using glucocorticoids, NSAIDs, and conventional synthetic DMARDs (csDMARD). Recommendations 6-9 stretch the use of targeted synthetic DMARDs (tsDMARDs) and biological DMARDs (bDMARDs). The suggested DMARD therapy includes initiation with methotrexate (MTX) or another csDMARD (in case of contraindication to MTX) in the first phase and the addition of a tsDMARD in the second phase, switching to an alternative tsDMARDs or bDMARDs in the subsequent phases. The TF included the Padua prediction score for the thromboembolism risk estimation. Recommendations 10-12 cover infection screening, vaccination, and DMARD tapering. Bangladesh has a higher prevalence of RA. This recommendation will serve as a tool to treat this high burden of patients with RA scientifically and more effectively.

To develop a culturally adapted Bengali version of the Short Form-36 (SF-36) Health Survey and to test its acceptability, reliability, and validity in patients with rheumatoid arthritis (RA). The US English SF-36 was translated into Bengali after established cross-cultural adaptation procedures. The questionnaire was interviewer administered to 125 consecutive outpatients with RA and readministered after 2 weeks to 40 randomly selected patients. Most participants (86.4%) did not have any problem in understanding the Bengali SF-36 and 98.4% of the questionnaires were fully completed. Only the role-physical and role-emotional scales showed substantial floor and ceiling effects. Principal component analysis confirmed that the hypothesized two-factor structure and tests of scaling assumptions were 100% successful for all eight scales expect physical functioning (98.8%) and general health (77.5%). Cronbach's α was higher than 0.78 and the test–retest reliability was high (r>0.82) for all scales. Correlations with other disease activity parameters were generally as expected and summary scores were able to discriminate between relevant subgroups. The interviewer-administered Bengali SF-36 appears to be an acceptable, reliable, and valid instrument for measuring health-related quality of life in Bangladeshi patients with RA. The questionnaire should be further evaluated in people from the general population and in patients with different medical conditions.

The age of onset of rheumatoid arthritis (RA) is an important outcome predictor. Northern countries report an age of RA onset of around 50 years, but apparently, variability exists across different geographical regions. The objective of the present study is to assess whether the age of onset of RA varies across latitudes worldwide. In a proof-of-concept cross-sectional worldwide survey, rheumatologists from preselected cities interviewed 20 consecutive RA patients regarding the date of RA onset (RAO, when the patient first noted a swollen joint). Other studied variables included location of each city, rheumatologist settings, latitudes (10° increments, south to north), longitudes (three regions), intracountry consistency, and countries’ Inequality-adjusted Human Development Index (IHDI). Data from 2481 patients (82% females) were obtained from 126 rheumatologists in 77 cities of 41 countries. Worldwide mean age of RAO was 44 ± 14 years (95% CI 44–45). In 28% of patients, RA began before age 36 years and before age 46 years in 50% of patients. RAO was 8 years earlier around the Tropic of Cancer when compared with northern latitudes ( p  < 0.001, 95% CI 3.5–13). Multivariate analysis showed that females, western cities, and latitudes around the Tropic of Cancer are associated with younger age of RAO ( R 2 0.045, p  < 0.001). A positive correlation was found between the age of RAO and IHDI ( r  = 0.7, p  < 0.01, R 2 0.5). RA often begins at an early age and onset varies across latitudes worldwide. We postulate that countries’ developmental status and their geographical and geomagnetic location influence the age of RAO.

The effective treatment of waste to be used as a resource in future has a major role in achieving environmental sustainability and moving towards circular economy. The current research is aimed to provide in-depth detail regarding prominent trends and research themes, evolution, future research orientation, main characteristics, and mapping of research publications on waste management, technological innovation in circular economy domain from the year 2000 to 2021. Different analyses including text mining and bibliometric and content analyses were applied to answer the research question and provide the details on aforementioned variables. From the bibliometric analyses, a total of 1118 articles were drawn out from the Scopus database to conceptualize the core body of research. As a result, the following themes were identified: electronic waste, circular economy transition, plastic waste, bio-based waste management, lifecycle assessment, and ecological impacts, and construction and demolition waste management. The highlighted features, future research orientation, and prominent research perspective can provide guideline for future research to enrich the literature through conducting studies on provided research directions and help lead waste management and technological innovation policymakers, professionals, and practitioners in moving towards circular transition.

To attain ecological sustainability and transition to sustainable supply chain management (SSCM), effective technological innovation (TI) and solid waste management (SWM), as likely impending resources, are essential components. From 2000 through 2021, a detailed map of SSCMs in the context of TI and systematic history will be created, highlighting the most significant research themes and trends, primary features, development, and possibly relevant areas for future study. Due to utilizing bibliometric analysis, text mining, and content analytics methodologies, the following concerns were addressed: (1) How has SSCM research progressed over time in the TI domain? (2) Which SSCM research areas and trends receive the most attention in the TI domain? Additionally, (3) what are the research directions for SSCM in the context of TI? As a result, bibliometric networks were developed and examined using 983 journal articles from the Scopus database to highlight the substantial body of literature. As a result, SSCM has been divided into five crucial study themes: (i) transition to TI, (ii) SSCM in closed-loop supply chains, (iii) municipal solid waste management (MSWM), (iv) environmental consequences and life-cycle evaluation, and (v) policymakers and practitioners in SSCM can use the SSCM research landscape and its primary highlight patterns to guide and add in the TI. Considering SSCM research as a way to reduce waste, future study directions are also suggested.

Various studies have reported culture conversion at two months as a predictor of successful treatment outcome in multidrug-resistant tuberculosis (MDR-TB). The present study was conducted with the aim to evaluate the rate and predictors of culture conversion at two months in MDR-TB patients. All confirmed pulmonary MDR-TB patients enrolled for treatment at Lady Reading Hospital Peshawar, Pakistan from 1 January to 31 December 2012 and met the inclusion criteria were reviewed retrospectively. Rate and predictors of culture conversion at two months were evaluated. Eighty seven (53.4%) out of 163 patients achieved culture conversion at two months. In a multivariate analysis lung cavitation at baseline chest X-ray (P = 0.006, OR = 0.349), resistance to ofloxacin (P = 0.041, OR = 0.193) and streptomycin (P = 0.017, OR = 0.295) had statistically significant (P<0.05) negative association with culture conversion at two months. A reasonable proportion of patients achieved culture conversion at two months. Factors negatively associated with culture conversion at two months can be easily identified either before diagnosis or early in the course of MDR-TB treatment. This may help in better care of individual patients by identifying them early and treating them vigorously.

PurposeThe current study investigates the effect of industry 4.0 on green practices, including green manufacturing and green logistics, in the context of emerging economies.Design/methodology/approachA cross-sectional data were collected from 234 manufacturing firms in Pakistan, and PLS-SEM was employed to test hypotheses.FindingsWith the advent of industry 4.0 in the current era, more emphasis is being given to the adoption of digital technologies in every field. The adoption of the green approach in supply chain management provides firms with socioeconomic and environmental benefits. The study results indicate that industry 4.0 positively affects green practices, including green manufacturing and green logistics. Moreover, the results also illustrate that these green practices have a substantial effect on the sustainability performance of the firms.Research limitations/implicationsThis study provides an amplified understanding of the industry 4.0 technologies in the adoption of green practices. The outcomes also offer a policy framework for managers, legislators and manufacturers to promote green practices (i.e. green manufacturing and green logistics) in businesses.Originality/valueAlthough several recent studies have tried to investigate the effect of green practices on sustainability performance. However, as per the author's best knowledge, very few studies have analyzed the influence of industry 4.0 on green practices (i.e. green manufacturing and green logistics) in the context of emerging economies.

PurposeThis study aims to explore the required leadership competencies for successful blockchain technology (BCT) implementation in public sector organizations from a sensemaking perspective.Design/methodology/approachThe study uses a multiple case study design. Primary data are collected by conducting semi-structured interviews with several representatives of Finnish public sector organizations. Written material from the selected organizations complements the primary data. NVivo14 is used to generate codes and analyze data.FindingsThe analysis shows that through sensemaking, leaders identify cues for digitally transforming their organizations through blockchain by leveraging their curious and rational vision. After identifying the cues, leaders then interpret these cues through technological understanding and exploring different technological solutions. Once the cues are interpreted for blockchain implementation, the third step is enactment after interpreting the cues. Leaders can facilitate the enactment of blockchain by connecting the outcomes of blockchain with organizational processes and goals. Furthermore, a dark side of BCT is identified, consisting of overly optimistic expectations and creating technological dependencies in the public sector.Research limitations/implicationsThe study was conducted in 11 public organizations in Finland, which limits the generalizability of the findings. Leadership competencies that are required for blockchain implementation within organizations can be studied further by considering more use cases. The potential dark side of blockchain implementation can be explored further.Originality/valueThe presented research model of leadership competencies for blockchain implementation is derived from sensemaking research and contributes to the literature on leadership competencies by applying sensemaking to the study of BCT.