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Kashif Asghar,1 Shaarif Bashir,2 Iftikhar Ali Rana,2 Muhammad Abu Bakar,3 Asim Farooq,1 Muhammad Hassan,1 Zukhruf Asif,1 Mahnoor Afzal,1 Iqra Masood,4 Muhammad Ishaq,2 Muhammad Tahseen,2 Sundus Bilal,5 Shafqat Mehmood,5 Nosheen Kanwal,6 Islah Ud Din,6 Asif Loya2 1Department of Basic Sciences Research, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan; 2Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan; 3Department of Cancer Registry and Clinical Data Management, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan; 4Department of Clinical Research, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan; 5Department of Internal Medicine (Gastroenterology), Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan; 6Department of Radiology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, PakistanCorrespondence: Kashif Asghar, Department of Basic Sciences Research, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 7-A Block R-3, Johar Town, Lahore, Punjab, 54000, Pakistan, Tel +92-42-35905000, Fax +92-42-35945206, Email kashifasghar@skm.org.pkBackground/Aim: Hepatocellular carcinoma (HCC) is one of the most common forms of liver cancer that is modulated by the immune system. Programmed cell death ligand-1 (PD-L1) has emerged as a novel therapeutic target in various cancers. Indoleamine 2,3-dioxygenase (IDO) is an immunosuppressive enzyme that is associated with poor prognoses in various cancer types. The aim of this study was to investigate the PD-L1 expression, and clinicopathological features of non-HCV and non-HBV-associated HCC patients, including IDO expression.Patients and Methods: In this study, immunohistochemical analysis was performed to analyze the expression of PD-L1 and IDO. Formalin-fixed paraffin-embedded HCC tumor tissues (n=50) were obtained from the pathology department, at Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH&RC) in Lahore, Pakistan between 2005 and 2022. All the patients were HBV and HCV negative. Furthermore, it was a rare group of patients with no previous history of any viral hepatitis. In addition, for categorical and continuous variables chi-square or Fisher exact test and Mann–Whitney U-test was performed.Results: Of 50 tissue specimens, PD-L1+ was observed in 21 [high: 12 (24%), low: 9 (18%)] and PD-L1- was observed in 29 HCC patients. IDO+ was observed in all 50 specimens [high: 42 (84%), low: 8 (16%)]. Additionally, both PD-L1 and IDO had high expression in 11 (22%) patients. While both PD-L1 and IDO had low expression in 2 (4%) patients. Furthermore, in IDO+/PD-L1- group, 20 (69%) out of 29 patients died while in the IDO+/PD-L1+ group, 9 (43%) out of 21 patients died.Conclusion: Evaluation of IDO and PD-L1 expression may add therapeutic advantage in non-HCV and non-HBV-associated HCC patients that overexpress IDO. Further validation in a larger cohort is warranted.Keywords: programmed cell death ligand-1, indoleamine 2, 3-dioxygenase, non-HCV HCC, non-HBV HCC, immune checkpoint molecules

From pivotal roles in autonomous vehicles, healthcare diagnostics, and surveillance systems to seamlessly integrating with augmented reality, object detection algorithms stand as the cornerstone in unraveling the complexities of the visual world. Tracing the trajectory from conventional region-based methods to the latest neural network architectures reveals a technological renaissance where algorithms metamorphose into digital artisans. However, this journey is not without hurdles, prompting researchers to grapple with real-time detection, robustness in varied environments, and interpretability amidst the intricacies of deep learning. The allure of addressing issues such as occlusions, scale variations, and fine-grained categorization propels exploration into uncharted territories, beckoning the scholarly community to contribute to an ongoing saga of innovation and discovery. This research offers a comprehensive panorama, encapsulating the applications reshaping our digital reality, the advancements pushing the boundaries of perception, and the open issues extending an invitation to the next generation of visionaries to explore uncharted frontiers within object detection.

Technology entrepreneur new venture creation (TENVC) plays an important role in developing and commercializing technologies worldwide. Yet, one of the critical and on-going debates is about the paradigm shift from the trait approach to the behavioral approach which emerges from what successful entrepreneurs do and how they perform, rather than what their personality traits are. Therefore, the purpose of this research was to study both the entrepreneurial spirit and self-efficacy as key factors for TENVC. The mixed methods research was employed by combining the quantitative and qualitative approaches. The samples were chosen based on convenience sampling for the quantitative study and judgment sampling for the qualitative study. The finding shows that both entrepreneurial spirit and self-efficacy are correspondingly important for TENVC among technical students and Institutes of Higher Learning (IHLs). There is only a small difference in value in their positive significant relationship led by self-efficacy compared to entrepreneurial spirit with r=.005 for TENVC of technical students in IHLs. This finding is convergent with the outcome of the case study analysis that both factors are among the key indicators for TENVC of technical students in IHLs. The technology entrepreneur development organizations (TEDO) may utilize this result in developing TENVC in their institutions.

Background A recent government white paper sets out proposals for reforms to the Mental Health Act 1983 (MHA). Some of these proposals affect people with intellectual disabilities and/or autism. Aims To explore both positive and unintended negative effects of the proposed reforms by gathering the perspectives of healthcare workers from multiple disciplines, working with intellectual disability and/or autism in community and in-patient settings. Method A 14-question electronic questionnaire, comprising free-text, multiple choice and five-point Likert scale responses, was sent out via email between April and July 2021, to all multidisciplinary team professionals working in specialist intellectual disability community and in-patient teams in Hertfordshire Partnership University NHS Foundation Trust. Results There were 45 responders, of whom 53% worked in in-patient settings and 47% in out-patient teams. Respondents comprised healthcare professionals from multiple disciplines, 80% of which were non-medical. Most responders agreed with the general principles of the proposed reforms. However, 80% felt there would be potentially unintended consequences, and 76% thought that substantial investment in community services was required in advance of the proposed reforms. Conclusions The proposed MHA reforms may have unintended consequences for people with intellectual disabilities and/or autism. The findings of this study raised key concerns that need to be explored further and addressed before the MHA reforms are implemented. These include community provision, safeguards and use of the Mental Capacity Act, the potential for under or overdiagnosis of mental illness, and effects associated with the criminal justice system.

In this work, we report the results of the compositional analysis of an aluminum gallium arsenide (AlGaAs) sample using the calibration-free laser-induced breakdown spectroscopy (CF-LIBS) technique. The AlGaAs sample was doped with three various concentrations of gallium (Ga), arsenic (As), and aluminum (Al), as reported by the manufacturer, and the CF-LIBS technique was employed to identify the doping concentration. A pulsed Q-switched Nd: YAG laser capable of delivering 200 and 400 mJ energy at 532 and 1064 nm, respectively, was focused on the target sample for ablation, and the resulting emission spectra were captured using a LIBS 2000+ spectrometer covering the spectral range from 200 to 720 nm. The emission spectra of the AlGaAs sample yielded spectral lines of Ga, As, and Al. These lines were further used to calculate the plasma parameters, including electron temperature and electron number density. The Boltzmann plot method was used to calculate the electron temperature, and the average electron temperature was found to be 5744 ± 500 K. Furthermore, the electron number density was calculated from the Stark-broadened line profile method, and the average number density was calculated to be 6.5 × 1017 cm−3. It is further observed that the plasma parameters including electron temperature and electron number density have an increasing trend with laser irradiance and a decreasing trend along the plume length up to 2 mm. Finally, the elemental concentrations in terms of weight percentage using the CF-LIBS method were calculated to be Ga: 94%, Al: 4.77% and As: 1.23% for sample-1; Ga: 95.63%, Al: 1.15% and As: 3.22% for sample-2; and Ga: 97.32%, Al: 0.69% and As: 1.99% for sample-3. The certified concentrations were Ga: 95%, Al: 3% and As: 2% for sample-1; Ga: 96.05%, Al: 1% and As: 2.95% for sample-2; and Ga: 97.32%, Al: 0.69% and As: 1.99% for sample-3. The concentrations measured by CF-LIBS showed good agreement with the certified values reported by the manufacturer. These findings suggest that the CF-LIBS technique opens up an avenue for the industrial application of LIBS, where quantitative/qualitative analysis of the material is highly desirable.

Objectives: This study aimed to investigate the microbiological and clinical heterogeneity of community-onset bloodstream infections (BSIs) and identify features to support targeted empirical antibiotic therapy in the Emergency Department (ED)., Methods: Clinical and microbiological data from 992 BSI cases (1,135 isolates) diagnosed within 24 hours of ED admission at IRCCS Humanitas Research Hospital, Milan, Italy (January 2015-June 2022), were analyzed. Drug resistance was interpreted using EUCAST-2023. Clinical features included age, sex, comorbidities (e.g., cancer, diabetes), infection source, presence of central venous catheters (CVC), ongoing therapies, and sepsis severity. Microbiological data included pathogen identification and antimicrobial susceptibility., Results: Antibiotic-susceptible Escherichia coli (29.5%) was the most common isolate, including extended-spectrum beta-lactamase (ESBL)-producing strains (11.3%), followed by methicillin-susceptible Staphylococcus aureus (MSSA, 8.4%). BSIs due to E. coli were more frequent in patients >60 years (43.9% vs. 27.3%, p<0.001) and associated with ESBL production (OR=2.202, p=0.031) and urosepsis (OR=1.688, p=0.006). Younger patients (≤60 years) had more S. aureus-associated BSIs (22.4% vs. 10.8%, p<0.001) and methicillin resistance (7.9% vs. 3.6%, p=0.021). Carbapenem-resistant Enterobacterales were rare (2.1%-2.8%), predominantly involving Klebsiella pneumoniae. Onco-hematological patients had a lower multidrug-resistance prevalence (9.5% vs. 21.1%, p<0.001)., Conclusions: Community-onset BSIs demonstrated substantial prevalence of resistant pathogens, including ESBL and MRSA, emphasizing the need for robust surveillance systems. Age is a critical factor in guiding empirical antibiotic therapy in the ED., (Copyright © 2025. Published by Elsevier Ltd.)

Acinetobacter baumannii is a significant public health concern due to the emergence of antibiotic-resistant strains. Cefiderocol (FDC), a novel siderophore cephalosporin, has shown promise as a last-line treatment for multidrug-resistant Gram-negative bacteria. However, the emergence of in vivo -acquired FDC-resistant A. baumannii strains highlights the need for advanced tools to identify resistance-associated genomic mutations and address the challenges of FDC susceptibility testing. This study aims to characterize a novel mutation responsible for FDC resistance in A. baumannii and to develop a workflow that integrates genomic and functional analyses for improved antimicrobial resistance monitoring. We examined two carbapenem-resistant A. baumannii isolates from bacteremia cases in two patients ( A. baumannii &#95;5406 from patient A and A. baumannii &#95;5577 from patient B). Initial whole-genome sequence BLAST typing identified both as the same strain. However, a minimum inhibitory concentration (MIC) analysis showed that A. baumannii &#95;5406 was resistant to FDC, while &#95;5577 was not. Further variant calling analysis revealed a novel chromosomal mutation in a gene encoding a TonB-dependent receptor homolog, which is involved in ferric-siderophore and heme uptake. This mutation causes a premature stop codon, likely impairing the receptor's function. Mass spectrometry confirmed that the FDC-resistant strain exhibited reduced antibiotic uptake and intracellular accumulation. This study demonstrates the utility of combining genomic and functional analyses to detect emerging mutations associated with antibiotic resistance. The variant calling approach, together with LC-MS/MS technology, offers a valuable complement to traditional susceptibility testing in clinical settings, potentially improving the identification and monitoring of FDC resistance in A. baumannii . Additionally, this workflow could aid in the epidemiological tracking of resistant strains., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Morosi, Golzato, Bussini, Guma, Tordato, Armanini, Asif, Carella, Morelli, Bartoletti, Da Rin, Casari, Martano, Rescigno, Segata, Carloni and Cento.)

IoT-based Sensors networks play a pivotal role in improving air quality monitoring in the Middle East. They provide real-time data, enabling precise tracking of pollution trends, informed decision-making, and increased public awareness. Air quality and dust pollution in the Middle East region may leads to various health issues, particularly among vulnerable populations. IoT-based Sensors networks help mitigate health risks by offering timely and accurate air quality data. Air pollution affects not only human health but also the region's ecosystems and contributes to climate change. The economic implications of deteriorated air quality include healthcare costs and decreased productivity, underscore the need for effective monitoring and mitigation. IoT-based data can guide policymakers to align with Sustainable Development Goals (SDGs) related to health, clean water, and climate action. The conventional monitor based standard air quality instruments provide limited spatial coverage so there is strong need to continue research integrated with low-cost sensor technologies to make air quality monitoring more accessible, even in resource-constrained regions. IoT-based Sensors networks monitoring helps in understanding these environmental impacts. Among these IoT-based Sensors networks, sensors are of vital importance. With the evolution of sensors technologies, different types of sensors materials are available. Among this carbon based sensors are widely used for air quality monitoring. Carbon nanomaterial-based sensors (CNS) and carbon nanotubes (CNTs) as adsorbents exhibit unique capabilities in the measurement of air pollutants. These sensors are used to detect gaseous pollutants that includes oxides of nitrogen and Sulphur, and ozone, and volatile organic compounds (VOCs). This study provides comprehensive review of integration of carbon nanomaterials based sensors in IoT based network for better air quality monitoring and exploring the potential of machine learning and artificial intelligence for advanced data analysis, pollution source identification, integration of satellite and ground-based networks and future forecasting to design effective mitigation strategies. By prioritizing these recommendations, the Middle East and other regions, can further leverage IoT-based systems to improve air quality monitoring, safeguard public health, protect the environment, and contribute to sustainable development in the region., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Shahid, Shahzad, Tutsak, Mahfouz, Al Adba, Abbasi, Rathore, Asif and Chen.)

Understanding how different Black and other racially minoritised communities thrive is an emerging priority area in mental health promotion. Literature demonstrates health benefits of social capital (social resources embedded within social networks). However, its effects are not always positive, particularly for certain subpopulations who are already disadvantaged.The CONtributions of social NEtworks to Community Thriving (CONNECT) study will use Participatory Action Research (PAR) to investigate social capital as a resource that benefits (or hinders) racially minoritised communities and their mental health. The CONNECT study was designed within a partnership with community organisations and responds to local policy in two South-East London Boroughs, thereby providing potential channels for the action component of PAR. Taking an anti-racism lens, we acknowledge the underpinning role of racism in creating health inequities. We apply an intersectional framework to be considerate of overlapping forms of oppression such as age, gender, socioeconomic status, and sexual orientation as an essential part of developing effective strategies to tackle health inequities. Key components of this mixed methods PAR study include (1) involving racialised minority community members as peer researchers in the team (2) collecting and analysing primary qualitative data via interviews, photovoice, and community mapping workshops, (3) developing relevant research questions guided by peer researchers and collaborating organisations and analysing secondary quantitative data accordingly, (4) integrating qualitative and quantitative phases, and (5) working closely with community and policy partners to act on our findings and use our research for social change.The PAR approach will allow us to engage community (voluntary sector and government) and academic partners in decision making and help address imbalances in power and resource allocation. Knowledge generated through this collaborative approach will contribute to existing community initiatives, policies, and council strategies. This will ensure the views and experiences of racially minoritised communities drive the changes we are collaboratively committed to achieving., Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interest: We have received funding from a commercial source, namely "Wellcome Trust". This does not alter our adherence to PLOS ONE policies on sharing data and materials. The authors have declared that no other competing interests exist., (Copyright: © 2023 Gnan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Extracellular vesicles (EVs) are membrane-derived messengers which have been playing an important role in the inflammation and pathogenesis of lung diseases. EVs contain varieties of DNA, RNA, and membrane receptors through which they work as a delivery system for bioactive molecules as well as intracellular communicators. EV signaling mediates tumor progression and metastasis. EVs are linked with many diseases and perform a diagnostic role in lung injury and inflammation so are used to diagnose the severity of diseases. EVs containing a variety of biomolecules communicate with the recipient cells during pathophysiological mechanisms thereby acquiring the attention of clinicians toward the diagnostic and therapeutic potential of EVs in different lung diseases. In this review, we summarize the role of EVs in inflammation with an emphasis on their potential as a novel candidate in the diagnostics and therapeutics of chronic obstructive pulmonary disease, asthma, and sarcoidosis., (© 2023. The Author(s), under exclusive licence to Springer Nature B.V.)

Surra is a zoonotic disease caused by Trypanosoma evansi (T. evansi), which affects a wide variety of animals worldwide. The disease has a severe impact on the productivity, health, and working capacity of camels and causes mortality and extensive economic losses if not diagnosed early. This is the first comprehensive report on the prevalence of T. evansi infection in dromedaries in Balochistan province. In the present study, 393 blood samples (indigenous, n = 240; imported, n=153) were collected from one-humped camels (Camelus dromedarius) and were tested by molecular methods to estimate the prevalence of T. evansi in three districts (Pishin, Nushki, and Lasbella) of Balochistan province. The overall prevalence of T. evansi among examined camel samples was 28.24% (95% confidence interval (CI): 24.02-32.89%). The risk of T. evansi infection in adult camels (> 10 years) is higher than that in young ones (odd-ration (OR) = 2.7; 95% CI: 1.3357-5.3164%). Moreover, male camels were six times more likely to get an infection than female camels. The detection of T. evansi infection in camels sampled in summer and spring was 3.12- and 5.10-fold higher, respectively, than in camels sampled in winter. In conclusion, our findings showed a high rate of T. evansi infection in camels from the three districts. Our study emphasizes the need for a strict surveillance program and risk assessment studies as prerequisites for control measures., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Levator ani muscle (LAM) avulsion is a common complication of vaginal childbirth and is linked to several pelvic floor disorders. Diagnosing and treating these conditions require imaging of the pelvic floor and examination of the obtained images, which is a time-consuming process subjected to operator variability. In our study, we proposed using deep learning (DL) to automate the segmentation of the LAM from 3D endovaginal ultrasound images (EVUS) to improve diagnostic accuracy and efficiency. Over one thousand images extracted from the 3D EVUS data of healthy subjects and patients with pelvic floor disorders were utilized for the automated LAM segmentation. A U-Net model was implemented, with Intersection over Union (IoU) and Dice metrics being used for model performance evaluation. The model achieved a mean Dice score of 0.86, demonstrating a better performance than existing works. The mean IoU was 0.76, indicative of a high degree of overlap between the automated and manual segmentation of the LAM. Three other models including Attention UNet, FD-UNet and Dense-UNet were also applied on the same images which showed comparable results. Our study demonstrated the feasibility and accuracy of using DL segmentation with U-Net architecture to automate LAM segmentation to reduce the time and resources required for manual segmentation of 3D EVUS images. The proposed method could become an important component in AI-based diagnostic tools, particularly in low socioeconomic regions where access to healthcare resources is limited. By improving the management of pelvic floor disorders, our approach may contribute to better patient outcomes in these underserved areas.

Volatile organic compounds (VOCs) in urban areas are of great interest due to their significant role in forming ground-level ozone and adverse public health effects. Emission inventories usually compile the outdoor VOCs emission sources (e.g., traffic and industrial emissions). However, considering emissions from volatile chemical products (e.g., solvents, printing ink, personal care products) is challenging because of scattered data and the lack of an effective method to estimate the VOCs emission rate from these chemical products. This paper aims to systematically analyse potential sources of VOCs emission in Canada's built environment, including volatile chemical products. Also, spatial variation of VOCs level in the ambient atmosphere is examined to understand the VOC relationship with ozone and secondary organic aerosol formation. The study shows that VOCs level may vary among everyday microenvironments (e.g., residential areas, offices, and retail stores) depending on the frequency of product consumption, building age, ventilation condition, and background ambient concentration in the atmosphere. However, it is very difficult to establish VOC speciation and apportionment to different volatile chemical products that contribute most significantly to exposure and target subpopulations with elevated levels. Thus, tracer compounds can be used to identify inventory sources at the consumer end. A critical overview highlights the limitations of existing VOC estimation methods and possible approaches to control VOC emissions. The findings provide crucial information to establish an emission inventory framework for volatile chemical products at a national scale and enable policymakers to limit VOCs emission from various volatile chemical products., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Carcinomas of the salivary gland are known to be aggressive in nature, making them difficult to manage. The therapeutic options offered include excision of the gland (maxillectomy in cases of palatal tumours), with or without lymph node dissection, proceeded with radiotherapy. Chemotherapy has not produced promising outcomes and has a minimal impact as a therapeutic alternative. Targeted therapy against human epidermal growth factor receptor 2 (HER-2), which is a commonly used treatment modality for their mammary analogues, is not being offered to these patients since scant literature is available showing its usefulness and no promising evidence is present regarding their efficacy and efficiency in such cases. The study aimed to evaluate and quantify the immunohistochemical expression of HER-2 in cases of adenoid cystic carcinoma (AdCC), mucoepidermoid carcinoma (MEC) and salivary duct carcinoma (SDC), which are analogues of similar tumours arising in breast tissue., Methods: A retrospective, cross-sectional study was carried out in the department of Histopathology, Armed Forces Institute of Pathology, Rawalpindi, duration of which was six months. A total of 45 cases (15 of each tumour) were taken, and sampled using non-probability convenience technique. The immunohistochemical marker, monoclonal HER-2 antibody (Leica microsystem Germany) was applied on appropriate blocks of all included cases. The staining pattern and intensity were recorded after visualizing the slides under a light microscope., Results: Seven cases of salivary duct carcinoma and a single case of mucoepidermoid carcinoma expressed positivity for HER-2, while no expression could be seen in the case of adenoid cystic carcinoma. A statistically significant difference was seen when HER-2 expression was compared among the aforementioned tumours., Conclusions: The use of targeted therapy against HER-2 is limited to patients of salivary duct carcinoma and a fraction of patients suffering from mucoepidermoid carcinoma.

Background: In 2005, the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) entered into force. This treaty was developed in response to the global tobacco epidemic, and it includes measures to reduce both demand for and supply of tobacco. The measures related to demand reduction include raising tax, providing cessation services, promoting smoke free public places, banning advertising, and raising awareness. However, there are a limited number of measures for supply reduction, and these mainly include fighting illicit trade, banning sales to minors and providing alternatives to tobacco workers and growers. Unlike regulation of many other goods and services that have been subjected to retail restrictions, there is a lack of resources about restricting tobacco availability through regulation of tobacco retail environment. Considering the potential of retail environment regulations in reducing tobacco supply and consequently reducing tobacco use, this scoping review aims to identify relevant measures., Methods: This review examines interventions, policies, and legislations to regulate tobacco retail environment to reduce tobacco availability. This was done by searching the WHO FCTC and its Conference of Parties decisions, a gray literature search including tobacco control databases, a scoping communication with the Focal Points of the 182 WHO FCTC Parties, and a databases search in PubMed, EMBASE, Cochrane Library, Global Health, and Web of Science., Results: Themes of policies were identified to reduce tobacco availability by regulating retail environment: four WHO FCTC and twelve non-WHO FCTC policies. The WHO FCTC policies included requiring a license to sell tobacco, banning tobacco sale via vending machines, promoting economically alternative activities to individual sellers, and banning ways of sale that constitute a way of advertising, promotion, and sponsorships. The Non-WHO FCTC policies included banning tobacco home delivery, tray sale, tobacco retail outlets in or within a minimum distance from specific facilities, sale in specific retail outlets, and sale of tobacco or one or more of its products, in addition to restricting tobacco retail outlets per density of population and per geographic area, capping the tobacco amount allowed per purchase, limiting the number of hours or days in which tobacco can be sold, requiring a minimum distance between tobacco retailers, reducing tobacco products availability and proximity within a retail outlet, and restricting sale to government controlled outlets., Discussion and Conclusion: Studies show the effects of regulation of the retail environment in influencing overall tobacco purchases, and there is evidence that having fewer retails reduces the level of impulse purchasing of cigarettes and tobacco goods. The measures covered by WHO FCTC are much more implemented than ones not covered by it. Although not all widely implemented, many themes of limiting tobacco availability by regulating tobacco retail environment are available. Further studies to explore such measures and the adoption of the effective ones under the WHO FCTC decisions, could possibly increase their implementation globally to reduce tobacco availability., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Alebshehy, Asif and Boeckmann.)

Introduction and Hypothesis: This study aimed to compare the difference in levator ani muscle (LAM) volumes between 'normal' and those with sonographically visualized LAM defects. We hypothesized that the 'muscle damage' group would have a significantly lower muscle volume., Methods: The study included patients who had undergone a 3D endovaginal ultrasound. The normal (NM) and damage (DM) muscle groups' architectural changes were evaluated based on anterior-posterior (AP), left-right (LR) diameter, and minimal levator hiatus (MLH) area. The puboanalis-puboperinealis (PA), puborectalis (PR), and pubococcygeus-iliococcygeus (PC) were manually segmented using 2.5 vs. 1.0 mm to find the optimal sequence and to compare the volumes between NM and DM groups. POPQs were compared between the NM and DM groups., Results: The 1.0-mm segmentation volumes created superior volume analysis. Comparing NM to the DM group showed no significant difference in LAM volume. Respectively, the mean total LAM volumes were 17.27 cm 3 (SD = 3.97) and 17.04 cm 3 (SD = 4.32), p = 0.79. The mean MLH measurements for both groups respectively were 10.06 cm 2 (SD = 2.93) and 12.18 cm 2 (SD = 2.93), indicating a significant difference (p = 0.01). POPQ analysis demonstrated statistically significant differences at Ba and Bp parameters suggesting that the DM group had worse prolapse (p = 0.05, 0.01, respectively)., Conclusions: While LAM volumes are similar, there is a significant difference in the physical architecture of the LAM and the POPQ parameters in muscle-damaged patients compared to the normal group., (© 2022. The International Urogynecological Association.)

Post-migration factors significantly influence refugee mental health. This scoping review looks at the role of place in refugee mental health. We included 34 studies in Global North high-income countries that elaborated on the place characteristics of facilities, neighbourhoods, urban and rural areas, and countries. While the role of place remains under-theorised, all studies reveal common characteristics that support a strong relationship between place of residence, refugee mental health and wellbeing outcomes in post-migration context. Given that refugees often have little or no choice of where they ultimately live, we suggest future research should focus on how characteristics of place co-constitute post-migration refugee mental health risks, protections, and outcomes., Competing Interests: Declaration of competing interest None., (Crown Copyright © 2023. Published by Elsevier Ltd. All rights reserved.)

Background: Outbreaks of small ruminant morbillivirus (SRMV) are regularly occurring in Pakistan despite vaccine availability. This study was designed to identify substitutions within the immunogenic structural and functional regions of the nucleocapsid, fusion, and hemagglutinin genes of SRMV and their comparison with vaccinal strains of Nigerian and Indian origin., Methods: Swabs and tissue samples were collected from diseased animals. RT-PCR was used to characterize selected genes encoded by viral RNA. The study's N, F, and H protein sequences and vaccinal strains were analyzed for B and T cell epitope prediction using ABCpred, Bipred, and IEDB, respectively., Results: Significant substitutions were found on the C terminus of the nucleocapsid, within the fusion motif region of the fusion gene and in the immunoreactive region of the hemagglutinin gene., Conclusion: Our results emphasize the need for the development of effective vaccines that match the existing variants of SRMV strains circulating in Pakistan.

This paper describes the development and implementation of a telehealth system in Pakistan to build capacity of healthcare service providers and caregivers of children with developmental disabilities. An asynchronous telehealth system, in the form of a web app, improved therapy-related communication between the therapists and caregivers, thus enabling capacity building through sustained communication among the stakeholders. Participatory Action Research (PAR) identified barriers associated with communication, knowledge transfer, and caregiver learning. Data were collected via observations, interviews, focus groups, and field notes. The experiences of therapists and caregivers were analyzed to design and develop a system that works as a learning mechanism for caregivers in their native languages. The system also addresses socio-economic, geographic, and communication barriers as well as pandemic-imposed obstacles., (Copyright © 2022 Rukaiya Yawar, Zaheeruddin Asif.)

COVID-19 is deemed as the most critical world health calamity of the 21st century, leading to dramatic life loss. There is a pressing need to understand the multi-stage dynamics, including transmission routes of the virus and environmental conditions due to the possibility of multiple waves of COVID-19 in the future. In this paper, a systematic examination of the literature is conducted associating the virus-laden-aerosol and transmission of these microparticles into the multimedia environment, including built environments. Particularly, this paper provides a critical review of state-of-the-art modelling tools apt for COVID-19 spread and transmission pathways. GIS-based, risk-based, and artificial intelligence-based tools are discussed for their application in the surveillance and forecasting of COVID-19. Primary environmental factors that act as simulators for the spread of the virus include meteorological variation, low air quality, pollen abundance, and spatial-temporal variation. However, the influence of these environmental factors on COVID-19 spread is still equivocal because of other non-pharmaceutical factors. The limitations of different modelling methods suggest the need for a multidisciplinary approach, including the 'One-Health' concept. Extended One-Health-based decision tools would assist policymakers in making informed decisions such as social gatherings, indoor environment improvement, and COVID-19 risk mitigation by adapting the control measurements., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2022 Elsevier Ltd. All rights reserved.)

Online learning is becoming more popular with the maturity of social and educational technologies. In the COVID-19 era, it has become one of the most utilized ways to continue academic pursuits. Despite the ease and benefits offered by online classes, their completion rates are surprisingly low. Although several past studies focused on online dropout rates, institutions and course providers are still searching for a solution to this alarming problem. It is mainly because the previous studies have used divergent frameworks and approaches. Based on empirical research since 2001, this study presents a comprehensive review of factors by synthesizing them into a logically cohesive and integrative framework. Using different combinations of terms related to persistence and dropout, the authors explored various databases to form a pool of past research on the subject. This collection was also enhanced using the snowball approach. The authors only selected empirical, peer-reviewed, and contextually relevant studies, shortlisting them by reading through the abstracts. The Constant Comparative Method (CCM) seems ideal for this research. The authors employed axial coding to explore the relationships among factors, and selective coding helped identify the core categories. The categorical arrangement of factors will give researchers valuable insights into the combined effects of factors that impact persistence and dropout decisions. It will also direct future research to critically examine the relationships among factors and suggest improvements by validating them empirically. We anticipate that this research will enable future researchers to apply the results in different scenarios and contexts related to online learning., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Shaikh and Asif.)

This paper presents a novel numerical environmental multimedia modeling system (RNEMM) for assessing the environmental fate of emerging organic contaminants and their relative health risk at a regional scale. The RNEMM is developed based on an integrated numerical algorithm that comprises four sub-models: a river network simulation module, a gaseous phase simulation module, a mass balance based simulation module for soil compartment, and a food web analysis module. This RNEMM has been applied to simulate the spatial distribution of PFOS and assess the consequent health risks for a central water basin region of the Pearl River in China. The study region includes the urban areas of Guangzhou, Foshan, and Dongguan Cities with emission sources of PFOS, which was detected in local water, sediments, and air environment. The spatial concentration distributions of PFOS in water, sediment, air, soil, and various fish species are examined based on RNEMM and compared with the measured data. With a focus on water environment, it shows that the simulated results essentially agree well with measured concentrations. Comparing the simulated results and the measured data collected in 2013, the relative errors are mostly less than 40 % in the surface water and sediment zones for this regional scale field study. Whereas the relative error in the atmosphere zone is less than 5%. In addition, the health risk assessment for children and adults is conducted based on the RNEMM approach. The hazard quotient (HQ) values for the 95th percentile in most subareas of the study region are higher than 0.1, showing a low-risk level for the study period. The results indicate that the RNEMM is a useful modeling tool to manage the environmental and health risks associated with emerging contaminants on regional air, water, soil, and ecosystem at an adequate spatial-temporal resolution., (Copyright © 2022. Published by Elsevier Ltd.)