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ABSTRACT Background and Aims The lack of therapeutic response characterizes treatment‐resistant depression despite undergoing at least two adequate monotherapy trials with medications from distinct pharmacologic classes. The inability to attain remission in patients diagnosed with major depressive disorder (MDD) is a significant issue of concern within public health. Therefore, the management of treatment‐resistant depression (TRD) poses significant obstacles for both patients and healthcare professionals. Our goal was to investigate the published literature concerning different options for treatment for TRD, including those that do not involve the use of medications. Methods We thoroughly searched the literature in the Google Scholar, PubMed, and ScienceDirect databases to find publications relevant to our narrative review and extracted data from appropriate data. For this review, literary works written solely in English were chosen. Results Ongoing research is being conducted to explore the treatment options for TRD, including pharmacological and nonpharmacological interventions. Pharmacological interventions include a wide range of therapeutic approaches, including but not limited to investigating innovative medications and strategies such as augmentation, switching, and combination therapies involving established and emerging drugs. Nonpharmacological interventions, including brain stimulation such as theta burst stimulation, deep brain stimulation, electroconvulsive therapy, repetitive transcranial magnetic stimulation, intermittent transcranial magnetic stimulation, and magnetic seizure therapy, as well as psychotherapeutic approaches, are being explored for the management of TRD in both present and future contexts. Conclusion Researchers are dedicating significant resources to the aforementioned therapeutic interventions to advance the development of novel and efficacious treatment options for TRD and enhance our comprehension of the underlying disease. This review focused on looking at recent research concerning therapeutic interventions for TRD.

Seed mycoflora poses significant challenges to rice production, leading to substantial economic losses. Fourteen samples of stored and freshly harvested seeds of five rice varieties were collected from the Agricultural farm of Orissa University of Agriculture and Technology, Bhubaneswar, Odisha, to study the morphology of the mycoflora associated with rice seeds and their impact on seed health and quality. Eight fungal species, including Fusarium pallidoroseum, Fusarium fujikuroi, Curvularia lunata, Helminthosporium oryzae, Trichoconis padwickii, Aspergillus flavus, Rhizopus sp., and Penicillium sp., were isolated, identified, and morphologically characterized based on colony growth, mycelial features, conidial structures, and spore measurements. The rice varieties, viz., Hema, Jyotirmayee, Swarna, Lalat, and Annapurna, were artificially inoculated with F. pallidoroseum, F. fujikuroi, T. padwickii, C. lunata, and H. oryzae. Seeds showed that the fungi had a variable effect on seed quality parameters like germination, seedling vigor index I and seedling vigor index II, speed of germination, and seed health. A maximum of 16.33% reduction of germination was observed by T. padwickii, followed by F. fujikuroi (14.80% in Hema). Seedling vigor (1754.81) incited by T. padwickii inoculation was recorded to be the lowest. Seed rot up to 15.8% was observed in the case of F. fujikuroi. The percentage of root discoloration reached 40.0% by F. pallidoroseum and T. padwickii. In Jyotirmayee, C. lunata caused an 18.88% germination reduction and the lowest seedling vigor (1866.03) by T. padwickii. T padwickii also caused the highest reduction of seedling dry weight (36.12%) in this variety. The result reveals the diversity and prevalence of fungal pathogens in rice seeds. Hence, this study underscores the importance of seed sterilization practices in reducing fungal contamination and the requirement of thorough seed examination to reduce the effects of seed mycoflora associated with rice seeds, which could affect rice production.

Abstract Pakistan has faced an electricity shortfall for over two decades despite various efforts taken at different levels. Though electricity supply in recent times has crossed the demand, the supply‐side stresses and deciding optimal power generation pathways have always been a challenge for policymakers and researchers. In this study using a LEAP energy model, following the sectoral electricity demand forecast, four supply‐side scenarios have been developed and analyzed for the study period 2017‐2055. In each scenario, referred to as Business as Usual (BAU), Renewable Energy Technologies (RET), Coal Power Penetration (CPP), and High‐Efficiency Low‐Emission (HELE) scenario, electricity generation, installed generation capacity, cost of production, and GHG emissions are estimated and compared for seeking long‐term optimal energy pathways for Pakistan. The study results reveal that for the end year (2055), RET is an environmentally sustainable scenario with an estimated electricity generation of 2421 TWh, which is enough to meet the electricity demand of 2374TWh. The GHG emissions under the RET scenario are estimated to be 857 million metric Tons, which are around 50% less than CPP and 40% less than the BAU scenario. However, the cost of generation is higher than BAU and CPP scenarios. The CPP scenario emerges to be cost‐competitive, however with the highest GHG emissions. This study thus suggests that convergence of RET with the CPP scenario could be an appealing option for Pakistan to meet increasing demand with energy security and environmental sustainability.

Payment through mobile phones is a vital breakthrough in the arena of online businesses and e-commerce. The purpose of this study was to investigate the determinants, enablers, and barriers involved in the success or failure of the mobile payment system (MPS) for the travel industry. The study employs the constructs operationalized from coping theory, unified theory of acceptance and use of technology (UTAUT 2), and innovation resistance theory (IRT). The data has been collected from the 378 travelers who have used MPS for travel bookings for the first time. The customers of various travel agencies have been approached using an online questionnaire. Data has been analyzed using Statistical Package for Social Sciences (SPSS) and Analysis of Moment Structures (AMOS) version 26. The analysis revealed several interesting findings. All of the direct hypotheses for coping theory constructs were accepted except for the mediating role of satisfaction. However, the factors of UTAUT 2 and IRT revealed very thought-provoking findings, questioning various obvious perceptions. The findings of the study can be used by the media agencies, hotels, and travel and tourism departments of the governments, especially in the context of developing nations.

The heat transfer ratio has some important applications in industries and the engineering sector. In this model, the authors used the hybrid nanofluid because the heat transfer ratio of hybrid nanofluid is more as compared to the base fluid; the key objective of this research work is to boost up the heat transfer ratio, for example, to regulate the energy is possible only by adding the heat transmission mechanism in the flow model. The current research paper investigates the steady 3D MHD mixed convection couple stress flow of hybrid nanofluid with hall and ion slip effect. The objective of the current research work is to increase the heat consignment ratio, which is the demand of the manufacturing and engineering sector, this type of flow has some important applications in the industries sector and engineering sector for the purpose of cooling and hotness effect, also hotness and cooling play some important role in daily life. To transform the nonlinear partial differential equation to a nonlinear ordinary differential equation we used the defined similarity transformation. The transform nonlinear ordinary differential equations are solved by an approximate analytical method. The important obtained results are presented in the graphs. The influence of different parameters such as couple stress parameter, mixed convection parameter, nanoparticle volume friction, Hall parameter, magnetic field parameter, thermophores parameter, Eckert number, and prandtl number are taken over graphs. The Cf(skin friction coefficient), Nu(nusselt number), convergence control parameter, and comparison of the present work with the published work are described in the form of tables.

Abstract Background Rhinovirus A and C infections are important contributors to asthma induction and exacerbations. No data exist on the interaction of local immune responses in rhinovirus infection. Therefore, we aimed to determine the tonsillar immune responses according to rhinovirus A, B and C infections. Methods We collected tonsillar samples, nasopharyngeal aspirates and peripheral blood from 42 rhinovirus positive tonsillectomy patients. Fifteen respiratory viruses or their types were investigated from nasopharynx and tonsil tissue, and rhinovirus species were typed. The expression of 10 cytokines and 4 transcription factors (IFN-α, IFN-β, IFN-γ, IL-10, IL-13, IL-17, IL-28, IL-29, IL-37, TGF-β, FOXP3, GATA3, RORC2 and Tbet) were studied from tonsil tissue by quantitative PCR. A standard questionnaire of respiratory symptoms and health was filled by the patient or his/her guardian. The patients were divided into three groups by the determination of rhinovirus species. Results Overall, 16 patients had rhinovirus A, 12 rhinovirus B and 14 rhinovirus C infection. In rhinovirus B positive group there were significantly less men (P = 0.0072), less operated in spring (P = 0.0096) and more operated in fall (P = 0.030) than in rhinovirus A or C groups. Rhinovirus A positive patients had more respiratory symptoms (P = 0.0074) and particularly rhinitis (P = 0.036) on the operation day. There were no significant differences between the groups in virus codetection. In adjusted analysis, rhinovirus C infections were associated with increased IFN-α (P = 0.045) and decreased RORC2 expression (P = 0.025). Conclusions Rhinovirus species associated differently with clinical characteristics and tonsillar cytokine responses.

Abstract Background Persistent human bocavirus 1 (HBoV1) infection is a common finding in patients suffering from chronic tonsillar disease. However, the associations between HBoV1 infection and specific immune reactions are not completely known. We aimed to compare in vivo expression of T‐cell cytokines, transcription factors, and type I/III interferons in human tonsils between HBoV1‐positive and ‐negative tonsillectomy patients. Methods Tonsil tissue samples, nasopharyngeal aspirate (NPA), and serum samples were obtained from 143 immunocompetent adult and child tonsillectomy patients. HBoV1 and 14 other respiratory viruses were detected in NPAs and tonsil tissues by polymerase chain reaction (PCR). Serology and semi‐quantitative PCR were used for diagnosing HBoV1 infections. Expression of 14 cytokines and transcription factors (IFN‐α, IFN‐β, IFN‐γ, IL‐10, IL‐13, IL‐17, IL‐28, IL‐29, IL‐37, TGF‐β, FOXP3, GATA3, RORC2, Tbet) was analyzed by quantitative reverse‐transcription (RT)‐PCR in tonsil tissues. Results HBoV1 was detected by PCR in NPA and tonsils from 25 (17%) study patients. Serology results indicated prior nonacute infections in 81% of cases. Tonsillar cytokine responses were affected by HBoV1 infection. The suppression of two transcription factors, RORC2 and FOXP3, was associated with HBoV1 infection (p

This study contributes to the literature by exploring the relationship between board financial expertise and cash holding policy and further showing how this relation is moderated by multiple large shareholders (MLS). This research is based on agency theory, resource dependence, trade-off, and pecking order theory to confirm how resourceful directors screen cash holding practices. This study selects the 100 listed family firms from the emerging economy of Pakistan for the period of 2006–2017. With the use of static (random and fixed effect estimator) and dynamic (GMM) estimation techniques, this study reveals that the financial expertise of the board members has a significant negative impact on the firms’ cash holding level. Further, moderating effect of MLS between board financial expertise and cash holding is significantly positive due to weak corporate governance mechanisms in family firms. Moreover, the research has implications for developing corporate governance mechanism and the management of liquid assets that corporate management might use for their benefits.

The 3D Prandtl fluid flow through a bidirectional extending surface is analytically investigated. Cattaneo–Christov fluid model is employed to govern the heat and mass flux during fluid motion. The Prandtl fluid motion is mathematically modeled using the law of conservations of mass, momentum, and energy. The set of coupled nonlinear PDEs is converted to ODEs by employing appropriate similarity relations. The system of coupled ODEs is analytically solved using the well-established mathematical technique of HAM. The impacts of various physical parameters over the fluid state variables are investigated by displaying their corresponding plots. The augmenting Prandtl parameter enhances the fluid velocity and reduces the temperature and concentration of the fluid. The momentum boundary layer boosts while the thermal boundary layer mitigates with the rising elastic parameter (α2) strength. Furthermore, the enhancing thermal relaxation parameter (γe)) reduces the temperature distribution, whereas the augmenting concentration parameter (γc) drops the strength of the concentration profile. The increasing Prandtl parameter declines the fluid temperature while the augmenting Schmidt number drops the fluid concentration. The comparison of the HAM technique with the numerical solution shows an excellent agreement and hence ascertains the accuracy of the applied analytical technique. This work finds applications in numerous fields involving the flow of non-Newtonian fluids.

Abstract Background Tonsils provide an innovative in vivo model for investigating immune response to infections and allergens. However, data are scarce on the differences in tonsillar virus infections and immune responses between patients with tonsillar hypertrophy or recurrent tonsillitis. We investigated the differences in virus detection and T cell and interferon gene expression in patients undergoing tonsillectomy due to tonsillar hypertrophy or recurrent tonsillitis. Methods Tonsils of 89 surgical patients with tonsillar hypertrophy (n = 47) or recurrent tonsillitis (n = 42) were analysed. Patients were carefully characterized clinically. Standard questionnaire was used to asses preceding and allergy symptoms. Respiratory viruses were analysed in tonsils and nasopharynx by PCR. Quantitative real-time PCR was used to analyse intratonsillar gene expressions of IFN-α, IFN-β, IFN-γ, IL-10, IL-13, IL-17, IL-28, IL-29, IL-37, TGF-β, FOXP3, GATA3, RORC2 and Tbet. Results Median age of the subjects was 15 years (range 2–60). Patients with tonsillar hypertrophy were younger, smoked less often, had less pollen allergy and had more adenovirus, bocavirus-1, coronavirus and rhinovirus in nasopharynx (all P

Abstract This paper explores the extent to which global health governance – in the context of the early implementation of the Sustainable Development Goals is grounded in the right to health. The essential components of the right to health in relation to global health are unpacked. Four essential functions of the global health system are assessed from a normative, rights‐based, analysis on how each of these governance functions should operate. These essential functions are: the production of global public goods, the management of externalities across countries, the mobilization of global solidarity, and stewardship. The paper maps the current reality of global health governance now that the post‐2015 Sustainable Development Goals are beginning to be implemented. In theory, the existing human rights legislation would enable the principles and basis for the global governance of health beyond the premise of the state. In practice, there is a governance gap between the human rights framework and practices in global health and development policies. This gap can be explained by the political determinants of health that shape the governance of these global policies. Current representations of the right to health in the Sustainable Development Goals are insufficient and superficial, because they do not explicitly link commitments or right to health discourse to binding treaty obligations for duty‐bearing nation states or entitlements by people. If global health policy is to meaningfully contribute to the realization of the right to health and to rights based global health governance then future iterations of global health policy must bridge this gap. This includes scholarship and policy debate on the structure, politics, and agency to overcome existing global health injustices.

Here, in this research article, we have investigated an incompressible viscoelastic fluid flow over a uniform stretching surface sheet along with slip boundary conditions in the presence of porous media. The partial differential equations which govern the fluid flow are changed into ordinary differential equations through suitable similarity transformation variables. Finally, the transformed ordinary differential equations are solved with the help of a seminumerical technique known as the homotopy analysis method (HAM). The uniqueness of our study is not only to analyze and carry out the effect of the elastic parameter but also to account for viscous dissipation which is important in the case of optically transparent flow. The novel effects for the parameters which affect the flow and heat transfer, such as the Eckert number, porous medium parameter, and the velocity slip parameter, are studied through graphs. Also, the convergence analysis for the proposed method is addressed. Additionally, for the sake of validation, the present work is also compared with the already published work and an outstanding agreement is found.

Aim. The aim of this study was to assess the changes of markers of DNA damage by glycation and oxidation in patients with type 2 diabetes and the association with diabetic nephropathy. Methodology. DNA oxidation and glycation adducts were analysed in plasma and urine by stable isotopic dilution analysis liquid chromatography-tandem mass spectrometry. DNA markers analysed were as follows: the oxidation adduct 7,8-dihydro-8-oxo-2′-deoxyguanosine (8-OxodG) and glycation adducts of glyoxal and methylglyoxal—imidazopurinones GdG, MGdG, and N2-(1,R/S-carboxyethyl)deoxyguanosine (CEdG). Results. Plasma 8-OxodG and GdG were increased 2-fold and 6-fold, respectively, in patients with type 2 diabetes, with respect to healthy volunteers. Median urinary excretion rates of 8-OxodG, GdG, MGdG, and CEdG were increased 28-fold, 10-fold, 2-fold, and 2-fold, respectively, in patients with type 2 diabetes with respect to healthy controls. In patients with type 2 diabetes, nephropathy was associated with increased plasma 8-OxodG and increased urinary GdG and CEdG. In a multiple logistic regression model for diabetic nephropathy, diabetic nephropathy was linked to systolic blood pressure and urinary CEdG. Conclusion. DNA oxidative and glycation damage-derived nucleoside adducts are increased in plasma and urine of patients with type 2 diabetes and further increased in patients with diabetic nephropathy.