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Key Clinical Message Multiple methods are used to tackle ipsilateral obstructed venous access in patients undergoing a device upgrade by implanting a new left ventricular lead. One feasible solution to tackle this is implantation of the upgrade lead contralaterally with pre‐sternal tunnelization to the opposite side under conscious sedation.

Background. COVID-19 is a pandemic disease due to viral infection. It spread throughout the world, and the association of COVID-19 with neuroendocrine system is a well-known fact especially while the connection between the endocrine and immune system neuroinflammation play a crucial role in pathophysiology. Therapeutic indication of Botulinum-neurotoxin-A (BoNT-A) is used in the treatment of focal post-stroke spasticity (PSS) and in re-habilitation which is regarded as a safe and effective type of treatment. Objective. To assess spasticity after COVID-19 infection. Methods. Thirty patients diagnosed as post-COVID-19 stroke spasticity were enrolled, their age ranged from (30-60 years). They had focal spasticity of lower extremities. BoNT-A was given in day 0 and 4 weeks later, in the gastrocnemius and soleus muscle. H-reflex was recorded from soleus muscles at 1st presentation and 4 weeks after injection of BoNT-A. Muscle power was assessed by Medical Research Council scale (MRC) and MAS. Results. The amplitude and latency of H-reflex record from soleus muscles and the H/M ratio showed a statistically significant difference between pre- and post-therapy with BoNT-A injection in cases with post COVID-19 spasticity. There was a significant increase in MRC scale but, MAS scale showed a significant reduction after injection of BoNT-A. Conclusion. Post COVID spasticity is a well-known complication after COVID-19 infection, there was clinical improvement in PSS post BoNT-A injections, which was assessed clinically by MAS and MRC scale, neurophysiological the H-reflex was correlated negatively regarding latency, while there was no correlation regarding H-reflex amplitude or Hmax/Mmax ratio and MAS.

The primary objective of this article is to provide a comprehensive analysis of the open network for digital commerce (ONDC), an innovative initiative by the Indian government. The study aims to explore the potential impact of ONDC on India’s digital commerce sector, focusing on how it seeks to democratize digital commerce and create an environment characterized by fair competition, innovation, and inclusivity. Our methodology involves an extensive review and thematic analysis of relevant literature. This approach includes a detailed examination of ONDC’s core objectives, its technological underpinnings, and the role of the government in facilitating its growth and adoption. The study is designed to provide a holistic view of ONDC, considering various aspects such as technology, policy, and market dynamics. The analysis suggests that ONDC could revolutionize India’s digital commerce ecosystem. Key findings indicate that ONDC can enhance interoperability, empower small businesses and local retailers, and diversify consumer choices. The initiative’s reliance on existing digital frameworks like the Unified Payments Interface and the Data Empowerment and Protection Architecture is crucial in streamlining transactions and bolstering data security. However, the realization of ONDC’s full potential is contingent upon its effective implementation and widespread acceptance among stakeholders. This study contributes to the existing body of knowledge by comprehensively analysing ONDC, a relatively new and underexplored area in digital commerce research. It offers original insights into the initiative’s potential to transform India’s digital commerce landscape. The article also identifies gaps in current research, such as the limited scope of existing studies, the absence of primary data, and the influence of external variables. It suggests avenues for future research, including longitudinal studies, international comparisons, and primary data collection, to understand ONDC better and its long-term impact on India’s digital commerce sector.

The emergence of smart and nanobiosensor (NB) technologies has transformed the monitoring and management of bacterial infections. These developments offer remarkable accuracy and precision for detecting infectious pathogens. Smart artificial intelligence (AI)-assisted and NB-based methods are used as powerful tools in biomedicine for bacterial detection, combatting multidrug resistance, and diagnosing infections. In this study, we delve into the advancements in these technologies, focusing on AI-based techniques for NBs in detecting bacterial infections from 2019 to 2024. We analyze the contributions of machine learning and deep learning techniques to enhance performance and reliability. The new approaches to improve the effectiveness and versatility of antibacterial treatments are critically analyzed. Our study includes the observations of carbon nanoparticles that selectively target bacteria using photothermal properties and the production of hybrid hydrogel composites with capabilities. Furthermore, the study emphasizes the crucial significance of NBs in propelling the progress of diagnostic methods, biosensing technologies, and treatments, thereby transforming the healthcare industry and the way diseases are managed. In addition, we explore pathogen-based infections, bacterial diagnosis, and treatment using engineered NBs enhanced with various modalities such as electrochemistry, acoustics, electromagnetism, and photothermal resonance. Our comprehensive review highlights the potential and throws light on future research directions for effective management and control of bacterial infections.

The designer of display systems in general and metal systems in particular is interested in harmonizing the various design inputs and outputs, so that the design system is integrated in its functional performance as well as in its characteristics and fulfills the desires of the users. The designer is also keen to achieve the best functional efficiency of the metal display system in order to be able to compete with similar systems in the quality and efficiency of performance, achieving this functional requirement, which is one of the most important requirements of the user that determines the extent to which the metal display system meets his desires and his desired needs. Also, making use of smart new materials technologies contributes to raising the efficiency of design and production of metal furnishing systems for exhibitions and providing many design solutions that can meet the needs of the Egyptian society. Therefore, the research aims to study the smart new materials and how to use them in metal furniture design systems for exhibitions and monitoring the functional, use, engineering, communication, economic, aesthetic and environmental values added to employ the smart materials developed for these systems. The research problem can be identified in that the smart developed materials are considered one of the most important inputs to the design process in many fields, but in return they do not receive sufficient attention at the local level, especially in the field of for exhibitions as it relies on traditional materials such as iron, aluminum, wood and marble, which can be replaced by novel materials that add functional, structural, aesthetic and economic values, as well as the limitations of the metal furnishing systems for exhibitions in the Egyptian market that depend on traditional materials in achieving added values for design at the functional, use, engineering and communication levels And the economic and the Aesthetic and environmental, which created the need to monitor these added values for employing smart materials developed in the design of metal furnishing systems for exhibitions, and the research concluded that each type of smart materials developed has its own characteristics and distinctive characteristics that distinguish it from other developed smart materials that have a role in the design of the metal display system. The new smart materials have the ability to cope with the environment surrounding the metallic display system and have a distinctive reaction to the surrounding stimuli.

A study of grape snails (Helix pomatia) using the electron paramagnetic resonance (EPR) spectroscopy method, where shells were exposed to ionizing gamma radiation, indicated that the effect of radiation up to certain doses results in the emergence of magnetic properties in the organism. The identification of the EPR spectra of the body and shell parts of the control and irradiated grape snails separately showed that more iron oxide magnetic nanoparticles are generated in the body part of the grape snail compared to the shells. A linear increase in free radical signals (g = 2.0023) in the body and shell parts of grape snails, and a non-monotonic change in the broad EPR signal (g = 2.32) characterizing iron oxide magnetic nanoparticles was determined depending on the dose of ionizing gamma radiation. Additionally, the obtained results showed that grape snails can be used as bioindicators for examining the ecological state of the environment. At the same time, the radionuclide composition of the body and shell parts of the grape snails and their specific activities were determined by CANBERRA gamma spectroscopy. The FTIR spectra of mucin, a liquid secreted by snails, were recorded.

Designer Receptors Exclusively Activated by Designer Drugs (DREADDs) are a powerful tool for neuroscience, but the standard DREADD ligand, CNO, has significant drawbacks. Here the authors report two novel high-potency DREADD ligands and a novel DREADD radiotracer for imaging purposes.

Histological structure of thrombi is a strong determinant of the outcome of vascular recanalization therapy, the only treatment option for acute ischemic stroke (AIS) patients. A total of 21 AIS patients from this study after undergoing non-enhanced CT scan and multimodal MRI were treated with mechanical stent-based and manual aspiration thrombectomy, and thromboembolic retrieved from a cerebral artery. Complementary histopathological and imaging analyses were performed to understand their composition with a specific focus on fibrin, von Willebrand factor, and neutrophil extracellular traps (NETs). Though distinct RBC-rich and platelet-rich areas were found, AIS patient thrombi were overwhelmingly platelet-rich, with 90% of thrombi containing + and neutrophil-elastase+) containing citrullinated histone-decorated DNA. Citrullinated histone-decorated DNA also accumulated extracellularly, pointing to NETosis by the activated neutrophils. Notably, NETs-containing areas showed strong reactivity to VWF, platelets, and high-mobility group box 1 (HMGB1), signifying a close interplay between these components.

Land use-transportation comprehensive planning has become an increasingly common technique in regional and sub-regional planning processes. Since land use management strategies act as an effective tool to achieve transportation planning objectives, it is important to identify the relationship between land use pattern and travel behaviour. This study examined the relationship between transportation and land use in Rajshahi city. Rajshahi is a major urban, commercial and educational centre of Bangladesh. In Rajshahi, Shaheb bazaar zero points to New Market road is one of the most important roads. After construction of this road in 2013 intense development has taken place beside it. To identify this primary relationship data has been collected from different types of field survey. Then the impact of land use and transportation has been determined by comparing with the previous database. The findings of the study show that there exist a reciprocal relationship between land use and transportation system and the impacts on both. The study also notes that the impact of transportation on land use is more than the impact of land use on transportation. The study will help to control the haphazard growth and traffic congestion of the concerned area in the future.

The study describes the development and preliminary validation of a simple reverse-phase chromatographic method for determination of a novel drug candidate, 5-[(4-chlorophenoxy) methyl]-1,3,4-oxadiazole-2-thiol (OXCPM), in bulk and stressed solution, in order to find out the intrinsic stability behavior of the compound. Isocratic elution was carried out at a flow rate of 1.0 mL min-1 through a Promosil C18 column maintained at 25 °C, using the mobile phase comprising acetonitrile and aqueous o-H3PO4 (pH 2.67) (1:1, V/V). Detection was performed at 258 nm. The response of the detector was linear in a concentration range of 1.25-50.00 μg mL-1 with the correlation coefficient of 0.9996 ± 0.0001. Cumulative intra-day, inter-day and inter-instrument accuracy (99.5 ± 1.0, 100.2 ± 1.0 and 100.3 ± 0.4 %, resp.) with RSD less than 5 % indicated that the method was accurate and precise. The resolution and selectivity factor (>2 and >1, resp.), particularly in copper metal- and dry-heat-stress solutions, depicted the selectivity of the method. OXCPM remained stable under hydrolytic (acidic and neutral pH, ≤ 37 °C), photolytic and moist heat stress conditions. Under alkaline conditions (hydrolytic and photolytic), polar products were formed that eluted very fast through the column (tR < 3.75 min). At room temperature, the compound was susceptible to oxidation by hydrogen peroxide and transition metals. The ionogram of most of the stress solutions indicated the presence of a product having m/z 256, which might be a result of N- or Smethylation or -SH oxidation. The results of the study indicate that the method is selective, sensitive and suitable to be used for determination of OXCPM in bulk and under stress conditions.

The design of the steel frame structure for beam, column, and beam-column elements usually takes several iterations to obtain optimum results that are safe, efficient, and economical. The problems that arise due to the number of iteration for the design process are the basis for this research. The research was conducted on 100 sections IWF and HCS which are consisted of 81 sections of IWF and 19 sections of HCS. The analysis was carried out regarding SNI 1729:2015. The results of this study are in the form of moment capacity graphs and tables of the axial capacity of steel sections as well as coefficients of m and U for beam-column design. Moment capacity graphs and tables of the axial capacity of IWF and HCS profiles produced could be used to reduce the number of iteration in designing safe and efficient steel profiles as beam, column, and beam-column elements. Analysis results show that the usage of the graphs and tables for the beam-column design process will reduce the number of iteration needed.

This study aims to analyze how much changes in column shape effect have on the strength of the column structure. This calculation is comparing a square-shaped concrete column with two different axis of a T-shaped column. Each sample is compared in terms of 6 different column dimensions, however, the cross-sectional area within the three samples ( Square, T-shaped axis1 and 2) has remained constant. The concrete quality (fc') is kept at 30 MPa while the reinforcement area used 1% and 5%. Column calculation analysis is using Hognestad stress-strain diagram relationship and finite difference method. The result shows, the greater the reinforcement ratio, the greater the difference of Mn value and the smaller the difference of Pn value, of T-shaped and square column for each area. The same cross-sectional area does not necessarily lead to the same behavior of a T-shaped column with a different axis

Educating people about disaster risk reduction is part of the responsibility of the local University. Enhancing people’s preparedness before disaster strike and how to cope with it, is compulsory and the education need to be done continuously since the natural disaster cannot be predicted. Seismic hazard is quite high in Bengkulu. The RTBI was chosen because of the locations which prone to tsunami hazard and most of the students come from different part of Bengkulu, so the knowledge about tsunami hazard nearby their area is very limited. This paper explains about the process of raising awareness of Tsunami hazard for students in RTBI. Twenty six students were involved in this study. The questionnaire was prepared to study their knowledge about tsunami hazard. The knowledge that they can absorb during the study could be measured by comparing their answer in the questionnaire before and after the study. The result shows, after the study, the students were more aware about the vulnerability of the area and know what to do when the disaster happen.

The results of research in the radiation processing of synthetic oil derived from oil–bitumen rock of the Balakhany deposit in Azerbaijan are presented. The study has been conducted on a 60Co gamma-source at a dose rate of P = 0.5 Gy/s and various absorbed doses of D = 43–216 kGy. Samples of synthetic oil from natural bitumen rocks have been analyzed by chromatography, gas chromatography–mass spectrometry, and IR-spectroscopy, and their radiation resistance has been evaluated. The results of the study allow for both assessment of the feasibility of manufacturing petrochemicals for various applications by radiation processing and use of these materials for isolating radioactive sources to preclude their impact on the environment.

This article argues that unremitting conflicts between the power centres and the individuals from the borderline spaces of the society characterise Doris Lessing’s novels The Fifth Child and Ben, in the World. The paper seeks to further the argument by applying Michel Foucault’s early work on power and Zygmunt Bauman’s theory on liquid, thus postmodern, fear to manifest the implosion of the contemporary civilization that lives on global/local disparities and operates through subversive surveillance.

Kinetic analysis was used to study the destabilization of mayonnaise by focusing on the fat crystals. Mayonnaise prepared from rapeseed oil and soybean oil was stored at temperatures ranging from −20 to −40 °C. The destabilization kinetic parameters were measured by observing oil separation over time. The destabilization rate constant, kd, increased with decreasing temperature. The highest value of kd was 1.28 × 10−3 min−1 at −40 °C for rapeseed oil mayonnaise (RoM) and the lowest was 1.95 × 10−6 min−1 at −20 °C for soybean oil mayonnaise (SoM). At each temperature, the kd value in RoM was higher than that in SoM. However, the order of destabilization, n, followed no specific pattern. The crystallization rate constant, Kc, and Avrami constant, n, were calculated using microscopic images of the fat crystals. The increase in crystallization kinetic parameters with decreasing temperature revealed changes in crystal behavior. Both the destabilization rate constant, kd, and the crystallization rate constant, Kc, depended on the temperature. This temperature dependency behavior showed a correlation between kd and Kc, suggesting that the destabilization rate depended on the rate of growth of fat crystals during the freeze-thawing of mayonnaise.

Abstract Background Appropriate immune activation of T cells and macrophages is central for the control of Mycobacterium tuberculosis infections. IFN-γ stimulated responses are lowered in tuberculosis (TB), while expression of Suppressor of Cytokine Signaling (SOCS) molecules – 1 and 3 and CD4+CD25+FoxP3+T regulatory cells is increased. Here we investigated the association of these molecules in regard to clinical severity of TB. Methods Peripheral blood mononuclear cells (PBMCs) were isolated from patients with pulmonary TB (PTB, n = 33), extra-pulmonary TB (ETB, n = 33) and healthy endemic controls (EC, n = 15). Cases were classified as moderately advanced or far advanced PTB, and less severe or severe disseminated ETB. M. tuberculosis -stimulated IFN-γ, SOCS1, SOCS3 and FoxP3 gene expression and secretion of Th1 and Th2 cytokines was measured. Statistical analysis was performed using Mann–Whitney U, Wilcoxon Rank and Kruskal Wallis non-parametric tests. Results In un-stimulated PBMCs, IL-6 (p = 0.018) and IL-10 (p = 0.013) secretion levels were increased in PTB while IL-10 was also increased in ETB (p = 0.003), all in comparison with EC. M. tuberculosis-stimulated IL-6 (p = 0.003) was lowered in ETB as compared with EC. SOCS1 mRNA expression in M. tuberculosis stimulated PBMCs levels in moderately advanced PTB (p = 0.022), far advanced (p = 0.014) PTB, and severe ETB (p = 0.009) were raised as compared with EC. On the other hand, SOCS1 mRNA titers were reduced in less severe ETB, in comparison with severe ETB (p = 0.027) and far advanced PTB (p = 0.016). SOCS3 mRNA accumulation was reduced in far advanced PTB (p = 0.007) and FoxP3 mRNA expression was increased in less severe ETB as compared with EC (p = 0.017). Conclusions The lowered SOCS1 mRNA levels in patients with less severe extra-pulmonary TB as compared to those with more severe ETB and PTB may lead to elevated IFN-γ pathway gene expression in the latter group. As localized ETB has shown to be associated with more effective Th1 immunity and adaptive responses, this suggests a role for SOCS1 in determining disease outcome in extra-pulmonary TB.

Abstract Background Stunting results from decreased food intake, poor diet quality, and a high burden of early childhood infections, and contributes to significant morbidity and mortality worldwide. Although food insecurity is an important determinant of child nutrition, including stunting, development of universal measures has been challenging due to cumbersome nutritional questionnaires and concerns about lack of comparability across populations. We investigate the relationship between household food access, one component of food security, and indicators of nutritional status in early childhood across eight country sites. Methods We administered a socioeconomic survey to 800 households in research sites in eight countries, including a recently validated nine-item food access insecurity questionnaire, and obtained anthropometric measurements from children aged 24 to 60 months. We used multivariable regression models to assess the relationship between household food access insecurity and anthropometry in children, and we assessed the invariance of that relationship across country sites. Results Average age of study children was 41 months. Mean food access insecurity score (range: 0–27) was 5.8, and varied from 2.4 in Nepal to 8.3 in Pakistan. Across sites, the prevalence of stunting (42%) was much higher than the prevalence of wasting (6%). In pooled regression analyses, a 10-point increase in food access insecurity score was associated with a 0.20 SD decrease in height-for-age Z score (95% CI 0.05 to 0.34 SD; p = 0.008). A likelihood ratio test for heterogeneity revealed that this relationship was consistent across countries (p = 0.17). Conclusions Our study provides evidence of the validity of using a simple household food access insecurity score to investigate the etiology of childhood growth faltering across diverse geographic settings. Such a measure could be used to direct interventions by identifying children at risk of illness and death related to malnutrition.

Abstract Background Assessment of knowledge among resident trainees and nurses is very important since majority of patients admitted in hospital have underlying diabetes which could lead to adverse clinical outcomes if not managed efficiently. Therefore, the purpose of this study was to evaluate and compare the knowledge related to the management of diabetes among registered nurses (RN) and trainee residents of internal medicine (IMR), family medicine (FMR) and surgery (SR) at tertiary care hospitals of Karachi, Pakistan. Methods A validated questionnaire consisting of 21 open ended questions related to diabetes awareness was acquired through a study done at Thomas Jefferson University Hospital, Philadelphia with the permission of primary author. Results 169 IMR, 27 FMR, 86 SR and 99 RN completed a questionnaire that assessed the knowledge related to different aspects of management of diabetes. The results were further stratified by participant's specialty and level of training. The percentage of knowledge based questions answered correctly was found to be low. The overall mean correct percentage among all the participants was 50% +/- 21. There was no statistical difference in terms of knowledge between IMR & FMR residents (64% +/- 14 vs. 60% +/- 16, p = 0.47) respectively. The total scores of SR and RN were quite low (40% +/- 16 & 31% +/- 15 respectively).SR and RN were found to have profound deficit in both inpatient and outpatient knowledge of diabetes. We did not observe any improvement in level of knowledge of FMR & SR with increase in duration of their training (p = 0.47 & 0.80 respectively). In contrast, improvement in the level of knowledge of IMR was observed from first to second year of their training (p = 0.03) with no further improvement thereafter. RN's didn't respond correctly on most of the items related to in-patient management of diabetes (Mean score 40% +/- 20). Conclusion As there are no prior studies in our setting evaluating knowledge related to diabetes management among residents and nurses, this study is of paramount importance. Based on these results, considerable knowledge gaps were found among trainee residents and nurses pointing towards need of providing additional education to improve the delivery of diabetes care.

Abstract Background Helicobacter species associated with human infection include Helicobacter pylori, Helicobacter heilmannii and Helicobacter felis among others. In this study we determined the prevalence of H. pylori and non-Helicobacter pylori organisms H. felis and H. heilmannii and analyzed the association between coinfection with these organisms and gastric pathology in patients presenting with dyspepsia. Biopsy specimens were obtained from patients with dyspepsia on esophagogastroduodenoscopy (EGD) for rapid urease test, histology and PCR examination for Helicobacter genus specific 16S rDNA, H. pylori phosphoglucosamine mutase (glmM) and urease B (ureB) gene of H. heilmannii and H. felis. Sequencing of PCR products of H. heilmannii and H. felis was done. Results Two hundred-fifty patients with dyspepsia were enrolled in the study. The mean age was 39 ± 12 years with males 162(65%). Twenty-six percent (66 out of 250) were exposed to cats or dogs. PCR for Helicobacter genus specific 16S rDNA was positive in 167/250 (67%), H. pylori glmM in 142/250 (57%), H. heilmannii in 17/250 (6%) and H. felis in 10/250 (4%), respectively. All the H. heilmannii and H. felis PCR positive patients were also positive for H. pylori PCR amplification. The occurrence of coinfection of H. pylori and H. heilmannii was 17(6%) and with H. felis was 10(4%), respectively. Only one out of 66 exposed to pets were positive for H. heilmannii and two for H. felis. Histopathology was carried out in 160(64%) of 250 cases. Chronic active inflammation was observed in 53(56%) (p = 0.001) of the patients with H. pylori infection alone as compared to 3(37%) (p = 0.73) coinfected with H. heilmannii and H. pylori and 3(60%) coinfected with H. felis and H. pylori (p = 0.66). Intestinal metaplasia was observed in 3(3%)(p = 1.0) of the patients with H. pylori infection alone as compared to 2(25%) (p = 0.02) coinfected with H. heilmannii and H. pylori and 1(20%) coinfected with H. felis and H. pylori (p = 0.15). Conclusion The prevalence of H. heilmannii and H. felis was low in our patients with dyspepsia. Exposure to pets did not increase the risk of H. heilmannii or H. felis infection. The coinfection of H. pylori with H. heilmannii was seen associated with intestinal metaplasia, however this need further confirmation.

Abstract Background Research suggests that food intolerance may be a precipitating factor for migraine like headaches. Aim To evaluate the effectiveness of the ELISA (Enzyme Linked Immuno-Sorbent Assay) Test and subsequent dietary elimination advice for the prevention of migraine like headaches. Design Randomised controlled trial. Setting Community based volunteers in the UK. Participants Volunteers who met the inclusion criteria for migraine like headaches and had one or more food intolerance were included in the study. Participants received either a true diet (n = 84) or a sham diet (n = 83) sheet. Participants were advised to remove the intolerant foods from their diet for 12 weeks. Main outcome measures Number of headache days over a 12 week period (item A MIDAS questionnaire). Other measures includes the total MIDAS score and total HIT-6 score. Results The results indicated a small decrease in the number of migraine like headaches over 12 weeks, although this difference was not statistically significant (IRR 1.15 95% CI 0.94 to 1.41, p = 0.18). At the 4 week assessment, use of the ELISA test with subsequent diet elimination advice significantly reduced the number of migraine like headaches (IRR 1.23 95%CI 1.01 to 1.50, p = 0.04). The disability and impact on daily life of migraines were not significantly different between the true and sham diet groups. Conclusions Use of the ELISA test with subsequent diet elimination advice did not reduce the disability or impact on daily life of migraine like headaches or the number of migraine like headaches at 12 weeks but it did significantly reduce the number of migraine like headaches at 4 weeks. Trial registration number ISRCTN: ISRTCN89559672

Abstract Background Helicobacter pylori (H. pylori) infection is known to be associated with a spectrum of gastroduodenal diseases. We studied the association of H. pylori virulence markers cytotoxin-associated gene (cagA) and vacuolating associated cytotoxin gene (vacA) alleles in patients with non ulcer dyspepsia (NUD), gastric ulcer (GU), gastric carcinoma (GC) and duodenal ulcer (DU). Methods H. pylori infection established by both rapid urease test and histology were studied. The cagA and vacA allelic status was determined by polymerase chain reaction (PCR). Sequencing of vacA i1 and i2 PCR product was carried out. Results Two hundred and twenty-four patients were included, 141 (63%) were males with a mean age of 45 ± 16, range 16-83 years. The virulence marker cagA was associated with GU in 20(63%) (p = 0.04), DU in 23(72%) (p = 0.003) and GC in 29(73%) (p = 0.001) compared to NUD in 51(42%). VacA s1am1 was associated with GU in 23(72%) (p = 0.001), DU in 17(53%) (p < 0.001) and GC in 23(58%) (p = 0.003) compared to NUD in 38(32%) while vacA s1bm1 was also associated with GU in 9(28%) (p = 0.001), DU in 12(37%) (p < 0.001) and GC 11(28%) (p < 0.001) compared to NUD in 13(11%), respectively. The diagnoses of GU in 21(66%), DU in 16(50%), GC in 20(50%) and NUD in 50(42%) were associated with moderately active chronic inflammation. CagA in 55(45%) (p = 0.037), vacA s1am1 in 51(51%) (P < 0.001), s1bm1 in 25(56%) (p = 0.002), s1am2 32(30%) (p < 0.001) and s1bm2 29(69%) (p = 0.004) were also associated with moderately active chronic inflammation. Conclusion CagA was negative in majority of NUD patients with H. pylori infection. However, cagA was associated with peptic ulcer and GC. VacA allele's s1am1 and s1bm1 were associated with H. pylori associated diseases and inflammation.

Abstract Background Cross-species gene expression analyses using oligonucleotide microarrays designed to evaluate a single species can provide spurious results due to mismatches between the interrogated transcriptome and arrayed probes. Based on the most recent human and chimpanzee genome assemblies, we developed updated and accessible probe masking methods that allow human Affymetrix oligonucleotide microarrays to be used for robust genome-wide expression analyses in both species. In this process, only data from oligonucleotide probes predicted to have robust hybridization sensitivity and specificity for both transcriptomes are retained for analysis. Results To characterize the utility of this resource, we applied our mask protocols to existing expression data from brains, livers, hearts, testes, and kidneys derived from both species and determined the effects probe numbers have on expression scores of specific transcripts. In all five tissues, probe sets with decreasing numbers of probes showed non-linear trends towards increased variation in expression scores. The relationships between expression variation and probe number in brain data closely matched those observed in simulated expression data sets subjected to random probe masking. However, there is evidence that additional factors affect the observed relationships between gene expression scores and probe number in tissues such as liver and kidney. In parallel, we observed that decreasing the number of probes within probe sets lead to linear increases in both gained and lost inferences of differential cross-species expression in all five tissues, which will affect the interpretation of expression data subject to masking. Conclusion We introduce a readily implemented and updated resource for human and chimpanzee transcriptome analysis through a commonly used microarray platform. Based on empirical observations derived from the analysis of five distinct data sets, we provide novel guidelines for the interpretation of masked data that take the number of probes present in a given probe set into consideration. These guidelines are applicable to other customized applications that involve masking data from specific subsets of probes.

Abstract Background Infections with hepatitis B virus (HBV) and hepatitis C virus (HCV) can lead to chronic liver disease and hepato-cellular carcinoma (HCC). This cross-sectional study estimated the prevalence and identified risk factors associated with Hepatitis B surface antigen (HBsAg) and HCV antibody (anti-HCV) sero-positivity among children 1 to 15 years of age. Methods The study targeted the low to middle socioeconomic population that comprises 80% to 85% of the population. Consent was obtained from parents of the eligible children before administering questionnaire and collected a blood sample for anti-HCV and HBsAg serology. Results 3533 children were screened for HBsAg and anti-HCV. 1826 (52 %) were males. 65 (1.8 %) were positive for HBsAg, male to female ratio 38:27; mean age 10 ± 4 years. 55 (1.6 %) were positive for anti-HCV with a mean age 9 ± 4 years. 3 (0.11%) boys were positive for both HBsAg and anti-HCV. The overall infection rate was 3.3 % in the studied population. Hepatitis BsAg was more prevalent in subjects who received therapeutic injections 45 (69.2%) positive [Odd Ratio OR = 2.2; 95% Confidence interval CI: 1.3–3.6] inspite of using new needle and syringe 44 (67.7%) positive [OR = 2.2; 95% CI: 1.3–3.7] and vaccination in the government healthcare facilities 46 (70.7 %) positive with [OR = 3.0; 95% CI: 1.4–6.4]. These factors were not significant in anti-HCV positive cases. Conclusion There is a need to educate general population regarding HBV and HCV infection and risks associated with inappropriate therapeutic injections. Hepatitis B vaccine should be administered to all newborns regardless of maternal HBsAg status.

Abstract Background The aim of this study was to determine the effect of commonly self-prescribed proton pump inhibitors (PPI) on the results of rapid urease test and histology for the diagnosis of H. pylori infection. Methods One hundred-nine consecutive patients with dyspeptic symptoms attending the endoscopy suite were enrolled in this study. Antrum biopsy specimens were collected at endoscopy for the rapid urease test (Pronto Dry, Medical Instrument Corp, France) and histopathology. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and like-hood ratio of a positive and negative of Pronto Dry test were compared against histology. The gold standard test for the diagnosis of H. pylori infection was histopathology. Results Sixty-one percent (66/109) patients were males with mean age of 43 ± 14.1 years and age range 17–80 years. Fifty-two percent (57/109) were not on any medications while 48% (52/109) used PPI before presentation to the outpatients. Pronto Dry was positive in 40% (44/109) and negative in 60% (65/109). Histopathology was positive for H. pylori in 57% (62/109) and negative in 43% (47/109). The sensitivity, specificity, PPV, NPV and like-hood ratio of a positive and negative Pronto Dry test with and without PPI were 43.3%, 86.4%, 81.3%, 3.18, 0.656 and 52.8% vs 71.9%, 80%, 82.1%, 69%, 3.59 and 0.35. Conclusion This study shows that the sensitivity, specificity, NPV and PPV of rapid urease test was reduced in patients who are on PPI. The exclusive use of the rapid urease test for the diagnosis of Helicobacter pylori cannot be recommended in patients with prior PPI use.

Entrepreneurial networks play an important role in identifying and exploiting entrepreneurial opportunities and the growth of entrepreneurial ambidexterity. This exploratory research aimed to explore the role of entrepreneurial networks on entrepreneurial ambidexterity with the mediating effect of novelty ecosystem and the moderating role of entrepreneurial intensity. The data is collected from 347 SME owners and managers of manufacturing and service industries in Jiangsu province, China. The hypotheses are analyzed using the partial least squares structural equation modeling PLS-SEM method. The results indicate that entrepreneurial networks are significantly associated with entrepreneurial ambidexterity. Moreover, findings show that the novelty ecosystem positively influences the association between entrepreneurial networks and entrepreneurial ambidexterity. Furthermore, results show that entrepreneurial intensity significantly moderated the relationship between novelty ecosystem and entrepreneurial ambidexterity. Lastly, the discussion and implications are elaborated in this study., Competing Interests: The author declares no conflict of interest., (© 2024 The Authors. Published by Elsevier Ltd.)

Background: Scleroderma, also referred to as systemic sclerosis, is a multifaceted autoimmune condition characterized by abnormal fibrosis and impaired vascular function. Pathologically, it encompasses the persistent presence of inflammation, abnormal collagen buildup, and restructuring of blood vessels in various organs, resulting in a wide range of clinical symptoms. This review incorporates the most recent scientific literature on scleroderma, with a particular emphasis on its pathophysiology, clinical manifestations, diagnostic approaches, and treatment options., Methodology: A comprehensive investigation was carried out on numerous databases, such as PubMed, MEDLINE, Scopus, Web of Science, and Google Scholar, to collect pertinent studies covering diverse facets of scleroderma research., Results: Scleroderma presents with a range of systemic manifestations, such as interstitial lung disease, gastrointestinal dysmotility, Raynaud's phenomenon, pulmonary arterial hypertension, renal complications, neurological symptoms, and cardiac abnormalities. Serological markers, such as antinuclear antibodies, anti-centromere antibodies, and anti-topoisomerase antibodies, are important for classifying diseases and predicting their outcomes., Discussion: The precise identification of scleroderma is crucial for promptly and correctly implementing effective treatment plans. Treatment approaches aim to improve symptoms, reduce complications, and slow down the progression of the disease. An integrated approach that combines pharmacological agents, including immunosuppressants, endothelin receptor antagonists, and prostanoids, with nonpharmacological interventions such as physical and occupational therapy is essential for maximizing patient care., Conclusion: Through the clarification of existing gaps in knowledge and identification of emerging trends, our goal is to improve the accuracy of diagnosis, enhance the effectiveness of therapeutic interventions, and ultimately enhance the overall quality of life for individuals suffering from scleroderma. Ongoing cooperation and creative research are necessary to advance the field and achieve improved patient outcomes and new therapeutic discoveries., Competing Interests: The authors declare no conflict of interest., (© 2024 The Authors. Health Science Reports published by Wiley Periodicals LLC.)

The SARS-CoV-2 3CLpro protein is one of the key therapeutic targets of interest for COVID-19 due to its critical role in viral replication, various high-quality protein crystal structures, and as a basis for computationally screening for compounds with improved inhibitory activity, bioavailability, and ADMETox properties. The ChEMBL and PubChem database contains experimental data from screening small molecules against SARS-CoV-2 3CLpro, which expands the opportunity to learn the pattern and design a computational model that can predict the potency of any drug compound against coronavirus before in-vitro and in-vivo testing. In this study, Utilizing several descriptors, we evaluated 27 machine learning classifiers. We also developed a neural network model that can correctly identify bioactive and inactive chemicals with 91% accuracy, on CheMBL data and 93% accuracy on combined data on both CheMBL and Pubchem. The F1-score for inactive and active compounds was 93% and 94%, respectively. SHAP (SHapley Additive exPlanations) on XGB classifier to find important fingerprints from the PaDEL descriptors for this task. The results indicated that the PaDEL descriptors were effective in predicting bioactivity, the proposed neural network design was efficient, and the Explanatory factor through SHAP correctly identified the important fingertips. In addition, we validated the effectiveness of our proposed model using a large dataset encompassing over 100,000 molecules. This research employed various molecular descriptors to discover the optimal one for this task. To evaluate the effectiveness of these possible medications against SARS-CoV-2, more in-vitro and in-vivo research is required., Competing Interests: NO - The authors have declared that no competing interests exist., (Copyright: © 2023 Ashraf et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Reckless release of contaminants into the environment causes pollution in various aquatic systems on a global scale. Biochar is potentially an inexpensive and environmentally friendly adsorbent for removing contaminants from water. Ball milling has been used to enhance biochar's functionality; however, global analysis of the effect of ball milling on biochar's capacity to adsorb contaminants in aqueous solutions has not yet been done. Here, we conducted a meta-analysis to investigate the effects of ball milling on the adsorption/removal capacity of biochar for contaminants in aqueous solutions, and to investigate whether ball milling effects are related to biochar production, ball milling, and other experimental variables. Overall, ball milling significantly increased biochar adsorption capacity towards both inorganic and organic contaminants, by 69.9% and 561.9%, respectively. This could be attributed to ball milling increasing biochar surface area by 2.05-fold, pore volume by 2.39-fold, and decreasing biochar pH by 0.83-fold. The positive adsorption effects induced by ball milling varied widely, with the most effective being ball milling for 12 to 24 h at 300 to 400 rpm with a biochar:ball mass ratio of 1:100 on biochars produced at 400-550 °C from wood residues. Based on this meta-analysis, we conclude that ball milling could effectively enhance biochar's ability to remove organic and inorganic contaminants from aquatic systems., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have influenced the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Objective: To find out the prevalence of diabetes mellitus in patients undergoing coronary artery bypass grafting (CABG)., Methods: This retrospective study was conducted in Northwest General Hospital and Research center Hayatabad, Peshawar over a duration of 15 months (December 2020 - March 2022). Every patient was tested through regular laboratory investigations. Diabetes mellitus was established according to WHO standards of fasting plasma glucose >126 mg/dl or two hours postprandial glucose level of 200 mg/dl. Data were analyzed using SPSS. Mean and standard deviation was used for quantitative data. Frequency and percentages were used for qualitative data. Shapiro Wilk's test was done to find the normality of the data., Results: Out of a total of 360 candidates, 129 (36%) individuals were non-diabetic and 231 (64%) candidates were diabetic. Among the diabetic patients, 64 (28%) were female and 167 (72%) were males with a ratio of 1:2.6 respectively., Conclusion: Prevalence of diabetes was 64% among the CABG population. Since the prevalence of diabetes can significantly affect the outcomes of people undergoing CABG, it is essential to generate awareness regarding diabetes among healthcare workers as well as the general population. More extensive research is needed to be carried by various health care centers to figure out the prevalence of diabetes mellitus in cardiac surgery patients., (Copyright: © Pakistan Journal of Medical Sciences.)

Semiconductor materials show a restricted degradation response to organic pollutants due to limited photocatalytic activity under visible light. Therefore, researchers have devoted much attention to novel and effective nanocomposite materials. For the first time, herein, a novel nano-sized semiconductor calcium ferrite modified by carbon quantum dots (CaFe 2 O 4 /CQDs) photocatalyst is fabricated via simple hydrothermal treatment for the degradation of aromatic dye using a visible light source. The crystalline nature, structure, morphology, and optical parameters of each of the synthesized materials were investigated using X-ray diffraction spectroscopy (XRD), Fourier transform infrared spectroscopy (FT-IR), scanning electron microscopy (SEM), and UV-visible spectroscopy. The nanocomposite exhibits excellent photocatalytic performance (90% degradation) against Congo red (CR) dye. In addition, a mechanism for CaFe 2 O 4 /CQDs improving photocatalytic performance has been proposed. The CQDs in the CaFe 2 O 4 /CQD nanocomposite are considered to act as an electron pool and transporter, as well as a strong energy transfer material, during photocatalysis. CaFe 2 O 4 /CQDs appear to be a promising and cost-effective nanocomposite for dye-contaminated water purification, according to the findings of this study., Competing Interests: There are no conflicts of interest to declare., (This journal is © The Royal Society of Chemistry.)

Artificial intelligence has significantly enhanced the research paradigm and spectrum with a substantiated promise of continuous applicability in the real world domain. Artificial intelligence, the driving force of the current technological revolution, has been used in many frontiers, including education, security, gaming, finance, robotics, autonomous systems, entertainment, and most importantly the healthcare sector. With the rise of the COVID-19 pandemic, several prediction and detection methods using artificial intelligence have been employed to understand, forecast, handle, and curtail the ensuing threats. In this study, the most recent related publications, methodologies and medical reports were investigated with the purpose of studying artificial intelligence's role in the pandemic. This study presents a comprehensive review of artificial intelligence with specific attention to machine learning, deep learning, image processing, object detection, image segmentation, and few-shot learning studies that were utilized in several tasks related to COVID-19. In particular, genetic analysis, medical image analysis, clinical data analysis, sound analysis, biomedical data classification, socio-demographic data analysis, anomaly detection, health monitoring, personal protective equipment (PPE) observation, social control, and COVID-19 patients' mortality risk approaches were used in this study to forecast the threatening factors of COVID-19. This study demonstrates that artificial-intelligence-based algorithms integrated into Internet of Things wearable devices were quite effective and efficient in COVID-19 detection and forecasting insights which were actionable through wide usage. The results produced by the study prove that artificial intelligence is a promising arena of research that can be applied for disease prognosis, disease forecasting, drug discovery, and to the development of the healthcare sector on a global scale. We prove that artificial intelligence indeed played a significantly important role in helping to fight against COVID-19, and the insightful knowledge provided here could be extremely beneficial for practitioners and research experts in the healthcare domain to implement the artificial-intelligence-based systems in curbing the next pandemic or healthcare disaster.

Yoga has become an integral part of human life to maintain a healthy body and mind in recent times. With the growing, fast-paced life and work from home, it has become difficult for people to invest time in the gymnasium for exercises. Instead, they like to do assisted exercises at home where pose recognition techniques play the most vital role. Recognition of different poses is challenging due to proper dataset and classification architecture. In this work, we have proposed a deep learning-based model to identify five different yoga poses from comparatively fewer amounts of data. We have compared our model's performance with some state-of-the-art image classification models-ResNet, InceptionNet, InceptionResNet, Xception and found our architecture superior. Our proposed architecture extracts spatial, and depth features from the image individually and considers them for further calculation in classification. The experimental results show that it achieved 94.91% accuracy with 95.61% precision., Competing Interests: Conflict of interestThe authors declare that they have no conficts of interest in this research work., (© The Author(s) 2023.)

The devastating impact of the Severe Acute Respiratory Syndrome-Coronavirus 2 (SARS-CoV-2) pandemic almost halted the global economy and is responsible for 6 million deaths with infection rates of over 524 million. With significant reservations, initially, the SARS-CoV-2 virus was suspected to be infected by and closely related to Bats. However, over the periods of learning and critical development of experimental evidence, it is found to have some similarities with several gene clusters and virus proteins identified in animal-human transmission. Despite this substantial evidence and learnings, there is limited exploration regarding the SARS-CoV-2 genome to putative microRNAs (miRNAs) in the virus life cycle. In this context, this paper presents a detection method of SARS-CoV-2 precursor-miRNAs (pre-miRNAs) that helps to identify a quick detection of specific ribonucleic acid (RNAs). The approach employs an artificial neural network and proposes a model that estimated accuracy of 98.24%. The sampling technique includes a random selection of highly unbalanced datasets for reducing class imbalance following the application of matriculation artificial neural network that includes accuracy curve, loss curve, and confusion matrix. The classical approach to machine learning is then compared with the model and its performance. The proposed approach would be beneficial in identifying the target regions of RNA and better recognising of SARS-CoV-2 genome sequence to design oligonucleotide-based drugs against the genetic structure of the virus., Competing Interests: The authors have declared that no competing interests exist.

The unique pool of features makes bacterial cellulose (BC) a robust platform to tailor its functionalities. Herein, the BC matrix was reinforced with multiwalled carbon nanotubes (MWCNT) to control infection and accelerate the healing process of diabetic wounds. The prepared BC-MWCNT composite film was characterized and antibacterial activity was assessed. Further, the in-vivo wound healing activity was performed and temporal expression of interleukin (IL-1α), tumor necrosis factor (TNF-α), vascular endothelial growth factor (VEGF) and platelets derived growth factor (PDGF) was quantitatively measured by real-time PCR. The characterization results confirmed the reinforcement of the BC matrix with MWCNT. The composite film showed antibacterial activity against all the tested strains. Moreover, the macroscopic analysis of the wound demonstrated faster closure of the diabetic wound in BC-MWCNT group (99% healing) as compared to negative control (77%) in 21 days. Histological studies further supported the results where complete reepithelization of the epidermis and healthy granulation tissue were observed in BC-MWCNT treated group. Molecular studies revealed that BC-MWCNT group showed relatively lesser expression of pro-inflammatory cytokines IL-1α and TNF-α and higher expression of VEGF than control that may have favored the faster healing. This study suggested that the tailorable properties of BC can be exploited to develop composites with potential applications in diabetic wound healing., (Copyright © 2022. Published by Elsevier B.V.)

Objectives: In this study we determine the modifiable factors related to bleeding and transfusion in post-cardiac surgery patients who underwent open heart surgery., Methods: This is a retrospective study that include two hundred patients who had undergone open heart surgery (OHS) at Northwest General Hospital and Research Center from December 2018 to July 2021. Platelet count and hemoglobin level were measured in the pre-operative period., Results: This study included both male and female patients. Postoperative platelets were counted as follow: 50-100 x10 9 L in 3.0% cases, 101-150 x10 9 L seen in 27.5% cases, and >150 x 10 9 L in 69.5% cases which required transfusion. We have also reported the increased requirement of transfusion of blood and blood products in patients with pre-operative hemoglobin (Hb) < 10 g/dl., Conclusion: Correction of pre-op Hb, post-op platelet count and total bypass time are the significant and preventable parameters in patients undergoing cardiac surgery if proper pre-op assessment of the patient is performed., Competing Interests: Conflicts of interest: None., (Copyright: © Pakistan Journal of Medical Sciences.)

Complete assessment of obstructive jaundice requires the use of various imaging modalities that are required to detect the cause and level of obstruction thus helping in treatment planning. Magnetic Resonance Cholangio Pancreatography (MRCP) is a current available technology which is a non-invasive technique that visualizes the gallbladder, biliary tree and pancreatic duct and also provides information about surrounding structures. This study was done to correlate the MRCP findings with post-operative result and thereby demonstrate the specificity, sensitivity and efficacy of MRCP as an accurate investigatory tool for biliary obstruction. Total of fifty (50) patients of clinically diagnosed obstructive jaundice were studied from March 2017 to August 2017 in the Department of Radiology and Imaging, Combined Military Hospital, Dhaka, Bangladesh. In all these cases, USG was the initial screening investigation followed by MRCP. Cause and level of obstruction were evaluated using MRCP findings. MRCP results were correlated with surgical findings and few cases also with direct ERCP findings. Statistical analysis was done to see the sensitivity, specificity, accuracy, positive and negative predictive values of MRCP in diagnosis of biliary obstruction. In this study, USG detected level of obstruction in 56% (28 out of 50) cases. USG could detect causes of obstruction in 100% (02 out of 02) cases of choledocal cyst and 66.67% (02 out of 03) benign stricture, 60% (03 out of 05) cases of periampullary carcinoma, 57.70% (06 out of 14) cases of choledocholithiasis, and 42.86% (15 out of 26) cases of cholangiocarcinoma. On the other hand, MRCP detected level of obstruction in 98% (49 out of 50) cases. MRCP could detect causes of obstruction in 100% cases of cholangiocarcinoma, choledocholithiasis, benign stricture and choledocal cyst and 80% (04 out of 05) cases of periampullary carcinoma. In this study, ERCP could detect causes of obstruction in 32 cases of choledocholithiasis and benign stricture, but in case of cholangiocarcinoma ERCP was failed in 3 cases. In this study, for detection of cause of obstruction, ERCP had the highest sensitivity (97.79%); followed by MRCP (96.65%) and USG (60.25%). The overall diagnostic accuracy for detection of cause of obstruction was the highest for ERCP (95.50%); followed by MRCP (94.50%) and USG (64.50%). MRCP can be done in a short duration and is a noninvasive diagnostic modality compared to ERCP. MRCP needs to be advocated as a viable and non-invasive alternative with compararable sensitivity and specificity to ERCP.

Objectives: Osteoarthritis is one of the most common musculoskeletal diseases which leads to functional decline and loss of quality of life. Knee osteoarthritis is considered as highly burdensome disease as well as highest contributor to global disability. Ḥijāmah (Cupping Therapy) and Dalk (Massage) are claimed effective in the treatment of Waja'ul Mafāṣil (osteoarthritis). Present study was framed to compare the efficacy of Ḥijāmah bilā Sharṭ (Dry Cupping) and Dalk-i-Layyin Kathīr (soft and prolonged massage) with Roghan-i-Bābūna (chamomile oil) in the management of Waja' ur Rukbah (knee osteoarthritis)., Methods: In present randomised controlled clinical trial, a total of 48 diagnosed patients of knee osteoarthritis were allocated randomly into group A (n=24) and group B (n=24). Group A was treated with soft and prolonged massage with Roghan-i-Bābūna while group B was managed with dry cupping on alternate day for 15 min. Visual Analog Scale (VAS) and Knee osteoarthritis outcome score (KOOS) were used for the assessment of efficacy. A total of 40 patients, group A (n=20) and group B (n=20), were completed the allocated duration of protocol therapy and were restricted to statistical analysis., Results: Statistically highly significant improvement was observed in objective parameters using both paired and unpaired t-tests. VAS and all KOOS subscales were found to be strongly significant at 20th day when compared with baseline (p<0.001). In intergroup comparison significant change (p>0.05) was not observed. Safety parameters were in their normal range after treatment., Conclusions: Dalk-i-Layyin Kathīr with Roghan-i-Bābūna and Ḥijāmah bilā Sharṭ both were found safe and effective in the management of Waja'ur Rukbah . Hence, it may be concluded that both regimenal therapies are safe, effective and almost equal in their efficacy in the management of Knee Osteoarthritis., (© 2021 Walter de Gruyter GmbH, Berlin/Boston.)

Objective: To find the incidence of intra-aortic balloon pump (IABP) induction and factors associated with its insertion in coronary artery bypass grafting (CABG)., Methods: This retrospective observational non interventional study was conducted at Cardiac Surgery Department, North West General Hospital and Research Center, Peshawar from December 2018 to March 2020. The total sample size was 360 patients who underwent coronary artery bypass grafting (CABG). The research was piloted in the cardiac operation theatre then cardiac intensive care unit (CICU) of Northwest General Hospital and Research center Hayatabad Peshawar. Data was collected from 360 patients scheduled for CABG. Total numbers of patients in whom IABP was inserted and factors associated with IABP insertions were noted. All the information was collected on a specifically prepared Form. Data was entered and evaluated in statistical package for social sciences form 25., Results: In this study, a total of 360 patients were observed who underwent coronary artery bypass grafting (CABG). We determined the frequency of IABP induction and the factors related to it. Gender distribution among patients who were assisted with IABP was 43% female and 57% male. IABP induction was done for most of moderately to severely reduced ejection fraction patients. Other factors related to patients who required IABP support were previous myocardial infarction 100%, hypertension 86%, diabetes mellitus 64%, coronary end-arterectomy 21% and smoking 7%. The results were analyzed. We have used the (SPSS) version 25 and Chi-square test for analysis in which the P-value less than 0.00001 is statistically significant., Conclusion: Incidence of insertion of IABP among CABG population was 3.9% in our hospital. It is an essential support to post CABG patient with left ventricular dysfunction after cardiopulmonary bypass with moderate to severely reduced ejection fraction, Myocardial infarction, hypertension, diabetes mellitus. Smoking and endarterectomy were not significantly related to IABP induction in our study. Multicenter study is still required to find out the other factors governing the IABP insertion., Competing Interests: Conflicts of interest: None., (Copyright: © Pakistan Journal of Medical Sciences.)

Introduction: There is a set of globally accepted and nationally adapted signal functions for categorising health facilities for maternal services. Newborn resuscitation is the only newborn intervention which is included in the WHO recommended list of emergency obstetric care signal functions. This is not enough to comprehensively assess the readiness of a health facility for providing newborn services. In order to address the major causes of newborn death, the Government of Bangladesh has prioritised a set of newborn interventions for national scale-up, the majority of which are facility-based. Effective delivery of these interventions depends on a core set of functions (skills and services). However, there is no standardised and approved set of newborn signal functions (NSFs) based on which the service availability and readiness of a health facility can be assessed for providing newborn services. Thus, this study will be the first of its kind to identify such NSFs. These NSFs can categorise health facilities and assist policymakers and health managers to appropriately plan and adequately monitor the progress and performance of health facilities delivering newborn healthcare., Methods and Analysis: We will adopt the Delphi technique of consensus building for identification of NSFs and 1-2 indicator for each function while employing expert consultation from relevant experts in Bangladesh. Based on the identified NSFs and signal function indicators, the existing health facility assessment (HFA) tools will be updated, and an HFA survey will be conducted to assess service availability and readiness of public health facilities in relation to the new NSFs. Descriptive statistics (proportion) with a 95% CI will be used to report the level of service availability and readiness of public facilities regarding NSFs., Ethics and Dissemination: Ethical approval was obtained from Research Review and Ethical Review Committee of icddr, b (PR-17089). Results will be disseminated through meetings, seminars, conference presentations and international peer-review journal articles., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

In this study, we posit that in determining the underpinnings and attributes of community resilience to disaster-shocks, an analysis of actual and potential disaster victims' emic perspectives, that is the views of cultural insiders, on recovery processes and community resilience is crucial. We argue that community resilience must be framed within a deeper understanding of the subjective views of the actors themselves, their local knowledge and culture, and the historical context of the place or social formation. In this context, the primary goal of this study was to delineate the fundamental elements of community recovery and attributes of resilience to cyclones, storm surges, and other environmental disaster-shocks in Bangladesh's coastal communities, and, recognizing that social actions are pivotal elements of community resilience, we attempt to make a novel contribution by underscoring local emic perspectives. Using the tools of participatory research methods, we collected empirical data from four sources: a household survey of 300 household heads, eight focus group discussions, 20 key informant interviews, and five in-depth, household case studies. Our research findings revealed that the roles of traditional-informal as well as quasi-formal institutions were vital for rapid recovery and transformation to new local economic and livelihood trajectories. Resilience attributes that were deeply embedded in community characteristics assisted in ameliorating immediate impacts as well as in building future adaptive capacities. Out of 12 resilience attributes identified by the respondents, 'knowledge, skills and learning', 'values and beliefs', 'people-place connection', 'social networks and support', 'active institutions', and 'self-organization' capacities were ranked highest. The community resilience attributes and their functionality in the context of the coastal communities studied varied significantly depending on their economic base, occupations, and their respective contexts of vulnerability. Overall, the findings demonstrate that community resilience attributes function interactively rather than independently, and analyses of community attributes therefore require a clear understanding of network functioning and the processes that drive institutional structures, relations, and outcomes., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

There is compelling evidence that drug molecules isolated from natural sources are hindered by low systemic bioavailability, poor absorption, and rapid elimination from the human body. Novel approaches are urgently needed that could enhance the retention time as well as the efficacy of natural products in the body. Among the various adopted approaches to meet this ever-increasing demand, nanoformulations show the most fascinating way of improving the bioavailability of dietary phytochemicals through modifying their pharmacokinetics and pharmacodynamics. Curcumin, a yellowish pigment isolated from dried ground rhizomes of turmeric, exhibits tremendous pharmacological effects, including anticancer activities. Several in vitro and in vivo studies have shown that curcumin mediates anticancer effects through the modulation (upregulation and/or downregulations) of several intracellular signaling pathways both at protein and mRNA levels. Scientists have introduced multiple modern techniques and novel dosage forms for enhancing the delivery, bioavailability, and efficacy of curcumin in the treatment of various malignancies. These novel dosage forms include nanoparticles, liposomes, micelles, phospholipids, and curcumin-encapsulated polymer nanoparticles. Nanocurcumin has shown improved anticancer effects compared to conventional curcumin formulations. This review discusses the underlying molecular mechanism of various nanoformulations of curcumin for the treatment of different cancers. We hope that this study will make a road map for preclinical and clinical investigations of cancer and recommend nano curcumin as a drug of choice for cancer therapy., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)