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Background: During the COVID-19 pandemic, migrant workers in India have gone through many hardships. After the lockdown, many construction sites, factories, and workplaces shut down, and innumerable migrant workers faced a loss of income, shortage of food, and uncertain future. This massive change in their living conditions made them vulnerable to psychological problems. Aim: To screen for depression, anxiety, stress, alcohol dependence, and resilience in migrant workers during the COVID-19 crisis. Materials and Methods: Migrant workers at seven camps in the Pimpri Chinchwad Municipal Corporation, Maharashtra, were surveyed with the help of the Depression Anxiety Stress (DASS-21) Scale to assess depression, anxiety, and stress levels, AUDIT C for assessing alcohol use disorders, and Connor–Davidson resilience scale short form (CD RISC) for assessing resilience. Results: A total of 1053 migrant workers were surveyed. It showed that 57.54% of workers had depressive symptoms, 64.96% had anxiety symptoms, and 39.32% had subjective stress. Female migrant workers had more severe depression, anxiety, and stress symptoms as compared to males while male workers were more at risk of alcohol use disorder as compared to females. Migrants without family had more symptoms of severe depression and alcohol use disorder as compared to those with family. Regression analysis showed that levels of anxiety were independently associated with female gender, unmarried status, stress, depression, and alcohol use disorder while resilience negatively predicted anxiety in these migrant workers. Conclusion: During the COVID-19 pandemic, migrant workers were at risk of depression, anxiety, stress, and alcohol use disorder. Females and migrants without families came out to be more vulnerable to these psychological problems. Hence during the pandemic situation, identifying this vulnerable population and special preventive or therapeutic programs for them can be of crucial importance.

The implementation of differentiated curriculum (DC) in junior high schools has been gaining momentum in recent years as a means to address the diverse needs of students. However, more information about how English as a foreign language (EFL) teachers perceive this change is needed. This study explored English teachers' attitudes and factors that affected the introduction of DC in junior high schools. Data were collected through DC questionnaire administration and interviews using a mixed-method approach. The quantitative data were statistically analyzed using SPSS 23, while the qualitative data were thematically analyzed. The participants were the EFL teachers who actively participated in the MGMP (Musyawarah Guru Mata Pelajaran, or Subject Teacher Forum) of English Subject at the junior high school level in Batu City, East Java, Indonesia. The findings showed that all participants depicted a positive attitude toward DC implementation. However, they found some support needed from all related parties due to some challenges they met during their attempts to implement DC. This study suggests that EFL teachers' positive attitudes drive increased efforts in successfully implementing DC. However, identified challenges necessitate collaborative support from educators, administrators, and policymakers, including professional development and resource provision, for successful DC integration in EFL classrooms.

Background: Typhoid fever, caused by Salmonella enterica serovar Typhi, is a significant public health concern due to the escalating of antimicrobial resistance (AMR), with limited treatment options for extensively drug-resistant (XDR) S. Typhi strains pose a serious threat to disease management and control. This study aimed to investigate the genomic characteristics, epidemiology and AMR genes of XDR S. Typhi strains from typhoid fever patients in Pakistan. Methodology: We assessed 200 patients with enteric fever symptoms, confirming 65 S. Typhi cases through culturing and biochemical tests. Subsequent antimicrobial susceptibility testing revealed 40 cases of extensively drug-resistant (XDR) and 25 cases of multi-drug resistance (MDR). Thirteen XDR strains were selected for whole-genome sequencing, to analyze their sequence type, phylogenetics, resistance genes, pathogenicity islands, and plasmid sequences using variety of data analysis resources. Pangenome analysis was conducted for 140 XDR strains, including thirteen in-house and 127 strains reported from other regions of Pakistan, to assess their genetic diversity and functional annotation. Results: MLST analysis classified all isolates as sequence type 1 (ST-1) with 4.3.1.1. P1 genotype characterization. Prophage and Salmonella Pathogenicity Island (SPI) analysis identified intact prophages and eight SPIs involved in Salmonella's invasion and replication within host cells. Genome data analysis revealed numerous AMR genes including dfrA7, sul1, qnrS1, TEM-1, Cat1, and CTX-M-15, and SNPs associated with antibiotics resistance. IncY, IncQ1, pMAC, and pAbTS2 plasmids, conferring antimicrobial resistance, were detected in a few XDR S. Typhi strains. Phylogenetic analysis inferred a close epidemiological linkage among XDR strains from different regions of Pakistan. Pangenome was noted closed among these strains and functional annotation highlighted genes related to metabolism and pathogenesis. Conclusion: This study revealed a uniform genotypic background among XDR S. Typhi strains in Pakistan, signifying a persistence transmission of a single, highly antibiotic-resistant clone. The closed pan-genome observed underscores limited genetic diversity and highlights the importance of genomic surveillance for combating drug-resistant typhoid infections.

The current study aimed to investigate the influence of taxifolin on depression symptoms alleviation in Male Sprague-Dawley rats by targeting underlying pathways of depression. Molecular docking analyses were conducted to validate taxifolin's binding affinities against various targets. In silico analysis of taxifolin revealed various aspects of post docking interactions with different protein targets. Depression was induced in rats via intraperitoneal injection of Lipopolysaccharide (LPS; 500 μ g/Kg) for 14 alternative days. Rats (n = 6/group) were randomly assigned to four groups: (i) Saline/Control, (ii) Disease (LPS 500 μg/kg), (iii) Standard (fluoxetine 20 mg/kg), and (iv) Treatment (taxifolin 20 mg/kg). At the end of the in vivo study, brain samples were used for biochemical and morphological analysis. Taxifolin exhibited neuroprotective effects, as evidenced by behavioral studies, antioxidant analysis, histopathological examination, immunohistochemistry, ELISA and RT PCR, indicating an increase number of surviving neurons, normalization of cell size and shape, and reduction in vacuolization. Taxifolin also decreased inflammatory markers such as TNF-α, NF-κb, IL-6 and COX-2, while significantly upregulating and activating the protective PPAR-γ pathway, through which it reduces the oxidative stress, neuroinflammation, neurodegeneration, thereby ameliorating depression symptoms in experimental rat model of depression. Our finding suggests that taxifolin act as neuroprotective agent partially mediated through PPAR-γ pathway.

Wide bandgap semiconductors such as Zinc Oxide (ZnO) have earned much attention on account of its interesting optical and electrical properties. Also, doping ZnO with suitable transition elements enables to tune its properties, making it suitable for applications like transparent conducting oxides and LEDs. To this aim, Vanadium-doped ZnO (V:ZnO) thin films are fabricated using the SILAR method and studied the structural, optical, vibrational, photophysical and electrical properties. Introducing vanadium creates lattice relaxation in the ZnO wurtzite structure, influencing its electronic band structure. The X-ray diffraction (XRD) analyses have verified the structural integrity of the vanadium-doped zinc oxide (V:ZnO) films, revealing their polycrystalline composition. The Raman spectroscopy shows the reduced phonon line widths due to the improved crystallite quality with the presence of vanadium. Furthermore, it has been noted that optical characteristics such as the bandgap and refractive index are sensitive to vanadium doping as a consequence of modified electronic structures. Hall-effect experiments have shown that undoped ZnO films possess a mobility of 1.31 cm2/Vs and a charge carrier density of 5.58 × 1013 cm−3. It has been observed that doping with V markedly influences these parameters of ZnO films. Then, the time-resolved photoluminescence measurements reveal the increased carrier lifetimes, suggesting the introduction of dopants mitigates carrier-phonon interactions. Such interactions need to be minimized to prevent the dissipation of carrier energy. In essence, the reported work demonstrates the potential of V:ZnO for optoelectronic applications.

This paper presents a case of a 35-year-old female patient diagnosed with Complex Regional Pain Syndrome (CRPS) type I and treated over a two-month period with a novel low-frequency sound-transduced focal pulsed stimulus. The patient received 21 treatments consisting of focally applied sound sweeps in the 15–100 Hz range. Outcome measures included the Visual Analogue Scale for pain, five physical assessment parameters, medication, and the Pain Catastrophizing Scale. A follow-up was conducted at six months. The results show that the patient’s low-back pain level was substantially reduced after treatment and after six months. CRPS-related peripheral pain was strongly reduced but had some rebound after six months. The low-frequency sound-transduced focal pulsed stimulus shows potential as a non-invasive treatment for CRPS and deserves controlled clinical trials.

Onion purple blotch is the most indispensable foliar disease of crop and has become a major concern for farmers and research fraternity. An attempt to investigate the role of injury in parasitism by Alternaria porri indicated that disease incidence and severity enhance considerably with injury. Thrips injured plants inoculated with A. porri presented 100% incidence and 52–72% severity while mechanically injured plants inoculated with A. porri showed 60–70% incidence and 28–34% severity. The uninjured plants showed considerably less disease incidence (30–40%) and severity (10–16%). Injured inoculated plants presented reduced leaf length and leaf area while the leaf diameter remained unaffected. The lesion number, lesion length and size was substantially enhanced with concomitant infestation of pest and pathogen. Thrips tabaci injury led to more pronounced symptoms of purple blotch compared to Thrips parvispinus injury. There was substantial decrease in photosynthetic rate and chlorophyll content with stress imposed on plant whilst the relative stress injury was enhanced. The induction of injury and inoculation of A. porri had an impact on the concentration of total phenolics, total soluble sugars, total proteins and hydrogen peroxide in onion leaves. A. porri combined with injury caused a more pronounced decrease in total soluble sugars and total protein content while enhancement in total phenolics and hydrogen peroxide content compared to uninjured plants. The dynamic nature of morpho-physiological and biochemical changes owing to stress conditions imposed on onion plant adds an extra layer of complexity in understanding the onion plant physiology and their ability to work out in response to challenging environment conditions.

In a solid-state dye-sensitized solar cell, a fast-ion conducting (σ25°C > 10−4 S cm−1) solid redox mediator (SRM; electrolyte) helps in fast dye regeneration and back-electron transfer inhibition. In this work, we synthesized solid Co2+/3+ redox mediators using a [(1 − x)succinonitrile: x poly(ethylene oxide)] matrix, LiX, Co(tris-2,2′-bipyridine)3(bis(trifluoromethyl) sulfonylimide)2, and Co(tris-2,2′-bipyridine)3(bis(trifluoromethyl) sulfonylimide)3 via the solution-cast method, and the results were compared with those of their acetonitrile-based liquid counterparts. The notation x is a weight fraction (=0, 0.5, and 1), and X represents an anion. The anion was either bis(trifluoromethyl) sulfonylimide [TFSI−; ionic size, 0.79 nm] or trifluoromethanesulfonate [Triflate−; ionic size, 0.44 nm]. The delocalized electrons and a low value of lattice energy for the anions made the lithium salts highly dissociable in the matrix. The electrolytes exhibited σ25°C ≈ 2.1 × 10−3 (1.5 × 10−3), 7.2 × 10−4 (3.1 × 10−4), and 9.7 × 10−7 (6.3 × 10−7) S cm−1 for x = 0, 0.5, and 1, respectively, with X = TFSI− (Triflate−) ions. The log σ–T−1 plot portrayed a linear curve for x = 0 and 1, and a downward curve for x = 0.5. The electrical transport study showed σ(TFSI−) > σ(Triflate−), with lower activation energy for TFSI− ions. The anionic effect increased from x = 0 to 1. This effect was explained using conventional techniques, such as Fourier transform infrared spectroscopy (FT-IR), X-ray diffractometry (XRD), X-ray photoelectron spectroscopy (XPS), scanning electron microscopy (SEM), UV–visible spectroscopy (UV-vis), differential scanning calorimetry (DSC), and thermogravimetric analysis (TGA).

The most common cause of infertility and metabolic problems among women of reproductive age is polycystic ovary syndrome (PCOS), a multifaceted disorder. It is an endocrine disorder that occurs in approximately one in seven women. Among these PCOS patients, two thirds will not ovulate on a regular basis and seek treatment for ovulation induction. The symptoms vary in their severity, namely ovulation disorders, excessive androgen levels, or polycystic ovarian morphology. All these symptoms require a therapeutic approach. Many drugs are used to eradicate PCOS symptoms, like metformin, clomiphene citrate, spironolactone, and pioglitazone. Long-term treatment is required to achieve the desired outcome, which is often accompanied by significant adverse reactions. Some herbs and phytochemicals are equally effective for treating PCOS and produce minimal side effects. Recently, herbal products are gaining popularity due to their wide biological activities, safety, availability, and efficacy. The present review covers aetiology, current treatment, pathophysiology, and detailed pre-clinical and clinical studies on plants and phytochemicals that are proven to be useful for the treatment of symptoms associated with PCOS.

Abstract Malaria, chikungunya virus (CHIKV), and dengue virus (DENV) are endemic causes of fever among children in Kenya. The risks of infection are multifactorial and may be influenced by built and social environments. The high resolution overlapping of these diseases and factors affecting their spatial heterogeneity has not been investigated in Kenya. From 2014-2018, we prospectively followed a cohort of children from four communities in both coastal and western Kenya. Overall, 9.8% were CHIKV seropositive, 5.5% were DENV seropositive, and 39.1% were malaria positive (3521 children tested). The spatial analysis identified hot-spots for all three diseases in each site and in multiple years. The results of the model showed that the risk of exposure was linked to demographics with common factors for the three diseases including the presence of litter, crowded households, and higher wealth in these communities. These insights are of high importance to improve surveillance and targeted control of mosquito-borne diseases in Kenya.

BackgroundNumerous reviews of the epidemiology and risk factors for breast cancer have been published previously which heighted different directions of breast cancer.AimThe present review examined the likelihood that incidence, prevalence, and particular risk factors might vary by geographic region and possibly by food and cultural practices as well.MethodsA systematic review (2017-2022) was conducted following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, reporting on epidemiological and risk factor reports from different world regions. Medical Subject Heading (MeSH) terms: “Breast neoplasm” “AND” country terms such as “Pakistan/epidemiology”, “India/epidemiology”, “North America/epidemiology”, “South Africa/epidemiology” were used to retrieve 2068 articles from PubMed. After applying inclusion and exclusion terms, 49 papers were selected for systematic review.ResultsResults of selected articles were summarized based on risk factors, world regions and study type. Risk factors were classified into five categories: demographic, genetic and lifestyle risk factors varied among countries. This review article covers a variety of topics, including regions, main findings, and associated risk factors such as genetic factors, and lifestyle. Several studies revealed that lifestyle choices including diet and exercise could affect a person’s chance of developing breast cancer. Breast cancer risk has also been linked to genetic variables, including DNA repair gene polymorphisms and mutations in the breast cancer gene (BRCA). It has been found that most of the genetic variability links to the population of Asia while the cause of breast cancer due to lifestyle modifications has been found in American and British people, indicating that demographic, genetic, and, lifestyle risk factors varied among countries.ConclusionThere are many risk factors for breast cancer, which vary in their importance depending on the world region. However, further investigation is required to better comprehend the particular causes of breast cancer in these areas as well as to create efficient prevention and treatment plans that cater to the local population.

Binary PdM-based nanocrystals are efficient electrocatalysts for a wide range of renewable and green fuel cell applications; however, their poisoning by CO is a great barrier for commercialization, so it is pivotal to solve this issue. Herein, we fabricated support-free PdM alloys (M = Fe, Co, and Ni) by a prompt one-step aqueous-solution co-reduction with sodium borohydride driven by the coalescence growth mechanism. This forms support-free PdM porous foam-like nanostructures with well-defined compositions from the ICP-OES analysis and clean surface without any hazardous chemicals or multiple reaction steps. The as-prepared PdM foam-like nanostructures were demonstrated for carbon monoxide oxidation (COOxid) electrocatalysis at varied electrolyte pH compared with commercial Pd/C catalyst. The foam-like PdFe nanocrystals achieved an excellent electrochemical COOxid activity that was at least 2.18-times of PdCo, 4.35-times of PdNi, and 1.56-times of Pd/C in both alkaline (KOH) and acidic (HClO4) electrolytes, but PdCo was the best in neutral (NaHCO3) medium. The superior activity of PdM is due to the strain and alloying effect, which promoted the superb CO oxidation durability for 1000 cycles than Pd/C catalyst. This study demonstrated the superiority of support-free bimetallic PdM alloys than Pd/C catalyst in all electrolytes, which may open new gates for understanding CO-poisoning in alcohol-based fuel cells.

The opto-photocatalytic applications of Mn-doped NiO nanoparticles (NPs) are discussed. A facile synthesis of NiO doped with different Mn contents is performed and studied using experimental techniques. The structural properties and microstructural parameters of Mn:NiO NPs were examined by X-ray diffraction patterns. The average crystallite sizes of the pure NiO and 1.0-, 2.5-, 5.0-, 10-wt.% Mn-doped NiO NPs were found to be 25–19 nm by Williamson–Hall plots and 23–18 nm by the Debye–Scherer method. The crystallite size decreases with increasing doping concentration in the NiO host lattice. The optical bandgaps are found to be 3.53, 3.46, 3.39, 3.24, and 3.12 eV for pure NiO and 1.0-, 2.5-, 5.0-, and 10-wt.% Mn:NiO NPs, respectively, using the Kubelka–Munk function. X-ray photoelectron spectroscopy spectra of 2.5-wt.% Mn:NiO NPs were recorded for Mn, Ni, and O to determine the oxidation states. The photocatalytic performances of pure NiO and Mn:NiO NPs are examined. The 2.5-wt.% Mn:NPs exhibit the best photocatalytic performance owing to the greatest activation sites. The mechanism of the photocatalytic decolorization reaction is also investigated. The results demonstrate the high ability of Mn:NiO NPs as photocatalysts for methylene blue dye degradation, with 92% removal.

Background: Use and abuse of alcohol is well known. Its abuse, predominantly its dependence, can cause medical, psychological, and social issues. Excessive alcohol intake over time is linked to cognitive problems, including memory loss. Excessive alcohol use has been linked to significant cognitive deficits that can last even after the person stops drinking. Executive functioning impairments are most likely to impact rehabilitation outcomes in people with cognitive impairment. Aim: To study the cognitive impairments in alcohol dependence and comparing with healthy individuals. Methods: An observational, analytical case–control study was done on 30 alcohol-dependent patients after stabilization and 25 healthy individuals from July 2019 to July 2021 in a tertiary care center in Pune; all subjects after diagnosis were assessed with Mini-Mental State Examination (MMSE), Frontal Assessment Battery (FAB), Barratt Impulsiveness Scale, Stroop Test, and the Wisconsin card sorting test (WCST). Results: The mean score on MMSE of the case group was 28.60 and the controls—29.72. The mean score on FAB of the case group was 16.45 and the controls—17.4. The mean score on BIS of the case group was 16.45 and in control 17.4. Stroop Effect score of the case group was 187.16 seconds and in control it was 146.92 seconds, all being statically significant in comparison. On the WCST, all the findings were statistically significant. Conclusion: Long-term alcohol consumption affects executive functions considerably. The current study showed significant cognitive deficits in individuals with alcohol dependence mainly in executive functions, working memory, and high impulsiveness.

Background: Improved healthcare extends life expectancy, but social and economic issues including poverty, family breakdown, and insufficient help for the elderly put people's mental health in danger. Because of feelings of loneliness and natural age-related decline in physiological and physical performance, the elderly are more prone to psychological disorders. With this aim in mind, the study of the prevalence of psychiatric morbidity in elderly hospitalized patients was taken up. Methods: A cross-sectional analytical study was carried out in a tertiary hospital in Pune on 200 hospitalized patients of 65 years of age and more from July 2019 to July 2021. Subjects with known psychiatric disorders were excluded. Subjects were evaluated with a sociodemographic proforma, mini-international neuropsychiatric interview (MINI), depression anxiety stress scale-21 (DASS-21), and the multidimensional scale of perceived social support (MSPSS). Results: A total of 35.5% of elderly subjects admitted to non-psychiatric wards were found to be suffering from psychiatric disorders, most commonly major depressive disorder, generalized anxiety disorders (GADs), and social anxiety disorders. On DASS-21, 55.5% of patients had stress, 24% anxiety, and 15.5% had depression. On the MSPSS scale, 53% had a high level of support. A mean score of 5.94 was obtained for family support, 5.413 for support from friends, and 3.486 for support from significant others. Males received higher support. Conclusion: We found that elderly patients admitted in non-psychiatric wards had psychiatric disorders. The most common psychiatric disorders were GAD (16.5%) and major depressive disorder (15%). It is more beneficial when physicians/surgeons also screen or refer their elderly patients to their psychiatrist colleagues to help alleviate their suffering to the extent possible.

Abstract Background Herbal medicines, derived from medicinal plants, are among the most popular alternative remedies around the globe. In Saudi Arabia, herbal medicines are extensively used by public as part of the culture as well as religious norms. Therefore, this study aimed to evaluate knowledge, attitudes, and practices regarding herbal medicines among the general population in Saudi Arabia. Methods A descriptive cross-sectional survey study was conducted on the general population of Jeddah city with the help of a validated and self-administered questionnaire. Sample size was calculated to be 450 with subjects between 20 and 60 years of either gender. Descriptive and inferential statistical analysis was performed using SPSS. Results Results of our data showed that 173 (42.2%) of the total participants used herbal medicines, however, significant association was found between female gender and the usage of herbal medicines (p

BackgroundMicronutrient deficiencies including vitamin A, vitamin D, and zinc are highly prevalent in children below 5 years of age in low and –middle-income countries. We aimed to evaluate the effectiveness of ready-to-use Lipid-based Nutrient Supplement—Medium Quantity (LNS-MQ) local name “Wawa-mum” on plasma micronutrient status, hemoglobin concentration and anthropometric measurements.MethodsA community-based non-randomized trial was conducted in the Kurram district of Khyber Pakhtunkhwa from January 2018 to June 2019. A total of 110 children aged 6 to 23 months old were recruited and allocated to the intervention and control arm of the study. A total of 57 children in the intervention arm received a daily ration of 50 g of Wawa-mum, for one year. To assess the impact of the intervention on primary outcome measures, i.e., serum vitamin A, D concentration, plasma zinc, and hemoglobin concentration. Blood samples were collected at baseline and after one year following the intervention. The vitamins concentration in serum were assessed using Enzyme-Linked Immunosorbent Assay (ELISA) and plasma zinc by atomic absorption spectrometry. The hemoglobin concentration was measured by an automated hematology analyzer. A 24-h dietary recall interview was used to assess the nutrient intake adequacy. Multivariate Linear regression models were used to analyze the outcomes while controlling for potential confounders.ResultsIn the intervention arm, children had on average 6.2 μg/dL (95% CI 3.0–9.3, value of p

Porous polymeric frameworks have received great interest over the past few years because of their nonstop growth as crystalline porous polymeric materials connected through covalent bonds and versatile utilities in diverse fields. The production of high-value organic compounds via sustainable and environment-friendly methods is an uphill struggle for researchers. The elegant strategy of using carbon dioxide as a C1 building block is an intriguing platform owing to its non-toxicity, easy accessibility, natural abundance, recyclability, non-flammability, and cheapness. Additionally, CO2 levels are regarded as the main contributor to the greenhouse effect (the most abundant greenhouse gas across the globe) and the aforementioned strategy needs to mitigate CO2 emissions. This present study describes the synthesis of silver nanoparticles (AgNPs) embedded in a porous polymeric framework, a reusable heterogeneous catalyst (recyclable over 5 times), TpMA (MC)@Ag. The synthesized catalyst is characterized by using FT-IR, PXRD, XPS, FE-SEM, TEM, EDAX, TGA DTA, and N2 sorption studies. Additionally, the catalysts can be easily recycled to generate the desired α-alkylidene cyclic carbonates and oxazolidinone compounds under solvent-free conditions. This research demonstrates the potential of nanoporous 2D porous polymeric framework-based materials in the area of catalysis, specially, in CO2 capture and chemical fixation. These findings offer a promising approach for the chemical fixation of CO2 into α-alkylidene cyclic carbonates and oxazolidinones from propargylic alcohols utilizing AgNPs embedded in a 2D catalyst, which functions as a potential heterogeneous catalyst under mild conditions (e.g., solvent-free approach).

Power is a critical factor in several types of diplomacy. India-EU relations are a classic case of how changing geopolitics prompted diplomatic acumen. This scoping review assesses the changing relations of both partners as a manifestation of Smart Power. The dynamic relations from normative-based to pragmatic and inclusive interests based are evaluated. Their value-based relations are put under international relations theories. Their changing factors of cooperation are used to justify their smart diplomacy, where contemporary relations are less likely to be affected by multilateral interests. To solidify claims of smart power in their relations, the recent TRIPS waiver schism illuminated health diplomacy between the two regions. This health diplomacy discourse promotes smart power diplomacy between India and the EU, where new avenues of cooperation emerge despite pandemic disagreements. The article explores how hybrid power is better than soft and hard power in silos by systematically searching and selecting the existing knowledge in the contemporary context.

In the current study, the quality of groundwater used for drinking purposes was assessed in Taluka Ghorābāri, Sindh, Pakistan. Twenty-five sampling locations were selected for the collection of groundwater. Samples were analyzed for physicochemical and heavy metal analysis, followed by standard methods. Detection of heavy metals was conducted using Atomic Absorption Spectrophotometer. Heavy metals which exceeded the WHO safe limit included Cr (28%), Fe (16%), Mn (48%), and Ni (16%) from the drinking water of the study area. The Cu and Zn were found within the safe limit in all drinking water samples of the study area. The Daily Intake of heavy Metals (DIM) and Health Risk Indexes (HRI) Assessments were calculated to determine risk assessments; the order of mean DIM values was observed as Ni > Cu > Fe > Zn > Cr while HRI was observed in the order of Cu > Mn > Zn > Fe > Cr. The HRI values were observed less than one for both adults and children, which shows the lack of possible health hazards for the people of the study area.

Background: Percutaneous coronary intervention (PCI) has been effective in increasing the longevity of patients with cardiovascular disease. Notwithstanding paucity of Indian studies on the psychological effects of PCI, there have been conflicting evidences with regard to improvement of quality of life in patients undergoing angioplasty. Aim: To evaluate change in the quality of life and emotional factors like depression, stress, and anxiety in patients undergoing angioplasty. Methods: This prospective longitudinal study was carried out at a tertiary care hospital and research centre in the western part of Maharashtra in a semi-urban location on 70 consecutive patients undergoing angioplasty from July 2019 to July 2021. Besides sociodemographic data patients were assessed with Type D Scale-14 (DS14), Depression Anxiety Stress Scale, and The MacNew heart disease health-related quality of life Questionnaire. After 15 days of the procedure, patients were re-evaluated with the same scales. Results: Mean age of our study population was 58.67 years of which 77.14% were men. The prevalence of Type D personality was 28.57%. There was a significant reduction in anxiety and stress scores and significant improvement in emotional and physical sub scales of Quality of life post angioplasty. On multiple regression analysis, anxiety and social inhibition emerged as predictors of depression. Conclusion: Angioplasty is associated with significant improvement in anxiety, stress, and emotional and physical subscales of Quality of life. Social inhibition, which is a component of Type D personality, anxiety, and loss of libido are significant predictors of depression in patients undergoing angioplasty.

This prospective quasi-experimental study from the NASAM (National Approach to Standardize and Improve Mechanical Ventilation) collaborative assessed the impact of evidence-based practices including subglottic suctioning, daily assessment for spontaneous awakening trial (SAT), spontaneous breathing trial (SBT), head of bed elevation, and avoidance of neuromuscular blockers unless otherwise indicated. The study outcomes included VAE (primary) and intensive care unit (ICU) mortality. Changes in daily care process measures and outcomes were evaluated using repeated measures mixed modeling. The results were reported as incident rate ratio (IRR) for each additional month with 95% confidence interval (CI). A comprehensive program that included education on evidence-based practices for optimal care of mechanically ventilated patients with real-time benchmarking of daily care process measures to drive improvement in forty-two ICUs from 26 hospitals in Saudi Arabia (>27,000 days of observation). Compliance with subglottic suctioning, SAT and SBT increased monthly during the project by 3.5%, 2.1% and 1.9%, respectively (IRR 1.035, 95%CI 1.007-1.064, p = 0.0148; 1.021, 95% CI 1.010-1.032, p = 0.0003; and 1.019, 95%CI 1.009-1.029, p = 0.0001, respectively). The use of neuromuscular blockers decreased monthly by 2.5% (IRR 0.975, 95%CI 0.953-0.998, p = 0.0341). The compliance with head of bed elevation was high at baseline and did not change over time. Based on data for 83153 ventilator days, VAE rate was 15.2/1000 ventilator day (95%CI 12.6-18.1) at baseline and did not change during the project (IRR 1.019, 95%CI 0.985-1.053, p = 0.2812). Based on data for 8523 patients; the mortality was 30.4% (95%CI 27.4-33.6) at baseline, and decreased monthly during the project by 1.6% (IRR 0.984, 95%CI 0.973-0.996, p = 0.0067). A national quality improvement collaborative was associated with improvements in daily care processes. These changes were associated with a reduction in mortality but not VAEs. Registration The study is registered in clinicaltrials.gov (NCT03790150).

The structural, optical, and dielectric properties of pure NiO and yttrium (Y) doped NiO (Y: NiO) were studied in the present article for optoelectronic application. The pristine and different concentrations of 1.0, 2.5, 5.0, 7.5, and 10 wt.% doped Y: NiO nanoparticles (NPs) were synthesized by flash combustion route. X-ray diffraction patterns (XRD), Raman spectroscopy and scanning electron microscopy (SEM) images were used to study the structural properties of as-prepared nanoparticles. The average crystallite sizes (29.8–6.7 nm) and grains size (159.2–17.9 nm) were found to be decreased with an increase in Y contents. The dislocation density (1.12–21.75 × 10−3 1/nm2), lattice strain (2.79–12.46 × 10−3) and surface area (29.48–131.13 cm2/g) were increased on increasing Y contents. Direct optical band gaps of prepared samples were estimated using the Tauc's relation in the range of 3.52–3.37 eV. Photoluminescent spectra of prepared samples exhibit spectra at 355 nm, 451–482 nm, and 493 nm emission bands, which confirm the existence of oxygen and nickel vacancies. The improvement in the dielectric constant (143), dielectric loss (1233), and loss tangent (8.67) were observed for 5.0 wt.% Y doped NiO from the dielectric analysis of the samples. The electrical conductivities of Y: NiO NPs were also improved compared to pure NiO NPs. The improvement in the optical and dielectric properties of NiO in the substitution of yttrium (Y) can be used for optoelectronics applications.

BackgroundEthnopharmacological relevance: Brugmansia, a genus of the Solanaceae family, has historically been utilized in many different parts of the world as an anti-inflammatory for treating skin infections, wounds, and bodily aches and pains. The current study aimed to investigate the potential benefits of a methanolic extract of Brugmansia aurea in the management of diabetes and underlying complications in alloxanized-induced diabetic rats.Materials and methodsAnimals were divided into nine groups (n = 6). Four groups received different standard oral hypoglycemic agents; three groups received 100, 200, and 400 mg/kg of B. aurea leaf extract for six consecutive weeks, and the remaining two were normal and disease control groups. All groups received alloxan (150 mg/kg) except for the normal control. Only those animals whose glucose levels were raised to 200 mg/dl were selected for the study. After a 6-week dosage period, various biochemical parameters, as well as HbA1c, antioxidant profile, oral glucose tolerance test (OGTT), insulin sensitivity, histopathology, and insulin resistance, were measured and compared with the untreated diabetic group.ResultsBrugmansia aurea leaf extract at a dose of 400 mg/kg showed potent antidiabetic activity by reducing blood glucose levels (p < 0.001) after 6 weeks of treatment. OGTT data showed that B. aurea exhibited significant (p < 0.001) glucose tolerance by significantly reducing blood glucose levels in just 2 h post-treatment. Other tests showed that plant extract significantly increased (p < 0.001) insulin sensitivity and decreased (p < 0.001) insulin resistance. The biochemical profile showed reduced triglyceride and cholesterol, while the antioxidant profile showed restoration of antioxidant enzymes in the pancreas, kidney, and liver tissues of treated rats.ConclusionThe present study indicated that crude extracts of B. aurea increase insulin sensitivity and reduce hyperlipidemia in diabetic rats, which rationalizes the traditional medicinal use of this plant as an antidiabetic agent.

Since March 2020, SARS-CoV-2 has plagued the world with COVID-19 and individuals of all ages have experienced varying symptoms of disease. Older adults were experiencing more severe disease compared to children and were prioritized by vaccination efforts. While biologic therapies and vaccinations were implemented, there were changes in public health restrictions with subsequent surges resulting in more infected children. During these surges there was a rise of different SARS-CoV-2 variants with the dominant variant initially alpha (B.1.1.7 and other Pango lineages) and epsilon (B.1.427/B.1.429) in early 2021 and a dramatic shift to delta (B.1.617.2 and other Pango lineages) by mid-summer 2021. In this study we aimed to characterize the clinical severity and host factors associated with disease by SARS-CoV-2 variant and evaluate if there are differences in disease severity by circulating variant. We retrospectively included all individuals 0–25 years of age who presented to our center and had a positive SARS-CoV-2 RT-PCR, SARS-CoV-2 variant mutation testing, and documented clinical notes from 1 January 2021 through 31 December 2021. We identified 745 individuals who met inclusion criteria and found the delta variant was associated with severe/critical disease compared to the other variants studied. The results of the model showed that underlying respiratory disease and diabetes were risk factors for progression to severe disease. These insights are important when evaluating public health measures and treatment options for children as more variants arise.

The utilization of heterogeneous catalysts during the production of biodiesel potentially minimize the cost of processing due to the exclusion of the separation step. The (X wt%)Ni–ZrO2 (where X = 10, 25 and 50) catalysts prepared through a hydrothermal process were tested for the production of biodiesel by the transesterification of waste cooking oil (WCO) with methanol. The influences of various reaction parameters were systematically optimized. While the physicochemical characteristics of the as-synthesized catalysts were examined using numerous techniques such as FTIR, XRD, TGA BET, EDX, SEM, and HRTEM. Among all the catalysts, (10 wt%)Ni–ZrO2 exhibited high surface area when compared to the pristine ZrO2, (25 wt%)Ni–ZrO2 and (50 wt%)Ni–ZrO2 nanocatalysts. It may have influenced the catalytic properties of (10 wt%)Ni–ZrO2, which exhibited maximum catalytic activity with a biodiesel production yield of 90.5% under optimal conditions. Such as 15:1 methanol to oil molar ratio, 10 wt% catalysts to oil ratio, 8 h reaction time and 180 °C reaction temperature. Furthermore, the recovered catalyst was efficiently reused in several repeated experiments, demonstrating marginal loss in its activity after multiple cycles (five times).

Cost-effective interventions are needed to address undernutrition, particularly micronutrient deficiencies, which are common in children under the age of five in low- and middle-income countries. A community-based, non-randomized clinical trial was undertaken in the Kurram district of Khyber Pakhtunkhwa from January 2018 to June 2019, to evaluate the effect of locally produced micronutrient powder (local name: Vita-Mixe) on plasma micronutrient status, hemoglobin level, and anthropometric outcomes. Children aged 24–48 months old were recruited and allocated to the intervention and control arm of the study. The enrolled children in the intervention arm received one micronutrient powder (MNP) sachet for consumption on alternate days for 12 months. To assess the impact of the intervention on plasma levels of zinc, vitamin D, vitamin A, and hemoglobin level, blood samples were taken at baseline and after one year following the intervention. The analysis was conducted using Enzyme-Linked Immunosorbent Assay (ELISA), atomic absorption spectrometry, and an automated hematology analyzer. For the impact on growth parameters, the anthropometric assessment was performed using WHO standard guidelines. A 24 h dietary recall interview was used to assess the nutrient intake adequacy. Results showed that in the intervention arm, children had on average a 7.52 ng/mL (95% CI 5.11–9.92, p-value < 0.001) increase in the plasma level of vitamin A, 4.80 ng/mL (95% CI 1.63–7.95, p-value < 0.002) increase in vitamin D levels and 33.85 µg/dL (95% CI 24.40–43.30, p-value < 0.001) increase in the plasma zinc level, as well as a 2.0g/dL (95% CI 1.64–2.40, p-value < 0.001) increase in hemoglobin level. Statistically significant improvement was observed in the weight-for-height z-score (WHZ) (from −1.0 ± 0.88 to −0.40 ± 1.01, p < 0.001) and weight-for-age z-score (WAZ) (from −1.40 ± 0.50 to −1.05 ± 0.49, p < 0.001) in the intervention group compared to the control group. No statistically significant change was observed in the height-for-age z-score (HAZ) in the intervention group (p = 0.93). In conclusion, micronutrient powder supplementation is a cost-effective intervention to improve the micronutrient status, hemoglobin level, and growth parameters in under-five children, which can be scaled up in the existing health system to address the alarming rates of undernutrition in Pakistan and other developing countries.

Objective: To assess the frequency of thrombocytopenia among the patients of trauma at an intensive care unit and to look for its relationship and other socio-demographic factors with the outcome. Study Design: Cross-sectional study. Place and Duration of Study: Intensive Care Unit, Combined Military Hospital Peshawar, from Mar to Aug 2017. Methodology: Thrombocytopenia was defined as platelet count of

From 1975-2009, the WHO guidelines classified symptomatic dengue virus infections as dengue fever, dengue hemorrhagic fever, and dengue shock syndrome. In 2009 the case definition was changed to a clinical classification after concern the original criteria was challenging to apply in resource-limited settings and not inclusive of a substantial proportion of severe dengue cases. Our goal was to examine how well the current WHO definition identified new dengue cases at our febrile surveillance sites in Kenya. Between 2014 and 2019 as part of a child cohort study of febrile illness in our four clinical study sites (Ukunda, Kisumu, Msambweni, Chulaimbo) we identified 369 dengue PCR positive symptomatic cases and characterized whether they met the 2009 revised WHO diagnostic criteria for dengue with and without warning signs and severe dengue. We found 62% of our PCR-confirmed dengue cases did not meet criteria per the guidelines. Our findings also correlate with our experience that dengue disease in children in Kenya is less severe as reported in other parts of the world. Although the 2009 clinical classification has recently been criticized for being overly inclusive and non-specific, our findings suggest the 2009 WHO dengue case definition may miss more than 50% of symptomatic infections in Kenya and may require further modification to include the African experience.

Terrorism has emerged as one of the major challenges for the Eurasian regional peace, security, and cooperation. Keeping these challenges in perspective, the Shanghai Cooperation Organization (SCO) was established to eliminate the menace of terrorism, fundamentalism, and secessionism. Against this background, the main objectives of this paper are to examine how terrorism emerged as a major determining factor in the Indo-Pak relations and how the Shanghai Cooperation Organization (SCO), was failed to play its effective role in the Indo-Pak conflict given the Pulwama terror attack. For this research, descriptive and analytical methods were used and the data was collected from secondary sources. The major findings of this article are that terrorism has emerged as one of the major determinants of Indo-Pak relations and the same has become a major challenge for the SCO to resolve the issue. Against the background of terror attacks, it was anticipated that the SCO would play a crucial role to pacify the situation. However, the role played by the SCO in this situation proved marked as a Whack-a-Mole.

Currently, highly luminescent colloidal upconversion nanoparticles (UCNPs) have expanded an increasing interest of researchers because of their facilitating lability in the biomedical/clinical field. In this study, NaYF4:Yb,Er UCNPs are prepared by eco-friendly metal complexation-based thermal decomposition method at a lower temperature in aqueous media. The phase structure, crystallinity, phase purity, morphology, colloidal dispersibility, surface structure, surface charge, and optical and luminescent properties were evaluated carefully by X-ray diffraction (XRD), scanning electron microscope (SEM), transmission electron microscope (TEM), energy dispersive x-ray analysis (EDX), Thermogravimetric analysis (TGA), zeta potential, Fourier transform infrared (FTIR), UV/visible and photoluminescent spectroscopic techniques. XRD pattern shows a pure single-phase cubic structure with an average grain size of 30–35 nm. TEM and SEM micrographs exhibited irregularly shaped spherical morphologies, porous surface structures highly aggregated UCNPs with the narrow-size distribution. Positive zeta potential has shown value signifying high absorption in the visible region which indicates particle's good colloidal stability in aqueous media. Under NIR-laser light excitation, the UCNPs emit strong UC emission transitions in the visible region. A broad infrared absorption peak of hydroxyl groups (–OH) in FTIR spectrum and mass loss at a lower temperature in TGA verified the surface functionality of UCNPs, with high colloidal stability, and excellent biocompatibility in aqueous media. In terms of their surface characteristics and high luminescent properties, the NaYF4:Yb,Er UCNPs could be interestingly applied in tagging of biomolecules, drug delivery, proteins labeling, and therapeutic and thermostats applications.