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Abstract The essence of quantum machine learning is to optimize problem-solving by executing machine learning algorithms on quantum computers and exploiting potent laws such as superposition and entanglement. Support vector machine (SVM) is widely recognized as one of the most effective classification machine learning techniques currently available. Since, in conventional systems, the SVM kernel technique tends to sluggish down and even fail as datasets become increasingly complex or jumbled. To compare the execution time and accuracy of conventional SVM classification to that of quantum SVM classification, the appropriate quantum features for mapping need to be selected. As the dataset grows complex, the importance of selecting an appropriate feature map that outperforms or performs as well as the classification grows. This paper utilizes conventional SVM to select an optimal feature map and benchmark dataset for predicting air quality. Experimental evidence demonstrates that the precision of quantum SVM surpasses that of classical SVM for air quality assessment. Using quantum labs from IBM’s quantum computer cloud, conventional and quantum computing have been compared. When applied to the same dataset, the conventional SVM achieved an accuracy of 91% and 87% respectively, whereas the quantum SVM demonstrated an accuracy of 97% and 94% respectively for air quality prediction. The study introduces the use of quantum Support Vector Machines (SVM) for predicting air quality. It emphasizes the novel method of choosing the best quantum feature maps. Through the utilization of quantum-enhanced feature mapping, our objective is to exceed the constraints of classical SVM and achieve unparalleled levels of precision and effectiveness. We conduct precise experiments utilizing IBM’s state-of-the-art quantum computer cloud to compare the performance of conventional and quantum SVM algorithms on a shared dataset.

Abstract Breast cancer (BC) has emerged as the most common malignancy among females. The genomic profile of BC is diverse in nature and complex due to heterogeneity among various geographically different ethnic groups. The primary objective of this study was to carry out a comprehensive mutational analysis of Indian BC cases by performing whole exome sequencing. The cohort included patients with a median age of 48 years. TTN, TP53, MUC16, SYNE1, and OBSCN were the frequently altered genes found in our cohort. The PIK3CA and KLC3 genes are driver genes implicated in various cellular functions and cargo transportation through microtubules, respectively. Except for CCDC168 and PIK3CA, several gene pairings were found to be significantly linked with co-occurrence. Irrespective of their hormonal receptor status, RTK/RAS was observed with frequently altered signaling pathways. Further analysis of the mutational signature revealed that SBS13, SBS6, and SBS29 were mainly observed in our cohort. This study supplements the discovery of diagnostic biomarkers and provides new therapeutic options for the improved management of BC.

Abstract Background While melanomas commonly harbor losses of 9p21, on which CDKN2A resides, the presence of additional tumor suppressor elements at this locus is incompletely characterized. Here we assess the expression levels and functional role of microRNA-876-3p (miR-876), whose gene also maps to 9p21. Methods Expression of miR-876 was assessed in human tissues and cell lines using quantitative miRNA reverse transcriptase polymerase chain reaction (qRT-PCR). MIR876 copy number was determined in The Cancer Genome Atlas (TCGA) melanoma cohort. The consequences of regulation of miR-876 expression were assessed on melanoma cell colony formation, migration, invasion, apoptosis, cell cycle progression, and drug sensitivity in culture, and on in vivo tumor growth in a xenograft model. Genome-wide transcriptomic changes induced by miR-876 overexpression were determined using RNA sequencing (RNA-Seq). Results miR-876 expression was significantly decreased in primary melanoma samples when compared with nevi, and in human melanoma cell lines when compared with human melanocytes. Analysis of the TCGA cohort revealed deletions in MIR876 in > 50% of melanomas. miR-876 overexpression resulted in decreased melanoma cell colony formation, migration, and invasion, which was accompanied by cell cycle arrest and increased apoptosis. Intra-tumoral injections of miR-876 significantly suppressed melanoma growth in vivo. RNA-Seq analysis of miR-876-treated tumors revealed downregulation of several growth-promoting genes, along with upregulation of tumor suppressor genes, which was confirmed by qRT-PCR analysis. Computational analyses identified MAPK1 (or ERK2) as a possible target of miR-876 action. Overexpression of miR-876 significantly suppressed luciferase expression driven by the MAPK1/ERK2 3’ UTR, and resulted in decreased ERK protein expression in melanoma cells. MAPK1/ERK2 cDNA overexpression rescued the effects of miR-876 on melanoma colony formation. miR-876 overexpression sensitized melanoma cells to treatment with the BRAF inhibitor vemurafenib. Conclusions These studies identify miR-876 as a distinct tumor suppressor on 9p21 that is inactivated in melanoma and suggest miR-876 loss as an additional mechanism to activate ERK and the mitogen activated protein kinase (MAPK) pathway in melanoma. In addition, they suggest the therapeutic potential of combining miR-876 overexpression with BRAF inhibition as a rational therapeutic strategy for melanoma.

Background & Aims: The article aims to evaluate trends in occupational radiation exposure for employees in different departments at the Center for Nuclear Medicine and Radiotherapy (CENAR), Quetta, Pakistan. Materials & Methods: This retrospective study examination of 9780 film dosimeter dose data was carried out from 2019 to 2023. The quantities analyzed were the highest and minimum annual effective doses, distribution of workers, and their average yearly effective doses in different effective dose intervals. The annual collective effective dose and average effective dosage were also included. Results: Yearly average effective doses in Radiotherapy, Nuclear Medicine, Medical Physics, and Diagnostic Radiology range from 0.5 to 3.00 mSv. Records show that 90% of workers fall within 1-3.00 mSv, with 10% between 0.5 mSv and the minimum detectable level. Minimum and maximum yearly individual doses in Radiotherapy and Nuclear Medicine are 0.10 mSv and 2.3 mSv. Average doses for the fields range from 1.01 to 1.14 mSv. Conclusion: Employees received doses that were lower than the yearly maximum, showing successful radiation shielding. The findings imply that safety measures are followed in the researched departments, which is important for clinical practice. This research improves our understanding of occupational radiation exposure, notably at CENAR, and promotes radiation safety in medical settings.

Background Measures of hemiparetic ankle dorsiflexor muscle strength and rate of force development (RFD) are often used to determine the efficacy of rehabilitation interventions after stroke. However, evidence supporting the reliability of these measures is limited. This brief report provides a secondary analysis investigating the between-session reliability of isometric ankle dorsiflexor muscle strength, rate of force development (RFD), and tibialis anterior electromyography (TA EMG), in people with chronic stroke. Method Participants (n=15) completed three maximal isometric contractions of the ankle dorsiflexor muscles as fast as possible using a rigid dynamometer. Tests were repeated seven days later. Outcomes included ankle dorsiflexor isometric maximal voluntary contraction (MVC), RFD in the first 200ms (RFD200ms), time to reach 90% MVC, and peak TA EMG. Data were analysed for 13 participants using intra-class correlation coefficients (ICC) and standard error of the measure percentage (SEM%). Results Reliability was higher when analysing the mean of three trials rather than the best of three trials. There was excellent reliability for isometric dorsiflexor MVC (ICC 0.97 [95% CI 0.92, 0.99], SEM% 7%). However, for other outcomes, while the ICC indicated good reliability, the lower bound of the 95% confidence interval of the ICC fell in the moderate range for TA EMG (ICC 0.86 [95% CI 0.60, 0.96], SEM% 25%) and time to reach 90% MVC (ICC 0.8 [95% CI 0.53, 0.93], SEM% 23%) and in the poor range for dorsiflexor RFD200ms (ICC 0.79 [95% CI 0.48, 0.92], SEM% 24%). Conclusion The findings raise concerns about the reliability of measures of rapid force production in the dorsiflexor muscles after stroke. Given the functional significance of the ankle dorsiflexors, larger studies should be conducted to further investigate these concerns and explore reliable methods for measuring rapid force production in the hemiparetic dorsiflexor muscles.

Purpose The global burden of mental health difficulties among children underscores the importance of early prevention. This study aims to assess the efficacy, feasibility and acceptability of the Strong Families programme in enhancing child behaviour and family functioning in low-resource settings in Gilgit-Baltistan, Pakistan.Methods and analysis This is a two-arm, multisite feasibility randomised controlled trial with an embedded process evaluation in three districts of Gilgit-Baltistan, namely Gilgit, Hunza and Skardu. 90 families living in these challenged settings, comprising a female primary caregiver aged 18 or above, and at least one child aged 8–15 years, will participate. Participants will be randomly assigned to either receive the Strong Families programme or to the waitlist group. Strong Families is a 7-hour family skills group intervention programme attended by children and their primary caregivers over 3 weeks. The waitlist group will be offered the intervention after their outcome assessment. Three raters will conduct blind assessments at baseline, 2 and 6 weeks postintervention. The primary outcome measures include the feasibility of Strong Families, as determined by families’ recruitment and attendance rates, and programme completeness (mean number of sessions attended, attrition rates). The secondary outcomes include assessment of child behaviour, parenting practices, parental adjustment and child resilience. Purposefully selected participants, including up to five caregivers from each site, researchers and facilitators delivering the intervention, will be interviewed. Descriptive statistics will be used to analyse primary and secondary outcomes. The process evaluation will be conducted in terms of programme context, reach, fidelity, dose delivered and received, implementation, and recruitment.Ethics and dissemination This study has been approved by the UNODC Drug Prevention and Health Branch in the Headquarters office of Vienna and the National Bioethics Committee of Pakistan. Findings will be disseminated through publication in reputable journals, newsletters and presentations at conferences.Trial registration number NCT05933850.

Introduction Sub-Saharan Africa (SSA) regions have the highest burden of cervical cancer (CC), accounting for nearly a quarter of global mortality. Many women in SSA are reluctant to access CC screening because they are uncomfortable exposing their private parts to healthcare providers. The perception of women who have experienced self-sampling in SSA is yet to be reviewed. This scoping review will explore the literature on the perception and attitude of women towards methods of collecting cervicovaginal samples for human papillomavirus (HPV) testing in SSA.Methods and analysis An extensive search using the Arksey and O’Malley framework will be conducted. The search criteria will be limited to original research conducted in community or clinical settings in SSA within the last 10 years. Four databases, namely, PUBMED, Cochrane, African Journals Online and Google Scholar, will be searched. Two independent persons (UIAB and DOO) will screen the titles and abstracts and later full texts using population, intervention, comparison and outcome criteria. IOMB will serve as a tiebreaker whenever there is no agreement on the choice of eligibility criteria. The screening process will be presented using Preferred Reporting Items for Systematic Reviews and Meta-Analyses for the scoping review flow format. The descriptive analysis of eligible studies for scoping reviews will be summarised. We will describe themes of attitude and perception covering pain, embarrassment, privacy and comfortability, willingness to self-sample, anxiety and confidence.Ethics and dissemination This is a scoping review protocol and does not require ethical approval. Findings from this review will be disseminated through peer-reviewed publications, the production of policy briefs, and presentations at local and international conferences.

Background High-quality contraceptive counselling can accelerate global efforts to reduce the unmet need for and suboptimal use of modern contraceptives. This study aims to identify a package of interventions designed to strengthen in Pakistan and Nigeria and determine their effectiveness in increasing client-level decision-making, autonomy and meeting of contraceptive needs.Methods A multisite, two-stage and five-phase intervention design will start with a pre-formative, formative, design, experimental and reflective phase. The pre-formative phase will map potential study sites and establish the sampling frame. The two-part formative phase will first use participatory approaches to identify clients’ perspectives, including young couples and providers, to ensure research contextualisation and address each interest group’s needs and priorities followed by clinical observations of client–provider encounters to document routine care. The design workshop in the third phase will result in the development of a package of contraceptive counselling interventions. In the fourth experimental phase, a multi-intervention, three-arm, single-blinded, parallel cluster randomised-controlled trial will compare routine care (arm 1) with the contraceptive counselling package (arm 2) and the same package combined with wider methods availability (arm 3). The study aims to enrol a total of 7920 participants. The reflective phase aims to identify implementation barriers and enablers. The outcomes are clients’ level of decision-making autonomy and use of modern contraceptives.Ethics and dissemination Ethical approval for this study was obtained from the WHO Scientific and Ethics Review Committee (Protocol ID Pakistan: ERC 006232 and Nigeria ERC: 006523). Each study site is required and has obtained the necessary ethical and regulatory approvals that are required in each specific country. Findings will be presented at local, national and international conferences and disseminated by peer-review publications.Trial registration number NCT06081842.

Introduction: Metabolic-associated fatty liver disease (MAFLD) is the liver manifestation of metabolic syndrome, which is commonly seen in primary care settings. This study aimed to determine the knowledge and practice of primary care physicians regarding MAFLD in Seremban District, Negeri Sembilan. Methods: This cross-sectional study was conducted among medical officers in 14 health clinics in Seremban District, using a validated, self-administered online questionnaire. Results: A total of 240 medical officers from 14 health clinics in Seremban District, participated in this study. Most participants (85.4%) passed the knowledge test. Their practice was acceptable, but only a minority were familiar with non-invasive testing of liver fibrosis (e.g. APRI or FIB-4), medication and specific diet for the treatment of MAFLD. Conclusion: Most primary care physicians in Seremban District are knowledgeable in identifying risk factors and managing patients with MAFLD. However, there are still areas to improve in terms of management, particularly regarding the use of silymarin, vitamin E and pioglitazone.

Background: Platelet-rich plasma (PRP) is widely used in various medical and surgical specialties for its regenerative properties, including aesthetics (facial rejuvenation, hair restoration, and skin tightening) and orthopedics (treatment of tendinitis and osteoarthritis). However, the inconsistent literature on PRP’s efficacy and safety leads to critical knowledge gaps. This systematic review evaluates quality control measures in PRP preparation and application and explores the regulatory environment governing its clinical use. Methods: Following PRISMA guidelines, a comprehensive search was conducted across multiple databases, including PubMed, EMBASE, and Web of Science, for studies published from January 2020 to April 2024. The review included randomized controlled trials (RCTs) involving human participants undergoing PRP treatment for aesthetic or regenerative purposes. Key parameters such as the PRP preparation methods, platelet concentration, and quality control measures were analyzed. The study protocol was registered with PROSPERO (ID: CRD42024557669). Results: Out of 75 RCTs involving 5726 patients, the review identified significant variability in PRP preparation methods and application techniques, including differences in centrifugation protocols and platelet concentration levels. A new evidence-based scoring system, the William–Eqram Scoring System for PRP Quality Reporting (WESS-PQR), was proposed to address these inconsistencies. Correlation analysis revealed a strong positive correlation (r = 0.79) between proper temperature control during preparation and PRP efficacy. Initial platelet count assessment showed a moderate positive correlation (r = 0.57) with efficacy. Conclusions: Standardized PRP preparation protocols and robust regulatory frameworks are urgently needed to ensure the safety and efficacy of PRP treatments. The proposed WESS-PQR scoring system can serve as a valuable tool for clinicians and researchers, promoting consistency and reliability in PRP applications.

The classification of bird species is of significant importance in the field of ornithology, as it plays an important role in assessing and monitoring environmental dynamics, including habitat modifications, migratory behaviors, levels of pollution, and disease occurrences. Traditional methods of bird classification, such as visual identification, were time-intensive and required a high level of expertise. However, audio-based bird species classification is a promising approach that can be used to automate bird species identification. This study aims to establish an audio-based bird species classification system for 264 Eastern African bird species employing modified deep transfer learning. In particular, the pre-trained EfficientNet technique was utilized for the investigation. The study adapts the fine-tune model to learn the pertinent patterns from mel spectrogram images specific to this bird species classification task. The fine-tuned EfficientNet model combined with a type of Recurrent Neural Networks (RNNs) namely Gated Recurrent Unit (GRU) and Long short-term memory (LSTM). RNNs are employed to capture the temporal dependencies in audio signals, thereby enhancing bird species classification accuracy. The dataset utilized in this work contains nearly 17,000 bird sound recordings across a diverse range of species. The experiment was conducted with several combinations of EfficientNet and RNNs, and EfficientNet-B7 with GRU surpasses other experimental models with an accuracy of 84.03% and a macro-average precision score of 0.8342.

BackgroundChronic cough (persisting for ≥8 weeks) is a common disorder affecting approximately 5 to 10% of adults worldwide that is sometimes refractory to treatment (refractory chronic cough [RCC]) or has no identifiable cause (unexplained chronic cough [UCC]). There is minimal information on the patient's experience of RCC/UCC in Canada. The aim of this study was to evaluate the patient journey and perceptions related to RCC/UCC management in Canada.MethodsOur exploratory study included Canadians in the Leger Opinion Panel and focused on individuals with RCC or UCC. Key entry criteria were: age ≥18 years, cough on most days for ≥8 weeks, no smoking within 1 year, no serious respiratory disease or lung cancer, and not taking angiotensin-converting enzyme inhibitors. Individuals who met entry criteria were invited to complete an approximately 30-minute online survey with questions on demographic characteristics, healthcare professional (HCP) interactions, diagnosis of underlying conditions, current treatments, and satisfaction with HCPs and chronic cough therapies.ResultsA total of 49,076 individuals completed the chronic cough screening questionnaire (July 30, 2021 to September 1, 2021): 1,620 (3.3%) met entry criteria for RCC or UCC, and 1,046 (2.1%) completed the online survey (mean age of 45 years, 61% female). Most respondents (58%) reported their chronic cough was managed by a general practitioner (GP). Forty-four percent of respondents did not have a diagnosis of an underlying condition for their cough. Breathing tests (39%) and chest imaging (34%) were the most common diagnostic tests. Cough suppressants (18%) were the most frequent current treatment. Respondents were moderately satisfied with their HCPs, but more than half considered their treatment ineffective and 34% had considered no longer seeking medical attention because of a lack of treatment success.ConclusionsIndividuals with RCC/UCC in Canada are largely unsatisfied with the effectiveness of treatment. Additional HCP education and new treatment options are needed to improve patient satisfaction.

BackgroundZinc deficiency poses significant health risks, particularly in low-income settings. This study aims to evaluate the impact of agronomically zinc biofortified (fermented and non-fermented) and post-harvest wheat flour flatbread on zinc status and metabolic health in adolescents and adult women in rural Pakistan.MethodsA four-arm triple-blind randomized controlled trial will be conducted in a rural district of Pakistan. Participants (adolescents aged 10-19 and adult women aged 20-40) will be assigned to receive fermented or unfermented high zinc agronomically biofortified wheat flour flatbread, post-harvest zinc-fortified wheat flour flatbread, or low zinc conventional whole wheat flour flatbread. The meal would be served once a day, six days a week for six months. The study aims to enroll 1000 participants and will be analyzed based on the intention-to-treat principle. The trial is registered with number NCT06092515.OutcomesPrimary outcomes will include serum zinc concentration and metabolic markers, while secondary outcomes include anthropometric measurements, blood pressure, and dietary intake.ConclusionThis trial will provide valuable insights into the efficacy of agronomically zinc biofortified wheat flour in improving zinc status and metabolic health. Findings may inform public health strategies to combat zinc deficiency in resource-limited settings.

Introduction A quasi-experimental study was conducted to estimate the impact of sequential emergency department (ED) capacity building interventions on key performance indicators such as patients’ length of stay (LOS) and wait time (WT) during the COVID-19 pandemic. This was achieved through augmenting personnel education and head count, space restructuring and workflow reorganisation.Setting and participants This study included 268 352 patients presenting from January 2019 to December 2020 at Indus Hospital and Health network Karachi, a philanthropic tertiary healthcare facility in a city of 20 million residents. A follow-up study was undertaken from January to December 2021 with 123 938 participants.Primary and secondary outcome measures These included mean and median ED-LOS and WT for participants presenting in different cohorts. The results of the pre-COVID-19 year 2019 (phase 0) were compared with that of the COVID-19 year, 2020 (phases 1–3 corresponding to peaks, and phase 4 corresponding to reduction in caseloads). The follow-up was conducted in 2021 to see the sustainability of the sequential capacity building.Results Phases 1, 2 and 3 had a lower mean adjusted LOS (4.42, 3.92 and 4.40 hours) compared with phase 0 (4.78 hours, p

Objectives In low/middle-income countries (LMICs), more than half of patients with first-episode psychosis initially seek treatment from traditional and religious healers as their first care. This contributes to an excessively long duration of untreated psychosis (DUP). There is a need for culturally appropriate interventions to involve traditional and spiritual healers to work collaboratively with primary care practitioners and psychiatrists through task-shifting for early detection, referral and treatment of first episode of psychosis.Methods To prevent the consequences of long DUP in adolescents in LMICs, we aim to develop and pilot test a culturally appropriate and context-bespoke intervention. Traditional HEalers working with primary care and mental Health for early interventiOn in Psychosis in young pErsons (THE HOPE) will be developed using ethnographic and qualitative methods with traditional healers and caregivers. We will conduct a randomised controlled cluster feasibility trial with a nested qualitative study to assess study recruitment and acceptability of the intervention. Ninety-three union councils in district Peshawar, Pakistan will be randomised and allocated using a 1:1 ratio to either intervention arm (THE HOPE) or enhanced treatment as usual and stratified by urban/rural setting. Data on feasibility outcomes will be collected at baseline and follow-up. Patients, carers, clinicians and policymakers will be interviewed to ascertain their views about the intervention. The decision to proceed to the phase III trial will be based on prespecified stop–go criteria.Ethics and dissemination Ethical approval has been obtained from Keele University Ethical Review Panel (ref: MH210177), Khyber Medical University Ethical Review Board (ref: DIR/KMU-EB/IG/001005) and National Bioethics Committee Pakistan (ref no. 4-87/NBC-840/22/621). The results of THE HOPE feasibility trial will be reported in peer-reviewed journals and academic conferences and disseminated to local stakeholders and policymakers.Trial registration number ISRCTN75347421.

Abstract Cotton is an international agricultural commodity and the main cash crop of Pakistan of which quality and quantity are subject to various whims of nature. Climate change, insect pest complex, and weeds are reducing its productivity. Here, we have developed triple gene cotton containing EPSPS gene along with two Bt toxin genes Cry1Ac and Cry2Ab using a strategy where all three genes are cloned in the same T-DNA, followed by successful cotton transformation via Agrobacterium-mediated transformation. This strategy has been developed to help cotton breeders in developing new cultivars by incorporating these genes into the non-transgenic or single Bt (Cry1Ac) gene cotton background where all three genes will inherit together. The expression of all three proteins was confirmed through immunostrips and was quantified through enzyme-linked immunosorbent assay (ELISA). The spatio-temporal expression of Bt protein in different parts of triple gene NIBGE cotton plants was determined. Maximum expression was found in leaves followed by seeds and boll rinds. Insect bioassays with cotton bollworms (Helicoverpa armigera), armyworms (Spodoptera litura), and pink bollworms (Pectinophora gossypiella) showed more than 90% mortality. The best performing line (NIBGE-E2) on the basis of spatiotemporal expression, glyphosate assays, and insect mortality data, was used for event characterization by using the genome sequencing approach. The event was successfully characterized and named NIBGE 20-01. A diagnostics test based on event-specific PCR was developed and its ability to distinguish NIBGE 20-01 event from other commercial transgenic cotton events was confirmed. To confirm stable expression of all three proteins in the field conditions, homozygous transgenic lines were grown in the field and the expression was confirmed through immunostrip assays. It was found that all three genes are expressed under field conditions. To show that all three genes are inherited together upon crossing with local elite cotton lines, the F1 generation was grown under glasshouse and field conditions. The expression of all three genes was confirmed under field conditions. Our results showed that transgenic cotton with three genes cloned in the same T-DNA can express all genes and can be conveniently transferred into elite cotton lines through a single cross.

Abstract Surfactant-polymer (SP) flooding is considered an efficient technique to increase the recovery of oil, especially from carbonates reservoirs, because of their complex nature. The objective of this study is to analyze the effect of polymer drive composition on surfactant retention. We developed a geochemical model that uses various surface complexation reactions at the mineral/brine interface, oil/brine interface, surfactant/brine interface, and oil/surfactant interface. We also incorporated four new surface complexation reactions that honor oil/surfactant geochemical interaction to determine the influence of polymer composition on surface retention for the first time. Then we validated the developed geochemical model against coreflooding experimental data. Additionally, we investigated the influence of various parameters of polymer drive on surface retention under high temperature and salinity using the suggested surface complexation model. The findings showed that our surface complexation model can estimate surfactant retention and its concentration in the effluent with a certain accuracy during polymer drive. The developed geochemical model is validated against single-phase and two-phase coreflooding experimental data. The findings revealed that for a more representative and accurate estimation of surfactant retention in chemical flooding, it is important to consider the oil/surfactant surface complexation reactions. Moreover, the detailed and comprehensive analysis showed that with the increase in temperature of the polymer drive, the retention of surfactant increases, and its concentration in the effluent decreases. The latter shows that surfactant retention is a more chemical process as opposed to physio-retention. It is also shown that the injection of a specific composition of polymer drive after a surfactant slug could decrease the surfactant retention, which is related to the force of repulsion between the ionic species and the rock surface. Moreover, the effect of hard ions (calcium and magnesium) in polymer drive is significant where the increase in the concentration of hard ions increases the retention of surfactant. Furthermore, it is important to mention that the lowest level of surfactant retention was achieved through a certain composition of polymer drive, thus the polymer solution dilution is not an effective approach. This is the first study to test a novel formulation of surface complexation modeling that considers the oil/surfactant effect on surfactant retention corresponding to the composition of polymer drive. The suggested framework to determine surfactant retention is conducted for harsh reservoir conditions of temperature and salinity and suggests that the surface complexation reactions for all rock-forming minerals must be considered.

Abstract The communication describes a theoretical framework for tangent hyperbolic fluid of nano-biofilm due to an extending or shrinking sheet that comprises a stagnation point flow, chemical reaction with activation energy, and bioconvection of gyrotactic microorganisms. The varying transport features due to dynamic viscosity, thermal conductivity, nano-particle mass permeability and microbe organisms diffusivity are taken into account for the novelty of this work. The inspiration is developed to enhance heat transfer. A set of leading partial differential equations is formed along with appropriate boundary constraints. Using similarity transformations, the basic formulation is transitioned into non-linear differential equations. To produce observational data, the shooting technique and Runge-Kutta fourth order method are employed. The coding of numerical scheme is developed in Matlab script. The visual representation of the effects of diverse fluid transport properties and distinctive parameters on speed, temperature, concentration and motile density are evaluated. The velocity become faster when the parameters $$\omega $$ ω , $$\lambda $$ λ , $$\epsilon $$ ϵ and $$V_0$$ V 0 are enhanced. Brownian motion, thermal conductivity, heat generation as well as thermophoresis factors all strengthen the temperature distribution, however the nano-particle concentration profile is enhanced as the nano-particle mass conductivity variable, activation energy as well as the thermophoresis variable are boosted. The microorganism density improves significantly when the microorganism diffusivity factor increases. The skin friction, Sherwood number, Nusselt number and motile density number decline against the incremented transport parameters.

Abstract This article is concerned with the study of MHD non-Newtonian nanofluid flow over a stretching/shrinking cylinder along with thermal radiation effects. Two-component slip mechanism models, namely Brownian motion and thermophoresis of nanofluid for the mass and energy transportation, developed by Buongiorno, are used. Convective heat transfer and nonuniform magnetic field are retained for the expanding/contracting cylinder. Variable thermal conductivity and heat generation effects along with slip boundary conditions are utilized over the cylinder surface. By utilizing the similarity transformation, these governing partial differential equations are converted into nonlinear ordinary differential equations (ODEs). To obtain numerical results, these ODE’S are solved by the shooting method using MATLAB software. The impact of different parameters like variable thermal conductivity, radiation parameter, magnetic parameter, Prandtl number, Brownian motion parameter, the magnetic parameter, Weissenberg number, the viscosity ratio parameter and mass transfer parameter, on the velocity, temperature and concentration is discussed graphically. Further, the Sherwood number, Nusselt number, the skin friction coefficient are also discussed through figures. It is noted through analysis that the speed of the nanofluid reduces for the higher Weissenberg number and expanding cylinder. For the contracting cylinder, i.e., for the negative unsteadiness parameter, the velocity increases.

Abstract The unsteady energy and mass transport of magnetohydrodynamics (MHD) second grade nanofluid via an exponentially extending surface with Dufour and Soret effects are investigated in this study. Variable thermal conductivity and mixed convection effects are used to investigate the heat transfer mechanism. There are also new characteristics such as slip flow, viscous dissipation, Brownian motion, nonlinear thermal radiation, and thermophoresis. In the problem formulation, the boundary-layer approximation is used. Using the suitable transformations, the energy, momentum, and concentration equations are generated into non-linear ordinary differential equations (ODEs). The solution to the resultant problems was calculated via the Homotopy analysis method (HAM). The effects of environmental parameters on velocity, temperature, and concentration profiles are graphically depicted. When comparing the current results to the previous literature, there was also a satisfactory level of agreement. In comparison to a flow based on constant characteristics, the flow with variable thermal conductivity is shown to be significantly different and realistic. The temperature of the fluid grew in direct proportion to the thermophoresis motion, buoyancy ratio, and Brownian motion parameters. According to the findings, the slippery porous surface may be employed efficiently in chemical and mechanical sectors that deal with a variety of very viscous flows.

Abstract Objectives This study aimed to determine the publication rate of free paper abstracts presented by the postgraduate (PG) trainees and determine the reasons for non-publication. A mixed methods study was conducted. PG trainees presenting free papers at the at the Pakistan Society of Chemical Pathologist conferences from 2012 to 2018 were included. Three databases were searched to identify if the abstracts were published or not. The PG trainee authors of abstracts not published as full manuscript, were surveyed to determine the barriers and challenges in publishing a manuscript. Results The average rate of full manuscript publication was 51.8% (n = 93/177) for the abstracts presented by the PG trainees. Publication rate was higher for oral (n = 73/119, 61.3%) compared to poster presentation (n = 20/58, 34.5%). Most of the manuscripts were published after two years of abstract presentation. The survey showed that the main challenges to publishing an abstract were lack of time, limited scientific writing or submission skills, lack of funding for publication fee, and negative or statistically non-significant results. This reflects a need to arrange workshops/symposia for the PG trainees of low-middle income country (LMIC) to enhance their writing and time management skills and improve the full manuscript publication rate from LMICs.

Objective During the COVID-19 pandemic, several vaccines that were efficacious in randomised controlled trials were authorised for mass vaccination. In developing countries, inactivated vaccines were widely administered. While inactivated vaccines have been deemed effective in reducing disease severity, for healthcare personnel (HCP), effectiveness against SARS-CoV-2 infections is essential to reduce the risk to vulnerable patients and ensure a stable healthcare workforce. There are limited studies examining inactivated vaccines’ effectiveness against SARS-CoV-2 variants of concern (VOCs) in real-world settings. We estimated the effectiveness of inactivated vaccines (BBIBP-CorV and CoronaVac) against reverse transcription PCR (RT-PCR)-confirmed SARS-CoV-2 infections among HCP in the setting of emerging SARS-CoV-2 VOCs in Pakistan.Design A retrospective matched, test-negative case–control analysis using existing data from an Employee Health database on HCP at a large, private healthcare system in Pakistan.Participants 4599 HCP were tested between 1 April and 30 September 2021. Each case (PCR positive) was matched to two to six controls (PCR negative) by the date of the RT-PCR test (±7 days) to reduce bias.Primary and secondary outcome measures The primary outcome was vaccine effectiveness (VE) against SARS-CoV-2 infection. The secondary outcome was VE against symptomatic SARS-CoV-2 infection. Per cent VE was calculated using (1-OR)*100, with the OR of getting a PCR-confirmed SARS-COV-2 infection estimated using conditional logistic regression, after adjusting for age, gender, work area and history of SARS-CoV-2 infection.Results Inactivated vaccines were ineffective against SARS-CoV-2 infections after receiving the first dose (VE 17%, 95% CI −10, 39; p=0.261). They showed modest effectiveness ≥14 days after the second dose against SARS-CoV-2 infections (VE 30%, 95% CI 7, 48; p=0.015) and symptomatic SARS-CoV-2 infections (VE 33%, 95% CI 6, 52; p=0.002).Conclusions Inactivated vaccines show modest effectiveness against SARS-CoV-2 infections in the setting of emerging VOCs. This builds a strong case for boosters and/or additional vaccination.

Background: Simple nephrectomy is a technique of removing the kidney from within the gerota’s fascia and is usually for a non-functioning kidney. While for renal tumors, radical nephrectomy is done, which involves the removal of the kidney with gerota’s fascia along with the ureter. Histopathology of patients who undergo simple nephrectomy sometime reveals renal malignancy. Such patients often need further treatment as simple nephrectomy in such cases is mostly suboptimal. The number of studies reporting tumors in simple nephrectomy specimens is limited. We aim to report single-center pathological findings in nephrectomy specimens from patients treated for non-functioning kidneys due to renal stone disease. Methodology: The medical record of patients (n=210) who underwent simple nephrectomy between 2014 and 2021 at the Kidney Centre Postgraduate Training Institute due to renal stone disease was reviewed retrospectively. Results: The total number of patients undergoing simple nephrectomy for non-functioning kidneys due to stone disease was 210. Of those patients, 117 were males, and 93 were females. The mean age was 45.33 ± 17.65 years. The histopathology report of specimens revealed renal malignancy in 10 patients (4.76%), xanthogranulomatous pyelonephritis in 11 patients, tuberculosis of the kidney in 7 patients, and chronic pyelonephritis in 182 patients. Conclusion: In conclusion, the prevalence of renal malignancy in patients undergoing simple nephrectomy is significantly high.

Abstract The choices of consumer towards food have been changed. Consumer prefers to eat food which is not only safe but also nutritious. Now a day, they like to eat the food which promote their health and help in minimizing nutrition related health hazards. Rice is a staple food in many countries, but most emerging issue is that rice is deficit in minerals. Rice ranks second among cereals in dietary uses around the world. Rice is deficit in iron (Fe) zinc (Zn) and these are important micronutrients for infants, men and women. Fortification of rice with iron and zinc would help to minimize nutrient deficient disorders among humans. Present study is aimed to introduce nutrients rich rice for consumers and also to encourage food-fortification organizations for diverting their focus on rice fortification. In south Asian countries, micronutrient deficiency especially Fe and Zn deficiency is very common. The rice because of its use as a staple food can be utilized as a carrier medium for transporting micronutrients from plants sources to human beings. Hence, rice fortification with microminerals can prove as a miracle for the virtual eradication of nutrition related diseases in humans.

Abstract There are contradictory data regarding the effect of intermittent pneumatic compression (IPC) on the incidence of deep-vein thrombosis (DVT) and heart failure (HF) decompensation in critically ill patients. This study evaluated the effect of adjunctive use of IPC on the rate of incident DVT and ventilation-free days among critically ill patients with HF. In this pre-specified secondary analysis of the PREVENT trial (N = 2003), we compared the effect of adjunctive IPC added to pharmacologic thromboprophylaxis (IPC group), with pharmacologic thromboprophylaxis alone (control group) in critically ill patients with HF. The presence of HF was determined by the treating teams according to local practices. Patients were stratified according to preserved (≥ 40%) versus reduced (

Abstract In an uncertain atmosphere, the magnetohydrodynamics (MHD) flow in three principal flows of the third grade fluid across two parallel plates is presented. Fuzzy differential equations are constructed by manipulating dimensionless differential equations. The prime purpose of the current article is to use a semi-analytical approach fuzzy-based Adomian decomposition method to achieve numerical results for nonlinear FDEs with fuzzy boundary conditions. Triangular fuzzy numbers are used in fuzzy BCs with help of $$\alpha {\text{-cut}}$$ α -cut approach. This strategy is linked to the membership function. In a graphic and tabular depiction, the effect of $$\alpha$$ α and other constraints on fuzzy velocity profiles is explored. The current findings are in good agreement with their previous numerical and analytical results in a crisp environment.

Abstract In a computer-aided diagnostic (CAD) system for skin lesion segmentation, variations in shape and size of the skin lesion makes the segmentation task more challenging. Lesion segmentation is an initial step in CAD schemes as it leads to low error rates in quantification of the structure, boundary, and scale of the skin lesion. Subjective clinical assessment of the skin lesion segmentation results provided by current state-of-the-art deep learning segmentation techniques does not offer the required results as per the inter-observer agreement of expert dermatologists. This study proposes a novel deep learning-based, fully automated approach to skin lesion segmentation, including sophisticated pre and postprocessing approaches. We use three deep learning models, including UNet, deep residual U-Net (ResUNet), and improved ResUNet (ResUNet++). The preprocessing phase combines morphological filters with an inpainting algorithm to eliminate unnecessary hair structures from the dermoscopic images. Finally, we used test time augmentation (TTA) and conditional random field (CRF) in the postprocessing stage to improve segmentation accuracy. The proposed method was trained and evaluated on ISIC-2016 and ISIC-2017 skin lesion datasets. It achieved an average Jaccard Index of 85.96% and 80.05% for ISIC-2016 and ISIC-2017 datasets, when trained individually. When trained on combined dataset (ISIC-2016 and ISIC-2017), the proposed method achieved an average Jaccard Index of 80.73% and 90.02% on ISIC-2017 and ISIC-2016 testing datasets. The proposed methodological framework can be used to design a fully automated computer-aided skin lesion diagnostic system due to its high scalability and robustness.

Aims: Noroviruses may cause both epidemic and sporadic acute gastroenteritis globally. Thus, this study evaluated the prevalence of norovirus in stool samples of hospitalized patients with acute gastroenteritis in Aydin, Turkey using enzyme-linked immunoassay (ELISA) and real-time reverse transcription-polymerase chain reaction (rRT-PCR) and genotyped positive samples to detect which genotypes have currently circulated. Methods: This retrospective descriptive study collected 92 stool samples from patients with acute gastroenteritis symptoms from Aydın Adnan Menderes University Hospital from September 2017 to May 2019. The samples were tested using the commercial Third Generation Ridascreen norovirus ELISA and rRT-PCR. Positive samples were genotyped by sequencing of conventional positive RT-PCR products followed by phylogenetic analysis. Results: Of the 92 samples, 5 (5.4%) using ELISA and 12 (13%) using rRT-PCR tested positive for norovirus. All positive samples were genogroup II (GII). Two norovirus positive samples were genotyped successfully using DNA sequencing of the nested conventional PCR products. One sample (GII/Hu/TR/2019/Aydin25) could be categorized as GII.3 and the other (GII/Hu/TR/2019/Aydin20) as GII.13. Conclusion: rRT-PCR testing of stool samples is more sensitive than Ridascreen ELISA. Data from our study provide protocols for how to study norovirus epidemiology.

Abstract Background Chronic quadriceps tendon rupture is technically challenging for surgeons due to scarring and tendon retraction. The presence of concurrent ipsilateral knee osteoarthritis compounds the issue even further. Although a combined presentation is rare, treatment options to manage each coexisting pathology simultaneously are scarcely reported. We describe the case of a 67-year-old Caucasian male who had such a presentation, and was subsequently treated with a one-stage extensor mechanism autograft reconstruction and total knee replacement with computer navigation. Case The patient was a 67-year-old male Caucasian, who had previously sustained an acute rupture of his right quadriceps tendon that was adequately repaired 6 months prior. Despite an initial satisfactory result, he reported deterioration in his mobility in the few months thereafter, with worsening knee pain. His comorbidities consisted of hypertension, asthma, and a body mass index of 40.4 kg/m2. Otherwise, there were no risk factors for tendon rerupture. Clinical examination later revealed a large palpable gap in the right suprapatellar region and weakness of active knee extension. No traumatic cause for this new presentation was identified. Suspicion of a chronic quadriceps tendon rupture was confirmed on radiological imaging, but the investigations also noted the presence of severe tricompartmental osteoarthritis of the ipsilateral, native knee joint. The combined procedure took place in one surgical sitting. The total knee replacement with patella resurfacing was performed first and assisted by computer navigation. The quadriceps tendon reconstruction was then conducted sequentially using the patient’s hamstring tendons (semitendinosus and gracilis). The tensile strength was reinforced with use of a Ligament Augmentation and Reconstruction System (LARS) ligament. Initial outcomes were excellent, and these results were maintained at 6 months postoperatively, with the patient reporting no pain and having full range of movement. Conclusion Our techniques used have not previously been reported, but are successful options in treating coexisting chronic quadriceps tendon rupture and ipsilateral knee osteoarthritis. The advantage of using computer navigation with an extramedullary femoral jig can lead to improved accuracy of bone cuts, which is important in the presence of anatomical disruption. Chronic failures of the extensor mechanism require different approaches depending on the inherent and underlying pathology. We feel that the multidisciplinary team approach to the management and use of two surgeons with differing expertise added to the successful outcome of this complex case.

Background: In approximately 25% of peripheral neuropathy cases, diagnosis remains obscure. In India, leprosy continues to remain one of the most frequent causes of peripheral neuropathy. We, in this prospective evaluation, performed nerve biopsies in patients with peripheral neuropathy for early confirmation of the diagnosis. Materials and Methods: A total of 55 consecutive cases of peripheral neuropathy were included in this study. All patients were subjected to clinical and electrophysiological evaluation. Sural nerve biopsies were performed in all the patients. Result: After a nerve biopsy in 29 cases, we were able to identify the underlying cause of peripheral neuropathy. In 26 cases, the diagnosis remained obscure. The most frequent histopathological diagnosis was leprosy, which was seen in 20 cases. Other diagnoses were chronic demyelinating neuropathy (four cases), vasculitis (two cases), and amyloidosis in one case. In two biopsies, the findings were consistent with hereditary neuropathies. The demonstration of lepra bacilli was the most distinctive feature. In addition, foamy macrophages (100%) and granuloma (100%) formation, epineurial (83.3%) and endoneurial infiltration (69%) along with epineurial (87.5%) and perineurial thickening (77.3%) were also noted more frequently in leprosy-associated neuropathy. Conclusion: The nerve biopsies revealed that leprosy was the most common etiology in patients with peripheral neuropathy. In approximately 47% of the cases, even nerve biopsies failed to establish a confirmed diagnosis.

Abstract The evolution of compact density heat gadgets demands effective thermal transportation. The notion of nanofluid plays active role for this requirements. A comparative account for Maxwell nanofluids and Williamson nanofluid is analyzed. The bioconvection of self motive microorganisms, non Fourier heat flux and activation energy are new aspects of this study. This article elaborates the effects of viscous dissipation, Cattaneo–Christov diffusion for Maxwell and Williamson nanofluid transportation that occurs due to porous stretching sheet. The higher order non-linear partial differential equations are solved by using similarity transformations and a new set of ordinary differential equations is formed. For numerical purpose, Runge–Kutta method with shooting technique is applied. Matlab plateform is used for computational procedure. The graphs for various profiles .i.e. velocity, temperature, concentration and concentration of motile micro-organisms are revealed for specific non-dimensional parameters. It is observed that enhancing the magnetic parameter M, the velocity of fluid decreases but opposite behavior happens for temperature, concentration and motile density profile. Also the motile density profile decrease down for Pe and Lb. The skin friction coefficient is enhanced for both the Williamson and Maxwell fluid.

Abstract Airflow through the left-and-right nostrils is said to be entrained by an endogenous nasal cycle paced by both poles of the hypothalamus. Yogic practices suggest, and scientific evidence demonstrates, that right-nostril breathing is involved with relatively higher sympathetic activity (arousal states), while left-nostril breathing is associated with a relatively more parasympathetic activity (stress alleviating state). The objective of this study was to further explore this laterality by controlling nasal airflow and observing patterns of cortical activity through encephalographic (EEG) recordings. Thirty subjects participated in this crossover study. The experimental session consisted of a resting phase (baseline), then a period of unilateral nostril breathing (UNB) using the dominant nasal airway, followed by UNB using the non-dominant nasal airway. A 64-channel EEG was recorded throughout the whole session. The effects of nostril-dominance, and nostril-lateralization were assessed using the power spectral density of the neural activity. The differences in power-spectra and source localization were calculated between EEG recorded during UNB and baseline for delta, theta, alpha, beta and gamma bands. Cluster-based permutation tests showed that compared to baseline, EEG spectral power was significantly (1) decreased in all frequency bands for non-dominant nostril UNB, (2) decreased in alpha, beta and gamma bands for dominant nostril UNB, (3) decreased in all bands for left nostril UNB, and (4) decreased in all bands except delta for right nostril UNB. The beta band showed the most widely distributed changes across the scalp. our source localisation results show that breathing with the dominant nostril breathing increases EEG power in the left inferior frontal (alpha band) and left parietal lobule (beta band), whereas non-dominant nostril breathing is related to more diffuse and bilateral effects in posterior areas of the brain.These preliminary findings may stimulate further research in the area, with potential applications to tailored treatment of brain disorders associated with disruption of sympathetic and parasympathetic activity.

Abstract Blood cancer has been a growing concern during the last decade and requires early diagnosis to start proper treatment. The diagnosis process is costly and time-consuming involving medical experts and several tests. Thus, an automatic diagnosis system for its accurate prediction is of significant importance. Diagnosis of blood cancer using leukemia microarray gene data and machine learning approach has become an important medical research today. Despite research efforts, desired accuracy and efficiency necessitate further enhancements. This study proposes an approach for blood cancer disease prediction using the supervised machine learning approach. For the current study, the leukemia microarray gene dataset containing 22,283 genes, is used. ADASYN resampling and Chi-squared (Chi2) features selection techniques are used to resolve imbalanced and high-dimensional dataset problems. ADASYN generates artificial data to make the dataset balanced for each target class, and Chi2 selects the best features out of 22,283 to train learning models. For classification, a hybrid logistics vector trees classifier (LVTrees) is proposed which utilizes logistic regression, support vector classifier, and extra tree classifier. Besides extensive experiments on the datasets, performance comparison with the state-of-the-art methods has been made for determining the significance of the proposed approach. LVTrees outperform all other models with ADASYN and Chi2 techniques with a significant 100% accuracy. Further, a statistical significance T-test is also performed to show the efficacy of the proposed approach. Results using k-fold cross-validation prove the supremacy of the proposed model.

Abstract Globally, Whitefly (Bemisia tabaci) is one of the most important insect pests of crops that causes huge economical losses. The current study was designed to exclusively screen the B. tabaci species in the cotton field of Pakistan during 2017–2020 and have to conduct comparative analysis of B. tabaci species in Asia where Asia II 1 has been reported. A total of 5142 B. tabaci sequences of mitochondrial cytochrome oxidase 1 (mtCO1) from Asian countries were analyzed to determine the species and their distribution in the region. Our analysis over time and space showed that Asia II 1 has gradually dominated over Asia 1 in Punjab Province and over both Asia 1 and MEAM1 in Sindh Province. Asia has been divided into three regions i.e., South Asia (2524 sequences), Southeast Asia (757 sequences) and East Asia (1569 sequences) and dominance of different species of B. tabaci has been determined by calculating the relative percentage of each species. Interestingly, Asia II 1 has been found dominant in the neighboring region (northern zone) of India and also being dominant in its central zone. The dominance of Asia II 1 in Pakistan and northern India explains whitefly epidemic being reported in recent years.

Abstract In this work, the heat transfer features and stagnation point flow of Magnetohydrodynamics (MHD) hybrid second-grade nanofluid through a convectively heated permeable shrinking/stretching sheet is reported. The purpose of the present investigation is to consider hybrid nanofluids comprising of Alumina $$\left( {{\text{Al}}_{{2}} {\text{O}}_{{3}} } \right)$$ Al 2 O 3 and Copper $$\left( {{\text{Cu}}} \right)$$ Cu nanoparticles within the Sodium Alginate (SA) as a host fluid for boosting the heat transfer rate. Also, the effects of free convection, viscous dissipation, heat source/sink, and nonlinear thermal radiation are considered. The converted nonlinear coupled fuzzy differential equations (FDEs) with the help of triangular fuzzy numbers (TFNs) are solved using the numerical scheme bvp4c. The numerical results are acquired for various engineering parameters to study the Nusselt number, skin friction coefficient, velocity, and temperature distribution through figures and tables. For the validation, the current numerical results were found to be good as compared to existing results in limiting cases. It is also inspected by this work that with the enhancement of the volume fraction of nanoparticles, the heat transfer rate also increases. So, it may be taken as a fuzzy parameter for a better understanding of fuzzy variables. For the comparison, the volume fraction of nanofluids and hybrid nanofluid are said to be TFN [0, 0.1, 0.2]. In the end, we can see that fuzzy triangular membership functions (MFs) have not only helped to overcome the computational cost but also given better accuracy than the existent results. Finding from fuzzy MFs, the performance of hybrid nanofluids is better than nanofluids.

Abstract This study briefings the roles of Coriolis, and Lorentz forces on the dynamics of rotating nanofluids flow toward a continuously stretching sheet. The nanoparticles are incorporated because of their unusual qualities like upgrade the thermal transportation, which are very important in heat exchangers, modern nanotechnology, electronics, and material sciences. The primary goal of this study is to improve heat transportation. Appropriate similarity transformations are applied for the principal PDEs to transform into nonlinear dimensionless PDEs. A widely recognized Numerical scheme known as the Finite Element Method is employed to solve the resultant convective boundary layer balances. Higher input in the solvent fraction parameter has a rising effect on the primary velocity and secondary velocity magnitude, and decreasing impact on the distributions of temperature. It is seen that growing contributions of the Coriolis, and Lorentz forces cause to moderate the primary and secondary velocities, but the temperature and concentration functions show opposite trend. The concentration, temperature, and velocities distributions for suction case is prominently than that of injection case, but inverse trend is observed for local Nusselt and Sherwood numbers. These examinations are relevant to the field of plastic films, crystal growing, paper production, heat exchanger, and bio-medicine.

Objective:This study aimed to retrospectively investigate Toxoplasma gondii IgG and IgM distribution and IgG avidity in serum samples with suspected toxoplasmosis in the medical microbiology serology laboratory of Faculty of Medicine Hospital at Bursa Uludağ University over a 24-month period (January 2016 to December 2018).Methods:An enzyme-linked fluorescent assay using the VIDAS automated analyzer (BioMérieux, France) was used to determine T. gondii IgM antibodies, T. gondii IgG antibodies, and T. gondii IgG avidity.Results:The T. gondii IgM antibody positivity was found to be 1.7% (101/6104), whereas the T. gondii IgG antibody positivity was 37.9% (1.149/3024). The seropositivity of T. gondii IgG was 31.5% in women belonging to the childbearing age group. In this group, T. gondii IgG high and low avidity rates were 70.1% (134/191) and 15.2% (29/191), respectively.Conclusion:Screening and diagnosis of toxoplasma serology in women of childbearing age is important. The results of this study may be useful for designing optimal control and preventive measures against T. gondii infection.

Abstract Iron (Fe) and zinc (Zn) stress significantly affects fundamental metabolic and physiological processes in plants that results in reduction of plant growth and development. In the present study, common bean variety; Shalimar French Bean-1 (SFB-1) was used as an experimental material. Four different MGRL media i.e. normal MGRL medium (Control), media without Fe (0-Fe), media without Zn (0-Zn) and media with excess Zn (300-Zn) were used for growing seeds of SFB-1 under in vitro condition for three weeks under optimum conditions. Three week old shoot and root tissues were harvested from the plants grown in these four different in vitro conditions and were, subjected to Fe and Zn estimation. Further, extraction of total RNA for differential gene expression of ten candidate genes selected based on our in silico investigation and their classification, phylogeny and expression pattern was unraveled. Expression analysis of three candidate genes (OPT3, NRAMP2 and NRAMP3) in roots revealed possible cross talk among Fe/Zn stress that was further confirmed by observing less accumulation of Fe in roots under both these conditions. However, we observed, higher accumulation of Fe in shoots under 0-Fe condition compared to control that suggests precise sensing for priority based compartmentalization and partitioning leading to higher accumulation of Fe in shoots. Furthermore, the expression analysis of IRT1, FRO1 and Ferritin 1 genes under Fe/Zn stress suggested their role in uptake/transport and signaling of Fe and Zn, whereas the expression of ZIP2, NRAMP1, HA2 and GLP1 genes were highly responsive to Zn in Phaseolus vulgaris. The identified genes highly responsive to Fe and Zn stress condition can be potential candidates for overcoming mineral stress in dicot crop plants.

Objective: To determine the commonest site of non-suicidal self-inflicted firearm wound in comparison with accidental firearm wounds. Study Design: Cross sectional study. Place and Duration of Study: Combined Military Hospitals Jhelum, Bannu & Kharian, from Nov 2014 to Nov 2018. Methodology: Sixty-four patients with firearm injuries were observed. All the participants were males between the ages of 18- 60 years. The injuries were determined to be either self-inflicted or accidental by an independent committee. The participants’ replies and responses were assessed by dividing them into five main domains by using quantitative software SPSS version 20. Variables involving demographic characteristics of participants such as age, occupation, marital and socioeconomic status, were associated with mental health variables such as psychological stress, previous history of self-harm and clinical psychiatric illness. Result: Fifteen subjects were found to have self-inflicted injuries and 50 had accidental injuries. There was a marked preference for left foot and left lower limb as a site for non-suicidal self-inflicted injuries (94.6%) as compared to other sites (left upper extremity 1.8%, chest 1.8% and right lower extremity 1.8%). Conclusions: Left lower limb and left foot was a more common site for self-injury as compared to the other sites.

Objective: To compare the research obstacles including lack of proper training, previous exposure, time management, motivation, faculty research knowledge, skill, social constrains and lack of interest among post-graduate residents of Balochistan with those of Children’s Hospital, Lahore. Study Design: Comparative cross-sectional study. Place and Duration of Study: Dental College, Bolan University of Medical and Health Sciences, Quetta, Quetta Institute of Medical Sciences & Institute of Public Health of Balochistan, from Mar to May 2018, and Children’s Hospital Lahore, Lahore, from Jul to Aug 2017. Methodology: A total of 72 postgraduates from three different institutes of Balochistan and 90 from Children’s Hospital, Lahore were recruited in this study. The questionnaire was distributed to the participants of both institutions; data was collected & entered into SPSS version 22. Results: Female predominance (64.4%) was observed in post-graduates of Children’s Hospital, Lahore in comparison to institutions from Balochistan while there were 61% males. Majority (90%) post-graduate residents of Balochistan recognized time management, deficient laboratory and other facilities followed by lack of mentoring by faculty 59 (83%) and lack of motivation 60 (84%) as the most important factors that hinder their scientific activities. Additionally, 91 (86.6%) postgraduates of Children’s Hospital, Lahore suggested lack of proper research training and 87 (83.3%) suggested lack of previous exposure as the main hindering factors in their research work. Conclusion: Post-graduate residents of diverse economic, educational and cultural backgrounds present different perceptions about research hurdles. However, those from both provinces identified that lack of..........

Background: Significant morbidity and mortality is caused by untreated hepatitis B virus infection through cirrhosis and hepatocellular carcinoma. The objectives of our study were to determine distribution of hepatitis B infected population by sex and age groups in District D.I.Khan, Pakistan. Materials Methods: This cross-sectional study was done at District Health Office, D.I.Khan, Pakistan from January 30, 2021 to February 15, 2021. Data was collected for period from March 14, 2013 to January 28, 2021 for 2368 hepatitis B infected cases from population at risk consecutively. Sex and age groups were demographic variables. Data type was nominal for sex and ordinal for age groups. Distribution was analyzed by count, percentage and confidence intervals for proportion for population. Hypotheses for distribution were substantiated by chi-square goodness-of-fit test. Results: Out of 2368 hepatitis B infected population, 1670 (70.52%) were men 698(29.48%) women, and 562 (23.73%) were in age group 0-20 years, 1266 (53.46%) in 21-40 years, 462 (19.51%) in 41-60 years 78 (3.30%) in 60 years. Our distribution by sex (p.00001) and age groups (p.00001) were different than expected respectively. Conclusion: In our study, hepatitis B infection was more common in men than women and most common in age group 21-40 years, followed by 0-20 years, 41-60 years and 60 years. Our observed prevalence of hepatitis B infection in men was higher than expected in women it was lower than expected. Our observed prevalence in the four age groups was not similar to expected.

Background: Hematopoietic stem cell transplantation (HSCT) is therapeutic option for many blood diseases. It has increased risk of complications with incompatible pair. The objective of this study was to determine the frequency of complications in ABO-incompatible HSCT in Pakistan. Materials Methods: This cross-sectional study was conducted at Armed Forces Bone Marrow Transplant Centre , Rawalpindi, Pakistan from 11th August 2018 till 15th March 2021. A sample of 73 ABO-incompatible HSCT patients was selected. Variables were sex, age groups, acute delayed hemolysis, pure red cell aplasia and acute GvHD. All variables being categorical were described by count and percentage with 80%CI. Complications in sample vs. population were compared through chi-square goodness of fit test. RESULTS: Seventy three patients with ABO-incompatible HSCT included 52 (71.23%) men 21 (28.77%) women, and 49 (67.12%) in age group ≤14 years 24 (32.88%) in ≥15 years. Out of 73 patients, eight (10.96%) had acute hemolysis, 26 (35.62%) had delayed hemolysis, four (5.84%) had pure red cell aplasia and 34 (46.58%) had acute GvHD. The observed prevalence in sample was similar to population for acute (p=.46893) and delayed hemolysis (p=.30759) and acute GvHD (p=.55841), while it was different for pure red cell aplasia (p=.00006). CONCLUSION: Most common complication in our study was acute GvHD, followed by delayed hemolysis, acute hemolysis pure red cell aplasia. The observed prevalence in sample was similar to population for acute delayed hemolysis and acute GvHD, while it was different for pure red cell aplasia.

Background: Untreated hepatitis C virus infection is major cause of cirrhosis and hepatocellular carcinoma causing significant morbidity and mortality. Our objectives were to determine distribution of active hepatitis C infected population by sex and age groups in District D.I.Khan, Pakistan. Materials Methods: This cross-sectional study was conducted at District Health Office, D.I.Khan, Pakistan from 25 April 2021 to 12 May 2021. Data was collected for period from 11 February 2017 to 22 April 2021. 1062 active hepatitis C infected cases were selected from population at risk consecutively. Sex (nominal) and age groups (ordinal) were variables. Distribution was analyzed by count, percentage and confidence intervals for proportion for population. Hypotheses for distribution were substantiated by chi-square goodness-of-fit test. Results: Out of 1062 active hepatitis C infected population, 569 (53.58%) were men 493 (46.42%) women, and 51 (4.80%) in age group 0-20 years, 433 (40.77%) in 21-40, 476 (44.82%) in 41-60 102 (9.61%) in 60 years. Our distribution by sex (p.00001) and age groups (p.00001) was different than expected. Conclusion: In our study, active hepatitis C infection was more common in men than women and most common in age group 41-60 years, followed by 21-40, 60 0-20 years. Our observed prevalence of active hepatitis C infection in men was lower than expected in women it was higher than expected. Our observed prevalence of active hepatitis C infection in the four age groups was not similar to expected.

Abstract Machine learning (ML) has emerged as a powerful technique in the Earth system science, nevertheless, its potential to model complex atmospheric chemistry remains largely unexplored. Here, we applied ML to simulate the variability in urban ozone (O3) over Doon valley of the Himalaya. The ML model, trained with past variations in O3 and meteorological conditions, successfully reproduced the independent O3 data (r2 ~ 0.7). Model performance is found to be similar when the variation in major precursors (CO and NOx) were included in the model, instead of the meteorology. Further the inclusion of both precursors and meteorology improved the performance significantly (r2 = 0.86) and the model could also capture the outliers, which are crucial for air quality assessments. We suggest that in absence of high-resolution measurements, ML modeling has profound implications for unraveling the feedback between pollution and meteorology in the fragile Himalayan ecosystem.

Abstract In the current study, APOB (rs1052031) genotype-guided proteomic analysis was performed in a cohort of Pakistani population. A total of 700 study subjects, including Coronary Artery Disease (CAD) patients (n = 480) and healthy individuals (n = 220) as a control group were included in the study. Genotyping was carried out by using tetra primer-amplification refractory mutation system-based polymerase chain reaction (T-ARMS-PCR) whereas mass spectrometry (Orbitrap MS) was used for label free quantification of serum samples. Genotypic frequency of GG genotype was found to be 90.1%, while 6.4% was for GA genotype and 3.5% was for AA genotypes in CAD patients. In the control group, 87.2% healthy subjects were found to have GG genotype, 11.8% had GA genotype, and 0.9% were with AA genotypes. Significant (p = 0.007) difference was observed between genotypic frequencies in the patients and the control group. The rare allele AA was found to be strongly associated with the CAD [OR: 4 (1.9–16.7)], as compared to the control group in recessive genetic model (p = 0.04). Using label free proteomics, altered expression of 60 significant proteins was observed. Enrichment analysis of these protein showed higher number of up-regulated pathways, including phosphatidylcholine-sterol O-acyltransferase activator activity, cholesterol transfer activity, and sterol transfer activity in AA genotype of rs562338 (G>A) as compared to the wild type GG genotype. This study provides a deeper insight into CAD pathobiology with reference to proteogenomics, and proving this approach as a good platform for identifying the novel proteins and signaling pathways in relation to cardiovascular diseases.

Objective: To evaluate the overall faculty performance by comparison of Self-assessment with peer and student assessment. Study Design:Acomparative cross sectional survey. Place and Duration of Study: Study was conducted from January to June 2012 in Riphah College of Rehabilitation Sciences, Riphah International University Islamabad. Materials and Methods: This research study was conducted among students of Doctor of physical therapy (DPT), post-professional Doctor of physical Therapy (PPDPT), and Master of Science in speech language pathology (MS-SLP), and faculty members at Riphah College of Rehabilitation Science (RCRS), Riphah International University Islamabad. The total sample size was 730, including 700 students and 30 faculty members. A questionnaire was developed according to likert scale, and after a pilot study on 20 student and 10 faculty member to determine the reliability. The questionnaire was circulated among all the 30 faculty members and 700 students, including 500 undergraduate and 200 post graduate students of all the 3 programs.The data was analyzed and Wilcoxon (Kruskal-Wallis) was applied at 95% level of significance for all the 3 groups. The group “A” included assessment of the performance of the faculty members done by the students, group “B” done by other faculty members, and group “C” included self assessment done by faculty members. The averages were calculated to determine the overall performance of the faculty members as assessed by themselves, other faculty members, and the by students as well, afterwards the averages of 3 groups were compared. Results: the overall performance of the faculty members was graded as 71% (P=0.015) as evaluated by the students, 77%(P=0.009) as evaluated by other faculty members, and 73% (P=0.011) as evaluated by the faculty members through self assessment. Conclusion: It is concluded that there was no significant difference in the performance of the faculty members, as assessed themselves, by the students and the other faculty members.

Objective: To compare the yield of interictal epileptiform discharges on prolonged (1-2 hours) electroencephalogram (EEG) as compared to standard routine (30 minutes) electroencephalogram (EEG). Study Design: Comparative observational study. Place and Duration of Study: Pak Emirates Military Hospital, Rawalpindi from Oct 2019 to Sep 2020. Methodology: A total of 364 outdoor patients with suspected epilepsy were recruited for the study. Out of these 55 electroencephalograms were excluded after applying exclusion criteria and 309 were included for final analysis. Electro-encephalograms were recorded using a 10-20 international system of electrode placement. The duration of each standard electroencephalogram was 30 minutes. It was followed by recording for an extended period of 60 minutes at least. The time to the appearance of the first abnormal interictal epileptiform discharge was noted. For analytical purposes, epileptiform discharges were classified as “early” if they appeared within the first 30 minutes and as “late” if appeared afterward. All electro-encephalograms were evaluated independently by two neurologists. Results: A total of 309 electroencephalograms were included for final analysis. Interictal epileptiform discharges were seen in 48 (15.6%) recordings. The mean time to appearance of first interictal epileptiform discharge was 14.6 ± 19.09 minutes. In 36 (11.7%) cases, discharges appeared early (within the first 30 minutes) whereas in the remaining 12 (3.9%) cases, discharges appeared late. This translates into a 33% increase in the diagnostic yield of electroencephalogram with an extended period of recording. Conclusion: Extending the electroencephalogram recording time results in a significantly better diagnostic yield of outdoor electroencephalogram.

Objective: To determine whether an educational program on personal protective measures can reduce anxiety and depression in Hospital workers exposed to COVID-19. Study Design: Quasi-experimental study. Place and Duration of Study: COVID Units & Emergency Room, from May to Jul 2020. Methodology: Educational tool based on World Health Organization and Pan American Health Organization guidelines including videos on Personal Protective Equipment usage was delivered to hospital staff assigned to areas with COVID-19 patients. Likert scale, Generalised Anxiety Disorder-7 score and Major Depression Inventory were used. Results: 100 hospital staff were included. About 40% doctors, 41% Nurses. None had preexisting anxiety or depression. 11% reported COVID-19, 46% reported quarantine, and 91% reported contact. About 93% stated insufficient knowledge of usage of personal protective equipment and 35% reported inadequate provision of personal protective equipment. Median score on the likert scale was 5 (IQR 4-7). Mean generalized anxiety disorder score was 6.48 ± 3.4, which improved to 4.65 ± 2.7 post session, p-value

Objectives To systematically review existing literature on hospital-based quality improvement studies in sub-Saharan Africa that aim to improve surgical and anaesthesia care, capturing clinical, process and implementation outcomes in order to evaluate the impact of the intervention and implementation learning.Design We conducted a systematic literature review and narrative synthesis.Setting Literature on hospital-based quality improvement studies in sub-Saharan Africa reviewed until 31 December 2021.Participants MEDLINE, EMBASE, Global Health, CINAHL, Web of Science databases and grey literature were searched.Intervention We extracted data on intervention characteristics and how the intervention was delivered and evaluated.Primary and secondary outcome measures Importantly, we assessed whether clinical, process and implementation outcomes were collected and separately categorised the outcomes under the Institute of Medicine quality domains. Risk of bias was not assessed.Results Of 1573 articles identified, 49 were included from 17/48 sub-Saharan African countries, 16 of which were low-income or lower middle-income countries. Almost two-thirds of the studies took place in East Africa (31/49, 63.2%). The most common intervention focus was reduction of surgical site infection (12/49, 24.5%) and use of a surgical safety checklist (14/49, 28.6%). Use of implementation and quality improvement science methods were rare. Over half the studies measured clinical outcomes (29/49, 59.2%), with the most commonly reported ones being perioperative mortality (13/29, 44.8%) and surgical site infection rate (14/29, 48.3%). Process and implementation outcomes were reported in over two thirds of the studies (34/49, 69.4% and 35, 71.4%, respectively). The most studied quality domain was safety (44/49, 89.8%), with efficiency (4/49, 8.2%) and equitability (2/49, 4.1%) the least studied domains.Conclusions There are few hospital-based studies that focus on improving the quality of surgical and anaesthesia care in sub-Saharan Africa. Use of implementation and quality improvement methodologies remain low, and some quality domains are neglected.PROSPERO registration number CRD42019125570