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Herein, we present the development and characterization of Yttrium oxide (Y2O3) films and Al/Y2O3/n-Si heterojunction diodes at various substrate temperatures using a low-cost facile jet nebulizer spray pyrolysis (JNSP) technique. The X-ray powder diffraction (XRD) pattern proved polycrystalline films of Y2O3 with a cubic structure. Field emission scanning electron microscope (FESEM) images reveal very fine nanograins formation in Y2O3 films at all temperatures. Scanning probe microscopy (SPM) analysis shows very low roughness of all films. The detailed compositional/homogeneity analysis was done via energy dispersive X-ray (EDX)/e-mapping analysis. All the films exhibited a sharp absorption edge at ∼ 280 nm, and the estimated energy gap values were noticed between 4.5 to 5.5 eV. Moreover, the observed photoluminescence (PL) spectrum indicated that the intensity of emission peaks quenched ∼ 3 times, indicating the reduction of defects with substrate temperature. From the current – voltage (I-V) characteristic, the calculated ideality factor (n) value was noticed to be drastically reduced from 7.66 and 2.87 on increasing the substrate temperature. Further, the diode ideality factor, series resistance (Rs) and barrier height (ФB) were obtained from Cheung's method. The results revealed that the developed Al/Y2O3/n-Si heterojunction diode is a promising contender for optoelectronic devices.

Resistance to platinum-based chemotherapy is a major clinical challenge in ovarian cancer, contributing to the high mortality-to-incidence ratio. Management of the platinum-resistant disease has been difficult due to diverse underlying molecular mechanisms. Over the past several years, research has revealed several novel molecular targets that are being explored as biomarkers for treatment planning and monitoring of response. The therapeutic landscape of ovarian cancer is also rapidly evolving, and alternative therapies are becoming available for the recurrent platinum-resistant disease. This review provides a snapshot of platinum resistance mechanisms and discusses liquid-based biomarkers and their potential utility in effective management of platinum-resistant ovarian cancer.

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.

The risk of acute respiratory tract infections is particularly pronounced in patients deficient in 25-hydroxyvitamin D (25(OH)D). With respect to COVID-19, there are conflicting evidence on the association of 25(OH)D levels with disease severity. We undertook this study to evaluate the 25(OH)D status in COVID-19 patients admitted in Karachi, Pakistan, and associated vitamin D deficiency with primary outcomes of mortality, length of stay, intubation, and frequency of COVID-19 symptoms. A total of 91 patients were evaluated for 25(OH)D status during their COVID-19 disease course. 25-hydroxyvitamin D levels were classified as deficient (< 10 ng/mL), insufficient (10–30 ng/mL), or sufficient (> 30 ng/mL). The study population comprised 68.1% males (N = 62). The mean age was 52.6 ± 15.7 years. Vitamin D deficiency was significantly associated with intensive care unit (ICU) admission (RR: 3.20; P = 0.048), invasive ventilation (RR: 2.78; P = 0.043), persistent pulmonary infiltrates (RR: 7.58; P < 0.001), and death (RR: 2.98; P < 0.001) on univariate Cox regression. On multivariate Cox regression, only death (RR: 2.13; P = 0.046) and persistent pulmonary infiltrates (RR: 6.78; P = 0.009) remained significant after adjustment for confounding factors. On Kaplan Meier curves, vitamin D deficient patients had persistent pulmonary infiltrates and a greater probability of requiring mechanical ventilation than patients with 25(OH)D ≥ 10 ng/mL. Mechanical ventilation had to be initiated early in the deficient group during the 30-day hospital stay (Chi-square: 4.565, P = 0.033). Patients with 25(OH)D ≥ 10 ng/mL also demonstrated a higher probability of survival than those with 25(OH)D concentrations < 10 ng/mL. 25-hydroxyvitamin D deficient population had longer hospital stays and worse outcomes.

Objective: To assess the role of pregabalin as premedication for preoperative sedation & anxiolysis with two different doses in laparoscopic cholecystectomy patients. Study Design: Prospective, randomized control study Place and Duration of Study: Department of Pharmacology and Therapeutics, Army Medical College, Rawalpindi in collaboration with Department of Anesthesiology, CMH, Rawalpindi from February 2019 to July 2019. Patients & Methods: 96 patients of either gender, aged between 18 to 60 years with ASA grade I-II, undergoing elective laparoscopic cholecystectomy were enrolled in this study. They were randomly divided into three groups having 32 patients each. Group 1 received oral placebo drug, Group 2 received oral pregabalin 150 mg, whereas Group 3 received oral pregabalin 300mg with sip of water 90 mins before the induction of general anesthesia. The effects of drugs on the patient’s level of sedation and anxiety were evaluated at baseline and before the induction of anesthesia using Ramsay Sedation Score and Beck Anxiety Inventory respectively. Results: Premedication with pregabalin 150mg and 300mg significantly produced sedation as compared to placebo. Though, pregabalin 300mg exhibited more sedation than pregabalin 150mg but the difference between them was statistically insignificant (p >0.05). Preoperative administration of pregabalin was related with anxiolysis, with the most prominent results shown by pregabalin 300mg (p 0.05). Conclusions: Premedication with pregabalin 300mg, 90 mins before the induction of general anesthesia is an effective regimen to alleviate preoperative anxiety and sedation.

Recommender systems have been exhaustively implemented in the e-commerce industry for providing accurate, efficient, and effective personalized recommendations to candidate users. The variants of matrix factorization (MF) techniques incorporating the stochastic gradient descent (SGD) are exploited to improve the efficacy of recommender systems through effectively dealing the fuzzy behavior. The iterative update mechanism of MF-based SGD techniques involves current but limited information for providing related recommendations. The strength of sliding window and multi-innovation-based approximations with memory can improve the accuracy of the recommender systems through prior knowledge by utilizing the fuzziness among ratings. In this work, a moving-information-based computing paradigm is presented to effectively handle the fuzzy nature of preferences by recommender systems with the ability to capture the collective effect of ratings of previous update history obtained for a defined information length to provide fast and precise recommendations.

As a possible suitor for application of solar cells and thermoelectric, halide based double perovskites has been developed due to their ecosystem stability, non-toxicity and noticeable performance. In current study, we have explored structural stability and elastic properties of Cs2ScAgX6 (X = I, Cl, Br) in the cubic phase through tolerance factor and Born stability criteria calculations. Further, we present an extensive analysis of optical, electronic and electronic transport characteristics. An indirect semiconducting bandgap in the range of 1.9 eV and 1.55 eV is observed while analyzing electronic band structure and play vital role in solar cells applications. According to their bandgap values, maximal absorption in visible region is perceived, which reduces the bandgap when chlorine is substituted with bromine and iodine. Dielectric constants and other relevant parameters were produced by studying optical characteristics of Cs2ScAgX6. Within the visible region, the maximum absorption of light has been recorded by investigating dielectric constant. Finally, thermoelectric properties are computed using the BoltzTraP package. The value of figure of merit, which is around 0.74 at 300 K, clearly suggests that these materials are also used as potential candidate for thermoelectric devices.

A medical error is a preventable adverse effect of medical care. Errors can happen in the hospital at the doctor’s office, at the pharmacy, laboratory and ward. These can also occur at home by the patient or the attendant. These errors may lead to death or major/minor injuries or can also be harmless. However these should be recorded, analysed and remedial measures implemented to reduce the risk of being committed in the future. We are reporting the medical care of our patient in persistent vegetative state over nineteen years due to medical error at our hospital resulting in brain anoxia. The key issues faced during the care were recurrent respiratory and urinary tract infections and in last one year kidney calculi leading to chronic kidney disease and its complications. There are no contractures or thrombo-embolic events and above all no bed sore over this period.

Reishi owes an exceptional value in nutritional, cosmeceutical, and medical treatments; however, none of the studies has provided its future-driven critical assessment. This study documents an up-to-date review (2015-2020, wherever applicable) and provide valuable insights (preclinical and clinical evidence-based) with comprehensive and critical assessments. Various databases 'Google scholar', 'Web of Science', 'ScienceDirect', 'PubMed', 'Springer Link', books, theses, and library resources were used. The taxonomic chaos of G. lucidum and its related species was discussed in detail with solution-oriented emphasis. Reishi contains polysaccharides (α/β-D-glucans), alkaloids, triterpenoids (ganoderic acids, ganoderenic acids, ganoderol, ganoderiol, lucidenic acids), sterols/ergosterol, proteins (LZ-8, LZ-9), nucleosides (adenosine, inosine, uridine), and nucleotides (guanine, adenine). Some active drugs are explored at an optimum level to make them potential drug candidates. The pharmacological potential was observed in diabetes, inflammation, epilepsy, neurodegeneration, cancer, anxiety, sedation, cardiac diseases, depression, hepatic diseases, and immune disorders; however, most of the studies are preclinical with a number of drawbacks. In particular, quality clinical data are intensely needed to support pharmacological activities for human use. The presence of numerous micro-, macro, and trace elements imparts an essential nutritional and cosmeceutical value to Reishi, and various marketed products are available already, but the clinical studies regarding safety and efficacy, interactions with foods/drinks, chronic use, teratogenicity, mutagenicity, and genotoxicity are missing for Reishi. Reishi possesses many valuable pharmacological activities, and the number of patents and clinical trials is increasing for Reishi. Yet, a gap in research exists for Reishi, which is discussed in detail in the forthcoming sections.

Purpose: Primary aim of the research study was to develop awareness among the participants about the benefits of exercise and its financial benefits. Methodology: Adults had to perform exercises on Unstable Surfaces (US), Stable Surface (SS) and Machine Based (MB). The protocol of exercises was divided into three categories with 30 participants in each group i.e., Machine Based Surface Resistance Training (M-SRT), Machine Based Unstable Surface Resistance Training (M-URT), and Free Weight Unstable Surfaces Resistance Training (F-URT). Equipment used for tests was imported. Cost of financial expenditure and effects of resistance training exercise protocol on the male adults’ lower limbs muscular power, body fats, and strength were compared. Leg extension strength, leg press, muscle fuel, and body fats were checked on the baseline and after a seven-week resistance training program in the adults and budget, effects took away from the parents. Main Findings: The subjects’ results in maximal resistance training of squad movement were significantly higher in M-SRT and M-URT as compared to F-URT. The average seven-week regular resistance training exercise protocol program in adults with proper supervision will minimize the risk of injury and develop the strength and endurance in the lower limbs of adults up to maximal and that the composition of the body fats was observed lesser. There are training and exercise centres in Dera Ismail Khan city and adults can easily manage to become members of those clubs with nominal registration fees. Fitness and wellbeing are directly associated with the financial benefits of exercise and training. It was observed that the student adults can easily manage the resistance training program for their fitness by curtailing their pocket money. The implication of the Study: The findings of the research study have vital impacts on the daily life routine life of adults. Adults can easily manage to spare some time from leisure and money to keep themselves fit and healthy. The nation needs healthy adults to serve the best and build a nation. The results of analyzed data will help the parents and teachers to motivate their children to participate in the activities of fitness centres and acquaint the adults with financial behaviour change theory. Proper counselling of the experts will be fruitful in light of the recommendations of the study. Novelty: For the first time such a study is going to be conducted in the field of sports and finance. This is primary research in the homeland to highlight the behavioural economics capitalization in sports and training. The financial impacts of training and exercise on the fitness of youth have been studied in length. Future researchers would be benefited from the results of the study and they will be able to include the purchase of basic equipment for exercise and training in the institute budget.

Thrombotic thrombocytopenic purpura (TTP) is a known menace in hematology and is quite rare in practice with known triggers. Lately, in the COVID-19 pandemic, hematology has seen a new pathology amongst which TTP associated with COVID-19 messenger RNA (mRNA) vaccine is unique. We report a case of a 69-year-old male with multiple comorbidities who presented to the hospital with severe fatigue and shortness of breath. Labs were significant for thrombocytopenia, anemia, and hemolysis with schistocytes consistent with TTP with a second dose of BNT162b2 mRNA vaccine as a likely culprit been documented.

Objectives. This study aimed to assess and make a pattern of factors causing stroke leading to cerebral haemorrhage in male patients as well as to assess association of demographic characteristics, diet and disease with haemorrhagic stroke in Quetta, Balochistan, Pakistan. Methods. In a cross sectional questionnaire based interviewing study, a questionnaire was designed to access the pattern of factors causing stroke leading to cerebral haemorrhage in male patients. Total 339 cases (adult male who had haemorrhagic stroke) were identified from two government and four private hospitals in Quetta City, Province Balochistan, Pakistan. The study was conducted within the time period of 9 months, from March to November, 2015. The data was piloted and then final data was analysed by using IBM SPSS 22. Results. In demographic characteristic study of patients, majority 219 (64.6%) were among the age group between 51 years and above, 330 (97.3%) were married, majority 186 (54.9%) were having urban residence and 277 (81.7%) were having own residence ownership, 127 (37.5%) were having addiction to smoking and 120 (35.4%) were addicted to tobacco and snuff. 124 (36.6%) were reluctant to mention whether their patients were either smokers or not. Among total 339 patients, majority 284 (83.8%) were not doing physical exercise routinely or if they were recommended by the physician. Among the 339 patients, all 339 (100%) of patients selected the multiple options among all given options (headache, unconscious/loss of consciousness, pain in neck). Conclusions. Demographic characteristics, low level of education, low income, urban residence in combined family setup, married, increased number of children are associated with hemorrhagic stroke. Smoking, tobacco and snuffing may also cause stroke. Lack of physical exercise, past history of stroke, diabetes mellitus, cardiovascular disease, hypertension (personal or family) of any type does not significantly cause stroke but may increase the risk of stroke. The order of events suddenly happened to the hemorrhagic patients are headache, pain in neck, vomiting and finally state of unconsciousness.

Background: Herbal medicine is becoming increasingly popular among the general population. Before consulting a medical practitioner, patients already try home remedies. Therefore, it becomes more pertinent that the medical students as future doctors, must possess some knowledge of the herbal medicine. In Saudi Arabia, no study has yet evaluated this aspect in medical students. Methods: A cross-sectional study was performed with 240 medical students at a Health Sciences University. The survey questionnaire was validated, and descriptive/inferential statistics analyses were conducted by SPSS. Results: Data showed 50/240 students (20.8 %) used herbal medicines and majority 36 (72%) used it without consultation with doctors. Moreover, male understanding of the sources of herbal medicine was less compared to females' (p < 0.05). In terms of attitude, majority agreed with the benefits of herbal medicines in the maintenance and promotion of health (123, 51.3%) and to treat illness (127, 52.9%). However, medical students did not want to use herbal medicines (122, 50.8%) or recommend it to their families (161, 67.1%). A significant number of the respondents (160, 66.7%) opined that the herbal medicines could be taken with conventional or allopathic medications. Male students were significantly more inclined towards use of herbal medicine than their female counterparts (p < 0.05). Conclusion: Medical students were found to be unaware of some important aspects regarding herbal medicines, like use of herbs with drugs without consultation. Inclusion of proper courses on alternative medicine in medical curriculum can fill this gap and clarify the misconceptions among medical students.

Instructional and assessment methods are varied and preferred by their teachers at higher-level institutions. A teacher guides their students with detail information and instructions to achieve their educational targets. Students share views regarding their faculty norms and standards that influence the adoption of their study methods. The major focus of this study was to find out the faculty-based differences of learners' views of assessment and its relationship with achievement at the university level. The study was correlational and the survey was conducted to investigate the research problem. All the public sector universities of Punjab were considered as a population of the study and only seven (07) public sector universities were taken as a sample. A questionnaire, students' perception of assessment (Waldrip et al., 2008) was adapted to collect the data from the respondents. Using the mean scores, standard deviation, t-test, and regression the collected data were analyzed. The findings of the study showed students have not the same perception about the assessment and the study concluded a significant relationship between students' perception of assessment and academic outcomes. Based on the study results, it was recommended that each faculty should well inform the students about the assessment methods and strategies for their outcomes improvement.

Background: Malnutrition continues to be a major public health problem in developing countries. It is the most important risk factor for the burden of diseases. There was lack of information regarding the prevalence, level and factors associated with malnutrition among children of under-five years of age from Baluchistan, Pakistan. Objective: Therefore, the current study was conducted to evaluate the prevalence, associated factors and parents’ awareness with malnutrition among children of under-five years of age. Methods: This cross-sectional analytical study was carried out at Basic Health Unit (BHU), Nawa Killi, BHU Killi Deba, BHU Spini Road, Mubarak Chowk, Sheikh Zahid Hospital Quetta, Rehnuma Center Satellite Town Quetta. A self-developed validated questionnaire was used to evaluate the parents’ awareness regarding children nutrition status. The mean mid upper-arm circumference (MUAC) value of the children was used to categorize the children nutritional status. Children with MUAC value < 12 cm were classified as malnourished, MUAC value =11-12 cm was considered as Moderate Acute Malnutrition (MAM) and, MUAC value < 11 cm was considered as Severely Acute Malnutrition (SAM). Data was analyzed by using Statistical Package for Social Sciences (SPSS version 20). Multivariate binary logistic regression was used to find factors associated with the presence of malnutrition. A p-value

Introduction Separation of Neurosensory retina from RPE(Retinal Pigment Epithelium) is described as retinal detachment. Recently Pars plana vitrectomy has emerged as a preferred surgical treatment for management of uncomplicated primary rhegmatogenous retinal detachment. Various studies have evaluated the results of combined phaco-vitrectomy, the combined approach allows faster visual recovery and has cost effectivity for patient. The rationale of this study is to compare the anatomical and visual outcome of combined phacoemulsification and vitrectomy vs vitrectomy alone Materials and methods This prospective randomized controlled trial was performed at Eye Unit II Mayo Hospital Lahore (tertiary care eye hospital in Lahore), Pakistan from August 2019 to February 2020. 36 patients full filling the inclusion criteria were divided into two groups 18 patients each. Group A was of combined Phaco-vitrectomy and Group B was of vitrectomy only. The Mann-whitney test as test of significance was applied and P≤0.05 was considered statistically significant. Results BCVA done Pre-operatively for Group A and B, P-value was > 0.05 which was insignificant. Best corrected visual acuity at first week post operatively was significantly lower in patients in which we used gasses as internal tamponade as compared those in which we used silicon oil as tamponade. The BCVA at 1 month showed improvements in both groups, however the BCVA in group B was significantly lower than group A, P-value being < 0.05. The BCVA at 3 month showed improvements in both groups, however the BCVA in group B was significantly lower than group A, P-value being < 0.05. Anatomical Outcome was seen as weather retina was attached or detached. In Group A detachment was present in all follow-ups in 2/18 patients while in Group B detachment was present in all follow-ups in 3/18 patients. The P-value was >0.05 and thus the difference between two groups was insignificant. Conclusion visual acuity did not differ among the two groups preoperatively and on first follow-up at 1 week. The P value being >0.05 in both. However there was significant difference between the two group at 1 month and 3 months follow up, P value being < 0.05 in each. The visual acuity was significantly better in Group A i.e combined phaco- vitrectomy. For anatomical outcome no difference was seen between the groups. The P value was > 0.05. So the visual outcome of group A was significantly better than group B while the anatomical outcome was the same. Keywords Phacoemulsification, Three ports pars plana vitrectomy, best corrected visual acuity, retinal detachment.

Late diagnosis, unreliable prognostic assessment, and poorly-guided therapeutic planning result in dismal survival of ovarian cancer (OC) patients. Therefore, identifying novel functional biomarker(s) is highly desired for improved clinical management. MYB is an oncogenic transcription factor with emerging functional significance in OC. Here we examined its clinicopathologic significance by immunohistochemistry and TCGA/GTex data analyses. Aberrant MYB expression was detected in 94% of OC cases (n = 373), but not in the normal ovarian tissues (n = 23). MYB was overexpressed in all major epithelial OC histological subtypes exhibiting the highest incidence (~ 97%) and overall expression in serous and mucinous carcinomas. MYB expression correlated positively with tumor grades and stages. Moreover, MYB exhibited race-specific prognostic association. Moderate-to-high MYB levels were significantly associated with both poor overall- (p = 0.02) and progression-free (p = 0.02) survival in African American (AA), but not in the Caucasian American (CA) patients. Consistent with immunohistochemistry data, we observed significantly higher MYB transcripts in OC cases (n = 426) than normal ovary (n = 88). MYB transcripts were significantly higher in all epithelial OC subtypes, compared to normal, and its greater levels predicted poor survival in AA OC, but not CA OC, patients. Thus, MYB appears to be a useful clinical biomarker for prognostication, especially in AA patients.

A successful flash combustion synthesis of NiO spherical nanoparticles with various contents of lanthanum (La) doping (La@NiO SNPs) with remarkably enhanced dielectric and electrical properties are reported. Single phase has been confirmed through X-ray diffraction and FT-Raman spectroscopic analysis. Increasing La content in NiO reduced the crystallite size by 341% to 6.65 nm from 22.70 nm. The composition of elements in the final product was assessed via EDX analysis. Moreover, monophasic La@NiO SNPs synthesis with size reduction was observed using field emission scanning electron microscopy (FESEM). A red shift in optical energy gaps (3.52–3.26 eV) was observed with increasing La contents from pure to 10 wt%. Capacitance (109–964 PF), impedance (9.41 × 104–1.67 × 104 kΩ), dielectric constant (100–967), dielectric loss (335–10666), and electrical conductivity (4–5 S/m) values were remarkably improved with La doping. The current (I)–voltage (V) characteristics of pure and La@NiO NPs were performed under the biased voltage of ±20 V. Current was noticed in the range of (3.81 × 10−4–9.91 × 10−3 amp) at pure, 1.0, 3.0, 5.0, and 10 wt% of La@NiO NPs. Enhancements in the dielectric and electrical properties of as-synthesized NPs make them suitable for optoelectronics uses.

Infection due to the protozoa Toxoplasma gondii can be life-threatening in hematopoietic stem cell transplantation (HSCT) recipients. Most cases of toxoplasmosis in HSCT recipients result from reactivation of latent infection in individuals who were Toxoplasma-seropositive before transplantation and did not receive appropriate prophylaxis. Pretransplantation screening with Toxoplasma IgG and IgM antibodies is suggested for all allogeneic HSCT recipients and their donors and all autologous HSCT recipients. Prevention of toxoplasmosis in T. gondii-seropositive HSCT recipients requires primary prophylaxis, preemptive screening, or both. Trimethoprim-sulfamethoxazole (TMP-SMX) is the preferred agent for Toxoplasma prophylaxis and should be continued for 6 months or until the patient is no longer receiving immunosuppression, whichever is longer, assuming that immune reconstitution has occurred. Preemptive weekly screening with whole blood Toxoplasma PCR should be considered for seropositive HSCT recipients if prophylaxis cannot be given or if prophylaxis other than TMP-SMX is used. The signs, symptoms, and radiographic findings of toxoplasmosis in HSCT recipients can be nonspecific, and the diagnosis requires a high degree of suspicion. Common presentations include fever, encephalopathy with mental status changes or seizures, and pneumonia. A Toxoplasma PCR analysis from whole blood (and other body fluids/tissues according to clinical symptoms) should be obtained in patients in whom there is a concern for toxoplasmosis. Treatment with oral pyrimethamine, sulfadiazine, and leucovorin for at least 6 weeks is the first-line therapy and should be followed by secondary prophylaxis. In this article, we review the published literature regarding the epidemiology, clinical presentation, treatment, and prevention of toxoplasmosis in HSCT recipients.

We describe the presentation and treatment of a patient who developed ongoing fever and diagnosed with disseminated toxoplasmosis post-hematopoietic stem cell transplantation. He was initially treated with trimethoprim-sulfamethoxazole (TMP-SMX) and there was dramatic improvement in his fever curve. He successfully completed a modified course of therapy.

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

Urolithiasis is one of the oldest diseases affecting humans, while plants are one of our oldest companions providing food, shelter, and medicine. In spite of substantial progress in understanding the pathophysiological mechanisms, treatment options are still limited, often expensive for common people in most parts of the world. As a result, there is a great interest in herbal remedies for the treatment of urinary stone disease as an alternative or adjunct therapy. Numerous in vivo and in vitro studies have been carried out to understand the efficacy of herbs in reducing stone formation. We adopted PRISMA guidelines and systematically reviewed PubMed/Medline for the literature, reporting results of various herbal products on in vivo models of nephrolithiasis/urolithiasis. The Medical Subject Heading Terms (Mesh term) "Urolithiasis" was used with Boolean operator "AND" and other related Mesh Unique terms to search all the available records (July 2019). A total of 163 original articles on in vivo experiments were retrieved from PubMed indexed with the (MeshTerm) "Urolithiasis" AND "Complementary Therapies/Alternative Medicine, "Urolithiasis" AND "Plant Extracts" and "Urolithiasis" AND "Traditional Medicine". Most of the studies used ethylene glycol (EG) to induce hyperoxaluria and nephrolithiasis in rats. A variety of extraction methods including aqueous, alcoholic, hydro-alcoholic of various plant parts ranging from root bark to fruits and seeds, or a combination thereof, were utilized. All the investigations did not study all aspects of nephrolithiasis making it difficult to compare the efficacy of various treatments. Changes in the lithogenic factors and a reduction in calcium oxalate (CaOx) crystal deposition in the kidneys were, however, considered favorable outcomes of the various treatments. Less than 10% of the studies examined antioxidant and diuretic activities of the herbal treatments and concluded that their antiurolithic activities were a result of antioxidant, anti-inflammatory, and/or diuretic effects of the treatments.

Fourteen rice lines and one cultivar were investigated for morphological traits and genetic diversity under normal and drought stress condition. Mean squares of years, environment and lines × environments were significant for all traits under observation, except for days to heading and grain yield/plant in years, days to heading in environment and days to heading and harvest index in lines × environments, respectively. The 10 SSR markers, covering seven chromosomes (1, 2, 4, 5, 6, 8 and 9) generated polymorphic alleles with sum of 72 alleles on seven chromosomes with 9 markers across the fifteen rice lines. Furthermore, genetic diversity values for all SSR markers varied from 0.94 to 1.00 with an average of 0.98. In addition, the PIC values ranged from 0.83 to 0.99 with an average value of 0.94. The promising lines of present investigation can be utilized in future plant breeding programs.

Background: Rheumatoid arthritis (RA) is a disabling condition that results in considerable suffering and negatively impacts an individual's psychological, financial, social, and quality of life (QoL). Pain, fatigue, and disabilities, which may be considered as stress factors, are common challenges that may subsequently lead to psychological distress. Aim: Assessment of Depression, Anxiety, Stress, and QoL in RA patients and Comparison with healthy individuals. Materials and Methods: This cross-sectional analytical study included 50 RA patients who have reported to a tertiary health care center on outpatient basis and an equal number of age- and sex-matched healthy individuals. The study was conducted after obtaining Institutional Ethics Committee approval and informed consent of the participants. Patients were assessed based on Disease Activity Score incorporating erythrocyte sedimentation rates, Depression Anxiety Stress Scale (DAS21), Health Assessment questionnaire, Visual Analog Scale, and Multidimensional scale of Perceived Social Support. Results: Levels of anxiety, depression, and stress in patients with RA were significantly higher as compared to age- and sex-matched healthy controls. RA patients had significantly lower scores on total social support, as well as social support of family and friends. However, there was no difference between RA patients and healthy controls on social support from significant others. Conclusion: Patients with RA had significantly higher levels of anxiety, depression, and stress and significantly lower levels of social support compared to age- and sex-matched healthy controls. The therapeutic implications of these findings need further evaluation.

Twitter is one of the most popular micro-blogging social media platforms that has millions of users. Due to its popularity, Twitter has been targeted by different attacks such as spreading rumors, phishing links, and malware. Tweet-based botnets represent a serious threat to users as they can launch large-scale attacks and manipulation campaigns. To deal with these threats, big data analytics techniques, particularly shallow and deep learning techniques have been leveraged in order to accurately distinguish between human accounts and tweet-based bot accounts. In this paper, we discuss existing techniques, and provide a taxonomy that classifies the state-of-the-art of tweet-based bot detection techniques. We also describe the shallow and deep learning techniques for tweet-based bot detection, along with their performance results. Finally, we present and discuss the challenges and open issues in the area of tweet-based bot detection.

Palmprint has attracted increasing attention due to its several advantages in the biometrics field. Deep learning has achieved remarkable performance in the computer vision area, so a large number of deep-learning-based methods have been proposed by the research community for palmprint recognition. The outputs of a deep hashing network (DHN) can be represented as a binary bit string, so DHN can reduce the storage and accelerate the matching/retrieval speed. In this paper, DHN is employed to extract the binary template for palmprint and palmvein verification. Spatial transformer network is used to overcome the rotation and dislocation. Palmprint and palmvein can be acquired from visible-light spectrums, including red (R), green (G), blue (B), and near infrared (NIR) spectrum, respectively. Since the features in different spectrums are different, their complementary advantages can be exploited to the full by fusion. Image-level fusion and score-level fusion are developed for palmprint-palmvein fusion recognition. The experiments demonstrate that score-level fusion can improve the accuracy efficiently.

Retinoblastoma is most common intraocular malignancy of childhood all over the world including Pakistan. Recent advances in the treatment of disease has improved the survival rates worldwide. Objective: To compare regression of retinoblastoma lesion after monotherapy (chemotherapy) vs combined therapy (chemotherapy + local consolidative therapy). Study Design: Randomized Control trial. Setting: Department of Pediatric Ophthalmology at College of Ophthalmology and Allied Vision Sciences/ King Edward Medical University, Mayo Hospital Lahore, Pakistan. Period: January 2015 to June 2016. Material & Methods: 43 patients with retinoblastoma (group C & D) were included in the study. Chemotherapy was given to patients in group1 and chemotherapy followed by local consolidative therapy was given to patients in group2. The percentage of regression of baseline lesion was noted after 6 cycles of chemotherapy. Results: The mean regression of lesion in group 1 was 24.5% and in group2 was 59.9%, after six months of treatment. The value t-test was 36.02 with p value 0.00 (

A comprehensive investigation of the physical characteristics of any material provides beneficial information regarding its application viewpoint in different industries. Herein, we report the tunable mechanical and optoelectronic properties of cubic CdZrO3 under variable pressure up to 80 GPa using density functional theory (DFT). The pressure-induced band gap engineering reveals a fantastic fact of transformation of the indirect to direct band gap with increasing pressure. The dielectric response disclosed that optical parameters dragged towards higher energy with an increase of pressure, which unveiled the potential of CdZrO3 for optoelectronic applications. Effective change in optoelectronic is attributed to indirect to direct band gap transition. This study provides a gateway to how the optoelectronic properties of cubic CdZrO3 could be tuned by employing external pressure.

Background: The gross domestic product (GDP) is one of the primary indicators used to gauge the health of a country's economy. It reflects the total market value of all finished products and services produced over a specific period within a country. GDP is presented as a comparison to the previous quarter or year and is considered the benchmark for the economy's size. India is emerging as one of the fastest-growing economies in the world and is expected to rank among the top three economic powers of the world over the next 15-20 years, supported by its stable democracy, population growth, and partnerships.Purpose: The purpose of this paper was to study the dynamics of the Indian economy's GDP growth for the period of 2014 to 2019. The present study tried to understand the trend, contribution, and structure of the various sectors such as agriculture, industry, and services in India's GDP growth.Methodology: The research methodology used in this paper was quantitative since this method can be used to analyze nearly infinite numbers of phenomena. The study used secondary data for the period 2014 to 2019. Data was collected from the Economic Survey of India and Reserve bank of India bulletins. Descriptive and inferential data analysis techniques were employed.Findings: The study of GDP growth between 2014-2019 and sectoral level analysis shows interesting facts that India will reach a $5 Trillion GDP mark by 2024-25 at current prices.Unique contribution to theory, practice, and policy: This paper intended to make policy recommendations that can help India's long-term sustainable growth. The study recommended strategies such as increasing public finance in the agricultural sector and strengthening the integrated public transport projects to the government to maintain stable economic growth to achieve a $5 Trillion economy. This paper will increase the economic researcher's awareness and position it in the library of an institution of higher education

Nickel oxide (NiO) is found to have several fascinating applications in optoelectronics and spintronic devices. Hence, herein we facilely fabricated the NiO thin films with 0.0, 1.0, 2.5 and 5.0 wt.% Sr doping by low-cost spin coater at RT. The single-phase confirmation of Sr@NiO films was done by X-ray diffraction and FT-Raman analyses. The crystallite size was estimated through Scherrer rule and noted to lie between 13 to 31 nm. The broad Raman peaks indicate low dimension nanostructured films formation. Sr doping in NiO was detected by EDX spectra and its homogeneity in final film by SEM e-mapping. AFM analysis revealed nano-spherical grains in all films. The grown films were tested for optical transparency and noticed that the films are transparent viz. ~ 45 to 65% over 500 to 1400 nm wavelength region. The direct energy gap and refractive index was determined and lies between 3.74 to 3.84 eV and 1.6 and 2.2 in the visible, correspondingly. The values of dielectric constant were calculated in range from 2 to 60. The linear, third order nonlinear and nonlinear refractive index values are noted to be enhanced by Sr content in energy range from 1 to 4 eV. The enhanced energy gap and nonlinear activities signify the importance of the grown Sr@NiO films for optoelectronics.

PbS films in undoped state and with various Eu contents (1 wt.%, 3 wt.%, and 5 wt.%) have been coated effectively on insulating glass substrates by a nebulized spray pyrolysis route. The effects of Eu doping on various properties including the photosensitivity of the PbS films were systematically analyzed. X-ray diffraction (XRD) analysis of the materials revealed a polycrystalline nature with crystallites showing simple cubic structure oriented along (200) direction. Based on the XRD data, the crystallite size, dislocation density, and lattice strain of the films with different doping concentrations were calculated and are consistently discussed. The secondary phase Eu3O4 formed when the Eu doping level was higher in the host solution. The Raman peaks detected at 190 cm−1, 236 cm−1, and 465 cm−1 confirmed formation of PbS. Scanning electron microscopy was used to reveal the morphology of the films as a function of the dopant concentration. Important optical properties including the bandgap, absorption coefficient, dielectric constant, index of refraction, and coefficient of extinction of the films are systematically reported. Optical study of the films revealed a variation of the bandgap from 2.14 eV to 2.81 eV with increasing Eu doping level. The 3 wt.% europium-doped PbS film showed better photosensitivity at 100 W/m2 compared with the other films based on current–voltage (I–V) measurements.

This paper proposes a new framework, named Deja-Vu+, which is an extension of Deja Vu framework, a classic study on hyper-heuristic framework with 2R (Record and Recall) modules. Deja-Vu+ has the ability to handle two other domains, namely regression and unsupervised learning. The extension examines the strength of Deja-Vu+ for solving regression and unsupervised learning tasks. The regression problems are treated here as multiclass classification tasks, and unsupervised learning tasks are considered as clustering problems. The proposed framework is tested on a number of regression and unsupervised learning benchmark problems and has shown promising results to handle regression as classification. The framework attains an overall average accuracy of 70% for regression and clustering data sets. Deja-Vu+ is knowledge-rich hyper-heuristic framework, which is capable enough to transfer knowledge successfully. This knowledge transfer improves the performance of learning by avoiding the extensive heuristic search process. Our experimental results show that using previously attained knowledge to reduce the computational effort is beneficial in solving multi-disciplinary machine learning problems.

Software-defined networking (SDN) is becoming more and more popular due to its key features like scalability, flexibility, and monitoring. SDN simplifies the network management and enables innovations in the network architecture and protocols. However, this flexible architecture also makes it vulnerable to different types of attacks, such as flooding, spoofing, and denial-of-service (DoS). Among these attacks, the DoS attack has the most severe impact as it can overwhelm the major components of SDN to degrade its performance. In this paper, we propose a simple and lightweight detection and mitigation system (DAISY) to secure SDN from DoS attacks by blocking malicious traffic from the attacker, after analyzing the collected statistics. The proposed system specifically blocks malicious traffic rather than blocking the whole port or a host. In addition, it unblocks a port or a host when there is no more malicious traffic originating from it. We evaluate our proposed system by comparing it with other approaches, and the simulation results show increased performance of SDN with DAISY in terms of CPU usage, response time, control channel bandwidth, packet delivery ratio, and flow requests sent to the controller.

SrTiO3 is a well-studied n-type metal oxide based thermoelectric (TE) material. In this work, the first-principles calculation of La-doped SrTiO3 has been performed using the density functional theory. In addition, high TE properties of bulk SrTiO3 material have been achieved by introducing nanoscale porosity and optimizing carrier concentration by La doping. The X-ray diffraction, atomic resolution scanning transmission electron microscopy imaging, and energy-dispersive X-ray spectrometry results show that La has been doped successfully into the lattice. The scanning electron microscopy images confirm that all the samples have nearly similar nanoscale porosities. The significant enhancement of electrical conductivity over the broad temperature range has been observed through optimization of La doping. Additionally, the samples possess very low thermal conductivity, which is speculated because of the nanoscale porosity of the samples. Because of this dual mechanism of doping optimization and nanoscale porosity, there is a remarkable improvement in power factor, 1 mW/m2K from 650 to 800 K, and figure of merit, zT of 0.26 at 850 K, of the sample, 22 at. % La-doped SrTiO3.

Objectives: To describe the pattern of thoracic surgical diseases at a tertiary care hospital in South-Punjab Pakistan. Study Design: Descriptive, cross-sectional study. Setting: Nishtar Medical University hospital Multan, Pakistan. Period: From 01-01-2018 to 31-12-2018. Material & Methods: All the patients who were admitted through the out-patient department or referred from other units, over the year 2018, were analyzed. Variables under consideration included mode of admission, patient’s diagnosis, a surgical procedure performed, type of anesthesia-induced and the mortality. Data were analyzed using IBM SPSS statistics version 20. Mean and percentages were used for numerical data. Data were presented using descriptive statistics. Results: A total of 634 patients (370 females and 264 males) were admitted during the study period, out of which 566 came through the out-patient department while the remaining were referrals from other wards. In total, 697 surgeries were performed with esophagoscopy and dilation being the most frequent (38.7%), followed by tracheostomy (16.3%). Corrosive intake (49.8%) accounted as the cause for the highest number of admissions followed by empyema thoracis (11.4%). Conclusion: Local study on the topic of Thoracic Surgery audit, in terms of surgeries performed and variation of cases presented has become an absolute necessity for better health care planning of Pakistan. The pattern of thoracic surgical diseases varies considerably in different regions and populations. The evaluation of these disease patterns can help to adopt appropriate preventive measures to reduce the incidence of these diseases. Furthermore, it can significantly improve our health system.

Hardware components, such as memory and arithmetic units, are integral part of every computer-controlled system, for example, Unmanned Aerial Vehicles (UAVs). The fundamental requirement of these hardware components is that they must behave as desired; otherwise, the whole system built upon them may fail. To determine whether or not a component is behaving adequately, the desired behaviour of the component is often specified in the Boolean algebra. Boolean algebra is one of the most widely used mathematical tools to analyse hardware components represented at gate level using Boolean functions. To ensure reliable computer-controlled system design, simulation and testing methods are commonly used to detect faults; however, such methods do not ensure absence of faults. In critical systems’ design, such as UAVs, the simulation-based techniques are often augmented with mathematical tools and techniques to prove stronger properties, for example, absence of faults, in the early stages of the system design. In this paper, we define a lightweight mathematical framework in computer-based theorem prover Coq for describing and reasoning about Boolean algebra and hardware components (logic circuits) modelled as Boolean functions. To demonstrate the usefulness of the framework, we (1) define and prove the correctness of principle of duality mechanically using a computer tool and all basic theorems of Boolean algebra, (2) formally define the algebraic manipulation (step-by-step procedure of proving functional equivalence of functions) used in Boolean function simplification, and (3) verify functional correctness and reliability properties of two hardware components. The major advantage of using mechanical theorem provers is that the correctness of all definitions and proofs can be checked mechanically using the type checker and proof checker facilities of the proof assistant Coq.

Background: Refractive errors and eye diseases are the main core issues in the jail inmates in Pakistan and especially in Punjab province but with best efforts the ophthalmic disorders can be controlled with the help of better screening process for refractive errors, presbyopia, low vision and the general ophthalmic disorders that are found among the jail inmates. The over burden of these ailments can be minimized following a comprehensive screening methods time to time using slandered guidelines approved by WHO. Methodology: A plan was executed for basic necessary screening process to find out the ophthalmic diseases and vision problems. A team of ophthalmologist, optometrists and ophthalmic technicians visited inmates in the jail who presented with any eye problem in this 1-day screening. Auto refraction and manual retinoscopy was done. Visual cut off point was 6/12. Ophthalmic eye medication and glasses (spectacles) was provided free of cost. Results: a total of 270 inmates were examined in the eye camp. The study showed prevalence of refractive errors 4% with a significant high ratio of presbyopia 34% as 79%of inmates were more than 40 year of age. Prevalence of other main eye disease was: conjunctivitis 3%, glaucoma 1% and cataract 2%. Conclusions: There is an urgent need to look into matter of presence the eye diseases and refractive errors found among jail inmates as they fall in the category of marginalized community and the health care provided with ease has no provision the general eye health care. So it is an important issue to lodge a comprehensive effective initiative for the provision of that need mentioned above and a training program for the medical staff of jail hospitals to screen out this community for effective screening knowledge in Primary Eye care.

Purpose: Previous phases of trachoma mapping in Pakistan completed baseline surveys in 38 districts. To help guide national trachoma elimination planning, we set out to estimate trachoma prevalence in 43 suspected-endemic evaluation units (EUs) of 15 further districts. Methods: We planned a population-based trachoma prevalence survey in each EU. Two-stage cluster sampling was employed, using the systems and approaches of the Global Trachoma Mapping Project. In each EU, residents aged ≥1 year living in 30 households in each of 26 villages were invited to be examined by trained, certified trachoma graders. Questionnaires and direct observation were used to evaluate household-level access to water and sanitation. Results: One EU was not completed due to insecurity. Of the remaining 42, three EUs had trichiasis prevalence estimates in ≥15-year-olds ≥0.2%, and six (different) EUs had prevalence estimates of trachomatous inflammation—follicular (TF) in 1–9-year-olds ≥5%; each EU requires trichiasis and TF prevalence estimates below these thresholds to achieve elimination of trachoma as a public health problem. All six EUs with TF prevalences ≥5% were in Khyber Pakhtunkhwa Province. Household-level access to improved sanitation ranged by EU from 6% to 100%. Household-level access to an improved source of water for face and hand washing ranged by EU from 37% to 100%. Conclusion: Trachoma was a public health problem in 21% (9/42) of the EUs. Because the current outbreak of extremely drug-resistant typhoid in Pakistan limits domestic use of azithromycin mass drug administration, other interventions against active trachoma should be considered here.

Security analysts have shown that it is possible to compromise the mobile two-factor authentication applications that employ SMS-based authentication. In this paper, we consider that offloading mobile applications to the cloud, which is resource-rich and provides a more secure environment, represents a good solution when energy limitation and security constraints are raised. To this end, we propose an offloading architecture for the two-factor mutual authentication applications, and a novel two-factor mutual authentication scheme based on a novel mechanism, named virtual smart card. We also propose a decision-making process to offload the authentication application and its virtual smart card, based on three conditions: security, mobile device's residual energy, and energy cost. We analytically derive the lower-bound on the mobile application running time from the energy cost formula to perform offloading. We analyze and verify the security properties of the proposed architecture, and provide evaluation results of the two-factor mutual authentication protocol and the offloading decision-making process.

The increased need to gather scientific data and the renewed drive to explore underwater natural resources has led more and more researchers to study the underwater environment. This has resulted in enormous attention being given to Underwater Wireless Sensor Networks (UWSNs) all over the world. However, UWSNs are faced with some major challenges including harsh environment, higher propagation delay, and limited battery power of the sensor nodes. To address these challenges, several routing schemes have been proposed. In this paper, we propose a routing strategy, called Reliable Path Selection and Opportunistic Routing (RPSOR) for UWSNs, which is a significantly improved version of Weighting Depth and Forwarding Area Division Depth Based Routing (WDFAD-DBR). RPSOR is based on three main factors: Advancement factor (ADVf), which depends on the depth of current as well as next hop forwarding node; Reliability index (RELi), which depends on the energy of the current forwarder as well as average energy in the next expected forwarding region; and Shortest Path Index (SPi), which is calculated on the basis of number of hops to the sink and average depth of neighbors in the next expected hop. To deal with the void hole problem and improve the Packet Delivery Ratio (PDR), we follow the more reliable path towards the sink by calculating RELi for a node. At the end, we perform extensive simulations and compare our proposed scheme with WDFAD-DBR, the results of which prove that RPSOR shows better performance in terms of PDR and energy tax in comparison to WDFAD-DBR. However, the proposed work compromises end-to-end delay in sparse networks.

The Internet of Things (IoT) has penetrated its roots in almost every domain of life. Smart healthcare is one of the major domains that extensively uses IoT infrastructures and solutions. IoT-based smart healthcare systems have immensely added value to the healthcare domain with the use of wearable and mobile devices. This leads to a substantial use of health data sharing for the improved, accurate, and timely diagnosis. However, smart healthcare systems are highly vulnerable to several security breaches and various malignant attacks, such as privacy leakage, tempering, forgery, etc. Recently, the blockchain technology emerged as a propitious solution against such breaches and challenges. This paper presents an up-to-date survey on different challenges and open issues faced in smart healthcare due to the traditional security measures along with the security requirements of such domains. It also amalgamates the potentials of blockchain technology as a promising security measure, highlights potential challenges in the healthcare domain, and provides an analysis of different blockchain-based security solutions.

In this study, a novel framework is proposed for efficient energy management of residential buildings to reduce the electricity bill, alleviate peak-to-average ratio (PAR), and acquire the desired trade-off between the electricity bill and user-discomfort in the smart grid. The proposed framework is an integrated framework of artificial neural network (ANN) based forecast engine and our proposed day-ahead grey wolf modified enhanced differential evolution algorithm (DA-GmEDE) based home energy management controller (HEMC). The forecast engine forecasts price-based demand response (DR) signal and energy consumption patterns and HEMC schedules smart home appliances under the forecasted pricing signal and energy consumption pattern for efficient energy management. The proposed DA-GmEDE based strategy is compared with two benchmark strategies: day-ahead genetic algorithm (DA-GA) based strategy, and day-ahead game-theory (DA-game-theoretic) based strategy for performance validation. Moreover, extensive simulations are conducted to test the effectiveness and productiveness of the proposed DA-GmEDE based strategy for efficient energy management. The results and discussion illustrate that the proposed DA-GmEDE strategy outperforms the benchmark strategies by 33.3% in terms of efficient energy management.

The facile synthesis of pristine and Terbium@Zinc oxide (Tb@ZnO) samples was produced by fast combustion route. The roughly spherical shaped morphology of Tb@ZnO was investigated by field emission scanning electron microscopy (FESEM) with agglomerated images of small size of particles. The dimension of particle shrinkages with increased the doping contents of Tb into ZnO lattice. The optical band gap of Tb@ZnO sample varies with the concentration of Tb and found to be decreased as 3.276, 3.267, 3.261 and 3.260 eV on increasing concentration of Tb from 1 to 5 wt%. The non-polar phonon mode with E2 symmetry was observed at 99 and 437 cm−1 while polar mode with A1 and E1 symmetry was reported at 330 and 580 cm−1, respectively, for pristine and Tb@ZnO samples. The photocatalytic activity of Tb@ZnO NPs has been investigated by the decolorization of methylene green (MG) dye under black light irradiation (367 nm). A remarkable photocatalytic performance of Tb@ZnO was noticed compared to the pure one and the highest percentage of activity was obtained for 1.0 wt% Tb@ZnO. Current outputs proposed the use of synthesized Tb@ZnO NPs in optoelectronic and photocatalyst applications.

Semiconductor manufacturing, including the multistep fabrication of ICs and tedious assembly of PCBs, has been outsourced to untrusted regions due to globalization. This invites many problems particularly for PCBs, which are vulnerable to nondestructive methods of attack such as X-ray data collection and surface trace probing. In the case of ICs, high-z materials have proven to be an effective countermeasure to block or scatter X-rays, but PCBs, because of their larger dimensions, are more difficult to fully secure. In this paper, a framework for passively obfuscating the critical connections between components on PCBs is demonstrated. A proof of concept is presented whereby an EDA tool combining the small features of micro electromechanical systems with X-ray simulation and 3D manufacturing processes is used to iteratively optimize a PCB design to thwart reverse engineering and probing attacks.

Background: Duplication of the vas deferens, a rare congenital anomaly of the pelvic anatomy, is often an incidental finding during surgeries involving the spermatic cord, such as inguinal hernia repair, varicocelectomy, orchidopexy, and vasectomy. Case Report: A 25-year-old male presented to our surgical outpatient clinic with bilateral swelling in the inguinal region. A diagnosis of bilateral inguinal hernia was established. While performing spermatic cord dissection during hernioplasty, a duplicated vas deferens was revealed within the left spermatic cord. Doppler ultrasonography confirmed the absence of waveforms in both vasa deferentia, differentiating them from adjacent vessels. The hernia repair was performed without complications. Conclusion: Our case highlights the importance of radiologists’ and surgeons’ ability to recognize a duplicated vas deferens to avoid possible iatrogenic injury.

Psychogenic vomiting is a syndrome in of recurrent vomiting without any organic pathology. It must be differentiated from cyclical vomiting syndrome, functional vomiting, and chronic idiopathic nausea. It occurs as a result of an emotional or psychic disturbance. This condition is highly disabling, increasingly recognized, and under-researched. In India, the number of patients reporting to the psychiatric outpatient department with eating disorders is comparatively very less. We describe how two patients with diagnostic dilemmas who were treated successfully after psychiatric intervention.

Fluorescence lifetime imaging provides more possibility of in vivo multiplexing in second near infrared (NIR-II) window. However, it still faces the obstacle that fluorescent probes with differentiable lifetime often exhibit quite different fluorescence intensity, especially the short lifetime usually accompanies with a weak fluorescence intensity, resulting in the difficulty for simultaneously decoding multiplexed lifetime information due to the interference of background noise. To facilitate high-fidelity lifetime multiplexed imaging, we developed a series of Er3+ doped double interface fluorescent nanoprobes (Er-DINPs): α-NaYF4 @NaErF4 : Ce@NaYbF4 @NaErF4 : Ce@NaYF4 with strong fluorescence intensity and easily distinguishable fluorescence lifetime. Both in vitro and in vivo experimental results confirmed the advantage of these probes with comparable fluorescence intensity for high-fidelity multiplexed lifetime bioimaging.