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Drought is one of the most severe natural disasters. It negatively influences the crop output considerably as water resources are inadequate across large geographic areas. Food insecurity, hunger, and poverty are widespread in three Pakistani provinces: Baluchistan, Khyber Pakhtunkhwa, and Sindh. Until March/April 2022, roughly 4.66 million people, or 25% of the population examined, were severely food insecure. Historically, the severity of a drought is evaluated using several different indicators, with the selection of indices depending on the data that is easily accessible. By multiple aspects, including potential evapotranspiration and rainfall data on a standard timescale and computing monthly, seasonal, or annual data, the Reconnaissance Drought Index (RDI) has a significant advantage over the other indices in determining drought severity. When rainfall in a region is significantly lower than the amount of potential evapotranspiration, drought situations can occur on the earth. Rainfall will often occur in locations with an increase in the relative humidity of the air. The reconnaissance drought index (RDI) for Khyber Pakhtaunkhawa province in Pakistan was calculated from 1981 to 2020 for 3-, 6-, and 12-month timeframes. This research employed rainfall, minimum and maximum temperature data from KPK province to describe drought using the DrinC program, the Man Kendall test, and Sen's slope calculator to determine drought patterns and variation. All regions had moderate, severe, and extreme droughts, with RDIs between -1.0 and -3.5. RDI 3-, 6-, and 12-month evaluations highlighted 1991, 1994, 2000, 2010, 2015, and 2017. These results indicate that productivity declines in dry and subsequent years due to seasonal rainfall and soil moisture retention.Wheat production averaged 1.7 tones ha-1 year-1, with significant variations. Between October and December, it is an essential to have favorable growing conditions to increase productivity. If droughts occur in this era, the yield will be substantially more negatively impacted than if they occur later in the growing cycle. The 3-month RDI values offer a more accurate description of this variation than the six-month and twelve-months RDI Values. Geospatial drought analysis indicates a considerable variance in drought patterns across the Kpk province over the last 4 decades. Because long-term droughts sometimes affect water quality, especially groundwater, a rise in the intensity of long-term droughts could pose a risk to the water management in the regions that have been examined. Analysis of the Landsat TM 30 m data took place. At the same time, Landsat imageries were utilized to generate the Normalized Difference Vegetation Index (NDVI) and Normalized Difference Water Index (NDWI) for drought evaluation. The findings of the NDWI indicate an increase in value from 0.58 to 0.7 for the KPK region.

Abstract Three hundred and twenty day old Hubbard broilers were randomly allocated to four treatments (8 replicates, 10 birds/pen) and were raised under standard management conditions. Birds in the first group served as control and were fed a corn based diet, while birds in the remaining three groups i.e.; A, B and C were fed with a basal diet supplemented with copper nanoparticles (CuNP) at 5, 10 and 15 mg /kg of diet respectively for 35 days. Supplementation of CuNP linearly increased (P≤0.05) body weight (BW), average daily weight gain (ADWG) and feed intake (FI) in broilers. Uric acid, glucose levels in blood and feed conversion ratio (FCR) reduced linearly (P≤0.05) with CuNP supplementation in diet. Supplementation of CuNP in the diet also linearly increased (P≤0.05) tibia weight, length, diameter, weight/length index (W/L) and Tibiotarsal index (TT index). Inclusion of CuNP in broilers diet linearly increased the measured parameters of muscle i.e.; pH, fiber diameter, fiber cross-sectional area, fascicle diameter, fascicle cross-sectional area (P≤0.05). Concentration of copper, iron, calcium and phosphorous in blood also increased line-arly (P ≤ 0.05) with CuNP supplementation. Overall, CuNP positively affected the growth performance, histological characteristics of muscles, bone strength and serum metabolites in broilers.

Abstract The focal plane camera is the core component of the Wide Field-of-view Cherenkov/fluorescence Telescope Array (WFCTA) of the Large High-Altitude Air Shower Observatory (LHAASO). Because of the capability of working under moonlight without aging, silicon photomultipliers (SiPM) have been proven to be not only an alternative but also an improvement to conventional photomultiplier tubes (PMT) in this application. Eighteen SiPM-based cameras with square light funnels have been built for WFCTA. The telescopes have collected more than 100 million cosmic ray events and preliminary results indicate that these cameras are capable of working under moonlight. The characteristics of the light funnels and SiPMs pose challenges (e.g. dynamic range, dark count rate, assembly techniques). In this paper, we present the design features, manufacturing techniques and performances of these cameras. Finally, the test facilities, the test methods and results of SiPMs in the cameras are reported here.

Abstract Poultry industry is amongst highly developed industries of Pakistan, fulfilling the protein demand of rapidly increasing population. On the other hand, the untreated poultry waste is causing several health and environmental problems. The current study was designed to check the potential of keratinolytic fungal species for the conversion of chicken-feather waste into biofortified compost. For the purpose, three fungal species were isolated from soil samples. These strains were pure cultured and then characterized phenotypically and genotypically. BLAST searches of 18S rDNA nucleotide sequence of the fungal isolates revealed that the two fungal isolates belonged to genus Aspergillus and one belonged to genus Chrysosporium. Optimum temperature for Aspergillus flavus, Aspergillus niger and Chrysosporium queenslandicum was 29, 26 and 25 oC, respectively. A. flavus showed maximum (53%) feather degradation, A. niger degraded feather waste up to 37%, while C. queenslandicum showed 21% keratinolytic activity on chicken feathers at their respective temperature optima. The degradation potential of these fungal species showed their ability to form compost that has agro-industrial importance.

Thymoquinone (TQ), a bioactive compound from black cumin (Nigella sativa), has demonstrated a broad range of therapeutic effects. The aim of this study is to evaluate the antifungal efficacy of TQ by targeting key virulence factors in Candida albicans, specifically focusing on isocitrate lyase (ICL) activity, biofilm formation, and gene expression. This study explored TQ’s impact on ICL, a decisive enzyme in the glyoxylate cycle, along with its effect on hyphal formation, biofilm development, and the virulent gene expression of C. albicans through in silico and in vitro studies. Molecular docking revealed a binding energy of −6.4 kcal/mol between TQ and ICL, indicating moderate affinity. The stability of the ICL-TQ complex was validated through 50 ns molecular dynamics simulations, showing the root mean square deviation (RMSD) values of 0.35 nm for ICL and 0.38 nm for the complex. In vitro studies further validated these findings, showing a dose-dependent inhibition of ICL activity. TQ at 2 µg/mL reduced enzyme activity by 57%, and at 4 µg/mL, by 91.4%. Additionally, TQ disrupted the yeast-to-hyphae switch, a key virulence factor, with 1 and 2 µg/mL doses significantly inhibiting hyphal formation. The biofilm formation was similarly affected, with a 58% reduction at 2 µg/mL and an 83% reduction at 4 µg/mL. TQ also downregulated the ALS1 and HWP1 genes that are associated with adhesion and biofilm development, demonstrating its broad-spectrum antifungal activity. These findings suggest that TQ is a promising candidate for antifungal therapies, targeting multiple virulence factors in C. albicans and potentially overcoming biofilm-associated drug resistance. Future research should focus on in vivo validation, optimization for clinical applications, and expanding its spectrum against other drug-resistant fungal species.

This article discusses the growing burden of smog in Pakistan, tracing its origins to vehicular emissions, industrial pollutants, and agricultural practices. It highlights current national initiatives and advocates for enhanced government interventions to mitigate smog's adverse effects on ocular health. It also emphasizes the need for collective action to safeguard ocular health amid rising smog pollution in Pakistan.

Objectives: To explores the perception & effectiveness of objectively structured viva examinations (OSVE) in 3rd year MBBS students as compared to routine general viva for future implementation at Rai Medical College, Sargodha. Methodology: This cross-sectional study was performed at Rai Medical College (RMC), Sargodha The total number of participants were 120 third-year MBBS students.Routine objectively structured viva examinations (OSVE) of forensic medicine was conducted. During the OSVE, each student was assigned to specific stations. The students' viewpoints were evaluated before and after the OSVE through a customize structured questionnaire.Categorical variables including the responses strongly agree, agree, neutral, strongly disagree, disagree are presented as frequencies and percentages. Chi square test was used to check the differences in proportions of perception of male and female concerning various aspects of OSVE. Results: This study was comprised of 120 medical students, of which 65(54.16%) and 55(45.93%) were female and male student respectively. Of total participants 39.2 and 25% of students were felt that structured viva format was more convenient than routine unstructured viva. Of total students 47.5 % of students agreed that the allocated time for answering questions in OSVE was appropriate. Concerning encouragement from teacher to give relevant answer during OSVE, 48.3 % and 45.0% of students were strongly disagreed and disagreed respectively rest were agreed or remain neutral. Only19.2 and 23.3% of students were strongly agreed and agreed presence of bias in unstructured oral viva. Most of students were strongly agreed (37.5 %) or agreed (29.2%) for implementation of OSVE for all academic years for all medical subjects. Significant statistical difference was observed in opinions of male and female with respect to encouragement in OSVE from examiner and biasness during unstructured viva with p values0.002 and 0.027, whereas we did not find any significant difference among gender point of views for all other aspects of OSVE. Conclusion: Objectively structured viva examinations, as perceived by the participants, was mostly convenient and bias free mode of assessment compared to traditional unstructured oral viva examination. OSVE should be implemented in all academic years for all subjects.

We evaluated the power of pregnant women's neutrophils in releasing the oxidant substances (such as H202, superoxide, ...) in the presence of luminol. In the presence of luminol these substances will emit light and we measured this light by a luminometer (chemiluminescence technicque). Baker's yeast was used for neutrophil activation."nThis study includes 45 pregnant women (mean age = 30.7 years) and 20 controls (mean age 31.8 years)."nResults : 1-the mean of maximum light in p.w (N-CL in p.w) was 209.1 mv (milivolt) and in controls 152.6 mv."n2-the mean of maximum time for N-CL in p.w is 10.3 min and in control 11.1 min."nWe observed that N-CL (power of phagocytosis) in p.w increased (P< 0.01) but the time didn't.

Staphyloccus aureus is one of the most important causes of nosocomial infections. In order to investigate the S. sureus colonization rate, 378 samples were taken from the nose and. throat of staffs of 4 university hospitals in Kerman."nThe control group consists of the same number of people with similar age and sex distribution. Seventy three hospitalized paients were also tested in this respect. The prevalence of nasal colonization of S. aureus was 33% in the control group, 36.8% in the staffs and 38.4% in the patients (the differences were not statistically significant). Throat colonization were seen in 12.4%, 25% and 22%, in the control group, staff and patients, respectively."nIn the staff and control groups, the rate of throat colonization was lower than the nasal colonization (P

Localisation of clinically relevant events within Electroencephalogram (EEG) recordings can be useful for explaining the decisions made by automated EEG screening and decision support systems. The majority of existing deep learning based approaches that have been proposed in recent literature only classify EEG records as normal or pathological without providing any justification for their decisions and thus are not very transparent. In clinical practice it is often observed that a significant proportion of EEG recordings does not contain any abnormal (or pathological) events; even in cases classified as pathological. If deployed in practice such a setup would not be very useful since it would require neurologists to invest additional time, manually searching for events within an EEG recording before accepting or rejecting the decision proposed by the automated system. This work presents open-source software that can automatically localise and classify abnormalities both across time and EEG channels. Our work can thus be used to reveal the reasons behind an EEG recording being classified as normal or pathological/abnormal. Training an automated event localisation system requires a dataset containing fine-grained labels pointing out precise locations of events. To facilitate further development we are also releasing the dataset and annotations used in this work for use by the research community. This dataset contains 1,075 EEG recordings with precise temporal and channel locations of two broad categories of abnormal events: (i) Epileptiform discharges and (ii) Non-epileptiform abnormalities. Our localisation system is based on features derived from wavelet transforms. For event classification we investigated the performance of both classic machine learning algorithms (support vector machines, decision trees, random forest classifier) and deep convolutional neural networks (VGG16, GoogLeNet and EfficientNet). Our results indicate that deep convolutional neural networks outperform classic machine learning algorithms in terms of average values of precision, recall, F1-score and accuracy.

This paper presents a single-element linearly polarized (LP) patch antenna characterized by a wide impedance bandwidth and low profile, optimized for 5G V2X applications. By inserting air gaps into the LP patch antenna structure, a circularly polarized (CP) antenna is generated. Moreover, a cross-stubs technique is employed to generate CP from LP, thereby enhancing the axial ratio (AR) bandwidth. In this work, we consider both linear and circular polarization patch antennas designed to operate suitable for V2X applications. The resonating structure for both antennas is designed on a 0.787 mm Rogers RT-duroid 5880 substrate with a relative permittivity of 2.2. The proposed design demonstrates resonance within the frequency range of 24 to 34 GHz and an AR bandwidth from 26.4 to 32.1 GHz. Additionally, the proposed design achieves a realized gain of 5.5 dBi along with a radiation efficiency of 94%. To extend the antenna’s gain capabilities, the single-element CP antenna is transformed into a series-fed 9-element array, achieving a maximum realized gain reaching 15.2 dBi and sidelobe levels (SLL) exceeding -17 dB. All proposed antennas are simulated, followed by fabrication and measurements, with the results demonstrating a good level of agreement between simulation and measurement. The proposed antennas’ low profile, wideband performance, and fabrication simplicity position them as ideal candidates for enhancing connectivity in next-generation V2X communications within the millimeter wave (mmWave) band.

Objective: This study was conducted to find the frequency of suboptimal health and its association with perceived stress levels among medical students at a private university medical college in Islamabad, Pakistan. Study Design: Descriptive cross-sectional study. Place and Duration of Study: The study was conducted at the Department of Community Medicine, Foundation University Medical College Islamabad, Pakistan over a period of 6 months from February 2024 to July 2024. Methods: A total of 210 medical students were randomly selected. They were asked to fill in questionnaires. Data on demographic profile, Suboptimal health status using (SHSQ-25) tool, and stress using the perceived stress scale (PSS-10) were obtained. SPSS version 20 was used to enter and analyze the data. Results: The frequency of sub-optimal health status was (50%, 105/210). The majority of students (80.0%) had moderate levels of perceived stress. Mostly females (82.4%) and day scholars (85.2%) reported moderate levels of stress. A weak positive correlation between SHS and stress was found. (P

Background/Objective: A-lines and B-lines are key ultrasound markers that differentiate normal from abnormal lung conditions. A-lines are horizontal lines usually seen in normal aerated lungs, while B-lines are linear vertical artifacts associated with lung abnormalities such as pulmonary edema, infection, and COVID-19, where a higher number of B-lines indicates more severe pathology. This paper aimed to evaluate the effectiveness of a newly released lung ultrasound AI tool (ExoLungAI) in the detection of A-lines and quantification/detection of B-lines to help clinicians in assessing pulmonary conditions. Methods: The algorithm is evaluated on 692 lung ultrasound scans collected from 48 patients (65% males, aged: 55 ± 12.9) following their admission to an Intensive Care Unit (ICU) for COVID-19 symptoms, including respiratory failure, pneumonia, and other complications. Results: ExoLungAI achieved a sensitivity of 91% and specificity of 81% for A-line detection. For B-line detection, it attained a sensitivity of 84% and specificity of 86%. In quantifying B-lines, the algorithm achieved a weighted kappa score of 0.77 (95% CI 0.74 to 0.80) and an ICC of 0.87 (95% CI 0.85 to 0.89), showing substantial agreement between the ground truth and predicted B-line counts. Conclusions: ExoLungAI demonstrates a reliable performance in A-line detection and B-line detection/quantification. This automated tool has greater objectivity, consistency, and efficiency compared to manual methods. Many healthcare professionals including intensivists, radiologists, sonographers, medical trainers, and nurse practitioners can benefit from such a tool, as it assists the diagnostic capabilities of lung ultrasound and delivers rapid responses.

In this paper, we explore the uses of Obata’s differential equation in relation to the Ricci curvature of an odd-dimensional sphere that possesses a semi-symmetric metric connection. Specifically, we establish that, given certain conditions, the underlying submanifold can be identified as an isometric sphere. Additionally, we investigate the impact of specific differential equations on these submanifolds and demonstrate that, when certain geometric conditions are met, the base submanifold can be characterized as a special type of warped product.

This paper explores the asymptotic and oscillatory properties of a class of third-order neutral differential equations with multiple delays in a non-canonical form. The main objective is to simplify the non-canonical form by converting it to a canonical form, which reduces the complexity of the possible cases of positive solutions and their derivatives from four cases in the non-canonical form to only two cases in the canonical form, which facilitates the process of inference and development of results. New criteria are provided that exclude the existence of positive solutions or Kneser-type solutions for this class of equations. New criteria that guarantee the oscillatory behavior of all solutions that satisfy the conditions imposed on the studied equation are also derived. This work makes a qualitative contribution to the development of previous studies in the field of neutral differential equations, as it provides new insights into the oscillatory behavior of neutral equations with multiple delays. To confirm the strength and effectiveness of the results, three examples are included that highlight the accuracy of the derived criteria and their practical applicability, which enhances the value of this research and expands the scope of its use in the field.

(1) Background: Chronic rhinosinusitis (CRS) is a common chronic inflammation of the nasal mucosa and the paranasal sinuses. The pathogenesis of chronic rhinosinusitis (CRS) is multifactorial and, as of yet, not well understood. (2) Methods: Nasal lavage fluid samples were collected from patients diagnosed with chronic sinusitis with nasal polyposis (CRSwNP) (n = 10) and individuals without sinusitis (control group) (n = 10) who had no nasal complaints. In the present study, we used an untargeted label-free LC-MS/MS mass spectrometric approach combined with bioinformatics and network pathway analysis to compare the changes in the proteomic profiles of the CRSwNP group and the control group. Data from LC-MS/MS underwent univariate and multivariate analyses. (3) Results: The proteomic analyses revealed distinct differences in the abundances of nasal lavage fluid proteins between the CRSwNP and control groups: a total of 234 proteins, 151 up- and 83 down-regulated in CRSwNP. Functional Gene Ontology (GO) analysis showed that dysregulated proteins were involved in airway inflammatory reaction, immune response, and oxidative stress. The biomarkers were evaluated using the Receiver Operating Characteristic (ROC) curve; an Area Under the Curve (AUC) of 0.999 (95% CI) identified potential biomarkers between the CRSwNP and control group. EMILIN-3 and RAB11-binding protein RELCH were down-regulated, and Macrophage migration inhibitory factor and deoxyribonuclease-1 were up-regulated, in CRSwNP compared to the control group. (4) Conclusions: These differentially expressed proteins identified in CRSwNP are involved in airway inflammatory reaction, immune response, and oxidative stress. In particular, the identification of increased interleukin-36 gamma (IL-36γ), which contributes to inflammatory response, and a decrease in SOD, in this group are notable findings. In the future, several of these proteins may prove useful for exploring the pathogenesis of nasal polyps and chronic sinusitis or as objective biomarkers for quantitatively monitoring disease progression or response to therapy.

Tobacco use is considered one of the largest public health threats facing the world. Waterpipe smoking (WPS) is a customary and cultural method of tobacco consumption in many parts of the world. This study aimed to find the prevalence of smoking among Duhok city University students in Iraq and to assess students’ knowledge regarding smoking. A cross-sectional, self-completed questionnaire-based study was conducted at four Universities in Duhok city. According to the study’s objectives, scientific and literature colleges from each university are selected. The selection of the number of enrolled colleges and departments is proportionate with total university students’ number. The colleges and departments are selected by a simple random sampling method. Descriptive and analytic statistical tools (SPSS-23) were used to assess significant associations. Chi-square test association is used to compare between proportions. The prevalence of cigarette smoking was 23.5% among studied students (41.9% among males and 6.8% among females), and the prevalence of WPS was 33.2% (56.7% among males and 11.8% among females). There is a significant correlation between cigarette smoking and WPS. Most of the students in this study were not well aware of the most harmful effects of smoking. There was a highly statistically significant association between cigarette and WPS. Smoking in males is more prevalent than females. Inclusion of a detailed and separate course in the university curriculum regarding tobacco control and the effects of smoking on health should be made compulsory. This course must be started from the 1st year of academic courses till the time of graduation or conducting health education and extensive counseling on the harmful effect of smoking for all university students.

Objectives Ocular surgery is a source of significant concern for many patients, especially in high-stakes circumstances. The purpose of this study was to explore patient experiences of undergoing surgery on their only-seeing eye.Design A qualitative investigation using semistructured face-to-face interviews. Transcripts were analysed using thematic analysis.Setting Hospital eye service in the UK.Participants Twelve participants with a diagnosis of glaucoma with worse eye visual acuity

Coronavirus disease 2019 (COVID-19) is forcing cardiology departments to rapidly adapt existing clinical guidelines to a new reality and this is especially the case for acute coronary syndrome pathways. In this focused review, the authors discuss how COVID-19 is affecting acute cardiology care and propose pragmatic guideline modifications for the diagnosis and management of acute coronary syndrome patients, particularly around the appropriateness of invasive strategies as well as length of hospital stay. The authors also discuss the use of personal protective equipment for healthcare workers in cardiology. Based on shared global experiences and growing peer-reviewed literature, it is possible to put in place modified acute coronary syndrome treatment pathways to offer safe pragmatic decisions to patients and staff.

S. aureus is a common commensal of the skin and mucosal membranes of humans, with estimates of 20% (range from 12% to 30%) of healthy people are persistent S. aureus nasal carriers, 30% (range from 16% to 70%) are intermittent carriers, and 50% (range from 16% to 69%) are non-carriers. The aim of this article is to explore the factors associated with Methicillin Resistant Staphylococcus Aureus carriage among food handlers. Across sectional study was done to involve 200 persons who are handling foods in 40 restaurants in Duhok city in the study. Methicillin Resistant Staphylococcus Aureus was detect among 27% of studied population. Methicillin Resistant Staphylococcus Aureus carrier rate showed a significant association with skin and soft tissue infections, health facilities visits and certain jobs of food handlers. Age, duration of work in the restaurants, personal protective measures and antibiotic use showed no significant association with the prevalence of MRSA. Methicillin Resistant Staphylococcus Aureus carrier rate was higher among food handlers working in popular restaurants when compared to other restaurants. Ongoing screening of all persons who handled foods is crucial to detect and treat those are MRSA carrier as one of major public health issues

Breast cancer is the most common cancer affecting women all over the world. it is estimated to account for around 25% of all malignant in women, and incidence shows continuously increasing trend in many countries all over the world. The aim of the study is to determine level of knowledge, awareness, and BSE practice for breast among SPU female students. A descriptive study was conducted a pre- tested questionnaire was used to determine knowledge, attitude and practices of female students in SPU regarding breast cancer and BSE. The face to face interview questionnaire was filled by systematic random sampling to 216 female students from 4 different colleges belongs to SPU, after getting verbal consent to participate voluntary in the study. Data were entered into Epi-data version 3.1.1 and exported to analyse in SPSS version 17. Descriptive analysis was performed and frequencies and percentages were reported. The mean age of participants was 20.7, the study result shows that the knowledge mean score of participants was 3.95 (SD ± 1.78).181(83.8%) have information of breast cancer, and 157(72.7%) have information on breast cancer sign,136(63.0%) have information on factor that increase change to get breast cancer,150(69.4%)have information on (BSE),86(39.8%)have information how to do (BSE),101(46.8%)have information on mammography .91(42.1%)practice of (BSE), only 10 ( 4.6 %) female students has performing this examination regularly , percentage of students that did not done mammography was 193 (89.4%) . only 2 (0.9 %) performs mammography screening regularly, 18 (8.3 %) have a family member that get breast cancer. Knowledge of female student about breast cancer was at unsatisfactorylevel. Knowledge of female student about S.B.E was also at unsatisfactory level. Poor practice was observed, regarding BSE. Knowledge regarding mammography was also poor.

Abstract Transparency within biomedical research is essential for research integrity, credibility, and reproducibility. To increase adherence to optimal scientific practices and enhance transparency, we propose the creation of a journal transparency tool (JTT) that will allow users to obtain information about a given scholarly journal’s operations and transparency policies. This study is part of a program of research to obtain user preferences to inform the proposed JTT. Here, we report on our consultation with clinicians and researchers. This mixed-methods study was conducted in two parts. The first part involved a cross-sectional survey conducted on a random sample of authors from biomedical journals. The survey asked clinicians and researchers about the inclusion of a series of potential scholarly metrics and user features in the proposed JTT. Quantitative survey items were summarized with descriptive statistics. Thematic content analysis was employed to analyze text-based responses. Subsequent focus groups used survey responses to further explore the inclusion of items in the JTT. Items with less than 70% agreement were used to structure discussion points during these sessions. Participants voted on the use of user features and metrics to be considered within the journal tool after each discussion. Thematic content analysis was conducted on interview transcripts to identify the core themes discussed. A total of 632 participants (5.5% response rate) took part in the survey. A collective total of 74.7% of respondents found it either ‘occasionally, ‘often’, or ‘almost always’ difficult to determine if health information online is based on reliable research evidence. Twenty-two participants took part in the focus groups. Three user features and five journal tool metrics were major discussion points during these sessions. Thematic analysis of interview transcripts resulted in six themes. The use of registration was the only item to not meet the 70% threshold after both the survey and focus groups. Participants demonstrated low scholarly communication literacy when discussing tool metric suggestions. Our findings suggest that the JTT would be valuable for both researchers and clinicians. The outcomes of this research will contribute to developing and refining the tool in accordance with researchers and clinicians.

Abstract Background The major breakthrough in cancer therapy with immune checkpoint inhibitors (ICIs) has highlighted the important role of immune checkpoints in antitumoral immunity. However, most patients do not achieve durable responses, making biomarker research in this setting essential. CD27 is a well known costimulatory molecule, however the impact of its soluble form in ICI is poorly investigated. Therefore, we aimed at testing circulating concentrations of soluble CD27 (sCD27) and CD27 bound to extracellular vesicles (EVs) as potential biomarkers to predict response and overall survival (OS) in patients undergoing ICI. Methods Serum and plasma levels of sCD27 were assessed by immunoassay in three patient cohorts (n = 187) with advanced solid malignancies including longitudinal samples (n = 126): a training (n = 84, 210 specimens, Aachen ICI) and validation cohort (n = 70, 70 specimens, Hamburg ICI), both treated with ICI therapy, and a second independent validation cohort (n = 33, 33 specimens, Hamburg non-ICI) undergoing systemic therapy without any ICI. In a subset (n = 36, 36 baseline and 108 longitudinal specimens), EV-bound CD27 from serum was measured, while EV characterization studies were conducted on a fourth cohort (n = 45). Results In the Aachen and Hamburg ICI cohorts, patients with lower circulating sCD27 levels before and during ICI therapy had a significantly longer progression-free survival (PFS) and OS compared to patients with higher levels, a finding that was confirmed by multivariate analysis (MVA) (Aachen ICI: pPFS = 0.012, pOS = 0.001; Hamburg ICI: pPFS = 0.040, pOS = 0.004) and after randomly splitting both cohorts into training and validation. This phenomenon was not observed in the Hamburg non-ICI cohort, providing a rationale for the predictive biomarker role of sCD27 in immune checkpoint blockade. Remarkably, EV-bound CD27 baseline levels and dynamics during ICI therapy also emerged as potent predictive biomarkers, acting however antagonistically to soluble sCD27, i.e. higher levels were associated with PFS and OS benefit. Combining both molecules (“multi-CD27” score) enhanced the predictive ability (HRPFS: 17.21 with p

In this study, cubic Hastelloy-X was manufactured by laser powder bed fusion process. A systematic investigation focused on the microstructure and anisotropic electrochemical corrosion behavior along the building direction was conducted. Distinctive columnar dendritic features across melt pool boundaries were consistently observed in the top (HX-T), middle (HX-M), and bottom (HX-B) regions along the building direction. A significant reduction in Mo content from the HX-T to the HX-B was observed, attributed to preferential segregation of Mo during the solidification process. Typical fish-scale molten pool was observed in the HX-B and HX-M, while HX-T consisted of strip molten pool in addition to fish scale molten pool. All samples showed the typical characteristics of Goss texture //BD. HX-M sample showed the largest grain size, highest intensity ∼6.35 mrd and lowest kernel average misorientation value as compared to HX-T and HX-B associated with the remelting of the former solidified layer due to the newly deposited layer. Electrochemical analysis including electrochemical impedance spectroscopy and potentiodynamic polarization scans were conducted in 10 wt% NaCl electrolytes at constant temperature of 25 ± 1 °C. HX-T showed the lowest corrosion rate as compared to HX-M, HX-B (0.55, 23.16 and 16.01 mpy for HX-T, HX-M and HX-B, respectively). The surface morphology of corroded samples revealed that the formation of a compact passive film due to the presence of high atomic % of Mo in HX-T restricted the chloride ions from the electrolyte to penetrate and react with the metal samples subsequently enhancing the corrosion resistance.

This study investigates the influence of extrusion and deformation temperatures on the mechanical properties of the AZ61 Mg alloy. Increasing the extrusion temperature from 300 to 400 °C led to larger grain size and higher basal texture intensity. At 400 °C, the AZ61 alloy exhibited more Al–Mn phases and fewer Mg17Al12 phases, indicating enhanced dissolution of Mg17Al12 in the α-Mg matrix. Uniaxial tensile tests were conducted at room temperature (RT) and cryogenic temperature (CT, −150 °C). Despite grain growth, a higher yield strength (YS) was achieved at higher extrusion temperatures due to the texture-strengthening mechanism. However, during deformation at CT, the higher YS was primarily attributed to the formation of multiple twinning within individual grains, causing twinning interactions. These twin-interacting boundaries create additional barriers to dislocation movement. Notably, the AZ61 sample extruded at 400 °C demonstrated the formation of stacking faults during deformation at CT, with dislocations accumulating around the faults. This contributed to the best strength without compromising ductility in this sample.

Abstract SARS-CoV-2 variants of concern (VOC) have been associated with increased viral transmission and disease severity. We investigated the mechanisms of pathogenesis caused by variants using a host blood transcriptome profiling approach. We analysed transcriptional signatures of COVID-19 patients comparing those infected with wildtype (wt), alpha, delta or omicron strains seeking insights into infection in Asymptomatic cases. Comparison of transcriptional profiles of Symptomatic and Asymptomatic COVID-19 cases showed increased differentially regulated gene (DEGs) of inflammatory, apoptosis and blood coagulation pathways, with decreased T cell and Interferon stimulated genes (ISG) activation. Between SARS-CoV-2 strains, an increasing number of DEGs occurred in comparisons between wt and alpha (196), delta (1425) or, omicron (2313) infections. COVID-19 cases with alpha or, delta variants demonstrated suppression transcripts of innate immune pathways. EGR1 and CXCL8 were highly upregulated in those infected with VOC; heme biosynthetic pathway genes (ALAS2, HBB, HBG1, HBD9) and ISGs were downregulated. Delta and omicron infections upregulated ribosomal pathways, reflecting increased viral RNA translation. Asymptomatic COVID-19 cases infected with delta infections showed increased cytokines and ISGs expression. Overall, increased inflammation, with reduced host heme synthesis was associated with infections caused by VOC infections, with raised type I interferon in cases with less severe disease.

Aim: Hypertension, a prevalent chronic condition, significantly contributes to cardiovascular diseases worldwide. Effective management of hypertension is highly dependent on patient adherence to prescribed medications, as the correct dose at the right time can lead to desirable therapeutic results. This study aims to analyze medication adherence among hypertensive patients in Islamabad and Rawalpindi through an open survey. Methods: A prospective cross-sectional study was conducted from 17th March 2024 to 30th May 2024, targeting hypertensive populations in Islamabad and Rawalpindi. 246 patients were recruited using a sample size formula, and a General Medication Adherence Scale (GMAS) questionnaire was used to collect data. All the tests were conducted as two-sided, with a significance level of P < 0.05 using Python. Results: Among 246 participants (mean age 57.1 years), most were married, literate, and living with families, 63% were from Islamabad, and 78.9% were employed. The study found high adherence in behavior-related areas but low adherence due to costs. Gender showed a statistically significant correlation (P = 0.03) by independent t-test. At the same time, ANOVA tests revealed that educational level (P = 0.02), monthly income (P = 0.001), family support (P = 0.04), and medication costs (P = 0.001) significantly impacted adherence, while factors like social status, employment status, and smoking did not have a considerable influence. Conclusions: 72.4% of patients adhered to their prescribed therapy, and 27.6% did not highlight a critical issue that requires urgent intervention. Variables like gender, educational status, social status, occupation, and living with family are strongly associated with adherence. Common problems include taking multiple medications, lack of awareness about the importance of adherence, and financial constraints.

Abstract Background and purpose This comparative systematic review and meta-analysis investigated the incidence of ischemic stroke in intermediate-to-high-risk patients undergoing transcatheter aortic valve replacement versus surgical aortic valve replacement. Methods We conducted a systematic review and meta-analysis following the PRISMA guidelines, searching PubMed, Google Scholar, Embase, Web of Science, and Cochrane CENTRAL databases from their inception to December 2023. The evaluated outcomes were primarily incidence of stroke and transient ischemic attack (TIA), along with other secondary safety end-points at 30 days and 1 year post-procedure. Odds ratios (ORs) with 95% confidence intervals (CIs) were utilized for each study, employing a random-effects model for data synthesis irrespective of heterogeneity. Statistical heterogeneity was assessed using I2 statistics. All statistical analyses were conducted using Review Manager. Results We screened 8028 articles and included 8 studies consisting of 5 randomized controlled trials and 3 observational studies. The studies examining 30-day and 1-year stroke incidence found no significant difference between TAVR and SAVR patients (OR 0.83, 95% CI 0.59 to 1.17, p = 0.30, OR 0.92, 95% CI 0.64 to 1.33, p = 0.67, respectively). Both TAVR and SAVR also had a comparable risk of having a transient ischemic attack within 30 days (OR 0.93, 95% CI 0.24 to 3.63, p = 0.92, I2 52%) and 1 year (OR 1.15, 95% CI 0.72 to 1.82, p = 0.56, I2 0%) following the procedure. Regarding safety endpoints, TAVR had lower rates of all-cause mortality and acute kidney injury at 1 year post-procedure, but a higher incidence of major vascular complications at both 30 days and 1 year compared with SAVR. Conclusion The results suggest that TAVR and SAVR have comparable outcomes for both TIA and stroke incidence at 30 days and 1 year post-procedure, but display varying safety profiles in intermediate-to-high surgical risk patients.

Abstract Multilevel converters have gained significant popularity in medium-voltage and high-power applications due to their numerous advantages over traditional two-level converters. These advantages include reduced harmonic distortion, improved efficiency, and lower stress on power semiconductors. Selective harmonic elimination (SHE) is a modulation method that can be employed with multilevel converters to achieve high-quality output voltage waveforms. In this work, an extension of Broyden’s method, known as the Quasi-Modified Newton Method, is implemented for selective harmonic elimination and accurate calculation of switching angles for a wide range of modulation indices. The proposed method is applied to cascaded H bridge inverters operating at levels 5, 7, and 9. The method offers simplicity, reduced computational burden, and faster convergence, making it easily implementable, reducing total harmonic distortion (THD), and reducing RMSE and MAD errors. The paper includes simulation and experimental results that validate the accuracy and effectiveness of the proposed approach.

Target tracking via Correlation Filter (CF) is a hot research area of computer vision domain, and offers various credible benefits. Existing CF algorithms face challenges when there are target appearance variations due to background noise, scale and illumination changes, occlusion, and fast motion, which severely degrades the overall tracker performance. To get maximum benefits, an object tracker should perform well with the less computational burden in the presence of real time challenging situations. To address this issue, a novel visual object tracker is proposed based on multi feature fusion and adaptive learning technique with aberrance suppression. At first, multiple features i.e., Histogram of gradient (HOG), Color Naming (CN), saliency, and gray level intensities are combined using feature fusion technique. Further, based on the evaluation of final fused response map using Peak-to-Sidelobe Ratio (PSR), an adaptive learning strategy is integrated to improve the learning phase of tracker. Tracking results show that the proposed strategy beats the other modern CF trackers with Distance Precision (DP) scores of 88.2%, 85.9%, and 74.1% and 64.7% over OTB2013, OTB2015, and TempleColor128 and UAV123 datasets respectively.

Abstract Objectives The main objective of the study was to explore the perspectives of healthcare professionals (HCPs) regarding artificial intelligence (AI) and to identify challenges in its incorporation in the healthcare sector of Pakistan. Methods A qualitative exploratory study design was adopted. The study was conducted from January 15th to February 29th, 2024, and HCPs (doctors, pharmacists and nurses) from two tertiary care teaching hospitals in southern Punjab, Pakistan were taken as the study population. The interviews were conducted with the help of a semi structured interview schema. A thematic approach was adopted to analyse the data. Results Out of 40 HCPs approached, 25 participated in the study with a response rate of 62%. The participants included in the study were doctors (14), pharmacists (6) and nurses (5). The participants had limited knowledge regarding AI and its basics. However, they showed positive perceptions about its incorporation. They believed that many of the problems faced by the healthcare sector of Pakistan can be minimized by AI incorporation. They believed that AI can boost up the efficiency of healthcare providers, reduce their workload, save time and minimize medical errors. Four main themes with multiple subthemes were identified: (1) Cognizance of AI, (2) Acceptability of AI among HCPs and training requirements for effective incorporation, (3) Merits and Demerits of AI, and (4) Challenges in incorporation of AI with proposed solutions. Conclusion HCPs showed a willingness to embrace AI incorporation and believed that it may bring numerous benefits to the health system. Policymakers should take necessary steps to ensure AI incorporation in our healthcare sector.

Abstract Ionized Mg (iMg) may offer a more reliable indicator of Mg status during acute illness than total Mg (tMg) concentrations. This study aimed to determine the prevalence of dysmagnesemia and their relationship using iMg and tMg. The clinical and biochemical characteristics as well as health outcomes and their association with iMg and tMg were also assessed. A prospective study including all eligible adult patients (≥18 years) who were hospitalized in the General Internal Medicine unit at Sultan Qaboos University Hospital (SQUH) for 3.5 months in 2023. The iMg and tMg concentrations were collected on all at the admission. In total 500 patients were included (females 49.2%) with a median age of 64.5 years (IQR: 48-77). The prevalence of hypomagnesemia and hypermagnesemia by iMg concentrations was 3.4% and 26.6%, respectively, while by tMg concentrations 13.2% and 11.0%, respectively. The agreement between both measurements was strong (r=0.665, p

Abstract Background Recently, efforts like crossbreeding, strain crossing, and inbred hybridization have been performed to improve productive performance in native chickens. This experiment was carried out to evaluate the effects of crossbreeding on the improvement of the productivity of a native chicken. The White Leghorn exotic chicken (WL) as dam line and the Marandi indigenous chicken (MA) as sire line were used to generate the crossbreds (MA × WL). Body weight and egg production traits were measured in the three groups. Results There are significant performance differences between WL and MA, with WL exhibiting superior body weight and egg production compared to MA (P

Abstract The high adoption of electric vehicles (EVs) and the rising need for charging power in recent years calls for advancing charging service infrastructures and assessing the readiness of the power system to cope with such infrastructures. This paper proposes a novel model for the integrated operation of dynamic wireless charging (DWC) and power distribution systems offering charging service to in‐motion EVs. The proposed model benefits from a hierarchical design, where DWC controllers capture the traffic flows of in‐motion EVs on different routes and translate them into estimations of charging power requests on power distribution system nodes. The charging power requests are then communicated with a central controller that monitors the distribution system operation by enforcing an optimal power flow model. This controller coordinates the operation of distributed energy resources to leverage charging power delivery to in‐motion EVs and mitigate stress on the distribution system operation. The proposed model is tested on a test distribution system connected to multiple DWC systems in Salt Lake City, and the findings demonstrate its efficiency in quantifying the traffic flow of in‐motion EVs and its translation to charging power requests while highlighting the role of distributed energy resources in alleviating stress on the distribution system operation.

Abstract Background Self-injurious thoughts and behaviours are a major global public health concern, not least because they are one of suicide’s strongest predictors. Solution-focused approaches are a psychotherapeutic approach currently being used to treat individuals with self-injurious thoughts and behaviours but there is little published evidence of their use. We conducted a scoping review to provide a comprehensive overview of how solution-focused approaches are being used to treat self-injurious thoughts and behaviours. Methods Publications describing a solution-focused approach being delivered to any individuals experiencing any form of self-injurious thought and/or behaviour were eligible for inclusion. Five databases were searched (EMBASE, PubMed, Web of Knowledge, PsycINFO, and Google Scholar) from inception to August 2024. Search terms contained keywords relating to both solution-focused and self-injurious thoughts and/or behaviours. Data were analysed using relevant steps from a narrative synthesis approach to summarise the participants, concepts, context and outcomes described in the included publications. Results Twenty-four publications were included in the review. Publications demonstrated a global reach although the majority were published in the UK and USA. Five publications formally assessed and reported outcomes; two randomised controlled trials, one experimental pilot study, one case study, and one single group study. Only the Beck Depression Inventory was collected in more than one study (n = 4), with a range of other psychopathology and wellbeing-related measures. Three studies reported qualitative data, finding positive perceptions of the approaches by patients and clinicians. Fifty-one unique components were identified within solution-focused approaches. Often specific adaptations were described, or components were introduced, that specifically addressed suicide or self-harm. For example, identifying and working on goals related to reducing or stopping self-harm, or scaling questions that assess how suicidal someone currently feels on a 0 to 10 scale. Conclusions This review demonstrates the application of solution-focused approaches for treating individuals with self-injurious thoughts and behaviours. The findings provide a comprehensive overview of how these approaches are delivered. The lack of outcome data and empirical studies highlights a need for more formalised evidence.

OBJECTIVE: To investigate the relationship between repeated blood transfusions and growth retardation in children with transfusion-dependent Thalassemia in Peshawar, Pakistan. METHODS: This cross-sectional study was conducted on transfusion-dependent thalassemia patients receiving treatment at the Fatimid Foundation, Peshawar Pakistan, between February and August 2022. Participants were categorized by age (2 years) to assess and measure growth patterns over six months. RESULTS: Out of 93 children with thalassemia major, 55 (59.1%) males and 38 (40.9%) females. Mean age of the participants was 10.86 ± 5.72 years, and mean age at their first transfusion was 8.13 ± 5.78 months. Mean body mass index was 16.38 ± 1.82 kg/m². Short stature was observed in 49 patients (52.7%), of whom 57.1% (n=28) were male and 42.9% (n=21) were female. Serum ferritin levels were significantly elevated in patients with short stature, with 57.1% (n=28/49) having ferritin levels >4001 μg/L compared to 40.9% (n=18/44) with normal stature. Only 3.2% of patients had normal ferritin levels. The ROC analysis identified a ferritin cut-off of 1636 μg/L for predicting short stature (sensitivity 86%, specificity 68%). Growth assessment showed that 71% of the children were

Context: Medical educators face different challenges in this digital era with the pressure for clinical practice as well as teaching. In blended learning Internet technologies are used along with face-to-face teaching to deliver learning methodologies. OBJECTIVE: To assess the efficacy of the blended learning dermatology course on Family Medicine residents at a teaching hospital. Methodology: It was interventional (pre and post) study with purposive sampling. All the Family Medicine residents enrolled at The Aga Khan University Hospital participated in the study after giving consents. The course covered most common skin conditions. Multiple slide sessions, online lectures, clinical presentations, case-based scenarios, and quizzes were included in the course. Knowledge was assessed through pre- test by multiple choice questions. Post tests were taken after completion of the modules to assess the improvement in the knowledge of residents about basic dermatological conditions by multiple choice questions. After completion of sessions a survey questionnaire was administered to evaluate the perception of participants about blended learning strategy. Results: The tests scores were significantly higher in the post test. The majority of the residents were satisfied with the course delivery. A statistically significant difference was found between pre and post test results with a P value 0.000. Conclusions and Recommendation: Blended learning is an effective and innovative teaching strategy that helped family medicine residents to enhance their learning more effectively. We recommend that this method of teaching strategy should be used in other clinical disciplines in different contexts.didifferent contexts.

Abstract Using a modified proximity extension assay, total and immunoglobulin (Ig) class-specific anti-SARS-CoV-2 antibodies were sensitively and conveniently detected directly from ø1.2 mm discs cut from dried blood and saliva spots (DBS and DSS) without the need for elution. For total Ig detection, antigen probes were prepared by conjugating recombinant spike protein subunit 1 (S1-RBD) to a pair of oligonucleotides. To detect isotype-specific antibody reactivity, one antigen probe was replaced with oligonucleotide-conjugated antibodies specific for antibody isotypes. Binding of pairs of oligonucleotide-conjugated probes to antibodies in patient samples brings oligonucleotides in proximity. An added DNA polymerase uses a transient hybridization between the oligonucleotides to prime synthesis of a DNA strand, which serves as a DNA amplicon that is quantified by real-time PCR. The S1-RBD-specific IgG, IgM, and IgA antibodies in DBS samples collected over the course of a first and second vaccination exhibited kinetics consistent with previous reports. Both DBS and DSS collected from 42 individuals in the autumn of 2023 showed significant level of total S1-RBD antibodies with a correlation of R = 0.70. However, levels in DSS were generally 10 to 100-fold lower than in DBS. Anti-S1-RBD IgG and IgA in DSS demonstrated a correlation of R = 0.6.

Abstract Background Ankylosing spondylitis (AS) is a chronic inflammatory condition primarily affecting the spine and sacroiliac joints, often associated with human leukocyte antigen B27 (HLA-B27) positivity. While musculoskeletal symptoms are typical manifestations, AS can also lead to systemic complications, including secondary systemic amyloidosis (SSA), also known as Amyloid A (AA) amyloidosis, involving multiple organs. Case presentation We present a case of a 45-year-old Asian male with a complex medical history, including diabetes and hypertension, who developed AS complicated by SSA. The patient exhibited a diverse range of symptoms, including cardiac, renal, gastrointestinal, and musculoskeletal manifestations. He reported shortness of breath on exertion, orthopnea, pedal edema, generalized weakness, back pain, neck pain, low-grade fever, decreased appetite, frothy urine, and significant weight loss over the past year. Diagnostic evaluations revealed HLA-B27 positivity and histologically confirmed AA amyloidosis, providing a comprehensive understanding of the systemic involvement. Conclusion This case report highlights the intricate interplay between AS and SSA, particularly AA amyloidosis, with a focus on its systemic impact beyond musculoskeletal symptoms. The tragic outcome, marked by severe cardiac involvement, underscores the challenges in managing such complex cases. This report emphasizes the importance of early diagnosis and treatment of AS to prevent severe complications, along with vigilant monitoring and individualized treatment plans, as well as the need for further research to enhance our understanding and improve management strategies for AS-related amyloidosis.

Caruncular Oncocytoma (CO) is a benign epithelial tumor, frequent in elderly females. Caruncular lesions are rare compared to conjunctival lesions, with a reported incidence of 0.3 to 1.1 %, and histologically proven oncocytoma are 0.3 million/year. The mitochondrial and somatic gene mutations, resulting in defective oxidative phosphorylation, are responsible for oncocytoma. This reduces ATP, resulting in a decrease in energy production, which, in compensation, increases mitochondrial content. The common complaint is epiphora, which is excessive lacrimation. CO is composed of oncocytes with fine, eosinophilic cytoplasm containing numerous mitochondria. A 60-year-old lady presented in an Ophthalmology outdoor clinic with a small, nodular, painless, reddish-colored swelling at the inner canthus of the left eye for three years. No clinical complaints and visual disability were noted. On physical examination, a mass with overlying, reddish-colored mucosa was located at the medial canthus of the left eye. Excision in Toto was done. Grossly, there was a 10 mm × 5 mm × 5 mm smooth surfaced, red-colored mass with round contours. Microscopy showed a wellencapsulated mass with overlying thinned-out stratified squamous epithelium and sebaceous glands. The underlying lesion is composed of tall, columnar, uniform cells with round to oval nuclei, fine chromatin, and abundant granular cytoplasm.

Abstract Background One of the most common congenital conditions detected globally, congenital heart diseases, and CT techniques provide a high-quality and thorough presentation of heart anatomy, thoracic vasculature, and extracardiac structures, and hence, it is becoming a more popular non-invasive diagnostic imaging method for congenital heart disease. The drawbacks with CT imaging are the radiation exposure from repeated scans is also rising, especially in young patients. The present study is aimed to evaluate the radiation dose in gated and non-gated cardiac CT for preoperative diagnosis of pediatric patients with congenital heart diseases. Results A total of 111 pediatric patients with mean age of 7.47 years were prospectively included in the study. The mean value of “Effective dose (E)” for gated CT at $$100\;{\text{kV}}_{{\text{p}}}$$ 100 kV p was found to be $$4.71\;{\text{mSv}}$$ 4.71 mSv which is higher than mean “E” of $$3.95\;{\text{mSv}}$$ 3.95 mSv observed for gated CT at $$80\;{\text{kV}}_{{\text{p}}}$$ 80 kV p . The average value of “E” for non-gated technique was observed less than that of gated technique at both $$100\;{\text{kV}}_{{\text{p}}}$$ 100 kV p and $$80\;{\text{kV}}_{{\text{p}}}$$ 80 kV p . The multiple regression analysis shows that “E” is significantly dependent on $${\text{DLP}}\left( {{\text{mGy}}\;{\text{cm}}} \right)$$ DLP mGy cm for both gated and non-gated techniques at 95% level of significance $$\left( {p < 0.05} \right)$$ p < 0.05 . The Student’s t-test verifies that the mean value of “E” for both the techniques at $$100\;{\text{kV}}_{{\text{p}}}$$ 100 kV p and $$80\;{\text{kV}}_{{\text{p}}}$$ 80 kV p are significantly different at 95% level of significance $$\left( {p < 0.05} \right)$$ p < 0.05 . Conclusions The effective dose received by pediatric patients is much higher when using ECG-gated acquisition with an average value of $$4.71\;{\text{mSv}}$$ 4.71 mSv and $$3.95\;{\text{mSv}}$$ 3.95 mSv at $$100\;{\text{kV}}_{{\text{p}}}$$ 100 kV p , and at $$80\;{\text{kV}}_{{\text{p}}}$$ 80 kV p respectively. Because low-voltage X-rays are more sensitive to high atomic number iodinated contrast media, the mean “E” for non-gated cardiac CT imaging at $$80\;{\text{kV}}_{{\text{p}}}$$ 80 kV p is $$2.26\;{\text{mSv}}$$ 2.26 mSv , and results in significant reduction of effective dose.

Abstract Background Pakistan reported 1.57 million COVID-19 cases between 2020 and 2022, based on approximately 30.6 million SARS-CoV-2 RT-PCR (reverse-transcription polymerase chain reaction) tests conducted. This study utilized data from one of the largest in-country testing facilities, Aga Khan University Hospital (AKUH) in Karachi, Pakistan, to explore gender and age-related in RT-PCR testing patterns. Methods We conducted a retrospective review of SARS-CoV-2 RT-PCR test data extracted from AKUH clinical laboratory records between February 2020 and February 2022. Gender and age distributions were examined in the context of testing patterns across the period. Multivariate regression models assessed independent associations between COVID-19 positivity and key variables. Results We reviewed 470,249 RT-PCR tests, finding that most tests were in those aged 21–40 years (48.1%). Overall, COVID-19 test positivity was 20.6%. In all, 57.7% were performed for males, predominant amongst those tested across all age groups and waves. Females had significantly lower odds of testing positive for COVID-19 (OR: 0.9; 95% CI: 0.9-1.0). However, when adjusted for gender, age and pandemic phases, the positivity rates between males and females were the same. The odds of a positive result increased significantly with age; individuals aged > 80 years had 2.5 times higher odds of testing positive than those aged 0–10 years (aOR 2.5, 95% CI 2.3–2.7). Conclusions The analysis indicates a consistent male dominance in COVID-19 testing, with higher positivity rates in older age groups. Our study highlight the importance of examining demographic characteristics in disease associated data especially, representation of females amongst cohorts.

Abstract Background Patient and public involvement and engagement (PPIE) in clinical trials is increasingly recognized as vital for ensuring research relevance and accessibility. Despite its proven benefits, PPIE remains limited, particularly in low- and middle-income countries, and more examples of effective strategies for involvement are needed. This commentary outlines the establishment of a PPIE group for clinical trials in a lower-middle-income country setting with limited research infrastructure. Main Body We established Pakistan’s first ever PPIE group for clinical trials within a new clinical trials unit at Ziauddin University in Karachi. The objectives of our project were focused on group formation, redesign of informed consent documents for trials, and dissemination of trial results to the public. Recruitment strategies involved referrals from clinicians and existing collaborators as well as engagement at public events, distribution of advertising leaflets and social media posts. Ten potential members were selected based on motivation, commitment and ability to contribute critically, with six members continuing their involvement long-term. An existing tool designed to establish the access needs of public partners was adapted to our project to help us document and account for members’ expectations and support requirements. The process of using the tool enabled deep engagement, clarified roles, and fostered trust between coordinators and group members. Patient and public members gained confidence about the legitimacy of the project and felt more comfortable participating in the first group meeting. Lessons learned emphasize the importance of wide-ranging engagement efforts and transparent discussions about expectations to build effective collaborative relationships. Conclusion Our experience demonstrates the feasibility of establishing a PPIE group for clinical trials in Pakistan and highlights strong public interest for research involvement. The use of a formal tool to document needs, prior experiences and expectations encouraged relationship-building and helped coordinators make relevant accommodations for members. This account contributes to the growing body of literature on effective PPIE practices, emphasizing the value of tailored support and transparent communication in facilitating meaningful public involvement in clinical trials.

Abstract Linear polarization (LP) and circular polarization (CP) holds paramount importance in Ku, K, and Ka bands for satellite based communication, and remote sensing applications. Satellite based remote sensing applications face challenges like atmospheric attenuation, noise & interference, and signal degradation. Moreover, satellite based communication application demands CP in two distinct, non-adjacent frequency bands with orthogonal polarizations at greater oblique angles, considering the unpredictable incidence angles of electromagnetic (EM) waves. Addressing these challenges, an innovative metasurface polarization converter is proposed to operate efficiently across the Ku-band (13.5–18.0 GHz), K-band (18.0–26.5 GHz), and Ka-band (26.5–38.5 GHz) frequency ranges. The converter achieves left-handed circular polarization (LHCP) in the Ku- and Ka-bands within the frequency ranges of 14.57–15.65 GHz and 27.47–33.85 GHz for y-polarized incident EM waves. Additionally, it provides right-handed circular polarization (RHCP) in the K- and Ka-bands at 17.27–23.92 GHz and 35.87–38.32 GHz for y-polarized incident EM waves. The LP conversion ratio exceeds 95% in the frequency bands of 15.97–16.85 GHz, 24.70–26.65 GHz, and 34.37–35.45 GHz for y-polarized, LHCP, and RHCP incident EM waves, respectively. The metasurface exhibits robust performance up to incidence angles of 45 degrees under oblique conditions. Experimental validation using traditional board-circuit manufacturing demonstrates close agreement between measured co- and cross-polarized reflection coefficients and simulations in the 13.5–18 GHz, and 24–38.5 GHz frequency range. Thin metasurface with a thickness of only 0.64 = 0.013λ o mm, the proposed design outperforms existing studies in the literature, establishing its competitive edge in terms of structure and performance.

This paper proposes a deep neural network (DNN)-based approach for radiation pattern synthesis of 8 elements phased array antenna. For this purpose, 181 points of a desired radiation pattern are fed as input to the DNN and phases of array elements are extracted as the outputs. Existing DNN techniques for radiation pattern synthesis are not directly applicable to higher-order arrays as the dataset size grows exponentially with array dimensions. To overcome this bottleneck, we propose novel and efficient methods of generating datasets for DNN. Specifically, by leveraging the constant phase-shift characteristic of the phased array antenna, dataset size is reduced by several orders of magnitude and made independent of the array size. This has considerable advantages in terms of speed and complexity, especially in real-time applications as the DNN can immediately learn and synthesize the desired patterns. The performance of the proposed methods is validated by using an ideal square beam and an optimal array pattern as reference inputs to the DNN. The results generated in MATLAB as well as in CST, demonstrate the effectiveness of the proposed methods in synthesizing the desired radiation patterns.

Background: Methamphetamine use can provide a quick and pleasurable rush, increased energy, heightened attention, and euphoria, but may also result in many adverse effects. Various cell lines have been utilized in vitro to determine the adverse impacts of methamphetamine on those cells. As enough data are not available on the effect of methamphetamine on skin fibroblast cells, this study determined its in vitro effect on proliferation, differentiation and apoptosis of human skin fibroblast cells.Methods: Phenotypic characteristics of fibroblasts cells were determined and real-time PCR examined the expression of matrix metalloproteinase1 (MMP1), matrix metalloproteinase 3 (MMP3), integrin alpha 11 (ITGA11), CD106, CD10, and CD26 markers. MTT assay checked the toxicity of recreational doses of 6 and 60 μM of methamphetamine. Quantitative real time polymerase chain reaction (qPCR) assessed expression of Bax, Bcl-2 and PPARγ genes.Results: Fibroblast cells were morphologically spindle-shape and were positive for fibroblast markers of CD10, CD26, MMP1 and MMP3 and negative for mesenchymal markers of ITGA11 and CD106. MTT assay revealed a decline in proliferation of fibroblast cells when they were exposed to methamphetamine. The expression of Bax and PPARγ genes increased and decreased for Bcl-2 gene after exposure of cells to methamphetamine.Conclusion: Our results confirmed adverse effects of methamphetamine on proliferation, viability and differentiation of skin fibroblast cells revealing a reduction in cell proliferation and differentiation as well as an increase in cell apoptosis. These findings can open a window to health status of people who target methamphetamine use for recreational purposes.

Abstract Among various natural hazards, those induced by hydrological and meteorological factors have emerged as the most frequent and damaging. India is at the second from the top, after Bangladesh, of flood hazard-affected countries of the world, causing immense damage to life and property every year. The Middle Ganga Plain in the country is one of the most severely affected regions due to the convergence of Himalayan rivers in the Ganga (Ganges) plain. This study focuses on optimizing novel ensemble models to enhance the mapping of flood hazard susceptibility in specific topoclimatic setting, characterized by a low-altitude-range, sub-tropical monsoonal climate, and a riverine floodplain environment of the tectonically active Middle Ganga Plain. This region forms part of the Ganga Foreland Basin prone to frequent floods. We employ a comprehensive flood inventory and twelve selected flood conditioning factors and is the first study that has developed these ensemble models in low relief riverine floodplain environmental setting with high resolution geomorphology as one of the conditioning factors. Four artificial intelligence ensemble models were employed in this work: Logistic Regression-Evidential Belief Function (LR-EBF), Logistic Regression-Frequency Ratio (LR-FR), Multi-Layer Perceptron-Evidential Belief Function (MLP-EBF), and Multi-Layer Perceptron-Frequency Ratio (MLP-FR). Results showed that LR-based ensembles outperformed MLP-based ensembles in the studied topoclimatic setting, with LR-EBF model achieving 87.2% and 84.7% success and prediction rates respectively. Our results reveal consistent performance differences between LR-based ensembles with FR and EBF models across different environmental settings. MLP-based ensembles, particularly with Frequency Ratio, displayed more significant performance variations. The findings underscore the importance of considering specific topoclimatic and altitudinal range environments when applying flood hazard susceptibility models. Our study also provides valuable insights for planning and policymaking in flood management practices in similar topoclimatic settings worldwide.