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Abstract This paper aims to analyze trends in income and consumption inequality for paid and self-employed households and examine to what extent changes in aggregate consumption and income inequality can be explained by changes in their permanent and transitory components over time using data from the Italian Survey of Household Wealth (SHIW) covering the period 1989-2016. The results obtained from the Generalized Method of Moments (GMM) analysis reveal differences in consumption and income inequality, as well as their permanent and transitory components, between self-employed and payroll households. In particular, self-employed households experience higher levels of both income and consumption inequality, the increase in total income and consumption inequality is mainly driven by an increase in its transitory component. Furthermore, findings from other descriptive measures of inequality, such as the Gini coefficient, the variance of the log, 90th/10th, and 50th/10th percentile ratios, support the notion that income inequality is higher than consumption inequality across all groups, with self-employed households exhibiting a more pronounced difference.

Objective: The spliced form of X-box binding protein 1 (XBP1s) is a key transcription factor in the unfolded proteinresponse (UPR), an adaptive mechanism for cell survival. Many studies demonstrated the induced expression ofXBP1s in various cancers, including hepatocellular carcinoma (HCC). Such upregulated expression is linked to anenhancement of cell proliferation, migration, and improvement of the survival rate. In this study, we aimed to assess thetherapeutic potential of targeting XBP1s, by specific decoy oligodeoxynucleotide (ODN) and evaluated the cancerousphenotypes in Huh-7 cells.Materials and Methods: In this experimental study, we transfected Huh-7 cells with XBP1s decoy oligonucleotide(ODN). Subsequently, we assess some cellular features, including viability, migration capacity, proliferation potential,and apoptosis. Therefore, various techniques included wound healing test, BrdU, and annexin/PI assays. Additionally,the colony formation capacity was evaluated. The mRNA expression levels of BAX, BCL-2, c-MYC, CCND1, MMP-9,CDH1, and CD133 were quantified by the reverse transcription-quantitative polymerase chain reaction (RT-qPCR).Results: Transfection of Huh-7 cells by XBP1s decoy ODN led to significant down-regulation of c-Myc, CCND1,MMP-9, BCL-2 and CD133 and up-regulation of CDH1 and BAX transcriptional expressions in comparison with thevehicle group. Our results also demonstrated that transfection of XBP1s-decoy reduced HCC cell viability, proliferation,migration capacity as well as colonization ability in comparison with the vehicle group.Conclusion: These findings proposed the potential application of XBP1s-decoy ODN to reduce cancerous phenotypessuch as cell proliferation, cell migration and apoptosis induction in the Huh-7 cell line. More experiments on other celllines and primary cells could validate our results.

Abstract Influenza viruses pose a threat to public health as evidenced by severe morbidity and mortality in humans on a yearly basis. Given the constant changes in the viral glycoproteins owing to antigenic drift, seasonal influenza vaccines need to be updated periodically and effectiveness often drops due to mismatches between vaccine and circulating strains. In addition, seasonal influenza vaccines are not protective against antigenically shifted influenza viruses with pandemic potential. Here, we have developed a highly immunogenic vaccination regimen based on live-attenuated influenza vaccines (LAIVs) comprised of an attenuated virus backbone lacking non-structural protein 1 (ΔNS1), the primary host interferon antagonist of influenza viruses, with chimeric hemagglutinins (cHA) composed of exotic avian head domains with a highly conserved stalk domain, to redirect the humoral response towards the HA stalk. In this study, we showed that cHA-LAIV vaccines induce robust serum and mucosal responses against group 1 stalk and confer antibody-dependent cell cytotoxicity activity. Mice that intranasally received cH8/1-ΔNS1 followed by a cH11/1-ΔNS1 heterologous booster had robust humoral responses for influenza A virus group 1 HAs and were protected from seasonal H1N1 influenza virus and heterologous highly pathogenic avian H5N1 lethal challenges. When compared with mice immunized with the standard of care or cold-adapted cHA-LAIV, cHA-ΔNS1 immunized mice had robust antigen-specific CD8+ T-cell responses which also correlated with markedly reduced lung pathology post-challenge. These observations support the development of a trivalent universal influenza vaccine for the protection against group 1 and group 2 influenza A viruses and influenza B viruses.

Abstract The plant extract-mediated method is eco-friendly, simple, safe, and low-cost, using biomolecules as a reducing agent to separate nanoparticles. Lanthanum (La) is a rare earth metal that positively affects plant growth and agriculture. Citrus limon is a leading citrus fruit with many varieties. Conventional vegetative propagation methods depend on season, availability of plant material and are time-consuming. It is the main reason for limiting the acceptance of new varieties. So, In-vitro propagation of the lemon method is practiced overcoming all these problems. Lanthanum oxide nanoparticles (La2O3-NPs) were synthesized using plant extract of C. aurantium. Ultraviolet (UV)-Visible Spectroscopy, Scanning Electron Microscopy (SEM), Transmission Electron Microscopy (TEM), Fourier Transform Infrared (FTIR) spectroscopy, and Thermal Gravimetric Analysis (TGA) were used to characterize the synthesized La2O3-NPs. Fabricated La2O3-NPs were oval and spherical, with an average size of 51.1 nm. UV-visible absorption spectra of La2O3-NPs were shown at a sharp single peak at 342 nm and FTIR showed stretching frequency at 455 cm−1-516 cm−1. In the TGA outcome, mass loss was 9.1%. In vitro experiments demonstrated that La2O3-NPs significantly enhanced the germination and growth of C. limon seeds, achieving an 83% germination rate at 5 mg/L concentration, with uncoated seeds showing root initiation at 10 days and shoot formation at 15 days. Furthermore, La2O3-NPs effectively stimulated callus induction and maturation, with optimal responses observed in media containing MS and 2 mg/L 2,4-D, resulting in a maximum callus frequency of 100% from leaves and 87.5% from shoots at 5 mg/L concentration. These findings underscore the potential of La2O3-NPs to improve seed germination rates, seedling vigor, and callogenesis efficiency, suggesting their promising integration into agricultural practices for sustainable crop production, especially in suboptimal growing conditions. Future research is recommended to explore the mechanisms and broader applications of La2O3-NPs across various plant species and environments.

Objective: To explore healthcare professionals' attitudes toward research, identify key barriers they face, and uncover potential solutions for overcoming these obstacles, as proposed by the professionals themselves. Study Design: Exploratory Sequential Design Mixed method study. Place and Duration of Study: It was conducted from 15th April 2022 to 15th Oct 2022 among health professionals working in tertiary care hospitals of Rawalpindi and Islamabad. Materials and Methods: A total of 276 junior to mid-level health professionals were included through nonprobability consecutive sampling. The quantitative part was done using a structured close ended questionnaire regarding research barriers. The SPSS version 24.0 was utilized for statistical analysis of quantitative data. Results: In this study a total of 276 health care professionals were included. Male and female doctors were 144 (52.2%) & 132 (47.8%)respectively. Regarding attitude of research 121 (43.8 %) participants believed that research promotes critical thinking and 116 (42.0%) considered it most helpful to improve patients' care. 133 (48.2%) participants attended research training of minimum 8 hours. The common barriers to research as identified by health professionals are absence of support especially technical guidance, less time allotted for research, less funding opportunities, no proper mentoring or supervision, lack of knowledge and skills about research. Conclusion: Health professionals face several research barriers, including a lack of technical support, time, funding, mentorship, and research skills. The absence of a research culture and logistical support further complicates the situation, leaving them overwhelmed and without time for research. Addressing these challenges is essential for enabling impactful research.

Abstract Background While death in old age is inevitable, premature death at younger ages is within our control. Premature mortality (death 8 years vs. no formal schooling, 0.46 (0.24, 0.88)], being married [0.60 (0.37, 0.97)], physical activity [3rd vs. 1st tertile, 0.38 (0.26, 0.57)], hip circumference [cm, 0.96 (0.92, 0.99)], estimated GFR [mL/min/1.73 m², 0.99 (0.978, 0.999)], and wealth score [4th vs. 1st quartile, 0.54 (0.32, 0.90)]. The PAF (95% CI) for all modifiable predictors was 0.83 (0.62, 0.92). Conclusions The predominant causes of premature mortality were IHD and stroke. To mitigate premature deaths, it is recommended to address both socioeconomic and behavioral factors simultaneously.

Introduction: Biomarkers of prognostic and predictive relevance are needed for the practical management of COVID-19. Objective: The authors aimed to assess a battery of inflammatory cytokines in patients with SARS-CoV-2 to determine the cytokines of prognostic and predictive relevance in COVID-19. Methods: In a cohort of 100 patients with SARS-CoV-2 (RT-PCR confirmed), hospitalised in Shri Maharaja Hari Singh Hospital associated to Government Medical College Srinagar, India, the level of a battery of cytokines, IL-6, IL-8, IL-10, IL-1α, vascular endothelial growth factor (VEGF), TNF-α, and ferritin were estimated by ELISA on a multimode microplate reader. Results: The deranged levels of these cytokines were mostly found in patients >60 years of age, with cough and pneumonia as the most common symptoms. A significant association was found between IL-6 and IL-8, disease severity (p=0.002; p=0.007), and poor disease outcome (p=0.040; p=0.009), respectively. A significant association was also found between decreased levels of VEGF and poor disease outcome (p=0.020). Further receiver operating characteristic analysis, univariant and multivariant (after adjusting for age, gender, and other inflammatory markers), revealed increased IL-10 (area under the curve [AUC]: 0.72) and IL-6 (AUC: 0.70) as independent markers of both disease severity (p=0.02; p=0.01) and disease outcome (P=0.03; p=0.02), respectively, and decreased VEGF (AUC: 0.69) as an independent marker of disease outcome (p=0.03). A significant association between cough and IL-8 (p=0.01) and IL-10 levels (p=0.03), and of diabetes and raised ferritin levels (p=0.01), with very high ferritin levels (>1500 ng/mL), was found in those who are likely to develop hyperinflammatory phenotype. Conclusion: The authors conclude that ‘IL-6, IL10, VEGF, and IL-8’ are the signature inflammatory cytokine panel/profile in COVID-19, particularly in patients from Kashmir. Increased IL-10 and IL-6 levels proved to be equally significant independent prognosticators of COVID-19 severity and outcome, and decreased VEGF levels were independent predictors of poor disease outcome in patients with SARS-CoV-2. Testing of the signature inflammatory cytokine panel is, therefore, recommended for optimal clinical decision-making in patients with COVID-19 from Kashmir, India.

Abstract Background Linezolid-resistant Enterococcus faecium (LRE) is a global priority pathogen. Thirteen LRE were reported from clinical specimens between November 2021 and April 2023 at two laboratories in Karachi, Pakistan. We aimed to investigate the strain types and genes associated with linezolid resistance among these isolates. Whole genome sequencing (WGS) was performed and analyzed by multilocus sequence typing (MLST). The presence of linezolid resistance genes was identified using ResFinder v4.1.11 and the LRE-finder tool. Results Twelve isolates belonged to clonal complex 17 (CC17); ST80 (n = 10), ST612 (n = 1) and ST1380 (n = 1). Six isolates showed the presence of optrA gene and G2576T mutations in the 23S rRNA gene, while six showed poxtA and cfr(D) genes. One isolate showed the combination of optrA, cfr(D) and poxtA genes. Conclusion Our findings show the circulation of CC17 sequence types with a known outbreak potential and we identified molecular mechanisms of resistance that were not previously reported from Pakistan.

Abstract Background Cardiovascular progenitor cells (CPCs) derived from human embryonic stem cells (hESCs) are considered valuable cell sources for investigating cardiovascular physiology in vitro. Meeting the diverse needs of this application requires the large-scale production of CPCs in an in vitro environment. This study aimed to use an effective culture system utilizing signaling factors for the large-scale expansion of hESC-derived CPCs with the potential to differentiate into functional cardiac lineage cells. Methods and results Initially, CPCs were generated from hESCs using a 4-day differentiation protocol with a combination of four small molecules (CHIR99021, IWP2, SB-431542, and purmorphamine). These CPCs were then expanded and maintained in a medium containing three factors (bFGF, CHIR, and A83-01), resulting in a > 6,000-fold increase after 8 passages. These CPCs were successfully cryopreserved for an extended period in late passages. The expanded CPCs maintained their gene and protein expression signatures as well as their differentiation capacity through eight passages. Additionally, these CPCs could differentiate into four types of cardiac lineage cells: cardiomyocytes, endothelial cells, smooth muscle cells, and fibroblasts, demonstrating appropriate functionality. Furthermore, the coculture of these CPC-derived cardiovascular lineage cells in rat tail collagen resulted in cardiac microtissue formation, highlighting the potential of this 3D platform for studying cardiovascular physiology in vitro. Conclusion In conclusion, expandable hESC-derived CPCs demonstrated the ability to self-renewal and differentiation into functional cardiovascular lineage cells consistently across passages, which may apply as potential cell sources for in vitro cardiovascular studies. Graphical Abstract

Abstract Hearing loss affects around 5% of the global population. Two preliminary studies have described genetic variants in sporadic individuals with hearing loss from Pakistan. Here we extend these studies to determine the spectrum of variants in a cohort of individuals with no previous history of hearing loss. Individuals with hearing loss born to consanguineous couples were identified from special schools. Audiograms were assessed. DNA from participants negative for GJB2 pathogenic variants was subjected to exome sequencing. Data were filtered to include variants with frequencies

Abstract Vasoactive intestinal polypeptide (VIP) is known to be present in a subclass of cortical interneurons. Here, using three different antibodies, we demonstrate that VIP is also present in the giant layer 5 pyramidal (Betz) neurons which are characteristic of the limb and axial representations of the marmoset primary motor cortex (cytoarchitectural area 4ab). No VIP staining was observed in smaller layer 5 pyramidal cells present in the primary motor facial representation (cytoarchitectural area 4c), or in the premotor cortex (e.g. the caudal subdivision of the dorsal premotor cortex, A6DC), indicating the selective expression of VIP in Betz cells. VIP in Betz cells was colocalized with neuronal specific marker (NeuN) and a calcium-binding protein parvalbumin (PV). PV also intensely labelled axon terminals surrounding Betz cell somata. VIP-positive interneurons were more abundant in the superficial cortical layers and constituted about 5–7% of total cortical neurons, with the highest density observed in area 4c. Our results demonstrate the expression of VIP in the largest excitatory neurons of the primate cortex, which may offer new functional insights into the role of VIP in the brain, and provide opportunities for genetic manipulation of Betz cells.

Abstract Psychological entitlement has appeared as a significant topic for research in the field of management and Psychology. From the perspective of social comparison theory, the present study aimed to investigate the impact of psychological entitlement on engagement in learning activities and psychological anxiety in the hotel industry. Furthermore, benign and malign envy were examined as an explanatory mechanism between psychological entitlement and its outcomes. Based on a three-wave time-lagged design, data were obtained from 242 employees working in the different hotels in Pakistan. We found that psychological entitlement’s has no direct influence on hotel employees engagement in learning activities, and psychological anxiety. In addition, the indirect effect of psychological entitlement on both outcomes (engagement in learning activities and psychological anxiety) was found significant through the mediating effect of benign and malign envy. The implications for research theory and practice are discussed.

Background and Aim: Trypanosomiasis, a parasitic infection caused by various Trypanosoma species, poses a significant threat to global livestock, affecting both human health and economic sectors. This study aimed to estimate the prevalence of Trypanosoma evansi in Southern Punjab, Pakistan, focusing on key ruminant species, including camels, cattle, buffaloes, goats, and sheep. Materials and Methods: A total of 240 blood samples, comprising 48 samples from each animal species (camel, cattle, buffaloes, goat, and sheep) were collected from three districts in Southern Punjab. The collected samples were subjected to thin smear microscopy, DNA extraction, and polymerase chain reaction (PCR) amplification. The molecular characterization was conducted using the TBR primer set, which targeted repeated satellite DNA regions and the cytochrome oxidase II gene of T. evansi. Results: About 22.08% (53/240) of overall samples were positive for trypanosomiasis, with prevalence rates being 23.75% (19/80), 21.25% (17/80), and 21.75% (17/80) for districts Muzaffargarh, Lodhran, and Bahawalpur, respectively. 5.83% (14/240) of samples tested for T. evansi using PCR were positive in the districts of Muzaffargarh 7.50% (6/80), Lodhran 5.00% (4/80), and Bahawalpur 5.00% (4/80). Among the animals tested, camels had the highest positivity rate. The microscopic examination confirmed infection rates of 45.83% (22/48) for camels, 18.75% (9/48) for cattle, 8.33% (4/48) for buffaloes, 18.75% (9/48) for goats, and 18.75% (9/48) for sheep (p < 0.001). PCR results did not reveal substantial differences (p < 0.05) in prevalence: camels 12.50% (6/48), cattle 6.25% (3/48), buffaloes 0% (0/48), goats 8.33% (4/48), sheep 2.08% (1/48); while distinct disparities were detected district-wise: Muzaffargarh 23.75% (19/80), Lodhran 21.25% (17/80), and Bahawalpur 21.25% (17/80). The PCR results for these districts were insignificantly different: 7.50% (6/80), 5% (4/80), and 5% (4/80). The microscopic infection rate in camels from Bahawalpur was 56.30% (9/16). The microscopic analysis in Buffaloes reported a 6.30% (1/16) infection rate, but PCR results indicated no infections (0%) in any district. A significant difference (p < 0.001) in identifying Trypanosoma species was found between positively and negatively tested animals in both microscopic and PCR methods. Conclusion: This study emphasizes the necessity of regularly using PCR-based screening for its superior sensitivity and specificity over traditional microscopy. The varying occurrence of trypanosomiasis among districts reflects the intricate nature of this diseases epidemiology in the region. Reducing economic losses from trypanosomiasis in Southern Punjab, Pakistan, requires targeted interventions, such as vector control measures and farmer education.

Abstract Most newly diagnosed pediatric cancer patients reside in LMICs. These countries face challenges in providing quality treatment, particularly with procedures requiring stillness or causing pain. Conscious sedation (CS) is underutilized in LMICs due, causing treatment delays and adverse outcomes. Advocacy for CS teams, training, and policy support is essential to improve outcomes.

Abstract Matricaria chamomilla (Asteraceae), commonly known as chamomile can tolerate freezing temperatures and grows in many soil types. This plant is found on all continents and has significant medicinal value. There are more than 120 chemicals detected in chamomile flowers, with the majority found in the essential oil. In this study, M. chamomilla was given the NaCl stress of 0 mM, 1 mM, 100 mM, and 150 mM concentrations This study was the first to assess the efficacy of German chamomile upon exposure to salt stress hence plant particles that had been dried and powdered were analyzed using, phytochemical tests, Fourier Transform Infrared and UV–Vis spectroscopy, thin layer chromatography, fluorescence recovery after photobleaching assay, antibacterial and antioxidant activity. The characterization and results of these activities show amazing results which enhance their antibacterial property with an increased zone of inhibition when the samples of salt stress of the above-given concentrations were compared to the control samples. More graph analysis indicates an effective impact of salt stress on the phytoconstituents of M. chamomilla. Other than that, there was a clear flower induction upon salt stress, as a variety of compounds are regarded as essential to the biological functions of chamomile flowers according to the phytoconstituent screening which can be further used in the cosmetic industry, pharmaceutical industry, and all other fields as well for various application as a nano-drug or bio-drug. Due to this, this plant became essential for plant biotechnology research.

Objective(s): Rhabdomyolysis, a potentially life-threatening condition, occurs when myoglobin is released from damaged muscle cells, leading to acute kidney injury (AKI). Alpha lipoic acid (ALA), an organosulfur compound known for its anti-oxidant and anti-inflammatory properties, was examined in this study for its potential impact on rhabdomyolysis-induced AKI in rats. Materials and Methods: Six groups of rats were included in the study, with each group consisting of six rats (n=6): Control, rhabdomyolysis, rhabdomyolysis treated with different doses of ALA (5, 10, and 20 mg/kg), and ALA alone (20 mg/kg) groups. Rhabdomyolysis was induced by intramuscular injection of glycerol on the first day of the experiment, while ALA was administered intraperitoneally for four consecutive days. Renal function parameters, oxidative stress markers, and histological changes in the kidneys were evaluated. Western blot analysis was performed to measure the levels of neutrophil gelatinase-associated lipocalin (NGAL) and tumor necrosis factor-alpha (TNF-α) proteins.Results: A significant increase in serum urea, creatinine, renal malondialdehyde, NGAl, and TNF-α protein levels was observed in glycerol-injected rats. In addition, a significant decrease in glutathione was recorded. Compared to the rhabdomyolysis group, treatment with ALA recovered kidney histological and biochemical abnormalities. Conclusion: Results suggest that rhabdomyolysis-induced AKI is associated with increased oxidative stress and inflammation. Treatment with ALA improved kidney histological abnormalities and reduced oxidative stress markers in rats. Therefore, ALA may have a potential protective effect against rhabdomyolysis-induced AKI.

Abstract Emerging evidence highlights cellular senescence’s pivotal role in chronic kidney disease (CKD). Proximal tubule epithelial cells (PTECs) and fibroblasts are major players in CKD and serve as cellular sources of senescence. The generation of a conditionally immortalized human kidney cell model would allow to better understand the specific mechanisms and factors associated with cellular senescence in a controlled setting, devoid of potential confounding factors such as age and comorbidities. In addition, the availability of human kidney cell lines for preclinical research is sparse and most cell lines do not reflect their in vivo counterparts due to their altered behavior as immortalized cancer-like cells. In this study, PTECs and fibroblasts from human kidneys were isolated and transduced with doxycycline-inducible simian virus 40 large T antigen (SV40LT) vector. By comparing their gene expression with single-cell RNA sequencing data from human kidneys, the newly produced human kidney cell lines demonstrated significant resemblances to their in vivo counterparts. As predicted, PTECs showed functional activity and fibroblasts responded to injury with fibrosis. Withdrawal of the immortalizing factor doxycycline led to p21+ cell-cycle arrest and the key hallmarks of senescence. The obtained senescence gene set largely overlapped between both cell lines and with the previously published SenMayo set of senescence-associated genes. Furthermore, crosstalk experiments showed that senescent PTECs can cause a profibrotic response in fibroblasts by paracrine actions. In 76 human kidney sections, the number of p21+ cells correlated with the degree of fibrosis, age and reduced glomerular filtration, validating the role of senescence in CKD. In conclusion, we provide a novel cellular ex vivo model to study kidney senescence which can serve as a platform for large scale compounds testing.

Abstract The contributions of Computerized Formative Assessment (CFA) to teachers’ instructional practices and students’ learning outcomes necessitate the development of valid and reliable instruments for measuring teachers’ literacy. To address this necessity, this study adopted an exploratory sequential mixed-methods design via drawing on a dual deductive–inductive approach to develop and validate a Computerized Formative Assessment Literacy (CFAL) questionnaire for language teachers. The participants comprised 489 Iranian male and female English as a Foreign Language (EFL) teachers teaching from elementary to advanced levels at different language institutes in eight big cities across the country. The results of Exploratory Factor Analysis (EFA) revealed that CFAL consisted of six factors including practical, theoretical, socio-affective, critical, identity-related, and developmental. The results of Cronbach’s alpha demonstrated that the questionnaire and its six components had satisfactory levels of reliability. The findings are discussed and implications for developing professional programs aiming at determining and promoting teachers’ CFAL are presented.

Abstract Background Jigsaw method is a structured cooperative-learning technique that lays the groundwork towards achieving collective competence, which forms the core of effective clinical practice. It promotes deep learning and effectively enhances team-work among students, hence creating a more inclusive environment. Objective Present study was designed to introduce jigsaw model of cooperative learning to early-year undergraduate medical students, measure its effectiveness on their academic performance, and evaluate the perspectives of both students and faculty members regarding the same. Methods It was a mixed method research, involving eighty second-year undergraduate medical students. The jigsaw cooperative learning approach was introduced in two themes within neurosciences module. Students were divided into two equal groups, with one group experiencing typical small-group discussions (SGDs) in first theme and other group exposed to jigsaw approach. The groups were then reversed for second theme. Following the activity, an assessment comprising multiple-choice-questions was conducted to evaluate the impact of jigsaw technique on students’ academic performance, with scores from both groups compared. Student perspectives were gathered through self-designed and validated questionnaire, while faculty perceptions were obtained through focus group discussions. Quantitative data were analyzed using SPSS v22, while thematic analysis was performed for qualitative data. Results The students of jigsaw group displayed significantly higher median assessment score percentage compared to control group (p = 0.003). Moreover, a significantly greater number of students achieved scores ≥ 60% in jigsaw group compared to control group (p = 0.006). The questionnaire responses indicated a favorable perception of this technique among students, in terms of acceptance, positive interdependence, improvement of interpersonal skills, and comparison with typical SGDs. This technique was also well-perceived within the educational context by faculty members. Conclusion The jigsaw method is associated with higher levels of academic performance among students when compared to typical small-group discussion. The students and faculty perceived this technique to be an effective cooperative learning strategy in terms of enhanced student engagement, active participation, and a sense of inclusivity.

It is now widely accepted that various subsets of hybrid fiber composites reinforced with combined natural and synthetic fibers can significantly expand the applicability of composite-based materials in design and technology practice. The already existing unnatural circumstances on the planet put natural fibers far ahead of traditions in the field of materials thanks to their biodegradability characteristics, availability and over-term endurance and corrosion resistance. At the same time, composites are rapidly taking their place in many industries and sectors of the economy as metals in as much as it is economically and energetically justified. This study evaluates the mechanical properties of hybrid composites reinforced with glass, hemp, and sisal fibers. Using a hand lay-up method with epoxy resin, composite laminates were fabricated and tested for tensile, flexural, impact strengths and hardness test in accordance with ASTM standards. The experimental results revealed that glass-sisal fiber composites achieved the highest tensile strength of 69.1 MPa, while glass-hemp-sisal fiber composites exhibited superior flexural strength of 15.22 MPa and impact strength of 137.45 kJ/m2 while best hardness value was 24.73 HV for glass-sisal fibre composite. These findings underscore the potential of glass-sisal-hemp fiber-reinforced epoxy composites as viable alternatives to traditional synthetic fiber-reinforced materials in automotive industry where there are no structural loadings i.e. automobile interiors; offering enhanced mechanical performance and sustainability.

Abstract Background Co-morbidity with respiratory viruses including influenza A, cause varying degree of morbidity especially in TB patients compared to general population. This study estimates the risk factors associated with influenza A (H1N1)pdm09 in TB patients with ILI. Methods A cohort of tuberculosis (TB) patients who were admitted to and enrolled in a TB Directly Observed Therapy Program (DOTs) in tertiary care hospitals of Lahore (Mayo Hospital and Infectious Disease Hospital) were followed for 12 weeks. At the start of study period, to record influenza-like illness (ILI), a symptom card was provided to all the participants. Every participant was contacted once a week, in person. When the symptoms were reported by the participant, a throat swab was taken for the detection of influenza A (H1N1)pdm09. A nested case control study was conducted and TB patients with ILI diagnosed with influenza A (H1N1)pdm09 by conventional RT-PCR were selected as cases, while those who tested negative by conventional RT-PCR were enrolled as controls. All cases and controls in the study were interviewed face-to-face in the local language. Epidemiological data about potential risk factors were collected on a predesigned questionnaire. Logistic analysis was conducted to identify associated risk factors in TB patients with ILI. Results From the main cohort of TB patients (n = 152) who were followed during the study period, 59 (39%) developed ILI symptoms; of them, 39 tested positive for influenza A (H1N1)pdm09, while 20 were detected negative for influenza A (H1N1)pdm09. In univariable analysis, four factors were identified as risk factors (p

Abstract Purpose To investigate the odds and associations of pregnancy outcomes with exposure to biopsy-confirmed celiac disease (CD) in Northeast Iran. Methods In this regional retrospective cohort study, pregnancy records of all women with celiac disease who visited Celiac Disease Clinic of Imam-Reza Hospital from 2017 to 2023 (exposed group) and a sample of women without CD (unexposed group) were extracted using the Electronic Health Record of Mashhad University of Medical Sciences called “Sina”. The unexposed group was randomly selected of the database and matched to exposed group on age, location of residence, socioeconomic factors. Our exclusion criteria included age ≥ 45, presence of concomitant disorders, history of non-obstetric uterine surgery, induction of pregnancy through assisted reproductive technology, and any concurrently ongoing pregnancy at the time of study. Pregnancy outcomes evaluated in this study included normal delivery, miscarriage, preterm labor, preeclampsia, and stillbirth. Adjusted odds ratios were calculated using logistic regression adjusted for confounders. Results Ninety pregnancy records of women with CD and 270 pregnancies of women without CD were included in this study. Low neonatal birthweight (i.e. under 2500 g) had no significant association with CD (aOR = 0.99, 95% CI = 0.92–1.06), as well as postpartum hemorrhage (aOR = 1.12, 95%CI = 0.91–1.38), fetal anomaly (aOR = 0.89, 95%CI = 0.69–1.15), miscarriage (aOR = 1.00, 95%CI = 0.91–1.10), ectopic pregnancy (aOR = 0.94, 95%CI = 0.73–1.20), preterm labor (aOR = 1.00, 95%CI = 0.92–1.10), gestational diabetes mellitus (aOR = 1.07, 95%CI = 0.98–1.16), gestational hypertension (aOR = 0.99, 95%CI = 0.89–1.11), and gestation hypothyroidism (aOR = 0.95, 95%CI = 0.82–1.11). However, we found significantly lower odds of preeclampsia in pregnancies affected by CD (aOR = 0.83, 95%CI = 0.69–0.99). Conclusion Celiac disease was not associated with increased odds of low neonatal birthweight, postpartum hemorrhage, fetal anomaly, miscarriage, ectopic pregnancy, preterm labor, gestational diabetes mellitus, gestational hypertension and gestational hypothyroidism. Preeclampsia had significantly lower odds in pregnancies affected with CD.

Abstract Background Understanding the relationship of thyroid hormones with the development of chronic kidney disease (CKD) has important clinical implications for managing patients with both thyroid and kidney dysfunction. In this review, our purpose was to provide a thorough comprehension of the interplay between thyroid hormones, thyroid dysfunctions, and CKD. Summary While there is evidence linking thyroid hormone levels to renal diseases, the association between thyroid hormones, specifically within the normal range, and the risk of CKD incidence is still a subject of debate. The Google Scholar, PubMed, Scopus, and Web of Science, were searched using the medical subject heading (MeSH) terms for the relevant keywords up to December 2023. Conclusion Based on the review, the development of CKD is more consistently associated with higher serum TSH and thereafter lower serum free T3 levels; however, its association with free T4 is more controversial. Furthermore, subclinical and overt hypothyroidisms were considerably associated with incident CKD. Hyperthyroidism and Hashimoto thyroiditis might increase the risk of CKD.

Abstract Background Effective cardiopulmonary resuscitation (CPR) training for nursing students is crucial for improving patient outcomes in cardiac arrest scenarios. This study assesses the impact of infographic versus video feedback on enhancing nursing students’ clinical skills in Basic Life Support (BLS). Methods In a randomized controlled setting, 76 nursing students at Torbat Heydariyeh University of Medical Sciences were divided into two groups: one received infographic-based education and the other video feedback training. Pre- and post-intervention assessments measured knowledge and skill retention using validated questionnaires. Results Post-training, the infographic group showed significantly higher knowledge scores, while the video feedback group exhibited greater improvement in CPR skill performance. No significant differences were noted in pre-training assessment scores between the groups. Conclusion Infographic-based education enhances BLS knowledge retention, and video feedback improves practical CPR skills. This suggests potential benefits of a combined infographic and video feedback approach for optimizing CPR training outcomes, addressing a critical need in medical education.

Moth eye protuberances, for instance, exhibit highly developed and well-organized nanostructures that allow them to adapt to a wide range of environmental conditions and achieve remarkable antireflective performance, which has inspired and been emulated by scientific advancement. Innovative studies have focused on bioinspired and imitating moth-eye patterns to provide a textured surface in multilayer antireflective coatings (ARC) using nanomaterials, polymers, or composites to eliminate undesired reflection in standard optical components and optoelectronic industrial applications. Multilayer AR systems provide a number of advantages over single-layer designs. Still, their limited applicability is due to obstacles such as mismatched properties at interfaces, high costs, poor mechanical durability, and wetting concerns. Using MgF2 and polytetrafluoroethylene, we develop a technique for fabricating high-performance AR nanostructures on borosilicate crown glass and Fluorine-doped Tin Oxide substrates via the glancing angle deposition technique. By inducing porosity and changing the deposition angle (α) at 550 nm, the refractive index of MgF2 is reduced from 1.38 to 1.14. In agreement with optical modelling predictions, high-performance ARC has been successfully produced on different substrates. Besides this, introducing a thin layer of polytetrafluoroethylene on MgF2 ARC via vapor deposition having a refractive index of 1.21 deposited at α ∼80° results in inducing water-repellent properties in ARC. Hence, our fabricated ARC yields stable AR efficiency with outstanding directional uniformity, durability, and negative temperature stability, having hydrophobic characteristics.

Abstract Hereditary spastic paraplegias are a diverse group of degenerative disorders that are clinically categorized as isolated; with involvement of lower limb spasticity, or symptomatic, where spastic paraplegia is complicated by further neurological features. We sought to identify the underlying genetic causes of these disorders in the participating patients. Three consanguineous families with multiple affected members were identified by visiting special schools in the Punjab Province. DNA was extracted from blood samples of the participants. Exome sequencing was performed for selected patients from the three families, and the data were filtered to identify rare homozygous variants. ExomeDepth was used for the delineation of the copy number variants. All patients had varying degrees of intellectual disabilities, poor speech development, spasticity, a wide-based gait or an inability to walk and hypertonia. In family RDHR07, a homozygous deletion involving multiple exons and introns of SPG11 (NC000015.9:g.44894055_449028del) was found and correlated with the phenotype of the patients who had spasticity and other complex movement disorders, but not those who exhibited ataxic or indeterminate symptoms as well. In families ANMD03 and RDFA06, a nonsense variant, c.985C > T;(p.Arg329Ter) in DDHD2 and a frameshift insertion‒deletion variant of AP4B1, c.965-967delACTinsC;p.(Tyr322SerfsTer14), were identified which were homozygous in the patients while the obligate carriers in the respective pedigrees were heterozygous. All variants were ultra-rare with none, or very few carriers identified in the public databases. The three loss of function variants are likely to cause nonsense-mediated decay of the respective transcripts. Our research adds to the genetic variability associated with the SPG11 and AP4B1 variants and emphasizes the genetic heterogeneity of hereditary spastic paraplegia.

Abstract The inhibition of tumor necrosis factor (TNF)-α trimer formation renders it inactive for binding to its receptors, thus mitigating the vicious cycle of inflammation. We designed a peptide (PIYLGGVFQ) that simulates a sequence strand of human TNFα monomer using a series of in silico methods, such as active site finding (Acsite), protein–protein interaction (PPI), docking studies (GOLD and Flex-X) followed by molecular dynamics (MD) simulation studies. The MD studies confirmed the intermolecular interaction of the peptide with the TNFα. Fluorescence-activated cell sorting and fluorescence microscopy revealed that the peptide effectively inhibited the binding of TNF to the cell surface receptors. The cell culture assays showed that the peptide significantly inhibited the TNFα-mediated cell death. In addition, the nuclear translocation of the nuclear factor kappa B (NFκB) was significantly suppressed in the peptide-treated A549 cells, as observed in immunofluorescence and gel mobility-shift assays. Furthermore, the peptide protected against joint damage in the collagen-induced arthritis (CIA) mouse model, as revealed in the micro focal-CT scans. In conclusion, this TNFα antagonist would be helpful for the prevention and repair of inflammatory bone destruction and subsequent loss in the mouse model of CIA as well as human rheumatoid arthritis (RA) patients. This calls upon further clinical investigation to utilize its potential effect as an antiarthritic drug.

Abstract Background There are limited data available, particularly in low- and middle-income countries (LMICs), on the long-term quality of life (QoL) and family functioning of primary caregivers of children and young people (CYPs) affected by primary brain tumors (PBTs). This study aimed to assess the factors associated with the mean change in QoL and family functioning scores of primary caregivers of CYP patients with PBTs 12 months posttreatment. Methods This prospective cohort study enrolled CYPs aged 5–21 years with newly diagnosed PBTs and their primary caregivers. The study was carried out between November 2020 and July 2023. The primary caregivers of CYPs were recruited from two major tertiary care centers in Karachi, Pakistan. The primary caregivers QoL were assessed by the Pediatric Quality of Life Inventory (PedsQL) Family Impact Module. The assessment was undertaken by a psychologist at the time of diagnosis and 12 months posttreatment. The data were analyzed with STATA version 12. Results Forty-eight CYPs with newly diagnosed PBTs and their primary caregivers (46 mothers and 2 fathers) were enrolled. At 12 months posttreatment, 25 (52%) CYPs and their primary caregivers (mothers) were reassessed, and 23 (48%) were lost to follow-up. On multivariable analysis, a significant decrease in mothers’ mean 12-month posttreatment QoL and family functioning scores was associated with CYP having posttreatment seizures (beta= -10.2; 95% CI: -18.4 to -2.0) and with the financial burden associated with the CYP’s illness (beta= -0.3; 95% CI: -0.4 to -0.1). However, in those cases where CYP had higher posttreatment quality of life scores (beta = 0.4; 95% CI = 0.1, 0.6) and posttreatment higher verbal intelligence scores (beta = 0.1; 95% CI = 0.01, 0.3), the mothers’ QoL and family functioning scores were significantly greater. Conclusion We found a significant decrease in QoL of mothers who had a high financial burden and whose CYP had posttreatment seizures. However, those whose CYPs had higher posttreatment verbal intelligence scores and quality of life scores had significantly greater QoL scores. Identification of the factors that influence primary caregivers QoL has the potential to aid in the development of targeted strategies to alleviate stressors and improve the overall quality of life for primary caregivers and their children who are at high risk.

Objective(s): Rhabdomyolysis leads to the release of myoglobin, sarcoplasmic proteins, and electrolytes into the blood circulation causing acute kidney injury (AKI). Thymoquinone, a natural compound found in Nigella sativa seeds, has antioxidant and anti-inflammatory effects. This investigation assessed the renoprotective effect of thymoquinone on rhabdomyolysis-induced AKI in rats.Materials and Methods: Male Wistar rats were categorized into six groups (n = 6): 1. Control: (normal saline), 2. Glycerol (50 ml/kg, single dose, IM), 3–5: Glycerol + thymoquinone (1, 2.5 and 5 mg/kg, 4 days, IP), 6. Thymoquinone (5 mg/kg). On day 5, serum and kidney tissue were isolated and the amounts of serum creatinine and blood urea nitrogen (BUN), renal malondialdehyde (MDA), glutathione (GSH.), tumor necrosis factor-alpha (TNF-α), neutrophil gelatinase-associated lipocalin (NGAL), and pathological changes were evaluated. Results: Glycerol increased creatinine, BUN, MDA, TNF-α, and NGAL levels. It decreased GSH amounts and caused renal tubular necrosis, glomerular atrophy, and myoglobin cast in kidney tissue. Co-administration of glycerol and thymoquinone reduced creatinine, BUN, histopathological alterations, and MDA levels, and enhanced GSH amounts. Administration of glycerol and thymoquinone (5 mg/kg) had no significant effect on TNF-α amount but decreased NGAL protein levels. The administration of thymoquinone (5 mg/kg) alone did not display a significant difference from the control group.Conclusion: Rhabdomyolysis from glycerol injection in rats can cause kidney damage. Thymoquinone may attenuate renal dysfunction and oxidative stress. However, the TNF-α level was not significantly affected. Further studies are needed to explore the potential therapeutic effects of thymoquinone in managing AKI.

Background: During the perimenopausal phase, women experience a myriad of somatic symptoms as well as changes in mood and emotions which could be related to the endocrine changes and psychological factors during this transition. Aim: The aim was to assess the prevalence of somatic symptoms and psychiatric morbidity in perimenopausal women. Material and Methods: By purposive sampling, 100 women in the age group of 45–55 years were included in the study with their consent. They were assessed with a self-made sociodemographic proforma, Mini-International Neuropsychiatric Interview (MINI), depression, anxiety, stress scale (DASS 21), Menopause Rating Scale, big five inventory scale (BFI-10), and social support scale. Results: Psychiatric morbidity was seen in 41% of perimenopausal women, out of which 32% showed somatic symptoms. Seventeen percent had mild-to-moderate depressive features, 17% showed mild-to-moderate anxiety, and 7% were dysthymic. Conclusion: Prevalent life stressors seemed to affect the transition into menopause for many women which directly corresponded to the prevalence of psychiatric morbidity and somatic symptoms in them.

The escalating demand for high-quality video streaming poses a major challenge for communication networks today. Catering to these bandwidth-hungry video streaming services places a huge burden on the limited spectral resources of communication networks, limiting the resources available for other services as well. Large volumes of video traffic can lead to severe network congestion, particularly during live streaming events, which require sending the same content to a large number of users simultaneously. For such applications, multicast transmission can effectively combat network congestion while meeting the demands of all the users by serving groups of users requesting the same content over shared spectral resources. Streaming services can further benefit from multi-connectivity, which allows users to receive content from multiple base stations simultaneously. Integrating multi-connectivity within multicast streaming can improve the system resource utilization while also providing seamless connectivity to multicast users. Toward this end, this work studied the impact of using multi-connectivity (MC) alongside wireless multicast for meeting the resource requirements of video streaming. Our findings show that MC substantially enhances the performance of multicast streaming, particularly benefiting cell-edge users who often experience poor channel conditions. We especially considered the number of users that can be simultaneously served by multi-connected multicast systems. It was observed that about 60% of the users that are left unserved under single-connectivity multicast are successfully served using the same resources by employing multi-connectivity in multicast transmissions. We prove that the optimal resource allocation problem for MC multicast is NP-hard. As a solution, we present a greedy approximation algorithm with an approximation factor of (1−1/e). Furthermore, we establish that no other polynomial-time algorithm can offer a superior approximation. To generate realistic video traffic patterns in our simulations, we made use of traces from actual videos. Our results clearly demonstrate that multi-connectivity leads to significant enhancements in the performance of multicast streaming.

Abstract This research presents a new adaptive exponentially weighted moving average control chart, known as the coefficient of variation (CV) EWMA statistic to study the relative process variability. The production process CV monitoring is a long-term process observation with an unstable mean. Therefore, a new modified adaptive exponentially weighted moving average (AAEWMA) CV monitoring chart using a novel function hereafter referred to as the "AAEWMA CV" monitoring control chart. the novelty of the suggested AAEWMA CV chart statistic is to identify the infrequent process CV changes. A continuous function is suggested to be used to adapt the plotting statistic smoothing constant value as per the process estimated shift size that arises in the CV parametric values. The Monte Carlo simulation method is used to compute the run-length values, which are used to analyze efficiency. The existing AEWMA CV chart is less effective than the proposed AAEWMA CV chart. An industrial data example is used to examine the strength of the proposed AAEWMA CV chart and to clarify the implementation specifics which is provided in the example section. The results strongly recommend the implementation of the proposed AAEWMA CV control chart.

Abstract Sea level rise (SLR) affects coastal flood regimes and poses serious challenges to flood risk management, particularly on ungauged coasts. To address the challenge of monitoring SLR at local scales, we propose a high tide flood (HTF) thresholding system that leverages machine learning (ML) techniques to estimate SLR and HTF thresholds at a relatively fine spatial resolution (10 km) along the United States’ coastlines. The proposed system, complementing conventional linear- and point-based estimations of HTF thresholds and SLR rates, can estimate these values at ungauged stretches of the coast. Trained and validated against National Oceanic and Atmospheric Administration (NOAA) gauge data, our system demonstrates promising skills with an average Kling-Gupta Efficiency (KGE) of 0.77. The results can raise community awareness about SLR impacts by documenting the chronic signal of HTF and providing useful information for adaptation planning. The findings encourage further application of ML in achieving spatially distributed thresholds.

Marchiafava-Bignami Disease (MBD) is an unusual neurological illness caused by prolonged alcoholism that is distinguished by demyelination of the corpus callosum. Clinicians encounter a wide range of alcohol-related diseases in their practice, and MBD is a rare condition that requires a high clinical suspicion due to its potential to mimic withdrawal symptoms, Wernicke’s-Korsakoff’s Psychosis, and various other neurological conditions, leading to confusion in diagnosis. It is a toxic-demyelinating syndrome that typically affects chronic alcoholics, but it has been described in rare instances in chronically malnourished teetotalers. The symptoms and warning signs are diffuse, and the onset could be abrupt or gradual. This is a case of a 54-year-old chronic alcoholic who presented with neurological symptoms. Magnetic Resonance Imaging (MRI) of the brain revealed typical features of MBD. The patient was treated with high doses of thiamine along with folic acid and other symptomatic treatments, after which significant improvement was observed. This case report reviews past reported cases to shed light on the varied presentation features of the disease. It adds to the limited corpus of MBD literature and highlights the intricate diagnostic process and management complexities associated with this condition. By integrating clinical observations, neuroimaging findings, and treatment outcomes, this report underscores the importance of maintaining a high clinical suspicion in cases involving alcohol abuse and the significance of tailored therapeutic strategies. As MBD continues to present diagnostic challenges, this report contributes valuable insights into its presentation, progression, and potential pathways to recovery. Therefore, it requires a high clinical suspicion for both clinical and radiological diagnosis.

Abstract In this study, we have presented a novel probabilistic model called the neutrosophic Burr-III distribution, designed for applications in neutrosophic surface analysis. Neutrosophic analysis allows for the incorporation of vague and imprecise information, reflecting the reality that many real-world problems involve ambiguous data. This ability to handle vagueness can lead to more robust and realistic models especially in situation where classical models fall short. We have also explored the neutrosophic Burr-III distribution in order to deal with the ambiguity and vagueness in the data where the classical Burr-III distribution falls short. This distribution offers valuable insights into various reliability properties, moment expressions, order statistics, and entropy measures, making it a versatile tool for analyzing complex data. To assess the practical relevance of our proposed distribution, we applied it to real-world data sets and compared its performance against the classical Burr-III distribution. The findings revealed that the neutrosophic Burr-III distribution outperformed than the classical Burr-III distribution in capturing the underlying data characteristics, highlighting its potential as a superior modeling toolin various fields.

Abstract We present an advanced electrochemical immunosensor designed to detect the vascular endothelial growth factor (VEGF) precisely. The sensor is constructed on a modified porous gold electrode through a fabrication process involving the deposition of silver and gold on an FTO substrate. Employing thermal annealing and a de-alloying process, the silver is eliminated from the electrode, producing a reproducible porous gold substrate. Utilizing a well-defined protocol, we immobilize the heavy-chain (VHH) antibody against VEGF on the gold substrate, facilitating VEGF detection through various electrochemical methods. Remarkably, this immunosensor performs well, featuring an impressive detection limit of 0.05 pg/mL and an extensive linear range from 0.1 pg/mL to 0.1 µg/mL. This emphasizes it’s to measure biomarkers across a wide concentration spectrum precisely. The robust fabrication methodology in this research underscores its potential for widespread application, offering enhanced precision, reproducibility, and remarkable detection capabilities for the developed immunosensor.

Abstract Background Semiparametric survival analysis such as the Cox proportional hazards (CPH) regression model is commonly employed in endometrial cancer (EC) study. Although this method does not need to know the baseline hazard function, it cannot estimate event time ratio (ETR) which measures relative increase or decrease in survival time. To estimate ETR, the Weibull parametric model needs to be applied. The objective of this study is to develop and evaluate the Weibull parametric model for EC patients’ survival analysis. Methods Training (n = 411) and testing (n = 80) datasets from EC patients were retrospectively collected to investigate this problem. To determine the optimal CPH model from the training dataset, a bi-level model selection with minimax concave penalty was applied to select clinical and radiomic features which were obtained from T2-weighted MRI images. After the CPH model was built, model diagnostic was carried out to evaluate the proportional hazard assumption with Schoenfeld test. Survival data were fitted into a Weibull model and hazard ratio (HR) and ETR were calculated from the model. Brier score and time-dependent area under the receiver operating characteristic curve (AUC) were compared between CPH and Weibull models. Goodness of the fit was measured with Kolmogorov-Smirnov (KS) statistic. Results Although the proportional hazard assumption holds for fitting EC survival data, the linearity of the model assumption is suspicious as there are trends in the age and cancer grade predictors. The result also showed that there was a significant relation between the EC survival data and the Weibull distribution. Finally, it showed that Weibull model has a larger AUC value than CPH model in general, and it also has smaller Brier score value for EC survival prediction using both training and testing datasets, suggesting that it is more accurate to use the Weibull model for EC survival analysis. Conclusions The Weibull parametric model for EC survival analysis allows simultaneous characterization of the treatment effect in terms of the hazard ratio and the event time ratio (ETR), which is likely to be better understood. This method can be extended to study progression free survival and disease specific survival. Trial registration ClinicalTrials.gov NCT03543215, https://clinicaltrials.gov/ , date of registration: 30th June 2017.

Abstract The study aimed to determine the accuracy of diagnosing periodontal conditions using the developed web-based PocketPerio application and evaluate the user’s perspective on the use of PocketPerio. First, 22 third-year dental students (DS3) diagnosed ten cases without PocketPerio (control) and with PocketPerio (test) during a mock examination. Then, 105 DS3, 13 fourth-year dental students (DS4), and 32 senior second-year International Standing Program students (ISP2) used PocketPerio chairside. Statistical analysis was performed using a non-parametric paired two-tailed test of significance with the Wilcoxon matched-pairs signed rank test. The null hypothesis that PocketPerio did not increase the accuracy of periodontal diagnoses was rejected at α

Abstract HPV vaccination with concomitant HPV-based screening of young women has been proposed for faster cervical cancer elimination. We describe the baseline results of a population-based trial of this strategy to reduce the incidence of HPV. All 89,547 women born 1994-1999 and resident in the capital region of Sweden were personally invited to concomitant HPV vaccination and HPV screening with 26,125 women (29.2%) enrolled between 2021-05-03 and 2022-12-31. Baseline HPV genotyping of cervical samples from the study participants finds, compared to pre-vaccination prevalences, a strong decline of HPV16 and 18 in birth cohorts previously offered vaccination, some decline for cross-protected HPV types but no decline for HPV types not targeted by vaccines. Our dynamic transmission modelling predicts that the trial could reduce the incidence of high-risk HPV infections among the 1994-1998 cohorts by 62-64% in 3 years. Baseline results are prevalences of HPV infection, validated transmission model projections, and power estimates for evaluating HPV incidence reductions at follow-up (+/−0.1% with 99.9% confidence). In conclusion, concomitant HPV vaccination and HPV screening appears to be a realistic option for faster cervical cancer elimination. Clinicaltrials.gov identifier: NCT04910802; EudraCT number: 2020-001169-34.

Abstract Background Approximately one in five pregnant women experience antenatal depression globally. The purpose of the present study was to estimate the prevalence of antenatal depression and explore its relationship between various demographic variables, recent sexual engagement, and recent adverse life events among pregnant Afghan women. Methods A cross-sectional survey study was carried out between January, 2023 and April 2023 among 460 women aged 15–45 years who were recruited using convenience sampling from Herat province (Afghanistan). Logistic regression models were utilized to explore the relationship between antenatal depression and socio-demographic characteristics among the participants. Results The prevalence of antenatal depression symptoms was 78.5%. Multiple regression analysis indicated that antenatal depression was significantly associated with (i) being aged 30–45 years (AOR: 4.216, 95% CI: 1.868–9.515, p = .001), (ii) being of low economic status (AOR:2.102, 95% CI: 1.051–4.202, p = .036), (iii) not being employed (AOR: 2.445, 95% CI:1.189–5.025, p = .015), (iv) not having had sex during the past seven days (AOR: 2.335, 95% CI: 1.427–3.822, p = .001), and (v) not experiencing a traumatic event during the past month (AOR:0.263, 95% CI: 0.139–0.495, p

Sinusitis, one of the most prevalent and undertreated disorders, is a term used to describe inflammation of the paranasal sinuses caused by either infectious or non-infectious sources. Bacterial, viral, or fungal infections can all cause sinusitis. Sinusitis is classified into 3 types: acute, subacute, and chronic. Acute sinusitis lasts for less than 1 month, subacute sinusitis lasts from 1 to 3 months, and chronic sinusitis persists for over 3 months. This condition affects a significant portion of the population, imposing a substantial burden on the healthcare system. Antibiotics are the gold standard of bacterial sinusitis treatment. However, due to the rise of antimicrobial resistance, especially in immune-compromised patients, it is necessary to investigate potential adjunctive therapies. Based on the literature, vitamins (eg, vitamin D) have antioxidant, anti-inflammatory, and immune-modulatory properties and may effectively treat sinusitis and reduce mucous membrane inflammation. Besides vitamins, many other supplements like quercetin, sinupret, and echinacea have immunomodulatory effects and have shown promising results in sinusitis treatment. In this review, we look at the therapeutic role, safety, and efficacy of vitamins and nutritional supplements in sinusitis treatment.

Peatlands are vital in the global carbon cycle, acting as significant sinks for carbon and releasing methane (CH4) and carbon dioxide (CO2) into the atmosphere. However, the complex interactions between environmental factors and the microbial communities responsible for these greenhouse gas emissions remain insufficiently understood. To address this knowledge gap, a pilot-scale mesocosm study was conducted to assess the impact of different terminal electron acceptors (TEAs), including sulfate (SO42−), humic acid (HA), and goethite, on CH4 and CO2 emissions and microbial community structures in peatlands. Our results revealed that the addition of TEAs significantly altered the CH4 and CO2 emissions. Specifically, the addition of SO42− nearly doubled CO2 production while substantially inhibiting CH4 emissions. The combined addition of SO42− and HA, as well as HA alone, followed a similar pattern, albeit with less pronounced effects on CH4. Goethite addition resulted in the highest inhibition of CH4 among all treatments but did not significantly increase CO2 production. Community composition and network analysis indicated that TEAs primarily determined the structure of microbial communities, with each treatment exhibiting distinct taxa networks. Proteobacteria, Acidobacteria, Chloroflexi, and Bacteroidetes were the most abundant phyla across all mesocosms. The presence of methanotrophs, including Methylomirabilales and Methylococcales, was linked to the inhibition of CH4 emissions in these mesocosms. This study provides novel insights into the spatial variability of microbial diversity and density in peatlands under various TEAs, emphasizing the role of methanogenesis and CO2 fluxes in carbon cycling. Our findings enhance the understanding of carbon cycling in microbe-rich environments exposed to TEAs and highlight the potential for future studies to investigate the long-term effects of TEAs on microbial communities, enzymes, and carbon storage.

Background Hypertension afflicts most patients with chronic kidney disease (CKD) and contributes to kidney disease progression, cardiovascular disease, and death in this patient population. The evidence and clinical guidelines support lowering blood pressure (BP) goals in patients with CKD. We evaluated if BP control improved among US adults with CKD. Methods and Results In the NHANES (National Health and Nutrition Examination Survey) for the periods 2011 to 2014, 2015 to 2016, and 2017 to 2020, we identified individuals with CKD defined as estimated glomerular filtration rate 20 to 59 mL/min per 1.73 m2 or urinary albumin/creatinine ratio≥30 mg/g. The following systolic BP categories were evaluated:

Congenital bilateral absence of vas deferens (CBAVD) is a urological syndrome of Wolffian ducts and is responsible for male infertility and obstructive azoospermia. This study is designed to explore the integrity of exon 10 of CFTR and its role in male infertility in a cohort of CBVAD patients in Pakistan. Genomic DNA was extracted from 17 male patients with CBAVD having clinical symptoms, and 10 healthy controls via phenol-chloroform method. Exon 10 of the CFTR gene was amplified, using PCR with specific primers and DNA screening was done by Sanger sequencing. Sequencing results were analyzed using freeware Serial Cloner, SnapGene, BioEdit and FinchTV. Furthermore, bioinformatics tools were used to analyze the mutations and their impact on the protein function and stability. We have identified 4 mutations on exon 10 of CFTR in 6 out of 17 patients. Two of the mutations were missense variants V456A, K464E, and the other two were silent mutations G437G, S431S. The identified variant V456A was present in 4 of the studied patients. Whereas, the presence of K464E in our patients further weighs on the crucial importance for its strategic location to influence the gene function at post-transcriptional and protein level. Furthermore, Polyphen-2 and SIFT analyze the mutations as harmful and deleterious. The recurrence of V456A and tactically conserved locality of K464E are evidence of their potential role in CBAVD patients and in male infertility. The data can contribute in developing genetic testing and treatment of CBAVD.

Auxiliary data needs to be incorporated into survey sampling in order to create a precise population parameter estimator. This study investigates improving the efficiency of these estimators, the researchers use study variable [cumulative distribution function, (CDF)] and auxiliary variable (CDF, mean and ranks) to achieve this goal in the condition of non-response. The researchers suggest two ideal families of exponential estimators to obtain an enhanced population (CDF) estimators in simple random sampling under non-response, by utilizing the data from dual auxiliary variable. The first-order approximation is used for the bias, mean squared error (MSE), and minimal mean squared error of the new and existing estimators. Using dual auxiliary information, the new families of exponential estimators turn out to be precise and efficient while estimating the distribution function, whenever non-response is contained within three Situation such as (Situation-I when non-response occurs in both study and auxiliary variables, next to it Situation-II when non-response occurs only in study variable and Situation-III when non-response occurs only in auxiliary variable). We employ a single population to assess the effectiveness and suitability of the suggested family estimators; varying values of k = 2 and 3 produce varying mean square error and percentage relative efficiency values. The suggested families of estimators have lower (MSE) and higher (PRE) values for the population which showed in tables 2–13 The percentage relative efficiency (PRE) of proposed families of estimators when k = 2 for all the three situation of non-response is 183.52715, 189.78448, 184.82791, 185.49885, and 223.06144 and when k = 3 for all the three situation of non-response is 223.06144, 119.32556, 165.89993, 166.29598, 112.90767 and 113.25086.

Probiotics have recently gained significant interest for their possible therapeutic effects in treating numerous health conditions. Probiotics containing Bacillus subtilis have been shown to have several health benefits, most notably in preventing diarrhea and gastrointestinal problems. A novel probiotic strain, Bacillus subtilis (NMCC-path-14), isolated from the rumen of a Nilli Ravi Buffalo, was evaluated for 28-day repeated dose toxicity in Balb/c mice. The NMCC-path-14 in low dose (1 × 108 CFU/ml) and high dose (1 × 1010 CFU/ml) was administered to the mice through gavage regularly. After 28 days of treatment, it was discovered that the no-observed-adverse-effect level (NOAEL) for NMCC-path-14 wasgreater than 1 × 1010 CFU/animal/day. This study also revealed no treatment-related changes in clinical parameters, body weight, gross pathology, or histology. Food consumption, hemoglobin, hematocrit, red blood cell counts, and colon length increased, while total/differential leukocyte count and platelets remained unchanged. The administration of NMCC-path-14 also resulted in decreased bilirubin and creatinine levels. Furthermore, NMCC-path-14 also displayed a promising antioxidant potential by increasing the antioxidant enzymes (GST, GSH, and CAT) and decreasing oxidant enzyme (MDA and NO) levels in vital organs like the liver, kidneys, spleen, and colon. TheNMCC-path-14also decreased the pathogenic bacterial population while increasing the beneficial population. Given the lack of adverse effects observed after NMCC-path-14 treatment, this strain is safe and must be considered as a potential probiotic in humans.

An early identification and subsequent management of cerebral small vessel disease (cSVD) grade 1 can delay progression into grades II and III. Machine learning algorithms have shown considerable promise in medical image interpretation automation. An experimental cross-sectional study aimed to develop an automated computer-aided diagnostic system based on AI (artificial intelligence) tools to detect grade 1-cSVD with improved accuracy. Patients with Fazekas grade 1 cSVD on Non-Contrast Magnetic Resonance Imaging (MRI) Brain of age >40 years of both genders were included. The dataset was pre-processed to be fed into a 3D convolutional neural network (CNN) model. A 3D stack with the shape (120, 128, 128, 1) containing axial slices from the brain magnetic resonance image was created. The model was created from scratch and contained four convolutional and three fully connected (FC) layers. The dataset was preprocessed by making a 3D stack, and normalizing, resizing, and completing the stack was performed. A 3D-CNN model architecture was designed to train and test preprocessed images. We achieved an accuracy of 93.12 % when 2D axial slices were used. When the 2D slices of a patient were stacked to form a 3D image, an accuracy of 85.71 % was achieved on the test set. Overall, the 3D-CNN model performed very well on the test set. The earliest and the most accurate diagnosis from computational imaging methods can help reduce the huge burden of cSVD and its associated morbidity in the form of vascular dementia.

BackgroundOpium use disorder is a significant health problem in our country, leading to a considerable number of health issues. Opium has several detrimental effects on its consumers. However, the effect of Opium use disorder on intracerebral hemorrhage (ICH) has not been evaluated. This study aims to evaluate the relationship between Opium use disorder and ICH.MethodsIn this case–control study, 402 patients with ICH and 404 patients without ICH enrolled. Opium use disorder, other vascular risk factors including diabetes mellitus, hypertension, hyperlipidemia, and tobacco smoking was compared between these groups. Patients with ICH were divided into two groups; first group are patients with history of Opioid Use Disorder and second group are those patients without Opioid Use Disorder. ICH features including clinical and imaging characteristics and prognostic findings were compared between patients with and without Opium use disorder.ResultsThis case–control study of 806 participants found that hypertension (OR = 6.84, 95% CI: 5.03–9.34, p-value:

Objectives This study aimed to investigate the association between age-specific and sex-specific continuous metabolic syndrome severity score (cMetS-S) and the risk of developing type 2 diabetes mellitus (T2DM). Additionally, the study aimed to assess the added value of cMetS-S in predicting T2DM compared with traditional MetS criteria.Design The study used a longitudinal cohort design, following participants for 18 years.Setting The research was conducted within the Tehran Lipid and Glucose Study, a community-based study in Tehran, Iran.Participants A total of 6957 participants aged 20–60 years were included in the study.Interventions/exposures The cMetS-S of each participant was determined using age-specific and sex-specific equations and Cox proportional hazard regression models were used to analyse the association between cMetS-S and T2DM using continuous and quantile approaches.Primary and secondary outcome measures The outcome measure was the association between cMetS-S and the development of T2DM during the 18-year follow-up.Results A total of 1124 T2DM cases were recorded over 18 years of follow-up. In the fully adjusted model, a 1-SD increase in the cMetS-S was associated with future T2DM (HR 1.72; 95% CI 1.54 to 1.91). Men and women had HRs of 1.65 (95% CI 1.40 to 1.95) and 1.83 (95% CI 1.59 to 2.10) for T2DM per 1-SD increase in cMetS-S, respectively. Higher cMetS-S was associated with increased risk of diabetes in both prediabetic (HR 1.42;95% CI 1.23 to 1.64) and normoglycaemic individuals (HR 2.11;95% CI 1.76 to 2.54); this association was more significant in normoglycaemic individuals. Unlike the traditional-based MetS definitions, the cMetS-S improved diabetes prediction (p