To examine the relationships between erectile dysfunction (ED) and diabetes and related complications, metabolic syndrome (MetS) components and lower urinary tract symptoms (LUTSs) in a cohort of men seeking care for urinary urgency and other LUTSs.

Cross-sectional analysis of baseline data from the Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN II) Urinary Urgency Phenotyping study, which aimed to characterise subgroups of persons with urinary urgency.

Six clinical sites of the NIH/NIDDK-sponsored Symptoms of LURN, US.

305 men enrolled in the LURN II Urinary Urgency Phenotyping study who provided complete baseline erectile function data.

Erectile function was assessed using the erectile function domain of the International Index of Erectile Function (IIEF). MetS components, diabetes-related complications and LUTS severity were compared between men with and without ED.

Among 305 men with urinary urgency, 181 (59%) had ED. Men with ED were significantly older and more likely to have type 2 diabetes (25% vs 12%, p

These data suggest that diabetes as well as markers of metabolic dysfunction are important factors in ED in treatment-seeking men with urinary urgency and other LUTS. Studies evaluating the mechanisms contributing to these interactions are warranted for targeting effective prevention or treatment.

High-risk neonates are at greater risk for neurodevelopmental impairment (NDI) despite improved neonatal survival. In low-income and middle-income countries, including Pakistan, developmental trajectories across infancy and toddlerhood of high-risk neonates are not well studied, especially when the survival is improving.

This 2-year longitudinal cohort study was performed at the neonatal intensive care unit and Child Development and Rehabilitation Centre of Aga Khan University Hospital in Pakistan. High-risk neonates who met predefined clinical criteria were enrolled and evaluated at 6 months, 12 months and 24 months of age using the Bayley Scales of Infant and Toddler Development, Fourth Edition. NDI has been defined as moderate–severe hearing or visual impairment, cerebral palsy or global developmental delay (ie, ≥2 SD delay in ≥2 Bayley domains).

Out of 369 eligible neonates, 198 of them had at least one assessment. NDI prevalence increased to 15.7% at 2 years compared with 8.2% at 6 months. Overall, language impairment showed the largest increase (2.6%–9.6%), while cognitive (5.2%–7.1%) and motor (5.2%–7.6%) impairments rose modestly.

Placental abruption was linked to the risk of NDI in univariable analysis (HR=3.53, 95% CI 1.07 to 11.62). Low birth weight was associated with gross motor impairments (HR=2.90, p=0.01), while preterm birth also showed association with gross motor (HR=3.66, p=0.01) and receptive (HR=2.61, p=0.02) impairments. Receptive language impairment was related to pre-eclampsia (HR=2.06, 95% CI 1.17 to 3.64) and preterm premature rupture of membranes (HR=2.24, 95% CI 1.22 to 4.09). Expressive impairment was linked to prolonged hospital stay (HR=1.81, 95% CI 1.04 to 3.14) and lower household income (HR=2.07, 95% CI 1.24 to 3.45).

Approximately 15% of high-risk neonatal survivors showed evidence of NDI by 2 years of age with evolving language vulnerabilities and persistent gross motor risks. Overall, study findings highlight the need for urgent structured developmental surveillance and early child development intervention programmes for high-risk infants in Pakistan, as part of routine neonatal care pathways.

To examine how household members, community health research workers (CHRWs) and broader social networks influenced pregnant women’s capabilities, opportunities and motivations to consume a daily balanced-energy protein (BEP) supplement or a multiple micronutrient supplement (MMS) in the context of an effectiveness trial in rural Bangladesh.

In-depth interviews, group interviews, focus group discussions, thematic analysis using the Capability, Opportunity, Motivation-Behaviour (COM-B) framework.

Gaibandha, Bangladesh.

Women (n=32) who had completed participation in the TARGET-BEP randomised trial, their husbands (n=13) and mothers-in-law (n=13), who participated in 13 group interviews, and CHRWs (n=39) who participated in six focus group discussions.

Capability to adhere to BEP and MMS was strengthened when family members understood the value of supplements and actively supported supplementation. Children emerged as unexpected facilitators, reminding mothers to consume supplements and tracking intake. Opportunity to use supplements consistently was enhanced by women’s educational attainment and the availability of household resources. Finally, motivation to take the supplements was influenced by many actors including neighbours, who could offer support but also often transmitted rumours and taboos, and CHRWs, who adeptly adapted adherence messages to the local context and to women’s specific concerns.

To improve antenatal supplement adherence and maternal–infant health in Bangladesh and similar contexts, pregnancy nutrition programmes should move beyond the woman-as-sole-agent paradigm by: (1) co-designing messages for husbands, mothers-in-law, children and neighbours in conversation with effective community health workers, such as those working in the TARGET-BEP trial; (2) equipping community health workers with flexible, family-engaging counselling strategies; and (3) complementing women’s education gains with gender-transformative and family-inclusive interventions.

ClinicalTrials.gov NCT05576207