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The stated objective of the present research investigation was to use a simultaneous nanodrug delivery approach to optimize the therapeutic effectiveness of anticancer drugs against breast cancer cells. For this purpose, Poly (lactic-co-glycolic acid) nanoparticles with two anticancer drugs; methotrexate (MTX) and doxorubicin (DOX) denoted as DOX/MTX@PLGA NPs was developed by nanoprecipitation method. The developed polymeric DOX/MTX@PLGA NPs exhibited hydrodynamic particle diameter of 170.6 ± 10.0 nm with a poly dispersity index (PDI) of 0.17 and zeta potential value of -9.2 ± 0.31 mV, and spherical geometry analyzed by TEM. Furthermore, the nanoparticles exhibited a pH-responsive drug release profile, outstanding encapsulation efficiency, excellent colloidal stability across various physiological media and pH responsive drug release profile. Additionally, polymeric nanoparticles demonstrated higher cell uptake, in-vitro cytotoxicity, and a high rate of apoptosis in comparison to free DOX and MTX through a synergistic effect, likely as a result of their small particle size. In conclusion, our work presents a novel and distinct approach for boosting the therapeutic efficacy of anticancer drugs by delivering drugs to breast cancer cells simultaneously. [ABSTRACT FROM AUTHOR]

This study aimed to analyze the prevalence and predictors of depression symptoms among Afghan hypertensive patients. Methods: This was a secondary analysis of a multi-center cross-sectional study conducted between August and December 2022 across three major provinces in Afghanistan. Socio-demographic and clinical characteristics of the eligible participants were used in the analysis. A score of ≥ 5 on the PHQ-9 (Patient Health Questionnaire) was considered the cut-off point for labeling hypertensive patients as screening positive for depressive symptoms. We performed binary logistic regression to determine the predictors of depression symptoms among hypertensive patients. Results: Out of 853 hypertensive patients, 51.8% (95% CI: 48.4– 55.2%) had depressive symptoms. Binary logistic regression revealed that low monthly household income [AOR=1.42, 95% CI (1.01– 1.97), low education level [2.41 (1.57– 3.71)], physical inactivity [1.81 (1.22– 2.71)], poor blood pressure control [2.41 (1.57– 3.71)], and the presence of medical comorbidity [1.59 (1.15– 2.19)] were the predictors of depression symptoms. Conclusion: This study showed a high prevalence of depressive symptoms among Afghan hypertensive patients. Moreover, we found that low monthly household income, physical inactivity, low education level, poor blood pressure control, and the presence of medical comorbidity were the predictors of depression symptoms. Our findings suggest that hypertensive patients should be screened for mental health symptoms, and those most at risk for depression should seek supportive counseling. [ABSTRACT FROM AUTHOR]

Financial integration plays an important role in fostering global economic growth. Energy demand, technology transfer, sustainable production, and climate change have emerged as key drivers of sustainable development. This study explores the influence of financial integration, bolstered by renewable energy-induced trade, industry-driven technology, and environmental concerns, on regional economic growth. This study analyzes a panel of 39 high- and upper-middle-income European and Central Asian countries in 2017–2021. Using a panel generalized method of moments estimator, we reveal an inverted U-shaped relationship between regional economic growth and carbon emissions. Moreover, renewable energy-induced trade contributes positively to regional growth while trade openness and technology transfer further enhance this growth. Industry-driven technology negatively impacts regional growth owing to inadequate financial integration. The absence of sustainable energy infrastructure and industrialization also negatively impacts regional growth. Our study underscores the importance of increasing financial integration to promote sustainable energy-driven trade openness and technology transfer in line with the United Nations' sustainable development agenda. [ABSTRACT FROM AUTHOR]

Background: Consistent and timely access to antibiotics is a hallmark of an antimicrobial stewardship program (ASP) and can be achieved through good procurement practices. However, flawed procurement modules result in poor antibiotic supply management within health facilities of low- and middle-income countries (LMICs), including Pakistan, exacerbating antimicrobial resistance (AMR). This study seeks to understand hospital pharmacists' perspectives on the antibiotic procurement process, its efficiency in ensuring consistent access to antibiotics, and the role of clinical pharmacists in rational procurement. Methods: Semi-structured interviews with 24 purposively selected hospital pharmacists from secondary healthcare facilities in Punjab, Pakistan, were conducted utilizing a qualitative case study methodology. Data analysis was conducted using MAXQDA 2024 software, following a thematic analysis technique using a codebook approach to thematic analysis. Results: The study identified five central themes: (1) The state of antibiotic use in hospitals is characterized by a lack of antibiotic use policy, resulting in mostly empirical and irrational prescribing practices. (2) Medicine availability significantly influences prescribing decisions, often taking precedence over clinical needs. (3) The procurement process, although structured, is flawed owing to rigid adherence to the Standard Medicine List (SML). (4) Rationality in procurement is compromised by disregard for AMR, with decisions driven more by cost and demand than clinical evidence. (5) The clinical acumen of pharmacists is underutilized in procurement due to multifarious barriers. Conclusion: Antibiotic procurement is the mainstay of implementing an ASP in hospitals. This study elucidates significant policy, practice, and education gaps regarding antibiotic use and procurement in Pakistan. There is a critical need for comprehensive antibiotic policies, including a revision in SML, enhancing pharmacist authority in procurement decisions, more rational prescribing, and ensuring access to antibiotics through more informed and data-driven processes to combat AMR effectively. [ABSTRACT FROM AUTHOR]

Lung cancer is a devastating public health threat and a leading cause of cancer-related deaths. Therefore, it is imperative to develop sophisticated techniques for the non-invasive detection of lung cancer. Extracellular vesicles expressing programmed death ligand-1 (PD-L1) markers (PD-L1@EVs) in the blood are reported to be indicative of lung cancer and response to immunotherapy. Our approach is the development of a colorimetric aptasensor by combining the rapid capturing efficiency of (Fe3O4)-SiO2-TiO2 for EV isolation with PD-L1 aptamer-triggered enzyme-linked hybridization chain reaction (HCR) for signal amplification. The numerous HRPs catalyze their substrate dopamine (colorless) into polydopamine (blackish brown). Change in chromaticity directly correlates with the concentration of PD-L1@EVs in the sample. The colorimetric aptasensor was able to detect PD-L1@EVs at concentrations as low as 3.6×102 EVs/mL with a wide linear range from 103 to 1010 EVs/mL with high specificity and successfully detected lung cancer patients' serum from healthy volunteers' serum. To transform the qualitative colorimetric approach into a quantitative operation, we developed an intelligent convolutional neural network (CNN)-powered quantitative analyzer for chromaticity in the form of a smartphone app named ExoP, thereby achieving the intelligent analysis of chromaticity with minimal user intervention or additional hardware attachments for the sensitive and specific quantification of PD-L1@EVs. This combined approach offers a simple, sensitive, and specific tool for lung cancer detection using PD-L1@EVs. The addition of a CNN-powered smartphone app further eliminates the need for specialized equipment, making the colorimetric aptasensor more accessible for low-resource settings. [ABSTRACT FROM AUTHOR]

Background: Type 2 diabetes (T2D) disproportionately affects individuals of South Asian descent. Additionally, diabetes distress (DD) may lead to complications with diabetes management. This study examines the prevalence of DD among foreign-born individuals of South Asian descent in New York City (NYC) and its association with sociodemographic and clinical factors. Methods: Baseline data was collected from the Diabetes Research, Education, and Action for Minorities (DREAM) Initiative, an intervention designed to reduce hemoglobin A1c (HbA1c) among South Asian individuals with uncontrolled T2D at primary care practices in NYC. The Diabetes Distress Scale (DDS) measured DD, and Core Healthy Days Measures assessed physical and mental healthy days. Sociodemographic variables were analyzed using descriptive statistics, Chi-square tests assessed categorical variables, and Wilcoxon Rank Sum tests evaluated continuous variables (Type I error rate = 0.05). Logistic regression models examined associations between HbA1c, mental health, and other covariates with dichotomized DD subscales. Results: Overall, 414 participants completed the DDS at baseline (median age = 55.2 years; SD = 9.8). All were born outside of the US; the majority were born in Bangladesh (69.8%) followed by India, Pakistan, and Nepal (24.7%) and Guyana and Trinidad and Tobago (5.5%). High emotional burden, regimen-related distress and physician-related distress were reported by 25.9%, 21.9%, and 6.2% of participants, respectively. In adjusted analyses, individuals with ≥ 1 day of poor mental health had higher odds of overall distress (OR:3.8, p = 0.013), emotional burden (OR:4.5, p < 0.001), and physician-related distress (OR:4.6, p = 0.007) compared to individuals with no days of poor mental health. Higher HbA1c (OR:1.45, p = < 0.001) was associated with regimen-related distress; and lower emotional support was associated with overall distress (OR:0.92, p < 0.001) and regimen-related distress (OR:0.95, p = 0.012). Individuals born in Bangladesh had significantly lower odds of overall distress, emotional burden, and regimen-related distress compared to individuals born in Guyana and Trinidad and Tobago. Conclusions: Findings highlight the rate and risk factors of DD among individuals of South Asian descent living in NYC. Screening for DD in patients with prediabetes or diabetes should be integrated to address mental and physical health needs. Future research can benefit from a longitudinal analysis of the impact of DD on diabetes self-management and health outcomes. Trial registration: This study uses baseline data from "Diabetes Management Intervention for South Asians" (NCT03333044), which was registered with clinicaltrials.gov on 6/11/2017. [ABSTRACT FROM AUTHOR]

Derivatives of aryl and hetero-aryl substituted oxazoles have several uses in agrochemicals, pharmaceuticals, and nonlinear optics (NLO). This study reports the synthesis and non-linear optical response (NLO) of three new compounds, viz., 2-(naphthalen-2-yl) oxazole (NTOZ), 2-(4-phenoxyphenyl) oxazole (PPOZ), and 2-(4'-bromo-2,2',6,6'-tetramethyl-[1,1'-biphenyl]-4-yl) oxazole (BMPOZ), for the first time by the palladium-catalyzed Suzuki coupling method. The structures of synthesized products were clarified by employing spectroscopic investigations using 1H, & 13C-NMR, FT-IR, and UV-visible. The DFT studies were conducted at the M06/6-31G (d,p) functional to visualize NLO properties. Various analyses, including frontier molecular orbitals (FMOs), natural bond orbitals (NBOs), transition density matrix (TDM), and density of state (DOS), were conducted to learn more about the NLO response of the aforesaid compounds. The results indicated that the NTOZ compound showed the lowermost band gap (4.764 eV) and uppermost bathochromic shift (307.257 nm) amongst NTOZ, PPOZ, and BMPOZ. Results of global reactivity correspond with FMO outcomes such as NTOZ with a lower band gap, which displayed lower hardness (2.382 eV) and higher softness (0.2099 eV) data. Owing to the unique properties of NTOZ, significant NLO responses such as βtotal = 1.3227 D and βtotal = 5.47910–30esu were investigated, indicating it is an effective NLO material. [ABSTRACT FROM AUTHOR]

This study explores the nonlinear optical (NLO) properties of hexamine (HMT) doped with transition metals scandium (Sc) and titanium (Ti), exhibiting enhanced NLO responses for advanced photonic devices. Employing ωB97XD functional for optimization and calculations, the study examines geometric parameters, electronic excitation, exciton binding energy (Eb), and vertical ionization energy (VIE) using DFT and TD-DFT. High VIE (3.25 to 4.52 eV) indicates enhanced stability in doped systems. The HOMO-LUMO gap decreases from 10.69 eV in pure HMT to 3.30 to 4.85 eV in the designed systems. These systems exhibit thermodynamic stability with binding energies 3.51 to 4.27 kcal/mol, and Ti-HMT-Ti being the most stable. A two-level approximation method is utilized to determine linear polarizability and nonlinear first and second hyperpolarizability (αstatic, βstatic, γstatic), which exhibits the highest γstatic (6546.63 au) value of Sc-HMT-Sc. Orbital transitions, charge distribution, electrophilicity, and nucleophilicity are examined using TDM, EDDM, and ESP, respectively. PDOS and TDOS provide insights into HOMO-LUMO gap reduction, NCI identifies the weak interactions and broadened and red-shifted UV absorption spectra, all are in the favour of NLO response of designed complexes. So, these materials show exceptional NLO properties and promising for optoelectronic applications. [ABSTRACT FROM AUTHOR]

The research used the encapsulation approach to enclose the promising natural food preserver, Origanum compactum essential oil (OM), with different wall materials to improve its stability, effectiveness, and antimicrobial properties. The essential delivery method consisted of a solid lipid structure composed of sugarcane wax (SRW) combined with various wall materials including whey protein (WN), maltodextrin (MN), and gum Arabic (GC), namely WN/RSW/OM, MN/SRW/OM, and GC/SRW/OM. The research analyzed the effectiveness of encapsulation, morphological, crystallization, thermal, and physiochemical characteristics. The results revealed that the most efficient microcapsule (95.5%) and a higher crystallinity (32.61%) were achieved by the WN/SRW/OM and demonstrated distinct thermal and physiochemical parameters within the microcapsules. The research evaluated the storage stability of the release phenolic compound, antioxidant activity, and oxidative stability over a 60-day storage period at 4 and 25 °C. Moreover, the antibacterial activity of the microcapsules was assessed at various doses, revealing their inhibitory impact on both Escherichia coli (gram-negative) and Staphylococcus aureus (gram-positive) bacteria, with an optimum inhibitory effect against both strains in the WN/SRW/OM. This research emphasizes that using WN/SRW as wall materials has superior qualities to preserve and deliver the core material OM, indicating potential applications in diverse industries. [ABSTRACT FROM AUTHOR]

The article focuses on the diagnosis and management of Kikuchi-Fujimoto Disease (KFD), a rare condition causing fever and cervical lymphadenopathy. Topics include the clinical presentation of KFD, diagnostic challenges, and treatment approaches, including the use of supportive care, corticosteroids, and lymph node excision.

Trichogramma chilonis (Ishii) is an important egg parasitoid of Helicoverpa species in tomato growing areas of Pakistan. Different insecticides are used for the management of H. armigera, but these insecticides have significantly reduced the effectiveness of T. chilonis. Therefore, this research aims to understand the compatibility of the selected insecticides with biological control strategies involving T. chilonis for managing Helicoverpa armigera in tomato-growing areas. For this purpose, the effects of five insecticides namely Novaluron, Bifenthrin, Emamectin Benzoate, Chlorantraniliprole and Imidacloprid were assessed against T. chilonis under laboratory conditions. The assays involved direct applications of different insecticides on Sitotroga cerealella eggs and their subsequent effect of T. chilonis life history parameters. A total of 200 eggs were used in each treatment. The results revealed that all the tested insecticides had subsequent negative effects on T. chilonis performance. The results showed that the insecticides Imidacloprid and Chlorantraniliprole led to low mean fecundity, minimum number of male and female adults emergence and prolonged the total pre-oviposition period of T. chilonis as compared to Bifenthrin and Novaluron. The bootstrap results recorded the highest value of the net reproductive rate (R0), intrinsic rate of increase (r) and the finite rate of increase (λ) of T. chilonis in host eggs treated with Bifenthrin and Novaluron as compared to the other tested chemicals. The results regarding percent parasitism showed that maximum percent parasitism was noted in control, Bifenthrin and Novaluron, while the insecticides Imidacloprid and Chlorantraniliprole resulted in minimum % parasitism (63.5% and 71%) respectively. The study revealed that Bifenthrin and Novaluron are relatively more compatible with the T. chilonis in the different integrated pest management programs for H. armigera as compared to other tested chemicals. [ABSTRACT FROM AUTHOR]

Trichogramma chilonis (Ishii) is an important egg parasitoid of Helicoverpa species in tomato growing areas of Pakistan. Different insecticides are used for the management of H. armigera, but these insecticides have significantly reduced the effectiveness of T. chilonis. Therefore, this research aims to understand the compatibility of the selected insecticides with biological control strategies involving T. chilonis for managing Helicoverpa armigera in tomato-growing areas. For this purpose, the effects of five insecticides namely Novaluron, Bifenthrin, Emamectin Benzoate, Chlorantraniliprole and Imidacloprid were assessed against T. chilonis under laboratory conditions. The assays involved direct applications of different insecticides on Sitotroga cerealella eggs and their subsequent effect of T. chilonis life history parameters. A total of 200 eggs were used in each treatment. The results revealed that all the tested insecticides had subsequent negative effects on T. chilonis performance. The results showed that the insecticides Imidacloprid and Chlorantraniliprole led to low mean fecundity, minimum number of male and female adults emergence and prolonged the total pre-oviposition period of T. chilonis as compared to Bifenthrin and Novaluron. The bootstrap results recorded the highest value of the net reproductive rate (R0), intrinsic rate of increase (r) and the finite rate of increase (λ) of T. chilonis in host eggs treated with Bifenthrin and Novaluron as compared to the other tested chemicals. The results regarding percent parasitism showed that maximum percent parasitism was noted in control, Bifenthrin and Novaluron, while the insecticides Imidacloprid and Chlorantraniliprole resulted in minimum % parasitism (63.5% and 71%) respectively. The study revealed that Bifenthrin and Novaluron are relatively more compatible with the T. chilonis in the different integrated pest management programs for H. armigera as compared to other tested chemicals. [ABSTRACT FROM AUTHOR]

Background: The optimum use of antenatal care (ANC) services can reduce pregnancy-related complications and deaths. However, there is limited information on the quality of ANC services in Afghanistan. This study aimed to assess the quality of ANC services and examine the influence of sociodemographic factors on the quality of ANC services received by pregnant women in Afghanistan. Methods: This study analyzed the data from the 2022–23 Afghanistan Multiple Indicators Cluster Survey (MICS), including 9,243 ever-married women aged 15–49 years who had given birth two years prior to the survey. ANC quality was classified as "good" if a woman had at least four ANC visits, initiated ANC during the first trimester, and received all four essential ANC services. Binary logistic regression was employed to examine the likelihood of receiving good-quality ANC across various sociodemographic variables. Results: Only 6.2% of women received good-quality ANC. Factors significantly associated with receiving good-quality ANC included woman's secondary (AOR:1.87, 95%CI: 1.33–2.63) and higher education levels (AOR: 1.75, 95%CI: 1.01–3.03), household head's higher education level (AOR:1.63, 95%CI: 1.11–2.40), and wealth status (1.71, 2.26, 1.92, and 1.97 higher odds of receiving good-quality ANC for 2nd, 3rd, 4th, and 5th as compared to 1st quintiles of wealth, respectively). Conclusion: The low utilization of good-quality ANC among women in Afghanistan, particularly among those at lower wealth status, with low education levels, underscores the need for targeted interventions to improve access and utilization of antenatal care services. [ABSTRACT FROM AUTHOR]

Marine natural products have long been recognized as a vast and diverse source of bioactive compounds with potential therapeutic applications, particularly in oncology. This review provides an updated overview of the significant advances made in the discovery and development of marine-derived anticancer drugs between 2019 and 2023. With a focus on recent research findings, the review explores the rich biodiversity of marine organisms, including sponges, corals, algae, and microorganisms, which have yielded numerous compounds exhibiting promising anticancer properties. Emphasizing the multifaceted mechanisms of action, the review discusses the molecular targets and pathways targeted by these compounds, such as cell cycle regulation, apoptosis induction, angiogenesis inhibition, and modulation of signaling pathways. Additionally, the review highlights the innovative strategies employed in the isolation, structural elucidation, and chemical modification of marine natural products to enhance their potency, selectivity, and pharmacological properties. Furthermore, it addresses the challenges and opportunities associated with the development of marine-derived anticancer drugs, including issues related to supply, sustainability, synthesis, and clinical translation. Finally, the review underscores the immense potential of marine natural products as a valuable reservoir of novel anticancer agents and advocates for continued exploration and exploitation of the marine environment to address the unmet medical needs in cancer therapy [ABSTRACT FROM AUTHOR]

Background: A significant overlap in the pathophysiological features of polycystic ovary syndrome (PCOS) and type 2 diabetes mellitus (T2DM) has been reported; and insulin resistance is considered a central driver in both. The expression and hepatic clearance of insulin and subsequent glucose homeostasis are mediated by TCF7L2 via Wnt signaling. Studies have persistently associated TCF7L2 genetic variations with T2DM, however, its results on PCOS are sparse and inconsistent. Methods: We performed a comprehensive literature review of the data published till June 2024, on rs7903146, rs12255372, and PCOS in PubMed, Medline, the Cochrane Library, Google Scholar, Science Direct, Scopus, and Web of Science, followed by a meta-analysis to evaluate the association between these genetic variations and the PCOS risk. Using a random effects model, the pooled odds ratio (OR) and confidence intervals (95%CI) were computed using STATA statistical software. Results: The genotypic data from 3052 controls and 2291 women with PCOS from ten published studies were analysed. The results indicated no cumulative association between the rs7903146 variant and PCOS risk in either the allelic (C vs. T: OR = 1.21; 95% CI: 0.96–1.47, p > 0.05) or genotypic models (CC vs. CT + TT: OR = 1.06; 95% CI: 0.90–1.23, p > 0.05). Similarly, the genetic variant rs12255372 was not associated with PCOS risk both in the allelic and the dominant inheritance model(p > 0.05). Unlike East Asians (MAF < 0.025), both variants are highly frequent across other global populations including America, South Asia, and Europe (MAF ≥ 0.19). Conclusion: Unlike T2DM, our results showed that rs7903146 and rs12255372 variants of the TCF7L2 gene do not modulate the PCOS risk. However, the role of other TCF7L2 variants remains to be studied in future studies. [ABSTRACT FROM AUTHOR]

Background: Portulaca oleracea L. (purslane) is a dietary plant and a botanical drug with antioxidant, antidiabetic, and anti-inflammatory activities. However, the effects of purslane against intestinal-inflammation-associated obesity are yet to be studied. In the present study, we hypothesized that purslane extract could reduce intestinal inflammation associated with metabolic disorder. Results: Male C57BL/6J mice were fed a high-fat diet (HFD, 60% kcal% of fat) for a total duration of 14 weeks to establish an obesity model; further, the treatment group was orally administered purslane extract (200 mg/kg/day) during the last 4 weeks. Then, intestinal tissues were detached from the mice for detecting protein expressions through Western blot and immunohistochemical analyses. Pro-inflammatory cytokines were determined using ELISA kits, whereas the components of purslane extract were detected by ultra performance liquid chromatography/electrospray ionization quadrupole time-of-flight mass spectrometry. Chronic oral administration of purslane extract ameliorated colon shortening syndrome and reduced bowel inflammation in HFD-induced obese mice through suppression of the toll-like receptor 4 (TLR4)/nuclear factor kappa B (NF-κB) signaling pathway to downregulate TLR4, myeloid differentiation factor 88 (MyD88), Ser32 phosphorylation of NF-κB inhibitor alpha (IκBα), and Ser536 phosphorylation of NF-κB p65 expression levels, thereby inhibiting the pro-inflammatory cytokines, tumor necrosis factor (TNF)-α and interleukin (IL)-6 levels. Conclusion: The present study supports the anti-inflammatory potential of purslane extract for modulating bowel inflammation under obesity through inhibition of the TLR4/NF-κB signaling pathway. [ABSTRACT FROM AUTHOR]

Type 2 diabetes mellitus (T2DM) is one of the most widespread chronic diseases globally, with its prevalence expected to rise significantly in the years ahead. Previous studies on risk stratification for T2DM identify certain biomarkers, including glycated hemoglobin (HbA1c), oral glucose tolerance testing (OGTT), fructosamine, and glycated albumin, as key indicators for predicting the onset and progression of T2DM. However, these traditional markers have been shown to lack sensitivity and specificity and their results are difficult to analyze due to non-standardized interpretation criteria, posing significant challenges to an accurate and definitive diagnosis. The strict measures of these traditional markers may not catch gradual increases in blood sugar levels during the early stages of diabetes evolution, as these might still fall within acceptable glycemic parameters. Recent advancements in research have suggested novel micro ribonucleic acid (miRNA) as circulatory molecules that can facilitate the early detection of prediabetic conditions in high-risk groups and potentially enable prevention of the progression to T2DM. This capability makes them a very powerful tool for potentially improving population health, enhancing outcomes for many patients, and reducing the overall burden of T2DM. These promising biomarkers are small, noncoding RNA involved in the regulation of many cellular functions that have a hand in the metabolic activities of cells, making them a very useful and relevant biomarker to explore for the diagnosis and risk stratification of T2DM. This review analyzes the current literature, outlining the occurrence of miRNAs in prediabetic and diabetic individuals and their implications in predicting dysglycemic disorders. [ABSTRACT FROM AUTHOR]

Background: Undernutrition among children is a public health concern in most low and middle-income countries (LMICs) and is associated with poor child growth and development. Knowledge about child feeding practices is needed for nutritional policies and programs. Hence, this study assessed the status of minimum acceptable diet (MAD) and its associated factors among children aged 6–23 months in Afghanistan. Methods: This cross-sectional study was based on a secondary dataset of the 2022–2023 Afghanistan Multiple Indicator Cluster Survey (MICS 2022–23). Complete data from 7,876 children aged 6–23 months were analysed. The outcome variable was MAD and was defined according to the WHO and UNICEF recommendations and indicators for young child feeding practices. Bivariate and multivariate binary logistic regression analyses were used to identify factors associated with MAD. Results: About 7.3% of children aged 6–23 months were fed with the recommended MAD. The likelihood of receiving MAD was higher in children aged 13–18 months [adjusted odds ratio (AOR) 2.01 (95%CI: 1.63–2.48)] and 19–23 months [2.11 (95%CI: 1.68–2.66)], in children belonging to households with higher wealth status [1.39 (95%CI: 1.04–1.87), 2.06 (95%CI: 1.51–2.82), and 3.07 (95%CI: 2.14–4.40) for the 3rd, 4th, and 5th quintile of wealth status, respectively], and in children living in rural areas [1.56 (95%CI: 1.21–2.01)]. On the other hand, the maternal age group 30–39 years [0.79 (95%CI: 0.64–0.96)] and non-institutional delivery [0.67 (95%CI: 0.54–0.83)] were associated with reduced odds of MAD. Conclusion: Our study revealed that a small percentage (7.3%) of children received MAD in Afghanistan. This emphasizes the need for policies and interventions aimed at the improvement of child feeding practices to ultimately lead to better child nutrition and health in Afghanistan. [ABSTRACT FROM AUTHOR]

Summary: In many real‐world applications, the problem of machine learning is based on multicriteria. The multicriteria learning process becomes problematic with data classification involving multiple class labels. The multilabel‐multicriteria classification (MLMCC) is an emerging research area among the data science community, and it has applications in many domains like sciences, computer vision, government, business, and engineering domains. Most of the existing classification techniques learn single criteria and fail to focus with the multicriteria‐based internal information. In order to overcome the above research problem, we propose an expert‐based pattern driven multilabel learning algorithms (E‐PDMLAs) to handle MLMCC. The whole framework is supported with expert knowledge observed as multicriteria, and it is summarized into three broad categories of linguistic terms, namely, MoreThan(>=), LessThan(<=), and Between(‐). Also, the top level of data analytics is to unfold the prescriptive analysis on the data. In this work, prescribing data is supported with linguistic terms, namely, Critical, Feasible, and Strong. In support of E‐PDMLA, the data have been preprocessed and prescribed into linguistic terms for the better insight of information. In this paper, we propose a novel automated prescriptive and fuzzy‐based preprocessing algorithm (prescriptive fuzzy‐based domain data preprocessing technique [PF‐DDPT]) for all the above three categories. The experimental study has been carried out with Indian coastal dataset, crop dataset, and breast cancer dataset, and the results have been compared with normal and modeling technique. The analysis manifests the strength of our proposed algorithm (PF‐DDPT) over accuracy on preprocessing and prescription based on expert perception. [ABSTRACT FROM AUTHOR]

Flagellin stimulates Toll-like receptor 5 (TLR5), triggering both innate and adaptive immune responses, making it a potential vaccine adjuvant. On mucosal surfaces, flagellin induces a strong release of cytokines, chemokines, and immunoglobulins. When used in its free monomeric form, flagellin has been shown to enhance immune responses when combined with vaccine antigens. Further research demonstrated that genetically linking flagellin to the antigen provides a more consistent immune boost. However, the bulky structure of flagellin presents challenges in designing the antigen-adjuvant construct, leading to ongoing research to determine the minimal flagellin domain necessary for its adjuvant effect. Early findings suggest that only the D0 and D1 domains are required for immune enhancement. Functional analysis revealed that the TLR5-binding region is located in the D1 domain, while TLR5 dimerization and signaling require the presence of D0. Further reductions in the size of the D0 and D1 domains may be possible as deeper studies aim to identify the key residues responsible for TLR5 activation and immune enhancement. Additionally, flagellin is being tested as a hapten carrier alongside its established adjuvant role. Recently, significant advancements in flagellin application have been observed as it progresses through clinical studies as an adjuvant, anti-radiation, and anti-cancer agent. [ABSTRACT FROM AUTHOR]

Background: A significant overlap in the pathophysiological features of polycystic ovary syndrome (PCOS) and type 2 diabetes mellitus (T2DM) has been reported; and insulin resistance is considered a central driver in both. The expression and hepatic clearance of insulin and subsequent glucose homeostasis are mediated by TCF7L2 via Wnt signaling. Studies have persistently associated TCF7L2 genetic variations with T2DM, however, its results on PCOS are sparse and inconsistent. Methods: We performed a comprehensive literature review of the data published till June 2024, on rs7903146, rs12255372, and PCOS in PubMed, Medline, the Cochrane Library, Google Scholar, Science Direct, Scopus, and Web of Science, followed by a meta-analysis to evaluate the association between these genetic variations and the PCOS risk. Using a random effects model, the pooled odds ratio (OR) and confidence intervals (95%CI) were computed using STATA statistical software. Results: The genotypic data from 3052 controls and 2291 women with PCOS from ten published studies were analysed. The results indicated no cumulative association between the rs7903146 variant and PCOS risk in either the allelic (C vs. T: OR = 1.21; 95% CI: 0.96–1.47, p > 0.05) or genotypic models (CC vs. CT + TT: OR = 1.06; 95% CI: 0.90–1.23, p > 0.05). Similarly, the genetic variant rs12255372 was not associated with PCOS risk both in the allelic and the dominant inheritance model(p > 0.05). Unlike East Asians (MAF < 0.025), both variants are highly frequent across other global populations including America, South Asia, and Europe (MAF ≥ 0.19). Conclusion: Unlike T2DM, our results showed that rs7903146 and rs12255372 variants of the TCF7L2 gene do not modulate the PCOS risk. However, the role of other TCF7L2 variants remains to be studied in future studies. [ABSTRACT FROM AUTHOR]

Innovation in the Information and Communication Technology (ICT) sector is critical for organizational growth and societal sustainability. However, the innovation capabilities of developing countries, particularly in the ICT sector, remain underexplored. This study is aimed at assessing the perceptions of senior leadership within Pakistan's ICT sector to identify the factors contributing to the limited scope of innovation. Through qualitative interviews with senior leaders from various ICT organizations, this research explores their views on the definition, types, and driving factors of innovation. Most interview participants reported that the major type of innovation practiced at the ICT sector of Pakistan is "product," the level is "partial replication," and the major driving source is "factors external to the organization." Based on these insights, we developed an innovation readiness framework (IRF) to help organizations enhance their innovation capacity. IRF is expected to provide actionable strategies for organizations to assess their current innovation practices, identify gaps, and adopt a structured approach to enhance both product development and operational processes. By addressing sector‐specific challenges such as limited resources and regulatory barriers, the IRF is aimed at empowering organizations to move from replication to more original, impactful innovations. Hence, implementing this framework is expected to improve the sector's competitiveness, drive sustainable growth, and contribute meaningfully to societal advancement by aligning with broader development goals. [ABSTRACT FROM AUTHOR]

Despite the field's interdisciplinary nature, academic specialization and the academic norm of in-field referencing have limited the scope of possibility that journalism studies may draw upon fields not part of its interdisciplinary repertoire. This paper invites readers to explore Interpretative Phenomenological Analysis (IPA), a rich analytical tradition from qualitative psychology and health studies and demonstrates its applicability in journalism research. By analyzing in-depth interviews with journalists at the cusps of two epochal ages of digital disruption in journalism—the rise of user-generated content (UGC) and social network sites around 2010, and the current explosion of generative AI—we show how IPA can serve as a powerful approach for journalism researchers. Paying tribute to the journalist as 'expert' of their own occupational lived experience, IPA provides a nuanced understanding of how journalists negotiate technological transformations in their occupational spaces. Through a triple hermeneutic analysis, where researchers attempt to make sense of journalists critically making sense of UGC and AI as a journalistic tool while reflectively engaging in sense-making of what it means to be a journalist in the age of social media and the age of AI, we explore the profound implications of these digital disruptions. Thematic findings reveal occupational identity crises, ethical dilemmas, and organizational challenges, all within the context of methodological reflection. This study underscores the value of IPA in capturing the depth and reflexivity of journalists' sense-making during significant technological transformations, advocating for a reflective turn in journalism research. [ABSTRACT FROM AUTHOR]

Objective. To provide a set of living treatment recommendations that will give contemporary guidance on the management of patients with axial spondyloarthritis (axSpA) in Canada. Methods. The Spondyloarthritis Research Consortium of Canada (SPARCC), in conjunction with the Canadian Rheumatology Association, organized a treatment recommendations panel composed of rheumatologists, researchers, allied health professionals, and a patient advocate. A Grading of Recommendations Assessment, Development, and Evaluation (GRADE)-ADOLOPMENT approach was used, in which existing guidelines were adopted or adapted to a Canadian context. Recommendations were also placed in a health equity framework. Results. Fifty-six recommendations were made for patients with active axSpA, stable axSpA, active or stable axSpA, for comorbidities, and for assessment, screening, and imaging. Recommendations were also made for principles of management, disease monitoring, and ethical considerations. Conclusion. These living treatment recommendations will provide up-to-date guidance for the management of axSpA for Canadian practice. As part of the living model, they will be updated regularly as changes occur in the treatment landscape. [ABSTRACT FROM AUTHOR]

The main protease (Mpro), also called 3C-like protease, activates the initial step of Covid-19 replication by the proteolytic cleavage of viral polyprotein. The Mpro of Covid-19 is distinctly different from the proteases of the host cell (human), which makes Mpro an attractive therapeutic target for small molecule inhibitors. Herein, we have employed extensive computational approaches to identify a novel chemical scaffold against the Mpro enzyme of Covid-19. The pharmacophore model was developed and then validated by Gunner–Henry method. The validated model was then used for the virtual screening. The identified natural product compounds revealed good docking score and interactions with receptor. The final candidate hit established hydrogen bond interactions with essential binding pocket residues of the Mpro enzyme. Moreover, several hydrophobic interactions were also observed between the final candidate hit compound and the Mpro enzyme. Molecular dynamics simulation confirmed the stability of the identified hits in complex with Mpro enzyme. Finally, we argue that this study will potentially contribute to expand the chemical space of Mpro enzyme inhibition and could potentially develop new safe and efficient natural drugs against the Covid-19. [ABSTRACT FROM AUTHOR]

Background To date, no research has compared longer-term outcomes (antibiotic provision; re-consultations; hospital admissions for quinsy; cost-effectiveness) following presentation with acute sore throat at general practice (GP) versus newer, pharmacy-led services. Methods A retrospective, longitudinal cohort study of sore throat consultations between 1 November 2018 and 28 February 2020 either with the Wales pharmacy-led sore throat test and treat (STTT) service or with a healthcare professional at GP. Individual-level pharmacy consultation data from the national Choose Pharmacy IT application were securely uploaded to the Secure Anonymised Information Linkage Databank and linked to routinely collected, anonymized, population-scale, individual-level, anonymized health and administrative data. Results Of 72 736 index consultations, 6495 (8.9%) were with STTT and 66 241 (91.1%) with GP. Antibiotic provision at the index consultation was 1382 (21%) with STTT and 25 506 (39%) with GP [adjusted odds ratio (AOR), 0.30; 95% CI, 0.27 to 0.32]. Antibiotic provision within 28 days of index occurred in 1820 (28%) STTT and 26 369 (40%) GP consultations (AOR, 0.44; 95% CI, 0.41 to 0.47). GP re-consultation rate within 28 days of index date was 21% (n  = 1389) with STTT compared with 7.4% (n  = 4916) with GP (AOR, 3.8; 95% CI, 3.5 to 4.1). Coding limitations may lead to overestimates of GP re-consultations rates in the STTT group. Hospital admissions for quinsy were rare in both STTT (n  = 20, 0.31%) and GP (n  = 274, 0.41%) (AOR, 0.68; 95% CI, 0.43 to 1.1). STTT was less costly than consultation with GP. Conclusions The pharmacy-led STTT service is safe, cost-effective, and contributes to antimicrobial stewardship. [ABSTRACT FROM AUTHOR]

(1) Background: Surra is a debilitating disease of wild and domestic animals caused by Trypanosoma evansi (T. evansi), resulting in significant mortality and production losses in the affected animals. This study is the first to assess the genetic relationships of T. evansi in naturally affected buffaloes from Multan district, Pakistan, using ITS-1 primers and evaluating the effects of parasitemia and oxidative stress on DNA damage and hematobiochemical changes in infected buffaloes. (2) Methods: Blood samples were collected from 167 buffaloes using a multi-stage cluster sampling strategy, and trypomastigote identification was performed through microscopy and PCR targeting RoTat 1.2 and ITS-1 primers. Molecular characterization involved ITS-1 via neighbor-joining analysis. The impact of parasitemia loads was correlated with oxidative stress markers, genotoxicity, and hematobiochemical parameters using Pearson correlation and multivariable regression models. (3) Results: Field-stained thin blood film microscopy and molecular identification revealed 8.98% and 10.18% infection rates, respectively. Phylogenetic analysis based on ITS-1 region sequences of the identified isolates showed close genetic associations with Indian isolates. The mean trypomastigote count observed in the infected buffaloes was 5.15 × 106 (±5.3 × 102)/µL of blood. The parasitemia loads were significantly correlated with the alterations in oxidative stress markers, DNA damage, and changes in hematobiochemical parameters. Infected animals exhibited significant (p < 0.05) alterations in oxidative stress biomarkers, including catalase, nitric oxide, and malondialdehyde concentrations. Noteworthily, a comet assay revealed a significantly (p < 0.0001) higher mean genetic damage index in the infected buffaloes (0.7 ± 0.04) compared with the healthy ones (0.196 ± 0.004). Alongside significant (p < 0.05) reductions in red cell indices, a marked elevation in leukocyte counts and serum hepatic enzyme levels was recorded in the affected buffaloes. (4) Conclusion: T. evansi isolates of buffaloes from Multan, Pakistan, have genetic similarities to Indian isolates. This study also revealed that higher parasitemia loads induce genotoxicity in the infected animals through oxidative stress and cause hematobiochemical alterations under natural field conditions. [ABSTRACT FROM AUTHOR]

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Objective: To compare the efficacy of a probiotic plus antibiotic with antibiotic therapy alone for the prevention of the recurrence of bacterial vaginosis. Method: A Randomized control trial was conducted in the Gynecological Department of Nishtar Hospital, Multan, between July 2022 and June 2023. One hundred and twenty (N=120) women with bacterial vaginosis, all cured with metronidazole, were enrolled and randomized. In Group-A, Probiotics were administered once a day for 14 days following antibiotic treatment (Tab Metronidazole 400mg, three times a day for seven days). In Group-B, only oral antibiotics were given. The patients were followed up in four visits for five months for bacterial vaginosis recurrence (responders, partial responders, non-responders, and drop-outs) using Amsel criteria by vaginal swabs. All the data was collected on a structured Performa. Results: The mean age of enrolled 120 women was 32.28±2.58, and 111(92.5%) were married. Of 120 enrolled women, 8 (6.7%) were dropped out. Evaluating the recurrence rate, the probiotic group (n=57) had fewer recurrences than the placebo (n=55) (8.9% vs 21.4%, p-value <0.05). Group-A had a better responder rate at five months of follow-up than the placebo group (39.2% vs. 25.8%) (RR 0.31, 95%CI: 0.1450-0.7998, p-Value <0.05). Comparing the effect of probiotics on the components of the Amsel criteria, only vaginal discharge had a statistically significant reduction by using probiotics plus antibiotics (p-value ≤0.05). Conclusion: This trial showed that probiotics plus antibiotics significantly reduced bacterial vaginosis recurrences than antibiotics alone. [ABSTRACT FROM AUTHOR]

Toll-like receptor 2 (TLR2) signaling is a pivotal component of immune system activation, and it is closely linked to the lipidation of bacterial proteins. This lipidation is guided by bacterial signal peptides (SPs), which ensure the precise targeting and membrane anchoring of these proteins. The lipidation process is essential for TLR2 recognition and the activation of robust immune responses, positioning lipidated bacterial proteins as potent immunomodulators and adjuvants for vaccines against bacterial-, viral-, and cancer-related antigens. The structural diversity and cleavage pathways of bacterial SPs are critical in determining lipidation efficiency and protein localization, influencing their immunogenic potential. Recent advances in bioinformatics have significantly improved the prediction of SP structures and cleavage sites, facilitating the rational design of recombinant lipoproteins optimized for immune activation. Moreover, the use of SP-containing lipobox motifs, as adjuvants to lipidate heterologous proteins, has expanded the potential of vaccines targeting a broad range of pathogens. However, challenges persist in expressing lipidated proteins, particularly within heterologous systems. These challenges can be addressed by optimizing expression systems, such as engineering E. coli strains for enhanced lipidation. Thus, lipoprotein signal peptides (SPs) demonstrate remarkable versatility as adjuvants in vaccine development, diagnostics, and immune therapeutics, highlighting their essential role in advancing immune-based strategies to combat diverse pathogens. [ABSTRACT FROM AUTHOR]

This review explores the advances in developing adsorbent materials for solid-phase microextraction (SPME), focusing on nanoparticles, nanocomposites, and nanoporous structures. Nanoparticles, including those of metals (e.g., gold, silver), metal oxides (e.g., TiO2, ZnO), and carbon-based materials (e.g., carbon nanotubes, graphene), offer enhanced surface area, improved extraction efficiency, and increased selectivity compared to traditional coatings. Nanocomposites, such as those combining metal oxides with polymers or carbon-based materials, exhibit synergistic properties, further improving extraction performance. Nanoporous materials, including metal–organic frameworks (MOFs) and ordered mesoporous carbons, provide high surface area and tunable pore structures, enabling selective adsorption of analytes. These advanced materials have been successfully applied to various analytes, including volatile organic compounds (VOCs), polycyclic aromatic hydrocarbons (PAHs), pesticides, and heavy metals, demonstrating improved sensitivity, selectivity, and reproducibility compared to conventional SPME fibers. The incorporation of nanomaterials has significantly expanded the scope and applicability of SPME, enabling the analysis of trace-level analytes in complex matrices. This review highlights the significant potential of nanomaterials in revolutionizing SPME technology, offering new possibilities for sensitive and selective analysis in environmental monitoring, food safety, and other critical applications. [ABSTRACT FROM AUTHOR]

Background: The oral cavity is a complex environment which harbours the second largest and most diverse microflora after the gastrointestinal tract. The bacteriome in the oral cavity plays a pivotal role in promoting the health and well-being of human beings. Gingivitis, an inflammation of the gingival tissue, arises due to plaque accumulation on the teeth, often leads to periodontitis. Progression of periodontitis resulting in clinical attachment loss, bone loss and eventually the tooth loss is poorly understood. The present study explores the transitions in microbioata, oxidative stress and polyamine levels during the disease evolution which can contribute to developing effective therapeutic approaches. Methods: Saliva samples were collected from seventy-two individuals after procuring informed consent who were either healthy, gingivitis or stage-specific periodontitis patients. Periodontitis stage was confirmed by clinical and radiographic analysis. Microbiota analysis was carried out by 16S rRNA sequencing on the Nanopore PromethIONsystem platform of Oxford Nanopore technologies. Polyamine levels were quantified with fluorescence spectrophotometer. Ornithine decarboxylase quantification was evaluated by ELISA method. Antioxidant levels of the salivary samples were measured by DPPH, SOD, and catalase assays. Autophagy was measured by acid phosphatase assay. Result: The salivary microbiota exhibited significant changes in their abundance and diversity between healthy individuals and those with conditions such as gingivitis, and chronic periodontitis. A significant increase in polyamines and ornithine decarboxylase was found in gingivitis and various stages of periodontitis. Elevated oxidative stress observed in gingivitis and periodontitis could have resulted in cell death. Conclusion: The current study shows the role of salivary microbiota and polyamines in gingivitis and different periodontitis stages. The progressive elevation of Streptococcus levels from gingivitis to periodontitis, coupled with polyamine concentrations, may serve as a promising identification marker for assessing the severity of periodontal disease. Insight into the oral bacterial flora and associated physiological changes provide a foundation for targeted therapeutic interventions in gingivitis and periodontitis diseases emphasising the importance of personalised oral health management strategies. [ABSTRACT FROM AUTHOR]

Riverbank erosion is a significant risk that results in damages and economic losses. India is severely vulnerable to riverbank erosion due to its demographic profile, socio-economic conditions, and physiographic setting. This paper attempts to analyze the studies on vulnerability to riverbank erosion in India through a systematic literature review from 2007 to 2023. A total of 68 articles were chosen for this study using keyword search. The findings revealed that studies on political as well as physical and psychological health vulnerability were underrepresented. Ecological vulnerability studies based on site-specific indicators were also found to be limited. The maximum number of studies were concentrated in West Bengal and Assam. Studies based on the use of machine learning and other automated techniques were scant in the existing literature. Most of the reviewed articles relied on a qualitative and descriptive approach. Though a substantial body of work has been carried out on riverbank erosion, the vulnerability posed by riverbank erosion requires adequate representation. The study calls for carrying out more research on specific target groups based on gender, age, and other socio-cultural parameters. Hydrodynamic models and machine learning algorithms for analyzing vulnerability to riverbank erosion are suggested for the future progression of the research. [ABSTRACT FROM AUTHOR]

Toxic environmental pollutants are considered to be posed a major threat to human and aquatic systems. The fast advancement of the petrochemical and chemical industries has woken up rising worries concerning the pollution of water by contaminants including phenolic Bisphenol A (BPA), an endocrine-disrupting chemical (EDC). The intermediate BPA used in synthesis of certain plastics, polycarbonate polymers, polysulfone, and epoxy resins of various polyesters. Due to potential health risks, severe toxicity, and widespread distribution, there is an urgent need to develop efficient techniques for the removal of BPA. Therefore, advance management for the active elimination of BPA prior to its release into the water sources is of serious concern. Degradation, membrane separation, adsorption, and biological treatments have been extensively examined as they are easy to operate and cost-effective for effective BPA removal. In this review, we summarized the mechanism and performance for removal of BPA by several sorbents, including natural polymers, natural inorganic minerals, porous and carbon-based materials. Comparative results revealed that composite materials and modified adsorbents have good performances for removal of BPA. Furthermore, kinetic study investigating adsorption mechanisms was also discussed. Hazardous quantities of such types of chemicals in various samples have thus been the subject of increasing concern of investigation. This review clarified the extensive literature regarding the major health effects of BPA and its advanced treatment technologies including biological treatment by natural and synthetic materials have been discussed briefly. It delivers regulation for future development and research from the aspects of materials functionalization, development of methods, and mechanism investigation that directing to stimulate developments for removal of emerging contaminants. [ABSTRACT FROM AUTHOR]

Neurodegenerative disorders such as Alzheimer's disease (AD), Parkinson's disease (PD), Huntington's disease (HD), and amyotrophic lateral sclerosis (ALS) are characterized by the progressive degeneration of neuronal structure and function, leading to severe cognitive and motor impairments. These conditions present significant challenges to healthcare systems, and traditional treatments often fail to account for genetic variability among patients, resulting in inconsistent therapeutic outcomes. Pharmacogenomics aims to tailor medical treatments based on an individual's genetic profile, thereby improving therapeutic efficacy and reducing adverse effects. This focused review explores the genetic factors influencing drug responses in neurodegenerative diseases and the potential of pharmacogenomics to revolutionize their treatment. Key genetic markers, such as the APOE ε4 allele in AD and the CYP2D6 polymorphisms in PD, are highlighted for their roles in modulating drug efficacy. Additionally, advancements in pharmacogenomic tools, including genome-wide association studies (GWAS), next-generation sequencing (NGS), and CRISPR-Cas9, are discussed for their contributions to personalized medicine. The application of pharmacogenomics in clinical practice and its prospects, including ethical and data integration challenges, are also examined. [ABSTRACT FROM AUTHOR]

The complexities of online brand advocacy (OBA) were investigated using social exchange theory. Recognizing the need to understand better the psychological antecedents influencing OBA, this research examines the interaction of e-commerce website assistance, self-presentation, hedonic value, and OBA. Data was gathered from consumers of e-commerce websites (i.e. AliExpress, Rakuten, and Amazon). The multigroup analysis findings show that e-commerce website assistance, self-presentation, and hedonic value positively influence OBA. Moreover, the nexus between self-presentation and OBA was positively affected by the hedonic value. This paper aims to comprehensively understand the psychological and rational motivations driving OBA behaviors, contributing to the theoretical foundations of consumer behaviors in e-commerce domains. Findings are expected to provide valuable insights for marketers and academics, guiding strategies to foster positive consumer–brand relationships in the ever-changing landscapes of online commerce. [ABSTRACT FROM AUTHOR]

Background: Clinical coding allows for structured and standardised recording of patients' electronic healthcare records. How clinical and non-clinical staff in general practice approach clinical coding is poorly understood. Aim: To explore primary care staff's experiences and views on clinical coding. Design and setting: Qualitative, semi-structured interview study among primary care staff across Wales. Method: All general practices within Wales were invited to participate via NHS health boards. Semi-structured questions guided interviews, conducted between February 2023 and June 2023. Audio-recorded data were transcribed and analysed using reflexive thematic analysis. Results: A total of 19 participants were interviewed and six themes were identified: coding challenges, motivation to code, making coding easier, daily task of coding, what and when to code, and coding through COVID. Conclusion: This study demonstrates the complexity of clinical coding in primary care. Clinical and non-clinical staff spoke of systems that lacked intuitiveness, and the challenges of multimorbidity and time pressures when coding in clinical situations. These challenges are likely to be exacerbated in socioeconomically deprived areas, leading to underreporting of disease in these areas. Challenges of clinical coding may lead to implications for data quality, particularly the validity of research findings generated from studies reliant on clinical coding from primary care. There are also consequences for patient care. Participants cared about coding quality and wanted a better way of using coding. There is a need to explore technological and non-technological solutions, such as artificial intelligence, training, and education to unburden people using clinical coding in primary care. [ABSTRACT FROM AUTHOR]

Echinococcusgranulosus is a zoonotic dog parasite, which causes cystic echinococcosis in humans and animals, adversely affecting health and food production. The resultant socio-economic impacts in lower–middle-income countries and the paucity of epidemiology data prompted the World Health Organization to classify cystic echinococcosis as a neglected tropical disease. Between November 2019 and December 2020, the prevalence of cystic echinococcosis was assessed from 3600 post-slaughter livestock (1142 sheep, 1258 goats and 1200 buffalo) from three districts, Narowal, Sheikhupura and Sialkot, in Northern Punjab, Pakistan. The collected hydatid cysts were subjected to microscopy and PCR followed by Sanger sequencing and phylogenetic analysis. A questionnaire targeted 3600 animal owners to assess disease risk factors. Of the 28 cyst samples sequenced for mtDNA COI, the species was confirmed as Echinococcus granulosus and phylogenetic analysis revealed the presence of both G1 and G3 lineages. Overall, we noted a regional difference in prevalence, where infections were significantly higher in Sheikhupura (9.8%) than Sialkot (6.1%) or Narowal (5.9%) districts. Prevalence was higher in buffalo (9.3%) than sheep (7%) or goats (5.5%), significantly higher (9.3%) in older (> 4 years) compared to younger (< 4 years) animals (5.7%) and higher in females (9.1%) compared to males (3.8%). In sheep and buffalo, more cysts were found in the liver (77.7% and 68.7%, respectively), whereas the lungs were more commonly infected in goats (67.1%). Epidemiological data revealed that combining dog deworming with effective disposal of viscera is needed for a significant reduction in infection prevalence. Similarly, animal deworming was only associated with significantly reduced infections when the animals were not kept near an abattoir, where dogs would normally be present and feeding on discarded viscera. This study adds to growing evidence that simple public health measures and awareness are needed to reduce the prevalence of cystic echinococcosis infection. [ABSTRACT FROM AUTHOR]

Objective: Axial spondyloarthritis (axSpA) is an inflammatory disease in which overactive interleukin (IL)‐17A–producing cells are implicated in a central role. Therapeutically, biologics that target IL‐17A, such as secukinumab, have demonstrated improved clinical outcomes. Despite this translational success, there is a gap in understanding why some patients with axSpA do not respond to IL‐17A–blocking therapy. Our study aims to discriminate immune profiles between secukinumab responders (SEC‐R) and nonresponders (SEC‐NR). Methods: Peripheral blood mononuclear cells were collected from 30 patients with axSpA before and 24 weeks after secukinumab treatment. Frequency of CD4+ subsets were compared between SEC‐R and SEC‐NR using flow cytometry. Mature CD45RO+CD45RA‐CD4+ T cells were fluorescent‐activated cell sorting sorted, and RNA was measured using NanoString analysis. Results: SEC‐NR had an increased frequency of IL‐17A–producing RORγt+CD4+ T cells compared to healthy controls before secukinumab treatment (P < 0.01). SEC‐NR had a significant increase of CXCR3+ CD4+ T cells before secukinumab treatment compared to SEC‐R (P < 0.01). Differentially expressed gene analysis revealed up‐regulation of type 1 interferon (IFN)‐regulated genes in SEC‐NR patients compared to SEC‐R patients after receiving the biologic. SEC‐R patients had an up‐regulated cytotoxic CD4+ T cell gene signature before receiving secukinumab treatment compared to SEC‐NR patients. Conclusion: The increased frequency of IL‐17A–producing cells in SEC‐NR patients suggests a larger inflammatory burden than SEC‐R patients. With treatment, SEC‐NR patients have a more pronounced type 1 IFN signature than SEC‐R patients, suggesting a mechanism contributing to this larger inflammatory burden. The results point toward more immune heterogeneity in axSpA than has been recognized and highlights the need for precision therapeutics in this disease. [ABSTRACT FROM AUTHOR]

Food and water security are critical challenges in Pakistan, exacerbated by rapid population growth, climate variability, and limited resources. This study explores the application of machine learning techniques to address these issues. We specifically examine the dimensions of food and water security in Pakistan, employing data-driven methods to enhance crop yield predictions, food production forecasting, and water resource management. Using secondary data, we refine machine learning models, such as random forest and linear regression, to analyze water availability, crop yield, and crop production. These models aim to optimize resource distribution, improve irrigation efficiency, and minimize water waste. We propose developing AI-based predictions to address food and water crises proactively. Our findings indicate that food insecurity persists in Pakistan, worsened by uneven distribution. Given the country's high dependence on irrigation for crop production, we analyze the impact of population growth on food production and water demand. We recommend a comprehensive strategy that includes infrastructure development, improved water use efficiency in agriculture, and policy adjustments to balance food imports and exports. [ABSTRACT FROM AUTHOR]

This study comprehensively and systematically reviews and integrates the prior literature on the role of tourists' psychographic profiles and elucidates the antecedents, consequences, and intervening factors influencing tourist destination selection and satisfaction. The Dimensions Research Database was used to search for relevant studies. A co-word analysis of 465 articles revealed three significant clusters of keywords, highlighting key themes in tourist psychographics and destination selection. Results indicate that tourist psychographic attributes (i.e. Demographics, motivation, values, attitude, and interest) influence destination image formation and tourist satisfaction. The study offers the Tourist Psychographics-Destination Image-Satisfaction Model (TPDIS Model), a comprehensive conceptual model, as further research agenda for exploring destination-specific tourist profiling and destination image perception to achieve tourism satisfaction. [ABSTRACT FROM AUTHOR]

The current project was designed to develop piperine-loaded solid lipid microparticles (SLMs) to assess the anti-arthritic potential of piperine (PIP). Variable proportions of carnauba wax, beeswax, and tween 80 were employed for preparing SLMs by using the solvent evaporation technique. The developed formulations were subjected to particle size measurements, entrapment efficiency (EE), and zeta potential (ZP) determination. Microparticles were also investigated for piperine-lipid compatibility, thermal analysis, surface morphology, piperine (PIP) release trend, and anti-rheumatic activity in rats. The network's grafting was confirmed by FTIR and XRD results. The thermal stability of the constructed network was confirmed by the DSC and TGA results. SEM findings confirm porous surface morphology. The dissolution experiments on SLMs confirmed the sustained release profile, delivering 87.82% to 94.92% of piperine at 7.4 pH for 24 h. All developed formulations followed a zero-order kinetic model and the Korsmeyer-Peppas model. Furthermore, the anti-rheumatic potentials of piperine from SLMs were also investigated and compared with diclofenac sodium (the standard treatment) in a rat model. The analysis revealed that PIP significantly reduced the severity of arthritis, as confirmed by the findings of multiple arthritic assessment parameters. [ABSTRACT FROM AUTHOR]

One of the consequences of the COVID-19 lockdown is that it hinders school-based dengue management interventions. This is due to the closure of schools and the limited availability of online lessons in certain schools. Conversely, the level of basic understanding that primary school children have about the condition is directly related to their likelihood of getting it and their ability to modify their behaviour to prevent it. Thus, the study aims to assess the understanding and develop a school-based model intervention for dengue solutions and larval indices surveillance systems suitable for primary schools. The study used a purposive and convenience technique to recruit participants in the Keawsan sub-district in Nabon district, Nakhon Si Thammarat province, Thailand. An applied community participatory action research (CPAR) design was used to develop a school-based model intervention. The pre-test result shows that more than 90% and 100% of the students have a poor understanding of dengue solutions (UDS) and larval indices surveillance systems (ULISS), respectively. The students with good scores on UDS increased from 2.9% to 54.6% after the intervention, and there is still a prevalent lack of good understanding among more than 85% of the students on ULISS. Meanwhile, gender, class, and school significantly influence (p <0.05) UDS and ULISS among students in either the pre-test or post-test. Based on the thematic analysis, it was determined that the students had learned about dengue fever transmission, dengue mosquitoes, container index calculation, dengue symptoms, and how to prevent dengue mosquitoes, among other topics. Overall, it was discovered that the trained students could convey their knowledge of the dengue solution and the larval indices surveillance system to other students. We recommend that further ULISS training be provided for schoolchildren in more simple terms that they can understand. [ABSTRACT FROM AUTHOR]

Increased intestinal leakiness and associated systemic inflammation are potential contributors to osteoarthritis (OA) and postural imbalance in the geriatric population. To date, no successful treatment to correct postural imbalance in OA is known. We aimed to explore the effects of a multistrain probiotic upon postural imbalance in OA-affected patients. In this randomised, double-blind trial with a placebo group, 147 patients suffering from knee OA (age span = 64–75 years) were divided into placebo (n 75) and probiotics (n 72) study groups. Vivomix 112 billion, multistrain probiotic was given once a day for 12 weeks. The outcomes of study variables were determined first at baseline and later after 12 weeks of intervention. These were Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), knee flexion range of motion (ROM), pain intensity by visual analogue scale, handgrip strength (HGS), gait speed and balance control assessed in standing, semi-tandem and tandem stances. We determined plasma zonulin to determine intestinal leak along with c-reactive protein and 8-isoprostanes levels. A total of 136 OA patients taking placebo (n 71) and probiotics (n 65) were analysed. The probiotics group exhibited a reduction in pain intensity, disease severity and WOMAC scores along with improvement in balance scores, HGS and walking speed (P < 0·05 for all), no change in ROM, resting pain and 8-isoprostanes levels. The correlation analysis revealed a robust association of balance scores with plasma markers of intestinal leakiness and inflammation in probiotics but not in the placebo group. Probiotics reduce postural imbalance in OA patients partly due to a reduction in intestinal leakiness. [ABSTRACT FROM AUTHOR]

Using postnatal care (PNC) within the first week following childbirth is crucial, as both the mother and her baby are particularly vulnerable to infections and mortality during this period. In this study, we examined the factors associated with early postnatal care (EPNC) use in Afghanistan. We used data from the multiple indicator cluster survey (MICS) 2022–2023. The study population was ever-married women who delivered a live child during their recent pregnancy within the 2 years preceding MICS 2022–23. The outcome was EPNC and defined as the first check of the mother within the first week of delivery. A binary logistic regression was used, and odds ratio (OR) and 95% CI were obtained. Out of 12,578 women, 16.0% received EPNC. EPNC was lower in women who delivered at home [AOR 0.35 (95% CI 0.28–0.44)] compared with women who delivered at public clinics. EPNC was higher in women with ≥ 4 antenatal care (ANC) visits [1.29 (1.02–162)], in women in the highest quintile of wealth status [1.70 (1.25–2.32)], and in women with access to radio [1.76 (1.45–2.15)]. EPNC use among Afghan women remains low (16.0%). Key factors associated with ENPC utilization include place of delivery, ANC utilization, wealth status, and radio access. [ABSTRACT FROM AUTHOR]

This study investigated the rise of implantable or cyborg technologies, also known as insideables, which offer the potential to improve health‐related conditions and enhance the capabilities of healthy individuals. This research focused on the acceptance of insideables among university students in Spain, utilizing the unified theory of acceptance and use of technology (UTAUT) framework along with analytical tools such as partial least squares structural equation modelling (PLS‐SEM) and fuzzy set qualitative comparative analysis (fsQCA). The PLS‐SEM analysis revealed that factors such as performance expectancy, effort expectancy, and social influence positively influenced the intention to use insideables. However, the fsQCA revealed that no single variable is a necessary condition for explaining technology acceptance or rejection. Instead, a combination of constructs is needed to understand both intention to use and rejection. Configurational analysis emphasized the importance of factors such as performance expectancy, social influence, and hedonic motivation in explaining technology acceptance, whereas effort expectancy and perceived risk were less conclusive in their impact on behavioral intention. Moreover, the research revealed that the configurations related to the acceptance and rejection of insideables are asymmetrical. This study sheds light on the complex dynamics of implantable technology acceptance and provides valuable insights into the factors influencing its adoption. From a theoretical perspective, the sequential use of both correlational and configurational methods within the UTAUT framework allows us to gain a deeper understanding of the reasons behind the adoption of emerging technology rather than using only one data analysis methodology. [ABSTRACT FROM AUTHOR]

Grapes have been widely used for dietary ailments due to their attributed pharmacological activities. Resveratrol, the chief constituent of grapes, is responsible for their pharmacological benefits. However, apart from their beneficial effects, grapes have also recently been considered in drug interaction studies. This study investigated the pharmacokinetic profile of omeprazole administered alone compared to omeprazole administered with grape juice, with a prior intake of grape juice, for 1 continuous week. The study was conducted on two groups of healthy male volunteers [n = 12]. One group was orally administered 40 mg of omeprazole alone, while the other group was administered omeprazole with grape juice. Blood samples were analyzed for omeprazole concentration by a reverse-phase HPLC method. Co-administration of 40 mg omeprazole with grape juice significantly decreased the AUC0-t and Cmax by 32% and 34%, respectively, suggesting a role being played by grapes in the activation of P-glycoprotein and omeprazole metabolizing enzymes, including CYP3A4 and CYP2C19. In conclusion, the addition of grapes as a dietary supplement in patients taking omeprazole for the management of peptic ulcer symptoms may lead to a higher required dose of omeprazole. [ABSTRACT FROM AUTHOR]