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Employees are the most important asset of organizations. Making them happy with their workplace and the work itself will benefit not only the employees but also the organizations. Employee satisfaction is also based on their awareness of future development. Hence, this paper aims to determine the relationship between job satisfaction and five variables of pay, colleague, management, nature of work and promotion toward individual happiness. Data were collected from 126 respondents from Universiti Teknikal Malaysia Melaka (UTEM), a public higher education institution in Malaysia using simple random sampling. Subsequently, the data were derived using SPSS Version 22.0. The findings indicated that there is a positive relationship between pay, colleague, management, nature of work, and promotion. Based on the results, the nature of work and promotion are the most important factors that influence employee happiness, thus leading to job satisfaction. Moreover, the result from the hypothesis test revealed that there is a significant relationship between pay, colleague, management, nature of work, and promotion. These findings may guide the implementation of policies by human resources or other organization management in a higher education institution. For instance, they may use job happiness (mental well-being) as a predictor of employee behaviors and then formulate recruitment policies that will help maintain employee happiness and satisfaction, thereby helping in employee retention.

Purpose Innovative health-promoting approaches of the era have verified phytoceutics as one of the prime therapeutic tools to alleviate numerous health-related ailments. The purpose of this paper is to probe the nutraceutic potential of ginger flowers and leaves against hyperglycemia. Design/methodology/approach The aqueous extracts of ginger flowers and leaves were observed on Sprague Dawley rats for 8 weeks. Two parallel studies were carried out based on dietary regimes: control and hyperglycemic diets. At the end of the experimental modus, the overnight fed rats were killed to determine the concentration of glucose and insulin in serum. The insulin resistance and insulin secretions were also calculated by formulae by considering fasting glucose and fasting insulin concentrations. Furthermore, the feed and drink intakes, body weight gain and hematological analysis were also carried out. Findings In streptozotocin-induced hyperglycemic rats, the ginger flowers extract depicted 5.62% reduction; however, ginger leaves extract reduced the glucose concentration up to 7.11% (p = 0.001). Similarly, ginger flowers extract uplifted the insulin concentration up to 3.07%, while, by ginger leaves extract, the insulin value increased to 4.11% (p = 0.002). For the insulin resistance, the ginger flower showed 5.32% decrease; however, the insulin resistance was reduced to 6.48% by ginger leaves (p = 0.014). Moreover, the insulin secretion increased to 18.9% by flower extract and 21.8% by ginger leave extract (p = 0.001). The feed intake and body weight gain increased momentously by the addition of ginger flowers and leaves; however, the drink intake and hematological analysis remained non-significant by the addition of ginger parts. Originality/value Conclusively, it was revealed that leaves have more hypoglycemic potential as compared to flowers.

Background: Congenital Lobar emphysema (CLE) is one of the rarest cystic lesions in the thoracic cavity among children. It is often misdiagnosed and managed incorrectly. We are reporting our institutional experience and recommendations regarding the prevention of common errors in the management of this condition. Methods: This study was conducted at the Paediatric Surgery Department, The Children’s Hospital & the University of Child Health Sciences Lahore from January 2015 to December 2018. All the patients who underwent thoracotomy for congenital lobar emphysema at our center were included in the study and their charts were reviewed. Results: A total of 19 patients had been treated at our center in this duration. The mean age of patients was 2.85 ± 2.11 months. Thirteen of them (68%) were male and the most common presenting complaint (94.7%) was respiratory distress. Chest X-ray was done in all of the patients while a CT scan was needed in 11 patients (57.9%). The most involved lobe was left upper (n=15). Lobectomy was done in all patients. Post-operative ventilation was required in 2 patients (10.5%) and pneumonia developed in 2 patients (10.5%). The most significant complication was wound infection (9/19, p=

Employer engagement, in existing literature, mostly refers to the engagement of the educational institutions in the corporate world; to benchmark their curricula and syllabi in-line with the employers' needs. This study has focused on the same construct with different relation; typically in the context of work-based learning providers and organizational practices. Although there has been theoretical discussions and calls to develop comprehensive measures for employer engagement, however, no contemporary measure for employer engagement exist to the context this study was carried out. The scope of this study covers the development of a new scale based on the guidelines to measure employer engagement specifically to the context of work based practices. The scale constitutes of 19 items that address, employer engagement based on 3 sub-dimensions. The scale was developed and validated through six phases beginning with the determination of valid dimensions / construct followed by generation of pool of items, assessing the content adequacy of the items and items refinement through exploratory and confirmatory factor analysis. Reliability and validity of the scale are also tested.

The blood transfusion (BT) system in Pakistan is fragmented, demand-driven and depends on weakly regulated transfusion practices. There is a considerable possibility that transfusion-transmissible infections (TTIs) are contributing to the current epidemic of hepatitis B virus (HBV) and hepatitis C virus (HCV) (affecting 7.4% of the general population) in the country. To study this issue, we conducted a systematic review to identify articles related to TTIs and transfusion safety in Pakistan from January 1, 2010 to January 31, 2020. A review of 33 articles met the final criteria for qualitative synthesis. Analysis of these studies showed a cumulative frequency of HBV 2.04%, HCV 2.44%, HIV 0.038%, syphilis 1.1% and malaria 0.11%. The frequency of coinfections among blood donors varied from 0.0099% to 0.35%. The highest number of coinfections were HCV and syphilis, followed by HCV and HBV infections. Syphilis and malaria were tested in only 38% and 46% of all the blood donations in one study. The rate of voluntary non-remunerated donations (VNRDs) was less than 13%, and male donors were 95% to 100% in these studies. There was a significant difference in the frequency of HBV and HCV in VNRDs (0.48%) as compared to replacement donors (RDs) (4.15%). In short, this review shows a high frequency of TTIs, especially HBV, HCV and syphilis in the blood donor population in Pakistan. There is a high dependency on RDs, minimal use of healthy voluntary blood donation practices, inadequate screening of high-risk donors, repeated collections of the blood from RDs, poor quality of screening methods and limited knowledge of donor health. Without standardized safe transfusion practices, there will be an ongoing increase in transmission of TTIs, especially HBV, HCV, syphilis, and HIV leading to a significant adverse public health impact.

Investigations into integrated millimeter-wave (mmW) Class-F−1 power amplifier (PA) in stacked configuration have not been reported previously. This article presents a novel two-stage double-stacked heterojunction bipolar transistor (HBT) Class-F−1 PA in the 130-nm SiGe-BiCMOS technology. The proposed amplifier operates at the mmW center frequency of 38 GHz. The driving stage of the amplifier is loaded with a Class-F harmonic network and the double-stacked power stage incorporates Class-F−1 loading. An interstage matching network is designed to deliver maximum power transfer from the driving stage to the power stage. The proposed new HBT amplifier yields a saturated output power of 21.2 dBm along with an overall gain of 22.1 dB and a peak power-added efficiency (PAE) of 30.1%. A figure-of-merit (FoM) of 69.68 was achieved for this amplifier which is the highest so far when compared with various recently reported integrated mmW Class-F−1/F PAs.

We report on an ‘in plane mode’ band gaps investigation of a novel diamond CRS (circle-rectangle-square) shaped holey phononic crystals in the desired operating frequency ranges. An ultra-wide band gap for diamond in the ‘in plane mode’ is observed. We also investigate an ultra-wide acoustic band gap for a finite one-dimensional (1D) diamond CRS phononic crystal (PnC) in the ‘out of plane mode’, and an ultra-wide acoustic band gap of a finite two-dimensional (2D) diamond CRS phononic crystal (PnC) in the ‘out of plane mode’ based on the FEA (Finite Element Analysis) method. We analyze that the transmission response of diamond in the length extension and width extension manner is more reasonable. Ultra-wide peak attenuations in the transmission spectra of a CRS shaped diamond phononic crystal successfully reveal the complete band gaps. The wide band gap of a CRS shaped diamond phononic crystal and the wide peak attenuation strongly agree in the same frequency region. It is analyzed that when a CRS-diamond phononic crystal is employed for MEMS resonators with different tether widths the quality Q of the resonators improved, and the energy losses decrease with extremely low insertion loss. In addition, it is observed that the vibrational displacement of a resonator is reduced by employing a diamond phononic crystal.

The global pandemic of COVID-19 has raised several questions and attracted researchers from all of the disciplines of scientific research. Regardless of advances in science and technology, equipped laboratories of virology, high literacy rates, and medical resources in developed countries, several nations and their health care systems completely failed to overcome the disaster. The fast spread is caused by frequent air travel for business, tourism, education, etc. COVID-19 can infect third world countries severely. United States of America has the highest per capita spending of health still 1/3 rdof the global burden of COVID-19 has consumed existing resources. The WHO has declared COVID-19 as a pandemic. More than 200 countries and territories have reported infected cases. The quarantine is the most effective way to slow the spread of disease and “Flatting of Curve” is a phenomenon to tackle the surge by health systems. To achieve good results from existing Medical Health Care Systems (MHCS), an accurate prediction for the spread of disease is crucial. This study utilizes the generalized method of SIR to accurately predict the spread of COVID-19 associated infection, recoveries, and deaths in Pakistan. The data from the National Command and Control of Pakistan (NCCP) is utilized. Through multiple cases applied on currently available data, the proposed mathematical models predict that by the end of April about more than 14553 infected and about 310 deaths are in Pakistan. The recovery rate is highest in the region up to 99.87 %.

We detected Crimean-Congo hemorrhagic fever virus infections in 4 provinces of Pakistan during 2017-2018. Overall, seroprevalence was 2.7% in humans and 36.2% in domestic livestock. Antibody prevalence in humans was highest in rural areas, where increased contact with animals is likely.

Clear cell renal cell carcinoma (ccRCC) is the most common subtype of renal cell carcinoma (RCC). If diagnosed in later stages, ccRCC is associated with high renal cancer related morbidity and poor prognosis. Recently, microRNAs (miRNAs) have attracted interest as potential diagnostic and prognostic biomarkers due to their important role in cancer development and progression. Availability of big omics data in the cancer genome atlas (TCGA) coupled with data mining and machine learning have revolutionized the identification of robust diagnostic and prognostic signatures in different types of cancers. In this study, we have utilized the miRNA sequencing data of 516 ccRCC patients from TCGA to identify a diagnostic and prognostic signature by using a combined approach of differential expression analysis, survival analysis and machine learning. Differential expression analysis identified 30 downregulated and 20 upregulated miRNAs in the primary tumor as compared to solid tissue normal samples. Out of these 50 differentially expressed miRNAs, higher expression of 7 and lower expression of 6 miRNAs were found to be significantly associated with poor survival when analyzed using the Kaplan-Maier survival method. Pathway enrichment analyses related to the differentially expressed miRNAs revealed that fatty acid biosynthesis was the most significantly enriched KEGG pathway while proteoglycans in cancer pathway was enriched by the highest number of survival-associated miRNAs target genes. Differential expression and association with poor survival was used as a prefilter for training a support vector machine model capable of classifying tumor samples from solid tissue normal samples with an accuracy and precision of 99.23% and 98.50%, respectively. We have identified here a nine-miRNA signature in ccRCC patients that is capable of segregating tumor from normal tissue samples with high accuracy and precision. The future validation of this classification model in in a clinical cohort will support translation of these findings into clinical practice for early detection and follow-up of ccRCC.

Conducted electromagnetic interference cases are increasing due to the rapid increase of energy efficient electrical equipment in smart grids. For example static energy meter readings are interfered due to non-linear pulsed currents drawn by dimmed lighting technology and a speed-controlled water pump. A communication interface can be added to the static energy meter to form a smart meter, for example using power line communication which works in the CENELEC-A band. This paper shows that the interference from a water pump does not only interfere with the readings of static energy meters but also affects the power line communication of a smart meter. It is shown that the interfered and lost frames during communication are affected by the average impedance of the speed-controlled water pump.

Detection and segmentation of defocus blur is a challenging task in digital imaging applications as the blurry images comprise of blur and sharp regions that wrap significant information and require effective methods for information extraction. Existing defocus blur detection and segmentation methods have several limitations i.e., discriminating sharp smooth and blurred smooth regions, low recognition rate in noisy images, and high computational cost without having any prior knowledge of images i.e., blur degree and camera configuration. Hence, there exists a dire need to develop an effective method for defocus blur detection, and segmentation robust to the above-mentioned limitations. This paper presents a novel features descriptor local directional mean patterns (LDMP) for defocus blur detection and employ KNN matting over the detected LDMP-Trimap for the robust segmentation of sharp and blur regions. We argue/hypothesize that most of the image fields located in blurry regions have significantly less specific local patterns than those in the sharp regions, therefore, proposed LDMP features descriptor should reliably detect the defocus blurred regions. The fusion of LDMP features with KNN matting provides superior performance in terms of obtaining high-quality segmented regions in the image. Additionally, the proposed LDMP features descriptor is robust to noise and successfully detects defocus blur in high-dense noisy images. Experimental results on Shi and Zhao datasets demonstrate the effectiveness of the proposed method in terms of defocus blur detection. Evaluation and comparative analysis signify that our method achieves superior segmentation performance and low computational cost of 15 seconds.

Introduction: The blood transfusion (BT) system in Pakistan is fragmented, demand-driven, and depends on weakly regulated transfusion practices. This is primarily a big problem in smaller cities and remote rural areas. Pakistan has one of the highest hepatitis B virus (HBV) and hepatitis C virus (HCV) prevalence worldwide, estimated around 5 & 10 million cases, respectively. There is a considerable risk that transfusion-transmissible infections (TTIs) may have contributed to the current epidemic of HBV & HCV, affecting 7.4 % of the general population, and potential risk of HIV transmission in the country. In this systematic review, we aim to identify the prevalence of TTIs among the blood donor population and associated safety challenges. Method & Material: We conducted a systematic literature search to identify studies related to TTIs and transfusion safety in Pakistan from January 1, 2010, to January 31, 2020. A search was conducted using PubMed and PakMedinet.com (largest medical database of Pakistan); initial search retrieved 981 articles, 166 met the inclusion criteria, and after review by two independent reviewers, 33 articles met the final criteria for qualitative synthesis. Results: Analysis of 33 studies showed the seroprevalence of HBV of 2.04 % (0.81% to 4.22%), HCV of 2.44% (1.29 % to 10%), HIV of 0.038% (0% to 0.18%), syphilis of 1.1% (0.11-3.01%) and malaria of 0.11% (0.05-1.20). The rate of coinfections among blood donors varied from 0.0099% to 0.35 %. The highest number of coinfections were HCV & syphilis, followed by HCV & HBV infections. The rate of TTIs was dependent on the number of donors, donor types (replacement vs. voluntary), screening techniques used, number, and type of TTIs tested. There was a lack of universal screening for common TTIs. Syphilis and malaria were tested only 38 % & 46 % of all the blood donations. The studies with a high number of replacement donors (RDs) noted a high prevalence of TTIs of 2.5 % to 12 % compared to the studies with a high number of voluntary non-remunerated donations (VNRDs) reported TTIs rates of 1.57% to 6.2 %. There was a significant difference in the prevalence of HBV & HCV in VNRDs (0.48%) compared to RDs (4.15%). The rate of VNRDs was 0.10 % to 13%. The majority of blood donations were from male donors, representing more than 70 % of all donations. The female donations varied from 0.03% to 15 % in government/public blood banks than 29 % in private sector blood banks. The HBV & HCV infections and anemia were the most common causes of blood donation deferral. The 69.5 % of donors who tested positive for TTIs in a study reported previous blood donations. The educational status of donors noted to have an association with knowledge about the risk of TTIs. Odds of having limited knowledge about TTIs (OR: 4.04, CI: 1.567-10.435, p Conclusion: This systemic review shows a high prevalence of TTIs, especially HBV, HCV & syphilis in the blood donor population. There is a high dependency on RDs, with minimal use of healthy voluntary blood donation practices, inadequate screening of high-risk donors, repeated collections of the blood from RDs, poor quality of screening methods, and limited knowledge of donors about their health. There is a lack of widespread standardized testing and follow up of patients who tested positive on initial testing. Large prospective multicenter clinical trials are required for a better understanding of the TTIs by testing and creating a follow-up system for both blood donors and recipients. Disclosures Anwer: Incyte, Seattle Genetics, Acetylon Pharmaceuticals, AbbVie Pharma, Astellas Pharma, Celegene, Millennium Pharmaceuticals.:Honoraria, Research Funding, Speakers Bureau.

Background: Acute lymphoblastic leukemia (ALL) is rare but aggressive. For refractory and relapsed ALL (R/R ALL), various treatment strategies are adopted, of which the use of blinatumomab has shown promising results in recent decades. Blinatumomab is a CD-19 directed CD3 bispecific T-cell engager antibody that has been approved by the FDA for the treatment of both adults and pediatric ALL. We report the efficacy and toxicity of blinatumomab in relapsed and refractory ALL adult patients. Materials/Methods: Following the PRISMA guideline, we performed a comprehensive literature search PubMed, Embase, Cochrane Library, Web of Science, and Clinicaltrials.gov. We used the following keywords, "acute lymphocytic leukemia" and "Blinatumomab" from the inception of data till 06/17/2020. We screened 1199 articles and included 7 trials and 6 retrospective studies. We excluded all case reports, case series, preclinical trials, review articles, and meta-analysis. We extracted the data for efficacy (complete response, relapse, overall survival, etc.) and safety (≥Grade 3 adverse events). Results: A total of 1393 patients with relapsed/refractory ALL were included. Monotherapy: In phase 3 TOWER trial, a total of 405 patients with heavily pretreated B-cell precursor ALL were randomized in a 2:1 ratio to either receive blinatumomab (n=271) or standard of care (SOC) (N=134). The mean age of both groups was 40.8 years and 41.1, respectively. The dose of blinatumomab (9-28 ug/d) was instituted to the intervention group, whereas the control group received investigator-chosen chemotherapy regimens. The CR/CRi rate for both groups was 95/267 (35.5 %) and 27/134 (31.34%), respectively (p In 6 phase 1b/2 studies (N=469), the starting dose of blinatumomab was 5 µg /m2/d and subsequently increased to 30 µg/m2/d. The pooled CR/CRi for these studies was 180/469 (38.37%). The most common hematological grade ≥3 adverse events were neutropenia 89/448 (19.87%), anemia 45/422 (10.70%), and thrombocytopenia 41/422 (9.7%). A total of 509 patients were included in 5 observational studies. The overall CR/CRi reported was 129/509 (25.34%). Grade ≥3 neutropenia and thrombocytopenia were reported as 14/52(26.92%) in one study.CRS was reported in another study as 5/14 (35 %). Combination regimens: In a phase II trial of Blinatumomab when given with a TKI (Dastanib), CR/CRi achieved was 27/47 (56.3%). Blinatumomab related neurotoxicity was observed in 2/12 (16.67%) patients. A total of 38 patients were included in 3 observational studies involving Blinatumomab and TKIs. The overall CR/CRi reported was 25/30(83.33%). In a multicenter phase I/II trial blinatumomab when given with PD-1 inhibitor pembrolizumab (pembro) achieved a CR/CRi of 2/4 (50%). In a phase II study, Blinatumomab and PD-1 and CTLA-4 inhibitors were used in combination in 8 patients. The CR/CRi achieved was 4/5 (80%). Grade ≥3 non-hematological adverse events (AEs) were observed in 1/5 (20%) patients. Blinatumomab has been used in combination with Hyper-CVAD in a phase II study. The ORR and CR achieved have been 14/14 (100%) and 13/14 (93%) respectively. In a recent study, blinatumomab has been used along with miniHCVD + INO in 17 patients. The CR/CRi achieved was 13/17 (76.47%). Conclusion: Blinatumomab alone and in combination with TKIs, PD-1 inhibitors, CTLA-4 inhibitors,hyper-CVAD and miniHCVD + INO were well tolerated by adult patients with acute lymphocytic leukemia. Blinatumomab in combination therapy has shown superior efficacy in adult ALL patients as compared to blinatumomab monotherapy. Additional multicenter randomized, double-blind clinical trials are needed to confirm these results. Disclosures Anwer: Incyte, Seattle Genetics, Acetylon Pharmaceuticals, AbbVie Pharma, Astellas Pharma, Celegene, Millennium Pharmaceuticals.:Honoraria, Research Funding, Speakers Bureau.

Introduction: β-thalassemia major (TM) is one of the most prevalent inherited hemoglobinopathies in Pakistan. It has one of the highest prevalence of transfusion-dependent TM patients globally, with an estimated greater than 100,000 active cases. Each year, an estimated 5000-9000 new cases of TM are being diagnosed in the country. Blood transfusions (BT) are essential in the management of severe TM; it is critical to have a safe BT to reduce the risk of transfusion transmissible infections (TTIs). Frequent blood transfusions in these patients increase their risk of acquiring TTIs compared to the general population. In this systematic review, we aimed to identify the prevalence of TTIs in transfusion-dependent β -thalassemia major patients in Pakistan. Methods & Material: We performed a systematic literature search to identify studies related to the TTIs and transfusion-related infections in Pakistan from January 1, 2010, to January 31, 2020. The search was conducted using PubMed and PakMediNet (Largest medical database of Pakistan), with initial search retrieved 981 studies. Among these, 166 studies met the inclusion criteria. After further screening by reviewing the articles for relevance and availability of full-length articles, only 14 studies met the final criteria for qualitative synthesis. Results Analysis of 14 studies (n=3786) showed that the seroprevalence of Hepatitis B virus (HBV) of 3.13% (0.66 % to 7.4%) and Hepatitis C virus (HCV) of 26 % (5.56% to 68.2%). There were only two studies reported HIV seroprevalence of 0 % & 0.5% (n=6). The rate of seropositivity for HBV and HCV was directly related to the number of transfusions, higher ferritin levels, and older age groups. There was an increase in the HCV rate with the increasing age of patients. Thalassemia patients who were older than ten years of age had a greater HCV compared to those who were less than ten years of age, i.e., 22% vs. 8.4%, p:0.005, respectively. The mean age was higher in HCV reactive children than non-reactive children. A comparison of HCV in healthy donors vs. thalassemia patients showed a rate of 1.9% vs. 13.1% for T.M. patients. There was HCV infection rate of 74% in the group with greater than 100 BTs compared to 33 % in a group with fewer than 35 BTs. The rate of HCV increased to 75% for the patients who had more than 100 BTs. The majority of the patients were males (51% to 88%). The seroprevalence of TTIs was higher in males than in females (73.4% vs. 26.6%). On average, a single TM patient is exposed to at least 17 different donors annually, requiring 1-2 transfusions every month. The free BT is accessible only in 1 out of 4 thalassemia centers. The majority of patients either need to bring their donors or are dependent on an external source of financial aid as they could not afford the cost of BT treatment. More than half of thalassemia patients (57.2%) need to contact multiple BT centers to search for required blood products. About 42.1% of parents of TM patients did not know about TTIs, whereas 31.6% of them did not know about the bloodborne transmission of HBV and HCV. The majority of parents of TM children had a low income, with 75% of them having income less than 10,000 Pakistani rupees (PKR) per month. The prevalence of TTIs in TM patients was significantly higher (96% vs. 4%) compared to the patients requiring multiple transfusions due to other causes such as leukemia, aplastic anemia, and thrombocytopenia. Conclusion: Our data highlights that the prevalence of transfusion-transmitted infections, especially HCV, is alarmingly higher (26%) in the TM population than in the general population. This is because of a lack of resources, inadequate safety measures, and a fragmented blood transfusion system. These findings warrant the urgent need for better public health measures, safe blood transfusion practices, voluntary remunerated blood-based transfusions, and universal quality-assured donor screening. Without these positive interventions, the current transfusion system can lead to a further worsening of the situation. Large prospective multi-centered clinical trials are required to understand better the high prevalence of TTIs in patients with TM. Disclosures Anwer: Incyte, Seattle Genetics, Acetylon Pharmaceuticals, AbbVie Pharma, Astellas Pharma, Celegene, Millennium Pharmaceuticals.:Honoraria, Research Funding, Speakers Bureau.

In this study, a stated preference (SP) survey based on a D-efficient experimental design was conducted for the Nanjing Metro to examine the passenger flow and elaborate the heterogeneity of the departure time choice behaviour of metro passengers during peak hours. A latent class logit model was applied to calibrate the data, and the attribute variables were studied using an elasticity analysis. The survey identified four classes of metro passengers in peak hours who have different preferences for the departure time choice. The results show that fixed working hours and arrival time constraints are the major attributes that determine the classification of the passengers, while travel costs and overcrowding are the key factors that affect the departure time choice. However, passengers are more sensitive to metro fares than crowdedness. By reducing travel costs and mitigating overcrowding, passengers’ choice of departure time, especially when deciding whether to depart earlier than usual, was significantly affected. This study aims to provide theoretical support and a basis for decision-making for metro operation departments to enact passenger flow control strategies.

Brain-computer interface (BCI) assists communication for the disabled and handicapped. It is usually electroencephalogram (EEG) based and uses motor imagery (MI) in its operation. EEG signals are known for being nonstationary and are sensitive to artifacts from various sources such as the physical and mental state of the patient, their mood, their posture, and any external noise or distractions, etc. Processing of this data directly affects the classification accuracy, making it a critical step in any BCI system. Ensemble learning has been used for many kinds of BCI classification applications including MI and P300 event related potential, which has been proven to be robust. The purpose of this paper is to generate an algorithm that uses ensemble pruning method for EEG classification evoked by an MI task. In order to achieve this, we extracted the features of an EEG dataset and trained a range of support vector machines to make a diverse ensemble of classifiers. This ensemble is then pruned by using a novel optimization model by a difference of convex algorithm, which has not been used on EEG data before.

5G (Fifth Generation) is the next generation of data network, offering faster speeds and reliable connections on smart phones and other devices than ever before. These networks are still under development and expected to operate on 28 and 38 GHz bands. However, multiple antennas required for these 5G devices will increase the overall system size. Single antenna which can switch to operate on multiple bands is the solution to this problem. A novel frequency reconfigurable antenna for 5G communication networks is presented in this paper. The antenna was designed on a Roger R5880 substrate having dielectric constant 2.2 and loss tangent 0.0009. The proposed antenna consists of simple radiator on top layer and two slots in the ground layer. The frequency re-configurability is achieved by placing three PIN diodes in each slot of the ground. The operating frequency band of antenna is controlled by switching states of PIN diodes. The proposed antenna covers a wide band from 25.6-39.3 GHz by simply switching the diodes ON/OFF. Thus it can cover 28 and 38 GHz bands that are anticipated to be the two working bands for 5G communication. The overall size of the antenna is 10x7 mm2. In addition to being small this antenna has a good gain ranging from 6.5-8.4 dB as well as 85% efficiency in the two 5G bands. All simulations have been done in CST (Computer Simulation Technology) Studio Suite. This reconfigurable antenna can find applications in future 5G communication networks.

Tetralogy of Fallot is the most common cyanotic congenital heart disease. It consists of right ventricular outflow tract obstruction, a ventricular septal defect, abnormally located aorta and right ventricular hypertrophy. It usually occurs as an isolated anomaly with a normally placed heart and abdominal viscera. We present a case of a 19 years old female who presented with a prolonged history of shortness of breath (SOB) and cyanosis. After undergoing echocardiography and cardiac computed tomography angiogram (CTA), she was diagnosed to be a case of Tetrology of Fallot (TOF) in association with situs inversus with levocardia also termed ‘isolated levocardia’. The patient underwent surgical correction and she was asymptomatic with no residual cardiac defects on follow up after 6 months. Isolated levocardia is a rare condition that is usually associated with severe cardiac defects and a low life expectancy in untreated patients. It is unusual for it to be diagnosed in adults as in our case.

In this work, we present a novel force-sensing device with zinc oxide nanorods (ZnO NRs) integrated with a metal-oxide-semiconductor (MOS) capacitor and encapsulated with Kapton tape. The details of the fabrication process and working principle of the integrated ZnO NRs-MOS capacitor as a force sensor and nanogenerator have been discussed. The fabricated ZnO-MOS device is tested for both the open-circuit and resistor-connected mode. For an input force in the range of 1–32 N, the open-circuit output voltage of the device is measured to be in the range of 60–100 mV for different device configurations. In the resistor-connected mode, the maximum output power of 0.6 pW is obtained with a 1 MΩ external resistor and input force of 8 N. In addition, the influence of different seed layers (Ag and ZnO) and the patterning geometry of the ZnO nanorods on the output voltage of ZnO-MOS device have been investigated by experiments. An equivalent circuit model of the device has been developed to study the influence of the geometry of ZnO NRs and Kapton tape on the ZnO-MOS device voltage output. This study could be an example of integrating piezoelectric nanomaterials on traditional electronic devices and could inspire novel designs and fabrication methods for nanoscale self-powered force sensors and nanogenerators.

Predictive maintenance (PM) strategies are based on real-time data for diagnosis of impending failure and prognosis of machine health. It is a proactive process, which needs predictive modeling to trigger an alarm for maintenance activities and anticipate a failure before it occurs. Various industries have adopted PM techniques because of its advantage in increasing reliability and safety. But in the aviation industry, expectations for safety are increased due to its high cost and danger to human life when an aircraft fails or becomes out of service. Flight data monitoring systems are regularly implemented in commercial operations using artificial intelligence (AI) algorithms, but there is limited work specific to safety critical systems such as engine and hydraulic system. This paper provides a survey of recent work on PM of aircraft's’ hydraulic system and engine, identifying new trends and challenges. This work also highlights the importance of PM and state-of-the-art data pre-processing techniques for large datasets.

Renal cell carcinoma (RCC) is a common malignancy in elderly males. Metastatic spread of this cancer is not an uncommon occurrence, even after nephrectomy. Lung, bone, liver, and brain are the most frequently involved sites. Such a type of presentation mostly occurs within five years after nephrectomy however, cases have been reported later as well. Here, we report a case of metastatic renal cell carcinoma that presented in the form of a lung growth 28 years after nephrectomy. This highlights the importance to consider relapsed metastatic renal cancer in the differential, even decades after its surgical removal.

Lichen planopilaris (LPP) is characterized by chronic cicatricial alopecia that is lymphocytic in nature. The underlying pathophysiology of LPP is not well understood. Failure of therapeutic management occurs quite often resulting in significant psychosocial stress on the patient when they are unable to prevent further hair loss or reverse it. Although the occurrence of LPP is rare, it is especially seldom observed in the pediatric population. Herein, we discuss a case of a nine-year-old child who was recently diagnosed with LPP.

Embedding piezoelectric nanowires within a soft elastomer material should provide a superior pressure sensing transducer, exploiting the piezoelectric properties of the nanowire material while maintaining flexibility. Here, a flexible sensor has been fabricated on a Kapton substrate and has incorporated a layer of polydimethylsiloxane with embedded zinc oxide nanowires as the pressure sensing mechanism. In response to applied compressive pressure up to 127 kPa, the device has generated a voltage, between electrodes on either side of the nanowire/polydimethylsiloxane layer, with a sensitivity of 23.6 mV/kPa, which is 100 times greater than previously reported zinc oxide nanostructure‐based flexible sensors.

Ischemic stroke is a rare phenomenon in young adults. A complete workup for hypercoagulable and myeloproliferative disorders is a cornerstone of evaluation. Essential thrombocytosis is a chronic myeloproliferative disorder that primarily involves platelets. It may remain undiagnosed in patients and subsequently present in the form of ischemic stroke. The management of this disorder is complex and often involves cytoreduction therapies. The initiation of these drugs in such patients may lead to unnecessary adverse effects and complications. This case report is an attempt to highlight an underappreciated cause of stroke when assessing young individuals.

Indoor positioning is useful in various venues including warehouses, convention centers, malls, airports, nursing homes. In these scenarios, reducing the complexity of location estimation both improves responsiveness and helps to elongate battery life of the mobile device. In this work, we carry out a detailed analysis of the impact of Principal Component Analysis (PCA) on the computational complexity and accuracy with different machine learning algorithms on a large data set containing 520 APs. We compare the algorithms' training and testing times, as well as their accuracies in the presence and absence of PCA. Our results show that (i) PCA significantly reduces both the training and testing times for classification and regression using k-nearest neighbor (kNN) and support vector machine (SVM) algorithms while preserving if not improving accuracy; (ii) PCA slightly improves the training/testing times for regression using multi-layer perceptron (MLP); (iii) random forest (RF) does not perform well with PCA.

With an emphasis on the global meat market and considering the ritual requirements and quality aspects, four types of slaughtering treatments were compared: (1) NSHS (without electrical stunning, halal neck cut, and subsequent bleeding for 180 s), (2) LSHS (electrically stunned at 250 mA for five seconds, halal neck cut, and subsequent bleeding for 180 s), (3) MSHS (electrically stunned at 500 mA for 10 s, halal neck cut, and subsequent bleeding for 180 s), and (4) HSHS (electrically stunned at 1000 mA for 20 s, halal neck cut, and subsequent bleeding for 180 s). Four hundred 36 day-old Ross 308 broiler chickens (body weights of 1.4 to 1.8 kg) were divided into four random groups of 100 birds each (ten replicated pens of ten birds). This study examined the livability, bleeding out, Pectoralis major and Flexor cruris medialis proximate composition, cholesterol content, fatty acid profile and post-mortem pH, microbial loads, and oxidative stability. The livability and bleeding out were higher in NSHS and LSHS than MSHS and HSHS (p &lt, 0.05). The Pectoralis major and Flexor cruris medialis proximate composition, cholesterol content and fatty acid profile, post-mortem pH, and microbial loads were unaffected by the slaughter treatments (p &gt, 0.05), but the oxidative stability of Pectoralis major differed during the eight-day post-mortem period (p &lt, 0.05). The results suggest that for capturing the global meat market, the meat industry can consider NSHS and LSHS because the ritual requirements are fulfilled, and there is no negative impact on the nutritional aspects.

Coronavirus disease 2019 (COVID-19) is a respiratory disease that has been reported to have a wide array of extrapulmonary manifestations. Our knowledge regarding this virus is constantly evolving, and new literature is being published every day. Children usually have a mild severity of COVID-19 infection. A variety of skin lesions have been documented in this disease. Similarly, our 18-month-old patient who was diagnosed with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection had mild symptoms, but three days later he presented to the hospital with the development of urticarial lesions followed by angioedema. In this case report, we have attempted to highlight a possible association of angioedema and urticarial with coronavirus infection. Physicians should be aware of this association and should always inquire about symptoms of respiratory illness (SARS-CoV-2) while dealing with patients in whom a specific trigger for angioedema/urticaria is un-identifiable.

doi: https://doi.org/10.12669/pjms.37.7.4489 How to cite this: Hamid MAB, Tariq S. Challenges of COVID-19 Vaccination Delivery in Pakistan. Pak J Med Sci. 2021;37(7):---------. doi: https://doi.org/10.12669/pjms.37.7.4489

This paper proposes an adaptive learning control and monitoring of oxygen for patients with breathing complexities and respiratory diseases By recording the oxygen saturation levels in real-time, this system uses an adaptive learning controller (ALC) to vary the oxygen delivered to the patient and maintain it in an optimum range In the presented approach, the PID controller gain is tuned with the learning technique to provide improved response time and a proactive approach to oxygen control for the patient A case study is performed by monitoring the time varying health vitals across different age groups to gain a better understanding of the relationship between these parameters for COVID-19 patients This information is then used to improve the standard of care supplied to patients and reducing the time to recovery Results show that ALC controlled the oxygen saturation within the target range of 90% to 94% SpO2, 77% and 80 1% of the time in patients aged 40 to 50-year-old and 50 to 60-year-old, respectively It also had faster time to recovery to target SpO2 range when the concentration dropped rapidly or when the patient became hypoxic as compared to manual control of the oxygen saturation by the healthcare staff Copyright © 2021 by SCITEPRESS – Science and Technology Publications, Lda All rights reserved

Purpose The aim of this study is to describe the technique of subpalpebral antibiotic lavage (SAL), which is a highly therapeutic, efficient, and cost-effective method for managing severe bacterial keratitis. Methods This case report describes a 26-year-old woman with severe bacterial keratitis in the right eye due to contact lens overwear, with progressive corneal thinning, a hypopyon, impending perforation, and marked visual loss to perception of light despite treatment with intensive topical antibiotics. This was managed with SAL that involves the insertion of a cannula transcutaneously into the upper conjunctival fornix to provide continuous antibiotic irrigation of the ocular surface. Results By 11 weeks after presentation, the cornea and anterior chamber appeared clinically quiescent, and visual acuity improved to 20/40 corrected in the right eye. Conclusions Bacterial keratitis is a potentially blinding condition for which contact lens wear is an important risk factor. Most cases are successfully managed with topical medications; however, in cases of treatment failure, a second-line approach such as SAL can be sight-saving. SAL uses readily available equipment for the delivery of high concentrations of antibiotics to the ocular surface, thus increasing therapeutic efficacy and reducing nursing staff workload. Despite its advantages, the literature reveals apparent underutilization of this technique.

This study examined the effects of a heating system using a ground source geothermal heat pump (GHP). A GHP was installed in a pig house, and a comparative analysis was performed between the GHP and the control (conventional heating system) in terms of the production performance, housing environment, noxious gas emissions, electricity consumption, and economics. The geothermal system performance index, such as the coefficient of performance (COP), inlet, and outlet temperature, were also evaluated. The outflow temperature during each period (weaning, growing, and finishing) was significantly higher than the inflow temperature in all three components of the GHP system. Similarly, the average internal temperature of the GHP-connected pig house was increased (p &lt, 0.05) during each period. The carbon dioxide (CO2) concentration, electricity usage, and cost of electricity during the 16-week experimental period were reduced significantly in the GHP system relative to the control. The concentrations of ammonia (NH3) during the growing and finishing period and the concentrations of formaldehyde during the weaning phase were also lower in the GHP-installed pig house (p &lt, 0.05). These results indicate that the GHP system can be used as an environmentally friendly renewable energy source in pig houses for sustainable pig production without harming the growth performance.

Wi-Fi fingerprinting has been widely used for indoor positioning, as Wi-Fi technology is easily deployed and supported. In fingerprinting, a database is created using the received signal strength indicator (RSSI) values in the area of interest; position prediction is performed by finding the best match for a measured RSSI among the values in the database. As location positioning gains importance for continuous interactive (CI) applications in large indoor spaces such as malls and airports, the fingerprinting databases become larger, making it computationally more difficult to position targets in real-time. On the other hand, CI applications such as Augmented Reality (AR) require low-latency positioning for a good user experience. In this work, we propose to use feature selection methods along with the K-nearest neighbors (KNN) classification and regression algorithms in order to create a simple and swift location positioning system. Our evaluation of various feature selection methods shows that computation times for positioning can be reduced by 75% using feature selection.

This paper presents the impact of LED lamps on the performance of Narrowband Power Line Communication (NB-PLC) in the CENELEC-A band between 9-95 kHz. NB-PLC in is only one of the many victims of interference in the frequency range 2-150 kHz. Only few emission standards for this frequency range are available, while the number of interference cases is growing rapidly. Most equipment will fail at a specific frequency and/or level. PLC is chosen as a victim, as the performance of the PLC is rated through well-established parameters. One of these is the Frame Error Rate (FER), which is calculated as the ratio between the erroneous frames and total received frames. The number of LED lamps has a strong correlation with the peak amplitude of the current pulses from the LED lamps and the FER of the PLC data frames.

The corona virus disease being aware commonly as Covid-19 in passing days among common masses is a novel viral illness of the systema respiratorium, causing a sustained pandemic which is in particular characterized by atypical pneumonia with specific symptoms of mild fever, runny nose with secreted fluid similar to flu, hypoxia, myalgia, anosmia, ageusia, shortness of breath, normal or decreased leukocyte count, ground glass opacities, sore throat and cough without phlegm. It is caused by an epidemic referred as SARS CoV-2 with abbreviation of severe acute respiratory syndrome coronavirus-2 nowadays. The procedures to be adopted for the diagnosis of COVID-19 should be based not only on clinical but epidemiological agents also and anyways stand on the link to an assessment and likelihood of the infection. The SARS CoV-2 is diagnosed with different test techniques like serological, molecular and others but most common for it is RT-PCR which is widely used and most reliable one to authenticate the findings of this disease. In the earlier times its detection was too an issue but luckily soon after its threat the scientists and organizations involved themselves and developed strong techniques to get reliable and accurate results with peaceful outcomes. The including such techniques are like immunological assay, amplification technique like RT-PCR (Spin column-and poly amino ester magnetic nanoparticle (pcMNPs) extraction method. Real-time nanopore target sequencing (NTS) and amplification methods) while on the other hands latest in use techniques are Isothermal nucleic acid amplification (as their subcategories include transcription-mediated amplification (TMA), Loop-mediated isothermal amplification (LAMP), rolling circle amplification (RCA) and clustered regularly interspaced short palindromic repeats (CRISP), and TMA assay). The novel techniques developed for this particular purpose are Biosensors, Localized surface plasma resonance (LSPR) sensor, the Field effect transistor (FET) and Cell-based potentiometric biosen.

Objective Our goal was to evaluate upper eyelid laxity by digital distraction, with the aim to determine sleeping laterality and the likelihood of obstructive sleep apnoea (OSA), and correlate these findings with polysomnography (PSG). Design We conducted a prospective, single-centre multidisciplinary study in a large sleep and respiratory department and an ophthalmology department within a tertiary referral university teaching hospital. Methods Patients with known OSA were evaluated using techniques based on the Lateralising Eyelid Sleep Compression (LESC) study. Upper eyelid laxity was assessed by two masked investigators, and the eyelid side with greater laxity was regarded as indicative of that patient’s sleeping laterality: ‘investigator-detected sleeping laterality’ (ID SL). Each patient was then asked about the laterality of his or her accustomed sleeping position: ‘patient-reported sleeping laterality’ (PR SL). PSG was conducted according to the standard protocol of the Department of Sleep and Respiratory Medicine (DSRM). ‘Polysomnography-detected sleeping laterality’ (PSG SL) permitted the extraction of sleep positional data by two masked sleep scientists. Results The reliability of the LESC technique for diagnosing ID SL was demonstrated to be statistically significant (p

Introduction: The World Health Organization (WHO) declared Covid-19 as a pandemic on March 11, 2020. Not only that the COVID-19 pandemic has brought the world to a complete lockdown but also burdened healthcare systems across the world immensely. Objective: In this paper, we discuss the different strategies we adopted in the Orthopaedics Department of District Head Quarter [DHQ] hospital Rawalpindi, during this ongoing pandemic and share our experience of successfully but cautiously providing orthopedic services to patients in a public hospital. We compare our workload and output of May 2020 [pandemic phase] to May 2019 [standard/normal phase]. Methodology: The Hospital policy was changed after the COVID-19 pandemic. We increased public awareness and reduced load in the OPD using different strategies. We postponed all elective cases; focusing our logistics and resources only on the patients in urgent need of surgical management. A minimum number of doctors and OTAs were allocated on each list. Inwards, the patient stay was reduced. As a standard PCR test for COVID-19 was expensive, we devised our screening through history, examination, and routine investigations. Results: The average stay inwards was reduced from 6.4±4.6 days in May 2019 to 2.7±3.6 days in May 2020. The decrease in the stay was statistically significant (p=.0206) and was associated with a 24.4% increase in the number of total patient admissions in May 2020 (n=56) as compared to May 2019 (n=45). The number of surgeries performed month to month was very similar in normal and pandemic periods. Our OPD patient attendance dropped from 200-250 patients per day in 2019 to 60-70 during the ongoing pandemic phase. Conclusion: We believe that sharing experiences between health care actors allows us to develop an effective strategy to provide the very best care to our patients during the COVID-19 pandemic.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), now known as coronavirus disease 2019 (COVID-19), has posed a serious threat to global health since December 2019. It has spread worldwide and is consuming healthcare resources rapidly. Published literature suggests that people with advanced age and comorbidities are affected more severely. It is crucial to uncover the underlying pathogenesis of acute kidney insufficiency in COVID-19 patients to understand better the reasoning behind the grave outcomes in these patients. In this review, we have included articles stating the prevalence and specific mortality rates of COVID-19 patients with acute kidney insufficiency. Our study included 1098 COVID-19 positive patients, of whom 66 (6%) developed acute kidney insufficiency and 62 patients died, showing a mortality rate of 94%. Patients with acute kidney insufficiency showed a more severe disease course, and these patients ended up more in intensive care units. Particular attention should be paid to those with already established kidney disease, such as chronic kidney disease, or renal transplant recipients, as these patients are already on immunosuppressive therapy. Our review focuses on the prevalence of acute kidney insufficiency in COVID-19 patients and mortality rates in this subset of patients.

Bathymetric survey is necessary in monitoring hydrographic environment. The conventional approach involves operators including engineer, surveyor and boat captain being onboard the vessel during survey works. Application of Autonomous Surface Vessel (ASV) is becoming popular for bathymetric mapping as it reduces operation cost and replaces human operation in high risk areas. Available commercial ASVs are typically designed for a particular task with limited expandability for other similar applications. Also, with current miniaturization of industrial sensors, a small-sized ASV is sufficient for most inland water survey operation. In this paper, the design and development components for a modular and mini ASV, named Suraya-1 is detailed. This vessel is developed for hydrographic survey using singlebeam depth sonar, measuring depth and temperature of a water body. The specifications and performance of developed ASV is compared to existing commercial unmanned vessels of same class and application. The dimension of the vehicle is the smallest compared to counterparts which is 1.04 m × 0.35 m × 0.32 m, weighing only 6.8 kg without payload. Our ASV is powered by two paralleled 18.5 V LiPo battery, which is in the mid-range, yet able to reach navigation speed of 4 knots as required for survey work. The real-time vessel poses and collected data are transmitted to the ground station within range of 2 km. For performance evaluation, the developed ASV is tested in pool environment. Qualitative outcome shows minimal error in navigation control. Also, output data obtained is shown consistent and reliable for a calm water environment.

Of late, fungal infections are increasingly being recognized in diabetic patients. Here we present a case of polymicrobial fungal empyema due to Trichosporon species and Fusarium species developed after community-acquired pneumonia in a diabetic patient. Trichosporon species are basidiomycetous yeast and Fusarium species are soil saprophytes with a worldwide distribution. Fungal empyema cases are rare and are mostly caused by Aspergillus and Candida species. Polymicrobial fungal empyema with Trichosporon species and Fusarium species has not been reported previously. Our patient was successfully treated with antifungal therapy. This case highlights that fungal empyema should be considered in diabetic patients especially if they are not responding to antibiotics.