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Patients with moyamoya arteriopathy are at high risk for developing ischemic stroke in the perioperative period. We sought to evaluate whether preoperative clinical and neuroimaging biomarkers are associated with postoperative stroke and transient ischemic attack in children with moyamoya following revascularization surgery. We performed a retrospective chart review of pediatric patients who underwent revascularization surgery for moyamoya in the last 15 years. Fifty-three patients who underwent 69 surgeries met the inclusion criteria. We recorded clinical predictors of stroke or transient ischemic attack within 7 days following surgery. We used Suzuki stage and Composite Cerebrovascular Stenosis Score to analyze neuroimaging. Significant risk factors for developing postoperative stroke or transient ischemic attack were younger age at surgery ( P = .004) and transient ischemic attack less than 1 month prior to surgery ( P

Introduction: Perihematomal edema is a consequence of primary intracerebral hemorrhage. On diffusion MRI, a corresponding heterogenous pattern of hypo- and hyper-intensity is visible on apparent diffusion coefficient (ADC), suggesting both cytotoxic and vasogenic edema. Analogously, endovascular therapy (EVT) for ischemic stroke can result in hemorrhagic transformation (HT) and a concomitant ring-like pattern, or “Rings” of mixed intensity on ADC. The objective of this study is to describe this pattern of secondary injury early after EVT. Methods: Patients were included if they consented to the prospective Natural History of Stroke GUARDS study from April 2018 to February 2022, were treated with EVT for anterior circulation LVO, achieved TICI 2b/3 reperfusion, and had early MRI, ~2h post-EVT. Two independent readers measured early and 24h DWI lesion volumes and 5d FLAIR lesion volumes using a semi-automated validated approach. Presence of any HT on GRE and Rings on ADC (Figure) on early, 24h, and 5d MRI were read independently by multiple readers who then reached consensus. The relationship of Rings with HT and lesion volume was explored. Results: Eighty-nine patients were included with median age 64y, 55% female, median admit NIHSS 18, 64% M1 LVO, and 47% IV tPA. On early MRI, 14 (16%) patients had Rings, 12 (86%) of whom also had HT (p Conclusions: Rings on ADC was seen in half of patients 24h post-EVT and appears to reflect peri-lesion edema associated with hemorrhagic transformation. This imaging marker was associated with larger lesion volumes at 5 days and may be able to serve as a target for adjunctive therapy post-EVT to mitigate edema formation.

Introduction: A substantial proportion of acute stroke patients experience poor outcomes following successful endovascular therapy (EVT) and reperfusion injury to the brain and vasculature may be a contributor. The purpose of this pilot study was to characterize hyperemia following recanalization and test the association of hyperemia with evolution of the ischemic lesion. Methods: Acute stroke patients were included with: i) large vessel occlusion of the anterior circulation, ii) successful recanalization, and iii) evaluable MRI early after EVT. Presence of hyperemia on MRI perfusion was assessed by consensus using a modified ASPECTS. Three different approaches were used to quantify relative cerebral blood flow (rCBF) on early post-EVT, 24 hours, and 5 days. Two independent trained readers measured lesion volumes using a semi-automated validated approach. Results: Sixty-seven patients with median age of 66 [59-76], 57% female, met inclusion criteria. Hyperemia was present in 35/67 (52%) patients early post-EVT (Figure), in 32/65 (49%) patients at 24 hours, and in 19/48 (40%) patients at 5 days. In comparison to control regions, rCBF was elevated by greater than 50% in hyperemic regions. Patients with hyperemia had larger ischemic lesion volumes and early lesion growth. A strong association (R2=0.81, p Conclusions: Hyperemia is frequently observed after successful EVT and is associated with lesion growth at 24 hours. Evidence of hyperemia may identify patients that may benefit from adjunctive therapy to prevent reperfusion injury, edema, and lesion growth.

Introduction: Lesion volume on MRI or CT provides evidence of tissue response to successful recanalization by endovascular therapy. The most appropriate time to estimate “infarct” volume remains unclear. Largely for convenience, 24-48 hours has been used in clinical trials and registry datasets which may be too early to determine the final infarct volume. The objective of this study was to quantify the comparability of lesion volume using MRI measured at 24 hours versus 5 days in acute stroke patients following successful recanalization. Methods: Patients were included if they consented to the prospective GUARDS study between April 2018 through February 2022, had LVO of the anterior circulation, were treated with EVT, achieved complete revascularization defined as TICI 2b/3, and imaged with MRI at 2 hours, 24 hours, and 5 days post EVT. Two independent readers measured lesion volumes using a semi-automated validated approach on DWI at 2 and 24 hours, and FLAIR at 5 days. Statistical comparisons of lesion volumes across time points were performed. Lesion growth was defined as change in lesion volume and percent change compared to lesion volume at 2 hours. Results: Sixty-nine patients met all study criteria and were included. Median age was 66 years, 55% female, median admit NIHSS of 18, 62% with M1 LVO, and 46% treated with IV thrombolysis. Post-EVT median lesion volumes were 24mL, 35mL, and 45mL respectively for 2-hour DWI, 24-hour DWI, and 5-day FLAIR. Lesion growth based on median percent change from the 2-hour DWI was 39% [21-96] and 52% [12-145] at 24 hours and 5 days. The difference in lesion growth based on percent change from 24 hours to 5 days was not significant (p=0.17). However, there was a significant difference based on change in lesion volume, 12mL [2-25] at 24 hours and 16mL at 5 days (p=0.029). Fifty-one (74%) patients had DWI volumes at 24 hours that were ≥80% of their FLAIR volumes at 5 days. However, 18 (26%) patients continued to have lesion growth beyond 24 hours, median lesion growth of 18mL,with 11 (61%) of those having lesion growth >20mL. Conclusions: Lesion growth >20mL continues in some patients beyond 24 hours, suggesting that infarct volume at 5 days should be used as the imaging outcome when assessing tissue response to recanalization.

Dahi is a very common and traditional fermented dairy product in Pakistan and its neighboring countries, it represents a rich source for the isolation of many new strains of lactic acid bacteria (LAB). The major objective of this study was to evaluate the probiotic potential of novel exopolysaccharide (EPS)-producing strains of

Human capital is the backbone of any business and its behavior reflects how the company would achieve its goals and objectives in its business. This study examines the relationship between psychological capital (PC) and employees’ engagement (EE) with the moderating role of conflict management (CM) in the financial sector of Pakistan. A questionnaire composed of established scales were administered to 278 employees in the financial sector, including various banks, investment companies, real estate companies, insurance companies, and brokerage firms at Islamabad. After determining the reliability, the model was analyzed with the help of correlation and regression. Research indicates that PC positively influences EE. This relationship improves further positively when conflicts are handled effectively. Overall, this effort contributes to the existing literature on the history of worker’s involvement by examining the direct impact of PC and CM on EE and moderation of CM.

Present scholarship targets to examine the robustness of EVA in Pakistan and information content while controlling prior research ignored firm-specific factors towards excess stock returns. The design of this research used panel data analysis whereby relevant, incremental information content and event analysis of EVA and conventional accounting performance measure via share prices is done by employing nested panel data analysis for 70 non-financial PSX listed companies from 13 industries for a study period of 2006-2015. Against prior research, EVA doesn’t add to the incremental information content of the model. Moreover asymmetric results were revealed using nested and separate regression analysis. This study is aimed to benefit stakeholders in the context of prudent investment choice. This study identifies ROA as the most important financial performance metric for local investor’s decision making. However firm-specific characteristics like financial leverage, liquidity, and firm size also play a pivotal role.

Introduction of multiple traits in crop plants for desirable character is an essential tool of Biotechnological application. To overcome problem of insect pests and weeds cotton variety FBS-37 was genetically modified by transformation of CEMB Cry1Ac+Cry2A and GTGene cloned in different plant expression vectors under CaMV35S Promoter and nopaline synthase Nos Terminator. CEMB optimized protocol of cotton gene transformation i.e. Agrobacterium mediated shoot apex cut method was applied for transformation of these genes constructs in cotton. Overall transformation efficiency was found to be 1.05%. Putative transgenic cotton plants were shifted to soil pots and acclimatized in the green house conditions. PCR with gene specific primers amplified 190bp for EPSPS (Glyphosate GTG) and 1000bp for each of Cry1Ac and Cry2A. Quantification of Cry1Ac, Cry2A and GTG protein through ELISA determined maximum of 0.8 µ g/g, 1 µ g/g and 0.9 µ g/g of tissue respectively. 100% mortality was obtained in 2 nd instar larvae of Heliothus armigera when compared with non-transgenic control cotton plants where maximum damaged was seen in leaf bioassay. Moreover, transgenic cotton plants successfully survived when sprayed with 1600ml/acre of glyphosate as compared to control where 100% mortality and necrosis occur after 7 days of spray assay in control conditions. Keyword: Herbicide resistant, glyphosate, Cry1Ac, GTG, weedicide resistant

Approximately 20% of all deaths in the USA occur in the intensive care unit (ICU) and the majority of ICU deaths involves decision of de-escalation of life-sustaining interventions. Life-sustaining interventions may include intubation and mechanical ventilation, artificial nutrition and hydration, antibiotic treatment, brain surgery, or vasoactive support. Decision making about goals of care can be defined as an end-of-life communication and the decision-making process between a clinician and a patient (or a surrogate decision maker if the patient is incapable) in an institutional setting to establish a plan of care. This process includes deciding whether to use life-sustaining treatments. Therefore, family discussion is a critical element in the decision-making process throughout the patient's stay in the neurocritical care unit. A large part of care in the neurosciences intensive care unit is discussion of proportionality of care. This chapter provides a stepwise approach to hold these conferences and discusses ways to do it effectively.

A Zea may is an important cereal crop. To nourish human and livestock, it is very important that the quality of maize grain and fodder must be higher. A study was conducted to evaluate maize accessions for grain and fodder quality traits. Results indicated that higher heritability was found for nutrient detergent fiber, fodder cellulose, fodder crude fiber, fodder crude and fodder moisture percentage while genetic advance was higher for fodder cellulose, fodder crude protein and fodder ash percentage. High significant genotypic and phenotypic correlation was found among grain protein, oil and starch percentage, nutrient detergent fiber, fodder cellulose, fodder crude fiber & protein and fodder moisture percentage. The higher cumulative additive effect was recorded for acid detergent fiber, fodder crude fiber; nutrient detergent fiber and fodder cellulose suggested that selections may be made to develop synthetic varieties for better quality. Higher dominance effect and degree of dominance indicated that selection may be useful for the development of good quality maize hybrids through heterosis breeding programme. Principle component bi-plot analysis indicated that B-11×EV-347, B-11, Sh-139, EV-1097×E-322, Sh-139×B-316, B-327×E-322, B-316, Raka-poshi, B-11×Pop/209, B-336×EV-340, B-327×E-322, B-327×F-96, EV-1097×E-322, Raka-poshi×EV-347, EV-1097×Pop/209 and EV-1097×EV-340 performed better for grain and fodder quality and may be used for improvement of grain and fodder quality of maize.

Background Cotton yield has been badly affected by different insects and weed competition. In Past Application of multiple chemicals is required to manage insects and weed control was achieved by different conventional means, such as hand weeding, crop rotation and polyculture, because no synthetic chemicals were available. The control methods shifted towards high input and target-oriented methods after the discovery of synthetic herbicide in the 1930s. To utilise the transgenic approach, cotton plants expressing the codon-optimised CEMB GTGene were produced in the present study. Results Local cotton variety CEMB-02 containing Cry1Ac and Cry2A in single cassette was transformed by synthetic codon-optimised 5-enolpyruvylshikimate-3-phosphate synthase gene cloned into pCAMBIA 1301 vector under 35S promoter with Agrobacterium tumifaciens. Putative transgenic plants were screened in MS medium containing 120 µmol/L glyphosate. Integration and expression of the gene were evaluated by PCR from genomic DNA and ELISA from protein. A 1.4-kb PCR product for Glyphosate and 167-bp product for Cry2A were obtained by amplification through gene specific primers. Expression level of Glyphosate and Bt proteins in two transgenic lines were recorded to be 0.362, 0.325 µg/g leaf and 0.390, 0.300 µg/g leaf respectively. FISH analysis of transgenic lines demonstrates the presence of one and two copy no. of Cp4 EPSPS transgene respectively. Efficacy of the transgene Cp4 EPSPS was further evaluated by Glyphosate spray (41 %) assay at 1900 ml/acre and insect bioassay which shows 100 %mortality of insect feeding on transgenic lines as compared to control. Conclusion The present study shows that the transgenic lines produced in this study were resistant not only to insects but also equally good against 1900 ml/acre field spray concentration of glyphosate. Electronic supplementary material The online version of this article (doi:10.1186/s13104-015-1397-0) contains supplementary material, which is available to authorized users.