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Purpose: To evaluate the current communication skills of resident physicians and identify areas for improvement. Study design: Using a cross-sectional design, data from medical students, residents, fellows, and faculty were assimilated at one of the largest academic medical centers in a low-and-middle-income country via a self-administered, validated survey with a 5-point LIKERT scale. One-way ANOVA was used to compare intra-group means, followed by the Bonferroni test, with a p-value <0.05 considered significant. Heat maps using means were generated and color-coded to signify the level of communication skills expertise. Results: A total of 320 participants (119 residents, 34 fellows, 78 medical students and 89 attendings) completed the survey. Most residents (58%) reported not having received formal communication skills training. Major barriers impeding effective patient-resident communication were long working hours, inadequate time, and difficulty understanding patients' language (p < 0.001). Residents' self-evaluation of communication skills was significantly higher than observer evaluations from faculty, fellows, and students, reflecting a lack of self-awareness and overestimation of communication expertise. Observer cohorts rated residents moderately on para-verbal communication skills while giving the lowest ratings for breaking bad news (mean 2.8, p-value <0.001) and residents' experience in dealing with workplace conflicts (mean 2.8, p-value = 0.023). Conclusions: Our study identified a clear and critical need for a structured, longitudinal, competency-based communication skills program for residents. Targeted efforts towards bridging the gaps in communication skills identified in this study can improve trainee communication skills expertise and augment patient satisfaction rates to improve the quality of care in developing countries. [ABSTRACT FROM AUTHOR]

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The quest to enhance solar cell performance has long been driven by increasing energy demands and environmental concerns, and much progress has been achieved by way of interface modifications. As the demand for sustainable energy increases and environmental awareness pushes us toward cleaner solutions, the spotlight turns to stable and eco-friendly metal oxide semiconductors for photovoltaic applications. This research highlights the exceptional electronic and optical characteristics of ZrO2@GO nanoparticles, focusing on molecular electrostatic potential (MEP), nonlinear optical properties (NLO), and electron localization function (ELF). Our findings highlight that ZrO2@GO exhibits superior electronic characteristics compared to bare graphene oxide. This superiority motivates us for the co-sensitization of ZrO2@GO with squaraine dyes, which are well known for their strong light harvesting in dye-sensitized solar cells (DSSC). Using density functional theory (DFT) with Gaussian 09, we examine critical parameters that include the highest occupied molecular orbital (HOMO), lowest unoccupied molecular orbital (LUMO), energy gap, maximum wavelength (λmax), electron injection efficiency (ΔGinject), open-circuit voltage (Voc), reorganization energy (λreorg), among others. Our research highlights the high optical transmittance of ZrO2@GO, positioning it as a promising material for advanced optical, electrical, and light-harvesting devices with improved performance and efficiency. [ABSTRACT FROM AUTHOR]

The present study holds significant implications, as it aims to investigate the comparative effect of biochar, zeolite, and bentonite minerals on the stabilization of Ni fractions, bioaccumulation, translocation indices, and the reduction in their absorption by pakchoi in smelter- and mine-contaminated soils. The results, which are of great interest, showed that the maximum fresh and dry biomasses of pakchoi were observed up to 28.21 and 18.43% for smelter-polluted soil and 61.96 and 67.90% for mine-contaminated soil amended with zeolite compared to the control. Applying zeolite increased pakchoi chlorophyll SPAD values 1.17-fold in smelter soil and 1.26-fold in mine-polluted soil. The highest Ni immobilization in smelter and mine soil was observed at 76.8 and 85.38% with the application of bentonite, which increased soil pH and CEC. The application of biochar, bentonite, and zeolite reduced the Ni residual, oxidizable, and acid-soluble fractions, but biochar and bentonite increased the reducible fraction of Ni in smelter soil. The highest reduction in Ni in the shoot and root was noted as 82.08 and 68.28% of smelter-polluted soil and 77.25 and 89.61% of mine-polluted soil with bentonite compared to control soil. Overall, it has been concluded that biochar, zeolite, and bentonite can be successfully used to mitigate the Ni concentration in smelter- and mine-polluted soil and reduce uptake by vegetable crops. [ABSTRACT FROM AUTHOR]

This study demonstrates the use of inkjet printing technology to directly deposit nanoparticles (NPs) onto polyurethane (PU) micro/nanofibers. The biocompatibility of as‐spun fibers was enhanced by depositing titanium dioxide (TiO2) and silver (Ag) NPs, which were synthesized using quince apple extract. The scanning electron microscope showed the presence of NPs on printed fibers. The Fourier Transform Infrared Spectroscopy (FTIR) analysis revealed a vibrational bond of TiOO around 564.5 cm−1 and broadness in a peak around 3458.8 cm−1 due to printed NPs. A significant decrease in the contact angle from 106.2 ± 1.1° to 73.1 ± 1.0° was observed. The printing also altered the tensile properties of pristine PU mats. An increase in the tensile strength from 6.48 to 7.83 MPa was seen. The printed mats having Ag NPs showed inhibitory properties against gram‐positive and negative bacterial strains. The maximum inhibition zones measuring 10.4 ± 0.10 mm against Escherichia coli and 10.1 ± 0.06 mm against Staphylococcus aureus were observed. The in‐vitro studies showed higher cellular viability in printed nanofibers. Moreover, the cell attachment results using 4,6‐diamidino‐2‐phenylindole (DAPI) staining revealed a uniform distribution of cells in TiO2 and Ag NPs deposited mats. The inkjet printing can be a simple technique to post‐modify micro/nanofiber with different materials to create an advanced biocompatible material. [ABSTRACT FROM AUTHOR]

Objectives: Trauma registries are essential tools for improving trauma care quality and efficiency, but many fail to capture long-term patient-reported outcome measures (PROMs). Focusing on these outcomes is crucial for understanding the extent of disability patients experience and identifying potential post-discharge interventions to optimize recovery. Studies reflecting the experience from low- and middle-income countries in this area are limited. Therefore, we aim to develop a digital trauma registry in Pakistan to prospectively capture patient-reported outcome measures at one, three, six, and twelve months post-injury. Methods: We will develop and implement a digital trauma registry at two tertiary care facilities in Karachi, Pakistan: Aga Khan University Hospital and Jinnah Postgraduate Medical Center. The registry will include all admitted adult trauma patients (≥ 18 years). Data collection will be conducted digitally using tablets, with mortality, level of disability, functional status, and quality of life as primary outcomes. Follow-up data will be collected through telephone interviews with patients and caregivers. We will employ descriptive statistics to summarize participant's socio-demographic and clinical characteristics. Additionally, we will perform survival analysis using Kaplan-Meier curves and Cox proportional hazard models and utilize mixed-effects linear regression to adjust for potential confounders for primary outcomes. Discussion: The trauma registry will fill the current gap in knowledge regarding long-term outcomes among trauma patients in low- and middle-income countries (LMICs). This study will delineate future direction for capturing post-discharge data, enhancing our understanding of recovery, and informing the design of interventions aimed at improving long-term outcomes. [ABSTRACT FROM AUTHOR]

Background: Patients perceive effective patient-doctor communication as an important metric when evaluating their satisfaction with health systems. Hence, optimal patient-physician communication is fundamental for quality healthcare. High-income countries (HICs) have extensively studied patient-resident communication. However, there is a dearth of similar studies in low- and middle-income countries (LMICs). Therefore, we aimed to explore the current state of and barriers to practicing good patient-resident communication and explore possible solutions to mitigate these challenges at one of the largest Academic Medical Centers in an LMIC. Methods: This study employed an exploratory qualitative study design and was conducted at the Aga Khan University Hospital in Pakistan. Through purposive maximum variation sampling, 60 healthcare workers from diverse cohorts, including attendings, fellows, residents, and medical students, participated in eight focus group discussions. Results: We identified three key themes from the data: Status-quo of residents' communication skills and learning (Poor verbal and non-verbal communication, inadequate training programs, and variable sources of learning), Barriers to effective communication (Institutional barriers such as lack of designated counselling spaces, lack of resident insight regarding effective communication and deficits in intra-team communication), and the need for developing a communication skills curriculum (Design, implementation and scaling to other cohorts of healthcare workers). Conclusions: Findings from this study show that multifaceted factors are responsible for inadequate patient resident-physician communication, highlighting the need for and importance of developing a formal communication skills training curriculum for residents. These insights can be used to create standardized training for equipping residents with adequate skills for effectively communicating with patients which can improve healthcare service delivery and patient outcomes. [ABSTRACT FROM AUTHOR]

ABSTRACT: Background: The strength of the binding between brackets and tooth surfaces has a major impact on how well orthodontic therapy works. The shear bond strength of orthodontic brackets may be strengthened by the invention of bonding agents supplemented with nanoparticles, thanks to recent developments in nanoparticle technology. Materials and Methods: In order to perform a randomized controlled experiment, 90 human premolars were excised for orthodontic purposes. Three groups of 30 teeth were randomly assigned to each group: Group A used a bonding agent augmented with nanoparticles of titanium dioxide (TiO2), Group B used nanoparticles of zirconium dioxide (ZrO2), and Group C used a standard bonding agent as a reference. The appropriate bonding chemicals were used to attach the brackets to the teeth, and a universal testing equipment was used to measure the shear bond strength. Stereomicroscopic analysis was used to evaluate the failure mechanisms. To do statistical analysis, Tukey's post hoc test and analysis of variance were used. Results: There were significant differences (P < 0.05) in the mean shear bond strength values across the groups. The average shear bond strength for Group A (TiO2) was 18.5 ± 2.3 MPa, that for Group B (ZrO2) was 17.2 ± 2.6 MPa, and that for Group C (control) was 14.8 ± 2.4 MPa. In comparison to Groups B and C, Group A exhibited a statistically greater bond strength, although Group B also showed an improvement over the control. According to the failure mode analysis, the control group had mostly adhesive failures, whereas the nanoparticle groups saw mixed failures. Conclusion: When TiO2 and ZrO2 nanoparticles are added to bonding agents, the shear bond strength of orthodontic brackets is greatly increased in comparison to traditional bonding agents. TiO2-reinforced materials performed better, pointing to possible benefits for orthodontic applications. It is advised that further study be done to examine the long-term impacts and therapeutic implications of these results. [ABSTRACT FROM AUTHOR]

The objective of the present study was to investigate the impact of MgO 0.5 g/kg loaded in different organic waste materials on the properties of the modified biochars obtained. The waste materials included tea waste, wood waste, water chestnut peel, and pomegranate peel, which were used to create tea waste MgO-modified biochar (TWMgO-MBC), wood waste MgO-modified biochar (WSMgO-MBC), water chestnut peel MgO-modified biochar (WCMgO-MBC), and pomegranate peel MgO-modified biochar (PPMgO-MBC). All the MgO-modified biochars were prepared at 600 °C for 2 h and applied at 0.5 and 1% doses for the immobilization of Ni, Cu, Pb, and Cr in stone crushing and mining-polluted soil and the reduction in their uptake by pearl millet (Pennisetum glaucum) plant. The greatest fresh and dry biomasses were observed at 45.04% and 31.29%, respectively, with the application of TWMgO-MBC 1% in stone-crushing-polluted soil. The highest degree of immobilization of Ni (76.67%) was observed for the WSMgO-MBC 1% treatment, Cu (73.45%) for WCMgO-MBC 1%, Pb (76.78%) for WSMgO-MBC 1%, and Cr (70.55%) for WCMgO-MBC 1%, in comparison with the control. The maximum uptake of Ni, Cu, Pb, and Cr in the shoot of pearl millet was reduced by 78.43% with WSMgO-MBC 1%, 75.06% with WSMgO-MBC 1%, 90.81% with WCMgO-MBC 1%, and 85.71% with WSMgO-MBC 1% as compared with the control. The greatest reduction in Ni, Cu, Pb, and Cr in the root of pearl millet was observed at 77.81% with WSMgO-MBC 1%, 68.09% with WCMgO-MBC 1%, 84.03% with WCMgO-MBC 1%, and 88.73% with WCMgO-MBC 1%, in comparison with the control. The present study demonstrated that the TWMgO-MBC 1% treatment was highly effective for improving plant growth, while the WSMgO-MBC 1%, and WCMgO-MBC 1% treatments were found to be highly effective for immobilizing heavy metals in polluted soils, thus facilitating safe crop cultivation. Future studies should concentrate on the long-term application of MgO-modified biochars for the remediation of multimetal-polluted soils. [ABSTRACT FROM AUTHOR]

Globally, land cover change poses a serious threat to biodiversity and climate change. Anthropogenic actions have been the dominant force among all natural and human forces shaping the Land use and Land cover, causing dramatic changes to the global Landuse and Land cover. The Rajparian Wildlife Sanctuary in the Kashmir Himalayas has undergone substantial changes over the past few decades, but lacks extensive assessment. A multispectral remotely sensed dataset was used to assess changes in land use and land cover of the Sanctuary over almost 27 years (1993–2021). A maximum likelihood algorithm was used to classify Landsat images for the years 1993, 2006, and 2021 and geometric correction were rectified in Earth Resources Data Analysis System (2014) software. The results of the present study indicate that the study area has undergone major changes between 1993 and 2020. Forest and snow-covered areas have shrunk, while non-forested areas like grassland, barren, scrub, built-up areas, and river beds have shown positive growth in the sanctuary. Within the studied time period, a total loss of 5.9 km2 was recorded for the forest areas and 1.5 km2 for the snow covered areas. The main threats driving the Land use and Land cover change in the Sanctuary were grazing pressure, natural resource exploitation, poaching, and development projects. The results of this study may potentially provide information to planners, and decision-makers for the sustainable management of natural resources and implementing important management decisions in order to preserve the rich biodiversity of the Sanctuary. [ABSTRACT FROM AUTHOR]

A sequence of dye-sensitized solar cells is proposed, utilizing TiO2@Zn/Al-layered double hydroxide (LDH) as their starting materials, in which Ruthenizer N719 was used as a photon absorber. The anticipated system was turned into sheet-like TiO2@mixed metal oxide (MMO) via post-processing treatment. The crystal quality indicated a relation to power conversion efficiency (PCE); this was combined with a comparable morphology profile. In detail, the optimum DSSC device exhibited average sheet-like thickness and a dye loading amount of 43.11 nm and 4.28 × 10 − 3 mM/cm−2, respectively. Concurrently, a considerable PCE enhancement of the optimum DSSC device (TiO2@MMO-550°) was attained compared to pristine MMO (0.91%), which could be due to boosted electron transfer efficiency. Of the fabricated devices, DSSC fabricated at 550° exhibited the highest PCE (1.91%), with a 35.6% enhancement compared to that obtained at 450°, as a result of its increased open-circuit voltage (3.29 mA/cm2) and short-circuit current (0.81 V). The proposed work delivers an enhanced efficiency as compared to similar geometries. [ABSTRACT FROM AUTHOR]

Blowflies (Diptera: Calliphoridae) are an important group of non-biting flies that are potential mechanical vectors of protozoan and helminthic pathogens. The present study was carried out to isolate and identify protozoan cysts and helminthic eggs transmitted by blowflies. Surveys were carried out at six different sites, viz., butcher shops, fish markets, garbage piles, water bodies, and open vegetation in the Kashmir Himalaya. The flies were collected with the help of a sweeping net and using day-old beef liver as bait from March 2021 to February 2023. A total of 968 blowflies were collected, out of which 83 were found carrying at least one protozoan cyst and helminthic egg with six identified species of parasites. Garbage piles were recorded with the highest number of positive cases (10.81%), while human habitation had the highest transmission rate (3.3%). Chrysomya megacephala (Fabricius) was reported to have the highest number of parasitic cysts and ova (one protozoan cyst and three helminthic eggs), while Ascaris lumbricoides and Entamoeba coli were found to be the most abundant parasites reported from the surface of these flies. The number of parasites isolated from the surface of the blowflies was statistically significant (F = 9.073, df = 1, and p = 0.014), indicating a positive association between the number of parasites isolated from blowflies and the collection sites. [ABSTRACT FROM AUTHOR]

Low-cost carbonaceous materials have been synthesized and explored for the removal of harmful colored pollutants from an aqueous medium. However, most of them are not economically viable under continuous-flow conditions and because of their slow kinetics. In this study, we report an economically viable, magnetically reparable adsorbent material synthesized by incorporating spinel zinc ferrite within a waste-char matrix obtained from municipal solid waste (MSW). X-ray diffraction (XRD), fourier transform infrared (FTIR) spectroscopy, X-ray photoelectron spectroscopy (XPS), transmission electron microscopy (TEM), and elemental mapping analyses confirm the successful incorporation of cube-shaped ZnFe2O4 into the multichannel system of the waste-char matrix. The as-prepared waste-char-ZnFe2O4 possesses a large surface area with multiple functional groups that aid in fast catalysis and in the removal of contaminants. Waste-char-ZnFe2O4 follows pseudo-first-order kinetics with photocatalytic degradation efficiencies of ∼72% and 92% and first-order rate constant (K1) values equal to 0.023 and 0.0039 min−1 for tetracycline and rhodamine B, respectively. The adsorption of model contaminants onto waste-char-ZnFe2O4 is best described by the Langmuir isotherm model with an R2 value of 0.99 and a pseudo-second-order kinetic model with an adsorption capacity of 25 mg g−1. The as-synthesized composite gives excellent results for real water samples with negligible interference due to other salt ions present in water. Moreover, the superparamagnetic nature of ZnFe2O4 facilitates the separation and reusability of the nanocomposite material. The material offers the advantage of converting MSW into a functional and more robust magnetic nanotrap for contaminants. [ABSTRACT FROM AUTHOR]

Background: Major surgeries can develop metabolic acidosis during the perioperative period. Any clinical condition leading to decreased tissue oxygenation causes lactate levels to rise proportionally. Aims and Objectives: This study was aimed at evaluating perioperative serum lactate as a predictor of length of hospital stay and in-hospital mortality in patients undergoing emergency major abdominal surgeries. Materials and Methods: Adult patients posted for emergency abdominal surgical procedures were enrolled for 2 years. Patients were observed intraoperatively and lactate levels were measured. In post-operative period lactate levels were recorded for 24 h. Relationship of lactate with hospital length of stay and in-hospital mortality was analyzed. Results: Total of 93 patients were enrolled for 2 years. Mean age was 50.4 years. Mean baseline lactate was 2.95 mmol/L. Total in-hospital mortality was 16.1%. Thirteen patients had perioperative serum lactate level of = 2 mmol/l, with a mean hospital length of stay of 8.6 days and no mortality. Fifty-one patients having perioperative serum lactate between 2 and 4 mmol/L, with a mean hospital length of stay of 11.2 days and mortality of 13.3%. Twenty-nine patients had serum lactate of >4 mmol/L, with a mean hospital length of stay of 17.3 days and mortality of 86.7%. Elevated serum lactate was associated with a longer length of hospital stay, with lactate at 12 h having the highest predictive value (area under curve 0.987). Similarly, lactate at 12 h had the highest accuracy at predicting mortality as per receiver operating characteristic (AUC 0.895). Conclusion: Serum lactate was associated with increased in-hospital mortality and longer length of hospital stay in emergency abdominal surgeries. [ABSTRACT FROM AUTHOR]

The article "Reply to Sheikh's Response to First record of Pieris napi L." published in the Journal of Threatened Taxa discusses the response to a previously published article on the first record of Pieris napi L. in Kashmir Valley, India. The authors emphasize the importance of continuous learning and the evolving nature of diversity in the field of entomology. They highlight the differences between Pieris napi and Pieris ajaka, two species of butterflies, in terms of taxonomy, appearance, habitat preferences, behavior, and ecological roles. The study provides valuable insights into the distinct characteristics and distribution of these butterfly species, contributing to the ongoing research in the field. [Extracted from the article]

Carbonization of waste material into functional carbonaceous material is a benign way of utilizing biomass. Herein, we report the decoration of SnS2 nanoparticles on the biochar carbonaceous material using a facile hydrothermal synthetic strategy. The biomass collected from staminate flowers was pyrolyzed to obtain a biochar material containing a hydrophilic surface that creates an efficient environment for the decoration of SnS2 nanoparticles. The SnS2 decoration was thoroughly investigated using state-of-the-art instrumentation techniques. The morphological investigations indicate the formation of flower-shaped SnS2 nanoparticles with a sufficiently exposed surface for effective surface activities. These include the photodegradation of the methylene blue (MB) dye and electrochemical sensing of Pb2+ and Hg2+ ions. The SnS2@BC composite exhibits superior photocatalytic activity for the degradation of MB. Almost 95% of MB is removed within 60 min of contact time by a collaborative effect of adsorption and sunlight-driven photocatalysis. The removal of MB followed pseudo-first-order kinetics with a high K1 value of ca. 0.013 min−1. The cyclic voltammetry (CV) and differential pulse voltammetry (DPV) traces of the SnS2@BC modified glassy carbon electrode (GCE) show a decent electrochemical response with limits of detection of ca. 0.28 and 0.55 μM in the case of Pb2+ and Hg2+ respectively. Furthermore, the DFT studies were carried out on a simulated model material and the results were in line with the experimental data. This work provides an economical treatment method for the photodegradation and electrochemical sensing of toxic contaminants present in wastewater. [ABSTRACT FROM AUTHOR]

Harnessing solar energy using semiconductor-based materials to generate charge pairs to effectively drive photo-redox reactions has been envisioned as a promising approach toward a sustainable future. In this arena, the metal sulfide nanoparticles have demonstrated excellent performance in photomineralizing colored matter. However, their small surface area and relatively slow charge transfer has limited their practical applications. Therefore, for the effective mineralization of colored matter, we devise and construct the Sn2S3–In2S3 S-scheme in collaboration with 2D graphene oxide nanosheets. The material offers a well-defined nanosheet and nanoflake morphology for the effective contact with and catalysis of crystal violet (CV) dye as a model contaminant. Compared to Sn2S3–In2S3/GO, the pristine Sn2S3 and Sn2S3–In2S3 cause negligible degradation of CV using a visible-light source. This enhanced photocatalysis is supported by the peculiar properties of GO, such as its high surface area, electron-shuttling performance, and ability to prevent charge back-recombination. Under simulated conditions, more than 99% of CV was mineralized within 60 min of contact time. The photodegradation follows pseudo-first-order kinetics with a rate constant (Kt) = 0.02317 min−1. Furthermore, the photo mineralization of CV dye was thoroughly investigated using the GC-MS technique. More importantly, Sn2S3–In2S3/GO exhibits promising recyclability over multiple degradation cycles. [ABSTRACT FROM AUTHOR]

There have been reports of influenza virus resistance in the past, and because this virus has the potential of resistance to cause several pandemics and also is lethal, we investigate the conditions under which the strains coexist as a result. The non-resistant strain undergoes mutation, giving rise to the resistant strain. The incidence rates of the non-resistant and saturated-resistant strains are bi-linear and saturated, respectively. In this study, two flu strain models (resistant and non-resistant) are investigated in a fractal–fractional sense, and the presence of solutions, stability, and numerical simulations are examined for various orders and derivative dimensions. Using numerical values from freely accessible open resources, a numerical technique that is based on Lagrange’s interpolation polynomial is constructed and validated for a particular example. [ABSTRACT FROM AUTHOR]

Rapid emissions of green-house gases (GHGs) are causing global warming, which is wreaking havoc on the earth's climate system. As a result, the coastal ecosystems of the world are on the verge of becoming endangered. We develop a fractal-fractional hybrid model to estimate the influence of rapid emissions of GHGs on the coastal ecosystems and climate changes. The fractal-fractional climate change model is considered for the theoretical and numerical aspects. The theoretical aspect includes the existence and Hyers–Ulam (HU) stability of the solutions while the numerical aspect is based on Lagrange's interpolation polynomial. Moreover, unique solutions are proved by the Banach contraction principle. Different fractal-fractional orders are considered for the numerical study of dynamics of solutions which prove the importance and accuracy of these hybrid operators. [ABSTRACT FROM AUTHOR]

Nitrobenzene (NB) is a hazardous aromatic compound known for its high environmental persistence and potential toxicity to both human health and ecological systems. The World Health Organization classified NB as a Group 2B carcinogen in 2017. Regular monitoring of NB in water systems remains the primary preventive measure to mitigate the risk of long-term harm to human and animal health. Herein, we report the synthesis of magnetically active NiS2/Fe3S4 nanoflakes for highly selective electrochemical detection and catalytic reduction of nitrobenzene. The NiS2/Fe3S4 nanocomposite was characterised using various techniques such as X-ray diffraction, X-ray photoelectron spectroscopy, scanning electron microscopy, transmission electron microscopy with energy-dispersive spectrometry and elemental mapping, and the NiS2/Fe3S4-modified electrode shows an enhanced electrochemical performance compared to other electrodes. Interestingly, the NiS2 nanospheres are anchored on Fe3S4 nanoflakes, which provides a sufficient pathway for rapid electron/ion transportation. The proposed sensor offers a wide detection range from 0.01 to 100 μM with a correlation coefficient of 0.998 and a very low detection limit of 7.0 nm. Moreover, nitrobenzene is catalytically reduced to the least toxic aniline in the presence of sodium borohydride as a mild reducing agent in just 10 min of contact time. The magnetically separable catalyst offers good recovery, higher stability, selectivity, reproducibility, and real-time monitoring of the contaminants. This work introduces a novel catalyst and a unique approach that combines electrochemical detection and catalytic reduction to efficiently monitor nitrobenzene and to remediate the environment. [ABSTRACT FROM AUTHOR]

Background: The efficacy of the erector spinae plane (ESP) block in mitigating postoperative pain has been shown for a range of thoracic and abdominal procedures. However, there is a paucity of literature investigating its impact on postoperative analgesia as well as its influence on weaning and subsequent recovery in comparison to thoracic epidural analgesia (TEA) in median sternotomy-based approach for open-cardiac surgeries and hence the study. Methods: Irrespective of gender or age, 74 adult patients scheduled to undergo open cardiac surgery were enrolled and randomly allocated into two groups: the Group TEA (thoracic epidural block) and the Group ESP (bilateral Erector Spinae Plane block). The following variables were analysed prospectively and compared among the groups with regard to pain control, as determined by the VAS Scale both at rest (VASR) and during spirometry (VASS), time to extubation, quantity and frequency of rescue analgesia delivered, day of first ambulation, length of stay in the intensive care unit (ICU), and any adverse cardiac events (ACE), respiratory events (ARE), or other events, if pertinent. Results: Clinical and demographic variables were similar in both groups. Both groups had overall good pain control, as determined by the VAS scale both at rest (VASR) and with spirometry (VASS) with Group ESP demonstrating superior pain regulation compared to Group TEA during the post-extubation period at 6, 9, and 12 h, respectively (P > 0.05). Although statistically insignificant, the postoperative mean rescue analgesic doses utilised in both groups were comparable, but there was a higher frequency requirement in Group TEA. The hemodynamic and respiratory profiles were comparable, except for a few arrhythmias in Group TEA. With comparable results, early recovery, fast-track extubation, and intensive care unit (ICU) stay were achieved. Conclusions: The ESP block has been found to have optimal analgesic effects during open cardiac surgery, resulting in a decreased need for additional analgesic doses and eliminating the possibility of a coagulation emergency. Consequently, it presents itself as a safer alternative to the potentially invasive thoracic epidural analgesia (TEA). [ABSTRACT FROM AUTHOR]

Background: Post-induction hypotension associated with various agents is well-known in adults undergoing general anesthesia for various procedures. However, this phenomenon has not been addressed well in pediatric patients. We studied the incidence of post-induction hypotension in patients 1-5 years using inhalational induction with sevoflurane, intravenous induction with propofol, and co-induction with sevoflurane plus propofol. Aims and Objectives: To compare three different induction techniques in children 1-5 years undergoing various infra-umbilical surgeries under general anesthesia with laryngeal mask airway using sevoflurane induction, propofol induction, and sevoflurane plus propofol co-induction. Materials and Methods: Out of 150 patients observed in this study, 50 patients (group S) received inhalational induction with sevoflurane, 50 (group P) patients received intravenous induction with propofol, and 50 (group SP) patients received co-induction with propofol and sevoflurane. Results: Intravenous induction with propofol resulted in maximum hemodynamic changes Inhalational induction was responsible for significant changes in heart rate whereas co-induction with propofol (1-1.5 mg/kg) and sevoflurane 5% yielded minimum hemodynamic variations with least adverse effects. Conclusion: We conclude that co-induction with propofol (1-1.5 mg/kg) plus Sevoflurane 5% provided better hemodynamic stability with the least adverse effects. [ABSTRACT FROM AUTHOR]

Background: Cross contamination and biosafety are concerns with the microscopic observation drug susceptibility assay. To address these issues, we modified the MODS technique in the current study. Methodology/Principal findings: Two hundred and seventy-five samples were processed on LJ media and drug susceptibility was performed by the Indirect agar proportion method. A modified MODS test was done in tissue culture bottles. GenoType MTBDRplus assay was performed to detect the resistance and mutational pattern associated with the resistances. Sensitivity, specificity, positive predictive value, and negative predictive value for the detection of tuberculosis by modified MODS were 97.44%, 80.00%, 97.44%, and 80.00% respectively. The perfect agreement was seen between modified MODS and the Indirect agar proportion method for drug susceptibility testing of isoniazid (kappa = 0.923) and rifampicin (kappa = 1). The contamination rate, cost and TAT for modified MODS were less as compared to the solid media. In the case of MDR-TB isolates S531L (66.66%) was the most prevalent mutation in the rpoB gene followed by S315T2 mutation (58.33%) and T8C (41.66%) in katG and inhA gene respectively. In hetero-resistant strains, C-15T mutation (37.50%) was the most common followed by A-16G (12.50%) in the inhA gene. In INH mono-resistant strains only two mutations were observed i.e., S-315T1(50%) and C-15T (50%) in the katG and inhA genes respectively. Conclusions/Significance: Modified MODS proved to be cost-effective and user-friendly, with minimal risk to the handler and no cross-contamination between samples were observed. Hence, it can be used in low-income countries for early detection of tuberculosis and its resistance. Author summary: Tuberculosis is a major health problem, particularly in developing countries. Globally efforts are being made to control this disease. However, the emergence of multi-drug resistance (MDR) is a major threat to the tuberculosis control program. Moreover, the available methods for the detection of tuberculosis and susceptibility testing are time-consuming and labour-intensive. All these methods require pre-culture before drug susceptibility testing hence the turnaround time is prolonged. The microscopic observation drug susceptibility method is a liquid-based culture method which simultaneously detects tuberculosis and its susceptibility. Originally developed microscopic observation drug susceptibility assay is done in 24 well tissue culture plates, but problems of false positivity which likely represent cross-contamination from another positive specimen or positive controls plated on each MODS plate is the limitation of this assay. This method also poses the risk of exposure to infection to the person performing the assay. To overcome these issues, in the present study, we introduced modified MODS using screw-capped tissue culture bottles instead of tissue culture plates. The advantage of this modification is that samples and controls are processed in separate bottles which are screw-caped hence reducing chances of cross-contamination and risk of exposure to infection. The mutational pattern of drug-resistant strains is not known in this region. GenoType MTBDRplus assay was performed to detect the resistance and mutational pattern associated with the resistances. [ABSTRACT FROM AUTHOR]

The ramifications of anthropogenic activities on the environment and the welfare of aquatic life in lakes worldwide are becoming increasingly alarming. There is a lack of research in the Indian Himalayas on fish biomarker responses to stressful aquatic conditions and the use of environmetric modelling in GIS. Our research evaluates the environmental health of urban lakes in multiple basins using multi-biomarker endpoints (13 features) in Schizothorax niger and hydrochemical characterization (9 features) of water. The study covers 31 grids, each at a distance of 1 km2. This study demonstrated a statistically significant (P = 0.001) increase in white blood cells (WBC), mean cell size (MCH), helminth infection, and health assessment index score (HAIS) score in fish from a highly eutrophic cluster or basin compared to a reference cluster, which is indicative of environmental stress in fish. Based on hydrochemical similarities, the lake water datasets were divided into three categories using hierarchical cluster analysis (HCA). In the PCA analysis, the first three principal components were responsible for 78.1% of the data's variance. The first principal component (PC1) accounted for 57.4% of the variance and had a strong positive loading from ammonia, total phosphate, pH, nitrates, and total alkalinity for water quality parameters. Additionally, PC1 had a favourable loading from WBC, helminth infection (%), and the health assessment index score (HAIS) for biological endpoints. These findings are in alignment with the results of the multivariate analysis. The trophic state index (TSI) showed a significant (P < 0.05) increase in Cluster 1, which includes the peripheral areas of Hazratbal and Gagribal side (> 70), compared to the reference cluster. The multiple regression model indicates that ammonia, phosphate, and nitrate significantly impact the general health of fish (R2 > 0.7). A novel methodology for monitoring water quality fluctuations across different basins and clusters is presented in this study. By integrating fish health biomarkers and GIS technology, we have developed a comprehensive approach to evaluate the overall well-being of aquatic habitat. This technique may prove beneficial in the management of urban lentic water bodies in the Kashmir Himalayas and other comparable water systems around the globe, while also supporting sustainable practices. [ABSTRACT FROM AUTHOR]

Introduction: Drug abuse is a global public health issue that poses significant challenges to healthcare systems particularly in intensive care units (ICU). This study aims to assess the clinical profile and outcomes of drug abuse patients admitted to ICU of a tertiary care hospital in North India. Methods: A prospective observational study was conducted over period of 3 years involving drug abuse patients admitted to the ICU. Demographic data, clinical characteristics, substance abuse patterns, co-morbidities, severity scores and outcomes were recorded. Results: A total of 35 patients were included in the study. All patients were males with a mean age of 29.1(± 11.68). 25 patients were from rural areas. 42.8% were unemployed. Most of the patients (85.7%) were unmarried. 34.3% were students. Mean APACHE II score on ICU admission was 13. Most of patients were admitted for heroin overdose (60%). All 35 patients admitted in ICU had low Glasgow coma scale (GCS< 7). 32 (91.4%) patients had associated respiratory failure. 7 patients had cardiovascular instability. 4 (11.4%) patients developed multi-organ failure during the ICU stay. Mean duration of ICU stay was 3.4 (± 2.68). 23 (65.7%) patients got extubated within 24 hours of ICU admission. 4 patients expired (11.4% mortality) in study group. Sepsis was cause of death in one patient, 3 patients died of multi-organ failure Conclusion: Most of the overdose was due to opioids specifically of heroin. CNS depression was found in all drug overdose patients followed by respiratory failure. Multi organ involvement have poor outcome. Mortality ensued in 11.4% of admitted patients as a result of sepsis and multi-organ failure. Majority of the patients had good outcome especially patients who presented early to healthcare facility. [ABSTRACT FROM AUTHOR]

Introduction- Compared to non-aspiration pneumonia, aspiration pneumonia has higher mortality and recurrence rates. Examining independent patient characteristics that are linked to mortality in patients needing acute admission for aspiration pneumonia at a tertiary centre was the main goal. Reviewing the potential effects of variables, including mechanical ventilation and speech-language pathology intervention, on patient mortality and length of stay (LOS) was one of the secondary objectives. Material & methods- The study included patients who were older than 18 and were admitted with aspiration pneumonia as their primary diagnosis at a tertiary care center. The patient characteristics were subjected to descriptive analysis using age as a continuous variable. In order to determine the independent factors that contributed to in-hospital mortality, multivariable logistic regression was employed. Cox proportional-hazard regression was performed to determine the independent factors that affected LOS. Results- This study covered 100 patients in total. Patients' average ages were 79.3 ± 13.5, and 22% of them died while they were hospitalized. LOS was longer in patients who passed away, with a median length of 11.5 days (p = 0.013). Female gender was revealed to be a protective factor (0.03), but age and invasive mechanical ventilation were independent predictors of mortality (p<0.05). When compared to younger patients, elderly patients had a higher risk of passing away while they were in the hospital. Conclusion - Elderly people have a higher mortality risk when hospitalized for aspiration pneumonia than other patient populations. This calls for better community-wide prevention measures. [ABSTRACT FROM AUTHOR]

Introduction-Compared to non-aspiration pneumonia, aspiration pneumonia has higher mortality and recurrence rates. Examining independent patient characteristics that are linked to mortality in patients needing acute admission for aspiration pneumonia at a tertiary centre was the main goal. Reviewing the potential effects of variables, including mechanical ventilation and speech-language pathology intervention, on patient mortality and length of stay (LOS) was one of the secondary objectives. Material & methods- The study included patients who were older than 18 and were admitted with aspiration pneumonia as their primary diagnosis at a tertiary care center. The patient characteristics were subjected to descriptive analysis using age as a continuous variable. In order to determine the independent factors that contributed to in-hospital mortality, multivariable logistic regression was employed. Cox proportional-hazard regression was performed to determine the independent factors that affected LOS. Results- This study covered 100 patients in total. Patients' average ages were 79.3 ± 13.5, and 22% of them died while they were hospitalized. LOS was longer in patients who passed away, with a median length of 11.5 days (p = 0.013). Female gender was revealed to be a protective factor (0.03), but age and invasive mechanical ventilation were independent predictors of mortality (p<0.05). When compared to younger patients, elderly patients had a higher risk of passing away while they were in the hospital. Conclusion - Elderly people have a higher mortality risk when hospitalized for aspiration pneumonia than other patient populations. This calls for better community-wide prevention measures. [ABSTRACT FROM AUTHOR]

Effective communication between physicians and patients plays an integral role in clinical care. Gaps in a physician's ability to ensure effective communication, especially with patients from diverse backgrounds, are known causes of medical errors. This study explores the potential biases and disparities in patient-resident communication, which may influence a patient's quality of care. This exploratory qualitative study was conducted at the largest academic medical center in Pakistan. Purposive sampling was used to approach participants from surgery, medicine, obstetrics and gynecology, pediatrics and family medicine. Faculty, fellows and residents working in these departments and medical students in their fourth and fifth years of undergraduate education with prior experience of at least one month in these specialties during their clinical rotations were included. Focus group discussions (FGDs) lasting 45–60 minutes were conducted with each cohort of healthcare professionals separately, using a semi-structured interview guide. Sixty participants (19 males and 41 females, mean age: 32.9, SD: 10.9) took part in the study. Thematic analysis revealed five major themes. Four themes focused on residents' biases and patient disparities hindering patient-resident communication: (1) patient-resident gender discordance (2) ethnicity and language barriers, (3) differing social class of the patient, and (4) challenging patient-resident interactions (patients resistant to treatment, exceedingly inquisitive and those with multiple attendants, etc.). The fifth theme identified the need for a communication skills curriculum in postgraduate medical education. Opposite gender and discordant socioeconomic/cultural backgrounds of patients pose a challenge to effective patient-physician communication. Self-identification and awareness of residents' biases when interacting with patients can ensure their active elimination and improve their communication skills. Integrating these components in a standardized curriculum within postgraduate programs can enable resident-physicians to provide the same level of care and communicate more efficiently with patients of all backgrounds. [ABSTRACT FROM AUTHOR]

Introduction: Balance impairments and an increased fall risk are common concerns among individuals with various health conditions. Resistance exercise has shown potential in improving balance and reducing fall risk. Aim: To determine the effects of home-based Thera-Band resistance training in reducing the risk of falls among the geriatric population and to compare it with weight-cuff resistance training. Materials and Methods: A Randomised Controlled Trial (RCT) was conducted at the Amity Institute of Health and Applied Science, Noida, India, from November 2022 to April 2023. The intervention period spanned four weeks, and a total of thirtythree subjects were enrolled in the study. The participants were divided into three groups: Group A, Group B, and Group C. Group A performed resistance exercises using weight cuffs combined with standard balance training, Group B performed resistance training with Thera-Band combined with standard balance training, and Group C received standard balance exercises alone. The effects of the interventions on fall risk reduction were assessed using the Berg Balance Scale (BBS), Timed Up and Go (TUG), and Fall Efficacy Scale (FES) among the geriatric population. Paired t-tests were employed to compare pre- and post-intervention data within each group, determining significant changes within each group over the intervention period. Analysis of variance (ANOVA) was utilised to assess between-group effects of the different interventions. Results: The FES scores were assessed pre- and postintervention for each group. Group B (Thera-Band) demonstrated significantly better outcomes in fall efficacy compared to Group A (Weight-cuff) (p<0.01) and Group C (p<0.01). For balance assessment using the BBS, both Group A and Group B showed better results compared to Group C (p<0.01). In terms of mobility assessed through the TUG test, Group B exhibited substantial improvement compared to both Group A and Group C (p<0.05). Improvements in fall efficacy, balance, and mobility were seen in Group B (Thera-Band). Conclusion: Home-based resistance training using Thera-Band was found to be the most effective method for reducing the risk of falls in the geriatric population, followed by weightcuff resistance training in combination with conventional balance training. Thera-Band is not only effective but also more convenient, hassle-free, and cost-effective. The geriatric population should be provided with more multi-mode exercises that are easy to perform and have been found to be effective and helpful at their advanced age. [ABSTRACT FROM AUTHOR]

Objective: To examine the anthropometric, blood sugar, and lipid profiles of healthy adults, including those with and those without a history of type 2 diabetes mellitus. Study Design: Case-control study. Setting: Peoples University of Medical & Health Sciences for Women (PUMHS) in Nawabshah. Period: October 1st 2022 to 31st March 2023. Material & Methods: The research included 110 participants. 55 of them had at least one parent with type 2 diabetes mellitus, and the other 55 did not. Males and females between the ages of 18 and 25 were present in the study. The following measurements were compared: fasting blood sugar, lipid profile, waist height to hip ratio, and body mass index. Results: This case-control study compares offspring with and without a family history of type 2 DM to determine if there are any anthropometric or metabolic differences. Participant with a family history of type 2 DM showed higher BMI, WC, and WHtR according to the anthropometric measurements. Statistically significant differences were found in their BMI (P-value <0.0001). Even though BMI showed a significant difference, the mean value did not fit into the criteria to be categorized as obese. Conclusion: The present research has shown that people with a family history of type 2 diabetes mellitus are overweight and have abnormal lipid profiles even before they manifest overt type 2 DM. [ABSTRACT FROM AUTHOR]

Background: The occurrence of emergence agitation (EA) is the most common and practical problem faced in the immediate post-operative period during the process of Extubation under General Anaesthesia. Dexmedetomidine, an α² adrenoceptor agonist is an excellent drug that has been shown effective to decrease the preoperative anxiety and smooth induction and emergence. Aims and Objectives: To assess the effect of intravenous dexmedetomidine primarily on EA and other complications that may occur during emergence from general anesthesia. Materials and Methods: 80 patients of either gender aged 18–65 years with ASA status I and II, undergoing various elective general and urological surgeries under general anesthesia were included in the study. Patients receiving adjuvant drug dexmedetomidine, were labelled as Group D (n=40) and those who didn’t receive any adjuvant were labelled as group C (n=40). Dexmedetomidine was given at 1 µg/kg and then maintained at infusion of 0.4 µg/kg/h till the end of the surgery for group D. The hemodynamic parameters and SpO2 were measured during the intraoperative period at various intervals of time till the end of surgery and also on arrival to the recovery room till patient was discharged from post-anesthesia care unit in both the groups. Results: The use of IV dexmedetomidine has proved significantly effective in prevention of incidence of EA with the overall incidence of agitation of 7.5% in Group D as compared to 42.5% in group C. Conclusion: Intraoperative administration of intravenous dexmedetomidine decreased the incidence of EA and other emergence phenomena like cough, pain and PONV with stable hemodynamics, safety profile, good analgesic properties and opioids sparing side effects. [ABSTRACT FROM AUTHOR]

Supply chain (SC) performance is being advanced through digitalization, automation, and real-time visibility, leading to improved operational efficiency, optimized inventory management, and proactive solutions for problems. This study focuses on managing SC performance by developing a real-time Microsoft Power BI dashboard using the ADR method. The aim is to help small business owners effectively and affordably manage their supply chains. The research analyzed data from Ly Foods Ltd. and utilized Microsoft Power BI to create the dashboard. The study highlights how this state-of-the-art dashboard enhances the measurement of operational and decision-making processes by providing efficient, visible, accessible, and shareable information. The findings demonstrate the potential benefits of leveraging advanced technologies to enhance supply chain management (SCM) practices. This research makes a significant contribution to the field of SCM by illustrating how SC performance can be managed using the ADR method and the SC key performance indicators (KPIs). The results of this study have important implications for businesses of all sizes, as they enhance SC efficiency and profitability. [ABSTRACT FROM AUTHOR]

The current study was conducted to investigate the variety of Odonata in Kashmir from November 2020 to November 2022. The study revealed the existence of 24 species, which includes 18 species of Anisoptera (dragonflies) under eight genera & two families and six species of Zygoptera (damselflies) in five genera & three families. New records of four species Orthetrum sabina (Drury, 1770), O. internum McLachlan, 1894, Aeshna petalura Martin, 1906, and Anax guttatus (Burmeister, 1839) from the region are provided herewith. Libellulidae (12 spp.) followed by Aeshnidae (six spp.) were recorded as two dominant families. This study provides some important baseline information on the odonates of Kashmir, Jammu & Kashmir, India. [ABSTRACT FROM AUTHOR]

The new eight‐coordinate complex of thorium(IV) was synthesized by the reaction of Th(NO3)4.4H2O with 1,10‐phenanthroline(phen) and 2‐hydroxy‐5‐sulfobenzoic acid (SSA) by coprecipitation method. An environment friendly chelating agent sulfosalicylic acid (SSA) having oxygen donor atoms, phen with delocalized π‐electron system, and N‐donor atoms were used during the preparation of complex. The complex was characterized on the basis of elemental analysis, Fourier transform infrared (FTIR) spectroscopy, UV–Vis spectroscopy, powder X‐ray diffraction (PXRD), thermogravimetric analysis (TGA), differential scanning calorimetry (DSC), and scanning electron microscopy (SEM). The complex was further assessed for structural and magnetic behavior. The results revealed that the complex has been completely formed as eight coordinated, amorphous in nature, diamagnetic, air stable, granular surface morphology, and water soluble. Furthermore, the FTIR studies of the complex demonstrate coordination of Th(IV) with SSA, phen, and nitrate by the participation of oxygen and nitrogen atoms. According to the results obtained, the changes in the IR spectra indicate that the coordination takes place via nitrogen atoms of phen, oxygen atoms of SSA and nitrate ions, the former two acting as bidentate ligands while as the latter coordinate via the monodentate mode. Moreover, from the emission spectra, the complex also showed emission atom excitation wavelength of 290 nm. [ABSTRACT FROM AUTHOR]

Biofouling is the growth of plants, bacteria, and aquatic animals on manmade surfaces submerged in seawater. Recently, biofouling has caused a negative impact on the marine sector such as hull weight increases, low speed, and excessive fuel consumption, etc. Layer-by-layer (LBL) self-assembly of alternate charged polyelectrolytes on film with various numbers of layers provides an efficient method for putting antibacterial and anti-adhesive compounds on films. This antifouling coating LBL approach is a novel solution, which is based on the alternate deposition of oppositely charged polyelectrolytes. In this study, we assembled different number of layers on film comprised of chitosan (CHT) and acid siloxane resin (ASR) as a cationic and an anionic solution for LBL assembly using the dipping method. Then, the as-prepared polyelectrolyte multilayer (PEM) films were investigated by various techniques. FTIR analysis of CHT, ASR and assembled (CHT/ASR)2 film was carried out to confirm the functional groups responsible for their successful synthesis. SEM analysis was observed for each film in order to see the surface morphology, which showed a successful assembly of PEM films. AFM was used to see the topography of each as-prepared film; it was also observed that AFM results have agreement with SEM observations. The contact angle (CA) measurement depicted that the CA for PEM films increased with the increasing number of layers. The chemical bonding nature and composition of the PEM films were determined using XPS analysis. Marine diatom settlement and growth inhibition test was observed against Nitzschia closterium (NC) on each film for antifouling performance. It was observed that more algae cells were attached to the film surface of the (CHT/ASR)2, (CHT/ASR)4, (CHT/ASR)6 layer as compared with the (CHT/ASR)8 and (CHT/ASR)10 layers in NC diatom suspension. On the seventh day, the (CHT/ASR)10 layer film showed 0.0619 cell/105 number/mL of diatom cell attachment in the suspension, which is only 11% of the blank. This study provides new insights into the LBL approach for the development of CHT/ASR PEM films with desirable antifouling and environmentally friendly properties. [ABSTRACT FROM AUTHOR]

Introduction: Effective communication is key to a successful patient-doctor interaction and improved healthcare outcomes. However, communication skills training in residency is often subpar, leading to inadequate patient-physician communication. There is a dearth of studies exploring the observations of nurses – key members of healthcare teams with a special vantage point to observe the impact of residents' communication with patients. Thus, we aimed to gauge the perceptions of nurses regarding residents' communication skills expertise. Methods: This study employed a sequential mixed-methods design, and was conducted at an academic medical center in South Asia. Quantitative data was collected via a REDCap survey using a structured validated questionnaire. Ordinal logistic regression was applied. For qualitative data, In-depth interviews were conducted with nurses using a semi-structured interview guide. Results: A total of 193 survey responses were obtained from nurses hailing from various specialties including Family Medicine (n = 16), Surgery (n = 27), Internal Medicine (n = 22), Pediatrics (n = 27), and Obstetrics/Gynecology (n = 93). Nurses rated long working hours, infrastructural deficits, and human failings as the main barriers to effective patient-resident communication. Residents working in in-patient settings were more likely to have inadequate communication skills (P-value = 0.160). Qualitative data analysis of nine in-depth interviews revealed two major themes: existing status-quo of residents' communication skills (including deficient verbal and non-verbal communication, bias in patient counselling and challenging patients) and recommendations for improving patient-resident communication. Conclusion: The findings from this study highlight significant gaps in patient-resident communication from the perception of nurses and identify the need for creating a holistic curriculum for residents to improve patient-physician interaction. [ABSTRACT FROM AUTHOR]

In this manuscript, a series of dye-sensitized solar cells (DSSCs) were fabricated as a function of post-processing temperature based on mesoporous CuO@Zn(Al)O-mixed metal oxides (MMO) in conjunction with dye N719 as the main light absorber; the proposed CuO@Zn(Al)O geometry was, in turn, attained using Zn/Al-layered double hydroxide (LDH) as a precursor via combination of co-precipitation and hydrothermal techniques. In particular, the dye loading amount onto the deposited mesoporous materials was anticipated via regression equation-based UV-Vis technique analysis, which evidently demonstrated a robust correlation along with the fabricated DSSCs power conversion efficiency. In detail, of the DSSCs assembled, CuO@MMO-550 exhibited short-circuit current ( J S C ) and open-circuit voltage ( V O C ) of 3.42 (mA/cm2) and 0.67 (V) which result in significant fill factor and power conversion efficiency of 0.55% and 1.24%, respectively. This could mainly be due to the relatively high surface area of 51.27 (m2/g) which in turn validates considerable dye loading amount of 0.246 (mM/cm−2). [ABSTRACT FROM AUTHOR]

Fe3S4, commonly known as greigite, is a transition metal chalcogenide and has attracted enormous attention in the field of energy storage and environmental remediation. Herein, a graphitic carbon nitride (g-C3N4) encapsulated zero-dimensional Fe3S4 nanostructure was synthesized by a solvothermal strategy. The nanocomposite material was characterized in detail by FTIR, PXRD, TGA, FE-SEM, TEM, HRTEM, BET, and XPS techniques. The highly active adsorption and catalytic centers in Fe3S4-g-C3N4 facilitate (a) the mineralization of methylene blue (MB) dye, (b) electrochemical sensing of Pb2+ and UO22+ ions, and (c) reductive adsorption of UO22+ ions from aqueous system. Almost complete (>98%) photo-Fenton degradation of MB dye was achieved at pH = 6.0 and by using direct sunlight with the least input of H2O2. A glassy carbon electrode (GCE) modified with Fe3S4-g-C3N4 was fabricated to sense micromolar concentrations of Pb2+ and UO22+ ions in the aqueous medium. The limit of detection for Pb2+ and UO22+ ions was 0.71 and 0.22 μM in the linear concentration range of 1–7 μM and 0.05–8 μM, respectively. Finally, the nanocomposite material was tested for the removal of uranyl ions. The removal of uranyl ions was very rapid, with >95% removed within 30 min of contact time. The adsorption of uranyl ions was described by the Langmuir model with a maximum monolayer adsorption of 185.20 ± 4.3 mg g−1. XPS analysis of U4f and S2p spectra confirmed the charge transfer from the sulfide ion to the uranyl ion, resulting in the reduction of U(VI) to U(IV). The magnetically recoverable Fe3S4-g-C3N4 nanocomposite showed excellent stability and reusability over multiple catalytic and adsorption cycles. [ABSTRACT FROM AUTHOR]

Introduction: With a growing interest in simulation-based training to develop clinical proficiency, bootcamps have been utilized for imparting basic skills to medical trainees. While considerable research on the topic exists in high income countries, no such neurosurgical teaching standards have been employed in Low- and Middle-Income Countries. Methods: We conducted a cross-sectional study to explore the effectiveness of first low-cost, multi-center regional neurosurgery bootcamp in South Asia. Twenty-two participants attended the bootcamp and practiced 12 hands-on skills over the course of 2 days. Burr-holes and craniotomies were done on 3D printed skulls. Lumbar drain insertion was practiced on a purpose-built lumbar puncture mannequin. For laminectomy, we used an in-house designed simulation. The modified Objective Structured Assessment of Technical Skills tool was utilized for skills Assessment. Feedback from faculty and residents was collected via a standard 5-point Likert scale. Results: Only one participant (4.55%) had previously attended a neurosurgical skills workshop. Comparison of outcomes on 1st and 3rd attempts of cranial and spinal skills showed a significant improvement in all 14 domains assessed (p <0.05). Positive feedback was received ranging from 3.9 up to 4.8 on a 5-point Likert scale. Overall cost per participant culminated to $145, significantly lower than previously reported data. Conclusion: Our findings report the effectiveness of sustainable, low-cost training models which can be easily reproduced elsewhere. These indigenously designed simulators can be modified for variable difficulty level and serve as an effective educational strategy in improving learners' skills, knowledge and confidence. [ABSTRACT FROM AUTHOR]

Fossil fuel-based energy systems are mostly used for supplying energy that creates negative impacts on the environment, so in this study, the development of a 100% renewable energy system is evaluated for Pakistan for sustainable climate change. This study modeled three scenarios, namely, ongoing (ONG), energy saving policy (ESP), and green energy policy (GEP) scenarios using low emission analysis platform (LEAP) software for the study period 2022 to 2050 for Pakistan. The results revealed that a 100% renewable energy supply could be achieved through the GEP scenario. Model results show that the share of renewable sources in the total energy mix is 1117.08 TWh and non-renewable sources contribute only 18.12 TWh to meet the energy demand of 966.05 TWh until 2050. Non-renewable production leads to the generation of 8.85 million metric tons of carbon emissions, which is too low compared with the 135.47 million metric tons under the ONG scenario. The USD 1482.46 billion investment cost required for adding renewable energy capacity until 2050 is too high as compared with the USD 46.80 billion under the ONG scenario. Energy demand and production requirements are reduced by 34.18% under the ESP scenario until 2050. This approach can also be applicable to the majority of nations worldwide. [ABSTRACT FROM AUTHOR]

Introduction: Sella turcica (ST) is a saddle-shaped structure located on the intracranial surface of the sphenoid bone in the middle cranial fossa. The sella turcica serves as an important anatomical reference in orthodontics partly because the s-point, placed centrally in the sella region, is a central fix point in cephalometric analysis and partly because the contour of the anterior wall is used in evaluation of craniofacial growth. Morphologically, three basic types - oval, round, and flat - have been classified, the oval and round types being the most common. Aim and objectives: To describe the predominant morphological shape of sella turcica. Materials and methods: Prospective clinical study which was conducted in the Postgraduate Department of Oral Medicine and Radiology of Government Dental College and Hospital Srinagar. This prospective study included total of digital lateral cephalometric radiographs of 180 patients (90 males and 90 females) between 12-65 years of age, Digital lateral cephalometric radiographs were taken by using CARESTREAM SC8100 machine Results: Morphology of sella turcica was found to be typical in just 33.9% of cases. Within the atypical sellae most had oblique anterior wall (27.2%), followed by double contour of the floor (15%), pyramidal shape (14.4%), irregular dorsum sella (6.7%) and bridging (2.8%). Conclusion: Morphological types of sella turcica in this study can be used as reference for additional investigators such as radiologists, orthodontists, maxillofacial surgeons, and neurosurgeons to interpret and plan surgical procedures involving the sellar region. [ABSTRACT FROM AUTHOR]

The experiment was conducted to determine drought tolerance of wheat genotypes under water stress conditions at Botanical Garden, Department of Plant Breeding and Genetics, Sindh Agriculture University, Tandojam during 2017-2018. The experiment was laid out in split plot design with three replications. Two irrigation regimes i.e. non-stress and water stress were considered as main plots and genotypes as sub-plots. The mean squares from analysis of variances showed that treatments were significant for most of the traits yet genotypes were significant for all the traits such as spike length, grains/spike, seed index, grain yield/plant, biological yield/plant and harvest index. Treatment x genotype interactions was also significant for most of the traits except spike/length. In non-stress, Marvi, TD-1, Kiran-95 and TJ-83 recorded higher mean performance for spike length, grains/spike, seed index, grain yield/plant, biological yield/plant and harvest index, while in water stress conditions, generally genotypes like TD-1, TJ-83, NIA-Sundar, Kiran-95 and Galaxy recorded higher mean values for spike length, grains spike, seed index, grain yield/plant, biological yield/plant and harvest index. The wheat genotypes like NIA-Sunder, TJ-83, Galaxy and Benazir recorded minimum reductions for majority of the traits, thus proved their water stress tolerance. The correlation coefficient revealed that in stress conditions, grain yield was significantly and positively associated with number of grains/spike (r = 0.62*), seed index (r = 0.48*), biological yield/plant (r = 0.91**) and harvest index (r = 0.80**). High heritability estimates were recorded in non- stress (ranged from h2=84.50 to 99.10%) as well as in water stress (ranged from h2= 88.28 to 98.22%) for all the studied traits. On the basis of minimum reductions in water stress, the genotypes such as NIA- Sunder, TJ-83, Galaxy and Benazir were considered as drought tolerant hence they could be grown in water stress environment. [ABSTRACT FROM AUTHOR]

The present study was aimed to assess the efficacy of individual and combined effects of novel fuller earth, rock phosphate, and biochar (grapefruit peel) at 1% dosage on maize plant growth, soil chemical properties anduptake of toxic metals (TMs), such as Cu, Zn, Fe, and Cd, by maize plant sown in Korangi (district of Karachi, Pakistan) heavily polluted and Korangi less polluted (K-HP and K-LP) soils. The obtained results indicate that the dry biomass of maize crop increased by 14.13% with combined (FE1% + GBC1%) on K-HP soil and 18.24% with combined (FE 1% + GBC 1%) effects on K-LP soil. The maximum immobilization of Cu, Zn, Fe, and Cd was observed by 36% with GBC1%, 11.90% with FE1%, 98.97% with combined RP1% + GBC1%, 51.9% with FE1% + GBC1% for K-HP, 11.90% with FE1%, 28.6% with FE1%, 22.22% with RP1% + GBC1%, and 57.05% with FE 1% + GBC 1% for K-LP soil. After the addition of proposed substances, modification of soil OM, SOC, TOC, and pH level appeared this lead to the changes in the phyto-availability of Cu, Zn, Fe, and Cd in maize plant. It was concluded that the application of individual and combined effects of novel fuller earth, rock phosphate, and biochar (grapefruit peel) have potential to stabilize pollutants from multi-metal polluted soils for safe crop production. [ABSTRACT FROM AUTHOR]

In this article, cadmium oxide (CdO) was deposited using pulsed laser deposition approach on porous silicon (Si) wafer for visible light photodetector application, through which a series of devices were proposed as a function of the deposition energy. The microstructural as well as optical characteristics of the prepared film/s were demonstrated, respectively, using x-ray diffraction (XRD), field emission scanning electron microscopy (FE-SEM), and ultraviolet visible light spectroscopy (UVâ€"Vis) analysis. In details, the UVâ€"Vis analysis revealed the occurrence of optical band gaps within the range of 2.38â€"2.42 eV , while an average nanoparticle diameter was found to be 45 nm using FE-SEM technique. This in turn demonstrated a sound relation with the photoresponsive behavior of the attained photodetectors. A photoresponsivity and specific detectivity of 1.9 ÎĽ A m W âˆ' 1 and 1.21 Ă— 10 9 Jones were attained using 700 mJ laser energy. In the meanwhile, the estimated response/recover time of the addressed laser energy was found to be 300 s and 340 s , respectively. The photo-responsive characteristics of the fabricated devices were found to be in positive linear correlation with the applied laser energy. [ABSTRACT FROM AUTHOR]

Summary: Hydrogen fuel, as an alternative renewable energy resource, has recently attracted much attention for meeting global energy crisis and environmental sustainability. However, the storage of hydrogen as a neat fuel in economical and technological feasible forms to replace the widespread use of fossil fuels in diverse applications is still a formidable challenge to scientists. As per earlier reports, metal‐doped pentalenes were found to be promising candidates for hydrogen storage as per their storage capacity but were found to possess certain thermodynamic constraints. Our calculations show that transition metal–doped pentalenes can exhibit a hydrogen storage capacity of 3.68% to 7.73% with an average adsorption energy of 0.66 to 1.23 eV/H2 without any thermodynamic limitations. We have evaluated various physico‐chemical parameters and hydrogen storage calculations that include adsorption energy, Gibbs free energy, and reactivity descriptors, which assist in understanding the comparative structure and properties of these pentalene‐based systems at the electronic structure level. In addition to that, these pentalenes were doped with two homo and hetero transition metals to enhance their storage capacity. Thermo‐chemistry‐based calculations have been performed in order to understand their working temperature and desorption behavior. The calculations based on energy gaps have proven the pentalenes to be kinetically stable. Details related to bond distance, charge density, single point energy, orientation, and mode of adsorption were also calculated for both the parent and their boron substituent complexes to provide a detailed idea about their hydrogen storage behavior. This study could open a new window, toward the use of pentalenes as hydrogen storing systems in near future. [ABSTRACT FROM AUTHOR]