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European grassland management has often favoured high production through frequent mowing and heavy fertilisation over biodiversity conservation, which is typically supported by less intensive management. Besides management, climate change and extremes are increasingly affecting grassland productivity and biodiversity, requiring timely adaptation of management practices. Here, we describe the development of a prototype Digital Twin (pDT) of grassland biodiversity dynamics intended to support researchers, farmers or regulatory decision-makers in monitoring the current state of selected grassland sites and projecting their future state under various management and climate scenarios. [ABSTRACT FROM AUTHOR]

Invasive alien species (IAS) threaten biodiversity and human well-being. These threats may increase in the future, necessitating accurate projections of potential locations and the extent of invasions. The main aim of the IAS prototype Digital Twin (IAS pDT) is to dynamically project the level of plant invasion at habitat level across Europe under current and future climates using joint species distribution models. The pDT detects updates in data sources and versions of the datasets and model outputs, implementing the FAIR principles. The pDT's outputs will be available via an interactive dashboard. All input and output data will be freely accessible. [ABSTRACT FROM AUTHOR]

The 2022 mpox (formerly monkeypox) outbreak affected predominantly men who have sex with men (MSM), likely through sexual transmission, which resulted in institutions specializing in sexual health being at the frontlines of the mpox outbreak. Fenway Health in Boston serves close to 10 000 MSM annually, which includes more than 2400 MSM who are living with HIV and 3320 MSM with active HIV preexposure prophylaxis (PrEP) prescriptions. We report on the programs implemented and changes to clinical practice at Fenway Health during the mpox outbreak. Fenway Health diagnosed its first case of mpox in June 2022 and treated this patient with tecovirimat. In early July 2022, Fenway Health administered its first dose of the Jynneos vaccine under the Emergency Use Authorization for protection against mpox. As of October 6, 2022, 69 people had tested positive for the mpox virus at Fenway Health. Among the 69 people who tested positive, 43 (62.3%) self-identified as male, with the remaining not reporting a sex or gender identity, and 40 (58.0%) reported their sexual orientation as gay or bisexual. Twenty-five people (36.2%) were treated with tecovirimat. As of October 30, 2022, Fenway Health had administered 6376 doses of the Jynneos vaccine. The programmatic changes involved in rollout and scale-up of vaccination, treatment, and community outreach services at Fenway Health during the 2022 mpox outbreak that we describe here could inform strategies to address subsequent outbreaks. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to estimate the magnitude of capital flight from Pakistan. Furthermore, it analyzes the impact of capital flight on the economic growth of Pakistan in the short and long run. Design/methodology/approach: This study uses the World Bank's residual method to estimate the magnitude of capital flight from Pakistan during 1976–2018. This study used the autoregressive distributed lag (ARDL) approach to estimate the effect of capital flight on the economic growth of Pakistan. Findings: ARDL results revealed a negative and statistically significant relationship between different measures of capital flight and economic growth in the long run. However, this relationship is not statistically significant in the short run. After correction for external borrowing and trade misinvoicing, this study finds that the total capital flight from Pakistan during the study period amounted to US$333bn (in 2010 dollars). With accrued interest earnings, the stock of capital amounted to US$124,768bn, significantly higher than the accumulated stock of long-term debt, which amounted to US$1,231bn during the study period indicating that Pakistan faces a severe challenge of capital flight. Originality/value: This study calculates the magnitude of capital flight from Pakistan for the first time. Furthermore, this study also calculates the magnitude of capital flight for military and democratic regimes. This study suggests many policy proposals to deal with the challenge of capital flight. [ABSTRACT FROM AUTHOR]

In this paper, a model based on constraint convex optimization is proposed for the radiation pattern synthesis in cylindrical and spherical microstrip conformal array antennas. The optimization algorithm is modeled to decrease the Euclidean distance between the obtained radiation pattern of the deformed array and the desired radiation pattern of the planar array by calculating the suitable amplitude and phase values for the individual array patches. Four prototypes of 2 × 2 , 3 × 3 , 4 × 4 , and 5 × 5 microstrip patch array antenna are used as the radiating elements which are deformed from planar arrangement and placed on the faces of prescribed spherical and cylindrical shapes with various radii of curvatures. The results reveal that the performance of optimization algorithm performs better in 5 × 5 array, followed by 4 × 4 array, 3 × 3 array, and 2 × 2 array. However, 5 × 5 array provides more degrees of freedom for tuning the radiation pattern in desired form. The 5 × 5 array computes suitable amplitude and phase values for the radiating elements of the array, which restore the radiation pattern in terms of mainlobe reconstruction, null locations, sidelobe levels, up to the deformation of 20   cm in both spherical and cylindrical configurations of conformal array. The proposed optimization technique when applied to conformal antenna array offers fast computational speed and good convergence accuracy for radiation pattern synthesis, which can be useful for various engineering applications. [ABSTRACT FROM AUTHOR]

Background: A minimum of 170 million individuals worldwide are thought to have chronic obstructive pulmonary disease (COPD), a common lung illness marked by reversible airflow limitation and chronic inflammation of the airways. Recent research indicated that symptoms associated with gastroesophageal reflux disease (GERD) are more prevalent in individuals with COPD. Objective: Objective of the present study was to find out the frequency of GERD in COPD patients. Methodology: The study was conducted at a Rehman medical institute in Pakistan from January 2022 to June 2022, using a cross-sectional design. Data was collected from 160 COPD patients, who underwent a comprehensive clinical examination and history. All these patients were assessed for GERD through a frequency scale for the symptoms of GERD (F.S.S.G questionnaire) instead of endoscopy and PH assessment. Spirometry was performed on each patient, and the findings were analyzed by a fellow specialist. The study also determined the frequency of GERD in COPD patients. SPSS version 23 was used for data analysis. Results: The current cross-sectional study includes a total of 160 participants including both males and females selected through a purposive sampling technique. Among them, 63.75% were males and 36.24% were female participants. The overall prevalence of GERD among the participants was 45%. GERD was found in 31.94%, 40.27 % and 16. 66 % among moderate, severe, and very severe cases of COPD. Conclusion: The study findings indicate that GERD was found in 45% of individuals with COPD. This underscores the importance for healthcare providers to thoroughly assess COPD patients for GERD to prevent further complications and enhance their quality of life. [ABSTRACT FROM AUTHOR]

HIV pre-exposure prophylaxis (PrEP) is highly effective, but PrEP use has been suboptimal. We describe a telementoring program for clinics in high-HIV burden areas, focusing on systems-level practice transformation and care for populations disproportionately affected by HIV. We developed and delivered a telementoring program for U.S. health centers. We analyzed participants' baseline and post-session surveys to ascertain experiences providing PrEP and caring for people disproportionately affected by HIV, comparing responses between medical and behavioral health clinicians. Forty-eight people from 16 health centers participated. Medical clinicians were more likely than behavioral health clinicians to care for people taking PrEP, but the groups did not differ in self-rated capacity to counsel about PrEP or care for populations disproportionately affected by HIV. Virtual training on practice transformation for PrEP, involving medical and behavioral health clinicians, is feasible and acceptable. PrEP training and delivery efforts should include behavioral health clinicians. [ABSTRACT FROM AUTHOR]

Pseudomonas aeruginosa is an opportunistic Gram-negative bacterium implicated in acute and chronic nosocomial infections and a leading cause of patient mortality. Pseudomonas aeruginosa infections are frequently associated with the development of biofilms, which give the bacteria additional drug resistance and increase their virulence. The goal of this study was to find strong compounds that block the Anthranilate-CoA ligase enzyme made by the pqsA gene. This would stop the P. aeruginosa quorum signaling system. This enzyme plays a crucial role in the pathogenicity of P. aeruginosa by producing autoinducers for cell-to-cell communication that lead to the production of biofilms. Pharmacophore-based virtual screening was carried out utilizing a library of commercially accessible enzyme inhibitors. The most promising hits obtained during virtual screening were put through molecular docking with the help of MOE. The virtual screening yielded 7/160 and 10/249 hits (ZINC and Chembridge). Finally, 2/7 ZINC hits and 2/10 ChemBridge hits were selected as potent lead compounds employing diverse scaffolds due to their high pqsA enzyme binding affinity. The results of the pharmacophore-based virtual screening were subsequently verified using a molecular dynamic simulation-based study (MDS). Using MDS and post-MDS, the stability of the complexes was evaluated. The most promising lead compounds exhibited a high binding affinity towards protein-binding pocket and interacted with the catalytic dyad. At least one of the scaffolds selected will possibly prove useful for future research. However, further scientific confirmation in the form of preclinical and clinical research is required before implementation. [ABSTRACT FROM AUTHOR]

Objective: To investigate the frequency of Depression in Patients with Rheumatic and Musculoskeletal diseases with particular emphasis on gender and compliance to treatment. Study Design: Descriptive, Cross-sectional study. Setting: Department of Rheumatology at Lady Reading Hospital, Peshawar. Period: August 2020 to February 2021. Material & Methods: A total of 189 patients were assessed with their detailed history, examination, and lab data collected. Depressive symptomatology was evaluated using DSM - 4 criteria. SPSS 26 was utilised for data analysis, and a p-value of<0.05 was considered statistically significant. Results: 131 (69.3%) were female and 58 (31.7%) were male patients. Seropositive Rheumatoid Arthritis ranked the highest concerning the diagnosis with 128 cases (68.25%). Methotrexate was the most commonly used drug with 134 (70.9%) patients receiving it. A total of 169 (89.4%) patients had Depressive disorder, with females outnumbering males, a finding reaching statistical significance (p=0.04). Conclusion: Undiagnosed Depression is common in patients affected by Rheumatic and Musculoskeletal diseases, especially among the female population. Routine screening for depressive symptoms with subsequent referral to the mental health service may serve detection of this comorbidity and improve patient outcomes. [ABSTRACT FROM AUTHOR]

Objective: To investigate the frequency of Depression in Patients with Rheumatic and Musculoskeletal diseases with particular emphasis on gender and compliance to treatment. Study Design: Descriptive, Cross-sectional study. Setting: Department of Rheumatology at Lady Reading Hospital, Peshawar. Period: August 2020 to February 2021. Material & Methods: A total of 189 patients were assessed with their detailed history, examination, and lab data collected. Depressive symptomatology was evaluated using DSM - 4 criteria. SPSS 26 was utilised for data analysis, and a p-value of<0.05 was considered statistically significant. Results: 131 (69.3%) were female and 58 (31.7%) were male patients. Seropositive Rheumatoid Arthritis ranked the highest concerning the diagnosis with 128 cases (68.25%). Methotrexate was the most commonly used drug with 134 (70.9%) patients receiving it. A total of 169 (89.4%) patients had Depressive disorder, with females outnumbering males, a finding reaching statistical significance (p=0.04). Conclusion: Undiagnosed Depression is common in patients affected by Rheumatic and Musculoskeletal diseases, especially among the female population. Routine screening for depressive symptoms with subsequent referral to the mental health service may serve detection of this comorbidity and improve patient outcomes. [ABSTRACT FROM AUTHOR]

Afghanistan is home to the largest illicit drug industry in the world. The depth, influence, and impact of its narco-economy remain unparalleled. Illicit drug production has become a dominant feature of Afghanistan's landscape. The opium economy is pervasive and deeply entrenched. Afghanistan's opium economy has become the source of security rather than the state. Therefore, the degree of dependence on the opium economy has thus become unprecedented in the modern history of drug production. The dependence means any immediate attempt toward opium poppy prohibition/eradication will result in political and socioeconomic crises not only in Afghanistan but the transit states in the region as well. In context of narco-economy, this paper expostulate that the construction of security in traditional and nontraditional discourse are linear, i.e. detached from reality or suffers from moralistic constraint, and therefore, needs to be revisited in line with ground reality of Afghanistan and transit states at large. Deviating from conventional literature on drug-security nexus, the paper argues that a complete prohibition of poppy cultivation in Afghanistan is by far a larger security concern than its retention. This research paper, therefore, takes a cursory examination of the security implications and challenges that may ensue as a result of a diminished production capacity of Afghanistan's opium economy either experienced through complete prohibition, eradication programs or through natural calamity. [ABSTRACT FROM AUTHOR]

Objective: To compare the ease of placement of arterial catheters using palpation versus ultrasound guidance under aseptic measures. Study Design: Quasi-experimental study. Place and Duration of Study: Combined Military Hospital, Rawalpindi Pakistan, from Feb to Aug 2022. Methodology: Patients of either gender, aged 18 to 90 years presenting to a paranesthesia clinic that required intra-arterial blood pressure monitoring were included in the study. After induction, under General Anaesthesia, arterial lines were placed following an aseptic technique using ultrasound or palpatory method; in Group-U (ultrasound) or Group-P (Palpation), respectively. Demographic variables of the patient along with hemodynamic readings and success rate at first or multiple attempts, along with the total time of cannulation, were recorded. Results: Out of the total 74 patients, 59(79.7%) patients belonged to ASA-1 Grade, and 15(20.3%) patients in ASA-2 Grade. The mean age of the patients was 48.3±16.3, while mean BMI was 25.42±2.8kg/m2. In Group-P, the first-pass success was achieved in 19(51.4%) patients as compared to 32(86.5%) in Group-U when ultrasound was used (p<0.05). Conclusion: The success rate in placing an arterial line using ultrasound was significantly greater than the conventional palpatory method. Therefore, ultrasound should be a preferred modality during intra-arterial line placement. [ABSTRACT FROM AUTHOR]

In this paper, a modified convex optimization technique is used for radiation pattern correction in a cylindrical‐shaped conformal microstrip array antenna. The technique uses numerical simulations to optimize the amplitude and phase excitations, with the goal to decrease the Euclidean distance between the desired field pattern and the obtained (simulated/measured) field pattern while maintaining the main beam direction, null's location, and side lobe levels under control. Two prototypes of 1×4 and 2×4 conformal microstrip antenna array deformed from linear/planar structure to the prescribed cylindrical shape, with different radii of curvature, are studied to demonstrate the performance of the proposed technique. The proposed convex optimization model when applied to conformal antenna array possesses fast computing speed and high convergence accuracy for radiation pattern synthesis, which can be a valuable tool for engineering applications. [ABSTRACT FROM AUTHOR]

The interest in the use of mathematical models for the simulation of hydrological processes has largely increased especially in the prediction of runoff. It is the subject of extreme research among engineers and hydrologists. This study attempts to develop a simple conceptual model that reflects the features of the arid environment where the availability of hydrological data is scarce. The model simulates an hourly streamflow hydrograph and the peak flow rate for any given storm. Hourly rainfall, potential evapotranspiration, and streamflow record are the significant input prerequisites for this model. The proposed model applied two (2) different hydrologic routing techniques: the time area curve method (wetted area of the catchment) and the Muskingum method (catchment main channel). The model was calibrated and analyzed based on the data collected from arid catchment in the center of Jordan. The model performance was evaluated via goodness of fit. The simulation of the proposed model fits both (a) observed and simulated streamflow and (b) observed and simulated peak flow rate. The model has the potential to be used for peak discharges' prediction during a storm period. The modeling approach described in this study has to be tested in additional catchments with appropriate data length in order to attain reliable model parameters. [ABSTRACT FROM AUTHOR]

Objective: To compare the ease of intubation using glide scope video laryngoscope versus direct laryngoscopy for nasotracheal intubation. Study Design: Quasi experimental study. Place and Duration of Study: Combined Military Hospital, Rawalpindi Pakistan, Aug 2022 to Feb 2023. Methodology: Patients of either gender with age greater than 18 years with American Society of Anesthesiologists (ASA) Grade I or Grade II planned for elective dental or maxillofacial procedures requiring nasotracheal intubation were included. A total of 60 patients were included, with 30 patients in each group. Recorded variables were time to intubate, glottic grade, use of Magill forceps, first attempt success, failure to intubate and postoperative sore throat. Results: With 60 patients after randomised allocation, 30 were allocated to Group-DL (Direct laryngoscopy) and Group-VL(Video laryngoscopy). The success rate in the first attempt was 27(90%) in Group-DL vs 30 (100%) in Group-VL, and the number of patients who could not be intubated was 1(3.3%) vs 0(0%) in both groups. The glottic grade recorded by the operator under vision, time to intubation, use of Magill forceps and post-operative sore throat in both groups was significant with a p-value of <0.05. Conclusion: Glide scope video laryngoscopy provides a better view of the vocal cords with less time to intubation, greater chances of successful intubation, and fewer post-operative chances of sore throat than direct laryngoscopy. [ABSTRACT FROM AUTHOR]

Objective: To analyze the perceptions of health care professionals from a variety of fields (Anesthesia, Radiology, Gynecology, Surgery, and Orthopedics) on inter-professional socialization in a clinical setting to determine any potential disparities between educational training and to identify gaps. Method: After obtaining ethical approval and informed consent, a cross-sectional study was conducted from April to June 2023 on 150 Healthcare professionals (Residents of Anesthesiology, Radiology, Gynaecology & Obstetrics, General Surgery and Orthopedics) working at CMH/PEMH. Consecutive non-probability sampling was utilized to collect the data. A closeended questionnaire with interprofessional socialization and valuing scale was administered to the participants, providing proper instructions through hard copy and Google Forms. Data was analyzed by using SPSS version 25. Descriptive statistics were applied. Results: Study results revealed that participants developed a recognition of the advantages of inter-professional collaboration with the highest score of valuing patient-centred care followed by self-perception of team responsibility and the lowest score of comfort in working with others. Conclusion: This research gives a unique perspective on the experiences of health science professionals from various fields (Anesthesiology, Gynecology, Orthopedics, Radiology, and Surgery) in Interprofessional socialization. [ABSTRACT FROM AUTHOR]

The application of coal ash (CA) in construction industries has grown rapidly, posing risk to the environment due to heavy metals leaching from the material. This research presents a simulation of ecological risk assessment and model risk indicators (ERI) of leached heavy metals (lead (Pb), copper (Cu), zinc (Zn) and arsenic (As)) from CA (FA: fly ash and BA: bottom ash) via response surface methodology (RSM). The ERI values were based on quantified leached heavy metals from the toxicity characteristic leaching procedure (TCLP-1311) and synthetic precipitation leaching procedure (SPLP-1312). The ecological risk index ( R I ) values for TCLP were 10.27 × 100 (FA), 9.91 × 100 (BA) and 12.58 × 100 (FA + BA); whereas R I for SPLP were 10.34 × 100 (FA), 9.90 × 100 (BA) and 12.61 × 100 (FA + BA). Twenty-nine combinations of operations were evaluated based on Box-Behnken design with ERI as the response variable. The established model risk indicator (i.e., coded and actual factors) of Pb, Cu, Zn and 'As' showed significant model terms that describe their relationship very well, perfectly fit to the corresponding ERI (sum of squares = 0.4160, F value = 682,375.55) with probability of 0.01% for an F-value could occur due to noise. The optimized models were validated with error percentage of less than 5%. The established ERI models showed significant model terms and will be useful for ecological monitoring of CA application in construction industries. [ABSTRACT FROM AUTHOR]

Background: The HIV Prevention Trials Network (HPTN) 083 trial showed that long-acting injectable cabotegravir was more effective than tenofovir disoproxil fumarate plus emtricitabine in preventing HIV in cisgender men and transgender women who have sex with men. We aimed to characterise the cohort of transgender women included in HPTN 083., Methods: HPTN 083 is an ongoing, phase 2b/3, randomised, multicentre, double-blind, double-dummy clinical trial done at 43 sites in seven countries (Argentina, Brazil, Peru, the USA, South Africa, Thailand, and Viet Nam). HIV-negative participants were randomly assigned (1:1) to receive injectable cabotegravir or tenofovir disoproxil fumarate plus emtricitabine. The study design and primary outcomes of the blinded phase of HPTN 083 have already been reported. An enrolment minimum of 10% transgender women was set for the trial. Here we characterise the cohort of transgender women enrolled from Dec 6, 2016, to May 14, 2020, when the study was unblinded. We report sociodemographic characteristics, use of gender affirming hormone therapy, and behavioural assessments of the transgender women participants. Laboratory testing and safety evaluations are also reported. The trial is registered at ClinicalTrials.gov, NCT02720094., Findings: HPTN 083 enrolled 570 transgender women (304 tenofovir disoproxil fumarate plus emtricitabine; 266 injectable cabotegravir). Transgender women were primarily from Asia (225 [39%]) and Latin America (205 [36%]); 330 (58%) reported using gender affirming hormone therapy. Intimate partner violence was common (270 [47%] reported emotional abuse and 172 [30%] reported physical abuse) and 323 (57%) reported a history of childhood sexual abuse. 159 (28%) transgender women disagreed that they were at risk for HIV, and 142 (25%) screened positive for depressive symptoms. During study follow-up, incidence of syphilis was 16·25% (95% CI 13·28-19·69), rectal gonorrhoea was 11·66% (9·14-14·66), and chlamydia was 20·61% (17·20-24·49). Frequency of adverse events was similar between the treatment groups. Nine seroconversions occurred among transgender women during the blinded phase of the study (seven in the tenofovir disoproxil fumarate plus emtricitabine group and two in the injectable cabotegravir group); overall incidence was 1·19 per 100 person-years (95% CI 0·54-2·25): 1·80 per 100 person-years (0·73-3·72) in the tenofovir disoproxil fumarate plus emtricitabine group and 0·54 per 100 person-years (0·07-1·95) in the injectable cabotegravir group (hazard ratio 0·34 [95% CI 0·08-1·56]). Cabotegravir concentrations did not differ by gender affirming hormone therapy use., Interpretation: HIV prevention strategies for transgender women cannot be addressed separately from social and structural vulnerabilities. Transgender women were well represented in HPTN 083 and should continue to be prioritised in HIV prevention studies. Our results suggest that injectable cabotegravir is a safe and effective pre-exposure prophylaxis option for transgender women., Funding: National Institute of Allergy and Infectious Diseases and ViiV Healthcare., Competing Interests: Declaration of interests MAM has received grant funding from ViiV/GSK and Gilead Sciences for industry-sponsored research. RJL reports receiving study products and additional support for study conduct to sites from ViiV Healthcare and was given study products from Gilead Sciences during the conduct of the study. RJL received advisory scientific board fees, and travel support from Merck Inc outside the submitted work. JFR is a paid employee and stockholder of Gilead Sciences. ARR is a paid employee and stockholder of ViiV Healthcare. CP reports grants from the National Institutes of Health (NIH), advisory board fees from University of North Carolina at Chapel Hill, The Fenway Institute, and University of California, Los Angeles, outside the submitted work, and participated in data safety monitoring boards at University of North Carolina at Chapel Hill and Massachusetts General Hospital. JF reports grants from ViiV Healthcare UK and the National Institute of Allergy and Infectious Diseases, during the conduct of the study. SF was a paid employee and stockholder of GSK during the conduct of the study. MSC reports grants from NIH, scientific and medical advisory board fees, respectively, from Aerium and Atea, honoraria for lectures from MJH Life Sciences, Clinical Care Solutions, Virology Education, Amgen, Medscape, and UpToDate, and for an educational panel from Astra Zeneca. MSC reports travel support from GSK and was co-chair in the HIV Prevention Trials Network and COVID-19 Prevention Network. All other authors declare no competing interests., (Copyright © 2023 Elsevier Ltd. All rights reserved.)