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In response to escalating environmental concerns driven by greenhouse gas emissions, Pakistan, amid accelerated climate change and deteriorating air quality, struggles with power crisis. Our purpose of this research was to develop a pivotal strategy to address the power crisis and provide clean transportation facilities by involving power transitioning from fossil fuel vehicles to electric vehicles (EVs). We aimed to establish EV charging stations powered by renewable sources like solar and wind energy using grid to vehicle (V2G) mechanism. Utilizing MATLAB Simulink, an optimal electric vehicle charging system with a Level 2 fast charging mechanism was designed, aiming to significantly reduce greenhouse gas emissions from both the transportation and energy sectors. This framework aligned with global trends in climate change mitigation, providing developing countries like Pakistan with a practical solution. The results indicated a 10-kW, AC power output at 240 V coupled with an ideal 50 kWh EV battery rating, which was achieved for EV charging. The output parameters, including current voltage and power output of solar PV, micro wind, and battery levels, were used before and after the incorporation of a boost converter. Consequently, the application of a boost converter and proportional integral (PI) controller resulted in low overshoot and steady state output parameters of the proposed system. Also, the battery backup helped to optimize the power output for load driven EVs. [ABSTRACT FROM AUTHOR]

Digital construction relies on effective sensing to enhance the safety, productivity, and quality of its activities. However, current sensing devices (e.g., camera, LiDAR, infrared sensors) have significant limitations in different aspects. In light of the substantial advantages offered by emerging 4D mmw technology, it is believed that this technology can overcome these limitations and serve as an excellent complement to current construction sensing methods due to its robust imaging capabilities, spatial sensing abilities, velocity measurement accuracy, penetrability features, and weather resistance properties. To support this argument, a scientometric review of 4D mmw-based sensing is conducted in this study. A total of 213 articles published after the initial invention of 4D mmw technology in 2019 were retrieved from the Scopus database, and six kinds of metadata were extracted from them, including the title, abstract, keywords, author(s), publisher, and year. Since some papers lack keywords, the GPT-4 model was used to extract them from the titles and abstracts of these publications. The preprocessed metadata were then integrated using Python and fed into the Citespace 6.2.R3 for further statistical, clustering, and co-occurrence analyses. The result revealed that the primary applications of 4D mmw are autonomous driving, human activity recognition, and robotics. Subsequently, the potential applications of this technology in the construction industry are explored, including construction site monitoring, environment understanding, and worker health monitoring. Finally, the challenges of adopting this emerging technology in the construction industry are also discussed. [ABSTRACT FROM AUTHOR]

Objectives: The objective of the current study was to determine the frequency of anxiety and depression among patients diagnosed with acute coronary syndrome (ACS) at a tertiary care cardiac center in Pakistan. Methodology: This cross-sectional study was conducted at a tertiary care cardiac center in Pakistan from May to November 2019. We included patients of either gender, between 30 and 70 years of age, diagnosed with ACS, and presented within 72 hours of onset of symptoms. After the standard treatment of the condition, the Beck Depression Inventory Scale (BDI) and Beck Anxiety Inventory (BAI) were used to assess post-AMI depression and anxiety. The BDI =17 was categorized as depression and BAI =11 was taken as anxiety. Results: In the selected sample of 122 patients, the mean age was 58.7 ± 10.2 years and 88 (72.1%) patients were male. Diabetes mellitus was detected in 76 (62.3%) patients and 64 (52.5%) patients were smokers. The mean BDI score was 28.6 ± 6.5 and mean BAI score was 19.5 ± 5.1. Anxiety and depression were observed in 36 (29.5%) and 51 (41.8%) patients, respectively. Conclusion: Depression and anxiety are a common remnants of ACS, hence, in our day to day clinical practice, appropriate consideration should be given to the psychological wellbeing of patients in addition to the management of ACS. [ABSTRACT FROM AUTHOR]

Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia (ARVD) is regarded to be one of the highest common cause of death especially in athletes due to sudden cardiac arrest. Epidemiologically, 1 among 5000 populations has estimated prevalence of ARVD. ARVD clinical indications or symptoms before the age of 12 are difficult to diagnose and it is also rare to acquire ARVD symptoms after the age of 60. 34-year-old male patient with noknown co-morbid received at Emergency Department of PNS Shifa Hospital Karachi. This case report is a typical case of ARVD in stage 4 with bi ventricular involvement. [ABSTRACT FROM AUTHOR]

Objective: To determine the frequency of cardiogenic shock in patients with acute non-ST-elevation myocardial infarction (NSTEMI). Study Design: Cross sectional study. Place and Duration of Study: Department of Cardiology, National Institute of Cardiovascular Diseases (NICVD), Karachi Pakistan, from Apr 2018 to Oct 2019. Methodology: All patients with NSTEMI were included in the study after taking informed consent. Patients with recurrent NSTEMI or previous NSTEMI, patients with valvular heart disease or neurological problems, and those with comorbid conditions such as renal failure were excluded. All patients underwent ECG in order to assess the cardiogenic shock. Data was collected on a semi-structured questionnaire. The first part of the questionnaire consisted of demographic information such as gender, age, body weight and height, and their comorbidity status. Second part of the questionnaire assessed cardiogenic shock. Results: Mean ± SD of age was 56.9 ± 9.2 years. Out of 203 patients, 131 (64.5%) were male while 72 (35.5%) were female. Hypertension was noted in 111 (54.7%) patients. Cardiogenic shock was found to be positive in 17 (8.4%) patients while negative in 186 (91.6%). Duration of symptoms was significantly associated with the occurrence of cardiogenic shock (p=0.05). Conclusion: It is concluded that cardiogenic shock is somewhat common in NSTEMI patients. The necessity of a stroke unit is highly appreciated to increase the care and decrease morbidities and mortalities. [ABSTRACT FROM AUTHOR]

Objectives: To determine the frequency of Acute Mitral Regurgitation in Post Percutaneous Transvenous Mitral Commissurotomy (PTMC) patients with severe mitral stenosis (MS). Methodology: A cross-sectional study was conducted at the Tabba Heart Institute, Karachi, Pakistan between September 2019 and April 2021. All patients irrespective of gender, aged between 19-80 years, and those who did not undergo PTMC were eligible to partake in the study. Patients with mitral regurgitation along with mitral stenosis, or those with clot in left atrium, or those suffering with the last stage of renal disease were excluded from the study. A predefined Proforma was used as a research instrument through which medical records of patients of PTMC are collected. The variables of the Proforma include patient's age, name, sex, echo findings, treatment procedure, post-procedure data and complications. Results: A mean age of 40.6 ± 12.63 years was reported. 86 (81.9%) of the patients developed 'no complications', 15 (14.3%) of the PTMC patients suffered from 'severe mitral regurgitation', 2 (1.9%) had local hematoma, and one patient had a cardiac tamponade after the procedure. Only one patient died post-procedure. Post-stratification analysis showed that the majority of the female patients and 83% of the patients with no previous commissurotomy history did not have any complications. While a total of 14.7% who had no history of previous commissurotomy suffered from severe MR. Conclusion: Our study revealed that only a small number of patients who underwent PTMC suffered from severe mitral regurgitation. Overall, the procedure is safe with a good outcome. [ABSTRACT FROM AUTHOR]

Next-generation networks are data-driven by design but face uncertainty due to various changing user group patterns and the hybrid nature of infrastructures running these systems. Meanwhile, the amount of data gathered in the computer system is increasing. How to classify and process the massive data to reduce the amount of data transmission in the network is a very worthy problem. Recent research uses deep learning to propose solutions for these and related issues. However, deep learning faces problems like overfitting that may undermine the effectiveness of its applications in solving different network problems. This paper considers the overfitting problem of convolutional neural network (CNN) models in practical applications. An algorithm for maximum pooling dropout and weight attenuation is proposed to avoid overfitting. First, design the maximum value pooling dropout in the pooling layer of the model to sparse the neurons and then introduce the regularization based on weight attenuation to reduce the complexity of the model when the gradient of the loss function is calculated by backpropagation. Theoretical analysis and experiments show that the proposed method can effectively avoid overfitting and can reduce the error rate of data set classification by more than 10% on average than other methods. The proposed method can improve the quality of different deep learning-based solutions designed for data management and processing in next-generation networks. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To assess breastfeeding support provided to urban working doctor mothers at their workplace. METHODS: This cross-sectional study was carried out among four tertiary level urban hospitals of Pakistan, between January-June 2017. Through random sampling, 215 working female doctors who were breastfeeding (3-24 months) were included. Data was collected using structured questionnaire based upon "World Alliance for Breastfeeding in Action" guidelines. The data was analyzed using SPSS software version 24. Breastfeeding facilities at workplaces were taken as outcome variables. RESULTS: Among non-physical facilities, 89% of the doctor mothers received at least 03 months fully paid maternity-leave, 15% received enough breastfeeding breaks, and almost 12% of the mothers were offered flexible-job and information with regards to breastfeeding support options at workplace (hospitals). Regarding physical facilities, breastfeeding corner and onsite nursery for childcare was accessible to 5% and 2.3% of doctor mothers. However, none of the hospitals supported mothers with refrigerator for storing mother's milk and breast milk pump. Additionally, statistically significant difference (<0.001) was observed by type of employer (government or private) breastfeeding breaks, lactation corner, and fully paid maternity leave. CONCLUSION: Enabling and supportive environment to working doctor mothers for breastfeeding at workplaces was missing in majority of the healthcare facilities. Female doctors having positive practical experience with solutions can be instrumental for their patients (working mother) in preventing early weaning. [ABSTRACT FROM AUTHOR]

Hypertrophic cardiomyopathy is a commonly occurring cardiovascular disease resulting primarily from changes in proteins participating in muscle contraction in the heart, including the cardiac actin protein. Changes in cardiac actin located exclusively in the myosin binding site are called M-class variants and include the H88Y, R95C, and E99K substitutions and F90Δ deletion. The prevailing hypothesis for these mutations is that hypertrophic cardiomyopathy is the result of increased calcium sensitivity of contraction in the myocardium. To test this hypothesis, we studied the activity of myosin at varying calcium concentrations in the presence of regulated thin filaments containing M-class cardiac actin variants. We found that all M-class cardiac actin variants exhibit increased calcium sensitivity, with the R95C variant also displaying significant decreases in maximal myosin activity. This work represents the first characterization of all M-class variant proteins and suggests that drugs targeting contraction specifically to treat hypertrophic cardiomyopathy must consider the impact on both calcium sensitivity and maximal myosin activity on overall heart health. • We show the first direct comparison of M-class cardiac actin variant calcium sensitivity in regulated thin filaments. • All M-class cardiac actin variants exhibited increased calcium sensitivity. • Increased calcium sensitivity may be a common mechanism for disease development for M-class variants. [ABSTRACT FROM AUTHOR]

The tradition of fastening planked boats using sewing is characteristic of the Indian Ocean region. Despite known disadvantages of sewn boats, including that perishable materials need regular maintenance and repair, operators of boats used in the sand‐mining industry of Goa still see potential in discarded sewn boats. The problems, raw materials used, technology, and process of re‐sewing and repairing these boats to give them a second life are reported and discussed here. [ABSTRACT FROM AUTHOR]

Health literacy is pre-requisite for better health outcomes. Health literacy is an unexplored concept in Pakistan. This study aimed to assess concept-based health literacy level in the adult population of Karachi. A cross-sectional survey was conducted in 2015, the respondents were recruited from three randomly selected towns of Karachi. A multistage random sampling technique was used to recruit 315 adult participants who were interviewed on validated the Health Literacy Survey Questionnaire (HLS-Asia-Q). Basic demographics, responses of each question and health literacy matrix were used to compile the results. The health literacy was limited in the majority (82.4%) of the population. Health Promotion domain scored least on the matrix (24.3±9.8) irrespective of gender, age, education, and profession. Most of the respondents (70%) faced difficulty in finding and understanding health information for their well-being. The health educators (health care professionals) can play a major role in helping to enhance the health literacy and act as an advocate for health education. [ABSTRACT FROM AUTHOR]

Background: Breastfeeding is considered to be an important measure to achieve optimum health outcomes for children, women's return to work has frequently been found to be a main contributor to the early discontinuation of breastfeeding. The aim of the study is to assess workplace breastfeeding support provided to working mothers in Pakistan. Method: A workplace based cross-sectional survey was conducted from April through December 2014. Employers from a representative sample of 297 workplaces were interviewed on pre-tested and structured questionnaire. The response rate was 93.7 %. Prevalence of workplace breastfeeding facilities were assessed in the light of World Alliance for Breastfeeding Action (WABA) guidelines. Results: Among non-physical facilities, all workplaces offered 3 months paid maternity leave, 45 % of the sites were offering task adjustment to mothers during lactation period. Only 15 % of the sites were offering breastfeeding breaks to working mothers. Physical facilities that include a breastfeeding corner, refrigerator for storing breast milk, breast milk pump and nursery for childcare were provided in less than 7 % of the sites. Multinational organizations provided better support compared to national organizations. Conclusion: Support for continuation of breastfeeding by working women at workplaces is inadequate; hence, women discontinue breastfeeding earlier than planned. Policies need to be developed and enforced, employers and employees need to be educated and supportive environment needs to be created to encourage and facilitate breastfeeding friendly worksite environment. [ABSTRACT FROM AUTHOR]

Acinic cell carcinoma is a salivary gland malignant epithelial neoplasm. It is characterized by cytoplasmic granules of zymogen. It is ranked as the third most common salivary gland malignancy in adults. We report a case of a 45-year-old male who for the past 15 years has been presenting a huge right-sided mass in parotid region associated with dysphagia. He underwent Total Parotidectomy right. The excised specimen was sent for histopathology, which turned out to be acinic cell carcinoma. [ABSTRACT FROM AUTHOR]

The study of traditional boats has enhanced our knowledge of the maritime past. Traditional boats are both river- and sea-worthy. They have been used in rivers for transporting cargo to inland ports from ships anchored at sea, and have often been used in naval warfare. In this paper an attempt has been made to study the sewn-plank boats of Goa, their building techniques and other features in order to understand their quality and how they were used in the past for an inland river-transport system. © 2011 The Authors [ABSTRACT FROM AUTHOR]

Background Almost 8000 pilgrims had returned to Pakistan at that time but before the government could set up a quarantine centre, the secondary cases started occurring in the country. Among all these reported cases, 60% were those people who travelled to Iran. The study aimed to assess the demographics of the spread of coronavirus in Baluchistan while also showing the rate of initial transmission of the virus from the Pakistan-Iran border also known as the Taftan Border. Methods This is a descriptive cross-sectional study from the very first COVID-19 positive tested case i.e. Mar 2019 up till 19th April 2020. Total 5315 COVID-19 tests were conducted, out of which 432 were found to be positive and screened for this study material. Result A total of 5315 tests were conducted and out of them, 432 were positive, and 4883 were negative. The results showed that 328 cases (75.9%) were from the Quetta district. Quetta and Loralai have displayed the highest COVID-19 attack rate among 14 of all the other districts. The first timeline for the spread of covid-19 was high as the religious pilgrims and other international travellers were entering the country till mid-March. Conclusion A significant contribution of this study provides the first account of the COVID-19 epidemic curves of Pakistan. However, this is the first report from Baluchistan, and it may be difficult to predict the course of this virus and its impact in the coming future. [ABSTRACT FROM AUTHOR]

Thermal issues in microprocessors have become a major design constraint because of their adverse effects on the reliability, performance and cost of the system. This article proposes an improvement in earliest deadline first, a uni-processor scheduling algorithm, without compromising its optimality in order to reduce the thermal peaks and variations. This is done by introducing a factor of fairness to earliest deadline first algorithm, which introduces idle intervals during execution and allows uniform distribution of workload over the time. The technique notably lowers the number of context switches when compare with the previous thermal-aware scheduling algorithm based on the same amount of fairness. Although, the algorithm is proposed for uni-processor environment, it is also applicable to partitioned scheduling in multi-processor environment, which primarily converts the multi-processor scheduling problem to a set of uni-processor scheduling problem and thereafter uses a uni-processor scheduling technique for scheduling. The simulation results show that the proposed approach reduces up to 5% of the temperature peaks and variations in a uni-processor environment while reduces up to 7% and 6% of the temperature spatial gradient and the average temperature in multi-processor environment, respectively. [ABSTRACT FROM AUTHOR]

Background and objective Cervical lymph node metastasis has a significant impact on the survival of patients with oral cavity tumors. The rate of occult neck node metastasis is reported to range from 20 to 40%. The depth of invasion (DOI) has been incorporated in the eighth edition of the American Joint Commission on Cancer (AJCC) staging manual and is an important predictor of cervical lymph node metastasis. In this study, we aimed to identify the occult neck node metastasis rate in early oral tongue squamous cell carcinoma (OTSCC) and correlate it with the DOI. Methods A retrospective review of all patients presenting to our facility with early-stage OTSCC was performed. Patients with tumor size of ≤4 cm and who underwent elective neck dissection at the time of surgery were included. The study outcomes were the rates of occult neck metastases in T1 and T2 OTSCC and their correlation with the DOI. Results There were 80 patients in total. Occult neck node metastases were seen in 29 (36.25%) patients. Patients with a DOI >5 mm were 1.41 times more likely to have occult neck node metastasis than those with a DOI ≤5 mm. Conclusion Occult neck node metastasis is significantly associated with the DOI. The risk of neck metastasis is higher in patients with a DOI >5 mm., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Muhammad et al.)