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Telehealth played a critical role during the COVID-19 pandemic and continues to function as an essential component of health care. Existing platforms cannot ensure privacy and prevent cyberattacks. The main objectives of this study are to understand existing cybersecurity issues in identity management and trustworthy communication processes in telehealth platforms and to design a software architecture integrated with blockchain to improve security and trustworthiness with acceptable performance. We improved personal information security in existing telehealth platforms by adopting an innovative interdisciplinary approach combining design science, social science, and computer science in the health care domain, with prototype implementation. We used the design science research methodology to implement our overall design. We innovated over existing telehealth platforms with blockchain integration that improves health care delivery services in terms of security, privacy, and efficiency. We adopted a user-centric design approach and started with user requirement collection, followed by system functionality development. Overall system implementation facilitates user requirements, thus promoting user behavior for the adoption of the telehealth platform with decentralized identity management and an access control mechanism. Our investigation identified key challenges to identity management and trustworthy communication processes in telehealth platforms used in the current health care domain. By adopting distributed ledger technology, we proposed a decentralized telehealth platform to support identity management and a trustworthy communication process. Our design and prototype implementation using a smart contract-driven telehealth platform to provide decentralized identity management and trustworthy communication with token-based access control addressed several security challenges. This was substantiated by testing with 10,000 simulated transactions across 5 peers in the Rahasak blockchain network. The proposed design provides resistance to common attacks while maintaining a linear time overhead, demonstrating improved security and efficiency in telehealth services. We evaluated the performance in terms of transaction throughput, smart contract execution time, and block generation time. To create a block with 10,000 transactions, it takes 8 seconds on average, which is an acceptable overhead for blockchain-based applications. We identified technical limitations in current telehealth platforms. We presented several design innovations using blockchain to prototype a system. We also presented the implementation details of a unique distributed architecture for a trustworthy communication system. We illustrated how this design can overcome privacy, security, and scalability limitations. Moreover, we illustrated how improving these factors sets the stage for improving and standardizing the application and for the wide adoption of blockchain-enabled telehealth platforms.

Due to the transition of vehicle fleets from conventional driver-operated vehicles (DVs) to connected vehicles (CVs) and/or automated vehicles (AVs), vehicles with different technologies will soon operate on the same roads in a mixed-vehicle environment. Although a major goal of vehicle connectivity and automation is to improve traffic safety, negative safety impacts may persist in the mixed-vehicle environment. Speed disparity measures have been shown in the literature to be related to safety performance. Therefore, speed disparity measures are derived from the expected speed distributions of different vehicle technologies and are used as surrogate measures to assess the safety of mixed-vehicle environments and identify the efficacy of prospective countermeasures. This paper builds on speed models in the literature to predict the speed behavior of CVs, AVs, and DVs on horizontal curves on freeways and major arterials. The paper first proposes a methodology to determine speed disparity measures on horizontal curves without any control in terms of speed limit. The impact of speed limit or advisory speed, as a safety countermeasure, is modeled and assessed using different strategies to set the speed limit. The results indicated that the standard deviation of the speeds of all vehicles (σc) in a mixed environment would increase on arterial roads under no control compared to the case of DV-only traffic. This speed disparity can be reduced using an advisory speed as a safety countermeasure to decrease the adverse safety impacts in this environment. Moreover, it was shown that compared to the practice of a constant speed limit based on road classification, the advisory speed is more effective when it is based on the speed behavior of various vehicle types.

Rural women in Bangladesh usually have lack of access, control and ownership over their land property because of existing patriarchal norms of the rural society. The prime objective of this study was to assess the impact of rural women’s access to land on their income as well as household income. A multistage, geographically clustered, probability-based sampling approach was adopted for this study. Primary data were collected from the rural women living in two selected districts of Bangladesh. The Propensity Score Matching technique was used to assess the impact of land accessibility on household income and rural women’s income. The Binary Logistic Regression technique was used to assess women’s opinions. The study findings revealed that land had a positive impact on household income but rural women’s income did not increase significantly despite having access to land. This study also showed that income, level of education, the existence of NGO operated programs in villages, and the number of visits to NGO offices by rural women were the key factors contributing to improving their overall well-being. Findings imply that the government should design an appropriate land ownership policy that guarantees titling as well as access for women to land.

Cellular dNTP pool homeostasis is maintained by the interplay between the biosynthetic ( de novo and salvage) pathways and hydrolyzing networks such as SAMHD1. Inhibiting de novo pathway using RNR inhibitors reduces the host cell dNTP pool size, thereby restricting HIV-1 infectivity reversibly. Whereas the salvage pathways cannot rescue HIV-1 infectivity to the full extent without the de novo pathway. This work correlates HIV-1 infectivity with the dynamic nature of dNTP turnover due to RNR small subunit switching between RRM2 & RRM2B and the action of SAMHD1. The observed modulation of HIV-1 reverse transcription and uncoating in response to RNR inhibition demonstrates the flexibility and adaptability of the virus to replicate in hostile internal cellular environments, which attempt to starve the virus of essential metabolites such as dNTPs. These findings provide insights into how RNR inhibition may impact subsequent steps, such as nuclear localization and integration, offering a foundation for future studies.

The present research deals with the identification of ethnomedicinal plants used by the local people for curing cardiovascular diseases in Manikganj district, Bangladesh. The present study aimed to record and validate the ethnomedicinal knowledge used by the local people for cardiovascular disease (CVD) management in Manikganj district, Bangladesh using recent ethnobotanical survey methods. The record of 131 ethnomedicinal plant species with diverse use patterns reflected the traditional knowledge richness in the study area. Among the ethnomedicinal plants, 10 plant species, including Phyllanthus emblica L., Allium sativum L., Terminalia arjuna (Roxb. Ex DC.) Wight & Arn, Achyranthes aspera L., Terminalia chebula Retz., Allium cepa L., Adhatoda zeylanica Nees, Cinnamomum tamala Nees & Eberm, Cajanus cajan (L.) Millsp, and Ipomea aquatica Forssk, were cited most frequently by the local people. Among the disease categories, the highest Fic (factor of informant consensus) value was obtained in cardiac complaints, followed by blood purifiers, chest pain, high blood pressure, and antioxidants. In this research, 131 plant species were recorded, and 45 plants obtained the highest Fl (fidelity level) value of 100%. The members of the most common medicinal plants were from the families of Fabaceae, Amaranthaceae, Asteraceae, Cucurbitaceae, and Apocynaceae. This result provides baseline data to link the local population, including traditional health professionals and scientific communities, which could be significant in drug discovery and is very important for the sustainable development program and conservation management in Bangladesh. Bangladesh J. Plant Taxon. 31(1): 101-121, 2024 (June)

Background Gavi, the Vaccine Alliance, supported a mass vaccination Measles-Rubella Campaign (MRC) in Bangladesh during January–February 2014. Methods We conducted a mixed-method process evaluation to understand the successes and challenges in implementation of the MRC. We reviewed documents for the MRC and the immunization programme in Bangladesh; observed meetings, vaccination sessions, and health facilities; and conducted 58 key informant interviews, 574 exit interviews with caregivers and 156 brief surveys with stakeholders involved in immunization. Our theory of Change for vaccination delivery guided our assessment of ideal implementation milestones and indicators to compare with the actual implementation processes. Results We identified challenges relating to country-wide political unrest, administrative and budgetary delays, shortage of transportation, problems in registration of target populations, and fears about safety of the vaccine. Despite these issues, a number of elements contributed to the successful launch of the MRC. These included: the comprehensive design of the campaign; strong partnerships between immunization authorities in the government system, Alliance partners, and civil society actors; and motivated and skilled health workers at different levels of the health system. Conclusions The successful implementation of the MRC in spite of numerous contextual and operational challenges demonstrated the adaptive capacity of the national immunization programme and its partners that has positive implications for future introductions of Gavi-supported vaccines.

ObjectiveTo assess the contribution of partners in the introduction of two new vaccines concurrently: pneumococcal 10-valent conjugate vaccine (PCV-10) and inactivated polio vaccine (IPV) into the routine Expanded Programme on Immunization (EPI) in Bangladesh.DesignWe conducted a prospective process evaluation that included the theory of change development, root cause analysis and in-depth investigation. As part of process tracking, we reviewed relevant documents, observed trainers’ and vaccinators’ training and key stakeholder meetings. We analysed the data thematically.SettingWe purposively selected eight Upazila (subdistrict) and one city corporation covering nine districts and seven administrative divisions of Bangladesh.ParticipantsNineteen national key informants were interviewed and 16 frontline health workers were invited to the group discussions considering their involvement in the vaccine introduction process.ResultsThe EPI experienced several challenges during the joint introduction of PCV-10 and IPV, such as frequent changes in the vaccine introduction schedule, delays in budget allocation, vaccine supply shortage and higher wastage rates of IPV. EPI addressed these challenges in collaboration with its partners, that is, the World Health Organization (WHO) and United Nations Children's Fund (UNICEF), who provided technical assistance to develop a training curriculum and communication materials and enhanced demand generation at the community level. In addition, the WHO conducted a country readiness assessment for PCV-10, and UNICEF supported vaccine shipment. Other government ministries, City Corporations and municipalities also supported the EPI.ConclusionsThe partnership among the EPI stakeholders effectively addressed various operational challenges during the joint introduction of PCV-10 and IPV helped strengthen Bangladesh’s immunisation systems. These accomplishments are attributed to several factors that should be supported and strengthened for future vaccine introductions in Bangladesh and other low and-middle countries.

Tannery workers in Bangladesh face persistent occupational health hazards due to exposure to toxic chemicals and limited safety protections. However, the factors of workers' perceptions of these health risks remain insufficiently understood. This study investigates factors associated with health concern among tannery workers in the Savar Tannery Industrial Estate, drawing on a cross-sectional survey of 400 workers. Ordinal logistic regression analyses were conducted to examine the influence of sociodemographic characteristics, knowledge, attitude, and workplace practices. Overall, 87.5% of workers reported being concerned about health risks, including 42.5% who were very concerned. Male workers had significantly higher odds of expressing concern (aOR = 2.05, p = 0.01), as did workers with more than ten years of experience (aOR = 3.37, p = 0.033) and married workers (aOR = 1.61, p = 0.039). Knowledge-related variables were strong predictors; awareness of health hazards (aOR = 2.75, p = 0.022), recognition of harmful chemicals (aOR = 2.90, p = 0.006), and correct PPE knowledge (aOR = 3.17, p < 0.001) were each associated with greater concern. Conversely, rarely using PPE (aOR = 0.11, p = 0.005) and rarely washing exposed skin (aOR = 0.03, p < 0.001) were associated with substantially lower concern. These findings highlight critical gaps in safety training and protective practices, emphasizing the need for targeted interventions to strengthen occupational health literacy and promote safer behaviors in Bangladesh's tannery sector.

Telehealth played a critical role during the COVID-19 pandemic and continues to function as an essential component of health care. Existing platforms cannot ensure privacy and prevent cyberattacks. The main objectives of this study are to understand existing cybersecurity issues in identity management and trustworthy communication processes in telehealth platforms and to design a software architecture integrated with blockchain to improve security and trustworthiness with acceptable performance. We improved personal information security in existing telehealth platforms by adopting an innovative interdisciplinary approach combining design science, social science, and computer science in the health care domain, with prototype implementation. We used the design science research methodology to implement our overall design. We innovated over existing telehealth platforms with blockchain integration that improves health care delivery services in terms of security, privacy, and efficiency. We adopted a user-centric design approach and started with user requirement collection, followed by system functionality development. Overall system implementation facilitates user requirements, thus promoting user behavior for the adoption of the telehealth platform with decentralized identity management and an access control mechanism. Our investigation identified key challenges to identity management and trustworthy communication processes in telehealth platforms used in the current health care domain. By adopting distributed ledger technology, we proposed a decentralized telehealth platform to support identity management and a trustworthy communication process. Our design and prototype implementation using a smart contract-driven telehealth platform to provide decentralized identity management and trustworthy communication with token-based access control addressed several security challenges. This was substantiated by testing with 10,000 simulated transactions across 5 peers in the Rahasak blockchain network. The proposed design provides resistance to common attacks while maintaining a linear time overhead, demonstrating improved security and efficiency in telehealth services. We evaluated the performance in terms of transaction throughput, smart contract execution time, and block generation time. To create a block with 10,000 transactions, it takes 8 seconds on average, which is an acceptable overhead for blockchain-based applications. We identified technical limitations in current telehealth platforms. We presented several design innovations using blockchain to prototype a system. We also presented the implementation details of a unique distributed architecture for a trustworthy communication system. We illustrated how this design can overcome privacy, security, and scalability limitations. Moreover, we illustrated how improving these factors sets the stage for improving and standardizing the application and for the wide adoption of blockchain-enabled telehealth platforms.

Online information avoidance is a behavior of delaying or rejecting information consumption from online sources. It is an understudied construct in information systems research; however, information avoidance is studied extensively in economics, psychology, health, and media disciplines. Economists argue that rational agents avoid information when they feel it is detrimental to their economic outcome (Golman et al., 2017; Gul, 1991). Psychologists identify different predictors of information avoidance behavior, such as individual differences, motivations, and situation factors (Sweeny et al., 2010). Health information researchers also identify different psychological factors as predictors of information avoidance behavior, particularly in terminal diseases such as cancer (Miles et al., 2008). Crisis literature suggests that people receive information from different sources in such unprecedented times, and online platforms have become one of the dominant sources. Crisis information from different online sources provides different psychological stimuli, shaping people's perceptions and behaviors in a crisis (Savage, 2020). While prior studies provide explanations of individual information avoidance behavior, there is not much attempt to identify how these findings relate to online information avoidance in a crisis. To understand the online information avoidance behavior in a crisis, we investigate online information avoidance in two different crises: a health crisis and a humanitarian crisis. Using the COVID-19 pandemic as the health crisis, essay one investigates how individuals' fear and situational motivation impact online information avoidance. Using the self-determination and information avoidance theories, we argue that fear and situational motivation constructs impact online information avoidance through response efficacy, optimism, and coping self-efficacy. From a pooled cross-sectional survey study, we find that fear and external regulation increase online information avoidance, whereas identified regulation is a significant inhibitor of online information avoidance. We also find that response efficacy, optimism, and coping self-efficacy mediate the relationship. Our robustness analysis using Important Performance Map Analysis (IPMA) and Artificial Neural Network (ANN) robustness checks support these results.Information sources often take a partisan position during a humanitarian crisis such as the Russia-Ukraine war. In that scenario, individuals with a need to consume information framed in a neutral way or individuals with a partisan view may not find information that matches their worldview. This deviation is referred to as expectation violation in communication and media research. Extant literature explains how information consumer's expectation violation can impact objectivity and trust; however, how these relationships will hold in a humanitarian crisis and how these mechanisms lead to online information avoidance are major research questions. Using expectation violation, objectivity, and trust theories, essay two argues that violation expectedness, source importance, and valence will impact online information avoidance through the mediation of perceived objectivity and source trust. We have generated interesting insights from a multi-country survey study based in Poland and the United States. In Poland, violation expectedness increases online information avoidance significantly, and the importance of the relationship with the information source is a significant inhibitor of online information avoidance. Moreover, both trust and perceived objectivity mediate the relationship. In the USA, source importance and valence are important inhibitors of online information avoidance. However, only trust mediates the relationships. Our IPMA and ANN robustness analyses support these results.While focusing on two different contexts, our studies contribute to the broader information systems research literature and specifically to the information avoidance literature during a crisis. Our study contributes to the literature by introducing online information avoidance as a vital outcome behavior after people are exposed to a myriad of information during a crisis. At a practical level, our studies’ findings will be helpful for online information providers, governments, response organizations, and communities who utilize online platforms, forums, and related outlets to reach larger audiences for disseminating pertinent information and recommendations during a crisis.