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Background: Despite reductions in dental caries experience in developed countries, early childhood caries remains the most prevalent health problem in developing countries. This has a direct impact on the oral health-related quality of life of both children and parents. The objective of this study was to examine the impact of comprehensive dental treatment under general anaesthesia on oral healthrelated quality of life in children, using a parental and caregiver perception questionnaire. Methods: A comparative cross-sectional study was conducted in the Children Hospital, Pakistan Institute of Medical Sciences, Islamabad from July to December 2015. A total of 40 children were enrolled in the study. The oral health-related quality of life questionnaire was completed by either a parent or caregiver during the initial visit and afterward in follow-up appointments, conducted 4-8 weeks after comprehensive dental treatment under general anaesthesia. Results: The mean age of all the enrolled children was 5.7±1.7 years. Among 40 children, 55% (22) were girls and 45% (18) were boys. A highly significant reduction was observed between the pre and post-treatment P-CPQ total scores from 76.9±15.8 to 13.3±9.5 with a p-value <0.0001. Regarding the P-CPQ domains, a significant reduction from the pre- to post-treatment scores was observed for oral symptoms; functional limitations, emotional well-being, and social well-being with a p-value <0.0001. Conclusion: The oral health-related quality of life was significantly improved after comprehensive dental treatment under general anaesthesia. The findings of this study may be utilized to improve future guidelines and betterment of dental health of children by health care providers and initiatives for future health programs. [ABSTRACT FROM AUTHOR]

Commercial broilers have a short production cycle and a high requirement for energy (3000 kcal/kg in starter phase and 3200 kcal/kg in finisher phase). Therefore, the need to add energy rich lipids to their diet is inevitable. Digestibility of fat depends on its multiple properties: chain length, the composition of fatty acids, ratio of saturated/unsaturated fatty acids and free fatty acids. The high cost of vegetable oils and less availability due to their consumption in human diet are the main reasons for searching for cheaper alternative fat sources. Animal oils like poultry and fish oil are the by-product of rendering plants and after refining, they are used in poultry diets as an energy source. Due to presence of impurities and free fatty acids, the digestibility of animal fat is lower. There is a limited amount of bile acids and lipase available during early age and when birds are reared on high energy diet (finisher phase). Supplementation of emulsifier or lipase in broilers' diet increase fat utilisation. Emulsifiers increase fat digestibility by increasing active surface area of lipid droplets. Lysolecithin and lysophospholipids are produced from hydrolyses of lecithin and phospholipids by phopholipase A2. The bile acids are mainly composed of cholic acid, hyodeoxycholic acid and chenodeoxycholic acid and have strong emulsification properties. Triacylglyceryl acylase (lipase) is an enzyme involved in catalysis and the hydrolysis of lipids. It can be concluded that use of emulsifier and lipase in broiler diet improves growth performance, nutrient digestibility and intestinal histology in broilers. [ABSTRACT FROM AUTHOR]

Background: Empathy is regarded as one of the leading elements of good physician-patient relationships, having a strong association with improved patient outcomes. It is an aspect of personality, which is considered to be an essential component in the development of interpersonal understanding and in assisting proficiency in communication. Developing empathy among medical students who are going to become tomorrow's physicians is an important part of medical education. The objective of this study was to measure the mean empathy score of medical students at a private medical college and identify associated factors. Methods: This cross-sectional study was conducted from January to June 2018 among 569 medical students at a private medical college in Lahore. Toronto empathy questionnaire (TEQ) was used to determine empathy levels among students. Data was analysed in IBM SPSS-20. Mean TEQ scores were calculated. Independent sample t-test and one-way ANOVA were used to determine association between mean Toronto empathy score and socio-demographic variables, significant at a p-value of <0.05. Results: The age of 569 respondents ranged from 17 to 27 years with a mean of 20.82±1.757. There were 317 (55.71%) females; and 312 (54.8%) were residing at home with parents. The overall mean TEQ score was calculated to be 42.57±7.513. The Cronbach's alpha was 0.710. There was a significant association between empathy levels and year of study of the respondents (p<0.001), gender (p<0.001) and students' permanent area of residence (p=0.018). Conclusion: Overall mean TEQ score was found to be 42.57±7.513. Statistically significant difference was found between gender, place of residence, year of study and mean empathy scores. [ABSTRACT FROM AUTHOR]

Objectives: Dental caries is among common oral conditions in children and adults. Several studies and preventive measures have been carried out over the world to reduce dental caries rate. The objective of this study was to evaluate the relationship between caries score and socioeconomic status among children. Study Design: Cross-sectional study. Setting: Primary schools of Hayatabad, Peshawar. Period: months (January to June 2019). Material and Methods: 240 children aged from 3 to 5 years old were recruited in our study from government and private schools of Hayatabad, Peshawar. Socioeconomic status of the children's parents was deduced by visiting government schools having lower fees and private schools having higher fees in Hayatabad, Peshawar. The frequency of dental caries among children was determined by clinical examination followed by decayed, extracted, filled teeth index. Results: In this study, 120 participants from private schools belonged to the upper class while the other 120 subjects from government schools belonged to the lower class. The mean DEFT value was found to be 30% greater in children of private schools. Conclusion: The study determined that the frequency of DEFT was found more in upper economic status as compared to the lower economic status, which shows association of socio-economic status with oral health condition. [ABSTRACT FROM AUTHOR]

Subcutaneous fat necrosis (SCFN) is a rare dermatologic condition which until recently was thought to occur only in term neonates. Its presentations are protean and early in the disease; it mimics other more common neonatal dermatologic conditions. Although benign, it runs a prolonged course and may be associated with some complications and therefore needs to be differentiated from other more life-threatening neonatal dermatologic conditions. We present a case of a term neonate with histology report highlighting some characteristic features of SCFN and the need to differentiate it from sclerema neonatorum (SN), a condition associated with fatal outcome. [ABSTRACT FROM AUTHOR]

Zinc and Boron dearth is an imperative soil constraint in Pakistan. Zinc (Zn) and boron (B) deficiency in soil is primary hindrance to achieve yield potential of maize. An experiment was conducted with the objectives to optimize methods of B and Zn application in maize and ultimately enhance profitability. The experiment was laid out in randomized complete block design with factorial arrangement during autumn 2015. Treatments were replicated three times. The treatments were comprised of C = no Zn and B (Control); Zn (S) = soil application of Zn @ of 12 kg ha-1; B (S): soil application of B @ 3 kg ha-1; Zn (F) = foliar application of 1% Zn at 9th leaf stage; B (F) = foliar application of 0.5% B at 9th leaf stage; Zn (S) + B (S) = soil application of Zn @ 12 kg ha-1 + B @ of 3 kg ha-1 and Zn (F) + B (F) = foliar application of 1% Zn + 0.5% B at 9 leaf stage. Foliar application of Zn and B produced more plant height, cob length, girth, stem girth, shelling percentage, number of grains per cob, 1000-grain weight, harvest index, grain and biological yield. Maximum marginal rate of return was obtained with foliar application of both Zn and B and using foliar Zn alone. Integrated B and Zn application produced more marginal rate of returns both in soil and foliar applications. Use of foliar Zn application also depicted promising results while foliar or soil B application without using Zn enhanced cost of production. [ABSTRACT FROM AUTHOR]

Climate holds a key position in driving the agriculture of an area. The changing climatic conditions are becoming a big threat for safety of agricultural system and food security across the globe. In developing countries of Asia and Africa, declining soil fertility and drought are the major constraints in harvesting the potential yields. The average temperature around the globe is also expected to rise globally by 6°C in the coming century which is mainly due to uncontrolled emission of greenhouse gases. A prominent elevation in CO2 and CH4 concentration has been observed in the past centuries largely due to fossil burning and urbanization. Further upto 35 percent increase in the concentration of nitrous oxide is also expected due to injudicious use of nitrogenous fertilizers. According to the prediction of climate models the rise in temperature and frequent happening of severe drought are going to affect the agricultural productivity in 21st century. In order to sustain the agricultural productivity it is need of the hour to properly understand the impact of these changes on soil fertility and crop productivity. This review is aimed to highlight the potential impacts of rising temperature, shifting precipitation patterns and rising CO2 concentrations on soil health and agricultural productivity. Soil organic carbon pool is also going to get negatively affected by these changing climatic conditions. It has also been tried to shed some light on the potential of various carbon sequestration strategies conservation tillage, cover crops, Proper nutrient management, proper irrigation management and restoration of degraded soils, in combating the devastating impacts of changing climate. In addition the nitrogen management strategies are also elaborated alongwith manure management to minimize the emission of greenhouse gases. [ABSTRACT FROM AUTHOR]

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Abiotic stresses are one of the major constraints to crop production and food security worldwide. The situation has aggravated due to the drastic and rapid changes in global climate. Heat and drought are undoubtedly the two most important stresses having huge impact on growth and productivity of the crops. It is very important to understand the physiological, biochemical, and ecological interventions related to these stresses for better management. A wide range of plant responses to these stresses could be generalized into morphological, physiological, and biochemical responses. Interestingly, this review provides a detailed account of plant responses to heat and drought stresses with special focus on highlighting the commonalities and differences. Crop growth and yields are negatively affected by sub-optimal water supply and abnormal temperatures due to physical damages, physiological disruptions, and biochemical changes. Both these stresses have multi-lateral impacts and therefore, complex in mechanistic action. A better understanding of plant responses to these stresses has pragmatic implication for remedies and management. A comprehensive account of conventional as well as modern approaches to deal with heat and drought stresses have also been presented here. A side-by-side critical discussion on salient responses and management strategies for these two important abiotic stresses provides a unique insight into the phenomena. A holistic approach taking into account the different management options to deal with heat and drought stress simultaneously could be a win-win approach in future. [ABSTRACT FROM AUTHOR]

Alanyl-glutamine ( Aln-Gln ), a highly soluble and stable Glutamine-dipeptide, is known to improve the performance of poultry birds. This study aimed to investigate the effect of Aln-Gln during the rearing period on growth performance, nutrient digestibility, digestive enzyme activity, immunity, antioxidant status and relative gene expression of Hy-Line brown hens. A total of 480 healthy day-old Hy-line brown chicks with similar body weights were randomly divided into four dietary groups (8 replicates/group and 15 birds/replicate). Groups A, B, C and D were fed diets containing 0%, 0.1%, 0.2% and 0.3% Aln-Gln, respectively, for 6 weeks. The body weight ( BW ) and average daily gain ( ADG ) were higher in hens fed test diets compared with the control ( p < 0.05). The feed conversion ratio ( FCR ) was better in test groups as compared to the control group ( p < 0.05). The ADFI showed no significant difference between the groups. Dietary treatments had no effect on dry matter ( DM ), organic matter ( OM ) and crude fiber ( CF ) digestibility. The Aln-Gln also improved gross energy ( GE ) and crude protein ( CP ) digestibility ( p < 0.05). It has also increased IgG levels in groups C and D. IgM levels were similar to the control in B, C and D. The Aln-Gln increased IL-1 in B and C, IL-2 in C and D, and IL-6 in all test groups ( p < 0.05). The supplementation of Aln-Gln had no effect on serum antioxidant indices like CAT, MDA, GSH-PX, GSH, and SOD in 42-day-old growing hens. Aln-Gln supplementation had no significant effect ( p > 0.05) on the activity of amylase and lipase, however, a significant improvement ( p < 0.05) in the activities of trypsin and chymotrypsin was observed in the test groups. Supplemented Aln-Gln levels in the birds' diets led to an increase in the expression of genes related to growth factors (IGF-1, IGFBP-5), immune markers (IL-1, IL-2, IL-6) and antioxidant status (GSH-Px1), as compared to control group. Aln-Gln supplementation in Hy-Line brown hens during their growing period improved growth, nutrient digestibility, immunity and digestive enzymes activity. These findings suggest that Aln-Gln is a promising dietary additive for enhancing poultry performance.

Background: Malaria remains one the leading communicable causes of death. Approximately half of the world's population is considered at risk of infection, predominantly in African and South Asian countries. Although malaria is preventable, heterogeneity in sociodemographic and environmental risk factors over time and across diverse geographical and climatological regions make outbreak prediction challenging. Data-driven approaches accounting for spatiotemporal variability could offer potential for location-specific early warning tools for malaria., Methods: In this case study, we developed and internally validated a data fusion approach to predict malaria incidence in Pakistan, India, and Bangladesh using geo-referenced environmental factors. For 2000-17, district-level malaria incidence rates for each country were obtained from the US Agency for International Development's Demographic and Health Survey datasets. Environmental factors included average annual temperature, rainfall, and normalised difference vegetation index, obtained from the Advancing Research on Nutrition and Agriculture (known as AReNA) project conducted by the International Food Policy Research Institute in 2020. Data on night-time light intensity was derived from two satellites of the National Oceanic and Atmospheric Administration Defense Meteorological Satellite Program-Operational Linescan System: Nighttime Lights Time Series Version 4, and VIIRS Nighttime Day/Night Band Composites version 1. A multi-dimensional spatiotemporal long short-term memory (M-LSTM) model was developed using data from 2000-16 and internally validated for the year 2017. The M-LSTM model consisted of four hidden layers, each with 100 LSTM units; a fully connected layer was used, followed by linear regression, to predict the malaria incidence rate for 2017 using spatiotemporal partitioning. Model performance was measured using accuracy and root mean squared error. Country-specific models were produced for Bangladesh, India, and Pakistan. Bivariate geospatial heatmaps were produced for a qualitative comparison of univariate environmental factors with malaria rates., Findings: Malaria incidence was predicted with 80·6% accuracy in districts across Pakistan, 76·7% in districts across India, and 99·1% in districts across Bangladesh. The root mean squared error was 7 × 10 -4 for Pakistan, 4·86 × 10 -6 for India, and 1·32 × 10 -5 for Bangladesh. Bivariate maps showed an inverse relationship between night-time lights and malaria rates; whereas high malaria rates were found in areas with high temperature, rainfall, and vegetation., Interpretation: Malaria outbreaks could be forecasted using remotely measured environmental factors. Modelling techniques that enable simultaneously forecasting ahead in time as well as across large geographical areas might potentially empower regional decision makers to manage outbreaks early., Funding: NIHR Oxford Biomedical Research Centre Programme and The Higher Education Commission of Pakistan., Competing Interests: Declaration of interests SK is supported by the Innovative Medicines Initiative, Bill & Melinda Gates Foundation, Health Data Research UK, the Alan Turing Institute, British Heart Foundation, and Medical Research Council and Natural Environment Research Council outside of this work. All other authors declare no competing interests., (Copyright © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)

Rationale: Coronavirus disease 2019 (COVID-19) can cause disruption of the renin-angiotensin system in the lungs, possibly contributing to pulmonary capillary leakage. Thus, angiotensin receptor blockers (ARBs) may improve respiratory failure. Objective: Assess safety of losartan for use in respiratory failure related to COVID-19 (NCT04335123). Methods: Single arm, open label trial of losartan in those hospitalized with respiratory failure related to COVID-19. Oral losartan (25 mg daily for 3 days, then 50 mg) was administered from enrollment until day 14 or hospital discharge. A post-hoc external control group with patients who met all inclusion criteria was matched 1:1 to the treatment group using propensity scores for comparison. Measures: Primary outcome was cumulative incidence of any adverse events. Secondary, explorative endpoints included measures of respiratory failure, length of stay and vital status. Results: Of the 34 participants enrolled in the trial, 30 completed the study with a mean age SD of 53.8 ± 17.7 years and 17 males (57%). On losartan, 24/30 (80%) experienced an adverse event as opposed to 29/30 (97%) of controls, with a lower average number of adverse events on losartan relative to control (2.2 vs. 3.3). Using Poisson regression and controlling for age, sex, race, date of enrollment, disease severity at enrollment, and history of high-risk comorbidities, the incidence rate ratio of adverse events on losartan relative to control was 0.69 (95% CI: 0.49-0.97) Conclusions: Losartan appeared safe for COVID-19-related acute respiratory compromise. To assess true efficacy, randomized trials are needed., Competing Interests: CB reported receiving grant support from the NIH National Center for Advancing Translational Sciences (NCATS) and Cystic Fibrosis Foundation (CFF) during the conduct of the study. NB reported receiving grant support from the NIH National Institute of Neurologic Disease and Stroke during the conduct of the study. MC reported receiving University grant support from the NIH, American Lung Association and PCORI; pharmaceutical grant support from AstraZeneca, GSK, Novartis, Pulmatrix, Sanofi-Aventis and Shinogi; is a consult for Genentech, Teva, Sanofi-Aventis and Novartis; is a speaker for AstraZeneca, Genentech, GSK, Regeneron, Sanofi and Teva; receives royalties from Elsevier – all unrelated to the conduct of this study. MS reported receiving grant support from the NIH NHLBI, James and Ester King Biomedical Research Program, FAMRI and CFF during the conduct of the study. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Bengtson, Montgomery, Nazir, Satterwhite, Kim, Bahr, Castro, Baumlin and Salathe.)