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The ankle is a region crowded with multiple neurovascular and musculotendinous structures. We describe a case of a rare neurological complication following ankle surgery.

In order to ensure safe and sustainable design of geosynthetic-reinforced soil foundation (GRSF), settlement prediction is a challenging task for practising civil/geotechnical engineers. In this paper, a new hybrid technique for predicting the settlement of GRSF has been proposed based on the combination of evolutionary algorithm, that is, grey-wolf optimisation (GWO) and artificial neural network (ANN), abbreviated as ANN-GWO model. For this purpose, the reliable pertinent data were generated through numerical simulations conducted on validated large-scale 3-D finite element model. The predictive power of the model was assessed using various well-established statistical indices, and also validated against several independent scientific studies as reported in literature. Furthermore, the sensitivity analysis was conducted to examine the robustness and reliability of the model. The results as obtained have indicated that the developed hybrid ANN-GWO model can estimate the maximum settlement of GRSF under service loads in a reliable and intelligent way, and thus, can be deployed as a predictive tool for the preliminary design of GRSF. Finally, the model was translated into functional relationship which can be executed without the need of any expensive computer-based program.

The acme of this paper was to examine the QR code payment services adoption by retailers in Pakistan. An all-inclusive review of the literature and data analysis has justified the purpose to use this inventive technology. The study established that innovation diffusion theory (IDT) dimensions and convenience impacted the usefulness of QR code payment services which are well-thought-out critical antecedents of accepting future technologies. The inferences of this research work provide valuable acumens for banks, financial institutions, and the government to develop a platform about digital payment for the retailers, wholesalers, and the end consumers. Further, the study approves that QR code payment services will aid to advance the business operations in Pakistan in the COVID-19 pandemic.

The amount of biological information generated in the last two decades is enormous because of Next generation sequencing (NGS) discovery that has enabled researches to sequence and model almost every organism and also due to rapid advancements in techniques and tools in experimental research. The research which was first carried out at fields, labs and clinics is now started with computational analysis (in-silico) of information, modeling, experiment planning and hypothesis development. Various applications of bioinformatics are algorithms, databases, and other data analysis tools and softwares that enable storage, analysis, retrieval, annotation and visual interpretation of biological information which in turn increases the knowledge of various biological systems that help in making new discoveries regarding production, human health, animal health and plant health keeping in mind the challenges of climate change, water and area shortage. This will help not only in increased plant and animal production but also in management and treatment of various human, animal and plant diseases in addition to the underlying mechanisms and strategies of the rapidly evolving pathogenic microorganism and antibiotic resistance.

Marston’s load theory is commonly used for understanding the soil–conduit interaction. However, there are no practical methods available which can estimate the Marston’s soil prism (MSP) width ratio. Moreover, the advent of soft computing methods has made many traditional approaches antiquated. The main purpose of this work is to compare and evaluate the predictive abilities of several machine learning-based models in predicting the MSP width ratio for the reinforced concrete (RC) and corrugated steel (CS) conduits. By utilizing the finite element modelling, a large-scale dataset was generated for the width of the soil prism for both types of conduit material, when buried under sandy soils of varying stiffness. After preparing the required dataset, feature validity technique based on correlation-based feature selection was employed to find the most influential parameters affecting the MSP width. Thereafter, five regression-based data driven models namely artificial neural networks (ANN), least-square support vector regression, extreme learning machine, Gaussian process regression, and multiple linear regression were developed to forecast the MSP width ratio. The results showed that the ANN outperforms the other predictive models for both the conduit types. In addition, due to the excellent overall performance of the ANN, it was translated into functional relationship for predicting the MSP width ratio for RC and CS conduits.

Purpose This paper aims to conceptualize the nexus between the participatory finance and the higher ethical objectives within the Islamic moral economy, also termed as Maqasid al Shari’ah. Design/methodology/approach Insights from the extant Islamic economics and finance literature are integrated through an interpretative systematic review using the principles from critical interpretative synthesis (CIS). Findings A coherent framework is synthesized comprising the typology of the Maqasid al Shari’ah, the axioms of participatory finance and their nexus which is formulated by theorizing the common thread of meaning through the axioms of participatory finance and Maqasid al Shari’ah at the interpretative level. This framework postulates that the participatory finance fits well in the ethos and the value system of Islam. Moreover, “social well-being” invariably provides the nexus between the Maqasid al Shari’ah and participatory finance. Originality/value This study contributes to the Islamic economics and finance literature by integrating the dissenting views from the divergent literature related to the basic philosophy of Shari’ah and participatory finance and provides grounds for policy implications, particularly, for designing the financial products. Moreover, it demonstrates an application of interpretative systematic review in Islamic banking and finance research.

Objective: The objective of this study is to to determine the association of high BNP level with heart failure in patients presenting with STEMI. Study Design: Cohort Study. Setting: Department of Cardiology, Punjab Institute of Cardiology, Lahore. Period: 01 January 2017 to 30 June 2017. Material & Methods: After meeting the inclusion criteria 150 patients were enrolled. Informed consent and demographic information was taken. Then patients divided in two groups, high and normal BNP groups. Then patients were admitted in cardiology wards and were followed-up there for 5 days. Patients evaluated for symptoms of heart failure and underwent echocardiography for confirmation of presence or absence of heart failure. All the collected data was entered and analyzed on SPSS version 21. Results: In this study the mean age high BNP group was 48.87± 10.18 years while the mean age in normal BNP group was 48.99±12.15 years. Male to female ratio of the patients was 2:1. The heart failure occurred in 19(12.67%) patients. There is 1.58 times higher risk of heart failure in high BNP than normal BNP i.e. RR=1.58[1.14-2.19]. Conclusion: This present study concluded that high BNP level is strongly associated with heart failure in patients presenting with STEMI.

With the increasing prevalence of solar photovoltaics in the renewable energy mix, the need for device-level assessment has greatly increased. This is challenging in rural, off-grid areas with limi...

Extracorporeal membrane oxygenation (ECMO) is considered a salvage therapy in patients with acute respiratory distress syndrome (ARDS) and refractory hypoxemia (hypoxemia persisting despite lung-protective ventilation). One aspect of ECMO is whether there would be an application of the technology related to the Coronavirus pandemic. The number of people diagnosed with Coronavirus disease (COVID19) has crossed the five million mark on 9 August 2020, with a case fatality rate of 5.2%. Due to this exponential increase in the number of coronavirus disease (COVID19) cases particularly the ones associated with ARDS, experts are evaluating the need for ECMO in intensive care units. Herein, we chronicle a review encompassing the available evidence on ECMO and its potential role in COVID19 ARDS, as we aim for optimal patient care with appropriate resource utilization and conservation.

The steady and controlled desalination is achievable with Hybrid-CV-CC capacitive deionization (CDI). In this paper, we assess the performance of Hybrid-CV-CC CDI by evaluating the standard perform...

This study aims to uncover the determinants for the formulation of accounting practices and their impact on firm performance in Pakistan through the lens of institutional theory. Based on a pragmatic approach, this study has collected data from 455 participants and 21 semi-structured interviews have been conducted. Firstly, it is noted that accounting practices can be traced back to the Mughal regime, and subsequently underwent a major development in the British colonial system. Secondly, our results indicate that institutional factors, namely, accounting regulatory framework, political factors, economic factors, cultural factors, and country-specific factors have also played a major role in the development of accounting practices after the creation of Pakistan as a separate state. Finally, this study suggests that the development of accounting practices have a novel contribution towards the performance of firms. This research thus provides a pathway for policymakers in this county to closing the gaps between accounting practices and the policies of the International Accounting Standard Board (IASB). Furthermore, firms can enhance their performance by implementing international accounting standards. This paper helps Pakistan’s regulatory institutions such as the SECP (Securities and Exchange Commission of Pakistan) and SBP (State Bank of Pakistan) in the process of developing new policies. Such decisions are related, but not limited to: attracting foreign investments, economic expansion, and international trade. Furthermore, it provides a pathway for firms to improve their performance. Ultimately, this research fills the gap as concerns international accounting standards by assessing, both empirically and theoretically, the role of various determinants for the formulation of accounting practices and their impact on the performance of firms.

This study empirically investigates the role of employees’ perceptions of CSR in improving their green behavior in the hospitality industry. In addition, this study investigates the mediating role of employee well-being and the moderating role of hotels’ environmental strategy in this relationship. Empirical analysis is performed in a cross-country setting using evidence from Pakistan and Italy. The study model is tested through PLS-SEM using survey data of 485 hotel employees. Findings from the overall sample and country-specific samples reveal that CSR is positively and significantly related to employee green behavior. Moreover, employee well-being serves as a significant mediator in the relationship between corporate social responsibility and employee green behavior, while hotels’ environmental strategy significantly moderates this relationship in the overall and country-specific samples. These results suggest that paradoxically, though the selected countries have different tourism implementation levels, economic development, and cultures, the employees’ perceptions of CSR and its effect on their green behavior do not vary significantly across both countries.

Background Households, as end energy users, consume grid electricity to meet their energy demands. However, grids across the globe for energy production are majorly based on fossil fuel technology and make the highest contributions to global warming and climate change due to greenhouse gases (GHG) emissions. This generic study aims to investigate the minute role of a single-end energy consumer in GHG mitigation by switching to a rooftop PV system to meet his energy demands and trading surplus energy to the grid through its techno-economic analysis. Method For the study impact, NASA Meteorological Data are used to select an ideal single energy user equipped with a 10-kW PV system based on annual average daily solar radiation and ambient temperature through MATLAB/Simulink, for 11 populous cities in Pakistan. Helioscope software is used to select tilt and azimuthal angles to maximize the solar radiation intercept. Afterward, RETScreen software is used for cost, financial and GHG analysis. Result and conclusion A single end energy user equipped with a 10-kW PV system switched to a green energy source from a fossil fuel-based grid has the potential to avoid the burning of 3570.6 L of gasoline by producing 16,832 kWh of green energy per annum, while financially recovering the 10-kW PV system’s 7337$ grid-tied investment in 5 years (equity) and in 9 years (equity) in a 9077$ stand-alone system over its 25-year life. This approach provides relief to end energy users from high priced grid electricity through environmental friendliness by mitigating 8.3 tons of CO2 equivalent emissions per annum from energy production, while providing relief to the main grid by grid stabilization through peak shaving, in the broad sense.

The security of communication protocols in the smart grid system is a crucial concern. An adversary can exploit the lack of confidentiality and authentication mechanism to cause damaging consequences. In the substation automation systems that rely on multicast communication between various intelligent electronic devices, the lack of security features in the standard IEC61850 and IEC62351 can invite attackers to manipulate the integrity of the employed publisher–subscriber communication paradigm to their advantage. Consequently, many researchers have introduced various approaches offering authenticity and confidentiality. However, such schemes and methods for the aforesaid standards have computational limitations in compliance with the stringent timing requirements of specific applications in the smart grid. In this paper, we propose an approach that can fully secure the publisher–subscriber communication against confidentiality attacks. In this direction, we develop a demo tool to validate the performance of our proposed security approach for potential factors such as timing requirements and the size of the messages. Finally, we evaluate our scheme considering the requirements of the GOOSE, SMV, and MMS protocols in the substation automation systems.

With the advent of software technologies, over a period of time, the Industrial Control Systems (ICSs) have grown exponentially. Whereas, almost all ICSs comprise Human Machine Interfaces (HMIs), which are the key component for monitoring and controlling complex industrial systems. For decades, traditional HMIs with simple User Interfaces (UIs) remained operational to minimize the complexities and resulting operational costs. However, due to the emergence of smartphone technologies, the perception about user interfaces has been transformed significantly and users now demand same sort of experience with industrial HMIs, as well. There are few industrial solutions, like, ICONICS GraphWorX to support the development of mobile HMI screens. However, such proprietary solutions are quite expensive. Furthermore, the underlying development approaches and source codes are not accessible in public domain. On the other hand, the state-of-the-art approaches for the development of native mobile HMI screens are hard to find in the literature. Consequently, there is dire need of a cost-effective, easy to use, open source framework for the development of native mobile HMI screens. In order to achieve this goal, here we propose, a M odel-driven M obile H MI F ramework ( MMHF ). MMHF comprises, a Unified Modeling Language (UML) Profile for Mobile HMI (UMLPMH) for modeling of HMI screens. MMHF also includes, an open source transformation engine and a M odel D riven M obile-based H MI C ode G enerator (MDMHCG) to automatically transform UMLPMH models into target native mobile HMI implementations. Consequently, MMHF enables simpler way to design the HMI screens using UMLPMH and generates native Mobile HMI Screen implementations automatically using MDMHCG. The empirical evidence of MMHF is demonstrated through three (3) benchmark case studies, which prove that the MMHF is a feasible, cost effective and scalable solution to develop native HMI screens for wide-ranging ICSs.

An efficient and robust alarms management is an extremely desirable feature to prevent critical failures in modern Industrial Control Systems. Generally, alarm systems are categorized into two major components; i.e., Alarm Server and Alarm Client . Alarm server is responsible to process alarms on real time values, while alarm clients display the generated alarms. With the advent of modern technologies, like, Internet of Thing (IoT), the need for mobile alarm clients has significantly been increased, as alarms need to be displayed on different gadgets instead of traditional big screens. Owing to significance of alarms in the industry, several state-of-the-art approaches have been introduced, suggesting various improvements. However, such approaches are only meant for specific industry and cannot be applied across-the-board. Furthermore, full support for mobile clients is not available. On the other hand, certain industrial software products like, SIMATIC WinCC, Genesis64 provide complete alarm solution including mobile client features , as well. However, such solutions are proprietary with higher costs, i.e., pay per tag model. Considering such limitations, this article proposes a novel M odel-driven A larms F ramework ( MAF ) with mobile clients ( Android and iOS ) support. Particularly, MAF comprises an A larm P rofile for I ndustrial C ontrol S ystems ( APICS ) for the modeling of server , mobile clients and configuration requirements of alarms with remarkable simplicity. Furthermore, a complete open source Alarms Profile Transformation Engine ( APTE ) has been implemented to automatically generate alarm server (Kotlin), native Android (Kotlin) and iOS (Swift) alarm clients from APICS-compliant models. The feasibility of proposed framework is demonstrated through two case studies ( flour mill and home automation ). The results prove that MAF not only provides complete alarm server solution to generate bulk of alarms simultaneously, but also supports android and iOS alarm clients for efficient visualization. Besides that, MAF is easy to use , cost-effective and can be applied in wide-ranging industrial applications.

The participatory modes of Islamic financing including Musharakah and Mudarabah are widely accepted as the ideal modes of financing among the jurists of Islamic banking and finance. However, paradoxically, these are not the most popular modes of financing in practice. The practice of the participatory financing in Islamic banking is constrained by several factors. Therefore, Islamic banks are applying the adapted variants of Musharakah. The present study aims to explore the prevailing variants of participatory financing in the Islamic banking industry of Pakistan using multiple case studies strategy. Findings suggest that Islamic banks adapt the participatory financing to make these fit for SME financing, corporate financing, consumer financing, and commodity operations financing within the embedded contractual variants of Musharakah namely diminishing Musharakah and running Musharakah, while pure Musharakah and Mudarabah are not applied in practice. The study also provide insights into the design of participatory financing arrangements and the procedures adopted by Islamic banks for assessing and mitigating the underlying risks associated to the participatory financing , particularly the risk induced by asymmetric information including adverse selection, and moral hazards.

With ever increased food processing in the new millennia, production of agro-industrial waste has been increased tremendously. Although, these waste are rich sources of essential bioactive compounds. In developing countries, the waste materials from agro-industries can help to obtain valuable components. The objective of this manuscript is to manage industrial potato peel waste and to highlight its nutritional and industrial uses. Potato peel waste, by various procedures such as fermentation, extraction and other treatments, can ensue into the products such as bio-fuels, dietary fibre, biofertilizer, biogas, biosorbent, antioxidants and food additives. This paper enlightens the application of potato peel utilization in food and nonfood purposes for example extraction, utilization of bioactive components, biotechnological usage, livestock feed and miscellaneous use. The present article summarized the literature pertaining to the studies of the last twenty years.

Throughout the world, public sector organisations are under continuous pressures from various stakeholders for performance improvement. Public sector, just like corporate sector is also utilising intellectual capital (IC) in various ways and it is being argued that IC as a strategic resource can also help in improving the performance of this sector. However, research on intellectual capital in public sector is still very scarce, and especially, in the context of developing countries, almost non-existent. The IC body of knowledge has evolved through various stages and currently it is moving towards the fourth stage. This paper is focussing on the third stage of ‘IC in practice’. The third stage of IC research advocates the complex and idiosyncratic nature of intellectual capital and stresses on researching ‘IC in action’ i.e., IC practices and managerial implications rather than measuring it. This theoretical paper aims to propose a framework to explore IC phenomenon in the knowledge intensive public sector organisations of a developing country (Pakistan). It raises the issues of the role of IC in value creation or destruction in the public sector and practices associated with intellectual capital, in such organisations which do not have explicit IC management strategies however, through their practices these organisations are managing it. It also develops a conceptual framework which proposes to study the IC practices of the public sector organisations through performative IC, social construction, and structuration lenses in order to grasp the complexity of conceptualising the IC, its particular nature, failure of generalisation of the IC grand theories, and development of IC body of knowledge. This framework focuses on understanding the phenomenon and its role in public sector organisations.The framework contributes towards the IC in Practice perspective of IC body of knowledge in the specific context of public sector organisations in a developing country and suggests that by adopting an appropriate methodology, the practices, management, and development of IC can be better comprehended through this framework.

Background: This study involves the analysis of spectrum of microorganisms, antibiotic resistance pattern, and treatment outcomes among empyema thoracis patients. This study also analyzes the factors associated with unsuccessful treatment outcome and duration of hospital stay among the patients.Methods: This was a descriptive, cross-sectional study carried out in the Pulmonology Ward of the Bahawal Victoria hospital, Bahawalpur, Pakistan. All patients with empyema thoracis registered at the study site during the period of 1 year were included in the study. Multivariate regression analysis was used to analyze the factors associated with duration of hospital stay and unsuccessful treatment outcome among the patients.Results: A total 110 patients were included in the study. Most of the patients (n = 73, 66.4%) were treated with piperacillin/tazobactam alone and in combination with either one or more than one antibiotics as an empiric therapy. Culture was positive in 58 (52.7%) patients and the most commonly identified organisms included, gram-negative Pseudomonas aeruginosa (n = 20; 18.8%) and Klebsiella sp. (n = 11, 10%) followed by same proportion of E. coli. The most commonly identified bacterial isolates showed high level of resistance against antibiotics used as an empiric therapy, while these showed low level of resistance against amoxicillin, clarithromycin, ertapenem, colistin, tigecycline, fosfomycin, rifampicin, and vancomycin. In this study, 82 (74.5%) patients successfully completed the treatment, while 12 (11%) showed no clinical improvement, 5 (4.5%) lost to follow up and 11 (10%) died. In multivariate binary logistic regression analysis, none of the patient attributes were significantly associated with unsuccessful treatment outcome, while in multivariate linear regression analysis, the factors which were significantly associated with duration of hospital stay included; duration of symptoms p = 0.008, beta = −0.247) and resistance to five antibiotic classes (p = 0.02, beta = 0.280).Conclusion: Close to 25% of the patients did not complete the treatment successfully. Most of the common bacterial isolates showed high level of resistance against the broad-spectrum antibiotics used as an empiric therapy. This is alarming. However, better sensitivity of common bacterial isolates against standardized first line treatment for empyema thoracis is promising.

The abstract test cases generated through model-based testing (MBT) need to be concretized to make them executable on the software under test (SUT). Multiple re-searchers proposed different solutions, e.g., by utilizing adapters for concretization of abstract test cases and generation of test scripts. In this paper, we propose our Model-Based Test scrIpt GenEration fRamework (TIGER) based on GraphWalker, an open source MBT tool. The framework is capable of generating test scripts for embedded software controlling functions of a cyber physical system such as passenger trains developed at Bombardier Transportation AB. The framework follows some defined mapping rules for the concretization of abstract test cases. We have evaluated the generated test scripts using an industrial case study in terms of fault detection. We have induced faults in the model of the SUT based on three mutation operators to generate faulty test scripts. The aim of generating faulty test scripts is to produce failed test steps and to guarantee the absence of faults in the SUT. Moreover, we have also generated the test scripts using the correct version of the model and executed it to analyse the behaviour of the generated test scripts in comparison with manually-written test scripts. The results show that the test scripts generated by GW using the proposed framework are executable, provide 100% requirements coverage and can be used to uncover faults at software-in-the-loop simulation level of sub-system testing.

Model-based testing (MBT) has been previously used to validate embedded systems. However, (i) creation of a model conforming to the behavioural aspects of an embedded system, (ii) generation of executable test scripts and (iii) assessment of test verdict, re-quires a systematic process. In this paper, we have presented a three-phase tool-supported MBT workflow for the testing of an embedded system, that spans from requirements specification to test verdict assessment. The workflow starts with a simplistic, yet practical, application of a Domain-Specific Language (DSL) based on Gherkin-like style, which allows the requirements engineer to specify requirements and to extract information about model elements(i.e. states and transitions). This is done to assist the graphical modelling of the complete system under test (SUT). Later stages of the workflow generates an executable test script that runs on a domain-specific simulation platform. We have evaluated this tool-supported workflow by specifying the requirements, extracting information from the DSL and developing a model of a subsystem of the train control management system developed at Alstom Transport AB in Sweden. The C# test script generated from the SUT model is successfully executed at the Software-in-the-Loop (SIL) execution platform and test verdicts are visualized as a sequence of passed and failed test steps.

Currently, a sufficient amount of literature is available on the application of food processing by-products in different food systems. This is much important for a successful valorization of these by-products, which always demands comparable quality and safety standards and higher consumer acceptability. The dairy industry carries a major share in the food sector where different types of ingredients and additives are required to produce a variety of dairy products. Ιn this chapter the potential applications of food-processing by-products in the dairy industry are discussed in detail.

Person re-identification refers to finding person images taken from different cameras at different times. Supervised re-id methods rely on labeled dataset, which is usually not available in real word situations. Therefore, a procedure must be devised to adapt unseen domains in an unsupervised manner. In this work we have proposed a domain adaptation methodology by using hybrid Vision Transformers and incorporating Cluster loss along with the widely used Triplet loss. Our proposed methodology has shown to improve results of exiting unsupervised domain adaptation methods for person re-id.

This chapter focuses on the energy and exergy optimization of a geothermal powered cogeneration system that can provide electrical energy and process heating. Geothermal is a form of renewable energy generated in the subsurface of the Earth due to the radioactive decay of matter. The thermodynamic state of geothermal fluid varies with location, and therefore, affects the overall production and efficiency in the cogeneration system. Parametric studies are carried out to observe the effects of variations of properties of the geothermal well on the energy and exergy outputs of the system. Multiobjective particle swarm optimization (MOPSO) is proposed as an optimization approach to optimize the energy and exergy parameters.

Successful deployment of Long-Range Wide Area Network (LoRaWAN) technology in several Industrial Internet of Things (IIoT) scenarios, such as Outage Management System (OMS) in smart metering, rely on low energy consumption of the end device. In this work, we conducted an experiment to demonstrate an on-off Denial-of-Service (DoS) attack to analyze the impact on the energy consumption of the LoRaWAN end device. We implemented the attack that manipulates the end device to remain in packet retransmission mode for several seconds. The conducted experiments show that the configurable parameters of LoRaWAN that are required for applications, like OMS, are susceptible to energy consumption attacks. In summary, our results show that when an on-off DoS attack is performed, the end device utilizing the Spreading Factor (SF) 12 consumes 92 times more energy due to packet retransmissions as compared to the end node using SF 7 under no attack.

The prevalent use of surveillance cameras in public places and advancements in computer vision warrants most sought-after research in the domain of anomalous activity detection. Several approaches have been proposed for the detection of an anomaly in videos. Spatio-temporal features using 3D Convolutional Network (C3D) is a state-of-the-art approach for this problem where deep multiple instance ranking framework is being investigated. However, this approach requires the segmentation of videos before feature extraction that can produce unstable segmentation results and can have a large memory footprint. In this paper, we extract video features using the Inception-v3 deep learning network which eliminates segmentation. Moreover, to improve the robustness of the backbone classifier we propose to use a homogeneous bagging ensemble of the 3-Layer Fully Connected (FC) Network. Experiments are conducted on the UCF-Anomaly detection dataset and exhibit improved performance over existing approaches.

Tanshinone is a herbal medicinal compound described in Chinese medicine, extracted from the roots of Salvia miltiorrhiza (Danshen). This family of compounds, including Tanshinone IIA and Tanshinone I, have shown remarkable potential as anti-cancer molecules, especially against breast, cervical, colorectal, gastric, lung, and prostate cancer cell lines, as well as leukaemia, melanoma, and hepatocellular carcinoma among others. Recent data has indicated that Tanshinones can modulate multiple molecular pathways such as PI3K/Akt, MAPK and JAK/STAT3, and exert their pharmacological effects against different malignancies. In addition, preclinical and clinical data, together with the safety profile of Tanshinones, encourage further applications of these compounds in cancer therapeutics. In this review article, the effect of Tanshinones on different cancers, challenges in their pharmacological development, and opportunities to harness their clinical potential have been documented.

Objective: To observe the positive predictive value of MRI, taking histopathology as gold standard in detecting spinal intradural tumors.Materials and Methods: Total 180 cases were included through non-probability purposive sampling, at Ganga Ram Hospital, Radiology department, Lahore. The radiological diagnosis obtained through MRI, was observed. The cases fit in inclusion criteria were underwent surgery and their histopathological findings were observed. Comparison between the outcomes of MRI and histopathology were undertaken, keeping histopathology as gold standard. Positive predictive value of MRI in the diagnosis of intradural spinal tumor was calculated andpresented in the form of percentages and frequency.Results: There were total 180 patients presenting in OPD with the mean age of 45.71 ± 13.57 years. There were 112 (62%) male. Male to female ratio was 1.6:1. There were 134 (74.4%) cases who were positive for malignant spinal intradural tumor on histopathology showing the PPV of MRI as 74.4%.Conclusion: Magnetic Resonance Imaging is very beneficial imaging tool for early diagnosis of spinal cord tumors.

This study focused on the modeling and simulation of the Ethylene Oxide (EO) production process in Aspen plus software and energy optimization of the whole process using the Pinch analysis. This work focused on ethylene oxide production by the air-based system and modeled and simulated the whole process in Aspen plus® using the S.R.K. and PSRK thermodynamic models. By process design, modeling and simulation, the behavior of the actual process has been predicted. After process simulation, it has been concluded that control the oxygen concentration by controlling the airflow and controlling the reactor's temperatures causes an impact on our desired product. When the oxygen concentration increases, ethylene is oxidized completely and generated useless products such as carbon dioxide and water to enhance production. Energy optimization of ethylene oxide production is completed through Pinch analysis and saves 18.27million $ per year, which is consumed in heating or cooling streams.

This article examines factors that can be argued to influence the academician's behavioral intentions in using open government data (OGD). Policy-makers and practitioners will determine policy instruments in increasing acceptance and use of OGD by maintaining a good understanding of these factors. In this article, Rogers' Diffusion of Innovations (DOI) theory has been proposed and used in order to empirically examine these factors taking perceived characteristics of innovations. Relevant hypotheses have been developed through the literature review, forming a preliminary research model, while respective influences of the factors on the behavioral intention to use open government data have been statistically tested. Results have shown that compatibility and voluntariness have had a strong influence on behavioral intention, whereas a 66.2% variance has been found in academicians' behavioral intentions to use open government data.

Interbody devices have revolutionized lumbar spinal fusion surgery by improving mechanical stability and maximizing fusion potential. Several approaches for interbody fusion exist with two of the most common being anterior lumbar interbody fusion (ALIF) and posterior lumbar interbody fusion (PLIF). This study aims to compare patient data, hospital outcomes, and post-operative complications between an anterior vs. posterior approach to lumbar interbody fusion.This retrospective cohort study utilized the Nationwide Inpatient Sample (NIS) and International Classification of Diseases, 10th edition (ICD10) codes to identify patients (18 +) from 2016 to 2018 who underwent lumbar interbody fusion under an anterior or posterior approach. Patients missing identifiers were excluded from this study. Patients were further investigated by demographic data and the presence of comorbidities. Hospital outcome data was investigated by length of stay (LOS), total hospital charges, mortality, and post-operative complications.373,585 patients were included in this study. 257,975 (69%) underwent fusion via a posterior approach, and 115,610 (31%) via an anterior approach. Patients undergoing posterior approach were found to have a greater number of comorbidities than anterior (3.5 vs. 2, respectively, p = 0.001). The posterior approach was associated with decreased LOS (3.59 vs 4.19 days, p = 0.0001) and decreased total hospital charges ($141,700 vs $211,015, p = 0.0001). A posterior approach was found to have lower rates of post-operative complications. For the anterior approach cohort, tobacco dependence (OR=1.31 [1.20-1.42, p = 0.001], diabetes (OR=2.41 [2.33-2.49, p = 0.001], and osteoporosis (OR=1.42 [1.30-1.54, p = 0.001] were found to be significant independent predictors of post-operative pseudoarthrosis. Obesity (OR=1.28 [1.14-1.42, p = 0.001], tobacco dependence (OR=1.48 [1.40-1.56, p = 0.001], diabetes (OR=2.21 [2.10-2.32, p = 0.001], congestive heart failure (OR=1.20 [1.01-1.39, p = 0.04], and osteoporosis (OR=1.65 [1.55-1.75, p = 0.001], were found to be independent predictors of post-operative pseudoarthrosis in the posterior cohort.Patients who underwent the anterior approach suffered from increased hospital charges, length of stay, and increased risk of post-operative complications including mortality, wound dehiscence, hematoma/seroma, and pseudoarthrosis. Comorbid disease plays a significant role in the outcome of successful fusion with variable effect depending on the surgical approach. Increasing due diligence in patient selection should be considered when choosing an approach in pre-operative planning.

Bridge deck systems developed using conventional materials like concrete and steel have low strength-to-weight ratios; take long time to install; are prone to premature deterioration due to corrosion, especially in humid environment; and have high maintenance needs. Therefore, prefabricated deck systems developed using modern materials are the need of the time. These deck systems are lightweight, easy to install, have low maintenance cost and have long life. Such deck systems have wide application, especially in movable bridges. This study summarizes the current state of knowledge on modern/lightweight bridge deck systems including aluminum, fiber-reinforced polymers (FRPs), ultra-high-performance concrete (UHPC) and Hybrid systems. Main findings and recommendations drawn by various researchers on the basis of experimental work and computer-aided analysis are presented. Prefabricated bridge deck systems developed using these materials mostly satisfy the strength and serviceability requirements, and have potential to replace the conventional deck systems. The primary objective of this study was to support researchers, highway engineers, consultants and contractors in the field of bridge engineering to get an outline of recent researches on prefabricated bridge deck systems.

This research work focuses on various aspects of hybrid fixed-wing Unmanned Aerial Vehicle (UAV), from conceptual design to hardware implementation. In this paper, we present different design parameters of the hybrid UAV, and also discuss the flight modes that the hybrid UAV is capable of attaining. Mathematical model is briefly discussed which comprises of general equations regarding force, moment and orientation. Control system was designed using the standard state space representation. The paper also shares information concerning the hardware implementation of the hybrid UAV. Different controllers were designed for implementing the control loop of pitch, yaw, roll and height. Software and hardware tuning results of these control loops are also given separately. Moreover, we also explain the establishment of a ground control system, which was used for providing complete telemetry and video feedback.

Background Abnormal peak plantar pressure in neuropathic diabetic foot during walking activities is well managed through the use of appropriate design and material selection for the fabrication of custom made insoles (CMI). The redistribution of plantar pressure is possible by selecting an appropriate material for the fabrication of CMI. The walking activities may alter the plantar pressure distribution; which may differ while using CMI with different materials. Objective The objective of the study was to evaluate the effectiveness of CMI’s materials on plantar pressure distribution during different walking activities, in diabetic feet with neuropathy. Methods The study was conducted on sixteen diabetic neuropathic subjects. The subjects were provided with two types of CMI; CMI-A (Plastazote® and microcellular rubber) and CMI-B (Multifoam, Plastazote® and microcellular rubber). Maximum peak plantar pressure and plantar pressure distribution were determined by Pedar-X® sensor insole during level walking, ramp walking and stair walking. Results The CMI-B lessened the maximum peak plantar pressure from the forefoot throughout the walking activities compared to CMI-A. The contact area was observed as lower using CMI-A compared to CMI-B, while performing walking activities. Conclusion CMI-B, with multifoam as an additional top layer, provided more effective peak plantar pressure reduction at forefoot and it had better plantar pressure distribution compared to CMI-A during level walking and ramp ascending in diabetic foot with neuropathy.

Objectives: The objective of the study is to identify the precipitating factorsamong the patients presenting with AHF (Acute Heart Failure). Study Design: Cross sectionalstudy. Setting: Punjab Institute of Cardiology, Lahore. Duration of Study: 6 months. From01-01-2007 to 30-06-2007. Methodology: The calculated sample size was 170 cases with 5%margin of error, 95% confidence level taking expected percentage of uncontrolled hypertensioni.e. 12% (least percentage among all precipitating factors). Results: In the study group, mostlypatients of AHF were young with mean age of 55 + 6.99 years, male (61.8%), Diabetic (53.5%)and have history of chronic Heart Failure (63.5%). In male the most common precipitating factorof AHF was ACS (39.04%) while in female uncontrolled hypertension (38.46%). Conclusion:In diabetic patients the most common precipitating factor of AHF was ACS (30.7%). In patientswith acute decompensation of chronic heart failure the most common precipitating factor wasnon-compliance of medication (30.55%) while in patients with de novo Acute Heart Failure itwas ACS (41.93%). ACS was the common precipitating factor of Acute Heart Failure (28.2%)among the study group irrespective of gender, diabetes and history of Heart Failure.

The problem of efficient placement of virtual machines VMs in cloud computing infrastructure is well studied in the literature. VM placement decision involves selecting a physical machine in the data center to host a specific VM. This decision could play a pivotal role in yielding high efficiency for both the cloud and its users. Also, reallocation of VMs could be performed through migrations to achieve goals like higher server consolidation or power saving. VM placement and reallocation decisions may consider affinities such as memory sharing, CPU processing, disk sharing, and network bandwidth requirements between VMs defined in multiple dimensions. Considering the NP-hard complexity associated with computing an optimal solution for this VM placement decision problem, existing research employs heuristic-based techniques to compute an efficient solution. However, most of these approaches are restricted to only a single attribute at a time. That is, a given technique of using heuristics to compute VM placement considers only a single attribute, while completely ignoring the impact of other dimensions of placing VMs. While this approach may improve the efficiency with respect to the affinity attribute in consideration, it may yield degraded performance with respect to other affinities. In addition, the criteria for determining VM-placement efficiency may vary for different applications. Hence, the overall goal of achieving VM placement efficiency becomes difficult and challenging. We are motivated by this challenging problem of efficient VM placement and propose policy-aware virtual machine management PAVM, a generic framework that can be used for efficient VM management in a cloud computing platform based on the service provider-defined policies to achieve the desired system-wide goals. This involves efficient means to profile different VM affinities and to use profiled information effectively by intelligent and efficient VM migrations at run time considering multiple attributes at a time. By conducting extensive evaluation through simulation and real experiments that involve VM affinities on the basis of network and memory, we confirmed that the PAVM architecture is capable of improving the efficiency of a cloud system. We elaborate the architecture of a PAVM system, describe its implementation, and present details of our experiments. Copyright © 2016 John Wiley & Sons, Ltd.

Objectives: To compare the frequency of in-hospital mortality of anterior wallmyocardial infarction with and without right bundle branch block. Study Design: Cohort Study.Setting: Cardiology Department of Faisalabad Institute of Cardiology, Faisalabad. Duration:1st September, 2013 to 28th February, 2014. Methodology: 80 patients including both gendersfulfilling the inclusion criteria were collected. Informed consent was obtained from the patients.Effect modifiers such as hypertension, diabetes mellitus, hyper-lipidemia and smoking werenoted. Patients were monitored according to the hospital protocol and mortality was noted.Results: Out of 80 patients, 62(77.5%) were males and 18(22.5%) were females. Smokingwas present in 45% patients, diabetes mellitus in 35% patients, hypertension in 27.5% patientsand hyper-lipidemia in 23.8% patients. In hospital mortality in group A was 23(57.5%) and ingroup B was 7(17.5%) with P value of 0.0001. Conclusion: Acute anterior wall myocardialinfarction combined with right bundle branch block suggests the severity of disease and is anindependent predictor of increased mortality. RBBB after myocardial infarction suggests poorprognosis.

Spina Bifida (SB) is a neural tube defect (NTD) due defect in neural tube,characterized by incomplete closure of spinal column. Occurrence of SB varies in differentcountries. In developed countries, it is about 0.4 per 1000 births, in US 0.7 per 1000 births and inAsia 1.9 per 1000 births. SB mostly occurs during first trimester of pregnancy. Variants of SB areSpina bifida Occulata, Spina bifida Cystica [meningocele and myelomeningocele], Spina bifidaManifesta and Spina bifida Aperta. Among these myelomeningocele is the most common type.Causing agents of SB may be genetic, non-genetic or environmental factors. Non-genetic factorsinvolve anti-convulsant drugs, anti-epileptic drugs, maternal obesity, maternal diabetes andpoor nutritional status (folate and vitamin B12 deficiency). Environmental factors are pesticides,nitrated compounds and air pollution. Common manifestations are brain malformations (ArnoldChiari II malformation and hydrocephalus), spinal cord abnormalities, latex allergy, breathingproblems, urological abnormalities and cardio-metabolic dysfunction. Diagnostic techniquesfor Spina bifida are ultrasound screening, Magnetic Resonance Imagining (MRI), amniocentesisand maternal serum alpha-fetoprotein. To prevent the risk of Spina bifida, it is recommended forthe mother to use 0.4mg of folic acid per day or in mothers affected with multiple pregnanciesrecommended dose of folic acid is 4mg per day.

There is ample literature within the realm of innovation management suggesting that social innovation is a process characterized by different stages. However, it is not too clear how different actors perform different activities within each stage of this process, thus lending us only a parochial view of social innovation so far. Taking influence from Murray et al.'s seminal work in 2010, this paper presents the role of actors within different stages of the social innovation process including prompts, proposal of ideas, prototyping, sustainability, scaling and systemic change. The case of the mobile courts project in Khyber Pakhtunkhwa has been taken as a social innovation by employing qualitative methods. Results suggest that mobile courts as an innovation for quick and low-cost dispensation of justice went through the first three stages successfully due to the crucial role played by the then Chief Justice as one of the key actors. However, the project encountered various problems during the sustainability stage such as security, legislation, resources, defective judicial system, lack of awareness, and people's perceptions about mobile courts. Consequently mobile court as an innovation did not pass through the last two stages, i.e. scaling and systematic change. One of the key problems was weak cross-sectoral collaboration among actors. The paper concludes by suggesting implications for future research on and practice of social innovations

Combine Pegylated interferon therapy and ribavirin is most commonly usedtreatment in chronic hepatitis C patients. Along with other complications, different psychiatricdisorders are observed during combination therapy including depression. Depression is themajor morbidity as it may lead to different destructive ideation including suicide among patientson treatment. We have tried to calculate the frequency of depression along with associatedfactors in our present study. Objectives: To find out the frequency of depression duringPegylated interferon therapy for chronic hepatitis C. Study Design: Descriptive study. Setting:Liaquat University of Medical & Health Sciences, Jamshoro / Hyderabad Duration: The durationof study was six months starting from 01-01-2014 to 31-06-2014. Methodology: Two hundredand fifty two cases of chronic hepatitis C on the basis of anti HCV (ELISA) and PCR positivewere selected in this study. Results: Out of 252 patients, 111 (44%) were males and 141(56%)were females. Most of the patients belonged to 26 to 50 years of age. The duration of treatmentwas 12 weeks. Two hundred & eight (82.5%) patients had ever married while the remaining17.5% were unmarried. Out of 106 (42%) depressed patients, 39 (37%) had mild, 31 (29%) hadmoderate, 20 (19%) had moderately severe and 15 (15%) had severe depression. Conclusion:It was observed that depression is a common during combination therapy with Peg interferonand the ribavirin in chronic HCV patients.

Subjects studied by people often impact their careers. The relation between education and careers has been well studied by social scientists, however limited research on this relation is available in network science. Network science has emerged as a promising field to understand complex systems. We study the relation between education and careers from a network science perspective. In this research we propose methods from network science to understand the relation between the subjects studied by a person and the impact of these subjects on the career of the person. We model the relation between favorite subjects and careers using a network. The model helps in understanding the positive and negative contributions of certain subjects towards other subjects and careers. The results show that mathematics and English are the two basic subjects that are highly related to most of the professions. The detailed results are of particular significance for people associated with higher education and career development.

In recent years, organizations are extracting knowledge from the huge volume of data to predict future trends. Specific applications have been developed for big data predictive analytics to utilize the current data in different industries. The efficiency of big data can be enhanced through the use of radio frequency identification (RFID) technique in supply chain management (SCM). The objective of this study is to establish and empirically investigate the relationship among big data predictive analytics (BDPA) acceptance, RFID acceptance, and supply chain performance (SCP). The population of this study is logistics industry in China. Results showed the positive direct effect between BDPA acceptance and SCP, and RFID acceptance has partially mediated. The implementation of this study will enhance supply chain performance in the logistics industry. This study also fills the literature gap because previous studies have not established the relationship between big data analytics acceptance and RFID acceptance in SCM.

Overweight and obesity are growing health complications mostly associated with metabolic and musculoskeletal comorbidities. The knowledge about the effects of obesity on the plantar pressure distribution in diabetic population is lacking. The purpose of this study was to assess the differences regarding plantar pressure distribution in participants with diabetic neuropathic feet who had a different body mass index (BMI). Peak plantar pressure was measured in 12 participants during level walking. The subjects were classified into three categories, each containing 4 participants, as non-obese, overweight and obese according to their BMI values. Peak plantar pressure was determined for the hindfoot, midfoot and forefoot regions using Pedar-X® in-shoe pressure measurement system. Lower peak plantar pressure was observed in midfoot compared to the hindfoot and forefoot. There was no significant difference in peak plantar pressure between the groups for forefoot and hindfoot. However, the obese group showed a significant higher peak plantar pressure in midfoot compared to the non-obese and overweight diabetic foot with neuropathy. Therefore, the high peak plantar pressure at the midfoot can cause a foot pain in obese diabetic neuropathic foot.

As medical science developed over time, we have relied on natural imagery to help us recognise and remember things. In this review article, we will be discussing some radiological signs named because of their resemblance to the occurrences in the natural world.

Background: Anxiety is defined as physical, behavioral, social and psychological response to treat self-concept characterized by subjective, consciously perceived feelings of tension. Nowadays anxiety is most commonly found among medical students. This study was conducted to find out the anxiety levels and ratio of severity of thirteen symptoms of anxiety. Methods: A questionnaire based study was conducted among 178 medical students which tests the level of anxiety and severity of symptoms of anxiety. The questionnaire used was hamilton anxiety rating scale (HAM-A). Results: Out of 178 students, 80 (44.94%) students scored mild anxiety levels, 63 (35.39%) students scored moderate anxiety levels and 35 (19.66%) students scored severe anxiety levels. Conclusions: Mild form of anxiety is much more common among medical students and majority of these medical students are females. Moreover, the symptoms of anxiety including tension, anxious mood, depressed mood, insomnia, fear and CVS symptoms appear with moderate severity in majority of medical students while on the other hand some symptoms including general somatic muscular and sensory symptoms, difficulties in concentration and memory, genitor-urinary symptoms, respiratory symptoms, GIT symptoms and other autonomic symptoms appear with least severity among majority of medical students.

Diabetes insipidus (DI) is a complex disease. DI is inability of the body to conserve water. Polydipsia and polyuria are the major manifestations of DI. DI has various variants including central diabetes insipidus (due to defect in ADH secretion), nephrogenic diabetes insipidus (due to defect in ADH receptors or urea receptors), gestational diabetes insipidus (due to catabolism of ADH by placental vasopressinase) and primary polydipsia (due to massive fluid intake). The cause of various variants of DI is either acquired or congenital. High plasma osmolality due to hypotonic urine excretion can be fatal because it can cause psychosis, lethargy, seizures, coma or even death. Polyuria and polydipsia help in the diagnosis of DI. Differential diagnosis of various variants of DI can be carried out on the basis of water deprivation test, MRI and other radiological techniques. The proper management of DI is the replenishment of water loss and correction of clinical presentations produced as a result of DI, major is hypernatremia. The best management for primary polydipsia is fluid restriction while fluid intake is used for adipsic diabetes insipidus. ADH replacement therapy is widely used to treat DI. DDAVP or desmopressin is mostly preferred ADH analogue because it has less side effects and resistant to placental vasoprssinase.

This paper examines movie projects from the perspective of organizational complexity. Drawing on qualitative data collected from production efforts within Pakistan's movie industry, this paper argues that there are causal relationships between the themes of quality, money, rework, malpractice, delays, and cancellations. Furthermore, feedback loops are present between the themes of ‘quality, money, and rework' and ‘quality, money, and malpractices'. These loops are consequential in that they often lead to contract cancellation, although the cause of cancellation is different in each case. Whilst the importance of these loops cannot be overstated, we argue that these concepts emphasize the non-linear, emergent, and stable/unstable nature of creative efforts