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The need for accurate and efficient malaria diagnosis has driven research into automated solutions using deep learning. This study presents a comparative analysis of five convolutional neural network (CNN) models for malaria detection in microscopic blood cell images. We evaluated models ranging from a basic architecture to advanced iterations employing data augmentation and VGG16 transfer learning. Using a dataset of 24,958 training and 2,600 test images, we assessed performance based on accuracy, precision, recall, F1-score, and computational efficiency. Our results demonstrate that a simpler CNN model (Model_1) achieved greater than 99% accuracy, surpassing the performance of more complex models while requiring significantly less computational resources. This finding underscores the potential of efficient deep learning strategies for developing scalable and cost-effective malaria diagnostic tools. more...

Abstract Emergency Medical Services (EMS) are vital for providing timely out‐of‐hospital care during medical emergencies. This research aims to optimize ambulance services by strategically allocating resources to minimize response time. A modified Whale Optimization Algorithm (mWOA) is introduced to achieve this goal, focusing on providing 24 × 7 services to every patient in need. The, conducted in Southern Delhi, India, considers the uncertain and stochastic nature of demand and traffic. The results demonstrate a 14.6% improvement in average EMS‐based response time, highlighting the effectiveness of the mWOA algorithm in enhancing ambulance allocation strategies. The results obtained using different algorithms are compared with those obtained using mWOA. The experiment outcomes demonstrate that the mWOA has higher efficiency and superiority than alternative algorithms regarding convergence rate and stability. more...

Abstract Partial discharges (PD) are initiated in electrical equipment during various points of the equipment’s lifecycle. The intensity of PD defects rises continuously with time, which can lead to insulation degradation and reduced operational life of the electrical equipment. The optimum feature selection of PD signals captured, from different insulation defects, can enhance the classification accuracy of PD defects and facilitate better visualization of PD parameters for electric motor (EM) insulation monitoring and diagnostics. This paper presents a hybrid approach, based on Maximize Relevancy and Minimize Redundancy (mRMR) and random forest (RF), for the optimum feature selection and classification of PD signals in EMs containing multiple defects. For this purpose, four PD defects are developed in the EMs insulation under laboratory conditions, and 800 PD signals are acquired using a conventional IEC-60,270 experimental platform. The severity of these defects is determined and investigated based on PD characteristic parameters. Several features of both PD sweep signals and conventional PD pulses are extracted. Consequently, the mRMR feature selection technique is implemented to select the significant features of the detected PD signals. To establish the plausibility of this technique, several other feature selection algorithms, including RefliefF, Gini Index (GI), and Information Gain (IG), are introduced for the same datasets. The performance of all these feature selection algorithms is validated using three commonly used classification techniques such as RF, support vector machines (SVM), and k-nearest neighbors (k-NN). In summary, the results show that the combination of mRMR and RF proves to be the most effective feature selection algorithm for the classification of insulation defects in EMs, achieving an accuracy of 99.875%. This accuracy is significantly better than other feature selection and classification techniques and indicates its potential for application to other power system components. more...

Summary: The long term and large scale energy storage operations require quick response time and round-trip efficiency, which are not feasible with conventional battery systems. To address this issue while endorsing high energy density, long term storage, and grid adaptability, the hydrogen energy storage (HES) is preferred. This proposed work makes a comprehensive review on HES while synthesizing recent research on energy storage technologies and integration into renewable energy (RE) applications. The proposed research also identifies critical challenges related to system optimization, energy management strategies, and economic viability while featuring emerging technologies like artificial intelligence (AI) and machine learning (ML) for energy management. The proposed survey also discusses key advancements in battery technologies (lithium-ion, Ni-Cd, Ni/MH, and flow batteries) that are examined alongside innovations in HES methods. The proposed survey utilizes an extensive list of publications to date in the open literature to canvass and portray various developments in this area. more...

Food security has become a major concern for most countries. This is due to: 1) the growth of the world population, 2) the decline of natural resources, 3) the loss of agricultural land, and 4) the increase of unforeseen environmental conditions (storms, fires, and other natural hazards). The fire outbreak, in general, has developed into a serious concern. In the coming years, the rate of fire outbreaks could rise exponentially, requiring immediate attention to avoid loss of property and life. To resolve such an issue, a shift from the agricultural industry to smart agriculture via applications of 1) the Internet of Things (IoT), 2) embedded systems, and 3) sensors for fire prevention are required to improve operational efficiency and productivity. A fire detection and anti-fire security (FDAS) system in smart agriculture using the IoT and embedded system is proposed. The proposed system has four technology levels: 1) the edge network layer, 2) the fog network layer, 3) the cloud computing layer, and 4) the data representation layer. The proposed system uses an embedded system like a Raspberry Pi device and sensors to measure the amount of fire smoke in the air and the proportion of fire in the area. The data obtained from the sensors are sent over the internet to the ThingSpeak platform using the machine-to-machine-based Message Queuing Telemetry Transport (MQTT) protocol for further display and analysis. Data available is then 1) stored, 2) processed, and 3) visualized through the ThingSpeak platform in real-time. An e-mail alert is sent to the farm owner if a fire is detected on the farm using the Simple Mail Transfer Protocol (SMTP). When a fire is detected, the anti-fire system is activated. It further filters and analyzes the data using the MATLAB application. Python programming language is also used to develop the program source code. The performance results of the proposed scheme show an accurate fire detection and anti-fire system performance for improving food security and sustainability in agriculture. more...

In the absence of portable charging devices, sectors such as transportation, communication, and emergency services deal with various challenges towards electric power needs while compromising on (1) operational efficiency, (2) insufficient portable charging solutions, and (3) limited versatility. This highlights the critical need for reliable and multi-functional power solutions. To provide a portable charging solution across diverse sectors, this paper proposes an innovative development of a solar-powered multi-functional portable charging device (SPMFPCD) with internet- of-thing (IoT)-based monitoring capabilities. The proposed scheme introduces a comprehensive model integrating advanced technologies which include a highly efficient solar panel, charge controller, sensors, and IoT module. The proposed system facilitates versatile charging solutions for a wide range of power requirements with real-time monitoring and data analysis through the IoT platform. Moreover, the proposed work explores the applications of the SPMFPCD in (1) emergency medical scenarios, (2) outdoor adventures, (3) disaster management, and 4) public spaces. Performance evaluation was made by proposing case studies to validate the (1) economic viability, (2) power management, and (3) environmental impact of widespread deployment of SPMPFCD in public spaces. Furthermore, detailed analysis of battery energy storage system (BESS) and photovoltaic (PV) integration for load management, seasonal dynamics, and renewable energy integration (REI) contribute to a comprehensive understanding of the proposed solution. more...

Wind energy systems have been flourishing on a rapid scale as a reliable renewable energy source in several countries. However, as the demand for these systems continues to grow, it becomes crucial to have a reliable and cost-effective condition monitoring system to enhance their availability. Condition monitoring plays a crucial role in achieving economic and reliable wind turbine operation. Recently, online monitoring and fault detection have been gaining greater interest in protecting these systems. Innovative and novel methods are developed to achieve real-time and remote monitoring of wind turbines. Online monitoring can offer real-time data to indicate the health condition of these systems while in service. This reduces (1) loss of production and downtime, and (2) maintenance and operational costs incurred due to system failures. This proposed work presents a comprehensive review of wind turbine online condition monitoring methods and techniques presented in the literature. Moreover, the (1) structure, (2) failures, and (3) signal processing methods of wind turbine systems were presented. Furthermore, a brief comparison was presented of (1) online monitoring techniques, and (2) signal processing methods utilized for wind turbine systems. A detailed list of published work to date has been gathered to portray a complete picture of addressed developments in this area. more...

The widespread adoption of electrical vehicles (EVs) has led to an increased demand for charging stations which required an adequate charging infrastructure. However, this challenge brings substantial financial and ecological implications for the power grid and other major stakeholders such as EV users, system operators and policymakers. To resolve this issue, this work proposes a smart EV charging infrastructure that provides 1) effective load management of EVs, 2) real-time monitoring of charging slots at a charging station, 3) smart security system, and 4) integration of renewable energy resources (RERs) into charging stations. This is achieved by setting out how to incorporate photovoltaic (PV) system into charging station infrastructure while suggesting effective EV load management with optimal energy utilization and minimal energy costs. Also, the annual power production of PV systems and power sharing between different power resources has been investigated to enable effective decisions about EV scheduling. The proposed infrastructure also offers an internet-of-things (IoT)-based monitoring of fast/slow charging units with real-time slot tracking to the users and charging station operators. The security aspect of the charging station is covered by a sensor-driven radio frequency identification (RFID) system. Experimental results that the proposed system generates 1,055,326 kWh/year, reducing grid reliance by 50% (to 335,775 kWh) and lowering CO2 emissions from 425,326 kg to 212,210 kg. Moreover, energy costs drop from $0.30 to $0.13 per kWh and 270,567 kWh/year energy is sold back to the grid. The proposed system yields a net present revenue of $1,020,000 which demonstrates significant economic and environmental benefits. more...

The integration of internet-of-things (IoT) technologies is proving crucial for optimizing crop management and monitoring in smart farming. The challenges posed by climate change which involve 1) increased pressure on natural resources, and 2) heightened food safety requirements, eventually call for innovative solutions to protect agricultural resources. Early fire detection, in particular, is essential to prevent major damage and ensure the sustainability of agricultural practices. This article presents an advanced IoT architecture for early fire detection. The proposed architecture integrates 1) smoke and flame sensors, 2) a Raspberry Pi for local processing, and 3) the ThingSpeak platform for data storage and visualization. The system is based on a three-layered architecture: 1) the IoT device layer, 2) the cloud layer, and 3) the application layer, enabling real-time collection and analysis of environmental data. Sensors collect real-time environmental data, which is then transmitted to ThingSpeak for storage. The ThingSpeak platform, combined with MATLAB visualization tools, enables continuous monitoring and in-depth trend analysis of historical data. The results show a clear improvement in accuracy and responsiveness in fire detection while contributing to the safety of agricultural resources and more sustainable management. The blend of IoT technologies, real-time data processing, and cloud-based visualization in this proposed detection system represents an important step towards safer and more resilient agriculture in the face of environmental risks. more...

IntroductionThe integration of electric vehicles (EVs) into the power network challenges the 1) grid capacity, 2) stability, and 3) management. This is due to the 1) increased peak demand, 2) infrastructure strain, and 3) intermittent charging patterns. Previous studies lack comprehensive integration of renewable energy and battery storage with EV charging.MethodsTo address these challenges, this study explores the effectiveness of incorporating renewable energy resources (RERs) and battery energy storage systems (BESS) alongside the traditional grid. The proposed study utilizes the HOMER Grid® and conducted a comprehensive analysis.ResultsThe proposed study compares two grid integrated scenarios: 1) Case-1 (grid and photovoltaic (PV) systems), and 2) Case-2 (grid, PV systems, and BESS). Both these scenarios are compared against a Base case relying solely on grid power. The evaluation employed techno-economic analysis while focusing on 1) net present cost (NPC), 2) cost of energy, and 3) annualized savings. Additionally, the proposed study analyzed 4) seasonal variations in EV charging demand, 5) grid interactions, 6) PV production, and 7) the operation of BESS in both summer and winter. The comparative analysis reveals that the Base case incurs a net present cost (NPC) of $546,977 and a cost of energy (COE) of $0.354 per kWh. In contrast, Case-1, which integrates a 100 kW PV system, shows a significantly lower NPC of -$122,962 and a reduced COE of -$0.043 per kWh, with annualized savings of $61,492. Case-2, incorporating both the 100 kW PV system and a BESS with a capacity of 9.8 kWh, has a higher NPC of $309,667 but a COE of $0.112 per kWh and provides annual savings of $51,233 compared to the Base case.DiscussionSeasonal analysis highlights that Case-2 achieves the lowest carbon emissions in summer, ranging from 2.0 to 2.5 tons, while Case-1 shows the lowest emissions in winter, ranging from 3.2 to 3.4 tons. This model 1) reduces operational costs, 2) minimizes carbon emissions, while 3) making it compelling for future energy systems in increasing EV adoption. more...

In modern agriculture, the threat of fire poses significant economic and environmental risks. Additionally, traditional fire detection methods are inadequate and poorly integrated with advanced technologies. It is crucial to develop a more efficient and reliable fire detection system. Also, the lack of real-time and accurate monitoring in current systems compromises the resilience and sustainability of farming operations. This article details developing and implementing a real-time fire detection system tailored for smart agriculture. It integrates cutting-edge technologies, including the Internet of Things (IoT), embedded systems, and a Flask-based web application, fortified by cybersecurity measures such as login authentication and secure HTTP protocols. The system's primary aim is to monitor environmental conditions continuously in agricultural fields to detect signs of smoke or flame swiftly, facilitating preventive actions to safeguard crops and infrastructure. The architecture employs sensors distributed across fields to monitor conditions, a Raspberry Pi 3 B+ as the central processing unit for data acquisition and transmission, and a web interface developed using Flask, HTML, and CSS for secure and real-time visualization of detection data. Critical components like the MCP3208 analog-to-digital converter ensure the system's reliability and accuracy. Experimental results confirm the system's efficacy in early fire detection and real-time data visualization via the web browser. Enhanced security features, such as login authentication, protect sensitive information, while regular updates maintain data relevance. This study advances fire prevention and farm preservation efforts, offering a high-performance technological solution for proactive monitoring and quick response to fire risks, thereby supporting food security and sustainable agricultural practices. more...

Agriculture, the key sector for food production, faces challenges exacerbated by the growing global demand for food and the scarcity of water resources. Traditional irrigation methods often lead to inefficient use of water, resulting in wastage. Moreover, unpredictable weather conditions and the need to adopt sustainable farming practices are driving us to develop advanced irrigation systems. This paper proposed a smart irrigation management system using new technology like 1) embedded systems, 2) Internet of Things (IoT), 3) telemetry data, 4) cloud computing, communication protocol, and 5) sensors to collect and process real-time data of the smart agriculture. This new technology and intelligent algorithm are used in this paper to improve agricultural practices. The architecture of the proposed scheme comprises three layers: 1) IoT devices, 2) ThingsBoard cloud, and 3) the dashboard, each playing a pivotal role in ensuring seamless data flow, secure communication, and enhanced user interaction. The algorithm orchestrates system operations, incorporating sensor data reading, JavaScript Object Syntax (JSON) payload creation, and secure telemetry data transmission via Hypertext Transfer Protocol (HTTP) protocol to the ThingsBoard cloud. Pump activation decisions are governed by predefined thresholds, preventing an over-irrigation system. The evaluation of system performance involves deploying temperature, humidity, moisture, and water level sensors in a testing field. Further, before data is sent to the cloud, sensor values are calibrated using a functional map. Tests carried out with temperature, humidity, and water level sensors demonstrate the system's dynamic efficiency. By visualizing and analyzing environmental information via ThingsBoard, the results provide real-time data on environmental parameters of the system proposed, improving the efficiency of water use and the sustainability of farming practices. In addition, the system features e-mail notifications for alerts. The integration of e-mail notifications reinforces monitoring and management practices by alerting farm owners and users. This study showcases the efficacy of the proposed paper in enhancing sustainability, water usage, and supporting smart agriculture practices. Further, this paper integrates embedded systems, IoT, cloud computing, and advanced algorithms to optimize and enhance crop productivity and contribute to global food and water security. more...

Abstract BackgroundThe driving force for many seeking plastic surgery is comfort in one's body. Along with comfort come satisfaction, improved self-awareness, and potential change in interoceptive awareness—a term defined as the conscious perception of one's body. Although conscious perception of bodily signals is influenced by many factors, sense of self and body image play significant roles. Studies show diminished interoceptive awareness in those with negative body image, but no research has assessed the impact of change in body image on interoceptive awareness. ObjectivesThe purpose of this study is to investigate how interoceptive awareness changes following elective breast surgery. MethodsThe Multidimensional Assessment of Interoceptive Awareness Version 2 (MAIA-2) was administered to females undergoing breast surgery. A baseline survey was administered preoperatively, with follow-up surveys at 1 week, 1 month, and 3 months postoperatively. ResultsData were collected from 39 females and analyzed using paired t ConclusionsFrom this study, it can be concluded that breast surgery positively impacts interoceptive awareness. These findings are clinically relevant as they offer providers’ insight into the psychological effects of breast procedures. A comprehensive understanding of procedure outcomes enables providers to educate patients on both anticipated physical results and changes in sense of self. Level of Evidence: 2 more...

The abundance of powered semiconductor devices has increased with the introduction of renewable energy sources into the grid, causing power quality disturbances (PQDs). This represents a huge challenge for grid reliability and smart city infrastructures. Accurate detection and classification are important for grid reliability and consumers’ appliances in a smart city environment. Conventionally, power quality monitoring relies on trivial machine learning classifiers or signal processing methods. However, recent advancements have introduced Deep Convolution Neural Networks (DCNNs) as promising methods for the detection and classification of PQDs. These techniques have the potential to demonstrate high classification accuracy, making them a more appropriate choice for real-time operations in a smart city framework. This paper presents a voting ensemble approach to classify sixteen PQDs, using the DCNN architecture through transfer learning. In this process, continuous wavelet transform (CWT) is employed to convert one-dimensional (1-D) PQD signals into time–frequency images. Four pre-trained DCNN architectures, i.e., Residual Network-50 (ResNet-50), Visual Geometry Group-16 (VGG-16), AlexNet and SqeezeNet are trained and implemented in MATLAB, using images of four datasets, i.e., without noise, 20 dB noise, 30 dB noise and random noise. Additionally, we also tested the performance of ResNet-50 with a squeeze-and-excitation (SE) mechanism. It was observed that ResNet-50 with the SE mechanism has a better classification accuracy; however, it causes computational overheads. The classification performance is enhanced by using the voting ensemble model. The results indicate that the proposed scheme improved the accuracy (99.98%), precision (99.97%), recall (99.80%) and F1-score (99.85%). As an outcome of this work, it is demonstrated that ResNet-50 with the SE mechanism is a viable choice as a single classification model, while an ensemble approach further increases the generalized performance for PQD classification. more...

Background: SARS-CoV-causing COVID-19 resulted in mortality, and the clinic-epidemiological profile at the time of admission of patients who died later could provide an insight into pathophysiological consequences due to infection. Method: Retrospective observational study of 64 RTPCR-confirmed COVID-19 non-survivors was conducted from April - June 2021 and January February 2022. Data were analyzed, and a P value more...

The growing industry and its complex and large information sets require Big Data (BD) technology and its open-source frameworks (Apache Hadoop) to (1) collect, (2) analyze, and (3) process the information. This information usually ranges in size from gigabytes to petabytes of data. However, processing this data involves web consoles and communication channels which are prone to intrusion from hackers. To resolve this issue, a novel machine learning (ML)-based security-centric approach has been proposed to evade cyber-attacks on the Hadoop ecosystem while considering the complexity of Big Data in Cloud (BDC). An Apache Hadoop-based management interface “Ambari” was implemented to address the variation and distinguish between attacks and activities. The analyzed experimental results show that the proposed scheme effectively (1) blocked the interface communication and retrieved the performance measured data from (2) the Ambari-based virtual machine (VM) and (3) BDC hypervisor. Moreover, the proposed architecture was able to provide a reduction in false alarms as well as cyber-attack detection. more...

Mitral valve prolapse (MVP) affects 2–3% of the general population, and despite its benign prognosis overall, it is associated with sudden death in a small subset of patients. The term “arrhythmic MVP syndrome” (AMVPS) refers to the presence of frequent or complex ventricular arrhythmias, commonly reported in female patients with a stereotypical phenotype including bileaflet myxomatous disease, ECG repolarisation abnormalities in inferior leads, mitral annular disjunction, and significant fibrosis in the inferolateral LV and papillary muscles. Modern imaging technologies have led to the identification of new risk factors that have been implemented in recent risk stratification guidelines; however, screening for patients with MVP who are at risk of sudden cardiac death (SCD) remains challenging. In addition, there is a limited amount of data on the outcomes of different treatment approaches in AMVP and no specific indication for targeted or disease-modifying therapies within current guidelines. Potential arrhythmic substrates in patients with AMVP syndrome have been the subject of interest in previous studies, with areas consisting of fibrosis at the papillary muscle level and the Purkinje system. Premature ventricular contractions (PVCs) originating from these areas have been shown to play an important role as triggers for ventricular fibrillation and SCD in patients with AMVP. Catheter ablation has emerged as a potential treatment modality in patients with MVP and ventricular arrhythmias (VAs), targeting arrhythmic substrates and triggering PVC foci. The aim of this review is to explore the role of catheter ablation in treating patients with AMVP. more...

Background:. There is a trend toward matching in a different region than previous training for the independent plastic surgery match cycles from 2019 to 2021, which differs from the trend to match within the same region for integrated plastic surgery programs. Notably, residency interviews transitioned from in-person to virtual in 2020 due to the coronavirus pandemic. Therefore, we compared in-person versus virtual interview match trends from 2019 to 2023. Methods:. Zip codes and regions of each successfully matched plastic surgery applicant’s medical school, residency, and plastic surgery program were gathered from publicly available data for the 2019 and 2020 in-person interview cycles and 2021, 2022, and 2023 virtual interview cycles. Results:. Although regions did not differ significantly in the proportions of positions each year (P = 0.85), there was a trend toward fewer positions in each region from 2019 to 2022. Overall, applicants were more likely to match in a different region as their medical school or residency during virtual compared with in-person interviews (P = 0.002 and P = 0.04). Applicants matched to programs further from their medical school zip code in virtual interview years (P = 0.02). There was no significant difference in distance between surgical residencies and plastic surgery residencies between the two time periods (P = 0.51). Conclusions:. Trends toward matching into a different region than prior training after the switch to virtual interviews could be attributed to applicant accessibility to interview broadly. However, this could also be due to the decreased number of independent residency positions over the years, requiring applicants to move regions and travel further from where they began their training. more...

Background: An early and effective immune response has a role in disease presentation and clearance of pathogen. Chemokine and cytokine responses in the immunopathogenesis of scrub typhus (ST) are the least explored aspect. This study aimed to analyze interleukin (IL)-2, IL-6, tumor necrosis factor-alpha (TNF-α), IL-10, transforming growth factor (TGF)-β, and human macrophage inflammatory protein-1 (HMIP-1) β cytokine levels in ST-positive patients during the acute phase of illness. Materials and Methods: A total of 112 ST-positive patients were included in the study with 30 healthy controls (HC). Diagnosis was confirmed by immunoglobulin M enzyme-linked immunosorbent assay (ELISA) and indirect immunofluorescence assay. The serum levels of cytokines were measured using the ELISA. Statistical analysis was performed with the IBM SPSS Statistics 20 and MedCalc 16.1 Software. Results: The mean level of IL-6, IL-10, TNF-α, and HMIP1-β (72 pg/ml, 86.7 pg/ml, 187.05 pg/ml, and 12.23 pg/ml vs. 7.30 pg. ml, 8.73 pg/ml, 56.62 pg/ml, and 6.94 pg/ml, respectively) was significantly raised among the ST patients compared to the control group (P < 0.001) However, the mean and median levels of IL-2 and TGF-β were not differed significantly between ST patients and HC (P = 0.0207 and 0.0386, respectively). The severity of the disease involved respiratory complications. Around 90.1% (101/112) of patients showed high levels of IL-6, whereas IL-10, TNF-α, and HMIP-1 β levels were raised in 97 (86.6%), 63 (56.2%), and 69 (61.6%) cases, respectively. There was a higher TNF-α level in severe cases with a few values up to 298.77 pg/ml. Conclusion: Proinflammatory cytokines and IL-10 were found to be increased in ST patients during the acute phase of infection. A proper balance of these cytokines is required for a better outcome. These findings suggest that the status of TNF-α levels in the acute phase may predict the severity of ST disease. more...

HIV infection has an impact on the natural course of chronic HBV infection, as it results in an increase in HBV DNA levels, accelerated progression of liver disease, and increased liver-related mortality compared with HBV mono-infection. In HIV/HBV co-infected individuals, widespread uptake and early initiation of HBV-active antiretroviral therapy have drastically improved the natural history of viral infection; however, liver disease remains common. In this paper we have reviewed the epidemiology, prevalence, treatment, pathogenesis of HIV and HBV co-infection. Co-infection of HBV-HIV is more likely to progress and complicate the disease and should be closely monitored and treated. more...

Multidrug resistance (MDR) among pathogenic bacteria is a global health concern as it has rendered the current antibiotic therapy ineffective. A recent and rapidly developing research area in the biomedical sector is the use of biogenic nanoparticles as antibacterial agents. In the current investigation, aqueous leaf extract of Phyllanthus niruri (Pn-AgNPs) were employed for the biogenic synthesis of silver nanoparticles, further characterized by SEM, EDX, FTIR, TEM, UV–Vis and XRD techniques. Electron microscopy images of the green-synthesized Pn-AgNPs showed them as evenly dispersed spherical particles having an average size of about ∼ 20 nm. The Pn-AgNPs were further tested for potential antibacterial activity against isolated drug-resistant pathogenic bacteria such as Burkholderia cepacia complex, carbapenem-resistant Enterobacterales (CRE), Citrobacter freundii, Enterococcus faecalis, Escherichia coli, Enterobacter clocae, MRSA, Salmonella typhi, Streptococcus spp, and vancomycin-resistant Enterococci (VRE).The Pn-AgNPs significantly inhibited growth all of the studied bacterial isolates, including antibiotic-resistant isolates such as MRSA, VRE, and CRE. Electron micrographs clearly showed the enhanced penetration of AgNPs leading to disruption of cell membrane causing death of the cell. Further, Pn-AgNPs dramatically reduced the ability of P. aeruginosa, Bacillus cereus, E. coli, and S. aureus to form biofilms. Leakage of protein from bacterial cells could be main reason for the effective bactericidal action of synthesized AgNPs. This antibacterial and antibiofilm potential of Phyllanthus niruri biosynthesized AgNPs against clinically significant drug-resistant bacteria is impressive and can be developed as a novel antimicrobial agent to combat the threat of drug-resistant bacterial infections. more...

Infectious diseases remain among the most pressing concerns for human health. This issue has grown even more complex with the emergence of multidrug-resistant (MDR) bacteria. To address bacterial infections, nanoparticles have emerged as a promising avenue, offering the potential to target bacteria at multiple levels and effectively eliminate them. In this study, silver nanoparticles (AA-AgNPs) were synthesized using the leaf extract of a medicinal plant, Abroma augusta. The synthesis method is straightforward, safe, cost-effective, and environment friendly, utilizing the leaf extract of this Ayurvedic herb. The UV-vis absorbance peak at 424 nm indicated the formation of AA-AgNPs, with the involvement of numerous functional groups in the synthesis and stabilization of the particles. AA-AgNPs exhibited robust antibacterial and antibiofilm activities against methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococci (VRE). The MIC values of AA-AgNPs ranged from 8 to 32 μg/mL. Electron microscopic examination of the interaction of AA-AgNPs with the test bacterial pathogens showed a deleterious impact on bacterial morphology, resulting from membrane rupture and leakage of intracellular components. AA-AgNPs also demonstrated a dose-dependent effect in curtailing biofilm formation below inhibitory doses. Overall, this study highlights the potential of AA-AgNPs in the successful inhibition of both the growth and biofilms of MRSA and VRE bacteria. Following studies on toxicity and dose optimization, such AgNPs could be developed into effective medical remedies against infections. more...

Background:. Immediate expander/implant-based breast reconstruction after mastectomy has become more sought after by patients. Although many patients choose this technique due to good aesthetic outcomes, lack of donor site morbidity, and shorter procedure times, it is not without complications. The most reported complications include seroma, infection, hematoma, mastectomy flap necrosis, wound dehiscence, and implant exposure, with an overall complication rate as high as 45%. Closed incision negative pressure therapy (ciNPT) has shown value in wound healing and reducing complications; however, the current literature is inconclusive. We aimed to examine if ciNPT improves outcomes for patients receiving this implant-based reconstruction. Methods:. This is a retrospective single-institution study evaluating the ciNPT device, 3M Prevena Restor BellaForm, on breast reconstruction patients. The study was performed between July 1, 2019 and October 30, 2020, with 125 patients (232 breasts). Seventy-seven patients (142 breasts) did not receive the ciNPT dressing, and 48 patients (90 breasts) received the ciNPT dressing. Primary outcomes were categorized by major or minor complications. Age, BMI, and final drain removal were summarized using medians and quartiles, and were compared with nonparametric Mann-Whitney test. Categorical variables were compared using chi-square or Fisher exact test. Results:. There was a statistically significant reduction in major complications in the ciNPT group versus the standard dressing group (P = 0.0247). Drain removal time was higher in the ciNPT group. Conclusion:. Our study shows that ciNPT may help reduce major complication rates in implant-based breast reconstruction patients. more...

Shahid Shah,1 Muhammad Hanif,2 Hafeez Ullah Khan,3 Faiz Ullah Khan,4 Ghulam Abbas,5 Haris Khurram,6 Ahmed Khames,7 Mohamed A Abdelgawad,8 Amira SA Said,9,10 Mohammed AS Abourehab,11 Safirah Maheen,3 Usman Rashid Chand,1 Muhammad Haris1 1Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Government College University Faisalabad, Faisalabad, Pakistan; 2Department of Pharmaceutics, Faculty of Pharmacy, Bahauddin Zakariya University Multan, Multan, Pakistan; 3College of Pharmacy, Department of Pharmaceutics, University of Sargodha, Sargodha, Pakistan; 4Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, People’s Republic of China; 5Department of Pharmaceutics, Faculty of Pharmaceutical Sciences, Government College University Faisalabad, Faisalabad, Pakistan; 6National University of Computer and Emerging Sciences, Chiniot-Faisalabad Campus, Chiniot, Pakistan; 7Department of Pharmaceutics and Industrial Pharmacy, College of Pharmacy, Taif University, Taif, 21944, Saudi Arabia; 8Department of Pharmaceutical Chemistry, College of Pharmacy, Jouf University, Sakaka, Al Jouf, 72341, Saudi Arabia; 9Clinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef, Egypt; 10Clinical Pharmacy Department, College of Pharmacy, Al Ain University, Al Ain, Abu Dhabi, United Arab Emirates; 11Department of Pharmaceutics, Faculty of Pharmacy, Umm Al-Qura University, Makkah, 21955, Saudi ArabiaCorrespondence: Shahid Shah; Ghulam Abbas, Email Shahid.waris555@gmail.com; ghulamabbas@gcuf.edu.pkBackground: Pharmacogenomics (PGx) is essential for optimizing drug therapy and reducing unwanted drug side effects. Our aim was to determine the knowledge, attitude and practice of senior pharmacy students in Punjab, Pakistan towards PGx.Methods: A cross-sectional study was conducted among 511 undergraduate pharmacy students from different universities in Punjab, Pakistan. A validated and pilot-tested structured questionnaire was administered to respondents to assess their knowledge, attitude, and practice regarding PGx. Descriptive statistics and multivariate logistic regression model were used to describe the results of the study. A p-value of less than 0.05 was considered statistically significant.Results: A total of 511 students (58.9% females and 41.1% males) responded to the survey. Most (87.7%) of the students knew that the drug response could be affected by genetic variations. Mean knowledge score of the students was 12.6. Good basic knowledge positively and significantly (p=0.01) affected students’ PGx test knowledge and attitudes. Most (> 70%) of students believed that human genetics affected the drug response due to interindividual variation and ethnic variation. Mean attitude score of the students was 5.23. The majority of students (> 92%) wanted to learn more about PGx and thought it could help them choose the right drug. Students’ knowledge was positively and significantly (p=0.01) affected by a good attitude. Mean practice score of the students was 11.95. When trying to solve a drug-related case study question, about 31.5% of students implemented the idea of human genetic variation. Only 28.8% of students attended a lecture related to the effects of genetic variations on drug therapy. Good practice positively and significantly (p=0.01) affected students’ knowledge of PGx tests.Conclusion: The senior pharmacy students had good knowledge and attitudes towards PGx. However, the practice of PGx needs to be improved to facilitate the application of PGx in clinical practice in Pakistan.Keywords: pharmacogenomics, knowledge, attitude, practice more...

Candida spp. is one of the most common opportunistic human fungal pathogens, responsible for 90–100% of mucosal infections. Germ tube formation, hyphal morphogenesis, the production of tissue-damaging extracellular enzymes, and drug-resistant biofilm formation contribute to their pathogenicity, which can lead to systemic infections in the worst scenarios. Thus, there is an urgent need to discover new therapeutic agents to overcome the above virulence factors. Therefore, we aimed to prepare Crinum latifolium leaves-mediated biosynthesis of gold nanoparticles (AuNPs) that was characterized by various sophisticated techniques, and further their antifungal, antibiofilm, and anti-virulence activities was investigated. The AuNPs show a zone of inhibition between 19 and 22 mm for test strains of Candida spp. at 1000 µg/ml, whereas the MIC values were ranged from 250 to 500 µg/ml. AuNPs inhibit germ tube formation in C. albicans by 93.3% at 50 µg/ml. Furthermore, exposure to AuNPs significantly reduced the secretions of phospholipase, proteinase, hemolysin, esterase, and lipase. Confocal laser scanning microscopy (CLSM) investigation shows that 25 µg/ml of AuNPs significantly inhibit colonization and biofilm formation. Lastly, the interaction of Candidal cells with AuNPs revealed, ultrastructural changes in the cell wall and cell membranes as visualized by a transmission electron microscope (TEM). more...

Background and Objectives: There are conflicting views regarding face mask guidelines amongst healthcare staff to prevent transmission of coronavirus disease 2019 (COVID-19), influenza and other respiratory viral infections (RVIs). We conducted a thorough meta-analysis to statistically compare mask use versus no mask use efficacy for RVIs in healthcare settings. Materials and Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were used for selecting researches published between 2003 and June 2022 from different databases, including Publisher Medline (PubMed), Web of Science, etc.; 6 studies qualified for inclusion. Data was pooled from in vivo randomized control, case-control and observational studies dealing with the relationship between face mask use and no use by patients or health personnel and RVI prevention in healthcare setups. Results: The fixed and random-effects model was carried out to determine pooled odds ratios (ORs) and their respective 95 percent confidence intervals (CIs). The results revealed that wearing a face mask significantly reduced the risk of contracting a respiratory viral illness in hospital settings, with pooled OR (95% CI) of 0.11 (0.04 to 0.33) (probability value (P) more...

An energy audit (EA) is a crucial step in boosting factory energy efficiency and obtaining certification for cleaner manufacturing. The results of a preliminary energy audit carried out at a sizable industrial facility in Jordan that creates some of the most well-known foods in the Middle East are presented in this study. The monthly demand of the factory for diesel ranged from 75,251.545 to 166,666.67 L. The factory energy model which is used to examine the impact of various energy-saving practices on the factory’s primary energy consumption, was developed with the help of the energy audit. It has been established that optimizing the factory’s energy use and the boiler systems' performance with regards to diesel consumption can withstand an expected monthly financial savings of 14205.85 Jordanian Dinar (JD). This has allowed a reduction in energy use of up to 18%. The CO2 harmful emissions were also decreased. Additionally, it is estimated that switching from the proposed motors to energy-efficient motors will cost less overall over time, saving around 3472.314 JD/month or 0.33576/year on average. Moreover, it was discovered that a total of 772.82021 Ton CO2/year emissions may be avoided each year. more...

Abstract Refractory cardiogenic shock (CS) often requires veno-arterial extracorporeal membrane oxygenation (VA-ECMO) to sustain end-organ perfusion. Current animal models result in heterogenous cardiac injury and frequent episodes of refractory ventricular fibrillation. Thus, we aimed to develop an innovative, clinically relevant, and titratable model of severe cardiopulmonary failure. Six sheep (60 ± 6 kg) were anaesthetized and mechanically ventilated. VA-ECMO was commenced and CS was induced through intramyocardial injections of ethanol. Then, hypoxemic/hypercapnic pulmonary failure was achieved, through substantial decrease in ventilatory support. Echocardiography was used to compute left ventricular fractional area change (LVFAC) and cardiac Troponin I (cTnI) was quantified. After 5 h, the animals were euthanised and the heart was retrieved for histological evaluations. Ethanol (58 ± 23 mL) successfully induced CS in all animals. cTnI levels increased near 5000-fold. CS was confirmed by a drop in systolic blood pressure to 67 ± 14 mmHg, while lactate increased to 4.7 ± 0.9 mmol/L and LVFAC decreased to 16 ± 7%. Myocardial samples corroborated extensive cellular necrosis and inflammatory infiltrates. In conclusion, we present an innovative ovine model of severe cardiopulmonary failure in animals on VA-ECMO. This model could be essential to further characterize CS and develop future treatments. more...

Abstract The photovoltaic (PV) cells are highly sensitive to temperature variations. The linear variation of PV cells with operating temperature could lead to the loss of conversion efficiency and permanent damage of PV material. To address this critical issue, while improving the performance of solar photovoltaic system (SPVS) during the operating period, the deployment of a proper cooling system is a prime requisite in the design process. Considering this, two new and cost‐effective cooling techniques are proposed in this study, which can improve efficiency and increase the life of the PV panel. The first technique is the active cooling design with water. The proposed design enhances the access to PV cells to maximize cooling. The second one is an improved passive cooling technique that uses fins mounted on the backside of PV module. This further reduces the temperature by increasing the heat dissipation. Additionally, a third PV module without any cooling system is deployed as a reference margin. The techniques have been experimentally evaluated and a recommendation is made in order to reduce the temperature variation across the PV panel. more...

Solar cells absorb sun light and convert it into electricity. However, the infrastructure of solar cells, their initial cost, energy conversion and efficiency could raise some challenges and concerns. This is because of the current–voltage properties of solar cells which are strongly dependent on the solar radiation and the ambient temperature level. This further causes fluctuations in the photovoltaic (PV) output power. In this article, a novel scheme is proposed to improve the PV system efficiency. This is achieved by using tracker techniques to calculate the maximum power point tracking (MPPT) where the energy can be safely passed to the load under suitable conditions. The scheme is further enhanced by investigating a PV generator and a direct-current (DC) shunt motor using a fuzzy logic controller (FLC) method for monitoring and tracking the maximum power point. A power electronics system based on boost DC-to-DC converter is used along with the PV module to raise the performance by the shift of the converter control input duty cycle. Evaluations were made to analyze the dynamical behavior and the steady state performance of the direct current shunt motor obtained from the PV module using MATLAB SIMULINK. more...

Introduction: Prevalence of asthma in children

Hybrid electric vehicle technology (HEVT) is emerging as a reliable alternative to reduce the constraints of battery-only driven pure electric vehicles (EVs). HVET utilizes an electric motor as well as an internal combustion engine for its operation. These components would work on battery power and fossil fuels, respectively, as a source of energy for vehicle mobility. The power is delivered either from battery or fuel or both sources based on user requirements, road conditions, etc. HEVT uses three major propelling systems, namely, front-wheel drive (FWD), rear-wheel drive (RWD), and four-wheel drive (4WD). In these propelling systems, the 4WD model provides torque to all four wheels at the same time. It uses all four wheels to propel thereby offering better driving capability, better traction, and a strong grip on the surface. The 4WD-based HEVs comprise four architectures, namely, series, parallel, series-parallel, and complex. The literature focuses primarily on any one type of architecture for analysis in the context of component optimization, fuel reduction, and energy management. However, a focus on dynamic analysis that gives a real performance insight was not conducted, which is the main motivation for this paper. The proposed work provides an extensive critical performance analysis of all four 4WD architectures subjected to various dynamic operating conditions (continuous, pulse, and step-up accelerations). Under these conditions, various performance parameters such as speed (of vehicle, engine, and motor), power (of engine and battery), battery electrical losses, charge patterns, and fuel consumption are measured and compared. Further, the 4WD architecture performance is validated with FWD and RWD architectures. From MATLAB/Simulink-based evaluation, 4WD HEV architectures have shown superior performance in most of the cases when compared to FWD type and RWD type HEVs. Moreover, 4WD parallel HEV architecture has shown superior performance compared to 4WD series, 4WD series-parallel, and 4WD complex architectures. more...

SARS-CoV-2–infected patients are reported to show immunocompromised behavior that gives rise to a wide variety of complications due to impaired innate immune response, cytokine storm, and thrombo-inflammation. Prolonged use of steroids, diabetes mellitus, and diabetic ketoacidosis (DKA) are some of the factors responsible for the growth of Mucorales in such immunocompromised patients and, thus, can lead to a life-threatening condition referred to as mucormycosis. Therefore, an early diagnosis and cell-based management cosis is the need of the hour to help affected patients overcome this severe condition. In addition, extended exposure to antifungal drugs/therapeutics is found to initiate hormonal and neurological complications. More recently, mesenchymal stem cells (MSCs) have been used to exhibit immunomodulatory function and proven to be beneficial in a clinical cell-based regenerative approach. The immunomodulation ability of MSCs in mucormycosis patient boosts the immunity by the release of chemotactic proteins. MSC-based therapy in mucormycosis along with the combination of short-term antifungal drugs can be utilized as a prospective approach for mucormycosis treatment with promising outcomes. However, preclinical and in mucormyIn mucormycosis, the hyphae of clinical trials are needed to establish the precise mechanism of MSCs in mucormycosis treatment. more...

Abstract Ventricular arrhythmias are an important cause of morbidity and mortality and come in a variety of forms, from single premature ventricular complexes to sustained ventricular tachycardia and fibrillation. Rapid developments have taken place over the past decade in our understanding of these arrhythmias and in our ability to diagnose and treat them. The field of catheter ablation has progressed with the development of new methods and tools, and with the publication of large clinical trials. Therefore, global cardiac electrophysiology professional societies undertook to outline recommendations and best practices for these procedures in a document that will update and replace the 2009 EHRA/HRS Expert Consensus on Catheter Ablation of Ventricular Arrhythmias. An expert writing group, after reviewing and discussing the literature, including a systematic review and meta‐analysis published in conjunction with this document, and drawing on their own experience, drafted and voted on recommendations and summarized current knowledge and practice in the field. Each recommendation is presented in knowledge byte format and is accompanied by supportive text and references. Further sections provide a practical synopsis of the various techniques and of the specific ventricular arrhythmia sites and substrates encountered in the electrophysiology lab. The purpose of this document is to help electrophysiologists around the world to appropriately select patients for catheter ablation, to perform procedures in a safe and efficacious manner, and to provide follow‐up and adjunctive care in order to obtain the best possible outcomes for patients with ventricular arrhythmias. more...

The exhaustion of natural energy and oil reserves has initiated the concept of renewable energy systems (RESs). This has expanded the vision of energy sector towards a diversified power grid while introducing the distributed energy resources (DERs) and distributed generation (DG). Though, this diversification is achieved by adding new energy generation sources and a two-way power flow, it opens the channel of production and trading with alternating current (AC) and direct current (DC) energy formats. But DC-based energy, due to its sporadic nature, can be further stored easily by energy storage devices. However, in recent years, a compelling need has arisen to understand the communication systems in distributed generation (DG) for better performance management, control and parallel power transfer. In this article, a bibliographic review on communication systems in distributed generations (DGs) is provided. The study identifies various communication technologies, standards, and protocols used in AC and DC-based DGs. Moreover, it contains the classification of different frameworks and methods involved. The methodology of different approaches and their likely combination are discussed for different types of communication networks. This study also represents useful information for readers, thereby demonstrate the complete life-cycle of digital data in sensors/actuators, transmitter, receiver, filter, decoder for control of DG elements and identifies future challenges as well. A comprehensive list of publications to date are compiled to provide a complete picture of different developments in this area. more...

Abstract Ventricular arrhythmias are an important cause of morbidity and mortality and come in a variety of forms, from single premature ventricular complexes to sustained ventricular tachycardia and fibrillation. Rapid developments have taken place over the past decade in our understanding of these arrhythmias and in our ability to diagnose and treat them. The field of catheter ablation has progressed with the development of new methods and tools, and with the publication of large clinical trials. Therefore, global cardiac electrophysiology professional societies undertook to outline recommendations and best practices for these procedures in a document that will update and replace the 2009 EHRA/HRS Expert Consensus on Catheter Ablation of Ventricular Arrhythmias. An expert writing group, after reviewing and discussing the literature, including a systematic review and meta‐analysis published in conjunction with this document, and drawing on their own experience, drafted and voted on recommendations and summarized current knowledge and practice in the field. Each recommendation is presented in knowledge byte format and is accompanied by supportive text and references. Further sections provide a practical synopsis of the various techniques and of the specific ventricular arrhythmia sites and substrates encountered in the electrophysiology lab. The purpose of this document is to help electrophysiologists around the world to appropriately select patients for catheter ablation, to perform procedures in a safe and efficacious manner, and to provide follow‐up and adjunctive care in order to obtain the best possible outcomes for patients with ventricular arrhythmias. more...

Background Leadless pacemaker is a novel technology, and evidence supporting its use is uncertain. We performed a systematic review and meta‐analysis to examine the safety and efficacy of leadless pacemakers implanted in the right ventricle. Methods and Results We searched PubMed and Embase for studies published before June 6, 2020. The primary safety outcome was major complications, whereas the primary efficacy end point was acceptable pacing capture threshold (≤2 V). Pooled estimates were calculated using the Freedman‐Tukey double arcsine transformation. Of 1281 records screened, we identified 36 observational studies of Nanostim and Micra leadless pacemakers, with most (69.4%) reporting outcomes for the Micra. For Micra, the pooled incidence of complications at 90 days (n=1608) was 0.46% (95% CI, 0.08%–1.05%) and at 1 year (n=3194) was 1.77% (95% CI, 0.76%–3.07%). In 5 studies with up to 1‐year follow‐up, Micra was associated with 51% lower odds of complications compared with transvenous pacemakers (3.30% versus 7.43%; odds ratio [OR], 0.49; 95% CI, 0.34–0.70). At 1 year, 98.96% (95% CI, 97.26%–99.94%) of 1376 patients implanted with Micra had good pacing capture thresholds. For Nanostim, the reported complication incidence ranged from 6.06% to 23.54% at 90 days and 5.33% to 6.67% at 1 year, with 90% to 100% having good pacing capture thresholds at 1 year (pooled result not estimated because of the low number of studies). Conclusions Most studies report outcomes for the Micra, which is associated with a low risk of complications and good electrical performance up to 1‐year after implantation. Further data from randomized controlled trials are needed to support the widespread adoption of these devices in clinical practice. more...

Nanoparticles (NPs) prepared through safer, eco-friendly and natural-based products can be used various applications including antimicrobial and biomedical applications. Quorum sensing (QS) is a complex system for intercellular communication that regulates the expression of many virulence determinants, in the opportunistic Pseudomonas aeruginosa. Thus, the disruption of QS-mediated communication system could be an alternative strategy to combat infection caused by drug resistant P. aeruginosa. In this study, zinc oxide nanoparticles (ZnO NPs) were synthesized by using seed extract of Butea monosperma and further characterized by XRD, SEM and TEM. The biosynthesized ZnO NPs were then subjected to the investigation of their antibacterial, antibiofilm activities as well as the anti-quorum sensing potentialities for biomedical applications. The minimum inhibitory concentration (MIC) value against P. aeruginosa was found 1600 µg/ml, and it was found that ZnO NPs effectively reduced virulence factors Viz. swarming and swimming of P. aeruginosa by 62.8 and 45%, respectively. Exopolysaccharides production was also affected by ZnO NPs which indicate the disruption of biofilm formation. Further, the in silico docking analysis displayed that ZnO NPs efficiently interacted within QS (Las/Rhl) mechanism of P. aeruginosa by binding to the catalytic cleft of LasI synthase (Gly-116-ZnO = 2.8 Å), RhlI synthase (Gly-180-ZnO = 3.7 Å) and transcription receptor protein LasR receptor (Asn-141-ZnO = 2.9 Å), RhlR receptor (Tyr-72-ZnO = 2.6 Å). Thus, it was concluded that the effective interaction of ZnO NPs with Las and Rhl system led to the inactivation of autoinducers such as N-acyl homoserine lactones (AHL) molecules which finally led to the inactivation of QS and down regulation of virulence determinants. Consequently, the present in vitro and in silico results obtained suggest that the synthesized ZnO NPs can be efficiently used as potent antimicrobial agents to prevent the colonization, biofilm formation as well as anti-QS-mediated determinants caused by pathogenic drug resistant bacteria. more...

Background: Genotypically, hepatitis B virus (HBV) is divided into 8 groups, A–H. The interaction between HBV replication and immune responses against HBV infection plays an important role in the pathogenesis of virus infection. Aims and Objectives: In an attempt to elucidate the role of immunomodulatory, pro-inflammatory, and anti-inflammatory mediators in the pathogenesis of HBV genotype D fulminant hepatitis (FH), we assessed the role of interferon gamma (IFN-γ), tumor necrosis factor-α (TNF-α), and interleukin-10 (IL-10) in such patients. Subjects and Methods: Two hundred and seventy-six cases of acute hepatitis among which 37 cases of fulminant hepatic failure were screened. A genotyping system based on polymerase chain reaction using type-specific primers was used in this study (Sami et al. 2013). TNF-α, IL-10 levels, and IFN-γ serum level were measured by ELISA. Results: Genotype D was detected in 10 cases (27.02%) out of 37 FH patients. Mean IL-10, IFN-γ, and TNF-α levels in FH patients were significantly higher than the healthy controls at 127.6 ± 73.45 pg/ml (P < 0.001), 10.6778 ± 5.23 pg/ml (P < 0.0001), and 62.9000 ± 21.67 pg/ml (P < 0.001), respectively. IFN-γ and IL-10 levels were much higher in cases of hepatitis B e-antigen (HBeAg) seronegative individuals, mean levels being 20.77 pg/ml and 36.53 pg/ml, respectively. Using multiple linear regression analysis, the presence of HBeAg was inversely associated with TNF-α. Conclusion: This study clearly highlights the excessive dysregulated response of the three cytokines, more so of IL-10 which appears pivotal in the pathogenesis of FH. Interventions leading to suppression of IL-10 levels may be beneficial in improving the patient outcome. more...

Objectives: Detection and comparison of metallo-β-lactamase (MBL) production in clinical isolates by phenotypic and genotypic measures. The objective of this study is to evaluate clinical characteristics and risk factors in patients infected with MBLs. Materials and Methods: Study was conducted by the Department of Microbiology, Jawaharlal Nehru Medical College from February 2014 to December 2015. Bacterial culture, identification, and antibiotic susceptibility were carried out according to standard guidelines. MBL production was detected both phenotypically (Modified Hodge test [MHT], imipenem-ethylene diamine tetraacetic acid double disk potentiation test [IMP-EDTA DDPT], IMP-EDTA combined disk synergy test [IMP-EDTA CDST]), and genotypically (bla NDM-1, bla VIM and bla IMP). Results: Among 116 carbapenem-resistant Gram-negative Bacilli (CRGNB), Citrobacter species 28 (24.1%) was the most common pathogen. Phenotypically, MHT, IMP-EDTA DDPT, and IMP-EDTA CDST detected MBL production in 105 (90.5%), 96 (81%), and 87 (75%) CRGNB, respectively. Bla NDM-1 genes were detected in 6 6 (56.8%) isolates, however, very few bla VIM (16, 15.2%) and bla IMP (1, 1.2%) were identified. Considering polymerase chain reaction (PCR) as the gold standard, it was observed that IMP-EDTA CDST was most specific (78.3%) while MHT was most sensitive (97.4%). Results of bla NDM-1 gene by PCR were further confirmed by sequencing (Triyat genomics, Nagpur). All the 11 representative strains were confirmed to be NDM-1 gene. Major risk factors in patients infected with MBLs were in-dwelling devices (68%), prolonged hospital stay (72%) and prior antibiotic treatment (86%). However, on tracing their outcome, it was interesting to note that mortality was relatively low 5 (4.3%). Conclusion: The present study shows a rising trend of bla NDM-1 in CRGNB, an ominous sign heralding the post antibiotic era. It is essential to assess the prevalence of various MBLs so that infection control measures can be reinforced. We recommend three phenotypic tests in tandem for the detection of MBL. While phenotypic tests are easy and cost-effective to perform, quick, effective molecular diagnostic techniques can tailor treatment guidelines to optimize patient's management. more...

Background: Scrub typhus is lesser known cause of fever of unknown origin in India. Even if there have been reports documenting the prevalence of scrub typhus in different parts of India, it is still an unknown entity, and clinicians usually do not consider it as differential diagnosis. The present study was performed to document the prevalence of scrub typhus among febrile patients in western part of Uttar Pradesh and to assess the clinical profile of infected patients on the one hand and knowledge, attitude, and practices among clinicians on the other. Materials and Methods: A total of 357 adult patients with fever of more than 5-day duration were recruited. All patients underwent complete physical examination, and detailed clinical history was elicited as per predesigned pro forma. After primary screening to rule out malaria, enteric fever, and leptospirosis infection, secondary screening for scrub typhus was done by rapid screen test and IgM ELISA. Results: Scrub typhus infection was positive in 91 (25.5%) cases. The most common symptoms among the patients were fever (100%), pain in abdomen (79.1%), pedal edema 56 (61.5%), rash 44 (48.3%), headache 44 (48.3%), vomiting 42 (46.1%), constipation 33 (36.2%), cough 28 (30.7%), and lymphadenopathy 20 (21.9%). The median values of interleukin-8, interferon-gamma, and tumor necrosis factor-alpha in healthy controls were 15.54 pg/ml, 7.77 pg/ml, and 54.1 pg/ml, respectively, while the median values of these cytokines in scrub typhus-positive patients were 21.04 pg/ml, 8.74 pg/ml, and 73.8 pg/ml, respectively. Conclusion: Our results highlight that scrub typhus infection is an important cause of pyrexia of unknown origin, and active surveillance is necessary to assess the exact magnitude and distribution of the disease. more...

The efficiency of a photovoltaic (PV) panels drops significantly in dusty environments. The variation in temperature could have a substantial impact on PV panel cells, which could further lead to high deterioration and eventually permanent damage to the PV material in the presence of dust. To resolve this issue, in this work a novel hydrophobic silicon dioxide (SiO2)-based nanoparticle coating is proposed for the PV panel, to shrink the surface stress developed between the water and the coated facet. Two identical PV modules were installed to conduct comparable experimental tests simultaneously. The first module is coated by the SiO2 nanoparticles, and the second is uncoated and used as a reference. To maintain coherency, the experiments are done in the same environmental conditions, cleaning the PV modules at regular intervals. Results reveal that the accumulated energy generated during this period of study was comprehensively enhanced. Moreover, the self-cleaning property of the hydrophobic surface of the coated panel allowed water droplets to slide smoothly down the PV module surface, carrying dust particles. Useful recommendations are made at the end to enhance the performance of PV panels in dusty environments. more...

The generation of the mix-based expansion of modern power grids has urged the utilization of digital infrastructures. The introduction of Substation Automation Systems (SAS), advanced networks and communication technologies have drastically increased the complexity of the power system, which could prone the entire power network to hackers. The exploitation of the cyber security vulnerabilities by an attacker may result in devastating consequences and can leave millions of people in severe power outage. To resolve this issue, this paper presents a network model developed in OPNET that has been subjected to various Denial of Service (DoS) attacks to demonstrate cyber security aspect of an international electrotechnical commission (IEC) 61850 based digital substations. The attack scenarios have exhibited significant increases in the system delay and the prevention of messages, i.e., Generic Object-Oriented Substation Events (GOOSE) and Sampled Measured Values (SMV), from being transmitted within an acceptable time frame. In addition to that, it may cause malfunction of the devices such as unresponsiveness of Intelligent Electronic Devices (IEDs), which could eventually lead to catastrophic scenarios, especially under different fault conditions. The simulation results of this work focus on the DoS attack made on SAS. A detailed set of rigorous case studies have been conducted to demonstrate the effects of these attacks. more...

Introduction: Urinary tract infection (UTI) continues to be the most common infection diagnosed in outpatients as well as in hospitalized patients. Citrobacter spp. is an emerging urinary pathogen. The present study assessed the prevalence and antibiotic sensitivity pattern of Citrobacter spp. in patients admitted to or attending outpatient departments with Complain of UTI in a tertiary care hospital. Materials and Methods: A total of 36,250 urine samples were included in the study. UTI was confirmed in 7099 samples. Of these 246 (3.46%) had UTI due to Citrobacter spp. Identification was by conventional biochemical methods. Antimicrobial susceptibility testing was performed using Kirby-Bauer disc diffusion method as recommended by Clinical and Laboratory Standards Institute M2-A9. Multidrug-resistant (MDR) was defined as resistance to more than two groups of drugs. Extended spectrum beta-lactamase (ESBL), AmpC, and metallo beta-lactamase (MBL) were detected by phenotypic methods. Results: Females predominated in the study 193 (78.4%) with 53 (21.5%) males. Most of the isolates were in the age group 21-30 and 31-40. 49 (19.9%) patients were inpatients, and 197 (80.08%) were outpatients. Aminoglycosides had a better spectrum of antimicrobial sensitivity (70.2%) with 85.2% isolates sensitive to amikacin. Fluoroquinolones had a poor activity against Citrobacter (46% sensitive). Ureidopenicillins had poor efficacy (15.4%). Out of the 246 strains, 129 (52.4%) were MDR, 61 (24.7%) of which were ESBL producers and 65 (26.4%) were AmpC producers. Most of the ESBL producing strains were isolated from inpatients. No MBL were identified in this study. Conclusion: Citrobacter though not uncommon isolate is posing a problem due to its MDR character. Infection control practices should be observed strictly, and any type of unnecessary instrumentation should be avoided. more...

Background: Cefotaximases (CTX-M), temoniera (TEM), and sulfhydryl variable (SHV) constitute a rapidly growing cluster of enzymes that have disseminated geographically. They are spreading to species other than Enterobacteriaceae and might be responsible for the presence of blaCTX-M,blaTEM, and blaSHVgenes in Pseudomonas and Acinetobacter spp. The present study was designed to characterize CTX-M, TEM, and SHV phenotypically and genotypically in Pseudomonas and Acinetobacter spp. Materials and Methods: A total of 90 isolates (73 Pseudomonas and 17 Acinetobacter spp.), resistant to any of the third-generation cephalosporins, were randomly selected from clinical samples. Results: Of 90 isolates, 64 (71.11%) were tested positive for extended-spectrum β-lactamase (ESBL) production. Among phenotypically tested ESBL producers, forty isolates were randomly selected for molecular characterization. The prevalence of CTX-M, TEM, and SHV was found to be 57.5%, 15%, and 75%, respectively. Multiplex polymerase chain reaction assay categorized blaCTX-Mgenes into Groups 1 and 26 where Group 1 was present in only 5 isolates and Group 25 was present in rest of the 18 isolates. Conclusion: This is among the premier systemic reports from India documenting phenotypic and molecular characterization of CTX-M, TEM, and SHV β-lactamases in Pseudomonas and Acinetobacter spp. With judicious use of antibiotics and strict infection control procedures, it may be possible to limit the effects of these newer β-lactamases. more...

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has caused a global pandemic and is posing a serious challenge to mankind. As per the current scenario, there is an urgent need for antiviral that could act as a protective and therapeutic against SARS-CoV-2. Previous studies have shown that SARS-CoV-2 is much similar to the SARS-CoV bat that occurred in 2002-03. Since it is a zoonotic virus, the exact source is still unknown, but it is believed bats may be the primary reservoir of SARS-CoV-2 through which it has been transferred to humans. In this review, we have tried to summarize some of the approaches that could be effective against SARS-CoV-2. Firstly, plants or plant-based products have been effective against different viral diseases, and secondly, plants or plant-based natural products have the minimum adverse effect. We have also highlighted a few vitamins and minerals that could be beneficial against SARS-CoV-2. more...

Synthesis of nanoparticles using the plants has several advantages over other methods due to the environmentally friendly nature of plants. Besides being environmentally friendly, the synthesis of nanoparticles using plants or parts of the plants is also cost effective. The present study focuses on the biosynthesis of zinc oxide nanoparticles (ZnO NPs) using the seed extract of Butea monsoperma and their effect on to the quorum-mediated virulence factors of multidrug-resistant clinical isolates of Pseudomonas aeruginosa at sub minimum inhibitory concentration (MIC). The synthesized ZnO NPs were characterized by different techniques, such as Fourier transform infra-red spectroscopy (FTIR), scanning electron microscopy (SEM), energy dispersive X-ray (EDX), and transmission electron microscopy (TEM). The average size of the nanoparticles was 25 nm as analyzed by TEM. ZnO NPs at sub MIC decreased the production of virulence factors such as pyocyanin, protease and hemolysin for P. aeruginosa (p ≤ 0.05). The interaction of NPs with the P. aeruginosa cells on increasing concentration of NPs at sub MIC levels showed greater accumulation of nanoparticles inside the cells as analyzed by TEM. more...

Development of multidrug resistance among pathogens has become a global problem for chemotherapy of bacterial infections. Extended-spectrum β-lactamase- (ESβL-) producing enteric bacteria and methicillin-resistant Staphylococcus aureus (MRSA) are the two major groups of problematic MDR bacteria that have evolved rapidly in the recent past. In this study, the aqueous extract of Murraya koenigii leaves was used for synthesis of silver nanoparticles. The synthesized MK-AgNPs were characterized using UV-vis spectroscopy, FTIR, XRD, SEM, and TEM, and their antibacterial potential was evaluated on multiple ESβL-producing enteric bacteria and MRSA. The nanoparticles were predominantly found to be spheroidal with particle size distribution in the range of 5–20 nm. There was 60.86% silver content in MK-AgNPs. Evaluation of antibacterial activity by the disc-diffusion assay revealed that MK-AgNPs effectively inhibited the growth of test pathogens with varying sized zones of inhibition. The MICs of MK-AgNPs against both MRSA and methicillin-sensitive S. aureus (MSSA) strains were 32 μg/ml, while for ESβL-producing E. coli, it ranged from 32 to 64 μg/ml. The control strain of E. coli (ECS) was relatively more sensitive with an MIC of 16 μg/ml. The MBCs were in accordance with the respective MICs. Analysis of growth kinetics revealed that the growth of all tested S. aureus strains was inhibited (∼90%) in presence of 32 μg/ml of MK-AgNPs. The sensitive strain of E. coli (ECS) showed least resistance to MK-AgNPs with >81% inhibition at 16 μg/ml. The present investigation revealed an encouraging result on in vitro efficacy of green synthesized MK-AgNPs and needed further in vivo assessment for its therapeutic efficacy against MDR bacteria. more...

Introduction: Urinary tract infection (UTI) is one of the most common infectious diseases in clinical practice. The choice of antibiotics for the treatment of UTI is limited by the rising rates of antibiotic resistance. There is an urgent need to discover new effective treatment solutions. Fosfomycin may be an interesting alternative to the currently used treatments of UTIs. Materials and Methods: The study was conducted over 6 months period (January to June 2013) in Department of Microbiology, JNMCH, AMU, Aligarh. A total of 1840 urine samples were submitted. Culture and sensitivity was done as per standard microbiological procedures. Methicillin-resistant Staphylococcus aureus (MRSA), high-level aminoglycoside resistance (HLAR), extended spectrum beta-lactamases (ESBL), AmpC and metallo-beta-lactamases (MBL) production was detected. Results: Culture was positive in 504 (27.4%) cases. Gram-negative etiology was identified in 390 (73%) cases. ESBL production was detected in 154 (37.1%) while 82 (21.6%) were Amp C. No, MBL was detected. Among Gram-positive bacteria, 68 (51.5%) were MRSA, while 4 (13.3%) were vancomycin resistant enterococci (VRE). HLAR was seen in 53.3% of enterococci. Fosfomycin was effective in 100% of MRSA, VRE, ESBL, HLAR, and overall, susceptibility to fosfomycin in AmpC producers was extremely high (99%). Norfloxacin and cotrimoxazole were not proved effective as only three isolates were sensitive to norfloxacin, while all Gram-negative isolates were resistant to cotrimoxazole. Pseudomonas species showed 65% and 75% susceptibility to colistin and polymixin B, respectively. Conclusion: Fosfomycin has emerged as a promising option, especially in cases involving multi-drug-resistant pathogens in which previous antibiotics have failed to cure the infection. more...