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Introduction: Alcoholic and aqueous extracts and total alkaloids of the seed of (Syrian rue) peganum harmala L. as scolicidal compound against Hydatid cyst protoscolices were assessed in this study. Methods and Materials: This study was carried out both invitro and by inoculating inside the intact cysts in the shaking bath and dry incubator at 37°c. Different concentration of suspensions were tested in different exposure times. Mortality of protoscolices was determined by their loss of mortality, ability to take vital stains and inactivity of flame cells. Results: The results indicated that alcoholic extract had scolicidal effect against protoscolices; total alkaloids had stronger action and rapid effect on protoscolices.

There are numerous well-established parameters to judge and evaluate the standard of a medical journal like quality of its contents and geographic distribution of manuscripts, it attracts for publication, indexation and coverage in important indexes and databases like Medline, Web of Sciences by Clarivate known for its Impact Factor (IF), PubMed Central, Scopus etc., journal visibility and readership, timely regular publication. Impact Factor is one of the criteria and not the only criteria, which should be used to judge the standard of a journal. However, too much importance being given to the Impact Factor by the regulatory bodies in Pakistan as well as by medical institutions, asking those doing PhD to publish their research work in Impact Factor journals has created a crisis like situation not only for the researchers but also made the life of the IF journal editors miserable. They are under tremendous pressure to accommodate more and more papers by the authors anxious for early publication to meet certain deadlines for the completion of their research project and award of degrees while the editors on their part are faced with a dilemma due to human resource and financial resource constraints. In an environment where political stability remains in short supply most of the time, law and order situation is unpredictable, not to forget the frequent breakdown of electricity and inefficient internet service, it is not possible to either increase the frequency of publications or plan some other measures which all call for additional investment. Finding trained human resource and then retaining those remains a constant problem.

Effective leadership is important in team management and the delivery of services in healthcare. Healthcare services work in a team that requires inter-team, intra-team, inter-department and effective communication with the hospital administration. It requires leadership with healthcare providers like paramedics and allied health workers. Different teams have conflicts and require motivation for better service delivery. The gap is evident in healthcare leadership in Pakistan. We do not have formal teaching and training in healthcare in emotional intelligence (EI). EI helps a leader understand, engage, and motivate a team. A leader’s EI skills have an important role in setting organizational culture. In the year 2022, this gap exists in health care regulations and accreditation bodies.

Abstract Through crosstalk, FLAGELLIN SENSITIVE 2 (FLS2) and RESPIRATORY BURST OXIDASE HOMOLOG D (RBOHD) are involved in regulating the homeostasis of cellular reactive oxygen species (ROS) and are linked to the metabolic response of plants toward both biotic and abiotic stress. In the present study, we examined the metabolome of Arabidopsis seedlings under drought and salt conditions to better understand the potential role of FLS2 and RBOHD‐dependent signaling in the regulation of abiotic stress response. We identified common metabolites and genes that are regulated by FLS2 and RBOHD, and are involved in the response to drought and salt stress. Under drought conditions, D‐aspartic acid and the expression of associated genes, such as ASPARAGINE SYNTHASE 2 (ASN2), increased in both fls2 and robed/f double mutants. The accumulation of amino acids, carbohydrates, and hormones, such as L‐proline, D‐ribose, and indoleacetaldehyde increased in both fls2 and rbohd/f double mutants under salt conditions, as did the expression of related genes, such as PROLINE IMINOPEPTIDASE, PHOSPHORIBOSYL PYROPHOSPHATE SYNTHASE 5, and NITRILASE 3. Collectively, these results indicate that the FLS2‐RBOHD module regulates plant response to drought and salt stress through ROS signaling by adjusting the accumulation of metabolites and expression of genes related to metabolite synthesis.

This study aimed to investigate the effectiveness of multidimensional spiritual therapy for reducing patients' anxiety after cardiac bypass surgery. The study utilized a quasi-experimental with a pretest-posttest design and follow-up with a control group. The statistical population of this study included patients who had coronary artery bypass surgery and were referred to the Rehabilitation Center of Tehran Heart Hospital in 2018. Thirty patients who scored high for anxiety on the Depression, Anxiety, and Stress Scale (DAS-21) questionnaire were selected by convenience sampling and were randomly assigned to experimental and control groups. The experimental group was exposed to an independent variable (multidimensional spiritual intervention) for ten 90-minute sessions in the hospital rehabilitation center. The results of repeated measurement test showed that there was a significant difference in the anxiety scores for the experimental and control groups in the pre-test, post-test, and one-month and three-month follow-up stages. In addition, there was a significant difference in the pretest-posttest in the spiritual group. There was no significant difference in post-test scores between one-month and three-month follow-ups. Reducing negative emotions by multidimensional spiritual therapy plays an important role in preventing the more severe complications of heart disease, therefore, interventions based on the results of this study are recommended for heart patients.IntroductionCardiovascular diseases, with 11 million deaths per year, are the most important cause of disability and death in the world (Alrawi & Alrawi, 2017). A large number of coronary artery disease (CHD) patients who do not respond to drug treatments undergo coronary artery bypass graft surgery (CABG) (Amjadian et al., 2018). This surgery is accompanied by psychological reactions such as stress, anxiety, and depression. As disturbing factors in treating patients, it affects patients' quality of life, recovery after surgery, the efficiency of surgery, and the rate of death after surgery (Turk-Adawi et al., 2018). The fear of death, disability, and reduced range of motion fuel this anxiety following the continuation of symptoms (Allen et al., 2018). Moreover, anxiety can cause various physical and psychological symptoms such as heart palpitations, increased blood pressure, inability to concentrate, insomnia, and fear of consequences. It seems that the intervention that helps to moderate patients' emotions is multidimensional spiritual treatment psychotherapy. In the form of Lazarus therapy, and in addition to the external dimension of personality, multidimensional spiritual treatment psychotherapy focuses on the spiritual dimension (Richards & Bergin, 2004). Activating the spiritual dimension can take all of them under the and give them unity (Khayatan Mostafavi et al., 2019). Therefore, this study aimed to investigate the effectiveness of multidimensional spiritual therapy on the anxiety of patients after heart bypass surgery. MethodThe study employed a quasi-experimental with a pre-test-post-test and follow-up design with a control group. The research population included cardiac patients with coronary artery bypass surgery (CABG) at Tehran Cardiac Rehabilitation Center, Iran in 2018. The sample included 30 patients who scored a high anxiety score on the DAS scale. They were selected via convenient sampling and were randomly assigned to two experimental and control groups. The experimental group received the multidimensional spiritual intervention, and the control group was placed on the waiting list. Finally, the repeated measurement test conducted by SPSS-20 software were used to analyze the data. ResultsThirty patients were studied to examine the effectiveness of multidimensional spiritual treatment for reducing their anxiety. From the sample, 66.81% were men and 33.19% were women. The highest frequency was related to the age group of 60-69 (45.7), and the lowest frequency was 49-40 (15.8). There was no significant difference between the experimental and control groups in demographic variables and clinical data at baseline. In the experimental group, there was a significant difference between the mean and standard deviation of anxiety in the pre-test and post-test stages. However, no significant difference was seen in the pre-test and post-test scores of the control group. Repeated measure variance analysis showed a significant difference in the anxiety scores between the experimental and control groups in the pre-test, post-test, and one-month and three-month follow-up. The results of the mean difference test comparing the spiritual group and the control group in four stages showed that there was a difference in anxiety scores in the pre-test and post-test scores of the experimental group (F=11.067, p

Using automatic identification system (AIS) data, this article first has extended the definition of three widely used roadway congestion indices to maritime transportation systems (MTS), traffic speed index (TSI), traffic rate index (TRI), and dwell time index (DTI). Next, a methodology is developed to measure the indices based on AIS data, considering various factors, including path geometry, time of day, and the type and size of vessels, and finally the method has been applied to the AIS data of the Houston Ship Channel (HSC) to evaluate the applicability in real cases. The results show that although average TSI and TRI cannot represent waterway congestion, the real-time values (rather than the average) at the micro level can help finding location, time, and severity of traffic congestion. Besides, while TSI and TRI have shortcomings, both average and real-time dwell time index (DTI) can quantify traffic congestion and highlight severity in different waterway segments for different types of vessels. When congestion happens at some narrow waterways, vessels need to wait at sea buoy or docks, thus dwell time index (DTI) can quantify traffic congestion better than in-transit indices such as travel speed, TSI. According to HSC DTI, most tankers experience long waiting times at the sea buoy and Galveston Bay, while cargo vessels experience delays at Bayport and Barbour's Cut terminals. This paper helps the decision-makers quantify congestion in different sections of a waterway and provides measures to compare congestion for national competing projects at different waterways.

This research introduces an online system for monitoring maritime traffic, aimed at tracking vessels in water routes and predicting their subsequent locations in real time. The proposed framework utilizes an Extract, Transform, and Load (ETL) pipeline to dynamically process AIS data by cleaning, compressing, and enhancing it with additional attributes such as online traffic volume, origin/destination, vessel trips, trip direction, and vessel routing. This processed data, enriched with valuable details, serves as an alternative to raw AIS data stored in a centralized database. For user interactions, a user interface is designed to query the database and provide real-time information on a map-based interface. To deal with false or missing AIS records, two methods, dead reckoning and machine learning techniques, are employed to anticipate the trajectory of the vessel in the next time steps. To evaluate each method, several metrics are used, including R squared, mean absolute error, mean offset, and mean offset from the centerline. The functionality of the proposed system is showcased through a case study conducted in the Gulf Intracoastal Waterway (GIWW). Three years of AIS data are collected and processed as a simulated API to transmit AIS records every five minutes. According to our results, the Seq2Seq model exhibits strong performance (0.99 R squared and an average offset of ~1400 ft). However, the second scenario, dead reckoning, proves comparable to the Seq2Seq model as it involves recalculating vessel headings by comparing each data point with the previous one.

In maritime logistics, accurately predicting the Estimated Time of Arrival (ETA) of vessels is pivotal for optimizing port operations and the global supply chain. This study proposes a machine learning method for predicting ETA, drawing on historical Automatic Identification System (AIS) data spanning 2018 to 2020. The proposed framework includes a preprocessing module for extracting, transforming, and applying feature engineering to raw AIS data, alongside a modeling module that employs an XGBoost model to accurately estimate vessel travel times. The framework’s efficacy was validated using AIS data from the Port of Houston, and the results indicate that the model can estimate travel times with a Mean Absolute Percentage Error (MAPE) of just 5%. Moreover, the model retains consistent accuracy in a simplified form, pointing towards the potential for reduced complexity and increased generalizability in maritime ETA predictions.

A novel absorber based on a one-dimensional photoniccrystal (PhC) is proposed by combining the absorptionproperty of gold and graphene films. We designed twophotonic crystals consisting of silicon and silicondioxide layers with lattice constants 125 and 260 thatalternate in one dimension. We placed a 125-nanometerthicklayer of graphene between the two photoniccrystals and an 8-nanometer-thick layer of gold at theend of the second photonic crystal. When graphene isplaced between two photonic crystals, a topological edgemode excitation creates a strong absorptionenhancement. In this study, the absorbing spectrums andfield distribution are analyzed by using the transfermatrix and the 2.5 dimensional variational finitedifference time domain method (2.5 var.FDTD). Theabsorption spectrum for different angles was studied(θ=0 to 60), and more than 87 percent absorption can bemaintained for θ =40°. The results of our studies willenhance the interaction between light and matter. Thus,opening up the possibility of their application for theabsorption and modulation of light

Mammalian carotid body arterial chemoreceptors function as an early warning system for hypoxia, triggering acute life-saving arousal and cardiorespiratory reflexes. To serve this role, carotid body glomus cells are highly sensitive to decreases in oxygen availability. While the mitochondria and plasma membrane signaling proteins have been implicated in oxygen sensing by glomus cells, the mechanism underlying their mitochondrial sensitivity to hypoxia compared to other cells is unknown. Here, we identify HIGD1C, a novel hypoxia-inducible gene domain factor isoform, as an electron transport chain complex IV-interacting protein that is almost exclusively expressed in the carotid body and is therefore not generally necessary for mitochondrial function. Importantly, HIGD1C is required for carotid body oxygen sensing and enhances complex IV sensitivity to hypoxia. Thus, we propose that HIGD1C promotes exquisite oxygen sensing by the carotid body, illustrating how specialized mitochondria can be used as sentinels of metabolic stress to elicit essential adaptive behaviors.

Background and Objective: Augmented Reality (AR) is an effective tool for learning as well as marketing with multilateral interactive communication. It allows brands to give their customers unique experiences with the convenience of tapping into their mobile devices. This study was conducted to assess the perceptions of healthcare professionals (HCPs) to learn through AR and its effectiveness in HCPs’ engagement and learning experience. Methods: An interventional study was conducted with HCPs across various tertiary care hospitals in Pakistan from May 2020 till December 2020. An AR based activity was carried out with the HCPs where they used pictures of objects around them to create a message. These were geo-tagged to a question related to hypertension and participants answered each question. Mobile application – WallaMe was utilized for this activity. At the end of the activity, HCPs were requested to fill a feedback form based on their experience with the AR app. Data was entered and analyzed by using SPSS version 22. Results: AR stimulated learning gives the participants an overall exciting (80%), captivating (81%), and fruitful learning experience (82%). AR for marketing campaign was more effective for Brand Recall with paper based campaign for 82.8% and more effective than digital campaign for 85.6% participants. AR was recommended by 80% participants for learning and brand recall. Conclusion: AR is a useful tool to enhance user experience for learning as well as improves brand recall and can be used for marketing campaigns.

The chloroplast is a complex cellular organelle that not only performs photosynthesis but also synthesizes amino acids, lipids, and phytohormones. Nuclear and chloroplast genetic activity are closely coordinated through signaling chains from the nucleus to chloroplast, referred to as anterograde signaling, and from chloroplast to the nucleus, named retrograde signaling. The chloroplast can act as an environmental sensor and communicates with other cell compartments during its biogenesis and in response to stress, notably with the nucleus through retrograde signaling to regulate nuclear gene expression in response to developmental cues and stresses that affect photosynthesis and growth. Although several components involved in the generation and transmission of plastid-derived retrograde signals and in the regulation of the responsive nuclear genes have been identified, the plastid retrograde signaling network is still poorly understood. Here, we review the current knowledge on multiple plastid retrograde signaling pathways, and on potential plastid signaling molecules. We also discuss the retrograde signaling–dependent regulation of nuclear gene expression within the frame of a multilayered network of transcription factors.

OBJECTIVES: To assess the effect of segmentation and user control on learning of basic surgical skills in a video-based instruction format as compared to non-segmented video-based instruction format in novices. METHODS: This quasi-experimental study was conducted at Dow University of health sciences Karachi, Pakistan. Sixty students were divided into four groups of 15 each. Each group had a different method of instruction. Group A: non-segmentation with facilitator; Group B: non-segmentation without facilitator; Group C: segmentation with no user control; Group D: segmentation with user control. All groups’ knot tying skill was assessed at the end of session. Data analyzed using SPSS version-17. Kruskal Wallis and Mann-Whitney U tests were applied for data analysis. RESULTS: Out of 60 participants, sixteen (26.7%) were male and forty-four (73.3%) were female. Overall, scores on performance examination [p=0.006] were statistically significant. With respect to method of instruction, scores on performance examinations of group A and group B were statistically significant [D(15)=0.300, p=0.001] and [D(15)=0.225, p=0.040] respectively. Levine test was employed to assess the homogeneity of variance assumption. For performance scores, the variances were equal for all four group students (i.e. non-significant) [F (3,56) =1.68, p=0.182] and [F (3,56) =1.90, p=0.140] respectively]. Median performance scores were significantly higher in group A as compared to group D [U=45.50, r=-0.73, p=0.004]. CONCLUSION: Non-segmented video-based instructions with expert feedback result in increased learning of basic surgical as compared to segmentation with user control, in novice students. Both segmented and non-segmented video resulted in similar amount of learning.

The lockdown resulting from COVID-19 outbreak affected individuals and nations equally. It not only harmed the economy but also led to the total shut down of all educational activities resulting in a significant gap in learning and understanding among students worldwide. Institutions, teachers, educators and students all had to quickly respond to an unexpected and ‘forced’ transition from face-to-face to remote teaching. The educational institutions also had to create learning environments for students and teachers in the light of the conditions in which both universities and schools had to operate. Although it leads to a number of challenges, but also provided opportunities that can best be described as blessing in disguise.

Objective: To observe the effect of rivaroxaban in patients with atrial fibrillation due to valvular heart diseases for proper anticoagulation to avoid stroke. Methodology: An observational follow up study was carried out in Cardiology Department of Aziz Fatimah Hospital, Faisalabad from February to August 2021. The study included 36 patients of valvular heart disease with atrial fibrillation on warfarin, whose INR was not tested during the last 4 months due to lack of facility nearby. All patients with non valvular atrial fibrillation were excluded .All patients were given rivaroxaban to replace warfarin. These patients were followed up for 6 months in the OPD of the same hospital to observe the end points including stroke and bleeding episodes and ischemic changes on ECG. Results: Total of 36 patients of mean age and SD of 56±7.00 years were followed up. Out of which 20 were male and 16 were female subjects.Not a single incident of stroke or bleeding episode or bruises was observed during the 6 month follow up. On echocardiographic examination, none of the patients showed clot in the left atrium. Left atrium size and LV ejection fraction remained the same, during next visit. LA size 44±5 and 44±6 on 1st and second visit respectively (p value =0.059) No other ischemic changes found in the ECG of any patient. International normalization ratio (INR) mean and SD was 2.1± 0.9, 2.2± 0.8, on 1st and 2nd visit of follow up respectively and no significant difference was noted between INR values. Conclusion: Rivaroxaban can be given safely to the patients with valvular heart disease with atrial fibrillation, particularly in patients who cannot get the INR checked on regular basis.

Background Persistent inflammation following vascular injury drives neointimal hyperplasia (NIH). Specialized lipid mediators (SPM) mediate resolution which attenuates inflammation and downstream NIH. We investigated the effects of a synthetic analogue of resolvin D1 (RvD1) on vascular cells and in a model of rat carotid angioplasty. Methods Human venous VSMC and endothelial cells (EC) were employed in migration, cell shape, toxicity, proliferation and p65 nuclear translocation assays. Murine RAW 264.7 cells were utilized to test the effect of pro-resolving compounds on phagocytic activity. A model of rat carotid angioplasty was used to evaluate the effects of 17R/S-benzo-RvD1 (benzo-RvD1) and 17R-RvD1 applied to the adventitia via 25% Pluronic gel. Immunostaining was utilized to examine Ki67 expression and leukocyte recruitment. Morphometric analysis was performed on arteries harvested 14 days after injury. Results Exposure to benzo-RvD1 attenuated PDGF- stimulated VSMC migration across a range of concentrations (0.1–100 nM), similar to that observed with 17R-RvD1. Pre-treatment with either Benzo-RvD1 or 17R-RvD1 (10, 100nM) attenuated PDGF-BB-induced VSMC cytoskeletal changes to nearly baseline dimensions. Benzo-RvD1 demonstrated modest anti-proliferative activity on VSMC and EC at various concentrations, without significant cytotoxicity. Benzo-RvD1 (10nM) inhibited p65 nuclear translocation in cytokine-stimulated EC by 21% (pConclusions 17R/S-benzo-RvD1 and 17R-RvD1 exhibit similar pro-resolving and anti-migratory activity in cell-based assays, and both compounds attenuated NIH following acute arterial injury in rats. Further studies of the mechanisms of resolution following vascular injury, and the translational potential of SPM analogues, are indicated.