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The control of active prostheses and orthoses requires the precise classification of instantaneous human activity and the detection of specific events within each activity. Furthermore, such classification helps physiotherapists, orthopedists, and neurologists in kinetic/kinematic analyses of patients’ gaits. To address this need, we propose an innovative deep neural network (DNN)-based approach with a two-step hyperparameter optimization scheme for classifying human activity and gait events, specific for different motor activities, by using the ENABL3S dataset. The proposed architecture sets the baseline accuracy to 93% with a single hidden layer and offers further improvement by adding more layers; however, the corresponding number of input neurons remains a crucial hyperparameter. Our two-step hyperparameter-tuning strategy is employed which first searches for an appropriate number of hidden layers and then carefully modulates the number of neurons within these layers using 10-fold cross-validation. This multi-class classifier significantly outperforms prior machine learning algorithms for both activity and gait event recognition. Notably, our proposed scheme achieves impressive accuracy rates of 98.1% and 99.96% for human activity and gait events per activity, respectively, potentially leading to significant advancements in prosthetic/orthotic controls, patient care, and rehabilitation programs’ definition.

The integration of advanced control systems in prostheses necessitates the accurate identification of human locomotion activities, a task that can significantly benefit from EEG-based measurements combined with machine learning techniques. The main contribution of this study is the development of a novel framework for the recognition and classification of locomotion activities using electroencephalography (EEG) data by comparing the performance of different machine learning algorithms. Data of the lower limb movements during level ground walking as well as going up stairs, down stairs, up ramps, and down ramps were collected from 10 healthy volunteers. Time- and frequency-domain features were extracted by applying independent component analysis (ICA). Successively, they were used to train and test random forest and k-nearest neighbors (kNN) algorithms. For the classification, random forest revealed itself as the best-performing one, achieving an overall accuracy up to 92%. The findings of this study contribute to the field of assistive robotics by confirming that EEG-based measurements, when combined with appropriate machine learning models, can serve as robust inputs for prosthesis control systems.

In this article, a central-upwind scheme (CUP) is extended to solve two-phase shallow granular flow (TPSF) model. The flow in this case is considered as incompressible and it is regarded to be a shallow layer of granular and liquid material. The model consists of continuity and momentum equations for both solid and liquid phases. Our main intrigue is the numerical approximation of the above-mentioned solid-liquid model, the complexity of which raises numerical challenges. The proposed method is non-oscillating upwind biased that does not require a Riemann solver at each step. A few test problems are approximated numerically to check the performance of suggested scheme. For validation the outcomes are compared with the conservation element solution element (CE/SE) and kinetic flux vector splitting (KFVS) schemes.

This article presents the development of a fifth-order multi-resolution finite volume weighted essentially non-oscillatory (WENO) scheme combined with the advection upstream splitting method based on flux vector splitting (AUSMV) numerical flux for analyzing two-phase flow in both horizontal and vertical pipelines. The drift flux flow model comprises of two separate mass conservation equations for each phase for liquid and gas and one momentum equation for mixture and submodels for thermodynamics and hydrodynamics. The two mass conservation equations describe the behavior of each phase in the flow. The mixture-momentum equation takes into account the frictional and gravitational forces acting on the mixture of both phases. The thermodynamic and hydrodynamic submodels provide additional information to fully describe the flow and close the drift flux model. In the presence of these source terms and submodels, it is a challenging task to develop a high order efficient and accurate numerical schemes. The proposed numerical technique captures the peaks of pressure wave, suppresses the erroneous oscillations at the transition zones and resolves the discontinuities more efficiently and accurately. The accuracy of proposed numerical technique is verified by solving the various test problems. Furthermore, the solution obtained by developed numerical technique are compared to those attained with the high-resolution improved CUP and simple finite volume WENO numerical schemes.

The baseline ecological exploratory studies of floristically rich areas like the western Himalaya are very important to determine the diversity variations. Based on research gaps detected in ecological literature of the western Himalayan forests of Sudhan Gali and Ganga summit, the study area is revisited. Plots data was collected during 2016, and advanced multivariate statistical tools were used to analyze it. Some of multivariate tools including permutation test, indicator species analysis and variation partitioning (partial CCA) were used for the first time in the area. The results of hierarchical clustering and permutation test revealed that there were four ecologically meaningful vegetation groups (1. Berberis- Micromeria-Desmodium (BMD), 2. Pinus-Rubus-Persicaria (PRP), 3. Viburnum-Abies-Dryopteris (VAD) and 4. Sibbaldia-Thymus-Bistorta (STB) associations) in the area. A significant (p ≤ 0.05) pairwise compositional difference of all the detected plant communities was observed. The results of canonical correspondence analysis (net effect) depicted that all the studied environmental variables were significantly important, and explains about 73.1% variations in the species data. The higher (r > 0.9) species-environment pseudo-canonical correlations values for the first four CCA-axes revealed that the selected explanatory variables were determinants of the response (species) data variations, and the high values for the CCA axes 2 to 4 indicated that there was no single dominant environmental gradient in this part of the western Himalaya. The highest β diversity value of Himalayan alpine scrubland at the Ganga summit depicted that even a minor variation in environment affects the high altitude vegetation more rapidly than the vegetation of low elevation areas. The vegetation of the study area is under continuous deterioration, and this exploratory work can be used as a baseline study for the future management, sustainable use, and conservation programs in the area. [ABSTRACT FROM AUTHOR]

In this article, two-layer shallow flow model with non-flat basal topography is considered. The presence of coupling terms in two layers make the system conditional hyperbolic. The kinetic flux-vector splitting (KFVS) scheme is applied to approximate the corresponding one-dimensional two-layer shallow flow equations. Our interest lies in the numerical approximation of the model referred to above, the complexity of which poses numerical problems. The higher order accuracy of the scheme is achieved by using a MUSCL-type initial reconstruction and Runge-Kutta time stepping method. The scheme is able to treat variety of flow conditions. A number of test cases are carried out to verify the performance of the suggested method. The conservation and solution element (CESE) scheme is used for comparison. It is observed from the comparison that KFVS resolves the shocks more effectively than CESE scheme.

Introduction: Coronavirus Disease-19 (COVID-19) Pandemic affected healthcare delivery worldwide from all quarters be it routine or essential care, including cancer care. All aspects like screening, diagnosis, and treatment were affected regardless of the developmental status of countries. Aim: To find out the extent and magnitude of cancer care affected during pandemic by comparing the data during pandemic for outpatient visits, new registrations, admissions, and day-care chemotherapy sessions with prepandemic data. Materials and Methods: This retrospective study was conducted in the Department of Medical Oncology of State Cancer Institute in Srinagar, India. The parameters assessed were the number of outpatient visits, new registrations, admissions, and day care chemotherapy sessions from the department of Medical Oncology. Anonymised cumulative data of all the patients who availed these services was included. Data were collected for eight months, during pandemic in 2020 and were compared with the data from previous year 2019. The effect of lockdown was assessed by comparing these parameters with the non lockdown period. Statistical analysis was done by independent t-test. Results: The number of outpatient visits dropped from 15425 from non lockdown period to 12670 in lockdown period (p-value=0.019), number of new admissions from 1613 to 1418 (p-value=0.001), and chemotherapy sessions from 9374 to 8081, (p-value=0.004). The number of patient registrations also declined but the drop was not significant (p-value=0.171). All the parameters except in-patient admission improved during the non lockdown period with the highest improvement in registration, but inpatient admission revealed a similar reduction as in the lockdown period. Conclusion: There was a significant effect of lock down due to COVID-19 pandemic on the number of outpatient visits, new admissions and chemotherapy sessions. This infers that, the treatment protocols and chemotherapeutic management of cancer care were badly affected by the advent of the pandemic.

The challenges accompanying socio-ecological and demographic transformations in the urban areas necessitate for coordinated efforts to ensure urban ecological resilience. Trans-disciplinary analytical construct of urban ecosystem services (UES) empowers the policy makers and urban planners to synchronize the orientations of human impacts and resilience of ecological resources in urban areas. The current study provides a systematic overview about the research orientations, approaches and techniques used in the recent studies regarding UES. The study examined: what types of evaluation methods were adopted in the recent UES research? What is their spatial and temporal pattern? What types of UES were focused and environmental components relied upon for the assessment? To address these questions, 116 relevant publications were scrutinized by using a set of assessment criteria. The findings indicated a lesser focus in research towards UES in developing countries as compared to the volume and increasing share of their urban population. The study also establishes that an overwhelming proportion of the UES research was carried out in the industrialized countries of the northern hemisphere but rather skewed towards studying regulatory ecosystem services. The recommendations for improving the relevancy of contemporary research for stakeholders were made. [ABSTRACT FROM AUTHOR]

The adverse effects of the weed flora on the agricultural yield are well documented. In an agroecosystem, weed species distribution pattern depends on both surrounding environment and farming practices. This first ever study was designed to compare and determine the weed species richness, distribution pattern and their ecologically meaningful groups in wheat and maize field of Gujrat, Pakistan. In this study, seasonal variation variable and satellite derived measurements like normalized difference vegetation index (NDVI), normalized difference moisture index (NDMI) and topographic wetness index (TWI) were calculated for each vegetation sample and their contribution towards explaining variations in the weed species data was tested by using direct unimodal ordination method. Phytosociological data was collected from 50 crop fields (25 each from wheat and maize fields during winter and monsoon season respectively) comprising of 250 sub-samples/plots (size 1 × 1 m) during 2016. The results of Monte Carlo testing and cluster analysis showed that there were four statistically significant weeds groups (i.e. 1. Anagallis-Medicago-Phalaris or AMP-Wheat weed group; 2. Chenopodium-Convolvulus-Vicia or CCVWheat weed group; 3. Cyperus Malva-Amaranthus or CMA-Maize weed group; 4. Cannabis-Cynodon-Digera or CCD-Maize weed group). A total of 60 weed species were recorded and the majority of them belongs to Poaceae and Amaranthaceae families. The majority of weed species flowered during monsoon season whereas therophytic life form and microphyllous leaf size categories were the most dominant. The highest mean weed diversity, NDVI and NDMI values were recorded for the weed communities of maize fields whereas the higher mean TWI value was recorded for the weed groups of wheat fields, suggesting strong linkage with the local climatic conditions. Canonical correspondence analysis (net effects) suggested that sum of local climatic conditions (seasonality variable) was found to be the most important in controlling the variations in the weed species data followed by longitude and altitude variables and least by the NDVI, NDMI and TWI. It is concluded that effective weed management activities are required to enhance the yield of these two important crops in the area. Thus, further studies related to determination of weed types and their distribution pattern by using factors like fertilization (type, timing, quantity), wheat and maize cultivar, land preparation (types, timing and intensities), soil management, pesticides (usage, type, quantity, quality), irrigation (type like rain-fed, tube-well, canals; timing, quantity), socio-economic and anthropogenic activities, and their relationship with the yield variable on temporal and spatial scales are recommended for this agro-ecosystem of the study area. [ABSTRACT FROM AUTHOR]

Zulkaif Ahmed Saqib,1 Jianhui Dai,2 Rashid Menhas,3 Shahid Mahmood,4 Maria Karim,5 Xuehui Sang,2 Yu Weng2 1Research Institute of Business Analytics & Supply Chain Management, College of Management, Shenzhen University, Shenzhen, Guangdong Province 518060, People’s Republic of China; 2School of Physical Education and Sports, Soochow University, Suzhou 215006, Jiangsu Province, People’s Republic of China; 3Research Center of Sports Social Sciences, School of Physical Education and Sports, Soochow University, Suzhou 215006, Jiangsu Province, People’s Republic of China; 4College of Management, Shenzhen University, Shenzhen, Guangdong Province 518060, People’s Republic of China; 5International Institute of Islamic Economics (IIIE), International Islamic University (IIU), Islamabad, 44000, Islamic Republic of PakistanCorrespondence: Jianhui DaiSchool of Physical Education and Sports, Soochow University, No. 50 Donghuan Road, Suzhou 215006 Jiangsu Province, People’s Republic of ChinaEmail sddjh@suda.edu.cnRashid MenhasResearch Center of Sports Social Sciences, School of Physical Education and Sports, Soochow University, No. 50 Donghuan Road, Suzhou 215006 Jiangsu Province, People’s Republic of ChinaEmail menhas.r@yahoo.comBackground: A modifiable risk factor for many diseases is physical inactivity. In this modern era, physical activity is acknowledged as a vital strategy to promote good health. According to the WHO, regular physical activity has various benefits for psycho-physical health. Decreased physical inactivity is happening in China due to the increased participation of the Chinese population in physical activity. The human body needs a specific level of physical activity to maintain good health.Objective: The main aim of the present study was to assess the Chinese people’s understanding of physical activity and participation in physical activity as a preventive measure against different diseases.Methods: The present study was exploratory and conducted in the Kunshan county-level city in Jiangsu Province, China. A well-designed questionnaire was used to collect the data from the survey participants. A total of 3390 residents were selected from 1300 households through a simple random sampling technique. The collected data were analyzed through SPSS software. Both univariate and bivariate analysis were performed.Results: The survey results showed that the majority of women are participating in physical activity. Most of the Kunshan people participate in physical activity one time or more than one time per week. They perform 30– 60 minutes of moderate-intensity physical activity to improve physical fitness, recreation, and disease prevention. Fitness walking is the most common type of physical activity among Kunshan people, and most of them participate in physical activity at night. Wilcoxon signed-rank test indicated that post-test ranks are statistically higher than pre-test ranks (P< 0.0039, 0.0039, 0.0039, 0.0020, 0.0001, 0.0156, 0.0313).Conclusion: The study results showed that physical activity plays a catalyst role in improving human health on a natural path. It reduces the risk factor of non-communicable diseases and promotes general wellbeing. These findings show that physical activity level increases in Chinese society as more people participate in physical activity for health-being.Keywords: physical activity, health, diseases, understanding, participation, wellbeing

Liver plays vital role in detoxification of exogenous and endogenous chemicals. These chemicals as well as oxidative stress may cause liver disorders. This study was aimed to evaluate the hepatoprotective effects of various fractions of Aconogonon alpinum methanolic extract against carbon tetrachloride (CCl4)-induced liver toxicity in mice. First, hepatoprotective potential of various fractions of A. alpinum was assessed and then antioxidant activity and profiling of polyphenolic compounds were assessed. A total of 78 male albino mice (BALB/c) were randomly divided into 13 groups (n = 6); Group I (normal control), Group II (CCl4 only), Group III (CCl4 + silymarin 100 mg/kg) and Groups IV–XIII (CCl4 + various fractions [200 and 400 mg/kg]). Hepatic biochemistry and liver injury were assessed by analysis of serum levels of hepatic enzymes and histopathological analysis, respectively. Results showed that polar fractions (ethyl acetate, n-butanol and aqueous fractions) exhibited highly significant (P < 0.01) reduction in increased level of liver biochemical parameters in a dose-dependent manner with consistent histopathological findings. Likewise, these fractions revealed strong antioxidant potential and polyphenolic compound contents. In conclusion, the present work has revealed promising antioxidant activity, polyphenolic profiling and potential hepatoprotective efficacy. Thus, the significant results unveil the study as a step forward towards evidence-based phytomedicine.

In this article, two-phase compressible six equation flow model is numerically investigated. The six-equation model consists of velocity, pressure equations, and also relaxation terms. An extra seventh equation is included describing the total energy of the mixture to ensure the correct treatment of the sharp discontinuities. The model is hyperbolic and poses numerous difficulties for numerical schemes. An efficient and well-balanced scheme can handle the numerical difficulties related to this model. The second order space-time CE/SE scheme is extended to solve the model. This scheme offers an effective numerical method for several continuum mechanics problems. The suggested scheme suppresses the numerical oscillations and dissipation effects. Several numerical test cases have been carried out to reveal the efficiency and performance of the proposed approach. The results are compared with the exact solution and also with Runge-Kutta Discontinuous Galerkin (RKDG) and central (NT) schemes.

In this article, a weighted essentially non-oscillatory (WENO) scheme is implemented to simulate two-phase shallow granular flow (TPSF) model. The flow is assumed to be incompressible and it is regarded as shallow layer of granular and liquid material. The mathematical model consists of two phases, that is, solid and liquid. Each phase has its continuity and momentum equation. The presence of the equations are coupled together involving the derivatives of unknowns which make it more challenging to solve. An efficient numerical technique is needed to tackle the numerical complexities. Our main intrigue is the numerical approximation of the above-mentioned solid-liquid model. The weighted essentially non-oscillatory (WENO) scheme of order 5 is utilized to handle the shock waves and contact discontinuities appear in the solution. The results are compared with the results already available in the literature by conservation element and solution element (CESE) scheme. It is observed the WENO scheme produces less errors as compared to CESE scheme and also effectively handle the shocks.

In this article, fifth order well-balanced finite volume multi-resolution weighted essentially non-oscillatory (FV MR-WENO) schemes are constructed for solving one-dimensional and two-dimensional Ripa models. The Ripa system generalizes the shallow water model by incorporating horizontal temperature gradients. The presence of temperature gradients and source terms in the Ripa models introduce difficulties in developing high order accurate numerical schemes which can preserve exactly the steady-state conditions. The proposed numerical methods are capable to exactly preserve the steady-state solutions and maintain non-oscillatory property near the shock transitions. Moreover, in the procedure of derivation of the FV MR-WENO schemes unequal central spatial stencils are used and linear weights can be chosen any positive numbers with only restriction that their total sum is one. Various numerical test problems are considered to check the validity and accuracy of the derived numerical schemes. Further, the results obtained from considered numerical schemes are compared with those of a high resolution central upwind scheme and available exact solutions of the Ripa model.

An oscillatory mixed-convection fluid flow mechanism across a nonconducting horizontal circular cylinder embedded in a porous medium has been computed. For this purpose, a model in the form of partial differential equations is formulated, and then, the governing equations of the dimensionless model are transformed into the primitive form for integration by using primitive variable formulation. The impact of emerging parameters such as porous medium parameter Ω, Richardson number λ, magnetic force parameter ξ, and Prandtl number Pr on skin friction, heat transfer, and current density is interpreted graphically. It is demonstrated that accurate numerical results can be obtained by the present method by treating nonoscillating and oscillating parts of coupled partial differential equations simultaneously. In this study, it is well established that the transient convective heat transfer, skin friction, and current density depend on amplitude and phase angle. One of the objects of the present study is to predict the mechanism of heat and fluid flow around different angles of a nonconducting horizontal circular cylinder embedded in a porous medium.

Objective: To assess the pattern of symptoms and underlying causes in patients presenting with post cholecystectomy syndrome. Study Design: Retrospective cross sectional study. Place and Duration of Study: All the patients who underwent open cholecystectomy from Jan 2014 to Dec 2015 in Military Hospital Rawalpindi under general anaesthesia were included in the study. Material and Methods: The study was carried out on 626 patients undergoing open cholecystectomy. Data was collected on a specially designed Proforma from hospital management system record. All the patients underwent open cholecystectomy in Military Hospital Rawalpindi under general anaesthesia. Results: A total of 626 patients were included in the study. About 101 (16.1%) patients presented with post cholecystectomy syndrome as a preliminary diagnosis. The study showed a female predisposition for PCS (18.73%) as compared to males (11.68%). Six (5.94%) patients presented with right hypochondrial pain and jaundice. Fifty nine (58.41%) patients presented with dyspepsia. Three (2.97%) patients presented with painless jaundice. Nine (8.91%) patients presented with diarrhea. Six (5.94%) patients presenting with pain right hypochondrium with no jaundice and 18 (17.82%) patients presenting with right hypochondrial pain and dyspepsia. Conclusion: A thorough preoperative evaluation is important before offering cholecystectomy to a patient. Moreover, good operative techniques and better endoscopic evaluation will further lessen the peroperative and postoperative biliary complications. However, gastritis leading to dyspepsia and psychiatric disorders make a large percentage of the cause of post cholecystectomy syndrome. Downloads

The current study supports the phytochemical screening, evaluation of antioxidant and enzyme inhibition potential and correlations between antioxidant activities and phenolics of Rumex dentatus (Family: Polygonaceae), Mentha spicata (Family: Lamiaceae), Withania somnifera (Family: Solanaceae), Nerium indicum (Family: Apocynaceae) and Artemisia scoparia (Family: Asteraceae). The herbal materials were extracted in ethanol (90%) and partitioned between several solvents based on polarities. Total phenols were determined with FC method and ranged 21.33 ± 1.53 - 355.67 ± 6.03 mg GAE/ mg of the extract. Antioxidant activities (DPPH, total iron reducing capacity, phosphomolybdate assay & FRAP) and enzyme inhibition potential (Protease, AChE & BChE) were performed by the standard protocols. The results showed that all extracts exhibited significant DPPH activity ranging from 12.67 ± 2.08 - 92.67 ± 1.53%. The extracts that were active in DPPH activity also potrayed marvelous FRAP, total iron reducing and phosphomolybdate values. Correlation studies of antioxidant activities and the content of phenolic compounds in plant materials exhibited positive correlation between them. The outcome of enzyme inhibition activity exhibited that about 80% of the fractions under surveillance plants intimated more than 50% inhibition. Isolation of bioactive compounds from these plants is in progress.

Abstract Background The plant species Aristolochia indica (AI), Melilotus indicus (MI), Tribulus terrestris (TT) and Cuscuta pedicellata (CP) are widely used in folk medicine in the villages around Chowk Azam, South Punjab, Pakistan. The aim of this study was to evaluate the antioxidant activity, phytochemical composition, and the antibacterial, antifungal, cytotoxic and anti-inflammatory potential of the four medicinal plants listed above. For CP stem, this study represents (to the best of our knowledge) the first time phytochemicals have been identified and the antioxidant and anti-inflammatory potential determined. Methods Phytochemicals were analyzed through chemical tests, thin layer chromatography (TLC) and spectrophotometric methods. Antioxidant activities (DPPH and H2O2) were also determined through spectrophotometric methods. Extracts were evaluated for antibacterial potential via the agar well diffusion method against Staphylococcus aureus, Pseudomonas aeruginosa, Klebsiella pneumonia and Acinetobacter baumannii. The minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) were determined by the microdilution method. Antifungal activities were tested using the agar tube dilution method against three species: Aspergillus fumigatus, Aspergillus flavus and Rhizopus oryzae. The cytotoxic potential of the plant extracts was checked using the brine shrimp assay. In vitro anti-inflammatory activity of the selected plant extracts was evaluated using albumin denaturation, membrane stabilization and proteinase inhibitory assays. Results Of all the methanolic extracts tested, those from CP (stem) and TTF (T. terrestris fruit) had the highest phenolic, flavonoid and flavonol contents (497±4 mg GAE/g, 385±8 mg QE/g and 139±4 mg QE/g; 426±5 mg GAE/g, 371±8 mg QE/g and 138±6 mg QE/g, respectively) and also exhibited strong antioxidant potential in scavenging DPPH and hydrogen peroxide (IC50 values; 20±1 and 18±0.7 μg/mL; 92±2 and 26±2 μg/mL, respectively). CP, TTF and TTL (T. terrestris leaf) extracts substantially inhibited the growth of the bacteria A. baumannii, S. aureus, and K. pneumonia and also exhibited the highest antifungal potential. The ranking of the plant extracts for cytotoxicity was TTF > TTL > AI > CP > MI, while the ranking for in vitro anti-inflammatory potential at a concentration of 200 μg/mL of the selected plant extracts was CP > TTL, TTF > AI > MI. The lowest IC50 (28 μg/mL) observed in the albumin denaturation assay was for CP. Positive correlations were observed between total phenolics, antioxidants, antibacterial, antifungal and anti-inflammatory potential of the selected plant extracts, indicating a significant contribution of phenolic compounds in the plant extracts to these activities. Conclusions This study revealed the strong antimicrobial, antioxidant, cytotoxic and anti-inflammatory potential of the plant species CP and TT used in folk medicine.

Introduction: Appendicitis is one of the most common causes of acute abdominal pain requiring surgical intervention, but the variability of diagnosis and management continue to challenge the surgeons. Aim: This study assessed patients undergoing appendectomy to identify opportunities to improve diagnostic accuracy and outcomes. Methods: An ethically approved retrospective cohort study was undertaken between March 2016 and March 2017 at a single university hospital of all consecutive adult and paediatric patients undergoing appendectomy. Demographic data including age, gender, co-morbidities, presentation and triage timings along with investigation, imaging and operative data were analysed. Appendicitis was defined as acute based on histology coupled with intraoperative grading with the American Association for the Surgery of Trauma (AAST) grades. Complications using the Clavien–Dindo classification along with 30-day re-admission rates and the negative appendectomy rates (NAR) were recorded and categorised greater and less than 25%. The use of scoring systems was assessed, and retrospective scoring performed to compare the Alvarado, Adult Appendicitis Score (AAS) and the Appendicitis Inflammatory Response (AIR) score. Results: A total of 201 patients were studied, 115 male and 86 females, of which 136/201 (67.6%) were adults and 65/201 (32.3%) paediatric. Of the adult group, 83 were male and 53 were female, and of the paediatric group, 32 were male and 33 were female. Median age was 20 years (range: 5 years to 81 years) and no patient below the age of 5 years had an appendectomy during our study period. All patients were admitted via the emergency department and median time from triage to surgical review was 2 h and 38 min, (range: 10 min to 26 h and 10 min). Median time from emergency department review to surgical review, 55 min (range: 5 min to 6 h and 43 min). Median time to operating theatre was 21 h from admission (range: 45 min to 140 h and 30 min). Out of the total patients, 173 (86.1%) underwent laparoscopic approach, 28 (13.9%) had an open approach and 12 (6.9%) of the 173 were converted to open. Acute appendicitis occurred in 166/201 (82.6%). There was no significant association between grade of appendicitis and surgeons’ categorical NAR rate (p = 0.07). Imaging was performed in 118/201 (58.7%); abdominal ultrasound (US) in 53 (26.4%), abdominal computed tomography (CT) in 59 (29.2%) and both US and CT in 6 (3%). The best cut-off point was 4 (sensitivity 84.3% and specificity of 65.7%) for AIR score, 9 (sensitivity of 74.7% and specificity of 68.6%) for AAS, and 7 (sensitivity of 77.7% and specificity of 71.4%) for the Alvarado score. Twenty-four (11.9%) were re-admitted, due to pain in 16 (58.3%), collections in 3 (25%), 1 (4.2%) wound abscess, 1 (4.2%) stump appendicitis, 1 (4.2%) small bowel obstruction and 1 (4.2%) fresh rectal bleeding. CT guided drainage was performed in 2 (8.3%). One patient had release of wound collection under general anaesthetic whereas another patient had laparoscopic drain placement. A laparotomy was undertaken in 3 (12.5%) patients with division of adhesions in 1, the appendicular stump removed in 1 and 1 had multiple collections drained. Conclusion: The negative appendectomy and re-admission rates were unacceptably high and need to be reduced. Minimising surgical variance with use of scoring systems and introduction of pathways may be a strategy to reduce NAR. New systems of feedback need to be introduced to improve outcomes.

The main goal of the current work was to study the coupled mechanism of thermophoretic transportation and mixed convection flow around the surface of the sphere. To analyze the characteristics of heat and fluid flow in the presence of thermophoretic transportation, a mathematical model in terms of non-linear coupled partial differential equations obeying the laws of conservation was formulated. Moreover, the mathematical model of the proposed phenomena was approximated by implementing the finite difference scheme and boundary value problem of fourth order code BVP4C built-in scheme. The novelty point of this paper is that the primitive variable formulation is introduced to transform the system of partial differential equations into a primitive form to make the line of the algorithm smooth. Secondly, the term thermophoretic transportation in the mass equation is introduced in the mass equation and thus the effect of thermophoretic transportation can be calculated at different positions of the sphere. Basically, in this study, some favorite positions around the sphere were located, where the velocity field, temperature distribution, mass concentration, skin friction, and rate of heat transfer can be calculated simultaneously without any separation in flow around the surface of the sphere.

This paper is concerned with the derivation of a well-balanced kinetic scheme to approximate a shallow flow model incorporating non-flat bottom topography and horizontal temperature gradients. The considered model equations, also called as Ripa system, are the non-homogeneous shallow water equations considering temperature gradients and non-uniform bottom topography. Due to the presence of temperature gradient terms, the steady state at rest is of primary interest from the physical point of view. However, capturing of this steady state is a challenging task for the applied numerical methods. The proposed well-balanced kinetic flux vector splitting (KFVS) scheme is non-oscillatory and second order accurate. The second order accuracy of the scheme is obtained by considering a MUSCL-type initial reconstruction and Runge-Kutta time stepping method. The scheme is applied to solve the model equations in one and two space dimensions. Several numerical case studies are carried out to validate the proposed numerical algorithm. The numerical results obtained are compared with those of staggered central NT scheme. The results obtained are also in good agreement with the recently published results in the literature, verifying the potential, efficiency, accuracy and robustness of the suggested numerical scheme.

Objectives : The objective of this study is to investigate the feasibility of transdermal drug delivery of Labetalol Hydrochloride (LHCl) and to study the effect of different penetration enhancers on the skin permeability of LHCl. Methods : The permeability experiments were conducted using a horizontal glass diffusion cell with a diffusional area of 2.37 cm-2 on albino rat skin. The effect of various penetration enhancers namely turpentine oil, dimethyl formamide (DMF), menthol, dimethyl sulfoxide, pine oil, and 2-pyrollidone, and the effect of the concentration of drug and enhancer in the donor phase on the skin permeability of LHCl was studied. Results : The apparent partition coefficient of the drug was found to be 6.95, suggesting it to be a lipophilic drug. The preliminary skin permeation studies revealed that the permeation of LHCL through albino rat skin was moderate (Kp = 6.490 Χ 10 -2 cm hr -1 ) from isotonic phosphate buffer of pH 7.4. An appreciable increase in the LHCl permeability coefficient was observed on using a co-solvent (ethanol 95%) with the penetration enhancers in the donor phase. DMSO (10% v/v) was found to be the most effective enhancer for Labetalol hydrochloride (Enhancement Factor = 1.165). An increase in the concentration of drug and enhancer in the donor cell accentuated the permeability coefficient of LHCl. Conclusions : It was concluded that LHCl could be delivered via the dermal route with the use of 10% DMSO as the penetration enhancer.

In this article, a compressible two-phase reduced five-equation flow model is numerically investigated. The model is non-conservative and the governing equations consist of two equations describing the conservation of mass, one for overall momentum and one for total energy. The fifth equation is the energy equation for one of the two phases and it includes source term on the right-hand side which represents the energy exchange between two fluids in the form of mechanical and thermodynamical work. For the numerical approximation of the model a high resolution central upwind scheme is implemented. This is a non-oscillatory upwind biased finite volume scheme which does not require a Riemann solver at each time step. Few numerical case studies of two-phase flows are presented. For validation and comparison, the same model is also solved by using kinetic flux-vector splitting (KFVS) and staggered central schemes. It was found that central upwind scheme produces comparable results to the KFVS scheme.

E-waste, a global environmental concern, particularly affects developing nations due to the rise in informal recycling practices. This leads to contamination of environmental matrices, posing threats to both ecosystems and human health. To assess this issue, we monitored brominated flame retardants (BFRs) in 164 samples (soil) from 32 informal e-waste operational locations and 9 background locations across nine mega cities of Pakistan from September 2020 to December 2021. The mean concentrations (ng/g) of ∑ 27 PBDEs (polybrominated diphenyl ethers), ∑ 2 PBB (polybrominated biphenyls), HBB (hexabromobiphenyl), and ∑HBCDD (hexabromocyclododecane) were 176 ( 0.76-11141), 31.0 (0.65-58.0), 1.39 (0.01-42.8), and 12.0 (0.22-461), respectively. These levels were significantly higher (6 to tenfold) than those at background sites. Karachi, Faisalabad, Gujranwala, and Lahore exhibited high levels of all BFRs. Notably, BDE-209 (mean = 45.5 ng/g) ranged (0.13-1152 ng/g) exhibited higher level in soil samples. Seasonally, total ΣBFR concentrations (ng/g) ranked higher in winter (11,620), followed by spring (3874), autumn (3139), and summer (1207) indicating a seasonal impact of recycling activities. The average daily dose for soil ingestion (ng/kg/day) was estimated for BDE-209 (0.10973) in Faisalabad, followed by BDE-47 (0.08616) and BDE-99 (0.06788) in Karachi. Our findings showed that these values were lower than RfD values, suggesting no ingestion risk from studied BFRs. However, the growing prevalence of such informal e-waste recycling facilities could lead to increased exposure to toxic chemicals in near future., Competing Interests: Declarations. Ethical approval: All the authors have read and approved the paper for publication. Competing interests: The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

The habitat suitability of Salvadora oleoides and Tamarix aphylla can be one of the most significant steps towards conserving these tree species. Habitat loss presents a critical threat to the existence of S. oleoides and T. aphylla. Protecting their suitable habitats and implementing conservation approaches is crucial to address this challenge. By ensuring the preservation of their habitats and adopting effective conservation strategies, we can mitigate the threat of habitat loss and promote the survival of these species. The potential distribution of S. oleoides and T. aphylla was predicted using a MaxEnt model. This study also presents the conservation status of S. oleoides and T. aphylla in the tropical thorn forests of the Bahawalpur subdivision. Data were gathered from the field survey based on bioclimatic variables. Overall, 20 sample plots were taken, and the coordinates were recorded for each sample plot. MaxEnt software and the environmental variables were used to study each tree species separately (19 bioclimatic variables were used). The Jackknife test was conducted to find the total general tree cover and mean temperature. The MaxEnt model showed high accuracy for each tree species, with the receiver operating characteristics (ROC) area under the curve (AUC) training mean testing values for S. oleoides being 0.976 and T. aphylla 0.987. The study showed that both species were distributed irregularly in the tropical thorn forest of the Bahawalpur subdivision. The results highlight that it is essential to implement proven long-term management and conservation techniques to ensure the well-being and sustainability of forest trees in the Bahawalpur sub-division. In conclusion, concerted efforts to map, understand habitat suitability, and raise awareness of endangered species in the tropical thorn forest are crucial for effective conservation planning and resource allocation in the face of climate change., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Hussain 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.)

Up to 25% of patients recovering from antibiotic-treated Clostridioides difficile infection (CDI) develop functional symptoms reminiscent of Post-Infectious Irritable Bowel Syndrome (PI-IBS). For patients with persistent symptoms following infection, a clinical dilemma arises as to whether to provide additional antibiotic treatment or to adopt a conservative symptom-based approach. Here, we review the literature on CDI-related PI-IBS and compare the findings with PI-IBS. We review proposed mechanisms, including the role of C. difficile toxins and the microbiota, and discuss implications for therapy. We suggest that gut dysfunction post-CDI may be initiated by toxin-induced damage to enteroglial cells and that a dysbiotic gut microbitota maintains the clinical phenotype over time, prompting consideration of microbiota-directed therapies. While Fecal Microbial Transplant (FMT) is currently reserved for recurrent CDI (rCDI), we propose that microbiota-directed therapies may have a role in primary CDI in order to avoid or mitigate futher antibiotic treatment that further disrupts the microbiota and thus prevent PI-IBS. We discuss novel microbial transfer therapies and as they emerge, we recommend clinical trials to determine whether microbial transfer therapy of the primary infection prevents both rCDI and CDI-related PI- IBS., Competing Interests: Conflict of interest The authors have no conflict of interest to declare., (Copyright © 2024 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)

Hemp (Cannabis sativa L.) is an annual, and dioecious herb belonging to the Cannabaceae family. This plant is native to Central and Southeast Asia. The wild races of this species are commonly growing in Khyber Pakhtunkhwa and Punjab provinces, as well as in Islamabad, Pakistan. This study provides crucial insights into how environmental variables influence the wild hemp populations, which can be utilized in for conservation and breeding. The present study was aimed at evaluating the effects of key environmental factors such as altitude, geographical location, precipitation, relative humidity, maximum, minimum, and average temperature on 16 morpho-agronomic traits of a wild population of hemp growing in the Potohar Plateau and Lesser Himalayas. Our findings indicated that high relative humidity (> 64%), low average temperature (< 15 °C), intermediate average temperature (19-22 °C), and high average temperature (> 22 °C) played significant roles in determining the distribution pattern of the wild hemp. Correlation analysis demonstrated that average annual temperature contributed a higher percentage of variation in phenotypic diversity than geographic variables. Additionally, cluster analysis indicated three groups for the selected 35 populations. Clustering and Principal Component Analysis (PCA) of the morpho-agronomic traits indicated that group 1 from the Lesser Himalayas showed high relative humidity (> 64%) and low average temperature (< 15 °C). Conversely, Group 2 populations from the Potohar Plateau demonstrated intermediate average temperature (19-22 °C). There is an existence of Group 3 in the Potohar Plateau with a high average temperature (> 22 °C) compared to Group 1 and Group 2. Our examination highlights the complex interplay between ecological factors, and morphological attributes in native landraces of Cannabis sativa, giving significant insight into knowledge for preservation and breeding initiatives. A study of genetic diversity could complement morpho-agronomic traits in future research to learn more about how genetic variation affects environmental adaptation., (© 2024. The Author(s).)